主动健康视角下老年人精神健康知信行现状及影响机制研究

摘要/Abstract

摘要： 目的本研究旨在从主动健康的角度,深入分析老年人群在精神健康方面的知识、信念及行为水平,并揭示其内在的影响机制。方法采用便利抽样方法,使用自行设计的《主动健康视角下老年人精神健康的现状调查问卷》对齐齐哈尔地区311名老年人进行问卷调查,对所得数据用软件 SPSS 25.0 进行处理,运用描述性统计分析、t 检验、单因素方差分析、多元线性回归分析、中介分析等方法进行分析。结果主动健康视角下老年人精神健康知识平均得分为（6.47±1.84）分;态度平均得分为（7.10±1.82）分;行为平均得分为（5.78±1.92）分。回归分析表明,民族、年收入、文化程度和医疗费用情况是知识和行为的影响因素;年收入、文化程度、锻炼情况和医疗费用情况是态度的影响因素。中介分析显示,精神健康知识对态度（β=0.577,P<0.001）、行为意愿（β=0.190,P<0.01）和行为（β=0.373,P<0.001）有预测作用,态度正向预测行为意愿（β=0.244,P<0.01）和行为（β=0.120,P<0.05）,行为意愿对行为（β=0.321,P<0.001）有正向预测作用。知识对行为的直接效应值为0.389,占总效应的68%,间接效应值为0.183,占总效应的32.01%。结论老年人精神健康知识和态度水平处于中等水平,行为转化水平较低;精神健康态度、行为意愿在知识和行为之间起部分中介作用。

关键词: 主动健康, 老年人, 精神健康, 知信行

Abstract: Objective This study aims to analyse in depth the knowledge, beliefs and behaviours of the elderly population regarding mental health from an active health perspective, and to identify the underlying mechanisms of influence. Methods Using a convenience sampling method, 311 elderly people were surveyed using the self-designed questionnaire on the current situation of mental health of the elderly from the perspective of active health, and the data obtained were processed using SPSS 25.0 software and analysed using descriptive statistical analysis, t-test, one-way analysis of variance (ANOVA), multivariate linear regression analysis and mediation analysis. Results The mean score of mental health knowledge of older people from an active health perspective was (6.47±1.84); the mean score of attitude was (7.10±1.82); and the mean score of behaviour was (5.78±1.92). Regression analysis showed that ethnicity, annual income, literacy level and medical expenses were the influencing factors of knowledge and behaviour; and the mean score of annual income, literacy level, exercise situation and medical expenses were the influencing factors of attitude. Mediation analysis showed that mental health knowledge predicted attitude (β=0.577, P<0.001), behavioural intention (β=0.190, P<0.01)and behaviour (β=0.373, P<0.001), and that attitude positively predicted behavioural intention (β=0.244, P<0.01)and behaviour (β=0.120, P<0.05). Behavioural intentions positively predicted behaviour (β=0.321, P<0.001). The value of the direct effect of knowledge on behaviour was 0.389 or 68% of the total effect and the value of the indirect effect was 0.183 or 32.01% of the total effect. Conclusion The level of mental health knowledge and attitudes among the elderly is at a medium level, and the level of behaviour change is low; mental health attitudes and behavioural intentions play a partial mediating role between knowledge and behaviour.

Key words: active health, older people, mental health, knowledge, beliefs and behaviours

中图分类号:

R195

郭荣煌, 齐丽, 刘已鸣, 张艳, 吴颖. 主动健康视角下老年人精神健康知信行现状及影响机制研究[J]. 中华养生保健, 2025, 43(12): 116-120.

Guo Rong-huang, Qi Li, Liu Yi-ming, Zhang Yan, Wu Ying. Older People's Mental Health Knowledge, Beliefs and Behaviours from an Active Health Perspective Current Situation and Influencing Mechanisms[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(12): 116-120.

