College of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, PR China.
College of Nursing, Daqing School of Harbin Medical University, Daqing, Harbin, PR China.
Public Health. 2017 Aug;149:21-27. doi: 10.1016/j.puhe.2017.04.006. Epub 2017 May 18.
This study aims to investigate the relationship between perceived stress, sleep quality, and depression among the elderly in urban communities, and further to determine whether sleep quality can serve as a mediator among the elderly in urban communities.
A cross-sectional survey.
Between May and July in 2015, we conducted a cross-sectional survey among 1050 community residents aged ≥60 years from Liaoning province, China. The Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Epidemiological Studies Depression Scale were used to estimate perceived stress, sleep quality, and depression, respectively. The data were analyzed with correlation, multiple linear regression, and structural equation modeling.
Of the 1050 participants surveyed, 1032 completed responses were ultimately acquired (98.3% effective response rate) and were included in the data analysis. Results revealed that the scores of perceived stress and sleep quality were positively correlated with Epidemiological Studies Depression Scale score. Sense of uncontrol, sense of nervous, sleep duration, and daytime dysfunction were identified as significant predictors of depression among the elderly. The effect of perceived stress on depression was partly mediated by sleep quality.
Our study reveals that not all dimensions of sleep quality are relevant factors affecting depression in the elderly, and there may be partial mediation effects of sleep quality, mainly through sleep duration and daytime dysfunction, within the impact of perceived stress on depression. This signifies that coping with perceived stress can be expected to ameliorate the severity of depression in the elderly by the intermediary role of sleep quality as well as the direct effect. However, longitudinal research is needed to confirm these findings and to investigate other mediators between perceived stress and depression among the elderly.
本研究旨在探讨城市社区老年人感知压力、睡眠质量和抑郁之间的关系，并进一步确定睡眠质量是否可以作为城市社区老年人的中介因素。
横断面调查。
2015 年 5 月至 7 月，我们对中国辽宁省 1050 名年龄≥60 岁的社区居民进行了横断面调查。使用感知压力量表、匹兹堡睡眠质量指数和流行病学研究抑郁量表分别评估感知压力、睡眠质量和抑郁。采用相关性分析、多元线性回归和结构方程模型进行数据分析。
在 1050 名被调查者中，最终获得了 1032 份有效应答（有效应答率 98.3%），并纳入数据分析。结果表明，感知压力和睡眠质量得分与流行病学研究抑郁量表得分呈正相关。不可控感、紧张感、睡眠时间和日间功能障碍是老年人抑郁的显著预测因素。感知压力对抑郁的影响部分通过睡眠质量中介。
本研究表明，并非所有睡眠质量维度都是影响老年人抑郁的相关因素，在感知压力对抑郁的影响中，睡眠质量可能存在部分中介作用，主要通过睡眠时间和日间功能障碍。这意味着通过睡眠质量的中介作用以及直接作用，应对感知压力有望改善老年人的抑郁严重程度。然而，需要进行纵向研究来证实这些发现，并探讨老年人感知压力和抑郁之间的其他中介因素。
