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中国社区老年人的日常生活内在能力与工具性活动:双向社会支持与连贯感的中介作用

Intrinsic Capacity and Instrumental Activity of Daily Living Among Community Dwelling Elderly in China: The Mediating Effect of Two-Way Social Support and Sense of Coherence.

作者信息

Hu Qingqing, Xu Jiajia, Ren Yifei, Ding Jie, Chu Ting

机构信息

Nursing School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People's Republic of China.

出版信息

Public Health Nurs. 2025 Mar-Apr;42(2):762-770. doi: 10.1111/phn.13505. Epub 2024 Dec 1.

Abstract

OBJECTIVES

To explore the influence of intrinsic capacity (IC) on instrumental activities of daily living (IADL) among community-dwelling elderly and to analyze the chain-mediated effects of two-way social support, and sense of coherence (SOC).

DESIGN

This study was a cross-sectional research design. Participants were recruited from September 2023 to December 2023 from Hangzhou City, Zhejiang Province, China, using a multistage sampling method.

SAMPLE

Participants in this study were at least 60 years old and had been currently living in the community for at least 1 year (n = 458).

MEASUREMENTS

The Integrated Care for Older People screening tool, the Brief Two-Way Social Support Scale, the Sense of Coherence Scale-13, and the Functional Activities Questionnaire were used to collect relevant data, which were statistically tested using structural equation modeling and multiple mediation effects.

RESULTS

There were correlations between IC, two-way social support, SOC and IADL in community-dwelling elderly (all p < 0.01). IC predicted two-way social support (β = 0.570, p < 0.001), SOC (β = 0.544, p < 0.001) and IADL (β = -0.492, p < 0.001); two-way social support had a positive predictive effect on SOC (β = 0.363, p < 0.001) but a negative predictive effect on IADL (β = -0.193, p < 0.001); SOC negatively predicted IADL (β = -0.150, p < 0.05).

CONCLUSIONS

To mitigate the impact of declining IC on IADL among community-dwelling elderly, to sustain independent living, and to reduce the risk of progression to illness and disability, this study proposes two-way social support and SOC as potential effective intervention targets. This conclusion holds implications for the assessment and intervention of elderly health, as well as the formulation of public health policies.

摘要

目的

探讨内在能力(IC)对社区居住老年人日常生活工具性活动(IADL)的影响,并分析双向社会支持和连贯感(SOC)的链式中介效应。

设计

本研究为横断面研究设计。采用多阶段抽样方法,于2023年9月至2023年12月从中国浙江省杭州市招募参与者。

样本

本研究的参与者年龄至少为60岁,目前在社区居住至少1年(n = 458)。

测量

使用老年人综合护理筛查工具、简短双向社会支持量表、连贯感量表-13和功能活动问卷收集相关数据,并采用结构方程模型和多重中介效应进行统计检验。

结果

社区居住老年人的IC、双向社会支持、SOC和IADL之间存在相关性(均p < 0.01)。IC预测双向社会支持(β = 0.570,p < 0.001)、SOC(β = 0.544,p < 0.001)和IADL(β = -0.492,p < 0.001);双向社会支持对SOC有正向预测作用(β = 0.363,p < 0.001),但对IADL有负向预测作用(β = -0.193,p < 0.001);SOC对IADL有负向预测作用(β = -0.150,p < 0.05)。

结论

为减轻IC下降对社区居住老年人IADL的影响,维持独立生活,并降低疾病和残疾进展风险,本研究提出双向社会支持和SOC作为潜在的有效干预靶点。这一结论对老年人健康评估和干预以及公共卫生政策制定具有启示意义。

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