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Article(id=1241522924457358295, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202307081, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1688745600000, receivedDateStr=2023-07-08, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773931731571, onlineDateStr=2026-03-19, pubDate=1710000000000, pubDateStr=2024-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773931731571, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773931731571, creator=13701087609, updateTime=1773931731571, updator=13701087609, issue=Issue{id=1241522919977841545, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773931730503, creator=13701087609, updateTime=1773931880386, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241523548695622547, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241523548695622548, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=904, endPage=909, ext={EN=ArticleExt(id=1241522924860011515, articleId=1241522924457358295, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=A study on the relationship between childhood bullying and loneliness of the floating elderly in mega-cities, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the relationship between childhood bullying and loneliness of the floating elderly in mega-cities.

Methods

By using the method of quota sampling, an effective questionnaire survey was conducted among 1 000 migrant elderly people ≥ 60 years old in Qingyundian Town, Daxing District, Beijing in 2022. The information of social demography, loneliness, and childhood bullying were collected. Univariate analysis and ordinary least squares (OLS) regression model were used to analyze the relationship between childhood bullying and loneliness of the floating elderly in mega-cities.

Results

After adjusting demographic variables, socio-economic status variables, physical health variables, length of stay in Beijing, and proficiency in Mandarin and social integration, the loneliness scores of floating elderly people in mega-cities who suffered childhood bullying increased by an average of 5.616 (4.153-7.079) points. Self-rated health, Mandarin proficiency, marital satisfaction, and social integration played a regulatory role in“childhood bullying-loneliness”. Compared with model 1, the 95%CI of models 2, 3, and 4 changed from 8.014 (6.580-9.447) to 7.498 (6.027-8.968), 7.402 (5.961-8.843), and 5.616 (4.153-7.079), respectively. Sub-sample regression showed that the results were stable in different gender, age, household registration, and marriage and spouse mobility (all P < 0.01), but there were differences in education level.

Conclusion

The floating elderly in mega-cities who suffered childhood bullying have a higher level of loneliness, and self-rated health, proficiency of Mandarin, marital satisfaction, and social integration are helpful to weaken the above-mentioned relationship.

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目的

探索超大城市流动老年人遭受童年欺凌经历与老年期孤独感的关系。

方法

采用配额抽样方法，2022年在北京市大兴区青云店镇共完成1 000名≥60岁常住外来老年人的有效问卷调查，收集社会人口学、孤独感及童年欺凌等信息，采用单因素分析和最小二乘回归（OLS）模型分析超大城市流动老年人遭受童年欺凌经历与老年期孤独感的关系及其调节因素，最后进行分样本回归。

结果

在调整人口学特征变量、社会经济地位变量、躯体健康变量、来京时长、普通话掌握程度和社会融入变量后，遭受过童年欺凌的超大城市流动老年群体孤独感得分平均提高5.616(4.153～7.079)分，自评健康、普通话的掌握程度、婚姻关系满意度以及社会融入在“遭受童年欺凌-孤独感”中起调节作用，与模型1相比，模型2、3、4的β值(95%CI)由8.014(6.580～9.447)变为7.498(6.027～8.968)、7.402(5.961～8.843)、5.616(4.153～7.079)。分样本回归表明在不同性别、年龄、户籍、婚姻与配偶流动情况中结果稳健（均P<0.01），但在受教育程度中结果存在差异。

结论

遭受过童年欺凌的超大城市流动老年人孤独感水平更高，自评健康、普通话的掌握程度、婚姻关系满意度以及社会融入有助于削弱上述关系。

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罗雅楠，E-mail:
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刘娅婷与姚丹为共同第一作者

刘娅婷（2003—），女，本科在读，研究方向：老年精神卫生；

姚丹（1982—），女，主管医师，研究方向：疾病预防控制；

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刘娅婷（2003—），女，本科在读，研究方向：老年精神卫生；

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Univariate analysis of loneliness score of elderly migrants in mega cities ［n（%），（）］

