Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China.
Shenzhen University, Shenzhen, China.
Aging Ment Health. 2020 Aug;24(8):1254-1262. doi: 10.1080/13607863.2019.1603285. Epub 2019 Apr 14.
This study aims to identify heterogeneous depressive symptom trajectories among the widowed elderly in China, to explore predictive variables of latent class membership, and to detect between-classes differences in life satisfaction across time. Data of 198 individuals widowed between 2011 and 2013 were drawn from The China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey. Latent class growth analysis was employed to identify depressive symptom trajectories across 2011, 2013, and 2015, and a three-step auxiliary approach was applied to detect predictive variables of latent class membership. Mixed Analysis of Variances was followed to make between-class comparisons on life satisfaction across time. Four grieving trajectories were identified: resilient (54.6%), chronic grief (23.7%), depressed-improved (11.6%), and chronic depression (10.1%). Older age, living exclusively with spouse before widowhood, and agricultural Hukou were significant predictors of depressed-improved, chronic grief, and chronic depression patterns, respectively. Life satisfaction in all groups except for the resilient one remained stable across time, and that of the chronic depression group was significantly lower than those of all the remaining groups. Consistent depressive symptom trajectories during late-life widowhood exist across nations while the specific culture, values, and resources in the Chinese context may have contributed to a particularly high proportion of the chronic grief trajectory. More efforts should be made to identify patterns with predictors before support are provided, and interventions need to be tailored to target specific needs in each subgroup of the elderly during their transitions to widowhood.
本研究旨在识别中国丧偶老年人中异质的抑郁症状轨迹，探讨潜在类别成员的预测变量，并检测随时间变化的生活满意度在不同类别之间的差异。这项研究的数据来自中国健康与退休纵向研究（CHARLS），该研究是一项具有全国代表性的调查，共纳入了 198 名在 2011 年至 2013 年间丧偶的个体。采用潜在类别增长分析来识别 2011 年、2013 年和 2015 年的抑郁症状轨迹，并应用三步辅助方法来检测潜在类别成员的预测变量。采用混合方差分析来比较不同类别随时间变化的生活满意度。共确定了四种悲伤轨迹：适应良好（54.6%）、慢性悲伤（23.7%）、抑郁改善（11.6%）和慢性抑郁（10.1%）。年龄较大、丧偶前与配偶单独居住以及农业户口是抑郁改善、慢性悲伤和慢性抑郁模式的显著预测因素。除适应良好组外，所有组别的生活满意度在整个研究期间均保持稳定，而慢性抑郁组的生活满意度明显低于其他所有组。在晚年丧偶期间，不同国家存在一致的抑郁症状轨迹，而中国特定的文化、价值观和资源可能导致慢性悲伤轨迹的比例特别高。在提供支持之前，应该努力识别有预测因素的模式，并且干预措施需要针对丧偶过渡期间每个老年亚组的特定需求进行调整。
