Article(id=1240972420266390168, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240972413354176744, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202312141, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1702224000000, receivedDateStr=2023-12-11, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773800481144, onlineDateStr=2026-03-18, pubDate=1715270400000, pubDateStr=2024-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773800481144, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773800481144, creator=13701087609, updateTime=1773800481144, updator=13701087609, issue=Issue{id=1240972413354176744, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773800479495, creator=13701087609, updateTime=1773800596829, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240972905568334240, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240972413354176744, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240972905568334241, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240972413354176744, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1625, endPage=1629, ext={EN=ArticleExt(id=1240972420643877568, articleId=1240972420266390168, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Study on the current situation and influencing factors of death anxiety of the elderly in rural areas of Sichuan Province, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the current situation of death anxiety of the elderly in rural areas of Sichuan and its influencing factors.

Methods

A questionnaire survey was conducted among 702 rural elderly from 6 prefecture-level cities in Sichuan Province. On the basis of describing the current situation of death anxiety, the χ2 test and logistic regression analysis were used to explore the influencing factors of death anxiety.

Results

The scores of emotional dimensions of death anxiety, stress and pain, time consciousness, and cognitive dimension of the elderly in rural areas of Sichuan were (1.10 ±1.33), (2.29 ±1.80),(0.76±0.79), and (1.18±0.79), respectively. The total score was (5.33±3.68), and 245 (34.90%) had high death anxiety. Multivariate analysis showed that the number of children (OR=0.742, 95%CI: 0.630-0.875)), subjective well-being (OR=0.453,95%CI: 0.335-0.612)) and physical fitness (OR=0.581, 95%CI: 0.452-0.746) were the protective factors of death anxiety in the elderly, while chronic diseases (OR=1.575, 95%CI: 1.032-2.404)) were the risk factors of death anxiety.

Conclusion

The death anxiety of the elderly in the rural areas of Sichuan is at a medium-low level, and the rural elderly with a small number of children, chronic diseases, poor physical fitness, and low subjective well-being have a higher level of death anxiety, which should be paid more attention to.

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目的

了解四川农村老年人死亡焦虑现状及其影响因素。

方法

抽取四川省6个地级市(州)的702名农村老年人,对其死亡焦虑现况进行问卷调查,描述死亡焦虑现况基础上,采用χ2检验及logistic回归分析探讨死亡焦虑的影响因素。

结果

四川农村老年人的死亡焦虑情感维度得分为(1.10±1.33)分,压力与痛苦维度为(2.29±1.80)分,时间意识维度为(0.76±0.79)分,认知维度为(1.18±0.79)分,总分为(5.33±3.68)分,高死亡焦虑245人,占34.90%。多因素分析结果显示子女人数(OR=0.742,95%CI:0.630~0.875)、主观幸福感(OR=0.453,95%CI:0.335~0.612)、健康体适能(OR=0.581,95%CI:0.452~0.746)是老年人死亡焦虑的保护因素,患慢性病(OR=1.575,95%CI:1.032~2.404)是死亡焦虑的危险因素。

结论

四川农村老年人死亡焦虑处于中等偏低水平,子女数少、患慢性病、健康体适能差、主观幸福感低的农村老年人的死亡焦虑水平较高,需重点关注。

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高晓凤,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=9WjYkuKKUb6xqPxSqvFxfw==, magXml=MC8S7tR1JznW4G3aBF6+Xg==, pdfUrl=null, pdf=kpwrdPPyko6psPsr6CsKxw==, pdfFileSize=544253, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=m7fPW6PTAgHUFiPhf1XeVw==, mapNumber=null, authorCompany=null, fund=null, authors=

林鑫(2002—),男,本科在读,研究方向:多元统计方法在医学中的应用

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林鑫(2002—),男,本科在读,研究方向:多元统计方法在医学中的应用

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林鑫(2002—),男,本科在读,研究方向:多元统计方法在医学中的应用

