Article(id=1321170564375494697, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170430187130949, articleNumber=null, orderNo=null, doi=10.11847/zgggws1145381, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1720281600000, receivedDateStr=2024-07-07, revisedDate=1727366400000, revisedDateStr=2024-09-27, acceptedDate=1737648000000, acceptedDateStr=2025-01-24, onlineDate=1792921208708, onlineDateStr=2026-10-25, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921208708, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921208708, creator=13701087609, updateTime=1792921208708, updator=13701087609, issue=Issue{id=1321170430187130949, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='2', pageStart='129', pageEnd='256', issueExtLink='null', onlineDate='null', pubDate='1739116800000', pubDateStr='2025-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921176716, creator='13701087609', updateTime=1792921176716, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=182, endPage=186, ext={EN=ArticleExt(id=1321170564547461162, articleId=1321170564375494697, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Influence of activities of daily living on feelings of uselessness among older adults in China, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the influence of activities of daily living (ADL) on feelings of uselessness among older adults in China, and the role of attitudes toward aging and age on this relationship, to provide a reference for developing health education and intervention strategies for older adults, and to effectively address the challenges of population aging.

Methods

Study data on 10 883 residents aged 60–98 years were collected from a wave of the China Longitudinal Aging Social Survey (CLASS) conducted in 2020 in 28 provincial-level administrative divisions across China in 2020. A moderated mediation model was used to analyze the relationships among ADL, attitudes toward aging , age, and feelings of uselessness. Statistical analysis and moderated mediation effect tests were conducted using SPSS 26.0 and its PROCESS 4.1 plug-in (Model 5).

Results

For all the participants with a mean age of 71.5±6.6 years, the number (percentage) of individuals who reported feeling useless often, sometimes, and never were 1 729 (15.89%), 4 582 (42.10%), and 4 572 (42.0%), and the mean scores for feelings of uselessness, ADL, and attitudes toward aging were 0.739±0.715, 0.238±1.075, and 14.311±3.638, respectively. Correlation analysis showed that the mean score of feelings of uselessness was positively correlated with the mean scores of ADL (r=0.140), attitudes toward aging (r=0.148), and mean age (r=0.163) (all P<0.001). Poorer ADL, more negative attitudes toward aging, and older age were associated with a greater feelings of uselessness. After controlling for gender, education, marital status, number of cohabitants, household registration, and self-rated economic status, the moderated mediation model analysis showed that ADL had a direct effect on feelings of uselessness (β=0.082, P<0.001); attitudes toward aging had an indirect effect on feelings of uselessness (β=0.010, P<0.001); and age played a negative moderating role on the influence of ADL on feelings of uselessness (β= –0.003, P=0.001).

Conclusions

Poorer ADL was associated with greater feelings of uselessness among older adults in China. Attitudes toward aging became more negative as ADL declined, indirectly increasing feelings of uselessness. However, the influence of ADL on feelings of uselessness gradually decreased with increasing age.

, authors=Jing GUO1, Yao YANG2, Pei WANG2, Yanan WANG2, He LIU2, Zirui WANG2, Libo ZHOU3, Yuan YAO4, authorsList=Jing GUO, Yao YANG, Pei WANG, Yanan WANG, He LIU, Zirui WANG, Libo ZHOU, Yuan YAO, authorCompany=null, correspAuthors=Yao YANG, authorNote=null, correspAuthorsNote=
YANG Yao, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321170567219232815, articleId=1321170564375494697, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=中国老年人日常生活活动能力对其无用感影响, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的

了解中国老年人日常生活活动能力对其无用感的影响及老化态度和年龄在其中发挥的作用,为制定老年健康教育与干预策略、有效应对人口老龄化挑战提供参考依据。

方法

收集2020年中国老年社会追踪调查(CLASS)数据中28个省级行政区10 883名60~98岁老年人的相关数据,采用有调节的中介模型对其日常生活活动能力、老化态度和年龄与无用感之间的关系进行分析,并应用SPSS 26.0及其插件PROCESS 4.1中的Model 5进行统计学分析及有调节的中介效应检验。

