Article(id=1241342455430312895, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241342451043061769, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202304289, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1681747200000, receivedDateStr=2023-04-18, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773888704402, onlineDateStr=2026-03-19, pubDate=1708790400000, pubDateStr=2024-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773888704402, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773888704402, creator=13701087609, updateTime=1773888704402, updator=13701087609, issue=Issue{id=1241342451043061769, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='4', pageStart='577', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773888703356, creator=13701087609, updateTime=1773893026321, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241360582939562716, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241342451043061769, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241360582939562717, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241342451043061769, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=680, endPage=685, ext={EN=ArticleExt(id=1241342455786828758, articleId=1241342455430312895, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Relationship between social support and quality of life in older people during the time of COVID-19: the moderating role of social support behaviours, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the quality of life of the elderly in Dongguan during the COVID-19 period, to explore the influence path of social support and social support behavior on the quality of life of the elderly, and to provide a reference basis for social support to improve the quality of life of the elderly.

Methods

From September to December 2020, face-to-face interview-type questionnaires were administered to older adults in six communities in Dongguan City using whole-cluster random sampling, and the Social Support Assessment Scale (SSA), Social Support Behaviour Scale (SS-B), and the Brief Health Questionnaire (SF-36) were used to assess older adults’ social support, social support behaviours, and quality of life. The t-test and one-way ANOVA were used for statistical analysis of variance, and Spearman’s correlation analysis and Model 1 in the PROCESS 4.0 macro program were used for path analysis.

Results

A total of 1 130 valid questionnaires (94.17%) were collected, with a mean age (78.85±9.04) years, 72.2% female and 27.8% male. Social support (r=0.16, P<0.01) and social support behaviors (r=0.14, P<0.01) were positively correlated with quality of life, while social support (r=0.11, P<0.01) and social support behaviors (r=0.14, P<0.01) were positively correlated with mental health. Social support behaviors had a positive predictive effect on quality of life (β=0.069, P<0.01) and mental health =0.119, P<0.01). The relationship between social support behavior and quality of life (β=-0.004, P<0.001) and mental health (β=-0.005, P<0.001), the boundary values of the regulatory effect were 10.270 and 7.145, respectively, and the regulatory effect below the critical value was significant.

Conclusion

Improving social support in the elderly can help improve the quality of life of the elderly, especially the elderly population with a low level of social support behavior.

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目的

了解疫情防控期间东莞地区老年人的生命质量状况,探索社会支持和社会支持行为对老年人生命质量的影响路径,为改善老年人生命质量提供社会支持视角的参考依据。

方法

于 2020 年9月—12月采用整群随机抽样对东莞市6个社区的老年人进行面对面访谈式问卷调查,采用社会支持评价量表(SSA)、社会支持行为量表(SS-B)和简明健康调查问卷(SF-36)评估老年人社会支持、社会支持行为及生命质量等。使用t检验、单因素方差分析用于统计学差异分析,Spearman相关分析和PROCESS 4.0宏程序中的模型1用于路径分析。

结果

共回收1 130份有效问卷(94.17%),平均年龄(78.85±9.04)岁,女性占72.2%,男性占27.8%。社会支持(r=0.16,P<0.01)、社会支持行为(r=0.14,P<0.01)与生命质量呈正相关,社会支持(r=0.11,P<0.01)、社会支持行为(r=0.14,P<0.01)与心理健康呈正相关。社会支持行为对生命质量(β=0.069,P<0.01)、心理健康(β=0.119,P<0.01)存在正向预测作用;社会支持行为调节社会支持与生命质量(β=-0.004,P<0.001)、心理健康(β=-0.005,P<0.001)的关系,调节作用的边界值分别为10.270、7.145,且均为临界值以下调节作用显著。

结论

提高老年人的社会支持有助于提高老年人的生命质量,特别是社会支持行为水平较低的老年人群。

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林艳伟,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=FVs9at98bycE4bNAMHkvkw==, magXml=EUAMJPKFDpkuAvkvjh0wcg==, pdfUrl=null, pdf=1frxu68N4lBUxefbPUGDew==, pdfFileSize=1082483, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=yNMG1JIs5rqub9MmK80Vxg==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=eE/D7mIf2l7LAJwxEL8Dlg==, mapNumber=null, authorCompany=null, fund=null, authors=

