摘要
背景我国人口老龄化程度不断加深,老年人丧偶率也在持续上升。丧偶作为人类生命历程中遭遇的最具压力的事件之一,其影响还涉及鳏寡者的精神健康和经济水平等层面。国内外关于丧偶对老年人心理健康影响的多项研究中,使用到的代理变量均是较为传统的指标,如主观幸福感、孤独感、抑郁水平等,且部分研究未考虑丧偶与健康状况之间存在的内生性问题。目的评估丧偶对我国老年人心理健康的影响,为制定我国丧偶老年人心理健康干预方案提供依据和参考。方法采用2018年中国健康与养老追踪调查(CHARLS)数据库,筛选4694名60岁及以上老年人作为研究对象,依据“是否丧偶”将纳入的研究对象分为丧偶组(n=644)和未丧偶组(n=4050)。以精神虚弱指数为视角进行老年人心理健康状况的评判。运用倾向得分匹配(PSM)模型,采用Logit回归计算倾向值,并通过标准偏差变化、共同支撑条形图以及核密度分布进行稳健性检验,使用k近邻匹配、半径匹配与核匹配分析丧偶对老年人身心健康的影响情况,并分别基于性别、户口类型和年龄段进行异质性检验。结果相比于未丧偶组,丧偶组老年人心理健康水平有所下降(P<0.05)。Logit回归模型结果显示,女性(OR=2.274,95%CI=1.917~2.698)、年龄(OR=0.975,95%CI=0.972~0.978)、中等教育水平(OR=0.618,95%CI=0.505~0.756)以及家庭月消费(OR=1.000,95%CI=1.000~1.000)与丧偶相关(P<0.05)。匹配后的稳健性检验效果良好,PSM结果显示,丧偶使精神虚弱指数明显升高(ATT值为0.054~0.055,P<0.05)。异质性检验结果显示,丧偶对老年人精神虚弱指数的影响存在城乡和年龄段差异,但无明显的性别差异,其中丧偶对农村老年人的影响更为显著(ATT值为0.072~0.075,P<0.05),但对城镇老年人的影响不明显;对低龄段与高龄段老年人影响较为显著(ATT值分别为0.061~0.081,P<0.05;0.067~0.078,P<0.05),而对中龄
Background Population aging in China is deepening,and the widowed rate of the elderly is also on the rise.Widower is one of the most stressful events in the human life course,and its impact also affects the mental health and economic level of widower.In many studies on the impact of widower on the mental health of the elderly at home and abroad,the proxy variables used are traditional indicators,such as subjective well-being,loneliness,depression level,and some studies do not consider the endogeneity between widowhood and health status.Objective To evaluate the impact of widowhood on the mental health of older adults in China,and provide a basis and reference for formulating the mental health intervention program for older adults in China.Methods Using the 2018 China Health and Retirement Longitudinal Study(CHARLS)as the data source,4694 older adults aged 60 years and above were selected as study subjects and divided into the widowed group(n=644)and non-widowed group(n=4050).The mental frailty index was used as a perspective for evaluating the mental health status of older adults.Using propensity score matching(PSM)model,the propensity score was calculated by using Logit regression analysis,the robustness was tested by using standard deviation variation,common support bar graph and nuclear density distribution,the impact of widowhood on the physical and mental health of older adults was analyzed by using K-nearest neighbor matching,radius matching and kernel matching,and the heterogeneity was tested based on gender,household type and age.Results Compared to the non-widowed group,the mental health of older adults in the widowed group was impaired(P<0.05).Logit regression model results showed that female(OR=2.274,95%CI=1.917-2.698),age(OR=0.975,95%CI=0.972-0.978),secondary education level(OR=0.618,95%CI=0.505-0.756)and monthly family consumption(OR=1.000,95%CI=1.000-1.000)were correlated with widowhood(P<0.05).The robustness test results after matching were better.The results of PSM showed that widowhood significan
作者
李阳
王振
曾智
LI Yang;WANG Zhen;ZENG Zhi(School of Public Health,Hubei University of Medicine,Shiyan 442000,China)
出处
《中国全科医学》
北大核心
2024年第6期663-669,共7页
Chinese General Practice
基金
2017年度教育部人文社会科学研究青年基金项目(17YJCZH015)
湖北医药学院“十四五”省级优势特色学科群(公共卫生与健康)2022年度资助项目(2022PHXKQ2)。
关键词
丧偶
虚弱指数
心理健康
老年人
倾向得分匹配
Widowhood
Frailty index
Mental health
Aged
Propensity score matching
