Roskoschinski Annika, Liang Wei, Duan Yanping, Al-Salehi Hayl, Lippke Sonia
Unit for Geriatrics and Physical Medicine, Helios Klinikum Berlin-Buch, Berlin, Germany.
Constructor University Bremen, Bremen, Germany.
Front Psychiatry. 2023 Oct 30;14:1232067. doi: 10.3389/fpsyt.2023.1232067. eCollection 2023.
As relatively little is known about self-efficacy and social support in individuals aged 65 years and older and whether they are facing a decline in life due to multimorbidity and previous COVID-19 infection, this study investigated hypotheses based on Social Cognitive Theory.
It was tested whether depressive symptoms in multimorbid patients who were hospitalized for COVID-19 infection, and recover post infection during their hospital stay, do not differ from those of multimorbid patients hospitalized for other conditions. Furthermore, we tested whether depressive symptoms are associated with increased loneliness scores, low self-efficacy beliefs, and poorly perceived social support. Additionally, it was investigated whether self-efficacy is a mediator variable, and social support is a moderator variable between loneliness and depression. = 135 patients with or without previous COVID-19 infection (mean age 64.76) were recruited. Paper questionnaires were collected at the time of inpatient hospital admission in the year 2021 and in a cross-sectional study design. The study compared = 45 multimorbid patients who survived COVID-19 infection with those = 90 who were not infected before.
No significant difference in depressive symptomology between these two groups revealed [ = 130, = 0.90, = 0.024); = 0.255, = 0.86]. The study found a positive correlation between loneliness and anxiety and depression in both groups ( = 0.419 and = 0.496). Self-efficacy mediated the relation between loneliness and depression. The completely standardized indirect effect was = 0.111, percentile Bootstrap 95% CI 0.027-0.201.
The research findings suggest the importance of self-efficacy, and loneliness in the development of depressive symptoms, and have several practical implications for improving the mental health of multimorbid patients: Prospectively, treatment should not only focus on physical and cognitive health, but also on promoting self-efficacy and perceived social support, as well as address loneliness with psychoeducational interventions. Replication of the findings and conducting interventional research also employing lifestyle components should follow up, as this study tested associations but no causal relationships.
由于对于65岁及以上人群的自我效能感和社会支持，以及他们是否因多种疾病并存和先前感染过新冠病毒而面临生活质量下降的情况了解相对较少，本研究基于社会认知理论对相关假设进行了调查。
我们测试了因感染新冠病毒住院且在住院期间感染后康复的多病共存患者的抑郁症状，是否与因其他疾病住院的多病共存患者的抑郁症状存在差异。此外，我们还测试了抑郁症状是否与孤独感得分增加、自我效能感信念较低以及社会支持感知较差有关。另外，我们调查了自我效能感是否为中介变量，以及社会支持是否为孤独感与抑郁之间的调节变量。招募了135名有或没有先前感染新冠病毒的患者（平均年龄64.76岁）。在2021年患者住院时通过纸质问卷进行收集，并采用横断面研究设计。该研究将45名从新冠病毒感染中康复的多病共存患者与90名未感染过新冠病毒的患者进行了比较。
两组之间的抑郁症状学无显著差异[F(1,130)=0.90，p=0.024；η²=0.255，ω²=0.86]。研究发现两组中孤独感与焦虑和抑郁之间均呈正相关（r=0.419和r=0.496）。自我效能感介导了孤独感与抑郁之间的关系。完全标准化间接效应为β=0.111，百分位数Bootstrap 95%置信区间为0.027 - 0.201。
研究结果表明自我效能感和孤独感在抑郁症状发展中的重要性，并且对于改善多病共存患者的心理健康有若干实际意义：前瞻性地看，治疗不仅应关注身体和认知健康，还应促进自我效能感和感知到的社会支持，并通过心理教育干预来解决孤独感问题。由于本研究测试的是关联而非因果关系，因此应后续进行研究结果的复制以及开展采用生活方式因素的干预性研究。