郝然(1996—),女,硕士在读,研究方向:社会因素与健康关系研究

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Psychology and Aging. 2020, 35(2): 159-168., articleTitle=Age differences in reported social networks and well-being, refAbstract=null)], funds=[Fund(id=1241342465618276892, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, awardId=71804029, language=CN, fundingSource=国家自然科学基金(71804029), fundOrder=null, country=null), Fund(id=1241342465693774373, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, awardId=C2018081, language=CN, fundingSource=广东省医学科研基金(C2018081), fundOrder=null, country=null), Fund(id=1241342465857352239, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, awardId=2023KTSCX040, language=CN, fundingSource=广东省普通高校特色创新类项目(2023KTSCX040), fundOrder=null, country=null), Fund(id=1241342465978987067, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, awardId=B2019033, language=CN, fundingSource=广东医科大学博士启动项目(B2019033), fundOrder=null, country=null), Fund(id=1241342467572822598, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, awardId=4SG22001G, language=CN, fundingSource=广东医科大学高水平学科建设工程项目(4SG22001G), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241342459477815381, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, xref=1., ext=[AuthorCompanyExt(id=1241342459486203991, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, companyId=1241342459477815381, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Social Medicine and Health Administration, School of Public Health, Guangdong Medical University, Dongguan, Guangdong 523808, China), AuthorCompanyExt(id=1241342459494592601, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, companyId=1241342459477815381, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.广东医科大学公共卫生学院社会医学与卫生事业管理系,广东 东莞 523808)]), AuthorCompany(id=1241342459666559077, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, xref=2., ext=[AuthorCompanyExt(id=1241342459674947686, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, companyId=1241342459666559077, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.广东医科大学公共卫生与健康研究院)]), AuthorCompany(id=1241342459788193905, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, xref=3., ext=[AuthorCompanyExt(id=1241342459800776820, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, companyId=1241342459788193905, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.广东医科大学公共卫生学院流行病与卫生统计学系)])], figs=[ArticleFig(id=1241342463982498187, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=EN, label=Fig.1, caption=Moderating role of social support behaviours in the relationship between social support and quality of life and psychological well-being, figureFileSmall=l+73jJibEXpsLaXFvDAqxw==, figureFileBig=yNMG1JIs5rqub9MmK80Vxg==, tableContent=null), ArticleFig(id=1241342464062189970, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=CN, label=图1, caption=社会支持行为在社会支持和生命质量、心理健康之间的调节作用

注:A为社会支持行为在社会支持和生命质量之间调节作用的简单斜率图;B为社会支持行为在社会支持和心理健康之间调节作用的简单斜率图。

, figureFileSmall=l+73jJibEXpsLaXFvDAqxw==, figureFileBig=yNMG1JIs5rqub9MmK80Vxg==, tableContent=null), ArticleFig(id=1241342464301265317, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=EN, label=Fig.2, caption=Schematic representation of J-N analysis of social support behaviour as a moderating variable, figureFileSmall=J1h0GXqfmRjPJfh+oPnjKw==, figureFileBig=EFCl96eoVdk+jFgTPobz8Q==, tableContent=null), ArticleFig(id=1241342464473231791, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=CN, label=图2, caption=社会支持行为作为调节变量的J-N分析示意图

注:A为不同社会支持行为水平下社会支持对生命质量影响的J-N分析示意图;B为不同社会支持行为水平下社会支持对心理健康影响的J-N分析示意图。

, figureFileSmall=J1h0GXqfmRjPJfh+oPnjKw==, figureFileBig=EFCl96eoVdk+jFgTPobz8Q==, tableContent=null), ArticleFig(id=1241342464636809657, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=EN, label=Table 1, caption=

Comparison of variability in demographic characteristics of survey respondents (n=1 130)