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Modern Preventive Medicine,2022, 49(3): 476-481., articleTitle=Influencing factors of health-related physical fitness of urban elderly in Guangzhou, refAbstract=null), Reference(id=1240986273708569564, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, doi=null, pmid=null, pmcid=null, year=2021, volume=27, issue=10, pageStart=1176, pageEnd=1189, url=null, language=null, rfNumber=[22], rfOrder=36, authorNames=崔德刚, 邱芬, 邱服冰, journalName=中国康复理论与实践, refType=null, unstructuredReference=崔德刚,邱芬,邱服冰,等.老年人参与身体活动对改善健康、生活质量和福祉效果的系统综述[J].中国康复理论与实践202127(10):1176-1189., articleTitle=老年人参与身体活动对改善健康、生活质量和福祉效果的系统综述, refAbstract=null), Reference(id=1240986273901507551, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, doi=null, pmid=null, pmcid=null, year=2021, volume=27, issue=10, pageStart=1176, pageEnd=1189, url=null, language=null, rfNumber=[22], rfOrder=37, authorNames=Cui DG, Qiu F, Qiu FB, journalName=Chinese Journal of Rehabilitation Theory and Practice, refType=null, unstructuredReference=Cui DG, Qiu F, Qiu FB, et al. Effect of participation physical activity on health, quality of Life and wellbeing for elderly adults: a systematic review[J]. Chinese Journal of Rehabilitation Theory and Practice, 2021, 27(10):1176-1189., articleTitle=Effect of participation physical activity on health, quality of Life and wellbeing for elderly adults: a systematic review, refAbstract=null)], funds=[Fund(id=1240986264883753658, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, awardId=202210634044, language=CN, fundingSource=国家级大学生创新创业训练计划项目(202210634044), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240986255803085038, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, xref=1., ext=[AuthorCompanyExt(id=1240986255832445169, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, companyId=1240986255803085038, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, North Sichuan Medical College, Nanchong, Sichuan 637007, China), AuthorCompanyExt(id=1240986255857610996, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, companyId=1240986255803085038, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.川北医学院公共卫生学院,四川 南充 637007)]), AuthorCompany(id=1240986256100880642, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, xref=2., ext=[AuthorCompanyExt(id=1240986256109269251, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, companyId=1240986256100880642, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.川北医学院医学影像学院)])], figs=[ArticleFig(id=1240986262216176190, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, language=EN, label=Table 1, caption=

General information of 702 rural elderly people in Sichuan [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征人数基本特征人数
居住区域子女孝顺
高经济水平200(28.49)都孝顺579(82.48)
中等经济水平211(30.06)有子女不孝顺110(15.67)
低经济水平291(41.45)无子女13(1.85)
性别身体残疾
女性371(52.85)94(13.39)
男性331(47.15)608(86.61)
年龄(岁)医保类型
60~70244(34.75)没有参保95(13.53)
70~79328(46.72)新农合374(53.28)
≥80130(18.52)其他233(33.19)
文化程度劳动强度
文盲或半文盲267(38.03)较大89(12.68)
小学231(32.91)一般284(40.46)
初中及以上204(29.06)较小329(46.82)
子女数(个)患慢性病
013(1.85)519(73.93)
1124(17.66)183(26.07)
2258(36.75)主观幸福感a
3162(23.08)低水平36(5.12)
≥4145(20.66)一般水平317(45.16)
近一年因健康原因住院高水平348(49.57)
269(38.32)健康体适能a
433(61.68)低水平328(46.79)
近一年因经济困难而未就医一般水平236(33.62)
61(8.69)高水平137(19.52)
641(91.31)
), ArticleFig(id=1240986262417502796, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, language=CN, label=表1, caption=

四川702名农村老年人的一般情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征人数基本特征人数
居住区域子女孝顺
高经济水平200(28.49)都孝顺579(82.48)
中等经济水平211(30.06)有子女不孝顺110(15.67)
低经济水平291(41.45)无子女13(1.85)
性别身体残疾
女性371(52.85)94(13.39)
男性331(47.15)608(86.61)
年龄(岁)医保类型
60~70244(34.75)没有参保95(13.53)
70~79328(46.72)新农合374(53.28)
≥80130(18.52)其他233(33.19)
文化程度劳动强度
文盲或半文盲267(38.03)较大89(12.68)
小学231(32.91)一般284(40.46)
初中及以上204(29.06)较小329(46.82)
子女数(个)患慢性病
013(1.85)519(73.93)
1124(17.66)183(26.07)
2258(36.75)主观幸福感a
3162(23.08)低水平36(5.12)
≥4145(20.66)一般水平317(45.16)
近一年因健康原因住院高水平348(49.57)
269(38.32)健康体适能a
433(61.68)低水平328(46.79)
近一年因经济困难而未就医一般水平236(33.62)
61(8.69)高水平137(19.52)
641(91.31)
), ArticleFig(id=1240986262585274964, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, language=EN, label=Table 2, caption=

