中国老年人日常生活自理能力的影响因素研究

发布时间：2018-12-18 21:03

【摘要】：日常生活自理能力是衡量老年人健康状况重要指标,包括最基本的日常生活自理能力(ADL)和工具性日常生活自理能力(IADL)。本文以60岁及以上的老年人为研究对象,选取了2008年中国老年健康长寿跟踪调查的个体微观数据和调查23个省市的宏观区域数据,在分析老年人日常生活自理能力的个体自然特征、个体社会经济特征、个体行为特征、个体情绪状况特征、个体躯体健康特征、个体患病情况特征、三大地带差异以及省际差异的基础上,运用多层线性模型(HLM),探索影响老年人ADL和IADL的影响因素。主要研究结论如下：一、随着年龄增长,老年人ADL和IADL的残障率越来越高。中国女性老年人日常生活自理能力的残障程度高于男性。老年人日常生活自理能力的民族差异不显著。农村的老年人ADL要好于城市的老年人,IADL的城乡差异并不显著。婚姻状况对老年人ADL和IADL的影响十分显著,凸显了婚姻对老年人日常生活自理能力的保护功能。受教育程度对老年人ADL的影响并不显著,但是对IADL的影响十分显著,即受过教育的老年人IADL优于未受过教育的。职业地位高低对老年人日常生活自理能力不显著。吸烟、喝酒、体育锻炼、体力劳动对老年人ADL的影响不显著。吸烟、喝酒对老年人IADL影响不显著,体育锻炼和体力劳动对老年人IADL产生正向作用。良好的情绪对于维护老年人的日常生活自理能力至关重要,经常感到孤独的老年人ADL和IADL的残障发生率高于较少感到孤独的老年人。听力和视力状况较好的老年人,ADL和IADL均优于听力和视力较差的老年人。对老年人日常生活自理能力影响程度较深的疾病主要集中在循环系统疾病和神经系统疾病。二、老年人ADL的残障比例在东中西三大地带中呈现由西向东依次递增的趋势。老年人IADL残障比例由高到低依次是中部地区、东部地区和西部地区。老年人ADL和IADL的省际差异均十分明显,老年人ADL的南北差异相当明显,ADL残障比例最高的省份是辽宁、天津和陕西,ADL残障比例最低的省份是浙江、江西和湖南。老年人IADL残障比例最高的省份是天津、江西和陕西,ADL残障比例最低的省份是浙江、重庆和黑龙江。三、在HLM模型中,个体因素中慢性疾病状况、年龄、性别、现居住地、躯体健康状况、情绪是影响老年人ADL的重要因素,特别值得注意慢性疾病中的高血压、中风等脑血管病、风湿骨病、痴呆这些疾病。自然因子、主食结构、医疗因子、非农业人口比重、人均预期寿命这些宏观区域因素对老年人ADL的产生显著影响。而老年人IADL产生显著影响的个体因素包括慢性疾病状况、年龄、性别、婚姻、教育、体力劳动、躯体健康状况、情绪,所选取的宏观区域因素并未对老年人IADL产生显著的影响,还有待进一步探索。
[Abstract]:The self-care ability of daily life is an important index to measure the health status of the elderly, including the most basic self-care ability of daily life (ADL) and the instrumental self-care ability of daily life (IADL). Taking the elderly aged 60 and above as the research object, this paper selects the individual microcosmic data of the 2008 China elderly Health and Longevity tracking Survey and the macro regional data of 23 provinces and cities. In this paper, the characteristics of individual nature, individual social economy, individual behavior, individual emotional status, individual body health and individual disease were analyzed. On the basis of the difference of three regions and the difference between provinces, the influence factors of ADL and IADL in the elderly were explored by using the multilayer linear model (HLM),). The main conclusions are as follows: first, the disability rate of ADL and IADL increases with age. The disabled degree of self-care ability of Chinese women is higher than that of men. There is no significant difference in the ability of the elderly to take care of themselves in daily life. The ADL of rural elderly is better than that of urban, but the difference of IADL between urban and rural is not significant. The influence of marital status on the ADL and IADL of the elderly is very significant, which highlights the protective function of marriage on the ability of the elderly to take care of themselves in daily life. The influence of education level on ADL of the elderly is not significant, but the effect on IADL is very significant, that is, the IADL of the educated elderly is better than that of the uneducated. The level of professional status is not significant to the ability of the elderly to take care of their daily life. Smoking, drinking, physical exercise and physical labor had no significant effect on ADL in the elderly. Smoking and drinking had no significant effect on IADL, but physical exercise and physical labor had positive effects on IADL. Good mood is very important to maintain the self-care ability of daily life of the elderly. The incidence of disability in the elderly who often feel lonely is higher than that in the elderly who feel lonely less. ADL and IADL were superior to those with poor hearing and vision in hearing and visual acuity. The diseases which have a great influence on the self-care ability of daily life of the elderly are mainly circulatory diseases and nervous system diseases. Secondly, the disability ratio of ADL in the elderly increased from west to east in three major areas of east, west and west. The ratio of IADL disability in the elderly is from high to low in the central, eastern and western regions. The difference between ADL and IADL in the elderly is very obvious, and the difference between the north and south of ADL is quite obvious. The provinces with the highest proportion of ADL disability are Liaoning, Tianjin and Shaanxi, and the provinces with the lowest ratio of ADL disability are Zhejiang, Jiangxi and Hunan. The provinces with the highest proportion of IADL disability among the elderly are Tianjin, Jiangxi and Shaanxi, and the provinces with the lowest proportion of ADL disability are Zhejiang, Chongqing and Heilongjiang. Third, in the HLM model, individual factors such as chronic disease, age, sex, current residence, physical health, and mood are important factors affecting ADL in the elderly, especially among chronic diseases, such as hypertension, stroke and other cerebrovascular diseases. Rheumatic bone disease, dementia, these diseases. The macroscopical factors such as natural factors, staple food structure, medical factors, proportion of non-agricultural population and average life expectancy have a significant effect on ADL of the elderly. However, the individual factors that had significant effects on IADL in the elderly included chronic disease status, age, sex, marriage, education, physical labor, physical health, emotion, and the macroscopical factors selected had no significant effect on IADL in the elderly. Further exploration is still needed.
【学位授予单位】：华东师范大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：C913.6

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