中国全科医学 ›› 2023, Vol. 26 ›› Issue (25): 3091-3095.DOI: 10.12114/j.issn.1007-9572.2023.0130

• 论著·人群健康研究 • 上一篇    下一篇

中国农村中老年女性抑郁状况及影响因素研究

杨璐*(), 宗占红, 易莹莹   

  1. 210023 江苏省南京市,南京邮电大学社会与人口学院
  • 收稿日期:2023-03-15 修回日期:2023-05-20 出版日期:2023-09-05 发布日期:2023-05-30
  • 通讯作者: 杨璐

  • 作者贡献:杨璐负责研究概念的提出和研究设计,对数据进行分析,撰写文章并对文章负责;宗占红负责数据解释;易莹莹负责文章修订。
  • 基金资助:
    国家社会科学基金项目(21BRK019,20BRK30); 2020年江苏高校哲学社会科学项目(TJ220006)

Current Status and Influencing Factors of Depression among Rural Middle-aged and Elderly Women in China

YANG Lu*(), ZONG Zhanhong, YI Yingying   

  1. School of Sociology and Population Studies, Nanjing University of Posts and Telecommunications, Nanjing 210023, China
  • Received:2023-03-15 Revised:2023-05-20 Published:2023-09-05 Online:2023-05-30
  • Contact: YANG Lu

摘要: 背景 随着人口老龄化问题的日益加重,中老年人尤其是中老年女性的心理健康问题成为社会关注的重点。与城市女性相比,农村女性的健康状况相对较差、教育水平较低、居住条件较为落后,故更易患心理疾病,但其面临的心理健康服务可及性较低。 目的 了解我国农村中老年女性的抑郁发生状况,并分析其影响因素,为提高中老年女性心理健康水平提供实证依据。 方法 于2021年5—7月,提取中国健康与养老追踪调查(CHARLS)的2018年随访数据,选取其中45岁及以上的农村户籍女性为研究对象(n=6 736)。采用流调用抑郁自评量表(CES-D)简化版得分判定农村中老年女性的抑郁症状发生情况。采用χ2检验及多因素Logistic回归模型分析影响农村中老年女性抑郁症状发生情况的因素(包括个体特征、健康行为、社会参与及医疗健康服务利用4个维度的因素)。 结果 6 736例农村中老年女性的CES-D简化版得分为(20.0±6.9)分,42.46%(2 860/6 736)有抑郁症状。多因素Logistic回归分析结果显示:对自身健康满意〔OR(95%CI)=0.402(0.356,0.453)〕、睡眠时长≥6 h〔OR(95%CI)=0.48(0.43,0.54)〕、使用互联网〔OR(95%CI)=0.63(0.50,0.80)〕、对生活满意〔OR(95%CI)=0.25(0.21,0.30)〕的农村中老年女性抑郁症状发生风险较低,有躯体残疾〔OR(95%CI)=1.41(1.16,1.71)〕、患慢性病〔OR(95%CI)=1.35(1.21,1.50)〕、过去1个月利用过门诊服务〔OR(95%CI)=1.25(1.09,1.43)〕、过去1年利用过住院服务〔OR(95%CI)=1.31(1.13,1.52)〕的农村中老年女性抑郁症状发生风险率较高。 结论 依据本研究结果,我国农村中老年女性抑郁状况较为严重,个体特征、健康行为、社会参与、医疗健康服务利用等方面对中国农村中老年女性抑郁的发生均有影响。建议各级政府和民政部门高度重视农村中老年女性的心理状况,特别是从健康促进与教育、医疗服务质量和信息获取的可及性等多维度进行干预和防控,以推动我国"健康乡村"及"健康老龄化"进程。

关键词: 抑郁, 精神卫生, 农村人口, 女性, 中老年人, 患病率, 影响因素分析

Abstract:

Background

With the population aging, mental health of the middle-aged and elderly adults is of great concern, especially in middle-aged and elderly women. Compared with urban women, rural women are more likely to suffer from mental diseases due to their poorer health status, lower education level and backward living conditions, however, the accessibility of mental health services among them is low.

Objective

To understand the prevalence of depression among middle-aged and elderly women in rural China and analyze its influencing factors, in order to provide empirical evidence for improving the mental health of middle-aged and elderly women.

Methods

From May to July 2021, the follow-up data of the 2018 China Health and Retirement Longitudinal Study (CHARLS) was extracted, and rural women aged 45 years and above were selected as the study subjects (n=6 736) . The scores of the simplified version of the Center for Epidemiologic Studies Depression Scale (CES-D) were used to determine the depression status of rural middle-aged and elderly women. Chi-square tests and multivariate Logistic regression model were used to analyze the influencing factors of the occurence of depressive symptoms among rural middle-aged and elderly women (including individual characteristics, health behaviors, social participation and utilization of medical services utilization) .

Results

The CES-D score of 6 736 rural middle-aged and elderly women was (20.0±6.9) , 42.46% (2 860/6 736) of whom had depressive symptoms. The results of multivariate Logistic regression analysis showed that satisfication with health status〔OR (95%CI) =0.40 (0.36, 0.45) 〕, sleep duration ≥6 h〔OR (95%CI) =0.48 (0.43, 0.54) 〕, Internet use〔OR (95%CI) =0.63 (0.50, 0.80) 〕 and satisfication with life 〔OR (95%CI) =0.25 (0.21, 0.30) 〕 were correlated with lower risk of depression; hysical disability〔OR (95%CI) =1.41 (1.16, 1.71) 〕, suffering from chronic diseases〔OR (95%CI) =1.35 (1.21, 1.50) 〕, receiving outpatient services within 1 month〔OR (95%CI) =1.25 (1.09, 1.43) 〕 and hospitalization services within 1 year〔OR (95%CI) =1.31 (1.13, 1.52) 〕 were correlated with higher risk of depression.

Conclusion

Based on the results of this study, the depression status of middle-aged and elderly women in rural China is relatively severe and affected by individual characteristics, health behaviors, social participation, and the medical services utilization. It is recommended that governments and civil affairs departments at all levels pay close attention to the mental health of rural middle-aged and elderly women, especially through the intervention and prevention from multiple dimensions such as health promotion and education, medical service quality, and accessibility of information, in order to promote the construction of healthy villages and process of health aging in China.

Key words: Depression, Mental health, Rural population, Female, Middle-aged and older people, Prevalence, Root cause analysis