中国老年夫妻抑郁症状与社会参与、共病的主客体互倚关系研究:基于中国健康与养老追踪调查数据

Actor-partner interdependence between depressive symptoms,social participation,and comorbidities among older couples in China:based on data from China Health and Retirement Longitudinal Study

目的探讨中国老年夫妻抑郁症状与社会参与、共病的主客体互倚关系,为老年人抑郁干预提供新方向。方法以2020年中国健康与养老追踪调查(CHARLS)数据为研究资料,纳入4346名老年人(2173对老年夫妻)。采用Spearman相关分析探讨中国老年夫妻社会参与、共病及抑郁症状的相关性,并使用AMOS软件建立中国老年夫妻抑郁症状与社会参与、共病的主客体互倚模型,分析老年人及其配偶社会参与、共病对抑郁症状影响的主客体效应。结果4346名老年人中抑郁症状检出率为38.66%(1680/4346),且妻子抑郁症状评分高于丈夫(Z=15.445,P<0.01)。主客体互倚模型分析结果显示,妻子与丈夫的社会参与、共病可对其自身抑郁症状产生主体效应(β=-0.097,P<0.01;β=0.275,P<0.01;β=-0.070,P<0.01;β=0.282,P<0.01);妻子与丈夫的社会参与可对其配偶抑郁症状产生客体效应(β=-0.054,P<0.01;β=-0.054,P<0.01),丈夫共病可对其妻子抑郁症状产生客体效应(β=0.057,P<0.01)。结论中国老年夫妻抑郁症状、社会参与、共病同时存在主体以及客体的二元交互影响效应。医务人员在进行老年人抑郁、慢性病干预过程中,应重视"患者—家庭照顾者"二元双重影响,且应重点关注老年女性的抑郁症状。

Objective To explore the actor-partner interdependence between depressive symptoms and social participation,comorbidity in older couples in China,so as to provide new directions for depression intervention in older adults.Methods A total of 4346 older adults(2173 older couples)were included using data from the 2020 China Health and Retirement Longitudinal Study(CHARLS).Spearman correlation was used to analyze the correlation between social participation,comorbidities,and depressive symptoms among older couples in China.AMOS software was used to establish an actor-partner interdependence model of depressive symptoms and social participation,comorbidities in older couples in China,and to analyze the actor-partner effects of social participation and comorbidities on depressive symptoms in older adults and their spouses.Results The detection rate of depressive symptoms among 4346 older adults was 38.66%(1680/4346),and the depressive symptom score of wives was higher than that of husbands(Z=15.445,P<0.01).The analysis of the actor-partner interdependence model showed that the social participation and comorbidity of wives and husbands had a actor effect on their own depressive symptoms(β=-0.097,P<0.01;β=0.275,P<0.01;β=-0.070,P<0.01;β=0.282,P<0.01),and the social participation of wives and husbands had a partner effect on their spouse's depressive symptoms(β=-0.054,P<0.01;β=-0.054,P<0.01),and the comorbidity of husband had a partner effect on his wife's depressive symptoms(β=0.057,P<0.01).Conclusions The dualistic interaction effects of actor-partner exist in the depressive symptoms,social participation,and comorbidities of older couples in China.Medical and nursing staff should pay attention to the dual effects of"patient-family caregiver"when intervening in depression and chronic diseases,and focus on the depressive symptoms of older women.