, figureFileSmall=null, figureFileBig=null, tableContent=
指标人数(%)生命质量总分(分,t/FP
性别2.5330.011
314(27.80)66.80±16.66
816(72.20)64.04±16.32
年龄(周岁)39.149<0.001
60~69178(15.80)72.05±14.14
70~79413(36.50)67.82±15.89
80~89410(36.30)61.46±15.92
≥90129(11.40)55.82±16.41
婚姻状况43.596<0.001
已婚581(51.40)69.11±15.37
离异/丧偶/分居510(45.10)60.47±16.15
未婚39(3.50)57.58±18.74
受教育程度5.4590.004
小学及以下980(86.70)64.21±16.45
初中107(9.50)69.60±15.34
高中及以上43(3.80)66.54±17.40
患慢性病数量(种)21.907<0.001
063(5.60)72.13±12.05
1592(52.40)66.48±15.94
≥2475(42.00)61.76±17.00
月平均收入(元)
<1 000567(50.20)63.39±15.737.1870.001
1 000~1 999400(35.40)65.30±17.59
≥2 000163(14.40)68.53±15.44
居住情况
自己一个人住452(40.00)60.25±15.9639.818<0.001
与配偶居住268(23.70)66.70±15.72
与配偶和子女居住239(21.20)73.52±13.74
与子女一起居住140(12.40)64.80±15.30
与其他人一起居住31(2.70)47.94±18.21
), ArticleFig(id=1241342464771027397, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=CN, label=表1, caption=

调查对象的人口学特征差异性比较(n=1 130)

, figureFileSmall=null, figureFileBig=null, tableContent=
指标人数(%)生命质量总分(分,t/FP
性别2.5330.011
314(27.80)66.80±16.66
816(72.20)64.04±16.32
年龄(周岁)39.149<0.001
60~69178(15.80)72.05±14.14
70~79413(36.50)67.82±15.89
80~89410(36.30)61.46±15.92
≥90129(11.40)55.82±16.41
婚姻状况43.596<0.001
已婚581(51.40)69.11±15.37
离异/丧偶/分居510(45.10)60.47±16.15
未婚39(3.50)57.58±18.74
受教育程度5.4590.004
小学及以下980(86.70)64.21±16.45
初中107(9.50)69.60±15.34
高中及以上43(3.80)66.54±17.40
患慢性病数量(种)21.907<0.001
063(5.60)72.13±12.05
1592(52.40)66.48±15.94
≥2475(42.00)61.76±17.00
月平均收入(元)
<1 000567(50.20)63.39±15.737.1870.001
1 000~1 999400(35.40)65.30±17.59
≥2 000163(14.40)68.53±15.44
居住情况
自己一个人住452(40.00)60.25±15.9639.818<0.001
与配偶居住268(23.70)66.70±15.72
与配偶和子女居住239(21.20)73.52±13.74
与子女一起居住140(12.40)64.80±15.30
与其他人一起居住31(2.70)47.94±18.21
), ArticleFig(id=1241342464909439442, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=EN, label=Table 2, caption=

Results of the correlation analysis of the variables

, figureFileSmall=null, figureFileBig=null, tableContent=
变量社会支持社会行为生命质量生理健康
社会支持1.00
社会行为0.47b1.00
生命质量0.16b0.14b1.00
生理健康0.10b0.050.81b1.00
心理健康0.11b0.14b0.59b0.04
), ArticleFig(id=1241342465026879968, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=CN, label=表2, caption=

各变量的相关性分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量社会支持社会行为生命质量生理健康
社会支持1.00
社会行为0.47b1.00
生命质量0.16b0.14b1.00
生理健康0.10b0.050.81b1.00
心理健康0.11b0.14b0.59b0.04
), ArticleFig(id=1241342465140126188, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=EN, label=Table 3, caption=

Tests of moderated models of older people’s social support behaviour

, figureFileSmall=null, figureFileBig=null, tableContent=
回归方程拟合指标系数显著性
结果变量预测变量RR2Fβt
生命质量0.1930.03714.445c
社会支持0.1463.376c
社会支持行为0.0692.274b
社会支持×社会支持行为-0.004-2.751c
生理健康0.4120.17022.912c
社会支持0.0731.316
社会支持行为-0.011-0.272
社会支持×社会支持行为-0.001-0.498
心理健康0.2500.0627.432c
社会支持0.1442.651b
社会支持行为0.1193.144b
社会支持×社会支持行为-0.005-2.592a
), ArticleFig(id=1241342465244983796, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=CN, label=表3, caption=

