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社区护理对老年人主观幸福感的影响:来自中国健康与养老追踪调查(CLASS)数据的证据

Community nursing on subjective well-being of the elderly: evidence from CLASS data.

作者信息

Jin Fulei, Chen Tao

机构信息

School of Labor Relations, Shandong Management University, Jinan, 250357, China.

Department of Economics, University at Albany, SUNY, Albany, NY, 12222, USA.

出版信息

BMC Nurs. 2025 Jul 1;24(1):757. doi: 10.1186/s12912-025-03205-7.

Abstract

BACKGROUND

With the acceleration of the global aging process, Subjective Well-being (SWB) of the elderly which focuses on their inner true feelings and reflects the meaning and happiness of their lives, has drawn extensive attention from all walks of life. However, due to factors like the flow of the labor force, the miniaturization and flattening of family structures, the traditional function of family care has been continuously weakened, and it's hard for families to take on the all-round care for the elderly.

METHODS

This study utilized the micro-panel data from the China Longitudinal Aging Social Survey (CLASS) in 2018 and 2020, covering a sample of 8,179 elderly people aged over 60 in China. The fixed effects model was employed for the benchmark regression. The two-stage least squares method (2SLS) was used to overcome the endogeneity problem. Replacing variables and samples as well as the propensity score matching (PSM) was adopted for the robustness test, and the mediating effect model was utilized for the mechanism analysis.

RESULTS

The findings of this study are as follows: (1) Community nursing increases the SWB of the elderly by 0.101 standard deviations. (2) Mechanism analysis demonstrates that community nursing can improve the SWB of the elderly by means of health improvement (0.029/0.003/0.006), social participation (0.014), and social identity (0.018/0.012). (3) Heterogeneity analysis discloses that for different types of elderly groups, community nursing plays a more crucial role in enhancing the SWB of vulnerable elderly individuals with low incomes (0.145, p < 0.01), low educational attainment (0.092, p < 0.01), living in rural areas (0.447, p < 0.01), and not living with their children (0.296, p < 0.01).

CONCLUSION

This study has confirmed the crucial role of community nursing in enhancing the SWB of the elderly. Moreover, this positive influence has a multi-dimensional impact mechanism and shows characteristics of group differences. Based on this, Special training programs for community nurses can be carried out, with a focus on enhancing their capabilities in elderly health assessment and planning, humanistic qualities, as well as communication and coordination abilities. Community institutions can implement a stratified nursing strategy, designing customized interventions for vulnerable elderly groups.

摘要

背景

随着全球老龄化进程的加速,关注老年人内心真实感受、反映其生活意义和幸福程度的主观幸福感(SWB)受到了各界的广泛关注。然而,由于劳动力流动、家庭结构小型化和平等化等因素,家庭照料的传统功能不断被削弱,家庭难以承担起对老年人的全方位照料。

方法

本研究利用了2018年和2020年中国老年社会追踪调查(CLASS)的微观面板数据,样本涵盖了中国8179名60岁以上的老年人。采用固定效应模型进行基准回归。使用两阶段最小二乘法(2SLS)来克服内生性问题。通过替换变量和样本以及倾向得分匹配(PSM)进行稳健性检验,并利用中介效应模型进行机制分析。

结果

本研究的结果如下:(1)社区护理使老年人的主观幸福感提高了0.101个标准差。(2)机制分析表明,社区护理可以通过改善健康(0.029/0.003/0.006)、社会参与(0.014)和社会认同(0.018/0.012)来提高老年人的主观幸福感。(3)异质性分析表明,对于不同类型的老年群体,社区护理在提高低收入(0.145,p<0.01)、低教育程度(0.092,p<0.01)、农村地区(0.447,p<0.01)以及未与子女同住(0.296,p<0.01)的弱势老年个体的主观幸福感方面发挥着更关键的作用。

结论

本研究证实了社区护理在提高老年人主观幸福感方面的关键作用。此外,这种积极影响具有多维度的影响机制,并呈现出群体差异的特征。基于此,可以开展针对社区护士的专项培训项目,重点提高其老年健康评估与规划能力、人文素养以及沟通协调能力。社区机构可以实施分层护理策略,为弱势老年群体设计定制化干预措施。

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