【摘要】 目的 基于2020年中国健康与养老追踪调查（CHARLS）数据，探讨我国45周岁以上中老年慢性病患者生活满意度现状及其影响因素，以期为中老年慢性病患者健康管理提供科学依据，揭示提升其生活满意度的潜在路径。方法 采用CHARLS最新发布的2020年第5次全国调查数据，筛选出13 487例45周岁以上中老年慢性病患者为研究对象，采用调查原问卷编码为da007的题目收集慢性病数据；纳入性别、年龄、受教育水平、居住地、与伴侣共同生活、患慢性病数量、子女满意度、社交活动数量、吸烟、饮酒、养老保险、医疗保险、躯体生活自理能力（BADL）、工具性日常生活能力（IADL）、夜晚睡眠时间和午间睡眠时间为人口学变量。采用原问卷编码为dc026的题目收集中老年慢性病患者生活满意度情况。结果 共纳入13 487例慢性病患者。中老年慢性病患者生活满意度在其性别、年龄、受教育水平、居住地、是否与伴侣共同生活、患慢性病数量、子女满意度、有无饮酒、是否有养老保险、是否有医疗保险、BADL受损情况、IADL受损情况、夜晚睡眠时间和午间睡眠时间上差异均有统计学意义（P<0.05）；在社交活动数量和是否吸烟上，差异无统计学意义（P>0.05）。中老年慢性病患者所患慢性病种类较多，患高血压、胃或其他消化系统疾病的概率超过50%。中老年慢性病患者患1种慢性病的有3 914例，患2种慢性病的有3 445例，患3种慢性病的有2 468例，患4种及以上慢性病的有3 660例。生活满意度状况为不满意的有1 232例，满意的有12 255例。二元Logistic回归分析结果显示，年龄为55～64岁（95%CI=0.49～0.77）、65～74岁（95%CI=0.37～0.59）、75～84岁（95%CI=0.28～0.46）和85岁及以上（95%CI=0.19～0.41），夜晚睡眠时间6～8 h(95%CI=0.72～0.95)、≥8 h(95%CI=0.62～0.88)，午间睡眠时间1～2 h(95%CI=0.65～0.86)和≥2 h(95%CI=0.56～0.86)是中老年慢性病患者对生活满意的保护因素（P<0.05）；居住在农村（95%CI=0.65～0.89）、不与伴侣共同生活（95%CI=1.39～1.81）、患4种及以上慢性病（95%CI=1.17～1.64）、对子女不满意（95%CI=3.27～4.66）、没有医疗保险（95%CI=1.22～2.04）、BADL受损（95%CI=1.20～1.62）、IADL受损（95%CI=1.26～1.70）是中老年慢性病患者对生活满意的危险因素（P<0.05）。结论 我国中老年慢性病患者对生活总体满意度较高，需要从家庭环境、社会支持的角度入手，创造良好家庭氛围，完善医疗保障体系，加强心理健康的监测和干预，为中老年慢性病患者的身心健康而努力。更多还原

【Abstract】 Objective This study used the 2020 China health and retirement longitudinal study(CHARLS) data to explore the current status and influencing factors of life satisfaction among middle-aged and elderly patients with chronic diseases aged 45 and above in China, in order to provide scientific basis for health management and reveal potential paths to improve their life satisfaction. Methods The latest 2020 wave 5 national survey data released by CHARLS was used, and 13 487 middle-aged and elderly patients with chronic diseases over 45 years old were selected as the research subjects. Chronic disease data were collected using the question with the original questionnaire code da007; gender, age, education level, place of residence, living with a partner, number of chronic diseases, child satisfaction, number of social activities, smoking, alcohol consumption, pension insurance, medical insurance, basic activities of daily living(BADL), instrumental activities of daily living(IADL), nighttime sleep duration, and midday sleep duration were included as demographic variables. The life satisfaction of middle-aged and elderly patients with chronic diseases was collected using the original questionnaire code dc026. Results A total of 13 487 patients with chronic diseases were included.There were significant differences in life satisfaction among middle-aged and elderly patients with chronic diseases in the following aspects: gender, age, education level, place of residence, whether living with partners, number of chronic diseases, child satisfaction,alcohol consumption, whether having pension insurance, whether having medical insurance, BADL impairment, IADL impairment,nighttime sleep duration and midday sleep duration(P<0.05). There were no statistically significant differences in the number of social activities and whether smoking(P>0.05). Middle aged and elderly patients with chronic diseases suffered from a wide range of chronic diseases, with a probability over 50% for hypertension, stomach or other digestive system diseases. There were 3 914 middleaged and elderly patients with one chronic disease, 3 445 patients with two chronic diseases, 2 468 patients with three chronic diseases,and 3 660 patients with four or more chronic diseases. A total of 1 232 patients were dissatisfied with their lives, and 12 255 patients were satisfied. The results of binary logistic regression analysis showed that age range of 55-64 years(95%CI=0.49-0.77), 65-74years(95%CI=0.37-0.59), 75-84 years(95%CI=0.28-0.46), and 85 years and above(95%CI=0.19-0.41), with a nighttime sleep duration of 6-8 hours(95%CI=0.72-0.95) and ≥8 h(95%CI=0.62-0.88), and a midday sleep duration of 1-2 hours(95%CI=0.65-0.86)and ≥2 h(95%CI=0.56-0.86) were protective factors for life satisfaction among middle-aged and elderly patients with chronic diseases(P<0.05); Living in rural areas(95%CI=0.65-0.89), not living with a partner(95%CI=1.39-1.81), having four or more chronic diseases(95%CI=1.17-1.64), being dissatisfied with children(95%CI=3.27-4.66), not having medical insurance(95%CI=1.22-2.04), impaired BADL(95%CI=1.20-1.62), and impaired IADL(95%CI=1.26-1.70) were risk factors for life satisfaction among middle-aged and elderly patients with chronic diseases(P<0.05). Conclusion Middle aged and elderly patients with chronic diseases in China have a high overall satisfaction with their lives. It is necessary from the perspective of family environment and social support to create a good family atmosphere, improve the medical security system, strengthen monitoring and intervention of mental health, and strive for the physical and mental health of middle-aged and elderly patients with chronic disease.更多还原