, figureFileSmall=null, figureFileBig=null, tableContent=
因素统计描述得分（分）t/F值P值
是否遭受过童年欺凌
否697(69.70)29.51±9.79-9.855<0.001
是303(30.30)35.92±8.63
遭受童年欺凌频率0.34±0.5631.45±9.9049.430<0.001
性别
男532(53.20)32.08±9.71-2.130<0.001
女468(46.80)30.74±10.07
年龄[岁）
<70819(81.90)31.00±10.00-3.1010.001
≥70181(18.10)33.51±9.16
户籍
农业户籍932(93.20)31.22±9.802.7920.003
非农业户籍68(6.80)34.68±10.76
婚姻与配偶流动情况
无配偶43(4.30)29.28±10.468.870<0.001
有配偶且一起来北京582(58.20)30.55±10.56
有配偶但未来北京375(37.50)33.11±8.45
受教育程度
小学及以下670(67.00)30.67±9.596.6200.001
初中311(31.10)33.12±10.46
高中及以上19(1.90)31.84±8.03
家庭年收入对数（元）9.98±3.0231.45±9.893.460<0.001
自评健康
不好28(2.80)42.79±7.906.262<0.001
好972(97.20)31.13±9.76
来京时长（月）
<48470(47.00)31.30±10.15-1.3080.1912
≥48530(53.00)31.59±9.67
普通话掌握程度
弱65(6.50)37.43±8.365.099<0.001
强935(93.50)31.04±9.86
社会融入4.66±0.6031.45±9.898.400<0.001
婚姻关系满意度
不满意578(57.80)30.26±10.05-4.519<0.001
满意422(42.20)33.09±9.45
), ArticleFig(id=1241678331549110891, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522924457358295, language=CN, label=表1, caption=

超大城市流动老年人孤独感得分情况单因素分析［n（%），（）］

, figureFileSmall=null, figureFileBig=null, tableContent=
因素统计描述得分（分）t/F值P值
是否遭受过童年欺凌
否697(69.70)29.51±9.79-9.855<0.001
是303(30.30)35.92±8.63
遭受童年欺凌频率0.34±0.5631.45±9.9049.430<0.001
性别
男532(53.20)32.08±9.71-2.130<0.001
女468(46.80)30.74±10.07
年龄[岁）
<70819(81.90)31.00±10.00-3.1010.001
≥70181(18.10)33.51±9.16
户籍
农业户籍932(93.20)31.22±9.802.7920.003
非农业户籍68(6.80)34.68±10.76
婚姻与配偶流动情况
无配偶43(4.30)29.28±10.468.870<0.001
有配偶且一起来北京582(58.20)30.55±10.56
有配偶但未来北京375(37.50)33.11±8.45
受教育程度
小学及以下670(67.00)30.67±9.596.6200.001
初中311(31.10)33.12±10.46
高中及以上19(1.90)31.84±8.03
家庭年收入对数（元）9.98±3.0231.45±9.893.460<0.001
自评健康
不好28(2.80)42.79±7.906.262<0.001
好972(97.20)31.13±9.76
来京时长（月）
<48470(47.00)31.30±10.15-1.3080.1912
≥48530(53.00)31.59±9.67
普通话掌握程度
弱65(6.50)37.43±8.365.099<0.001
强935(93.50)31.04±9.86
社会融入4.66±0.6031.45±9.898.400<0.001
婚姻关系满意度
不满意578(57.80)30.26±10.05-4.519<0.001
满意422(42.20)33.09±9.45
), ArticleFig(id=1241678331914015348, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522924457358295, language=EN, label=Table 2, caption=

Multivariate analysis of childhood bullying and loneliness scores in the elderly migrants in mega cities

