老年人虐待与心理健康:社会支持的调节效应

  目的  探讨农村地区老年人虐待和心理健康的关系及社会支持在两者关系中的调节效应。  方法  采用多阶段分层随机抽样的方法在湖南省长沙、株洲和湘潭农村地区抽取1 418名60岁及以上老年人作为调查对象，建立Logistic回归分析模型对变量间的关系进行检验。  结果  在控制了人口基本特征变量后，虐待经历、精神虐待、照料忽视、虐待长期性与多重性每提高一个单位，心理健康水平分别下降21.4%（OR=2.14，95% CI:1.49~2.83，P=0.001）、34.2%（OR=3.42，95% CI:1.53~4.26，P < 0.001）、17.8%（OR=1.78，95% CI:1.36~2.41，P=0.001）、25.4%（OR=2.54，95% CI:1.68~2.93，P < 0.001）和13.7%（OR=1.37，95% CI:1.15~2.37，P=0.001）。当加入社会支持变量后，虐待对心理健康的负面影响系数下降了，但男性老年人中差异无统计学意义，主观支持比客观支持的调节效应更大。  结论  虐待是老年人心理健康问题的危险因素，高水平社会支持可以减少虐待对女性老年人心理健康的负面影响。

Elder abuse and mental health: the modifying effect of social support

  Objective  To explore the relationship between elder abuse and mental health, and the modifying effect of social support between them in rural area.  Methods  A multi-stage stratified random sampling method was used to select 1 418 elderly people aged 60 years and above from rural areas of Changsha, Zhuzhou and Xiangtan in Hunan Province. Logistic regression model was established to test the relationship among the variables.  Results  After controlling the basic characteristic variables, when the abuse experience, mental abuse, care neglected, chronicity and multiplicity of abuse increased by one unit, the level of mental health decreased by 21.4%(OR=2.14, 95% CI: 1.49-2.83, P=0.001)、34.2%(OR=3.42, 95% CI: 1.53-4.26, P < 0.001)、17.8%(OR=1.78, 95% CI: 1.36-2.41, P=0.001)、25.4%(OR=2.54, 95% CI: 1.68-2.93, P < 0.001) and 13.7%(OR=1.37, 95% CI: 1.15-2.37, P=0.001), respectively. After social support variables were added, the negative impact coefficient of abuse on mental health decreased. However, it had no statistical significance among the male elderly. Subjective support had greater moderating effect than objective support.  Conclusions  Abuse is a risk factor for mental health among the elderly. High level of social support can reduce the negative impact of abuse on the mental health among female elderly.