在一个全国性的 65 岁及以上的社区居住的加拿大人样本中，身体活动和社会支持在慢性病与积极心理健康之间起中介作用：结构方程分析。

Physical activity and social support mediate the relationship between chronic diseases and positive mental health in a national sample of community-dwelling Canadians 65+: A structural equation analysis.

机构信息

School of Public Health, University of Saskatchewan, 104 Clinc Place, Saskatoon, Saskatchewan, S7N 2Z4, Canada.

School of Public Health, University of Saskatchewan, 104 Clinc Place, Saskatoon, Saskatchewan, S7N 2Z4, Canada; Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 0W8, Canada.

出版信息

J Affect Disord. 2022 Feb 1;298(Pt A):142-150. doi: 10.1016/j.jad.2021.10.055. Epub 2021 Oct 30.

DOI:10.1016/j.jad.2021.10.055

PMID:34728294

Abstract

BACKGROUND

Mental health is a critical component of healthy aging. Aging increases the likelihood of developing chronic diseases. The negative effects of chronic diseases on mental health have been extensively documented. Physical activity and social support have been reported to influence mental health positively.

METHODS

Data analyzed are drawn from the national Canadian Community Health Survey - Mental Health in 2012. Structural equation modeling (SEM) techniques were used to estimate and test the mediating role of physical activities and social support in the relationship between chronic disease, positive mental health, and psychological distress in a national adult population sample aged 65+.

RESULTS

Approximately 83% of the older adults sample reported having at least one chronic disease, and the mean score of psychological distress and positive mental health was 14.15 ± 4.73 and 55.28 ± 10.67, respectively. Initial analysis found that chronic illness was negatively related to positive mental health (β= -0.72, P < 0.001) and positively related to psychological distress (β=0.98, P < 0.001). The final structural model found that physical activity and social support partially mediated the negative consequences of chronic disease on psychological distress and strengthened seniors' positive mental health.

LIMITATIONS

Limiting causal attribution, potential reporting bias and limited in recognizing negative and positive social support are the major limitations.

CONCLUSIONS

Older adults with chronic diseases should be encouraged to increase physical activity and social support levels. The study outcomes have clinical implications for the delivery of mental health services to improve mental health and resilience to coping with stress among older adults.

摘要

背景

心理健康是健康老龄化的重要组成部分。随着年龄的增长，患慢性病的可能性增加。慢性病对心理健康的负面影响已有大量记载。有报道称，身体活动和社会支持对心理健康有积极影响。

方法

本研究的数据来自于 2012 年加拿大全国社区健康调查-心理健康调查。采用结构方程模型（SEM）技术来估计和检验身体活动和社会支持在慢性病与积极心理健康和心理困扰之间的关系中的中介作用，该研究对象为 65 岁及以上的全国成年人群体样本。

结果

约 83%的老年样本报告患有至少一种慢性病，心理困扰和积极心理健康的平均得分分别为 14.15±4.73 和 55.28±10.67。初步分析发现，慢性病与积极心理健康呈负相关（β=-0.72，P<0.001），与心理困扰呈正相关（β=0.98，P<0.001）。最终的结构模型发现，身体活动和社会支持部分缓解了慢性病对心理困扰的负面影响，并增强了老年人的积极心理健康。