孤独感对养老机构老年人生活质量的影响:抑郁与衰弱的链式中介作用

目的 探究抑郁与衰弱在孤独感与养老机构老年人生活质量之间的中介作用。方法 使用老年抑郁量表、Tilburg衰弱量表、孤独感量表及SF-12简明健康调査量表对183名养老机构老年人进行测查，采用偏差校正的百分位 Bootstrap 法（Process 插件）进行链式中介检验。结果 孤独感与抑郁、衰弱呈正相关（r¹=0.71，r²=0.60，P＜0.01），与生活质量呈负相关(r=-0.61，P＜0.01)；回归模型显示，孤独感对养老机构老年人生活质量的直接效应有统计学意义（β=-0.14，P<0.05），抑郁、衰弱在孤独感与生活质量之间的中介作用均有统计学意义（β¹=-0.11，β²=-0.16，P<0.05)，且抑郁-衰弱的链式中介作用也有统计学意义（β=-0.19，P<0.05）。结论 孤独感既可直接预测老人的生活质量，又可分别通过抑郁、衰弱的中介作用，以及抑郁-衰弱的链式中介作用间接预测生活质量。

The effect of loneliness on the quality of life of the elderly in nursing home: chain mediation of depression and frailty

To explore the mediating role of depression and frailty in the sense of loneliness and the quality of life to the elderly in nursing home. Methods The elderly depression scale，Tilburg frailty scale，loneliness scale and SF － 12 concise health survey scale were used to test 183 elderly people in nursing home，and the deviation － corrected percentile Bootstrap method ( Process plug － in) was used for chain intermediary inspection. Ｒesults The loneliness was positively correlated with depression and frailty( r1 = 0. 71，r2 = 0. 60，P ＜ 0. 01) and negativly correlated with quality of life ( r = － 0. 61，P ＜ 0. 01) .Ｒegression model showed that the direct effect of loneliness on the quality of life of the elderly in nursing home was statistically significant ( β = － 0. 14，P ＜ 0. 05) . The mediating effect of depression and frailty between loneliness and quality of life was statistically significant ( β1 = － 0. 11，β2 = － 0. 16，P ＜ 0. 05) ，and the chain － mediation of depression － frailty was also statistically significant( β = － 0. 19，P ＜ 0. 05) . Conclusion Loneliness can directly predict the quality of life of the elderly，and indirectly predict the quality of life through the mediating effects of depression，frailty，and the chain － mediated role of depression － frailty.