Hardy Susan E, Concato John, Gill Thomas M
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06504, USA.
J Am Geriatr Soc. 2004 Feb;52(2):257-62. doi: 10.1111/j.1532-5415.2004.52065.x.
To assess resilience of community-dwelling older persons using a new scale based on response to a stressful life event and to identify the demographic, clinical, functional, and psychosocial factors associated with high resilience.
Cross-sectional study.
Community.
Five hundred forty-six nondisabled persons aged 70 and older who had experienced a stressful life event.
Resilience (as assessed using a simple six-item scale), demographic factors, chronic conditions, medications, cognitive status, grip strength, functional status, physical activity, self-efficacy, depressive symptoms, self-rated health, and social support.
Participants showed a wide range of resilience in response to a stressful event, with a mean score+/-standard deviation of 8.9+/-4.0 on an 18-point scale. In bivariate analyses, male sex, living with others, high grip strength, independence in instrumental activities of daily living (IADLs), having few depressive symptoms, and having good to excellent self-rated health were associated with high resilience, defined as a score in the best tertile (>10). Independence in IADLs (relative risk (RR)=1.36, 95% confidence interval (CI)=1.05-1.69), having few depressive symptoms (RR=1.59, 95% CI=1.13-2.11), and good to excellent self-rated health (RR=1.38, 95% CI=1.01-1.79) remained independently associated with high resilience in multivariate analysis. Depressive symptoms and self-rated health remained associated with high resilience after controlling for the perceived stressfulness of the event.
Functional and psychosocial factors are associated with high resilience. Further research is needed to determine the relationship between resilience and future well-being.
使用一种基于对压力性生活事件反应的新量表评估社区居住老年人的复原力,并确定与高复原力相关的人口统计学、临床、功能和心理社会因素。
横断面研究。
社区。
546名70岁及以上经历过压力性生活事件的非残疾人士。
复原力(使用一个简单的六项量表进行评估)、人口统计学因素、慢性病、药物治疗、认知状态、握力、功能状态、身体活动、自我效能感、抑郁症状、自评健康状况和社会支持。
参与者在应对压力事件时表现出广泛的复原力,在18分制量表上的平均得分±标准差为8.9±4.0。在双变量分析中,男性、与他人同住、握力高、在工具性日常生活活动(IADL)中独立、抑郁症状少以及自评健康状况良好至优秀与高复原力相关,高复原力定义为得分处于最佳三分位数(>10)。在多变量分析中,IADL独立性(相对风险(RR)=1.36,95%置信区间(CI)=1.05-1.69)、抑郁症状少(RR=1.59,95%CI=1.13-2.11)以及自评健康状况良好至优秀(RR=1.38,95%CI=1.01-1.79)仍然与高复原力独立相关。在控制事件的感知压力后,抑郁症状和自评健康状况仍然与高复原力相关。
功能和心理社会因素与高复原力相关。需要进一步研究以确定复原力与未来幸福感之间的关系。