Zang Yuli, Wang Lihua, Choi Kai Chow, Du Hongxia
School of Medicine, Hangzhou City University, Hangzhou, Zhejiang Province, China.
Primary Care Unit, Taolin Township Hospital, Taolin County, Shandong Province, China.
Nurs Open. 2025 Apr;12(4):e70203. doi: 10.1002/nop2.70203.
To investigate the effects of depression on patient activation and summer heat adaptation, considering important contributory factors in older adults with increased cardiovascular health concerns on extremely hot days.
Cross-sectional study adhering to the STROBE guidelines.
Between July and August 2020, a questionnaire survey was administered to 245 older adults at increased risk of cardiovascular diseases in rural areas. Data were collected utilising validated and reliable tools to assess patient activation, depression, summer heat adaptation, frailty, physical activity and other health-related characteristics. Hierarchical regression, mediation and path analyses were conducted to examine the association between activation, depression and summer heat adaptation, while controlling for covariates.
Most participants exhibited the lowest level of activation (75.1%) and a low/moderate level of summer heat adaptation (80.4%). Depression negatively affected activation (β = -0.247), while its indirect effect on patient activation through summer heat adaptation was insignificant (p > 0.05). Education (β = 0.380) and a family history of cardiovascular disease (β = 0.121) positively influenced activation, while alcohol consumption had a negative influence (β = -0.219). When integrating the influence of these three contributory factors, the associative relationship between depression and activation through summer heat adaptation demonstrated a good model fit (chi-square = 8.944, p > 0.05; comparative fit index = 0.987; root mean square error of approximation = 0.045).
Improving older adults' activation for self-managing chronic conditions in summer requires tackling depression, enhancing heat adaptation and addressing concerns related to lack of education and alcohol consumption.
Patients with cardiovascular diseases were involved in piloting the questionnaire and provided examples to address older adults' concerns related to self-management and heat adaptation.
探讨抑郁对患者能动性及夏季热适应的影响，同时考虑到在天气酷热时心血管健康问题增加的老年人中的重要促成因素。
遵循STROBE指南的横断面研究。
2020年7月至8月期间，对农村地区245名心血管疾病风险增加的老年人进行了问卷调查。使用经过验证且可靠的工具收集数据，以评估患者能动性、抑郁、夏季热适应、虚弱、身体活动及其他与健康相关的特征。进行分层回归、中介分析和路径分析，以检验能动性、抑郁和夏季热适应之间的关联，同时控制协变量。
大多数参与者表现出最低水平的能动性（75.1%）和低/中等水平的夏季热适应（80.4%）。抑郁对能动性有负面影响（β = -0.247），而其通过夏季热适应对患者能动性的间接影响不显著（p > 0.05）。教育程度（β = 0.380）和心血管疾病家族史（β = 0.121）对能动性有积极影响，而饮酒有负面影响（β = -0.219）。综合这三个促成因素的影响后，抑郁与通过夏季热适应产生的能动性之间的关联关系显示出良好的模型拟合度（卡方 = 8.944，p > 0.05；比较拟合指数 = 0.987；近似均方根误差 = 0.045）。
在夏季提高老年人自我管理慢性病的能动性，需要解决抑郁问题、增强热适应能力，并关注与教育程度不足和饮酒相关的问题。
心血管疾病患者参与了问卷的试点工作，并提供了实例，以解决老年人与自我管理和热适应相关的问题。
