School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China.
Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China.
Front Public Health. 2023 Sep 19;11:1116263. doi: 10.3389/fpubh.2023.1116263. eCollection 2023.
The aging trend of China's population is severe and successful aging (SA) is imminent. Aging can lead to various chronic diseases, with hypertension being the most common. Due to this lifelong disease, patients suffer from many anxieties, as death anxiety (DA) can be the most prevalent. Studies have exhibited that middle-aged adults approaching the transition to an older state show more pronounced DA than the more senior. It has been suggested that psychological resilience (PR) can reduce DA. Therefore, this study aimed to analyze the mediating effect of SA between PR and DA in middle-aged and older adults with hypertension.
A cross-sectional survey was designed. From August to December 2021, 298 middle-aged and older adults with hypertension were selected by multistage cluster random sampling in three districts (Ling he District, Gu ta District, and Tai He District) of Jinzhou City, Liaoning Province. They were surveyed using the demographic questionnaires, the Conner-Davidson Resilience Scale, the Successful Aging Inventory, and the Chinese version of a Likert-type Templer-Death Anxiety Scale. Descriptive analyses, independent sample -test, and one-way analysis of variance (ANOVA) were used to describe demographic characteristics among hypertensive patients with different characteristics, respectively. Statistics were considered significant when < 0.05. Pearson correlation coefficients describe the relationship between PR, SA, and DA. The research model was shaped through Structural Equation Modeling (SEM). SPSS PROCESS macro was used to verify the mediation model. A binary logistic regression model was used with DA as the dependent variable.
The scores for PR, SA, and DA in hypertensive patients are (49.52 ± 14.38) points, (51.22 ± 7.63) points, and (46.67 ± 9.03) points. PR was negatively correlated with DA ( = -0.307, < 0.01). Moreover, incorporating SA as a mediating variable in PR and DA, SA was positively correlated with PR ( = 0.335, < 0.01) and DA ( = 0.085, > 0.05). The direct effect is opposite to the sign of the indirect effect. There is a suppression between PR and DA with a percentage of 20.7%. Good self-assessed health status [0.057 (0.018, 0.183)] may be a protective factor for DA.
Healthcare providers should improve the PR of middle-aged and older adults with hypertension through interventions that reduce DA and increase the likelihood of SA.
中国人口老龄化趋势严峻，成功老龄化（SA）迫在眉睫。衰老会导致各种慢性疾病，其中高血压最为常见。由于这种终身疾病，患者会产生许多焦虑，其中死亡焦虑（DA）最为普遍。研究表明，从中年向老年过渡的成年人表现出比更年长的成年人更明显的 DA。有研究表明，心理弹性（PR）可以降低 DA。因此，本研究旨在分析 PR 通过 SA 对中年和老年高血压患者 DA 的中介作用。
采用横断面调查设计。2021 年 8 月至 12 月，采用多阶段整群随机抽样方法，在辽宁省锦州市凌河、古塔和太和三个区（县）选取 298 名中年和老年高血压患者进行调查。采用一般情况问卷、康纳-戴维森韧性量表、成功老龄化量表和中文 Likert 式 Templer-死亡焦虑量表对患者进行调查。采用描述性分析、独立样本 t 检验和单因素方差分析（ANOVA）分别描述不同特征高血压患者的人口统计学特征。当 < 0.05 时，统计学差异具有显著性。Pearson 相关系数描述了 PR、SA 和 DA 之间的关系。通过结构方程模型（SEM）构建研究模型。使用 SPSS PROCESS 宏验证中介模型。采用二元逻辑回归模型，以 DA 为因变量。
高血压患者的 PR、SA 和 DA 得分分别为（49.52 ± 14.38）分、（51.22 ± 7.63）分和（46.67 ± 9.03）分。PR 与 DA 呈负相关（ = -0.307， < 0.01）。此外，将 SA 作为 PR 和 DA 的中介变量纳入，SA 与 PR（ = 0.335， < 0.01）和 DA（ = 0.085， > 0.05）呈正相关。直接效应与间接效应的符号相反。PR 和 DA 之间存在抑制作用，抑制程度为 20.7%。良好的自我健康评估[0.057（0.018，0.183）]可能是 DA 的保护因素。
医疗保健提供者应通过降低 DA 和提高 SA 来提高中年和老年高血压患者的 PR，从而改善他们的状况。