, figureFileSmall=null, figureFileBig=null, tableContent=
因素模型1模型2模型3模型4
β值（95%CI）P值β值（95%CI）P值β值（95%CI）P值β值（95%CI）P值
是否遭受过童年欺凌（对照：否）
是8.014(6.580～9.447)<0.0017.498(6.027～8.968)<0.0017.402(5.961～8.843)<0.0015.616(4.153～7.079)<0.001
性别（对照：女）
男-0.138(-1.314～1.039)0.818-0.076(-1.249～1 .097)0.899-0.545(-1.703～0.613)0.356-0.691( -1.813～0.430)0.227
年龄（岁，对照：<70）
≥702.503(0.994～4.011)0.0012.705(1.196～4.215)<0.0012.483(1.002～3.963)0.0012.246(0.813～3.680)0.002
户籍（对照：城市户籍）
农村户籍-0.875(-3.201～1.451)0.461-1.311(-3.647～1 .026)0.271-1.581(-3.871～0.710)0.176-1.834(-4.053～0.385)0.105
婚姻与配偶流动情况（对照：无配偶）
有配偶且一起来北京1.854(-1.034～4.741)0.2082.872(-0.088～5.831)0.0573.667(0 .758～6.575)0.0143.632(0.801～6.462)0.012
有配偶但配偶未来北京3.341(0.385～6.297)0.0274.082(1.095～7.070)0.0075.061(2.119～8.002)0.0014.501(1.611～7.392)0.002
受教育程度（对照：小学及以下）
初中3.311(2.050～4.571)<0.0013.206(1.948～4.464)<0.0013.354(2.121～4.587)<0.0013.317(2.121～4.514)<0.001
高中及以上1.623(-2.593～5.838)0.4501.879(-2.325～6.082)0.3812.014(-2.104～6.132)0.3381.700(-2.287～5.687)0.403
家庭年收入对数（元）0.644(0.421～0.867)<0.0010.681(0.458～0.905)<0.0010.668(0.449～0.887)<0.0010.317(0.086～0.548)0.007
婚姻关系满意度（对照：不满意）
满意1.884(0.603～3.166)0.0041.629(0.371～2.886)0.0110.568(-0.684～1.819)0.374
自评健康（对照：不好）
好-11.362(-14.785～-7.939)<0.001-6.343(-9.900～-2.786)<0.001
来京时长（月，对照：<48）
≥480.897(-0.270～2.063)0.132
普通话掌握程度（对照：弱）
强-3.050(-5.309～-0.792)0.008
社会融入-4.031(-5.106～-2.956)<0.001
), ArticleFig(id=1241678332207616632, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522924457358295, language=CN, label=表2, caption=

超大城市流动老年人是否遭受童年欺凌与老年期孤独感得分情况多因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素模型1模型2模型3模型4
β值（95%CI）P值β值（95%CI）P值β值（95%CI）P值β值（95%CI）P值
是否遭受过童年欺凌（对照：否）
是8.014(6.580～9.447)<0.0017.498(6.027～8.968)<0.0017.402(5.961～8.843)<0.0015.616(4.153～7.079)<0.001
性别（对照：女）
男-0.138(-1.314～1.039)0.818-0.076(-1.249～1 .097)0.899-0.545(-1.703～0.613)0.356-0.691( -1.813～0.430)0.227
年龄（岁，对照：<70）
≥702.503(0.994～4.011)0.0012.705(1.196～4.215)<0.0012.483(1.002～3.963)0.0012.246(0.813～3.680)0.002
户籍（对照：城市户籍）
农村户籍-0.875(-3.201～1.451)0.461-1.311(-3.647～1 .026)0.271-1.581(-3.871～0.710)0.176-1.834(-4.053～0.385)0.105
婚姻与配偶流动情况（对照：无配偶）
有配偶且一起来北京1.854(-1.034～4.741)0.2082.872(-0.088～5.831)0.0573.667(0 .758～6.575)0.0143.632(0.801～6.462)0.012
有配偶但配偶未来北京3.341(0.385～6.297)0.0274.082(1.095～7.070)0.0075.061(2.119～8.002)0.0014.501(1.611～7.392)0.002
受教育程度（对照：小学及以下）
初中3.311(2.050～4.571)<0.0013.206(1.948～4.464)<0.0013.354(2.121～4.587)<0.0013.317(2.121～4.514)<0.001
高中及以上1.623(-2.593～5.838)0.4501.879(-2.325～6.082)0.3812.014(-2.104～6.132)0.3381.700(-2.287～5.687)0.403
家庭年收入对数（元）0.644(0.421～0.867)<0.0010.681(0.458～0.905)<0.0010.668(0.449～0.887)<0.0010.317(0.086～0.548)0.007
婚姻关系满意度（对照：不满意）
满意1.884(0.603～3.166)0.0041.629(0.371～2.886)0.0110.568(-0.684～1.819)0.374
自评健康（对照：不好）
好-11.362(-14.785～-7.939)<0.001-6.343(-9.900～-2.786)<0.001
来京时长（月，对照：<48）
≥480.897(-0.270～2.063)0.132
普通话掌握程度（对照：弱）
强-3.050(-5.309～-0.792)0.008
社会融入-4.031(-5.106～-2.956)<0.001
), ArticleFig(id=1241678332522189440, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522924457358295, language=EN, label=Table 3, caption=

Relationship between childhood bullying and elderly loneliness among elderly migrants in mega cities with different characteristics

