农村养老院老年人孤独感对自杀意念的影响——有调节的中介效应

The Effect of Loneliness on Suicidal Ideation among Rural Nursing Home Residents—A Moderated Mediation Model

摘要: 本研究旨在探讨孤独感与农村养老院老年人自杀意念的关系，以及生活质量的中介效应和社会支持的调节作用。采用UCLA孤独量表、健康调查简表、领悟社会支持量表、贝克抑郁量表对山东省新泰市五所农村养老院共205名老年人进行问卷调查，数据采用描述统计、Spearman秩相关分析，并使用Mplus8.3路径分析检验中介及调节中介效应。结果发现生活质量与孤独感(r = −0.652, P < 0.001)、自杀意念显著负相关(r = −0.638, P < 0.001)，与社会支持显著正相关(r = 0.438, P < 0.001)；生活质量在孤独感及自杀意念中起到了部分中介作用(效应值 = 0.309，95% CI = 0.255~0.422)；社会支持对孤独感–生活质量(B = −0.113, P < 0.001)、生活质量–自杀意念(B = 0.238, P = 0.003)起到了调节作用。自杀预防工作可从提高社会支持水平入手，改善养老院老人的生活质量，降低自杀风险。

Abstract: This study aims to explore the relationship between loneliness and suicidal ideation of rural nursing home residents through the mediating effect of quality of life, and the moderating effect of social support, respectively. UCLA Loneliness Scale, The 36-Item Medical Outcome Short Form Health Study Survey, Perceived Social Support Scale and Baker Depression Inventory were used to conduct a investigation on 205 older adults from five rural nursing homes in Xintai city, Shandong Province. Descriptive statistics and Spearman correlation analysis were used to analyze the data, and Path Analysis by Mplus 8.3 was employed to examine the mediation and moderated mediation effect. Results showed that Quality of life was negatively correlated with loneliness (r = −0.652, P < 0.001), suicidal ideation (r = −0.638, P < 0.001), and positively correlated with social support (r = 0.438, P < 0.001); Quality of life mediated the effect of loneliness on suicidal ideation (effect value = 0.309, 95% CI = 0.205~0.422); Social support had a moderating effect on loneliness-quality of life (B = −0.113, P < 0.001), and quality of life-suicidal ideation (B = 0.238, P = 0.003). Social support can be a target for suicide prevention, so as to improve quality of life among nursing home residents, and reduce the risk of suicide.