Death anxiety scores of rural elderly in Sichuan(

, figureFileSmall=null, figureFileBig=null, tableContent=
死亡焦虑维度条目数得分条目均分
情感61.10±1.330.18±0.22
压力与痛苦42.29±1.800.57±0.45
时间意识20.76±0.790.38±0.40
认知31.18±0.790.40±0.26
总分155.33±3.680.36±0.25
), ArticleFig(id=1240986262727881311, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, language=CN, label=表2, caption=

四川农村老年人死亡焦虑得分(

, figureFileSmall=null, figureFileBig=null, tableContent=
死亡焦虑维度条目数得分条目均分
情感61.10±1.330.18±0.22
压力与痛苦42.29±1.800.57±0.45
时间意识20.76±0.790.38±0.40
认知31.18±0.790.40±0.26
总分155.33±3.680.36±0.25
), ArticleFig(id=1240986262992122470, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, language=EN, label=Table 3, caption=

Results of single factor analysis of influencing factors of death anxiety among rural elderly in Sichuan

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征调查人数高死亡焦虑人数[n(%)]χ2P
居住区域3.8830.143
高经济水平20080(40.00)
中等经济水平21165(30.81)
低经济水平291100(34.36)
性别6.0600.014
女性371145(39.08)
男性331100(30.21)
年龄(岁)1.2920.524
60~7024491(37.30)
70~79328113(34.45)
≥8013041(31.54)
文化程度4.3710.113
文盲或半文盲267106(39.70)
小学23174(32.03)
初中及以上20465(31.86)
子女数(个)9.6380.047
0136(46.15)
112450(40.32)
225897(37.60)
316256(34.57)
≥414536(24.83)
近一年因健康原因住院3.2790.070
269105(39.03)
433140(32.33)
近一年因经济困难而未就医9.0650.003
6132(52.46)
641213(33.23)
子女孝顺2.9680.227
都孝顺579194(33.51)
有子女不孝顺11045(40.91)
无子女136(46.15)
身体残疾4.5700.033
9442(44.68)
608203(33.39)
医保类型7.2170.027
没有参保9541(43.16)
新农合374137(36.63)
其他23367(28.76)
劳动强度1.4210.491
较大8936(40.45)
一般28498(34.51)
较小329111(33.74)
患慢性病12.841<0.001
519201(38.73)
18344(24.04)
主观幸福感a61.379<0.001
低水平3629(80.56)
一般水平317134(42.27)
高水平34881(23.28)
健康体适能a45.143<0.001
低水平328149(45.43)
一般水平23677(32.63)
高水平13718(13.14)
合计702245(34.90)
), ArticleFig(id=1240986263155700338, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, language=CN, label=表3, caption=

四川农村老年人死亡焦虑影响因素的单因素分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征调查人数高死亡焦虑人数[n(%)]χ2P
居住区域3.8830.143
高经济水平20080(40.00)
中等经济水平21165(30.81)
低经济水平291100(34.36)
性别6.0600.014
女性371145(39.08)
男性331100(30.21)
年龄(岁)1.2920.524
60~7024491(37.30)
70~79328113(34.45)
≥8013041(31.54)
文化程度4.3710.113
文盲或半文盲267106(39.70)
小学23174(32.03)
初中及以上20465(31.86)
子女数(个)9.6380.047
0136(46.15)
112450(40.32)
225897(37.60)
316256(34.57)
≥414536(24.83)
近一年因健康原因住院3.2790.070
269105(39.03)
433140(32.33)
近一年因经济困难而未就医9.0650.003
6132(52.46)
641213(33.23)
子女孝顺2.9680.227
都孝顺579194(33.51)
有子女不孝顺11045(40.91)
无子女136(46.15)
身体残疾4.5700.033
9442(44.68)
608203(33.39)
医保类型7.2170.027
没有参保9541(43.16)
新农合374137(36.63)
其他23367(28.76)
劳动强度1.4210.491
较大8936(40.45)
一般28498(34.51)
较小329111(33.74)
患慢性病12.841<0.001
519201(38.73)
18344(24.04)
主观幸福感a61.379<0.001
低水平3629(80.56)
一般水平317134(42.27)
高水平34881(23.28)
健康体适能a45.143<0.001
低水平328149(45.43)
一般水平23677(32.63)
高水平13718(13.14)
合计702245(34.90)
), ArticleFig(id=1240986263394775676, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, language=EN, label=Table 4, caption=