, figureFileSmall=null, figureFileBig=null, tableContent=
分层变量OLS
β值(95%CI)P值
性别男性6.462 (4.705～8.219)<0.001
女性4.589 (2.004～7.173)0.001
年龄（岁）<705.667 (3.963～7.371)<0.001
≥705.078 (2.123～8.034)0.001
户籍农业户籍4.869 (3.315～6.423)<0.001
非农业户籍10.686 (7.239～14.133)<0.001
婚姻与配偶流动情况无配偶&有配偶但配偶未来北京6.061 (4.331～7.791)<0.001
有配偶且一起来北京3.673 (1.321～6.026)0.002
受教育程度小学及以下5.820 (4.271～7.369)<0.001
初中3.706 (0.135～7.277)0.042
高中及以上19.617 (-5.782～45.016)0.115
), ArticleFig(id=1241678332954202754, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522924457358295, language=CN, label=表3, caption=

不同特征超大城市流动老年人遭受童年欺凌与老年期孤独感关系

, figureFileSmall=null, figureFileBig=null, tableContent=
分层变量OLS
β值(95%CI)P值
性别男性6.462 (4.705～8.219)<0.001
女性4.589 (2.004～7.173)0.001
年龄（岁）<705.667 (3.963～7.371)<0.001
≥705.078 (2.123～8.034)0.001
户籍农业户籍4.869 (3.315～6.423)<0.001
非农业户籍10.686 (7.239～14.133)<0.001
婚姻与配偶流动情况无配偶&有配偶但配偶未来北京6.061 (4.331～7.791)<0.001
有配偶且一起来北京3.673 (1.321～6.026)0.002
受教育程度小学及以下5.820 (4.271～7.369)<0.001
初中3.706 (0.135～7.277)0.042
高中及以上19.617 (-5.782～45.016)0.115
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超大城市流动老年人遭受童年欺凌经历与老年期孤独感的关系研究
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刘娅婷 1 , 姚丹 2 , 郭娜 3 , 李卓 4 , 张继艳 5 , 郑斐然 5 , 吴小平 6 , 洪晨璐 7 , 王延涛 8 , 罗雅楠 7
现代预防医学 | 健康与社会行为 2024,51(5): 904-909
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现代预防医学 | 健康与社会行为 2024, 51(5): 904-909
超大城市流动老年人遭受童年欺凌经历与老年期孤独感的关系研究
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刘娅婷1, 姚丹2, 郭娜3, 李卓4, 张继艳5, 郑斐然5, 吴小平6, 洪晨璐7, 王延涛8, 罗雅楠7
作者信息
  • 1.北京大学护理学院，北京 100191
  • 2.北京市经济技术开发区疾控中心，北京 100176
  • 3.中国人口与发展研究中心
  • 4.清华大学社会科学学院
  • 5.中央民族大学民族学与社会学学院
  • 6.中国社会科学院大学国际政治经济学院
  • 7.北京大学公共卫生学院全球卫生学系，北京 100191
  • 8.司法部预防犯罪研究所

    • 刘娅婷（2003—），女，本科在读，研究方向：老年精神卫生；

    姚丹（1982—），女，主管医师，研究方向：疾病预防控制；

通讯作者:

罗雅楠，E-mail:
A study on the relationship between childhood bullying and loneliness of the floating elderly in mega-cities
Ya-ting LIU1, Dan YAO2, Na GUO3, Zhuo LI4, Ji-yan ZHANG5, Fei-ran ZHENG5, Xiao-ping WU6, Chen-lu HONG7, Yan-tao WANG8, Ya-nan LUO7
Affiliations
  • School of Nursing, Peking University, Beijing 100191, China
出版时间: 2024-03-10 doi: 10.20043/j.cnki.MPM.202307081
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摘要
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目的

探索超大城市流动老年人遭受童年欺凌经历与老年期孤独感的关系。

方法

采用配额抽样方法，2022年在北京市大兴区青云店镇共完成1 000名≥60岁常住外来老年人的有效问卷调查，收集社会人口学、孤独感及童年欺凌等信息，采用单因素分析和最小二乘回归（OLS）模型分析超大城市流动老年人遭受童年欺凌经历与老年期孤独感的关系及其调节因素，最后进行分样本回归。

结果

在调整人口学特征变量、社会经济地位变量、躯体健康变量、来京时长、普通话掌握程度和社会融入变量后，遭受过童年欺凌的超大城市流动老年群体孤独感得分平均提高5.616(4.153～7.079)分，自评健康、普通话的掌握程度、婚姻关系满意度以及社会融入在“遭受童年欺凌-孤独感”中起调节作用，与模型1相比，模型2、3、4的β值(95%CI)由8.014(6.580～9.447)变为7.498(6.027～8.968)、7.402(5.961～8.843)、5.616(4.153～7.079)。分样本回归表明在不同性别、年龄、户籍、婚姻与配偶流动情况中结果稳健（均P<0.01），但在受教育程度中结果存在差异。

结论

遭受过童年欺凌的超大城市流动老年人孤独感水平更高，自评健康、普通话的掌握程度、婚姻关系满意度以及社会融入有助于削弱上述关系。

孤独感  /  童年欺凌  /  流动老年人  /  超大城市
Objective

To investigate the relationship between childhood bullying and loneliness of the floating elderly in mega-cities.

