老年人的网络疑病症及其与认知融合、健康相关生活质量和心理健康的关系：中介分析

Cyberchondria in Older Adults and Its Relationship With Cognitive Fusion, Health-Related Quality of Life, and Mental Well-Being: Mediation Analysis.

作者信息

Xu Richard Huan, Starcevic Vladan

机构信息

Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong).

Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, Brain and Mind Centre, University of Sydney, Sydney, Australia.

出版信息

JMIR Aging. 2025 May 21;8:e70302. doi: 10.2196/70302.

DOI:10.2196/70302

PMID:40397949

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12138317/

Abstract

BACKGROUND

Cyberchondria is the compulsive searching for health information online that continues despite harmful effects. It leads to increased health anxiety and lower health-related quality of life (HRQOL). Older adults face higher risks of cyberchondria due to their limited digital literacy skills and more frequent health concerns. However, researchers have not thoroughly studied how cyberchondria affects this age group.

OBJECTIVE

This study aimed to explore cyberchondria in the older population and investigate its relationship with cognitive fusion (ie, the tendency to become entangled with thoughts and perceive them as literal truths that dictate behavior), HRQOL, and mental well-being.

METHODS

A web-based, cross-sectional survey was conducted in May 2024 with a sample of 638 participants from China aged ≥60 years recruited through the online panel of a survey company. The participants completed questionnaires assessing cyberchondria (using the Cyberchondria Severity Scale-12 [CSS-12]), cognitive fusion, HRQOL, and mental well-being. Structural equation modeling (SEM) was used to assess the hypothesized mediation model, and standardized estimates and their 95% CIs were calculated for all structural paths.

RESULTS

Participants had a mean CSS-12 score of 40 (SD 8.5), suggesting a fairly high level of cyberchondria in this sample. Participants with a higher socioeconomic status tended to report lower levels of cyberchondria. The SEM showed that cyberchondria was positively associated with cognitive fusion (β=0.505, P<.001 for both models) and negatively associated with HRQOL (β=-0.221, P<.001) and mental well-being (β=-0.212, P<.001). The mediation model showed a good fit and demonstrated that cognitive fusion fully mediated the total effect of cyberchondria on HRQOL and mental well-being.

CONCLUSIONS

Cyberchondria may be more prominent in older Chinese adults, especially those residing in rural areas and with a lower socioeconomic status. Additionally, cyberchondria can enhance cognitive fusion, contributing to poor HRQOL and mental well-being. Interventions focused on "defusing" cyberchondria-relevant thoughts may help reduce maladaptive behaviors associated with cyberchondria and improve the overall well-being of older populations.

摘要

背景

网络疑病症是指尽管有害但仍持续在网上强迫性地搜索健康信息。它会导致健康焦虑增加和与健康相关的生活质量（HRQOL）降低。由于数字素养技能有限且健康问题更频繁，老年人面临更高的网络疑病症风险。然而，研究人员尚未深入研究网络疑病症如何影响这个年龄组。

目的

本研究旨在探讨老年人群中的网络疑病症，并调查其与认知融合（即倾向于与想法纠缠并将其视为决定行为的字面真理）、HRQOL和心理健康的关系。

方法

2024年5月进行了一项基于网络的横断面调查，样本为通过一家调查公司的在线面板招募的638名年龄≥60岁的中国参与者。参与者完成了评估网络疑病症（使用网络疑病症严重程度量表-12[CSS-12]）、认知融合、HRQOL和心理健康的问卷。采用结构方程模型（SEM）评估假设的中介模型，并计算所有结构路径的标准化估计值及其95%置信区间。

结果

参与者的CSS-12平均得分为40（标准差8.5），表明该样本中的网络疑病症水平相当高。社会经济地位较高的参与者往往报告较低水平的网络疑病症。SEM显示，网络疑病症与认知融合呈正相关（两个模型的β=0.505，P<.001），与HRQOL呈负相关（β=-0.221，P<.001），与心理健康呈负相关（β=-0.212，P<.001）。中介模型显示拟合良好，并表明认知融合完全中介了网络疑病症对HRQOL和心理健康的总效应。