本文選題：老年人 + 心理衛(wèi)生�。� 參考：《中國全科醫(yī)學》2014年31期

【摘要】：目的了解社區(qū)老年人心理健康水平及其隨年齡分布特點,探尋出影響心理健康的高風險預警因子及人群,為將來老年人的社區(qū)心理健康管理提供有方向性的干預策略。方法利用癥狀自評量表(SCL-90)與相關(guān)影響因素的量表(包括自制版調(diào)查問卷、狀態(tài)-特質(zhì)焦慮問卷、生活事件評定量表問卷、家庭親密度和適應(yīng)性量表-中文版、社會支持評定量表)對2013年1—12月上海市龍柏社區(qū)所屬團隊管轄的常住人口中60歲及以上的老年人進行問卷調(diào)查,并分析調(diào)查結(jié)果。結(jié)果 (1)SCL-90總分值、總因子癥狀指數(shù)、陽性項目數(shù)均低于中國常模(P0.01),其中軀體化、抑郁、恐怖因子癥狀指數(shù)高于中國常模(P0.01)。女性在軀體化、抑郁上的癥狀指數(shù)高于男性(P0.01),男性在焦慮、恐怖的癥狀因子高于女性(P0.05)。(2)對SCL-90總癥狀指數(shù)進行單、多因素分析顯示:婚姻、年齡與SCL-90總癥狀指數(shù)呈負相關(guān)(P0.05)。家庭月收入、吸煙、體育鍛煉、焦慮特質(zhì)、心身疾病種類、生活事件與之呈正相關(guān)(P0.01)。(3)進一步以年齡為界定做二元Logistic回歸,篩選出老年人軀體化、抑郁強及極強優(yōu)勢比(OR/RR)的預警因素及人群。結(jié)論 (1)根據(jù)SCL-90總癥狀指數(shù)分析說明:對整個老年人來說,非婚狀態(tài)(獨居、單身、喪偶)、年齡近60歲、家庭月收入高、吸煙、不鍛煉、焦慮特質(zhì)分值高、生活事件值高及不尋求社會幫助易造成老年人心理痛苦的根源。(2)以年齡為界定的老年人軀體化、抑郁:慢性病種類多對65~69歲組軀體化及70~74歲組抑郁影響程度為最明顯;性別作為強的危險因素的老年人軀體化發(fā)生在60~64歲組,抑郁在65~69歲組及75~79歲組;軀體化與年齡強相關(guān)的是70~74歲組;焦慮特質(zhì)高值是60~64歲組、65~69歲組和75~79歲組老年人抑郁的強或極強的危險因素;婚姻狀況是65~69歲組老年人的抑郁強預警因素;≥80歲組家庭類型中間型是老年人軀體化的中度危險因素。以年齡界定的導致老年人軀體化、抑郁的高危人群為:女性(60~74歲組)、非婚狀態(tài)(65~69歲組)、焦慮特質(zhì)高值(60~79歲組)、處于更年期(60~64歲組及70~74歲組)、慢性病病種多(65~69歲組、70~74歲組)。(3)根據(jù)篩選出的強高危的預警因素和人群,在今后的心理健康促進的全科團體授課中增添積極心理學的觀點,學會用逆向思維的方式看待疾病和死亡,從而提升老年人對慢性病,尤其是重大疾病如癌癥等的心理應(yīng)對健康管理策略。同時,應(yīng)用心理學知識幫助60~64歲離退休老年人和65~74歲更年期老年人平穩(wěn)、安全地渡過離退休期和更年期,以實現(xiàn)心理層面的健康促進。
[Abstract]:Objective to understand the mental health level of the elderly in the community and its distribution characteristics with age, to find out the high risk early warning factors and the crowd that affect the mental health, and to provide a directional intervention strategy for the community mental health management of the elderly in the future. Methods symptom Checklist-90 (SCL-90) was used to evaluate the related factors (including self-made questionnaire, State-Trait anxiety questionnaire, Life event scale, Family cohesion and adaptability scale). The Social support rating scale (SSS) was used to investigate the elderly aged 60 and above in the resident population of Longbai Community in Shanghai from January to December 2013, and the results were analyzed. Results the total score of SCL-90, the symptom index of total factor and the number of positive items were lower than those of Chinese norm (P0.01). The symptom index of somatization, depression and phobic factor were higher than that of Chinese norm (P0.01). The symptom index of somatization and depression in women was higher than that in men (P 0.01), and the symptom factors of anxiety and phobia in men were higher than that in women (P 0.05). Multivariate analysis showed that marriage, age and total symptom index of SCL-90 were negatively correlated with P0.05. Family monthly income, smoking, physical exercise, anxiety traits, psychosomatic diseases and life events were positively correlated with family income, smoking, physical exercise, and life events (P 0.01). Furthermore, dual Logistic regression was made according to age to screen out somatization of the elderly. Depression and extreme odds were higher than ORR-R early warning factors and population. Conclusion 1) according to the analysis of total symptom index of SCL-90, the non-marital status (living alone, single, widowed, nearly 60 years old), family monthly income, smoking, non-exercise, high score of anxiety trait, and so on. The causes of mental pain of the elderly were high life event value and not seeking social help. (2) somatization of the elderly defined by age: depression was the most obvious effect of chronic diseases on somatization of 6569 years old group and 70 to 74 years old group. Sex as a strong risk factor of somatization occurred in the 60 to 64 years old group, depression in 6569 years old group and 75 to 79 years old group, the strong correlation between somatization and age was 70 to 74 years old group; The high value of anxiety trait was a strong or very strong risk factor of depression in 65-69-year-old group and 75-79-year-old group, and marital status was a strong early-warning factor of depression in the 65-69-year-old group. The intermediate type of family type was a moderate risk factor for somatization in the elderly aged 鈮，

本文編號：1959796