社会疏离对老年患者移动医疗使用行为的影响：一个有中介的链式模型

Social Isolation and Mobile Health Service Adoption among Older Adults: A Chain Model with an Intermediary

摘要: 目的：探讨社会疏离对移动医疗服务使用行为的影响，并检验心理资本与使用意愿的链式中介作用。方法：于2025年6~8月随机抽取贵阳市5家医院的394例老年患者进行问卷调查，使用一般疏离感量表、心理资本量表、老年人移动医疗服务使用行为影响因素测量量表收集数据，利用SPSS 27.0与Process插件模型6进行数据分析和链式中介效应分析。结果：社会疏离与心理资本(r = −0.313, P < 0.001)和使用意愿(r = −0.207, P < 0.001)呈显著负相关；使用意愿与使用行为呈显著正相关(r = 0.430, P < 0.001)。中介分析显示，社会疏离对使用行为的直接效应不显著(β = 0.026, P > 0.05)，但可通过使用意愿路径(Boot CI: [−0.082, −0.004])以及心理资本→使用意愿链式路径(Boot CI: [−0.030, −0.006])间接影响使用行为。结论：社会疏离通过降低心理资本和使用意愿，间接影响移动医疗服务使用行为。培育积极的心理资源和增强使用意愿，推进“深度适老化”设计和社群支持，有助于促进使用行为。

Abstract: Objective: To explore the influence of social isolation on the use behavior of mobile medical services, and to test the chain intermediary role between psychological capital and use intention. Methods: From June to August, 2025, 394 elderly patients from five hospitals in Guiyang were randomly selected for a questionnaire survey. The data were collected by using the general alienation scale, the psychological capital scale and the measurement scale of influencing factors of the use of mobile medical services for the elderly. SPSS 27.0 and Process plug-in model 6 were used for data analysis and chain mediation effect analysis. Results: Social isolation was negatively correlated with psychological capital (r = −0.313, P < 0.001) and use intention (r = −0.207, P < 0.001). There is a significant positive correlation between use intention and use behavior (r = 0.430, P < 0.001). Intermediary analysis shows that the direct effect of social isolation on use behavior is not significant (β = 0.026, P > 0.05), but it can be indirectly influenced by the use intention path (BootCI: [−0.082, −0.004]) and the psychological capital → use intention chain path (BootCI: [−0.030, −0.006]). Conclusion: Social isolation indirectly affects the use behavior of mobile medical services by reducing psychological capital and use intention. Cultivating positive psychological resources and enhancing the willingness to use them, and promoting the design of “deep aging adaptation” and community support will help promote the use behavior.