社区居住的尼泊尔老年人孤独感和抑郁与感知社会支持的中介作用。
The mediating role of perceived social support on loneliness and depression in community-dwelling Nepalese older adults.
机构信息
School of Nursing and Midwifery, Patan Academy of Health Sciences, Lalitpur, Nepal.
Hospital Nursing Administrator Health Directorate, Pokhara, Gandaki Province, Nepal.
出版信息
BMC Geriatr. 2024 Oct 21;24(1):854. doi: 10.1186/s12877-024-05461-9.
BACKGROUND
Loneliness has been identified as a significant independent predictor of depression among older adults. Social support has been reported to play a protective role against both loneliness and depression in older adults. However, few studies to date have investigated the three constructs concurrently and the mediating role of Perceived Social Support (PSS) on the relationship between loneliness and depression in this age group. The current study aimed to assess the relationship between loneliness and depression among community-dwelling Nepalese older adults based on the mediating role of PSS.
METHODS
This descriptive cross-sectional research study included 367 community-dwelling older adults from a randomly selected ward in Kathmandu, Nepal. The University of California, Los Angeles Loneliness Scale, Geriatric Depression Scale, and Multidimensional Scale of Perceived Social Support were used. Correlation analysis, regression analysis, and the PROCESS 4.1 macro developed by Hayes with a bootstrapping procedure were used to test the mediating effect of the PSS on the relationship between loneliness and depression.
RESULTS
Loneliness was negatively associated with the PSS (β = -0.405; 95% CI: -0.473, -0.337; P < 0.001), and the PSS was positively associated with depression (β = 0.057; 95% CI: 0.014, 0.099; P = 0.009). The direct effect of loneliness on depression was positive and significant (β = 0.151; 95% CI: 0.117, 0.184; P < 0.001), whereas the indirect effect of loneliness on depression through the PSS was negative (path c; β = -0.023, 95% CI: -0.041, -0.005). The results indicated that the PSS partially mediated the relationship between loneliness and depression.
CONCLUSION
These findings suggest that interventions focusing on reducing loneliness and fostering social support may be able to lessen depressive symptoms in older adults. By addressing these factors, healthcare providers and carers can promote the mental health of older adults.
背景
孤独感已被确定为老年人抑郁的一个重要独立预测因素。有报道称，社会支持对老年人的孤独感和抑郁都有保护作用。然而，迄今为止，很少有研究同时调查这三个结构，以及在这一年龄组中，感知社会支持（PSS）在孤独感和抑郁之间关系中的中介作用。本研究旨在根据 PSS 的中介作用，评估尼泊尔社区居住的老年人群体中孤独感和抑郁之间的关系。
方法
这是一项描述性的横断面研究，纳入了来自尼泊尔加德满都一个随机选择的区的 367 名社区居住的老年人。使用了加利福尼亚大学洛杉矶孤独量表、老年抑郁量表和多维感知社会支持量表。采用相关分析、回归分析和 Hayes 开发的 PROCESS 4.1 宏（采用自举程序）来检验 PSS 对孤独感和抑郁之间关系的中介作用。
结果
孤独感与 PSS 呈负相关（β=-0.405；95%置信区间：-0.473，-0.337；P<0.001），而 PSS 与抑郁呈正相关（β=0.057；95%置信区间：0.014，0.099；P=0.009）。孤独感对抑郁的直接影响是正向且显著的（β=0.151；95%置信区间：0.117，0.184；P<0.001），而孤独感通过 PSS 对抑郁的间接影响是负向的（路径 c；β=-0.023，95%置信区间：-0.041，-0.005）。结果表明，PSS 部分中介了孤独感和抑郁之间的关系。
结论
这些发现表明，关注减少孤独感和培养社会支持的干预措施可能能够减轻老年人的抑郁症状。通过解决这些因素，医疗保健提供者和护理人员可以促进老年人的心理健康。
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