老年人社会支持行为的调节模型检验

, figureFileSmall=null, figureFileBig=null, tableContent=
回归方程拟合指标系数显著性
结果变量预测变量RR2Fβt
生命质量0.1930.03714.445c
社会支持0.1463.376c
社会支持行为0.0692.274b
社会支持×社会支持行为-0.004-2.751c
生理健康0.4120.17022.912c
社会支持0.0731.316
社会支持行为-0.011-0.272
社会支持×社会支持行为-0.001-0.498
心理健康0.2500.0627.432c
社会支持0.1442.651b
社会支持行为0.1193.144b
社会支持×社会支持行为-0.005-2.592a
), ArticleFig(id=1241342465354035713, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=EN, label=Table 4, caption=

Effects of social support on quality of life and psychological well-being with different levels of social support behaviour

, figureFileSmall=null, figureFileBig=null, tableContent=
结果变量社会支持行为效应值(95% CI标准误tP
生命质量0.170(0.073~0.269)0.0503.4150.001
0.114(0.034~0.194)0.0412.8090.005
0.058(-0.035~0.152)0.0481.2250.221
心理健康0.236(0.106~0.366)0.0663.555<0.001
0.144(0.037~0.250)0.0542.6510.008
0.051(-0.073~0.175)0.0630.8080.419
), ArticleFig(id=1241342465488253457, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342455430312895, language=CN, label=表4, caption=

不同水平的社会支持行为下社会支持对生命质量及心理健康的影响

, figureFileSmall=null, figureFileBig=null, tableContent=
结果变量社会支持行为效应值(95% CI标准误tP
生命质量0.170(0.073~0.269)0.0503.4150.001
0.114(0.034~0.194)0.0412.8090.005
0.058(-0.035~0.152)0.0481.2250.221
心理健康0.236(0.106~0.366)0.0663.555<0.001
0.144(0.037~0.250)0.0542.6510.008
0.051(-0.073~0.175)0.0630.8080.419
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疫情防控期间老年人社会支持与生命质量的关系:社会支持行为的调节作用
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郝然 1, 2 , 王婷仙 2, 3 , 彭瑾 2, 3 , 林艳伟 1, 2
现代预防医学 | 健康与社会行为 2024,51(4): 680-685
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现代预防医学 | 健康与社会行为 2024, 51(4): 680-685
疫情防控期间老年人社会支持与生命质量的关系:社会支持行为的调节作用
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郝然1, 2, 王婷仙2, 3, 彭瑾2, 3, 林艳伟1, 2
作者信息
  • 1.广东医科大学公共卫生学院社会医学与卫生事业管理系,广东 东莞 523808
  • 2.广东医科大学公共卫生与健康研究院
  • 3.广东医科大学公共卫生学院流行病与卫生统计学系
  • 郝然(1996—),女,硕士在读,研究方向:社会因素与健康关系研究

通讯作者:

林艳伟,E-mail:
Relationship between social support and quality of life in older people during the time of COVID-19: the moderating role of social support behaviours
Ran HAO1, 2, Ting-xian WANG2, 3, Jin PENG2, 3, Yan-wei LIN1, 2
Affiliations
  • Department of Social Medicine and Health Administration, School of Public Health, Guangdong Medical University, Dongguan, Guangdong 523808, China
出版时间: 2024-02-25 doi: 10.20043/j.cnki.MPM.202304289
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目的

了解疫情防控期间东莞地区老年人的生命质量状况,探索社会支持和社会支持行为对老年人生命质量的影响路径,为改善老年人生命质量提供社会支持视角的参考依据。

方法

于 2020 年9月—12月采用整群随机抽样对东莞市6个社区的老年人进行面对面访谈式问卷调查,采用社会支持评价量表(SSA)、社会支持行为量表(SS-B)和简明健康调查问卷(SF-36)评估老年人社会支持、社会支持行为及生命质量等。使用t检验、单因素方差分析用于统计学差异分析,Spearman相关分析和PROCESS 4.0宏程序中的模型1用于路径分析。

