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社会关系和休闲活动对多发性硬化症老年患者幸福感的预测作用:丹麦的一项横断面调查研究。

Social relations and leisure activities as predictors of wellbeing among older adults with multiple sclerosis: A cross-sectional survey study in Denmark.

机构信息

The Danish Multiple Sclerosis Society, Valby, Denmark; Center for Healthy Aging, Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

Mult Scler Relat Disord. 2023 Sep;77:104878. doi: 10.1016/j.msard.2023.104878. Epub 2023 Jul 4.

DOI:10.1016/j.msard.2023.104878
PMID:37429098
Abstract

BACKGROUND

Due to the growing number of people aging with multiple sclerosis (MS), there has been a call for rehabilitation specially targeted older adults with MS in order to support them in better wellbeing, despite physical and cognitive impairment. However, the existing research within the area of rehabilitation has primarily focused on the physical and psychological aspects of aging with MS, omitting the social element.

OBJECTIVE

This study aims to examine how social relations and engagement in leisure activities predict wellbeing among older adults with MS living in Denmark. Furthermore, the study aims to identify which sociodemographic and health-related factors are the most important in predicting whether older adults with MS face challenges in participating in leisure activities and experiencing different kinds of social relations.

METHOD

A cross-sectional survey was designed to measure social relations, wellbeing, and engagement in leisure activities among older adults with MS. Of the 4,329 people over 65 years diagnosed with MS in Denmark in 2022, 2,574 (59.46%) were invited to participated in the study, and 1,107 (43.03%) ended up answering the survey. Linear and logistic regression analyses and dominance analyses were conducted to examine the associations between wellbeing, leisure activities, social relations, sociodemographic and health-related factors.

RESULTS

The results of the study show that perceived emotional social support (mean difference 8.69, 95% CI 5.23; 12.14) and perceived instrumental social support (mean difference 4.15, 95% CI 0.95; 7.35), were associated with better wellbeing among older adults with MS. Perceived strained social relations (mean difference -7.95, 95% CI -10.66; -5.26) were on the contrary associated with lower levels of wellbeing. Strained social relations were the most important predictors of wellbeing accounting for 59% of the predicted variance. Experiencing social emotional support from friends, coworkers, or neighbors (39% of the predicted variance), experiencing instrumental social support from children or children in law (43% of the predicted variance), and experiencing strained social relations with partner (48% of the predicted variance) constituted he most important predictor of wellbeing. Engagement in five out of fourteen leisure activities were associated with better wellbeing among the participants. The leisure activities there was found to be the most important predictor of wellbeing represented both social (37% of the predicted variance), physical (18% of the predicted variance), and creative elements (13% of the predicted variance). Finally, cohabitation was found to be the most important predictor of having perceived emotional social support (59% of the predicted variance), instrumental social support (78.9% of the predicted variance) and strained social relations (18.8% of the predicted variance) and mobility was found to be the most important predictor of challenges in participating in leisure activities (81.8% of the predicted variance).

CONCLUSION

The findings of the study highlight that rehabilitation targeting older adults with MS should focus on both physical, psychological, and social elements of peoples' everyday life. Further, the results indicate that future rehabilitation focusing on social elements of aging with MS should take into account health and sociodemographic characteristics such as cohabitation, mobility, age, and sex, as these potentially relate to participation in leisure activities as well as social relations among older adults.

摘要

背景

由于多发性硬化症(MS)患者老龄化人数不断增加,有人呼吁专门为老年 MS 患者提供康复服务,以支持他们更好地保持健康,尽管他们存在身体和认知障碍。然而,该领域现有的康复研究主要集中在 MS 患者老龄化的身体和心理方面,忽略了社会因素。

目的

本研究旨在探讨丹麦老年 MS 患者的社会关系和休闲活动参与度如何预测其幸福感。此外,本研究还旨在确定哪些社会人口和健康相关因素是预测老年 MS 患者是否面临参与休闲活动和体验不同社会关系挑战的最重要因素。

方法

采用横断面调查设计,测量老年 MS 患者的社会关系、幸福感和休闲活动参与度。在 2022 年丹麦被诊断为 65 岁以上的 4329 名 MS 患者中,邀请了 2574 名(59.46%)参与研究,最终有 1107 名(43.03%)回答了调查。采用线性和逻辑回归分析以及优势分析来检验幸福感、休闲活动、社会关系、社会人口和健康相关因素之间的关联。

结果

研究结果表明,感知到的情感社会支持(平均差异 8.69,95%CI 5.23;12.14)和感知到的工具性社会支持(平均差异 4.15,95%CI 0.95;7.35)与老年 MS 患者的幸福感呈正相关。感知到的紧张社会关系(平均差异-7.95,95%CI-10.66;-5.26)则与较低的幸福感呈负相关。紧张的社会关系是幸福感的最重要预测因素,占预测方差的 59%。从朋友、同事或邻居那里获得社会情感支持(预测方差的 39%)、从子女或子女的配偶那里获得工具性社会支持(预测方差的 43%)以及与伴侣关系紧张(预测方差的 48%)构成了幸福感的最重要预测因素。参与 14 项休闲活动中的 5 项与参与者的幸福感呈正相关。研究发现,休闲活动是幸福感的最重要预测因素,它既代表了社会(37%的预测方差)、身体(18%的预测方差)和创造性元素(13%的预测方差)。最后,同居被发现是感知到情感社会支持(59%的预测方差)、工具性社会支持(78.9%的预测方差)和紧张社会关系(18.8%的预测方差)的最重要预测因素,而行动能力被发现是参与休闲活动的挑战(81.8%的预测方差)的最重要预测因素。

结论

本研究结果强调,针对老年 MS 患者的康复治疗应同时关注人们日常生活中的身体、心理和社会等方面。此外,研究结果表明,未来以 MS 患者老龄化的社会元素为重点的康复治疗应该考虑健康和社会人口特征,如同居、行动能力、年龄和性别,因为这些因素可能与老年患者的休闲活动参与度和社会关系有关。

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