Methods

By using the method of quota sampling, an effective questionnaire survey was conducted among 1 000 migrant elderly people ≥ 60 years old in Qingyundian Town, Daxing District, Beijing in 2022. The information of social demography, loneliness, and childhood bullying were collected. Univariate analysis and ordinary least squares (OLS) regression model were used to analyze the relationship between childhood bullying and loneliness of the floating elderly in mega-cities.

Results

After adjusting demographic variables, socio-economic status variables, physical health variables, length of stay in Beijing, and proficiency in Mandarin and social integration, the loneliness scores of floating elderly people in mega-cities who suffered childhood bullying increased by an average of 5.616 (4.153-7.079) points. Self-rated health, Mandarin proficiency, marital satisfaction, and social integration played a regulatory role in“childhood bullying-loneliness”. Compared with model 1, the 95%CI of models 2, 3, and 4 changed from 8.014 (6.580-9.447) to 7.498 (6.027-8.968), 7.402 (5.961-8.843), and 5.616 (4.153-7.079), respectively. Sub-sample regression showed that the results were stable in different gender, age, household registration, and marriage and spouse mobility (all P < 0.01), but there were differences in education level.

Conclusion

The floating elderly in mega-cities who suffered childhood bullying have a higher level of loneliness, and self-rated health, proficiency of Mandarin, marital satisfaction, and social integration are helpful to weaken the above-mentioned relationship.