结果

中国10 883名60~98岁老年人中,平均年龄为(71.5±6.6)岁,经常、有时和没有感受到无用感者分别为1 729人(15.89%)、4 582人(42.10%)和4 572人(42.01%);中国老年人无用感、日常生活活动能力和老化态度平均得分分别为(0.739±0.715)、(0.238±1.075)和(14.311±3.638)分。相关分析结果显示,老年人无用感平均得分与日常生活活动能力平均得分(r=0.140)、老化态度平均得分(r=0.148)和平均年龄(r=0.163)均呈正相关(均P<0.001),老年人日常生活活动能力越差、老化态度越消极、年龄越大,其无用感越强烈;在控制了性别、文化程度、婚姻状况、同住人数量、户籍和自评经济状况等混杂因素后,有调节的中介模型分析结果显示,老年人日常生活活动能力对其无用感存在直接影响(β=0.082,P<0.001),老化态度对无用感存在间接影响(β=0.010,P<0.001),年龄在日常生活活动能力对无用感的影响机制中发挥负向调节作用(β= –0.003,P=0.001)。

结论

中国老年人日常生活活动能力越差,其无用感越强;老化态度会随日常生活活动能力的下降而愈发消极,间接增加老年人的无用感,但随着年龄增长,老年人日常生活活动能力对其无用感的影响会逐渐减小。

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郭静(1973—),副教授,博士生导师,博士,研究方向:老年人健康教育、健康促进

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杨瑶,E-mail:
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age) on feelings of uselessness in Chinese older adults: mediation model analysis of 2020 CLASS data (A denotes P<0.05), figureFileSmall=T2ooohy0JRAzgRA50vTUZw==, figureFileBig=62+shiIly23gbh4g35lWOA==, tableContent=null), ArticleFig(id=1321170572113985647, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170564375494697, language=CN, label=图1, caption=中国老年人日常生活活动能力对其无用感影响有调节的中介模型分析图

注:a P<0.05。

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Influence of activities of daily living on feelings of uselessness (Models I/Ⅲ/Ⅳ) and attitudes toward aging (Model Ⅱ) in Chinese older adults: mediation model analysis of 2020 CLASS data (with gender, education, marital status, number of cohabitants, registered residence and self-rated economic status as control variables, attitudes toward aging as a mediator and age as a modifier or a interactive variable on activities of daily living in Model Ⅳ)

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变量模型Ⅰ模型Ⅱ模型Ⅲ模型Ⅳ
(Y=无用感)(Y=老化态度)(Y=无用感)(Y=无用感)
β值t值P值β值t值P值β值t值P值β值t值P值
日常生活活动能力0.08513.40<0.0010.39512.17<0.0010.0629.61<0.0010.2704.26<0.001
老化态度0.02412.87<0.0010.02412.95<0.001
年龄0.01110.09<0.0010.01210.56<0.001
日常生活活动能力×年龄–0.003–3.300.001
性别–0.033–2.420.0160.1341.890.059–0.047–3.450.001–0.048–3.470.001
文化程度–0.061–10.96<0.001–0.161–5.67<0.001–0.044–7.74<0.001–0.043–7.68<0.001
婚姻状况–0.056–3.450.001–0.152–1.820.068–0.012–0.740.460–0.013–0.760.447
同住人数量–0.003–0.540.5870.0973.69<0.001–0.007–1.430.152–0.007–1.310.189
户籍0.0241.650.1000.5777.73<0.001–0.002–0.120.9080.0010.050.960
自评经济状况0.0201.560.1180.1963.060.0020.0131.040.3000.0131.080.281
), ArticleFig(id=1321170572566970483, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170564375494697, language=CN, label=表1, caption=