结果

共回收1 130份有效问卷(94.17%),平均年龄(78.85±9.04)岁,女性占72.2%,男性占27.8%。社会支持(r=0.16,P<0.01)、社会支持行为(r=0.14,P<0.01)与生命质量呈正相关,社会支持(r=0.11,P<0.01)、社会支持行为(r=0.14,P<0.01)与心理健康呈正相关。社会支持行为对生命质量(β=0.069,P<0.01)、心理健康(β=0.119,P<0.01)存在正向预测作用;社会支持行为调节社会支持与生命质量(β=-0.004,P<0.001)、心理健康(β=-0.005,P<0.001)的关系,调节作用的边界值分别为10.270、7.145,且均为临界值以下调节作用显著。

结论

提高老年人的社会支持有助于提高老年人的生命质量,特别是社会支持行为水平较低的老年人群。

社会支持  /  社会支持行为  /  生命质量  /  调节作用
Objective

To understand the quality of life of the elderly in Dongguan during the COVID-19 period, to explore the influence path of social support and social support behavior on the quality of life of the elderly, and to provide a reference basis for social support to improve the quality of life of the elderly.

Methods

From September to December 2020, face-to-face interview-type questionnaires were administered to older adults in six communities in Dongguan City using whole-cluster random sampling, and the Social Support Assessment Scale (SSA), Social Support Behaviour Scale (SS-B), and the Brief Health Questionnaire (SF-36) were used to assess older adults’ social support, social support behaviours, and quality of life. The t-test and one-way ANOVA were used for statistical analysis of variance, and Spearman’s correlation analysis and Model 1 in the PROCESS 4.0 macro program were used for path analysis.

Results

A total of 1 130 valid questionnaires (94.17%) were collected, with a mean age (78.85±9.04) years, 72.2% female and 27.8% male. Social support (r=0.16, P<0.01) and social support behaviors (r=0.14, P<0.01) were positively correlated with quality of life, while social support (r=0.11, P<0.01) and social support behaviors (r=0.14, P<0.01) were positively correlated with mental health. Social support behaviors had a positive predictive effect on quality of life (β=0.069, P<0.01) and mental health =0.119, P<0.01). The relationship between social support behavior and quality of life (β=-0.004, P<0.001) and mental health (β=-0.005, P<0.001), the boundary values of the regulatory effect were 10.270 and 7.145, respectively, and the regulatory effect below the critical value was significant.

Conclusion

Improving social support in the elderly can help improve the quality of life of the elderly, especially the elderly population with a low level of social support behavior.