Loneliness  /  Childhood bullying  /  Floating elderly  /  Mega-city
刘娅婷, 姚丹, 郭娜, 李卓, 张继艳, 郑斐然, 吴小平, 洪晨璐, 王延涛, 罗雅楠. 超大城市流动老年人遭受童年欺凌经历与老年期孤独感的关系研究. 现代预防医学, 2024 , 51 (5) : 904 -909 . DOI: 10.20043/j.cnki.MPM.202307081
Ya-ting LIU, Dan YAO, Na GUO, Zhuo LI, Ji-yan ZHANG, Fei-ran ZHENG, Xiao-ping WU, Chen-lu HONG, Yan-tao WANG, Ya-nan LUO. A study on the relationship between childhood bullying and loneliness of the floating elderly in mega-cities[J]. Modern Preventive Medicine, 2024 , 51 (5) : 904 -909 . DOI: 10.20043/j.cnki.MPM.202307081
正文
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孤独感是老年人普遍面临的身心健康问题，在中国、印度、美国、欧洲和拉丁美洲地区，20%～34%的老年人感到孤独[1]。大量研究表明，孤独感对老年人的身心健康、生活质量和寿命均有严重影响[2-6]，会给社会带来沉重的经济负担，因此，孤独感被认为是老年人的一个优先公共卫生问题和政策问题，联合国“健康老龄化十年（2021—2030年）计划”将解决老年人的孤独问题作为四个主要行动领域的主题之一[7]。与一般老年人相比，超大城市流动老年人在“年龄”和“流动”双重弱势叠加下，往往面临语言文化差异、社会网络和社会支持缺乏以及歧视等问题，孤独感问题更加严重[8]。童年不良经历被证明与晚年孤独感有关[9-10]，童年欺凌作为主要的童年不良事件，对成人心理健康有长期不良影响[11]。有研究表明，在童年时期被长期欺负的老年男性更容易感到孤独，与没有童年被欺凌经历的人相比，童年遭受过欺凌的人在老年时期伴有更严重的抑郁症状，也可能对生活更不满意[12]。与一般城市老年人相比，超大城市老年人由于面临严格的户口准入制度与不平等性，在社会身份、经济地位方面处于更加劣势，缺乏与当地居民的有效融合，这可能使他们的孤独感问题更加严重[13-15]。目前没有针对超大城市流动老年人童年欺凌和老年期孤独感问题的研究，本研究以北京市大兴区青云店镇流动老年人为例，探究遭受童年欺凌与晚年孤独感的关系，以期为降低老年人孤独感和实现健康老龄化目标提供科学证据和解决思路。
1　资料与方法
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1.1　资料来源
本研究所用资料来源于课题组在2022年8—10月北京市大兴区青云店镇开展的超大城市流动老年人精神健康问卷调查。第七次全国人口普查显示，大兴区外省来京人口为1 017 900人，占常住人口的51.1%，是北京市外来人口大于100万的四个区域之一。青云店镇是外来人口占比较大的区域，外来人口占比超过50%。根据第七次全国人口普查，至2020年11月1日零时，青云店镇人口数为6.96万人，人口密度为1 738人/km2，可满足研究需求。
1.2　研究对象
调查对象为现居地在北京市半年以上，但户口登记在外省市且年龄为60周岁及以上的常住外来老年人。因该群体流动性强，缺乏在京户籍信息，难以制定完整抽样框和采用分层多阶段等概率抽样。因此，本研究从青云店镇51个社区/行政村中随机抽取11个社区/行政村（东店村、西鲍辛庄村、东鲍辛庄村、大东新村、北店村、北辛屯村、北野场村、垡上营村、大谷店村、曹村、沙堆营村），针对每个社区采用配额抽样的方式进行调查。配额抽样比例依据最新一期的中国流动人口动态监测调查数据（2018年）关于北京市60岁及以上老年人口的社会人口特征比例（性别、年龄结构比）进行调查。样本量计算以老年人孤独感为主要依据指标，根据文献资料中国老年人孤独感发生率29.6%[16]，以95%的可信度，允许误差3.4%，则样本量至少为730人，考虑到80%应答率，应调查人数为913名，本研究实际调查1 042人，排除逻辑错误后，获得有效样本1 000份，满足研究所需样本量。
1.3　调查方法
由北京市大兴区青云店镇社区服务中心医务人员作为调查员，经过统一培训后，调查员以线下面对面问答的方式开展问卷调查，所有调查对象均已签署知情同意书。问卷调查内容包括调查对象的基本社会人口信息、流动经历家庭状况、社区居住情况、童年时期经历、躯体健康状况、精神健康状况、医疗服务利用以及社会适应情况等多个方面的内容。该调查通过了北京大学生物医学伦理委员会审查批准（批件号为：IRB00001052-22059）。
1.4　研究方法
（1）孤独感评估：UCLA孤独量表（University of California at Los Angeles, UCLA loneliness scale）由Russell等编制，中文版量表包括正序条目11个与反序条目9个，共20个条目[17-18]，每个条目均采用4级评分，即从不、很少、有时、一直，依次得分为1～4分，反序条目则反向计分。量表总分为20～80分，得分越高孤独感程度越深。该量表的Cronbach α系数为0.89[19]。