Variable assignment for Logistic regression analysis

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变量赋值
死亡焦虑低水平=0,高水平=1
性别男=0,女=1
子女数(个)0=0,1=1,2=2,3=3,≥4=4
近一年因经济困难而未就医否=0,是=1
身体残疾否=0,是=1
医保类型没有参保=(0、0),新农合=(1、0),其他=(0、1)
患慢性病否=0,是=1
主观幸福感低水平=0,一般水平=1,高水平=2
健康体适能低水平=0,一般水平=1,高水平=2
), ArticleFig(id=1240986263898092174, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, language=CN, label=表4, caption=

Logistic回归分析的变量赋值

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
死亡焦虑低水平=0,高水平=1
性别男=0,女=1
子女数(个)0=0,1=1,2=2,3=3,≥4=4
近一年因经济困难而未就医否=0,是=1
身体残疾否=0,是=1
医保类型没有参保=(0、0),新农合=(1、0),其他=(0、1)
患慢性病否=0,是=1
主观幸福感低水平=0,一般水平=1,高水平=2
健康体适能低水平=0,一般水平=1,高水平=2
), ArticleFig(id=1240986264275579543, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, language=EN, label=Table 5, caption=

Logistic regression analysis results of influencing factors of death anxiety in rural elderly in Sichuan

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变量B Wald χ2POR值( 95%CI)
子女数-0.2980.08412.678<0.0010.742(0.630-0.875)
患慢性病(参照:否)0.4540.2164.4320.0351.575(1.032-2.404)
主观幸福感-0.8260.15229.435<0.0010.453(0.335-0.612)
健康体适能-0.5040.12516.157<0.0010.581(0.452-0.746)
), ArticleFig(id=1240986264481100451, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240972420266390168, language=CN, label=表5, caption=

四川农村老年人死亡焦虑影响因素的logistic回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量B Wald χ2POR值( 95%CI)
子女数-0.2980.08412.678<0.0010.742(0.630-0.875)
患慢性病(参照:否)0.4540.2164.4320.0351.575(1.032-2.404)
主观幸福感-0.8260.15229.435<0.0010.453(0.335-0.612)
健康体适能-0.5040.12516.157<0.0010.581(0.452-0.746)
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四川农村老年人死亡焦虑现况及其影响因素研究
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林鑫 1 , 张心怡 1 , 张雨婧 1 , 董美志 2 , 高晓凤 1
现代预防医学 | 基层卫生服务 2024,51(9): 1625-1629
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现代预防医学 | 基层卫生服务 2024, 51(9): 1625-1629
四川农村老年人死亡焦虑现况及其影响因素研究
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林鑫1, 张心怡1, 张雨婧1, 董美志2, 高晓凤1
作者信息
  • 1.川北医学院公共卫生学院,四川 南充 637007
  • 2.川北医学院医学影像学院
  • 林鑫(2002—),男,本科在读,研究方向:多元统计方法在医学中的应用

通讯作者:

高晓凤,E-mail:
Study on the current situation and influencing factors of death anxiety of the elderly in rural areas of Sichuan Province
Xin LIN1, Xin-yi ZHANG1, Yu-jing ZHANG1, Mei-zhi DONG2, Xiao-feng GAO1
Affiliations
  • School of Public Health, North Sichuan Medical College, Nanchong, Sichuan 637007, China
出版时间: 2024-05-10 doi: 10.20043/j.cnki.MPM.202312141
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目的

了解四川农村老年人死亡焦虑现状及其影响因素。

方法

抽取四川省6个地级市(州)的702名农村老年人,对其死亡焦虑现况进行问卷调查,描述死亡焦虑现况基础上,采用χ2检验及logistic回归分析探讨死亡焦虑的影响因素。