中国老年人日常生活活动能力对其无用感影响有调节的中介模型分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型Ⅰ模型Ⅱ模型Ⅲ模型Ⅳ
(Y=无用感)(Y=老化态度)(Y=无用感)(Y=无用感)
β值t值P值β值t值P值β值t值P值β值t值P值
日常生活活动能力0.08513.40<0.0010.39512.17<0.0010.0629.61<0.0010.2704.26<0.001
老化态度0.02412.87<0.0010.02412.95<0.001
年龄0.01110.09<0.0010.01210.56<0.001
日常生活活动能力×年龄–0.003–3.300.001
性别–0.033–2.420.0160.1341.890.059–0.047–3.450.001–0.048–3.470.001
文化程度–0.061–10.96<0.001–0.161–5.67<0.001–0.044–7.74<0.001–0.043–7.68<0.001
婚姻状况–0.056–3.450.001–0.152–1.820.068–0.012–0.740.460–0.013–0.760.447
同住人数量–0.003–0.540.5870.0973.69<0.001–0.007–1.430.152–0.007–1.310.189
户籍0.0241.650.1000.5777.73<0.001–0.002–0.120.9080.0010.050.960
自评经济状况0.0201.560.1180.1963.060.0020.0131.040.3000.0131.080.281
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中国老年人日常生活活动能力对其无用感影响
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郭静 1 , 杨瑶 2, *, * , 王沛 2 , 王雅楠 2 , 刘荷 2 , 王子睿 2 , 周立波 3 , 姚远 4
中国公共卫生 | 调查报告与分析 2025,41(2): 182-186
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中国公共卫生 |调查报告与分析 2025 , 41 (2) : 182 -186
中国老年人日常生活活动能力对其无用感影响
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郭静(1973—),副教授,博士生导师,博士,研究方向:老年人健康教育、健康促进

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郭静1, 杨瑶2, *, * , 王沛2, 王雅楠2, 刘荷2, 王子睿2, 周立波3, 姚远4
作者信息
  • 1中国人民大学人口与发展研究中心 中国人民大学国家治理大数据和人工智能创新平台健康与医改政策子实验室,北京 100872
  • 2中国人民大学人口与健康学院,北京 100872
  • 3山东大学齐鲁医院科研处,济南 250012
  • 4中国人民大学社会学院,北京 100872
通讯作者:
杨瑶,E-mail:
作者简介:

郭静(1973—),副教授,博士生导师,博士,研究方向:老年人健康教育、健康促进

Influence of activities of daily living on feelings of uselessness among older adults in China
Jing GUO1, Yao YANG2 , Pei WANG2, Yanan WANG2, He LIU2, Zirui WANG2, Libo ZHOU3, Yuan YAO4
Affiliations
  • 1Center for Population and Development Studies, Health and Reform Policy Sub-Laboratory, Bigdata and Responsible Artificial Intelligence for National Governance, Renmin University of China, Beijing 100872, China
  • 2School of Population and Health, Renmin University of China, Beijing 100872, China
  • 3Department of Science and Technology, Qilu Hospital of Shandong University, Jinan 250012, China
  • 4School of Sociology, Renmin University of China, Beijing 100872, China
  • Corresponding Author:
    YANG Yao, E-mail:
出版时间: 2025-02-10 doi: 10.11847/zgggws1145381
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目的

了解中国老年人日常生活活动能力对其无用感的影响及老化态度和年龄在其中发挥的作用,为制定老年健康教育与干预策略、有效应对人口老龄化挑战提供参考依据。

方法

收集2020年中国老年社会追踪调查(CLASS)数据中28个省级行政区10 883名60~98岁老年人的相关数据,采用有调节的中介模型对其日常生活活动能力、老化态度和年龄与无用感之间的关系进行分析,并应用SPSS 26.0及其插件PROCESS 4.1中的Model 5进行统计学分析及有调节的中介效应检验。

结果

中国10 883名60~98岁老年人中,平均年龄为(71.5±6.6)岁,经常、有时和没有感受到无用感者分别为1 729人(15.89%)、4 582人(42.10%)和4 572人(42.01%);中国老年人无用感、日常生活活动能力和老化态度平均得分分别为(0.739±0.715)、(0.238±1.075)和(14.311±3.638)分。相关分析结果显示,老年人无用感平均得分与日常生活活动能力平均得分(r=0.140)、老化态度平均得分(r=0.148)和平均年龄(r=0.163)均呈正相关(均P<0.001),老年人日常生活活动能力越差、老化态度越消极、年龄越大,其无用感越强烈;在控制了性别、文化程度、婚姻状况、同住人数量、户籍和自评经济状况等混杂因素后,有调节的中介模型分析结果显示,老年人日常生活活动能力对其无用感存在直接影响(β=0.082,P<0.001),老化态度对无用感存在间接影响(β=0.010,P<0.001),年龄在日常生活活动能力对无用感的影响机制中发挥负向调节作用(β= –0.003,P=0.001)。

