增加社交互动可以减少生活空间受限与老年 HIV 感染者和非感染者日常幸福感降低之间的关联：GPS 和生态瞬时评估研究。
Increased Social Interactions Reduce the Association Between Constricted Life-Space and Lower Daily Happiness in Older Adults With and Without HIV: A GPS and Ecological Momentary Assessment Study.
机构信息
Department of Psychiatry (LK, EWP, LMC, BT, MJM, CAD, RCM), University of California, San Diego, San Diego, CA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (LK, EWP, LMC), San Diego, CA.
Qualcomm Institute/Calit2, University of California, San Diego (JAY), San Diego, CA.
出版信息
Am J Geriatr Psychiatry. 2021 Aug;29(8):867-879. doi: 10.1016/j.jagp.2020.11.005. Epub 2020 Nov 20.
OBJECTIVE
Older persons with human immunodeficiency virus (HIV) (PWH) are particularly susceptible to life-space restrictions. The aims of this study included: 1) using global positioning system (GPS) derived indicators as an assessment of time spent at home among older adults with and without HIV; 2) using ecological momentary assessment (EMA) to examine real-time relationships between life-space, mood (happiness, sadness, anxious), fatigue, and pain; and 3) determining if number of daily social interactions moderated the effect of life-space on mood.
METHODS
Eighty-eight older adults (PWH n = 54, HIV-negative n = 34) completed smartphone-based EMA surveys assessing mood, fatigue, pain, and social interactions four times per day for two weeks. Participants' smartphones were GPS enabled throughout the study. Mixed-effects regression models analyzed concurrent and lagged associations among life-space and behavioral indicators of health.
RESULTS
PWH spent more of their time at home (79% versus 70%, z = -2.08; p = 0.04) and reported lower mean happiness (3.2 versus 3.7; z = 2.63; p = 0.007) compared to HIV-negative participants. Controlling for covariates, more daily social interactions were associated with higher ratings of real-time happiness (b = 0.12; t = 5.61; df = 1087.9; p< 0.001). Similar findings were seen in lagged analyses: prior day social interactions (b = 0.15; t = 7.3; df = 1024.9; p < 0.0001) and HIV status (b = -0.48; t = -2.56; df = 1026.8; p = 0.01) attenuated the effect of prior day time spent at home on happiness.
CONCLUSION
Accounting for engagement in social interactions reduced the significant effect of time spent at home and lower happiness. Interventions targeting social isolation within the context of constricted life-space may be beneficial for increasing positive mood in older adults, and especially relevant to older PWH.
目的
感染人类免疫缺陷病毒（HIV）的老年人（PWH）特别容易受到生活空间限制。本研究的目的包括：1）使用全球定位系统（GPS）衍生指标评估 HIV 阳性和阴性老年人在家中度过的时间；2）使用生态瞬时评估（EMA）实时检查生活空间、情绪（快乐、悲伤、焦虑）、疲劳和疼痛之间的关系；3）确定每日社交互动次数是否调节了生活空间对情绪的影响。
方法
88 名老年人（PWH n=54，HIV 阴性 n=34）完成了基于智能手机的 EMA 调查，在两周内每天四次评估情绪、疲劳、疼痛和社交互动。在整个研究过程中，参与者的智能手机都启用了 GPS。混合效应回归模型分析了生活空间与健康行为指标的并发和滞后关联。
结果
PWH 在家中的时间比例更高（79%对 70%，z=-2.08；p=0.04），实时幸福感评分也更低（3.2 对 3.7，z=2.63；p=0.007）。控制了协变量后，更多的日常社交互动与更高的实时幸福感评分相关（b=0.12；t=5.61；df=1087.9；p<0.001）。滞后分析也得到了类似的结果：前一天的社交互动（b=0.15；t=7.3；df=1024.9；p<0.0001）和 HIV 状态（b=-0.48；t=-2.56；df=1026.8；p=0.01）减弱了前一天在家时间对幸福感的影响。
结论
考虑到社交互动的参与度，在家时间和幸福感降低的显著影响得到了缓解。在受限生活空间的背景下，针对社交隔离的干预措施可能对增加老年人的积极情绪有益，特别是对老年 PWH 更为相关。
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