结果

四川农村老年人的死亡焦虑情感维度得分为(1.10±1.33)分,压力与痛苦维度为(2.29±1.80)分,时间意识维度为(0.76±0.79)分,认知维度为(1.18±0.79)分,总分为(5.33±3.68)分,高死亡焦虑245人,占34.90%。多因素分析结果显示子女人数(OR=0.742,95%CI:0.630~0.875)、主观幸福感(OR=0.453,95%CI:0.335~0.612)、健康体适能(OR=0.581,95%CI:0.452~0.746)是老年人死亡焦虑的保护因素,患慢性病(OR=1.575,95%CI:1.032~2.404)是死亡焦虑的危险因素。

结论

四川农村老年人死亡焦虑处于中等偏低水平,子女数少、患慢性病、健康体适能差、主观幸福感低的农村老年人的死亡焦虑水平较高,需重点关注。

死亡焦虑  /  农村  /  老年人  /  影响因素
Objective

To understand the current situation of death anxiety of the elderly in rural areas of Sichuan and its influencing factors.

Methods

A questionnaire survey was conducted among 702 rural elderly from 6 prefecture-level cities in Sichuan Province. On the basis of describing the current situation of death anxiety, the χ2 test and logistic regression analysis were used to explore the influencing factors of death anxiety.

Results

The scores of emotional dimensions of death anxiety, stress and pain, time consciousness, and cognitive dimension of the elderly in rural areas of Sichuan were (1.10 ±1.33), (2.29 ±1.80),(0.76±0.79), and (1.18±0.79), respectively. The total score was (5.33±3.68), and 245 (34.90%) had high death anxiety. Multivariate analysis showed that the number of children (OR=0.742, 95%CI: 0.630-0.875)), subjective well-being (OR=0.453,95%CI: 0.335-0.612)) and physical fitness (OR=0.581, 95%CI: 0.452-0.746) were the protective factors of death anxiety in the elderly, while chronic diseases (OR=1.575, 95%CI: 1.032-2.404)) were the risk factors of death anxiety.

Conclusion

The death anxiety of the elderly in the rural areas of Sichuan is at a medium-low level, and the rural elderly with a small number of children, chronic diseases, poor physical fitness, and low subjective well-being have a higher level of death anxiety, which should be paid more attention to.

