Chinese General Practice

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Progress in the Study of Influencing Factors and Intervention Strategies of Mental Health in Elderly Patients with Multiple Chronic Conditions

  

  1. 1.School of Nursing,Zunyi Medical University,Zunyi 563099,China;2.Department of Anesthesiology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;3.School of Medical Information Engineering,Zunyi Medical University,Zunyi 563006,China
  • Received:2024-10-31 Accepted:2024-12-30
  • Contact: LUO Xu,Associate professor;E-mail:542622637@qq.com

老年慢性病共病患者心理健康的影响因素及干预策略研究进展

  

  1. 1.563099 贵州省遵义市,遵义医科大学护理学院;2.510515 广东省广州市,南方医科大学南方医院麻醉科;3.563006 贵州省遵义市,遵义医科大学医学信息工程学院
  • 通讯作者: 罗旭,副教授;E-mail:542622637@qq.com
  • 基金资助:
    贵州省科技计划项目[CXTD(2023)028];贵州省健康卫生委员会科技计划项目(gzwkj2024-283)

Abstract: The accelerated aging of China's population has contributed to the increasing prominence of chronic disease comorbidities,significantly increasing the medical burden and threatening patients' physical and mental health. Elderly patients with chronic disease comorbidities are more likely to have psychological problems such as anxiety and depression due to multiple comorbidities,and their symptom detection rate is significantly higher than that of the healthy or single chronic disease population. Although the pathogenesis is unclear,demographic(age,gender,education),socioeconomic(household income,place of residence),social support,health status,and lifestyle factors are strongly associated with mental health,and elucidation of these factors is essential for the development of precise intervention strategies. Existing interventions are classified as both pharmacological and non-pharmacological. Although medications provide symptomatic relief,the risk of polypharmacy limits how they're used. Non-pharmacological interventions show unique advantages through diversified means:group psychological intervention strengthens the social support network,cognitive behavioral therapy corrects negative cognition,exercise therapy improves both physical and psychological health,music/nostalgia/narrative therapy regulates emotional states,Internet+ technology breaks through time and space constraints to increase accessibility of interventions,traditional Chinese medicine therapy realizes physical and mental co-treatment,and health education and co-psychological care enhance self-management ability through knowledge and empowerment. These interventions have been shown to be effective in improving the mental health of comorbid patients. This article reviews national and international studies focusing on the epidemiology,influencing factors,and intervention strategies of elderly multimorbid patients to provide a basis for mental health promotion. In the future,it is necessary to deepen research on the mechanism of multidisease interaction,establish a personalized intervention system based on risk assessment,and verify the effect of intervention through multicenter long-term follow-up,in order to achieve the goal of healthy aging.

Key words: Multiple chronic conditions, Aged, Anxiety, Depression, Root cause analysis, Psychological interventions, Review

摘要: 我国人口老龄化进程的加速致使慢性病共病问题愈发突出,这不仅给医疗体系带来沉重负担,也对患者身心健康构成严重威胁。老年慢性病共病患者因多病共存更易出现焦虑、抑郁等心理问题,症状检出率明显高于无病或患单一慢性病人群。尽管发病机制尚不明确,但人口学(年龄、性别、教育程度)、社会经济(家庭收入、居住地)、社会支持、健康状况和生活方式等因素均与心理健康密切相关,明确这些因素对制定精准干预策略至关重要。现有老年慢性病共病患者心理健康干预措施分为药物与非药物两类。药物治疗虽能缓解症状,但多药联用风险限制了其应用。而非药物干预通过多元化手段展现独特优势:团体心理干预强化社会支持网络,认知行为疗法修正负性认知,运动疗法改善躯体与心理双重健康,音乐/怀旧/叙事疗法调节情绪状态,“互联网+”技术突破时空限制提升干预可及性,中医疗法实现身心同治,健康教育联合心理护理通过知识赋能增强自我管理能力。这些措施已被证实能有效提升共病患者心理健康水平。本综述聚焦老年慢性病共病患者的流行病学、影响因素及干预策略,为心理健康促进提供依据。未来需深化多病交互机制研究,构建基于风险评估的个性化干预体系,并通过多中心长期随访验证干预效果,以助力健康老龄化目标的实现。

关键词: 慢性病共病, 老年人, 焦虑, 抑郁, 影响因素分析, 心理干预, 综述

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