School of Social Development and Public Policy, Beijing Normal University, Beijing, China.
School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA.
Aging Ment Health. 2022 Feb;26(2):345-354. doi: 10.1080/13607863.2020.1867824. Epub 2021 Jan 7.
This study set out to examine the bidirectional relationship between loneliness and productive engagement, delineate the association between different dimensions of productive engagement and depression, and explore the potential mediating effect of sleep-wake disturbances in the relationship between loneliness and/or productive engagement and depression.
Data from a total of 4427 older adults in China were included in the analysis. Factor analysis was conducted to explore a set of discrete dimensions of productive engagement (recreational activities, group artistic and learning activities, sportive activities, paid work, volunteering, and family caregiving). Structural equation modeling was used to assess the potential relationships between loneliness, multidimensional productive engagement, sleep-wake disturbances, and depression.
All dimensions of productive engagement were found to be negatively associated with loneliness, except for paid work which was associated with elevated level of self-reported loneliness. Sleep-wake disturbances mediated the relationship between leisure activities and depression but this was not significantly related to other forms of productive engagement. The direct effect of productive engagement on depression varied, in that leisure activities and family caregiving were negatively associated with depressive symptoms, while doing paid work was positively associated with depressive symptoms. Volunteering was not significantly related to depressive symptoms.
This study makes an important contribution to the research on the relationship between loneliness, productive engagement, sleep-wake disturbances, and depression, by distinguishing the different effects of different dimensions of productive engagement. The findings provide a robust stimulus for intervention programs and other forms of social work practice seeking to mitigate depressive symptoms in older adults.
本研究旨在检验孤独感与生产性投入之间的双向关系，描绘生产性投入的不同维度与抑郁之间的关系，并探讨睡眠-觉醒障碍在孤独感和/或生产性投入与抑郁之间的关系中的潜在中介作用。
本研究共纳入中国 4427 名老年人的数据。采用因子分析探讨了生产性投入（娱乐活动、团体艺术和学习活动、体育活动、有偿工作、志愿服务和家庭护理）的离散维度。结构方程模型用于评估孤独感、多维生产性投入、睡眠-觉醒障碍和抑郁之间的潜在关系。
所有生产性投入维度均与孤独感呈负相关，除有偿工作与自我报告的孤独感升高有关外。睡眠-觉醒障碍中介了休闲活动与抑郁之间的关系，但与其他形式的生产性投入无关。生产性投入对抑郁的直接影响因维度而异，其中休闲活动和家庭护理与抑郁症状呈负相关，而有偿工作与抑郁症状呈正相关。志愿服务与抑郁症状无显著相关性。
本研究通过区分生产性投入的不同维度对孤独感、生产性投入、睡眠-觉醒障碍和抑郁之间关系的不同影响，对孤独感、生产性投入、睡眠-觉醒障碍和抑郁之间关系的研究做出了重要贡献。研究结果为旨在减轻老年人抑郁症状的干预计划和其他形式的社会工作实践提供了有力的启示。
