社会支持对我国中老年人共病及其相关结局的影响研究

  目的  基于2015年中国健康与养老追踪调查数据（CHARLS），分析中老年共病患者社会支持现状，探讨不同维度的社会支持与共病及其相关结局的关联，旨在揭示共病的复杂社会背景及社会支持对共病的影响。  方法  本研究共纳入有效样本 9168 例，平均年龄59.60岁。将受访者的社会支持相关变量进行因子分析，构建社会支持公因子与共病相关结局的回归模型，分析社会支持公因子对中老年共病的影响。  结果  我国中老年人群共病与否与多个社会支持因素相关，且差异有统计学意义；Logistic回归结果显示活动设施-医疗支持是共病的保护性因素；家庭情感和经济支持对共病患者生活满意度起正向作用；教育社交-居住环境支持与共病人群发生灾难性医疗支出存在负相关（P<0.05）。  结论  我国中老年人群享有的社会支持分布不均；活动设施-医疗支持可能降低中老年人群的共病发病风险；良好的家庭经济和情感支持能提高中老年共病患者的生活满意度；教育社交-居住环境支持可能降低中老年共病人群发生灾难性医疗支出的风险。

Effect of Social Support on Multimorbidity and Related Outcomes of Middle-Aged and Older Adults in China

  Objective  To analyze the current status of social support for middle-aged and older adults with multimorbidity and to explore the correlation between different dimensions of social support and multimorbidity and the related outcomes on the basis of China Health and Retirement Longitudinal Study (CHARLS) 2015 survey data so as to reveal the complex social background of multimorbidity and the impact of social support on multimorbidity.   Methods  A total of 9168 valid samples, with an average age of 59.60 years, were included in the study. Using the social support-related variables of the respondents, we conducted factor analysis and constructed regression models of common factors of social support and multimorbidity-related outcomes, intending to analyze the impact of common factors of social support on multimorbidity in the middle-aged and older adults.   Results  The multimorbidity of middle-aged and older adults in China was related to multiple factors of social support, and the differences were statistically significant. Logistic regression showed that social support in the form of activity/recreational facilities and medical resources was a protective factor of multimorbidity, that family emotional support and economic support had a positive effect on life satisfaction of comorbid patients, and that social support in the form of education, social life and housing conditions was negatively correlated with catastrophic medical expenditure of the comorbid population (P<0.05).   Conclusion  Social support for middle-aged and older adults in China is unevenly distributed. Social support in the form of activity/recreational facilities and medical resources may reduce the risks of multimorbidity among middle-aged and older adults. Good family economic and emotional support can improve the life satisfaction of middle-aged and older adults with multimorbidity. Social support in the form of education, social life and housing conditions may reduce the risk of catastrophic medical expenditure in middle-aged and older adults with multimorbidity.