Death anxiety  /  Rural areas  /  Elderly  /  Influencing factors
林鑫, 张心怡, 张雨婧, 董美志, 高晓凤. 四川农村老年人死亡焦虑现况及其影响因素研究. 现代预防医学, 2024 , 51 (9) : 1625 -1629 . DOI: 10.20043/j.cnki.MPM.202312141
Xin LIN, Xin-yi ZHANG, Yu-jing ZHANG, Mei-zhi DONG, Xiao-feng GAO. Study on the current situation and influencing factors of death anxiety of the elderly in rural areas of Sichuan Province[J]. Modern Preventive Medicine, 2024 , 51 (9) : 1625 -1629 . DOI: 10.20043/j.cnki.MPM.202312141
死亡焦虑是指个体由于意识到死亡这种显著且有意识的威胁而产生的恐惧、恐慌和其他痛苦的状态,这种负性情绪会影响个体的身心健康和生活质量[1]。现有研究表明,老年人的死亡焦虑程度很高,有近五成的老年人处于高死亡焦虑状态[2],且农村老年人的死亡焦虑程度显著高于城市老年人[3]。因此,识别、评价和控制影响农村老年人死亡焦虑的因素,对于促进农村老年人身心健康、提升生活质量具有重要意义。主观幸福感是指个体按照自己设定的标准对自己的生活质量进行综合评价,该指标是衡量个体生活质量的综合性心理标准[4]。健康体适能是指应对日常生活、工作、环境及突发事件等因素时,人的身体、心理和社会等方面应变能力的完好状态[5],能反映了个体健康素质和适应能力,有研究发现,好的健康状况能减轻老年人的死亡焦虑[6]。四川是我国老龄化较严重省份,农村人口老龄化水平明显高于城镇[7],故本研究以四川农村老年人作为研究对象,于2023年6—8月对其进行死亡焦虑问卷调查,并分析其主观幸福感、健康体适能等因素对死亡焦虑的影响,现报告如下。
四川省常住农村老年人。纳入标准:(1)年龄≥60岁;(2)理解和沟通能力良好;(3)在当地农村居住半年以上。根据现况调查的样本含量估算公式:,根据文献[7]估计老年人死亡焦虑得分标准差为3.26分;d为容许误差,要求少于0.25分;α=0.05,计算出样本量n=654。考虑到样本收集时出现拒访、不合格问卷等情况,将样本量增加到750份。首先将四川省地级市(州)按照经济水平分为高、中、低三个层次,然后在每个层次选取2个地级市(州)(成都市、南充市、乐山市、广安市、攀枝花市、甘孜州),再从6个市(州)各抽一个县(彭州市、仪陇县、夹江县、岳池县、米易县、泸定县),随后从6个县中各选取一个镇(丹景山镇、立山镇、华头镇、酉溪镇、攀莲镇、泸桥镇),最后根据第七次全国人口普查报告的6个镇的老年人口数,按人口数比例分别从6个镇下辖的行政村中采用便利抽样方法抽取110、110、100、120、190和120名老年人作为调查对象。本研究经川北医学院医学伦理委员会审核批准(编号:2023009),研究对象均知情同意。
包括老年人的一般情况(年龄、性别、子女人数等)、健康体适能、主观幸福感及死亡焦虑情况。
健康体适能采用健康体适能评定量表[8]进行测量,该量表有15个条目,分为器官功能、活动功能及躯体调适能力三个维度,其中条目15为总体评价,不纳入量表总得分的评定,每个条目采用Likert 5级评分法,从“很低”到“很高”分别赋值1~5分,三个维度得分之和为量表总得分。将量表总得分转化为百分制,转化分越高,表示健康体适能水平越高。转化分≥63.75分为高健康体适能水平,50.24~63.74分为一般水平,≤50.23分为低水平。本研究中量表的Cronbachα系数为0.86。
主观幸福感采用纽芬兰纪念大学幸福度量表[9]进行测量,该量表有24个条目,分为正性情感(PA)、负性情感(NA)、一般正性体验(PE)、一般负性体验(NA)四个维度,每个条目采用“是”、“不知道”和“否”回答,分别计为2、1和0分,总分=PA-NA+PE- NE+24,总分范围为0~48分,分值越高表明主观幸福感越高。总分≥36分为高主观幸福感水平,13~35分为一般水平,≤12分为低水平。本研究中量表的Cronbach α系数为0.87。
死亡焦虑采用汉化的死亡焦虑量表[10]进行测量,该量表分为情感、压力与痛苦、时间意识、认知四个维度,共15个条目,采用“是”和“否”回答,计为1、0分,其中9个条目正向计分,6个条目为反向计分,总分为0~15分,分值越高表明死亡焦虑越严重。总分≥7分为高死亡焦虑水平,<7分作为低水平。本研究中量表的Cronbach α系数为0.71。
数据分析由SPSS 20.0完成。采用()描述老年人健康体适能、主观幸福感及死亡焦虑得分。采用χ2检验、二分类logistic回归分析探讨性别、年龄等因素对老年人死亡焦虑水平的影响。检验水准α=0.05。
共发放问卷750份,回收有效问卷702份。老年人年龄为60~95岁,平均(72.71±7.48)岁;男性331人(47.15%),女性371人(52.85%);患有慢性病519人(73.93%)。见表1
健康体适能得分为(52.66±13.34)分,其中高水平137人(19.52%),一般水平236人(33.62%),低水平328人(46.79%);主观幸福感得分为(32.90±9.77)分,其中高水平348人(49.57%),一般水平317人(45.16%),低水平36人(5.12%)。