结论

中国老年人日常生活活动能力越差,其无用感越强;老化态度会随日常生活活动能力的下降而愈发消极,间接增加老年人的无用感,但随着年龄增长,老年人日常生活活动能力对其无用感的影响会逐渐减小。

日常生活活动能力  /  无用感  /  影响  /  老年人  /  中国
Objective

To understand the influence of activities of daily living (ADL) on feelings of uselessness among older adults in China, and the role of attitudes toward aging and age on this relationship, to provide a reference for developing health education and intervention strategies for older adults, and to effectively address the challenges of population aging.

Methods

Study data on 10 883 residents aged 60–98 years were collected from a wave of the China Longitudinal Aging Social Survey (CLASS) conducted in 2020 in 28 provincial-level administrative divisions across China in 2020. A moderated mediation model was used to analyze the relationships among ADL, attitudes toward aging , age, and feelings of uselessness. Statistical analysis and moderated mediation effect tests were conducted using SPSS 26.0 and its PROCESS 4.1 plug-in (Model 5).

Results

For all the participants with a mean age of 71.5±6.6 years, the number (percentage) of individuals who reported feeling useless often, sometimes, and never were 1 729 (15.89%), 4 582 (42.10%), and 4 572 (42.0%), and the mean scores for feelings of uselessness, ADL, and attitudes toward aging were 0.739±0.715, 0.238±1.075, and 14.311±3.638, respectively. Correlation analysis showed that the mean score of feelings of uselessness was positively correlated with the mean scores of ADL (r=0.140), attitudes toward aging (r=0.148), and mean age (r=0.163) (all P<0.001). Poorer ADL, more negative attitudes toward aging, and older age were associated with a greater feelings of uselessness. After controlling for gender, education, marital status, number of cohabitants, household registration, and self-rated economic status, the moderated mediation model analysis showed that ADL had a direct effect on feelings of uselessness (β=0.082, P<0.001); attitudes toward aging had an indirect effect on feelings of uselessness (β=0.010, P<0.001); and age played a negative moderating role on the influence of ADL on feelings of uselessness (β= –0.003, P=0.001).

Conclusions

Poorer ADL was associated with greater feelings of uselessness among older adults in China. Attitudes toward aging became more negative as ADL declined, indirectly increasing feelings of uselessness. However, the influence of ADL on feelings of uselessness gradually decreased with increasing age.

