Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, Zhejiang, China.
BMC Geriatr. 2022 Jul 16;22(1):589. doi: 10.1186/s12877-022-03247-5.
The prevalence of dependency personality disorder (DPD) is high among elderly people living in rural areas. This study aims to explore the association between dependency on community resources and social support among elderly individuals living in rural areas.
A cross-sectional study was conducted in 26 locations in China. A total of 1160 participants aged ≥ 60 years were selected using a complex multistage sampling design. All data were obtained using questionnaires via face-to-face interviews. DPD was measured using the Minnesota Multiphasic Personality Inventory-II in the standardized Chinese version. Self-efficacy was assessed using the Chinese version of the General Self-Efficacy Scale. Social support was measured using the Chinese version of the questionnaires of the Older American Resources and Services scale. Community services and resources comprised 44 items. The association between DPD and levels of social support and self-efficacy was evaluated using a logistic regression model. The association between social support and self-efficacy was assessed using analysis of covariance.
Univariate analysis results showed that elderly people living in rural areas had higher DPD scores and lower levels of self-efficacy compared with those living in urban areas (P < 0.001). Logistic regression analysis showed that DPD was positively associated with the received frequencies of community health service, contracted family doctor services, and regular lectures on health knowledge among the elderly people with odd ratios of 1.58 (P < 0.001), 2.03 (P = 0.013), and 2.67 (P = 0.005), respectively. Logistic regression analysis showed significant interaction between social support and self-efficacy effect on DPD was found in the additive model (P < 0.001).
DPD was associated mainly with the community resources among elderly people living in rural areas. Social support and self-efficacy were commonly associated with DPD through a synergistic effect. These results suggest that DPD among elderly people may be reduced through effective social support to directly and indirectly promote the elderly's use of community resources and improve their self-efficacy.
农村地区老年人群中依赖型人格障碍（DPD）的患病率较高。本研究旨在探讨农村老年人对社区资源的依赖与社会支持之间的关系。
采用多阶段复杂抽样设计，在中国 26 个地点进行横断面研究。共纳入 1160 名年龄≥60 岁的参与者，所有数据均通过面对面访谈使用问卷收集。使用标准化中文版本的明尼苏达多相人格测验第二版（MMPI-II）测量 DPD。使用一般自我效能量表的中文版评估自我效能。使用老年资源与服务量表的中文版问卷测量社会支持。社区服务和资源包含 44 个项目。使用逻辑回归模型评估 DPD 与社会支持和自我效能水平的关系。使用协方差分析评估社会支持和自我效能之间的关系。
单变量分析结果显示，与居住在城市的老年人相比，居住在农村地区的老年人 DPD 评分更高，自我效能感更低（P<0.001）。逻辑回归分析显示，DPD 与农村老年人接受社区卫生服务、签约家庭医生服务和定期健康知识讲座的频率呈正相关，比值比分别为 1.58（P<0.001）、2.03（P=0.013）和 2.67（P=0.005）。在加性模型中，社会支持和自我效能对 DPD 的影响存在显著的交互作用（P<0.001）。
DPD 主要与农村老年人的社区资源有关。社会支持和自我效能通过协同作用与 DPD 共同相关。这些结果表明，通过有效的社会支持，可以减少农村老年人的 DPD，从而直接和间接促进老年人利用社区资源，提高自我效能。
