中高龄罹患慢性病老年人衰弱与抑郁的关系研究

Study on the relationship between frailty and depression in middle-aged and elderly people with chronic diseases

目的 探讨中高龄罹患慢性病老年人衰弱与抑郁的关系,并分析领悟社会支持和抗逆力在衰弱和抑郁间的链式中介效应。方法 采用分层整群随机抽样方法,于2020年10月-2021年4月从河北省唐山市随机选取2个社区卫生服务中心所管辖社区内罹患慢性病的老年人为研究对象,使用一般资料调查表、衰弱综合评估工具(CFAI)、老年抑郁量表(GDS)、领悟社会支持(PSSS)、抗逆力量表(CD-RISC)对其进行面对面问卷调查。结果 中高龄罹患慢性病老年人衰弱与抑郁呈正相关(r=0.267,P<0.01),与领悟社会支持和抗逆力(r1=-0.252,r2=-0.372,P<0.01)呈显著负相关,领悟社会支持和抗逆力(r1=-0.336,r2=-0.365,P<0.01)与抑郁呈显著负相关。领悟社会支持、抗逆力、领悟社会支持→抗逆力的路径在衰弱与抑郁间的中介效应分别为占总效应的20.0%、25.6%和7.1%。结论 中高龄老年人的衰弱不仅可以直接作用于抑郁,还可以分别通过领悟社会支持、抗逆力的独立中介作用,以及领悟社会支持-抗逆力的链式中介作用间接影响抑郁。

Objective To explore the relationship between frailty and depression in middle-aged and elderly people with chronic diseases,and to analyze the chain mediating effect of perceived social support and resilience between frailty and depression.Methods From October 2020 to September 2021,elderly people with chronic diseases from the communities under the jurisdiction of 2 Community Health Service Centers in Tangshan in Hebei province were randomly selected as the research objects by using stratified cluster random sampling method.The general information questionnaire,Comprehensive Frailty Assessment Instrument(CFAI),Geriatric Depression Scale(GDS),Perceived Social Support Scale(PSSS),and the Connon-Davidson Resilience Scale(CD-RISC)were used to conduct face-to-face questionnaire survey.Results Frailty of middle-aged and elderly people with chronic diseases was positively correlated with depression(r=0.267,P<0.01),and significantly negatively correlated with perceived social support and resilience(r 1=-0.252,r 2=-0.372,P<0.01).Perceived social support and resilience(r 1=-0.336,r 2=-0.365,P<0.01)were positively correlated with frailty,and was significantly negatively correlated with depression.The mediating effects of perceived social support,resilience,and perceived social support→resilience between frailty and depression accounted for 20.0%,25.6%,and 7.1%of the total effects,respectively.Conclusion The frailty of middle-aged and elderly people can not only directly affect depression,but also indirectly affect depression through the independent mediating effect of perceived social support and resilience,and the chain mediating effect of perceived social support and resilience,respectively.