（2）童年欺凌评估：通过询问调查对象“在您小时候，在学校是不是被其他同学欺负？”和“在您小时候，是不是被邻居孩子欺负？”两个问题测量，选项分为“从没有”“很少”“有时”“经常”四类进行自评打分，并依次以0～3分进行赋值，由此产生变量“是否遭受过童年欺凌”（0=否，1=是）[4]。
（3）其他协变量：包括性别、年龄、户籍、婚姻及配偶流动状况等人口学特征变量，受教育程度、家庭年收入等社会经济地位变量，自评健康等躯体健康情况，以及来京时长、普通话的掌握程度、社会融入和婚姻关系满意度等变量。其中，社会融入变量通过社会融入量表（community integration measure, CIM）测量[20]，该量表主要用于测量社区融合程度，或者测量社会归属感和社区独立活动能力，共包含10个项目，每个项目1～5分，对应非常不同意至非常同意5种程度。本文通过主成分分析法计算社会融入量表综合得分，得分范围为1.70～5.00分。
1.5　统计学方法
采用STATA 17.0 SE软件进行数据分析。计数资料采用频数、百分比（%）进行统计描述，计量资料采用（均数±标准差）进行统计描述；单因素分析采用t检验、方差分析；采用OLS（普通最小二乘）回归模型进行分析童年欺凌经历和超大城市流动老年人孤独感之间的关联。本文以孤独感得分为因变量，分别以是否遭受童年欺凌和遭受童年欺凌频率为自变量。由于老年人孤独感水平受人口学特征（性别、年龄、户籍、婚姻状况等）、社会经济地位特征（受教育年限、收入等）、其他变量（自评健康、来京时长、普通话掌握程度、社会融入、婚姻关系满意度）影响，故将上述变量逐步放入多元线性回归模型，构建四个模型，分析童年欺凌与超大城市流动老年人孤独感的关系，并通过比较童年欺凌以及童年欺凌频率的偏回归系数(β)值，来研究婚姻关系满意度、自评健康、来京时长、普通话掌握程度、社会融入在“童年欺凌-孤独感”中的调节作用。其中，模型1：控制了性别、年龄、户籍、婚姻与配偶流动情况；模型2：在模型1的基础上，调整婚姻关系满意度变量；模型3：在模型2基础上，调整自评健康变量；模型4：在模型3基础上，调整来京时长、普通话掌握程度、社会融入变量。最后以性别、年龄、户籍和来京时长进行分样本回归，检验结果稳健性。双侧检验，检验水准α=0.05。
2　结果
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2.1　一般情况
共纳入有效样本1 000名，其中男性532名（53.20%），女性468名（46.80%）。年龄在70岁以下的为819名（81.90%），年龄在70岁及以上的为181名（18.10%）。小学及以下文化程度者最多，占67.00%。遭受过童年欺凌的老年人为303名（30.30%），未遭受过童年欺凌的老年人为697名（69.70%）。本研究超大城市流动老年人的平均孤独感得分为31.45，标准差为9.89。见表1。
2.2　超大城市流动老年人孤独感得分情况单因素分析
通过比较不同人口学特征下超大城市老年孤独感得分差异，结果显示是否遭受过童年欺凌、性别、年龄、户籍、婚姻与配偶流动情况、受教育程度、家庭年收入对数、自评健康、普通话掌握程度、社会融入、婚姻关系满意度与孤独感得分相关统计学意义显著（均P<0.01），来京时长与孤独感得分在5%的显著性水平下无显著相关性。见表1。
2.3　童年欺凌与超大城市流动老年人孤独感的最小二乘回归（OLS）关系分析
如表2所示，遭受过童年欺凌与超大城市流动老年人孤独感得分之间存在正向关联，初步控制人口学特征和社会经济地位因素后，与未遭受过童年欺凌的超大城市流动老年人相比，遭受过童年欺凌的超大城市流动老年人孤独感得分更高（β=8.014，P<0.001）。与模型1比较，调整婚姻关系满意度、自评健康、来京时长、普通话掌握程度和社会融入后，模型2、3、4中的是否遭受过童年欺凌与孤独感得分之间的关系削弱，β值由8.014变为7.498、7.402、5.616（除“来京时长”外，其余变量均P<0.001）。这说明，婚姻关系满意度、自评健康、普通话掌握程度和社会融入在该关系中起调节作用，而来京时长的调节作用在统计学上不具有显著性。
2.4　超大城市流动老年人遭受童年欺凌经历与老年期孤独感关系的分样本分析
表3显示超大城市流动老年人是否遭受童年欺凌与老年期孤独感以基础模型变量进行的分样本回归的统计分析结果：在不同性别、年龄、户籍、婚姻与配偶流动情况中结果稳健，但在受教育程度中结果存在差异，在学历为小学及以下群体中“遭受童年欺凌-孤独感”关系最强（β=5.820，P<0.001），学历为初中群体中关系次之（β=3.706，P<0.042），高中群体中关系不显著。
3　讨论
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本研究以北京市大兴区青云店镇流动老年人为例，研究了遭受童年欺凌和超大城市流动老年人孤独感的关系，结果证明遭受过童年欺凌的流动老年人孤独感水平更高，自评健康、普通话的掌握程度、婚姻关系满意度以及社会融入对上述关系有调节作用。