activities of daily living  /  feeling of uselessness  /  influence  /  older adults  /  China
郭静, 杨瑶, 王沛, 王雅楠, 刘荷, 王子睿, 周立波, 姚远. 中国老年人日常生活活动能力对其无用感影响. 中国公共卫生, 2025 , 41 (2) : 182 -186 . DOI: 10.11847/zgggws1145381
Jing GUO, Yao YANG, Pei WANG, Yanan WANG, He LIU, Zirui WANG, Libo ZHOU, Yuan YAO. Influence of activities of daily living on feelings of uselessness among older adults in China[J]. Chinese Journal of Public Health, 2025 , 41 (2) : 182 -186 . DOI: 10.11847/zgggws1145381
近年来,中国正逐步迈入中度老龄化社会,第七次全国人口普查数据显示,我国≥60岁人口已达2.6亿,占总人口的18.70%,较第六次人口普查增长了5.44%[1]。随着老龄化趋势的不断加深,如何积极应对人口老龄化、构建老年友好型社会已成为亟待解决的重要社会议题,而老年人的健康状况则是这一议题的关键要素之一[2]。日常生活活动能力是衡量老年人健康状况的重要指标[3],直接反映了老年人失能或部分失能的程度,对老年人的心理健康和生活质量均有明显影响[4–5],研究表明目前我国失能或部分失能老年人数量已>4400万[6],其规模之大不容忽视。无用感是老年人自我歧视的主要表现,是老年人对自身有用性和重要性的否定评价,对老年人的思想和行为方式均产生消极影响,甚至会增加死亡风险[7],目前我国已有>2 500万老年人总是或经常感受到无用感[8],因此老年人无用感已成为我国公共健康的一大挑战。老化态度是老年人对自身衰老过程及年老的认知和主观评价,与老年人的心理健康同样密切相关[9–10],积极的老化态度有助于保持良好的身体和心理健康,而消极的老化态度则会导致老年人对负性事件更为敏感,引发更多的不适应行为[11]。此外,年龄是日常生活活动能力和无用感的重要影响因素,随着年龄增长,老年人身体功能逐渐衰退,日常生活活动能力也随之下降,且年龄越大的老年人感受到的无用感越强,这在很大程度上与日常生活活动能力的下降有关[12–13]。但目前鲜有研究系统阐述日常生活活动能力等健康指标对老年人无用感的影响机制,因此,本研究收集2020年中国老年社会追踪调查(China Longitudinal Aging Social Survey,CLASS)数据中国28个省级行政区10 883名60~98岁老年人的相关数据,采用有调节的中介模型对其日常生活活动能力、老化态度和年龄与无用感之间的关系进行分析,旨在了解中国老年人日常生活活动能力对其无用感的影响及老化态度和年龄在其中发挥的作用,为制定老年健康教育与干预策略、有效应对人口老龄化挑战提供参考依据。结果报告如下。
资料来源于CLASS,该调查是由中国人民大学组织实施的全国性、连续性大型社会调查,采用分层多阶段概率抽样方法在28个省级行政区(香港、澳门、台湾、海南、新疆、西藏地区除外)开展调查,该数据库免费向社会公开,申请后经其审核可下载使用。本研究收集其中2020年调查的10 883名60~98岁老年人的相关数据,内容包括性别、年龄、文化程度、婚姻状况、同住人数量、户籍、自评经济状况、日常生活活动能力情况、无用感情况和老化态度情况等。其中,日常生活活动能力是个体参与日常生活活动的能力,反映个体的健康状况和生活质量[3],本研究采用躯体生活自理量表(physical self-maintenance scale, PSMS)[14]进行测量,该量表包括穿衣、洗澡、吃饭、如厕、上下床和室内走动6个项目,每个项目按“不需要别人帮助”“需要一些帮助”和“完全做不了”分别计0、1和2分,6个项目总分为0~12分,总分越高代表日常生活活动能力越差;无用感是一种负面情绪,即个体认为自己对家庭或社会失去价值[15],本研究采用 CLASS 问卷中“您觉得自己不中用了吗?”这一问题进行测量,回答“没有”“有时”和“经常”分别计0、1和2分,得分为0~2分,得分越高代表无用感越强;老化态度是个体对变老过程及年老的体验和评价,对身心健康有重要影响[16],本研究采用老化态度问卷(the attitudes toward a ageing questionnaire, AAQ)[17]进行测量,该问卷包括“我觉得我已经老了”“在我看来,变老就是一个不断失去的过程”“老了以后,我发觉更难交到新朋友了”“因为我的年龄,我感到我被排斥在一边”“年龄越大的人,处理生活问题的能力越强”“智慧随年龄而增长”和“变老也有许多令人愉快的事”7个问题,每个问题回答从“完全不同意”到“完全同意”分为5个程度,前4个问题依次计0、1、2、3和4分,后3个问题依次计4、3、2、1和0分,总分为0~28分,总分越高代表老化态度越消极。