Social support  /  Social support behaviors  /  Quality of life  /  Moderator effects
郝然, 王婷仙, 彭瑾, 林艳伟. 疫情防控期间老年人社会支持与生命质量的关系:社会支持行为的调节作用. 现代预防医学, 2024 , 51 (4) : 680 -685 . DOI: 10.20043/j.cnki.MPM.202304289
Ran HAO, Ting-xian WANG, Jin PENG, Yan-wei LIN. Relationship between social support and quality of life in older people during the time of COVID-19: the moderating role of social support behaviours[J]. Modern Preventive Medicine, 2024 , 51 (4) : 680 -685 . DOI: 10.20043/j.cnki.MPM.202304289
2020年突如其来的新冠病毒感染(COVID-19,以下简称新冠)疫情给我国公共卫生事业带来了巨大的挑战。作为社会群体中的免疫力低下群体、数字弱势群体,老年群体的健康受到严重威胁,社交隔离等防疫政策可能导致的心理问题更加突出[1]。同时,第七次人口普查数据显示,中国60岁及以上人口达2.64亿人,占比18.7%,社会迈入中度老龄化阶段[2],老年人健康问题愈发受到关注。生命质量(quality of life,QOL)作为衡量晚年健康的新指标,近年来在流行病学研究中备受关注。生命质量是在不同的文化和社会环境中对个人身心健康的一种主观的自我评价[3]。有学者[4]认为作为健康老龄化的核心目标,老年人生命质量的提高将有助于社会的稳定、社会负担的减轻。
大量实证研究表明,可以通过提高社会支持改善老年人生命质量[3]。社会支持是一种被关心和尊重的感觉或体验,也是个人感知相互支持的社交网络的一部分[5],按性质可以归为客观社会支持和主观社会支持两类。相对于客观社会支持,主观社会支持更加接近个体的心理感受,能够更加有效地预测个体的生命质量[6]。关于主观社会支持,国际学者多关注领悟性社会支持和功能性的社会支持。领悟性社会支持指的是对家庭支持、朋友支持和其他支持(支持源)的感知,即社会支持;而功能性的社会支持侧重于对情感支持、认知支持和行为支持等实际行为支持(支持内容)的评价[7],即社会支持行为。
明晰不同类型的社会支持对老年人生命质量的影响路径于老年人社会政策的制定具有一定的参考价值和实践意义。然而经文献检索发现,不同的社会支持类型虽均对生命质量有积极影响,但其影响是否存在差异以及是否存在交叉影响等路径不明[7]。据此,本研究提出以下路径假设:①社会支持显著正向预测老年人生命质量;②社会支持行为调节社会支持和老年人生命质量的关系。
研究于2020年9月—12月开展,以社区为整群抽样单位,在东莞市采用整群随机抽样抽取6个社区,对符合纳排标准的老年人进行面对面访谈式的问卷调查。纳入标准:①年龄≥60周岁;②签署知情同意书。排除标准:①老年人认知功能智力状态简易评价(MMSE)分数<27(认知功能障碍);②疾病急性发作期。本研究经广东医科大学附属医院机构审查伦理委员会(PJ2019-064)批准,所有参与调查者均签署知情同意书。根据2020年东莞统计年鉴数据显示,近25%的社区常住人口数分布在10 000至16 000人之间。本研究将人口数在此规模的社区作为研究开展社区。参考东莞市第七次人口普查数据65岁及以上人口占比3.54%,估算社区符合纳入标准的研究对象约354~567人,假定应答率为50%,则估算社区中可调查对象约为177~284人。本研究采用中数231人用于方差膨胀因子的计算(m=231),参照以往研究预估老年人生命质量总体标准差σ=23.00%,差异达到10%时被认为有统计学意义,假设允许犯Ⅰ类错误的概率为0.05(α=0.05),检验效能为0.8(β=0.2),估计组内相关系数ρ1=0.05。因此,样本量估算如下:
本研究样本量将不少于1 037例,最终选取6个社区作为调研现场。
参照相关研究,结合研究目的,由研究者自行设计,主要包括老年人的性别、年龄、婚姻状况、受教育程度、月平均收入、慢性病患病情况、居住状况等。
采用学者Vaux在1986年制定的老年人社会支持评价量表(The social support appraisals scale,SSA)[8],经课题组信效度评估后用于评价老年人社会支持[9]。主要测量被试者与家庭成员、朋友及其他人的社会关系等,包含三个维度(家庭、朋友和其他人),共20个项目。量表Cronbach α为0.934,采用Likert 4级计分,从1分的“非常不同意”到4分的“非常同意”。采用标准公式:转换分数= (原始分数-最低可能分数)/可能分数范围×100,将最终得分转化为百分制,分值范围0~100,分数越高,社会支持水平越高。
