南京地区社区老年2型糖尿病患者孤独感现状及影响因素分析

doi:10.12183/j.scjpm.2022.0826

摘要/Abstract

摘要： 目的调查社区老年2型糖尿病患者孤独感现状并分析其影响因素。方法以随机抽样法选取本社区老年2型糖尿病患者作为研究对象,以孤独感量表（ULS-8）评估患者孤独感,以简版自我感知老化量表（B-APQ）评估患者自我感知老化情况,以健康问卷抑郁症状群量表（PHQ-9）评估患者抑郁症状。分析患者ULS-8评分与B-APQ评分和PHQ-9评分的相关性,并分析患者孤独感发生的影响因素。结果 2型糖尿病患者ULS-8评分平均（20.14±2.13）分,B-APQ评分平均（46.75±5.42）分,PHQ-9评分平均（6.23±1.54）分。Pearson相关分析结果显示,2型糖尿病患者ULS-8评分与B-APQ评分、PHQ-9评分均呈正相关（均P<0.01）。多重线性逐步回归分析显示,未婚/离异/丧偶（β’=0.315）、高中及以下（β’=0.458）、独居（β’=0.217）、从不锻炼（β’=0.170）、B-APQ评分高（β’=0.373）、PHQ-9评分高（β’=0.135）的2型糖尿病患者孤独感较高。结论 2型糖尿病患者ULS-8评分处于较高水平,婚姻状况、文化程度、居住方式、锻炼情况、B-APQ评分及PHQ-9评分为2型糖尿病患者孤独感发生的影响因素,应针对以上高危人群采取干预措施,以尽量减轻患者孤独感,促进其恢复。

关键词: 2型糖尿病, 老年人, 社区, 影响因素, 孤独感

Abstract: Objective To investigate the loneliness status of elderly patients with type 2 diabetes mellitus （T2DM） in the community and analyze its influencing factors. Methods The elderly T2DM patients in the community were selected by random sampling method. The loneliness of T2DM patients was assessed by the Loneliness Scale （ULS-8）, the self-perceived aging was assessed by the Brief Ageing Perceptions Questionnaire （B-APQ）, and the depressive symptoms were assessed by the Patients Health Questionnaire Depressive Symptoms Scale （PHQ-9）. The correlation between the patient's ULS-8 score, B-APQ score, and PHQ-9 score was analyzed, and the factors that affected the occurrence of loneliness in patients were analyzed. Results The average ULS-8 score, B-APQ score, and PHQ-9 score of T2DM patients were （20.14±2.13）, （46.75±5.42）, and （6.23±1.54）, respectively. Pearson correlation analysis showed that the ULS-8 score was positively correlated with the B-APQ score and PHQ-9 score in T2DM patients （both P<0.01）. Multiple stepwise regression analysis showed that T2DM patients who were unmarried/divorced/widowed （β’=0.315）, with an educational level of high school and below （β’=0.458）, living alone （β’=0.217）, never exercise （β’=0.170）, high B-APQ score （β’=0.373）, high PHQ-9 score （β’=0.135） had a high sense of loneliness. Conclusion The ULS-8 score of T2DM patients is at a high level. Marital status, education level, living style, exercise situation, B-APQ score, and PHQ-9 score are the factors that affect loneliness in T2DM patients. Intervention measures should be taken for the above high-risk groups to minimize the loneliness of patients and promote their recovery.

Key words: Type 2 diabetes mellitus, Elderly, Community, Influencing factor, Loneliness

中图分类号:

R195.4

王颖, 王晓玲, 姜田甜, 周伟, 张琛. 南京地区社区老年2型糖尿病患者孤独感现状及影响因素分析[J]. 华南预防医学, 2022, 48(7): 826-830.

WANG Ying, WANG Xiao-ling, JIANG Tian-tian, ZHOU Wei, ZHANG Chen. Status and influencing factors of loneliness in community elderly patients with type 2 diabetes mellitus in Nanjing[J]. South China Journal of Preventive Medicine, 2022, 48(7): 826-830.