本研究发现，遭受过童年欺凌的流动老年人比未遭受过童年欺凌的流动老年人孤独感水平更高。目前，尚缺乏童年欺凌和超大城市流动老年群体孤独感水平关系的证据，孤独感是老年人心理健康的一个重要方面[21]，童年欺凌受害对心理健康的影响可以持续到成年、中年甚至老年[11-12]。两者的关联机制可能来源于：童年欺凌经历对晚年孤独感有直接和间接影响[12,22]。一方面，在童年时期反复暴露于不良事件促使体内压力管理系统过度激活和失活，导致儿童大脑受损，并随着时间的推移影响其生长和发育甚至功能[23]，有研究发现31～51岁报告被童年欺凌的人有更高的抑郁风险[24]。另一方面，童年欺凌经历通过其他生活结局间接影响晚年孤独感[22，25]。童年不良经历引起的心理问题可能伴随自我调节能力和认知能力的下降，并导致后续生活的其他逆境。有研究表明童年时期被欺负与成年经济困难有关[26]，而成年经济困难与老年心理健康有关[27]，这说明童年时期遭受欺凌可能会通过成年时期经济状况间接影响老年人心理健康问题。
本研究做进一步分析发现，非农业户籍超大城市流动老年人的孤独感平均得分显著高于农业户籍超大城市流动老年人，这是可能是由于非农业户籍的流动老年人照顾子孙占比，为85.29%，大于农业户籍流动老年人的60.62%，非农业户籍流动老年人与家人同住比例更高，社会关系主要集中在家庭，而家庭关系并没有满足他们的情感需求[28]。本研究结果还表明，对婚姻关系满意的超大城市流动老年人的孤独感平均得分显著高于对婚姻关系不满意的超大城市流动老年人，这是由于本研究超大城市流动老年人的孤独感不仅是单纯由于婚姻满意度所决定的，还与配偶的随迁情况有关。在本文数据中，对婚姻关系满意的流动老年人的配偶随迁的比例为42.18%，低于对婚姻关系不满意的流动老年人的69.90%。因此，很可能是因为对婚姻关系满意的超大城市流动老年人无法长期与配偶一起生活，从而导致其孤独感更高。
本研究结果表明，自评健康、普通话的掌握程度、婚姻关系满意度和社会融入对“遭受童年欺凌-孤独感水平”具有调节作用。一方面，自评健康好的老年人身体机能、自理能力和生活满意度均较高，更有能力去参与社交活动，拓展社会网络，从而降低孤独感[29-30]。另一方面，和谐的婚姻关系使流动老年人获得可靠的情感和家庭支持，孤独感也较低[31-32]。老年人从家乡迁移到超大城市，面临着城乡地区之间的巨大差异所带来的日常生活变化、方言差异的交流困局、风俗人情差异等问题，普遍存在着社会生活和心理适应问题，在人际关系上，与本地人交流较少，部分流动老人基本不参加集体活动，社会融入较差[33-34]。因此，较好的普通话掌握程度和较高的社会融入水平利于老年人适应社会，从而降低老年人孤独感水平。
本文是第一个针对超大城市流动老年人探讨其童年欺凌与孤独感关系的研究，但仍存在以下局限性。第一，本文使用的童年欺凌数据为自我报告的回溯性数据，可能存在回忆性偏倚问题。但Rivers[35]发现，人们对欺凌受害的记忆随着时间的推移是稳定和可靠的，并得出结论，这些信息在回顾性研究中是可以使用的。另外，Patten等人[36]利用追踪和回顾性数据进行的研究得到了类似的结果，一定程度上验证了使用回顾性数据进行研究的可信性。第二，无法控制儿童时期的行为问题及遗传因素和成年期重大事件等可能干扰童年欺凌和老年孤独感关系的混杂因素变量。
综上所述，本研究发现遭受过童年欺凌的超大城市流动老年人孤独感水平更高，自评健康、普通话的掌握程度、婚姻关系满意度以及社会融入对其关系有调节作用，这将为政府和社会各界联合采取行动来减少老年人孤独问题提供思路，未来研究将侧重于童年欺凌对社会和历史背景不同的老年人的孤独感的影响以及其影响机制的深入分析。
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  • 超大城市流动人口的精神健康风险评估与应对策略研究(21CRK014)
  • 人口老龄化背景下的残疾预防策略与应用研究(21&ZD187)
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doi: 10.20043/j.cnki.MPM.202307081
  • 接收时间：2023-07-08
  • 首发时间：2026-03-19
  • 出版时间：2024-03-10
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  • 收稿日期：2023-07-08
基金
超大城市流动人口的精神健康风险评估与应对策略研究(21CRK014)
人口老龄化背景下的残疾预防策略与应用研究(21&ZD187)
作者信息
    1.北京大学护理学院，北京 100191
    2.北京市经济技术开发区疾控中心，北京 100176
    3.中国人口与发展研究中心
    4.清华大学社会科学学院
    5.中央民族大学民族学与社会学学院
    6.中国社会科学院大学国际政治经济学院
    7.北京大学公共卫生学院全球卫生学系，北京 100191
    8.司法部预防犯罪研究所

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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