使用SPSS 26.0及其插件PROCESS 4.1中的Model 5进行统计学分析及有调节的中介效应检验[18–19]。采用Pearson相关分析变量间关系。将性别、文化程度、婚姻状况、同住人数量、户籍和自评经济状况等变量作为控制变量,采用回归分析进行有调节的中介效应分析:(1)分析日常生活活动能力对无用感的直接影响;(2)分析老化态度的中介作用和年龄的调节作用;(3)有调节的中介效应检验:一是通过逐步检验模型中的各个路径系数,评估调节变量对中介效应的影响;二是采用中介效应差异检验,利用基于偏差校正的非参数百分位Bootstrap方法计算中介效应及其95%CI,Bootstrap抽样次数设定为5000次;三是使用Johnson-Neyman图进一步分析年龄的调节作用,通过计算年龄取不同值时日常生活活动能力对无用感影响的简单斜率及其95%CI进一步判断日常生活活动能力对无用感影响强度随年龄变化的情况。为便于比较中介与调节效应,本研究对所有数值型变量均进行了标准化处理。检验水准为双侧检验α=0.05。
中国10 883名60~98岁老年人中,男性5 491人(50.5%),女性5 392人(49.5%);年龄60~69岁4 868人(44.73%),70~79岁4 500人(41.35%),80~89岁1 432人(13.16%),90~98岁83人(0.76%);文化程度高中以下9 683人(88.97%),高中及以上1 200人(11.03%);婚姻状况非在婚2 664人(24.48%),在婚8 219人(75.52%);同住人数量<4人8 125人(74.66%),≥4人2 758人(25.34%);户籍为非农村地区5 087人(46.74%),农村地区5 796人(53.26%);自评经济状况较差1 250人(11.49%),中等7 667人(70.45%),较好1 966人(18.06%);经常感受到无用感者1 729人(15.89%),有时感受到无用感者4 582人(42.10%),没有感受到无用感者4 572人(42.01%)。
中国老年人无用感、日常生活活动能力和老化态度平均得分分别为(0.739±0.715)、(0.238±1.075)和(14.311±3.638)分,平均年龄为(71.5±6.6)岁;相关分析结果显示,老年人无用感平均得分与日常生活活动能力平均得分(r=0.140,P<0.001)、老化态度平均得分(r=0.148,P<0.001)和平均年龄(r=0.163,P<0.001)均呈正相关,老年人日常生活活动能力越差、老化态度越消极、年龄越大,其无用感越强烈。
以中国老年人无用感为因变量,日常生活活动能力为自变量,性别、文化程度、婚姻状况、同住人数量、户籍和自评经济状况等为控制变量构建模型Ⅰ,结果显示,中国老年人日常生活活动能力对其无用感的影响有统计学意义(β=0.085,P<0.001),老年人日常生活活动能力越差,其无用感越明显。在模型Ⅰ基础上,将老化态度作为因变量构建模型Ⅱ,结果显示,中国老年人日常生活活动能力对其老化态度的影响有统计学意义(β=0.395,P<0.001),老年人日常生活活动能力越差,其老化态度越消极。模型Ⅰ基础上,新纳入老化态度作为中介变量、年龄作为调节变量构建模型Ⅲ,结果显示,中国老年人老化态度对其无用感的影响亦具有统计学意义(β=0.024,P<0.001),与模型Ⅱ结果相结合,表明老化态度在老年人日常生活活动能力对其无用感的影响中发挥中介作用。在模型Ⅲ基础上,新纳入日常生活活动能力和年龄的交互项构建模型Ⅳ,结果显示老年人日常生活活动能力的下降会明显增强其无用感(β=0.270,P<0.001);以此模型分析中国老年人日常生活活动能力对其无用感的影响以及老化态度和年龄在其中所发挥的作用的结果显示,中国老年人日常生活活动能力对其无用感存在直接影响(β=0.082,P<0.001),老化态度在日常生活活动能力与无用感的关系中发挥部分中介作用(β=0.010,P<0.001),年龄则发挥调节作用(β= –0.003,P=0.001)(见图1)。进一步的Bootstrap检验结果显示,中国老年人日常生活活动能力对其无用感的直接效应系数为0.082,老化态度对其无用感的间接效应系数为0.010,占总效应的10.35%,且直接和间接效应的Bootstrap检验置信区间上限和下限之间均不包含0,表明老化态度在日常生活活动能力与无用感之间起部分中介效应,老年人日常生活活动能力较差既会直接增加其无用感,又会通过使老年人的老化态度更加消极来间接增加老年人的无用感;从图2可见,中国老年人日常生活活动能力对无用感影响的斜率随着年龄的增长而逐渐减小,说明低龄老年人的无用感更易受日常生活活动能力变化的影响,但这一影响会随着年龄的增长而逐渐减弱。
