【摘要】 目的 应用网络分析探讨中国老年人社会参与和抑郁症状之间的复杂相互关联,并比较不同性别、年龄和城乡居住的老年人社会参与-抑郁症状网络结构的差异。方法 利用中国老年健康影响因素跟踪调查2018年的横断面数据,共纳入65岁至105岁的老人12 043名。采用中文版流调中心抑郁量表测量抑郁症状,并调查10种社会参与活动情况,包括做家务、太极拳、广场舞等。采用R 4.2.1软件对社会参与-抑郁症状网络模型进行估计,并计算强度和桥强度指标。结果 21.60%(2 601/12 043)的研究对象存在抑郁症状。调整社会人口学因素后,老年人社会参与总分与抑郁症状负向关联。社会参与-抑郁症状的网络显示,D9(感到无法继续自己的生活)和S9(看电视听广播)分别在抑郁症状群组和社会参与群组具有最高的强度中心性,S1(家务)、S9(看电视听广播)和D5(绝望)在两群组之间具有最高的桥梁中心性。两群组之间的大部分边线呈负相关。“S5(园艺)-D5(绝望)”和“S6(阅读报纸/书籍)-D4(做什么事都很费劲)”具有最强负相关。女性比男性老年人的网络结构更紧密。与65～80岁的老人相比,81～105岁的老人具有更高的网络整体强度。结论 结果显示,除了做家务以外,其他社会参与活动对抑郁水平有保护作用。针对不同性别、不同年龄的老年人,应采取不同的预防和缓解抑郁症状的护理策略。更多还原

【Abstract】 Objective: Network analysis was used to explore the complex inter-relationships between social participation activities and depressive symptoms among the Chinese older population, and the differences in network structures among different genders, age groups, and urban-rural residency would be compared.Methods: Based on the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS), 12,043 people aged 65 to 105 were included. The 10-item Center for Epidemiologic Studies Depression(CESD) Scale was used to assess depressive symptoms and 10 types of social participation activities were collected, including housework, tai-chi, square dancing, visiting and interacting with friends, garden work, reading newspapers or books, raising domestic animals, playing cards or mahjong, watching TV or listening to radio, and organized social activities. R 4.2.1 software was used to estimate the network model and calculate strength and bridge strength.Results: 21.60%(2,601/12,043) of the participants had depressive symptoms. The total social participation score was negatively associated with depressive symptoms after adjusting for sociodemographic factors. The network of social participation and depressive symptoms showed that “D9(Inability to get going)” and “S9(Watching TV and/or listening to the radio)” had the highest strength within depressive symptoms and social participation communities, respectively, and “S1(Housework)”, “S9(Watching TV and/or listening to the radio)”, and “D5(Hopelessness)” were the most prominent bridging nodes between the two communities. Most edges linking the two communities were negative. “S5(Graden work)-D5(Hopelessness)” and “S6(Reading newspapers/books)-D4(Everything was an effort)” were the top 2 strongest negative edges. Older females had significantly denser network structures than older males.Compared to older people aged 65—80, the age group 81—105 showed higher network global strength.Conclusions: This study provides novel insights into the complex relationships between social participation and depressive symptoms. Except for doing housework, other social participation activities were found to be protective for depression levels. Different nursing strategies should be taken to prevent and alleviate depressive symptoms for different genders and older people of different ages.更多还原