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控制感对老年人身体、行为和心理社会健康的积极影响:一种全结局方法。

The positive influence of sense of control on physical, behavioral, and psychosocial health in older adults: An outcome-wide approach.

机构信息

Department of Psychology, University of British Columbia, Canada; Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.

Department of Psychology, Brandeis University, Boston, MA, USA.

出版信息

Prev Med. 2021 Aug;149:106612. doi: 10.1016/j.ypmed.2021.106612. Epub 2021 May 11.

Abstract

Accumulating research indicates robust associations between sense of control and salutary health and well-being outcomes. However, whether change in sense of control is associated with subsequent outcomes has been under-evaluated. Participants (N = 12,998) were from the Health and Retirement Study-a diverse, nationally representative, and longitudinal sample of U.S. adults aged >50 years. We examined how increase in sense of control (from t:2006/2008 to t: 2010/2012) was associated with better outcomes on 35 indicators of: physical-, behavioral-, and psychosocial-health (t:2014/2016). We used multiple logistic-, linear-, and generalized-linear regression models and controlled for sociodemographic characteristics, personality traits, sense of control, and all outcomes in the pre-baseline wave (t:2006/2008). During the 4-year follow-up, people in the highest (vs. lowest) quartile of sense of control, conditional on prior sense of control, had reduced risk of mortality and improved physical-health outcomes (lower risk of: stroke, lung disease, physical limitations, cognitive impairment, chronic pain and higher self-rated health). Sense of control was related to better health-behaviors (increased physical activity, reduced sleep problems), higher psychological well-being (positive affect, life satisfaction, optimism, purpose, personal-, health-, financial-mastery), lower psychological distress (depression, hopelessness, negative affect, perceived constraints), decreased loneliness, and increased contact with friends. Sense of control was unrelated to other physical health indicators (diabetes, hypertension, heart disease, cancer, arthritis, overweight/obesity), health behaviors (binge drinking, smoking), and social factors (living with spouse/partner, frequency of contact with children and other family). These findings underscore the importance of sense of control as a potential intervention target for fostering physical-, behavioral-, and psychosocial-health.

摘要

越来越多的研究表明,控制感与有益的健康和幸福感之间存在强有力的关联。然而,控制感的变化是否与随后的结果有关尚未得到充分评估。参与者(N=12998)来自健康与退休研究——一个多样化、具有全国代表性的美国 50 岁以上成年人的纵向样本。我们研究了控制感的增强(从 t:2006/2008 到 t:2010/2012)如何与 35 个指标的更好结果相关:身体、行为和心理社会健康(t:2014/2016)。我们使用了多种逻辑、线性和广义线性回归模型,并控制了社会人口特征、人格特质、控制感以及基线前波(t:2006/2008)中的所有结果。在 4 年的随访期间,在控制先前的控制感的情况下,处于控制感最高(与最低)四分位数的人死亡风险降低,身体健康状况改善(中风、肺部疾病、身体限制、认知障碍、慢性疼痛和自我报告的健康状况较低的风险)。控制感与更好的健康行为(增加体力活动、减少睡眠问题)、更高的心理幸福感(积极情绪、生活满意度、乐观、目标、个人、健康、财务掌握)、较低的心理困扰(抑郁、绝望、消极情绪、感知限制)、孤独感降低以及与朋友的接触增加有关。控制感与其他身体健康指标(糖尿病、高血压、心脏病、癌症、关节炎、超重/肥胖)、健康行为(狂饮、吸烟)和社会因素(与配偶/伴侣同住、与子女和其他家庭成员的接触频率)无关。这些发现强调了控制感作为促进身体、行为和心理社会健康的潜在干预目标的重要性。

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