采用老年人社会支持行为量表(The Social Support Behaviors scale,SSB)[10]测量社会支持行为。该量表由学者Vaux在1987年制定,课题组经信效度评估后用于测量老年人可用的支持行为[11]。该量表包含四个维度(即建议或指导、情感支持、实际援助和社会化),共31个项目。量表Cronbach α为0.927,采用Likert 5级计分,从1分的“没有人会这样做”到5分的“大部分家庭成员/朋友会这样做”。采用标准公式将最终得分转化为百分制,分值范围为0~100分,得分越高,社会支持行为越好。
采用简明健康调查问卷(The Medical Outcomes Study Short Form 36-Item Health Survey,SF-36)测量生命质量。该量表包含生理健康(physical health components,PHC)和心理健康(mental health components,MHC)维度,共36个项目。总量表的Cronbach α为0.722,参考相关研究[12],对量表各维度得分、心理健康得分和生理健康得分进行计算,取所有维度得分总分为生命质量总评分(QOL)[13],并依据标准公式转换为百分制,分值范围为0~100分,分值越高,生命质量情况越好。
计量资料采用描述,计数资料采用例数和构成比(%)进行描述。t检验、单因素方差分析进行老年人生命质量的差异性比较,Spearman相关分析用于检验社会支持、社会支持行为及生命质量的相关性,PROCESS 4.0宏程序中的模型1用于社会支持、社会支持行为及生命质量的多重回归分析,检验社会支持行为对社会支持与生命质量的调节作用。检验水准为双侧检验α = 0.05。
本研究共发放1 200份问卷,回收问卷1 146份,有效问卷为1 130(94.17%)份。其中男性314人(27.80%),女性816人(72.20%);年龄在70~79岁和80~89岁的老年人较多,分别占36.50%和36.30%;平均年龄(78.85±9.04)岁;已婚(581人)占51.40%;980人(86.70%)文化程度为小学及以下,患有一种疾病的老年人占比52.40%,有40.00%的老人处于独居状态;平均月收入<1 000元的占50.20%。详见表1
男性、年龄较低、已婚、受教育程度较高、无慢性病、月平均收入越高、与配偶、子女居住的老年人生命质量水平较高,差异具有统计学意义。详见表1
Spearson相关分析结果显示社会支持、社会支持行为与生命质量呈显著正相关,社会支持、社会支持行为与心理健康呈显著正相关。社会支持与生理健康呈显著正相关,社会支持行为与生理健康无显著相关关系。详见表2
将PROCESS 4.0宏程序中的模型1用于社会支持行为的调节作用检验,为避免多重共线性,在构建交互项的过程中,首先对数据进行中心化处理,处理后的各变量VIF值均小于2,满足进一步分析要求。社会支持为自变量,生命质量为因变量,社会支持行为为调节变量,以性别、年龄、婚姻状况、受教育程度、患慢性病数量、月平均收入、居住情况为控制变量。如表3所示,社会支持行为对生命质量及心理健康维度存在正向预测作用(β=0.069,P<0.01;β=0.119,P<0.01);社会支持与社会支持行为的交互项对生命质量及心理健康维度也具有统计学意义(β=-0.004,t=-2.751,P<0.001;β=-0.005,t=-2.592,P<0.001)。但是社会支持行为对社会支持与生理健康(β=-0.001,P> 0.05)之间关系的调节作用未具有统计学意义。由此推测:社会支持行为在社会支持对生命质量的关系中有调节作用,进一步分析发现这种作用仅存在于对心理健康的影响中。
采用简单斜率图进一步分析社会支持行为的调节作用。采用均数和标准差对社会支持行为进行分组,将社会支持行为得分均数加1个标准差划分为高社会支持行为组(),将社会支持行为得分均数划分为中社会支持行为组(),将均数减1个标准差划分为低社会支持行为组()。社会支持对生命质量、心理健康的影响均因社会支持行为水平的不同有所差异。结果如表4所示,在中、低社会支持行为组,社会支持对生命质量(P=0.001;P=0.005)、心理健康(P<0.001;P=0.008)的预测作用均有统计学意义。
进一步绘制简单斜率图,结果如图1A、图1B所示。低社会支持行为组的老年人社会支持水平对生命质量及心理健康维度有较强正向预测作用(β=0.170,P=0.001;β=0.236,P<0.001),上升趋势显著高于中、高社会支持行为的老年人。这表明随着社会支持行为的上升,社会支持对生命质量和心理健康维度的预测作用均有逐渐变小的趋势。
此外,为进一步了解调节作用的临界值以及具有统计学差异的调节变量取值的区间范围,本研究利用Johnson-Neyman技术绘制J-N图。由图2A、图2B可以看出,社会支持行为对社会支持和生命质量、心理健康调节作用的边界值(95% CI下限纵坐标的0点截点值)分别为10.270和7.145,还原为原始分数为68.600分和65.475分。当社会支持行为绝对值取值<68.600分时,社会支持行为对社会支持与生命质量之间关系的调节作用显著;当社会支持行为绝对值取值<65.475分时,社会支持行为于社会支持与心理健康之间关系调节作用显著。即随着社会支持行为水平的增强,社会支持对生命质量和心理健康的影响的调节效应逐渐降低直至消失。本研究中低于68.600分和65.475分的人分别有824位(72.92%)、763位(67.52%),说明大多老年群体的社会支持行为水平不高,且通过提高社会支持行为水平可有效提升多数老年人的生命质量及心理健康。
