分度式预警因素对社区老年人心理健康影响的相关性研究

发布时间：2018-05-31 13:08

  本文选题：老年人 + 心理卫生　； 参考：《中国全科医学》2014年31期

【摘要】：目的了解社区老年人心理健康水平及其随年龄分布特点,探寻出影响心理健康的高风险预警因子及人群,为将来老年人的社区心理健康管理提供有方向性的干预策略。方法利用症状自评量表(SCL-90)与相关影响因素的量表(包括自制版调查问卷、状态-特质焦虑问卷、生活事件评定量表问卷、家庭亲密度和适应性量表-中文版、社会支持评定量表)对2013年1—12月上海市龙柏社区所属团队管辖的常住人口中60岁及以上的老年人进行问卷调查,并分析调查结果。结果 (1)SCL-90总分值、总因子症状指数、阳性项目数均低于中国常模(P0.01),其中躯体化、抑郁、恐怖因子症状指数高于中国常模(P0.01)。女性在躯体化、抑郁上的症状指数高于男性(P0.01),男性在焦虑、恐怖的症状因子高于女性(P0.05)。(2)对SCL-90总症状指数进行单、多因素分析显示:婚姻、年龄与SCL-90总症状指数呈负相关(P0.05)。家庭月收入、吸烟、体育锻炼、焦虑特质、心身疾病种类、生活事件与之呈正相关(P0.01)。(3)进一步以年龄为界定做二元Logistic回归,筛选出老年人躯体化、抑郁强及极强优势比(OR/RR)的预警因素及人群。结论 (1)根据SCL-90总症状指数分析说明:对整个老年人来说,非婚状态(独居、单身、丧偶)、年龄近60岁、家庭月收入高、吸烟、不锻炼、焦虑特质分值高、生活事件值高及不寻求社会帮助易造成老年人心理痛苦的根源。(2)以年龄为界定的老年人躯体化、抑郁:慢性病种类多对65~69岁组躯体化及70~74岁组抑郁影响程度为最明显;性别作为强的危险因素的老年人躯体化发生在60~64岁组,抑郁在65~69岁组及75~79岁组;躯体化与年龄强相关的是70~74岁组;焦虑特质高值是60~64岁组、65~69岁组和75~79岁组老年人抑郁的强或极强的危险因素;婚姻状况是65~69岁组老年人的抑郁强预警因素;≥80岁组家庭类型中间型是老年人躯体化的中度危险因素。以年龄界定的导致老年人躯体化、抑郁的高危人群为:女性(60~74岁组)、非婚状态(65~69岁组)、焦虑特质高值(60~79岁组)、处于更年期(60~64岁组及70~74岁组)、慢性病病种多(65~69岁组、70~74岁组)。(3)根据筛选出的强高危的预警因素和人群,在今后的心理健康促进的全科团体授课中增添积极心理学的观点,学会用逆向思维的方式看待疾病和死亡,从而提升老年人对慢性病,尤其是重大疾病如癌症等的心理应对健康管理策略。同时,应用心理学知识帮助60~64岁离退休老年人和65~74岁更年期老年人平稳、安全地渡过离退休期和更年期,以实现心理层面的健康促进。
[Abstract]:Objective to understand the mental health level of the elderly in the community and its distribution characteristics with age, to find out the high risk early warning factors and the crowd that affect the mental health, and to provide a directional intervention strategy for the community mental health management of the elderly in the future. Methods symptom Checklist-90 (SCL-90) was used to evaluate the related factors (including self-made questionnaire, State-Trait anxiety questionnaire, Life event scale, Family cohesion and adaptability scale). The Social support rating scale (SSS) was used to investigate the elderly aged 60 and above in the resident population of Longbai Community in Shanghai from January to December 2013, and the results were analyzed. Results the total score of SCL-90, the symptom index of total factor and the number of positive items were lower than those of Chinese norm (P0.01). The symptom index of somatization, depression and phobic factor were higher than that of Chinese norm (P0.01). The symptom index of somatization and depression in women was higher than that in men (P 0.01), and the symptom factors of anxiety and phobia in men were higher than that in women (P 0.05). Multivariate analysis showed that marriage, age and total symptom index of SCL-90 were negatively correlated with P0.05. Family monthly income, smoking, physical exercise, anxiety traits, psychosomatic diseases and life events were positively correlated with family income, smoking, physical exercise, and life events (P 0.01). Furthermore, dual Logistic regression was made according to age to screen out somatization of the elderly. Depression and extreme odds were higher than ORR-R early warning factors and population. Conclusion 1) according to the analysis of total symptom index of SCL-90, the non-marital status (living alone, single, widowed, nearly 60 years old), family monthly income, smoking, non-exercise, high score of anxiety trait, and so on. The causes of mental pain of the elderly were high life event value and not seeking social help. (2) somatization of the elderly defined by age: depression was the most obvious effect of chronic diseases on somatization of 6569 years old group and 70 to 74 years old group. Sex as a strong risk factor of somatization occurred in the 60 to 64 years old group, depression in 6569 years old group and 75 to 79 years old group, the strong correlation between somatization and age was 70 to 74 years old group; The high value of anxiety trait was a strong or very strong risk factor of depression in 65-69-year-old group and 75-79-year-old group, and marital status was a strong early-warning factor of depression in the 65-69-year-old group. The intermediate type of family type was a moderate risk factor for somatization in the elderly aged 鈮，

本文编号：1959796