Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden.
Department of Biomedical and Clinical Sciences/Center for Social and Affective Neuroscience, Medicine, Linköping University, Linköping, Sweden.
BMC Public Health. 2024 Jun 5;24(1):1502. doi: 10.1186/s12889-024-19034-3.
A person's sense of coherence (SoC) is likely to affect coping when exposed to a life changing event like the COVID -19 pandemic, which impacted the older population especially hard, an age group that already suffers from a lot of mental illness. Thus, the aim of this study was to investigate the associations between SoC and mental health in older adults using both screening scales and hair cortisol concentrations (HCC).
A cross-sectional design studying a cohort of 70-80 years old, N = 260, set in Swedish primary care during the pandemic years 2021-2022. Instruments used are sense of coherence 13 (SoC-13), EQ-5D-3L, Geriatric depression scale 20 (GDS-20), Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS-10). Sociodemography and factors concerning SoC, and mental health are explored. HCC are measured using radioimmunoassay. Outcome measures are factors independently associated with SoC. Linear regression models were performed with SoC as dependent variable, and priory path analyses explored whether associations with SoC were direct, or indirect via anxiety.
SoC was significantly associated with anxiety (p < 0.001), perceived economic status (p = 0.003), belief in the future (p = 0.001), and perceived negative mental effect from the COVID -19 pandemic (p = 0.002). The latter was 96% indirectly associated with SoC (p < 0.001), whereas perceived economic status together with belief in the future was 82% directly associated with SoC (p = 0.17). HCC and sex were not significantly associated with SoC, but, noticeably, high HCC was equally distributed between women and men. Women reported significantly lower quality of life (p = 0.03), and more symptoms of anxiety (p = 0.001) and depression (p < 0.001).
Anxiety, belief in the future, perceived negative effect on mental health due to the pandemic, and perceived economic status were significantly associated with SoC. Anxiety is suggested to be important in explaining the association between perceived negative mental effect from the COVID-19 pandemic and SoC. Women reported significantly poorer mental health and life quality than men.
一个人的心理一致感（SoC）可能会影响应对生活变化的方式，例如 COVID-19 大流行，这对老年人影响尤其严重，这个年龄段已经患有很多精神疾病。因此，本研究的目的是使用筛查量表和头发皮质醇浓度（HCC）来调查 SoC 与老年人心理健康之间的关联。
这是一项横断面设计研究，对 2021-2022 年期间在瑞典初级保健中接受 COVID-19 大流行筛查的 70-80 岁的 260 名老年人进行研究。使用的工具包括心理一致感 13 项量表（SoC-13）、EQ-5D-3L、老年抑郁量表 20 项（GDS-20）、医院焦虑和抑郁量表（HADS）和感知压力量表 10 项（PSS-10）。探索了社会人口统计学和与 SoC 以及心理健康有关的因素。使用放射免疫分析法测量 HCC。主要结局指标是与 SoC 独立相关的因素。以 SoC 为因变量进行线性回归模型，探索与 SoC 的关联是否为直接关联，或是否通过焦虑间接关联。
SoC 与焦虑（p<0.001）、感知经济状况（p=0.003）、对未来的信念（p=0.001）和感知 COVID-19 大流行对心理健康的负面影响（p=0.002）显著相关。后者与 SoC 有 96%的间接关联（p<0.001），而感知经济状况加上对未来的信念与 SoC 有 82%的直接关联（p=0.17）。HCC 和性别与 SoC 无显著关联，但值得注意的是，男性和女性的 HCC 水平相当。女性报告的生活质量明显较低（p=0.03），焦虑（p=0.001）和抑郁症状（p<0.001）也明显较多。
焦虑、对未来的信念、感知 COVID-19 大流行对心理健康的负面影响以及感知经济状况与 SoC 显著相关。焦虑可能是解释 COVID-19 大流行对心理健康的负面影响与 SoC 之间关联的重要因素。女性报告的心理健康和生活质量明显低于男性。