本研究结果显示,目前中国老年人感知到无用感的频率较高,有15.89%的老年人经常感受到无用感,没有感受到无用感的老年人仅占42.01%,与既往研究[7,15]结果一致。作为老年人心理健康的重要组成部分,无用感越强,越容易导致老年人产生抑郁和焦虑等负面情绪,降低其生活满意度和幸福感,同时也可能影响其社交参与度和身体健康状况,从而形成恶性循环,最终严重损害老年人的整体生活质量和晚年幸福。本研究结果还显示,老年人日常生活活动能力的下降会明显增强其无用感(β=0.270,P<0.001),凸显了身体功能与心理健康之间的密切关联。一方面,老年人日常生活活动能力的下降导致其在日常任务中丧失自主性,使其更加依赖他人的帮助,这种依赖会削弱他们的自我效能感,即他们对自身能力的信心[20],进而引发强烈的无用感;另一方面,日常生活活动能力的下降限制了老年人与外界的互动,减少了社交机会,增强了孤独感,从而进一步加剧无用感[21]。因此,为减少日常生活活动能力下降对老年人无用感的影响,应通过积极的康复训练维持其正常身体功能,为老年人提供心理支持以增强其自我效能感,并优化家庭和社区的支持系统以提升其社会参与感。
进一步进行的有调节的中介模型分析结果显示,中国老年人的老化态度在日常生活活动能力与无用感的关系中发挥部分中介作用(β=0.010,P<0.001),老年人日常生活活动能力越差,其老化态度越消极,这种消极态度又强化了其对自身价值和作用的负面看法,进而间接加剧其无用感,这与谷璜等[16]和王西鸽等[22]研究结果相似,提示仅关注老年人的身体功能是片面的,应通过积极的健康教育引导老年人树立积极健康的老化态度以改善老年人的心理健康,同时在制定老年人尤其是失能老年人的健康干预策略时,应将心理健康干预特别是培养积极老化态度的项目与功能性康复训练相结合,以全面提升老年人的身心健康水平。本研究模型分析结果还显示,年龄在中国老年人日常生活活动能力与无用感的关系中发挥调节作用(β= –0.003,P=0.001),提示年龄越小的老年人对日常生活活动能力的下降越敏感,越容易因此产生无用感,这与赵媛等[7]研究中百岁老年人与65~79岁年轻老年人无用感水平相似的结果一致。因此,应针对不同年龄段老年群体制定更加精准的干预政策,如,对于低龄老年人,可提供有针对性的适应性训练维护和提升其日常生活活动能力,同时辅以老年生活规划指导及心理支持帮助其更好地适应日常生活活动能力的变化,重新定位自我价值,有效降低其无用感的产生,从而提升其心理健康水平;而对于高龄老年人,则应侧重于提供日常生活辅助服务、增加医疗护理支持以及改善居家环境的无障碍设施等方面,保障其在生活中能够相对独立、安全地进行日常活动。
综上所述,中国老年人日常生活活动能力越差,其无用感越强;老化态度会随日常生活活动能力的下降而愈发消极,间接增加老年人的无用感,但随着年龄增长,老年人日常生活活动能力对其无用感的影响会逐渐减小。这些发现对老年健康政策和实践具有重要启示:首先,维护和提升老年人日常生活活动能力应成为健康老龄化策略的核心内容之一;其次,心理健康干预,特别是培养积极老化态度的项目,应与功能性康复训练相结合,以全面提升老年人的身心健康水平;最后,针对不同年龄段老年人的差异化干预策略尤为必要,特别要加强对刚进入老年期老年人的适应性训练和心理支持。但由于本研究为横断面研究,因此不能对变量间的因果关系进行推断,今后可进一步采用队列研究方法以更好地揭示这些关系的动态变化过程。此外,本研究主要关注了个体层面的因素,未来可进一步探讨社会环境因素(如社会支持和社区环境等)在这一过程中的作用,以构建更为全面的理论机制。

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2025年第41卷第2期
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doi: 10.11847/zgggws1145381
  • 接收时间:2024-07-07
  • 首发时间:2026-10-25
  • 出版时间:2025-02-10
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  • 收稿日期:2024-07-07
  • 修回日期:2024-09-27
  • 录用日期:2025-01-24
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    1中国人民大学人口与发展研究中心 中国人民大学国家治理大数据和人工智能创新平台健康与医改政策子实验室,北京 100872
    2中国人民大学人口与健康学院,北京 100872
    3山东大学齐鲁医院科研处,济南 250012
    4中国人民大学社会学院,北京 100872

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
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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