老年共病患者心理危机脆弱性现状及影响因素分析

Analysis of the current situation of psychological crisis vulnerability and influencing factors of the elderly multimorbidity

目的了解老年共病患者心理危机脆弱性现状并分析其影响因素,为提高心理危机应对能力提供参考。方法采用横断面调查设计,于2022年5月1日至11月30日通过便利取样法选取在武汉大学人民医院门诊及住院老年患者为研究对象,对其关于老化态度、生命意义感和心理危机脆弱性问卷结果进行统计分析,采用单因素、多元线性回归分析老年共病患者心理危机脆弱性的影响因素,采用Pearson相关性分析老化态度、生命意义感和心理危机脆弱性之间的相关性。结果共发放685份问卷,回收有效问卷602份,有效回收率为87.9%。老年共病患者生命意义感总分为(39.2±8.3)分,老化态度总分为(80.2±13.5)分,心理危机脆弱性总分为(69.4±12.8)分,心理危机脆弱性处于中高等水平。多元线性回归分析结果表明,对老年共病患者心理危机脆弱性的影响由大到小依次为:居住状况、经济情况、婚姻状况、年龄、患慢病种类、近半年是否住院。老年共病患者心理危机脆弱性与生命意义感呈负相关、与老化态度呈负相关(r=-0.315、-0.264,P<0.01),老化态度与生命意义感呈正相关(r=0.515,P<0.01)。结论老年共病患者的心理危机脆弱性受多方面因素影响,医护人员应多关注高龄、养老机构居住、丧偶、经济能力不足、患病种类多且未住院的共病患者。

ObjectiveTo understand the current situation of psychological crisis vulnerability among elderly individuals with multimorbidity and analyze the factors that influence it,to provide insights for improving their coping abilities.MethodsA cross-sectional survey design was conducted at Renmin Hospital of Wuhan University from May 1 to November 30,2022.The attitudes toward aging,sense of meaning of life,and vulnerability to psychological crisis were analysed among outpatients and inpatients.Statistical analysis was performed on the questionnaire results,and the influencing factors of vulnerability to psychological crisis in elderly patients with co-morbidities were analyzed using one-way linear regression and multivariate linear regression.Additionally,the correlation between aging attitudes,sense of meaning of life,and vulnerability to psychological crisis was examined using Pearson correlation analysis.ResultsA total of 685 questionnaires were distributed,and 602 valid questionnaires were collected,resulting in a valid recovery rate of 87.9%.The total score for the sense of meaning of life in elderly co-morbid patients was(39.2±8.3),while the total score for aging attitudes was(80.2±13.5).The total score for psychological crisis vulnerability was(69.4±12.8),indicating a medium-high level of vulnerability.The results of multiple linear regression analysis revealed that the factors influencing psychological crisis vulnerability in elderly multimorbidity,in descending order,were residence status,economic situation,marital status,age,type of chronic disease,and hospitalization history in the past six months.Psychological crisis vulnerability in elderly multimorbidity showed a negative correlation with the sense of meaning of life and the attitude of aging(r=-0.315,-0.264,both P<0.01),while the attitude of aging exhibited a positive correlation with the sense of meaning of life(r=0.515,P<0.01).ConclusionsThe vulnerability of elderly individuals with multimorbidity to psychological crises is influenced by several factors.Healthcare professionals should prioritize individuals who are elderly,residing in nursing institutions,widowed,financially disadvantaged,experiencing multiple illnesses,and not currently hospitalized.