本研究结果显示,老年人生命质量得分为(64.81±16.45)分,其中生理健康得分为(61.69±18.02)分、心理健康得分为(67.93±17.70)分,老年人生命质量水平显著低于疫情爆发前我国常模水平[13]。老年人社会支持得分为(63.43±12.99)分、社会支持行为得分为(58.33±18.68)分,相较于非疫情状态[14],疫情状态下老年人的社会支持、社会支持行为得分更低。
老年人生命质量水平较低可能与两个方面的原因有关,一是本研究的研究对象多为中高龄老年人,相比于低龄老年人,中高龄老年人机体能力减退、失能风险高发等问题愈加明显,从而生命质量得分可能更低[15];二是疫情防控期间社交隔离等防护措施使老年人外出受限,社会隔离风险升高,身体活动频率降低,对老年人身心健康易造成负面影响,导致生命质量下降。这提示疫情后应关注老年人生命质量问题。政府及相关部门可推动社区养老服务建设,创建更好的社会支持环境,促进老年人身心健康的全面发展;社区可通过开展健康教育、文体活动等社区活动,帮助老年人建立和保持社会网络,营造老年友好的健康社区,以提升老年人生命质量。
本研究发现社会支持正向预测老年人生命质量,与已有研究结论一致[3,5,7],证实了假设1。这说明疫情防控下,社会支持仍旧是提高老年人生命质量的重要因素,特别是在心理健康方面。尽管在生理健康维度并未发现社会支持的显著影响路径,但心理健康维度的作用路径不容忽视,符合缓冲器模型的假设[16]。即社会支持可以作为对因新冠疫情产生的压力和心理状况的缓冲,减轻面对压力事件时对老年人的负面影响。因此,在疾病流行的背景下,可通过社会支持等积极缓冲使老年人社会隔离状况得到缓解,以满足老年人在其情感等方面的需求。
本研究发现社会支持行为调节社会支持与生命质量及心理健康维度的关系,证实了假设2。结合简单斜率图分析发现,特别是对于社会支持行为水平较低的老年人群,社会支持尤为重要。这可能是因为低社会支持行为的老年人,日常独立生活能力较强,社交活动更为活跃,社会支持来源丰富。而疫情爆发初期的防控措施下,社交活动受限,日常社会支持来源途径受阻,无法满足依旧强烈的社会支持需求,造成心理更加脆弱。提示低社会支持行为老年人群应为重点关注人群。此外,本研究利用Johnson-Neyman技术观察调节效应的变化情况发现社会支持行为分数低于临界值的老年人占本比50%以上,说明提高社会支持行为水平可有效提升多数老年人的生命质量和心理健康。已有研究证明核心家庭成员尤其是子女提供的照料和情感支持对提升老年人的身心健康具有积极作用[2]。且随着老年人年龄的增加,朋友支持对健康的影响更为突出[7,17]。建议社会层面引导老年人与子女和同辈进行积极有效的交流,提升不同来源的社会支持水平,从而促进老年人的生命质量。
本研究明晰了在疫情防控期间社会支持和社会支持行为对于老年人生命质量的影响路径,阐述不同类型的社会支持对于生命质量的作用,为相关政策的制定提供参考依据。但是,本研究也存在一定的局限性。本研究是横断面研究,无法说明社会支持类型对于老年人生命质量的影响机制,仅能提供干预路径参考;另外研究范围仅在东莞地区,未来有待进一步扩大调查范围,并开展干预研究,探索社会支持、社会支持行为和生命质量的作用机制。
  • 国家自然科学基金(71804029)
  • 广东省医学科研基金(C2018081)
  • 广东省普通高校特色创新类项目(2023KTSCX040)
  • 广东医科大学博士启动项目(B2019033)
  • 广东医科大学高水平学科建设工程项目(4SG22001G)
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doi: 10.20043/j.cnki.MPM.202304289
  • 接收时间:2023-04-18
  • 首发时间:2026-03-19
  • 出版时间:2024-02-25
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  • 收稿日期:2023-04-18
基金
国家自然科学基金(71804029)
广东省医学科研基金(C2018081)
广东省普通高校特色创新类项目(2023KTSCX040)
广东医科大学博士启动项目(B2019033)
广东医科大学高水平学科建设工程项目(4SG22001G)
作者信息
    1.广东医科大学公共卫生学院社会医学与卫生事业管理系,广东 东莞 523808
    2.广东医科大学公共卫生与健康研究院
    3.广东医科大学公共卫生学院流行病与卫生统计学系

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
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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