老年人死亡焦虑总分平均为(5.33±3.68)分,其中高死亡焦虑245人(34.90%),低死亡焦虑457人(65.10%);各维度中,以压力与痛苦维度得分最高,其条目均分为(0.57±0.45)分,见表2。各条目中,以“我一点也不害怕死亡”“我不是很害怕患癌症”得分为高,均为(0.52±0.50)分。
结果表明,老年人的性别、儿女数、近一年因经济困难而未就医、身体残疾、医保类型、慢性病患病情况、主观幸福感得分和健康体适能得分对其高死亡焦虑的影响有统计学意义(P<0.05);而老年人的居住区域、年龄、文化程度、近一年因健康原因住院、子女孝顺情况、劳动强度对其死亡焦虑的影响无统计学意义(P>0.05)。见表3
以死亡焦虑水平为因变量,将单因素分析中具有统计学意义的变量作为自变量进行多因素logistic回归分析。结果发现,子女数(OR=0.742)、主观幸福感(OR=0.453)、健康体适能(OR=0.581)是老年人死亡焦虑的保护因素,患慢性病(OR=1.575)是死亡焦虑的危险因素。见表4表5
本研究显示,四川农村老年人的死亡焦虑总分为(5.33±3.68)分,低于江西农村老年人得分(7.47±4.09)分[11],处于中等偏低水平。这与四川农村老年人的社会支持水平相对较高有关[12],一项对安徽农村老年人的调查显示,高水平的社会支持可缓解死亡焦虑[13]。良好的社会支持有益于个人身心健康,促进生活质量。因此,子女、家庭成员的情感支持和经济支持对于缓解农村老年人的死亡焦虑至关重要;同时,政府也应尽可能挖掘社会资源帮扶农村老年人群体。同时,各维度得分中,农村老年人在压力与痛苦维度的得分最高,其条目均分为(0.57±0.45)分,意味着疾病所带来的死亡恐惧和痛苦对农村老年人的影响最大,因此,尽管四川农村老年人死亡焦虑处于中等偏低水平,仍有必要在农村地区适时开展死亡教育和健康科普教育,提高农村老年人对死亡和疾病的认知,从而预防或减轻其对死亡的焦虑和恐惧。
本研究发现,患有慢性病的农村老年人死亡焦虑水平更高,这和焦卉等[11]对江西老年人的研究结果类似,这可能是因为慢性病的病程迁延不愈,对老年人的身体、生活质量都会造成很大影响,致其心理健康状况不佳,从而加重其死亡焦虑[14];子女多的农村老年人死亡焦虑水平低,这与刘雯静等[15]对北方老年人研究结果类似,农村老年人的社会经济地位较为低下,需要依靠子女提供养老和生活相关的经济支持[16],接受子女的经济支持会增强老年人的自尊和安全感[17],而老年人自尊与死亡焦虑呈负相关[18]。本研究发现,主观幸福感强的四川农村老年人其死亡焦虑水平较低,这与邓岚等[19]的研究结果类似,这提示可通过改善农村老年人的社会福利、养老保障,降低其养老的经济压力,提升主观幸福感来缓解其死亡焦虑。健康体适能越好的四川农村老年人死亡焦虑水平越低,一方面健康体适能越好的农村老年人,其认知功能越好,而认知功能又与死亡焦虑呈负相关[20],认知功能越好的农村老年人其死亡焦虑水平越低;另一方面健康体适能与健康状况呈正相关[21],健康体适能水平越高,其健康状况越好,患慢性病的风险更低,生活质量越高,从而有利于缓解其死亡焦虑情绪。轻度身体活动与老年人健康体适能、认知功能显著正相关[22],因此,可通过健康科普宣讲让农村老年人减少久坐时间,增加轻度身体活动,从而促进健康体适量和认知功能改善,降低死亡焦虑水平。
本研究为横断面研究,采用的抽样方法为多阶段方便抽样,这一定程度上会影响调查对象的代表性。但是,基于目前农村老年人死亡焦虑影响因素相关研究文献较少的现实,本研究结果可为及早干预和预防农村老年人死亡焦虑提供参考。
  • 国家级大学生创新创业训练计划项目(202210634044)
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2024年第51卷第9期
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doi: 10.20043/j.cnki.MPM.202312141
  • 接收时间:2023-12-11
  • 首发时间:2026-03-18
  • 出版时间:2024-05-10
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  • 收稿日期:2023-12-11
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国家级大学生创新创业训练计划项目(202210634044)
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    1.川北医学院公共卫生学院,四川 南充 637007
    2.川北医学院医学影像学院

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2种不同金属材料的力学参数

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total species (%)

Genus
种数
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species
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Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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