参考文献

[1] 傅小兰,张侃,陈雪峰. 中国国民心理健康发展报告[2019-2020][M].上海:社会科学文献出版社,2021.
[2] LUJ,X X,HUANG Y,et al.Prevalence of depressive disorders and treatment in China:across-sectional epidemio logical study[J].The lancet,Psychiatry,2021,8(11):981-990.
[3] LI Q,MIAO Y,ZENG X,et al.Prevalence and factors for anxiety during the coronavirus disease 2019 (COVID-19) epidemic among the teachers in China[J].J Affect Disord,2020,277:153-158.
[4] 李文翠,章鹰,曾子莹,等.基于内容分析法和5W1H分析法的主动健康内涵探析[J].现代医院,2023,23(5):667-670.
[5] 中华人民共和国国家卫生健康委员会宣传司.国家卫生健康委员会2022年6月10日新闻发布会文字实录[EB/OL].(2022-06).https://www.nhc.gov.cn/xcs/c100122/202206/d6d3657ee26d461b9b2715f11ccd25da.shtml.
[6] ABDI I H,FIRDOS R,ALI LAGHARI Q,et al.Role of laparo-scopic cholecystectomy in geriatric patients (>60 years of age)[J].Prof Med J,2020,27(1):62-67.
[7] ENTRIKEN C,PRITTS T A.Perioperative pulmonary support of the elderly[J].Curr Geriatr Rep,2021.10(4):167-174.
[8] 李晓松. 卫生统计学[M].北京:人民卫生出版社,2017:287-289.
[9] 杨心妍. 广东省老年人心理健康素养与抑郁症状的关系及失眠的中介效应分析[D].长春:吉林大学,2024.
[10] 周鼒,尹佳慧,郝世超等.老年人多维健康公平性及其影响因素研究[J].中国卫生统计,2018,35(4):500-503.
[11] 李琴,赵锐,张同龙.养老保险制度是否缓解了丧偶对老年健康的不利冲击[J].世界经济,2021,44(9):180-206.
[12] CHEN X,SU D,CHEN X,CHEN Y.Effect of informal care on health care utilisation for the elderly in urban and rural China:evidence from China health and retirement longitudinal study(CHARLS)[J].BMC Health ServRes,2022,22(1):271.
[13] 夏咪. 湘西地区老年人家庭功能与多维健康现状及相关性研究[D].吉首大学,2024.
[14] YANG C C,LI C L,YEH T F,CHANG Y C.Assessing Older Adults' Intentions to Use a Smartphone:Using the Meta-Unified Theory of the Acceptance and Use of Technology[J].IntJ Environ Res Public Health,2022,19(9):5403.
[15] 覃志良. 桂西地区老年人生理健康与心理健康现状及影响因素研究[D].百色:右江民族医学院,2023.
[16] ZHANG Y,SU D,CHEN Y,et al.Effect of socioeconomic status on the physical and mental health of the elderly:the mediating effect of social participation[J].BMC Public Health,2022,22(1):605.
[17] 田艳梅,肖文文,乔慧.宁夏5县农村老年人生命质量及影响因素分析[J].中国公共卫生,2021,37(1):1-4.
[18] 吴娇健,钟小明,马利,等.新疆生产建设兵团养老机构老年人生命质量现状及其影响因素[J].中国公共卫生,2021,37(4):728-732.
[19] SZELIGA E,BRZOZOWSKA-MAGOńA,BORYS R,WOLAN-NIERODA A,WALICKA-CUPRYśK.The Relationship between Physical Activity Leveland Functional Status of Subjects with High Spinal Cord Injury[J].Int J Environ Res Public Health,2022,19(3):1787.
[20] 杨心妍. 广东省老年人心理健康素养与抑郁症状的关系及失眠的中介效应分析[D].长春:吉林大学,2024.
[21] 郭艳童,于媛媛,陈莹莹,等.山东省主动健康示范区域老年人慢病管理知信行现状及影响机制[J].山东大学学报(医学版),2024,69(7):98-105.
[22] ZHANG X M,LI C Y,LIU M,et al.The mediation effect of health literacy on social support and health lifestyle of patients with chronic diseases[J].Appl Nurs Res,2024,75:151763.
[23] 黄河银,张蓝之,张勤修,等.多种养老模式和服务技术现状与思考[J].中国老年学杂志,2021,41(1):203-207.
[24] 程新峰,刘一笑,葛廷帅.社会隔离、孤独感对老年精神健康的影响及作用机制研究[J].人口与发展,2020,26(1):76-84,96.
[25] RIVERA S C,LIU X,CHAN A W,et al.SPIRIT-AI and CONSORT-AI Working Group.Guidelines for clinical trial protocols for interventions involving artificial intelligence:the SPIRIT-AI Extension[J].BMJ,2020,370:m3210.