参考文献

[1] 王晓丽,张亚宁,王春丽,等. 西安市新城区2型糖尿病患者自我效能及其影响因素研究[J]. 华南预防医学, 2021, 47(7):944-947.
[2] Mukherjee N, Chaturvedi SK.Depressive symptoms and disorders in type 2 diabetes mellitus[J]. Curr Opin Psychiatry, 2019, 32(5):416-421.
[3] Guerrero Fernández de Alba I, Gimeno-Miguel A, Poblador-Plou B, et al. Association between mental health comorbidity and health outcomes in type 2 diabetes mellitus patients[J]. Sci Rep, 2020, 10(1):19583.
[4] Hackett RA, Hudson JL, Chilcot J.Loneliness and type 2 diabetes incidence: Findings from the English Longitudinal Study of Ageing[J]. Diabetologia, 2020, 63(11):2329-2338.
[5] 邓祺丹,胡雅静,李林静,等.抑郁症状在社区老年糖尿病患者相关痛苦与衰弱状况间的中介效应[J].中南医学科学杂志,2020,48(3):229-232,237.
[6] Huang CJ, Hsieh HM, Tu HP, et al.Generalized anxiety disorder in type 2 diabetes mellitus: Prevalence and clinical characteristics[J].Braz J Psychiatry,2020,42(6):621-629.
[7] 毕雅昕,张露,李翔宁,等.2型糖尿病病人孤独感现状及影响因素的研究进展[J].护理研究, 2022,36(1): 96-99.
[8] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志, 2018, 10(1):4-67.
[9] Hays RD, Dimatteo MR.A short-form measure of loneliness[J]. J Pers Assess,1987,51(1):69-81.
[10] 周亮,黎芝,胡宓,等. ULS-8孤独感量表信效度检验及其应用[J].中南大学学报(医学版), 2012,37(11):1124-1128.
[11] Sexton E, King-Kallimanis BL, Morgan K, et al.Development of the Brief Ageing Perceptions Questionnaire(B-APQ): A confirmatory factor analysis approach to item reduction[J].BMC Geriatrics,2014,14(1):1-11.
[12] 扈娜,孟令弟,刘堃.简版自我感知老化量表在社区老年人中应用的信效度研究[J].现代预防医学,2018,45(4):655-658,682.
[13] 孙羽燕,张会敏,高杰,等.社区老年高血压病人孤独感现状及影响因素分析[J].护理研究, 2021, 35(5):808-814.
[14] 中国疾病预防控制中心.中国慢性病及其危险因素监测报告(2010)[M].北京:人民卫生出版社,2012:43-45.
[15] 冯祥,冯学强,边迎光,等. 扬中市中老年居民糖尿病患病率,知晓率,治疗率和控制率现状及其与社会经济地位关系[J].中国公共卫生, 2021, 37(6):960-964.
[16] 韩志红,郭智慧.隔代抚养对农村儿童孤独感和心理健康的影响[J].华南预防医学, 2016, 42(2):167-170.
[17] 李少杰,崔光辉,尹永田.社区老年人社会隔离及孤独感对衰弱影响[J].中国公共卫生, 2022,38(4):399-403.
[18] Hackett RA, Poole L, Hunt E, et al.Loneliness and biological responses to acute stress in people with type 2 diabetes[J].Psychophysiology, 2019, 56(6):13341-13447.
[19] Kobos E, Szewczyk A, Kokoszka-Paszkot J, et al.Factors associated with loneliness in patients with diabetes mellitus[J]. Nurs Open, 2020, 8(1):517-524.
[20] Taylor HO, Nguyen AW, Sands LP.Depressive symptoms and loneliness among black and white older adults:The moderating effects of race[J]. Innov Aging, 2020, 4(5):1-13.