隔代照料对老年人心理健康的影响及机制分析

Analysis of the Effects of Intergenerational Caregiving on the Mental Health of Older Adults and the Mechanisms of the Effects

摘要: 目的：了解我国老年人隔代照料与老年人心理健康现状，探讨二者关系以及影响心理健康的其他因素，通过机制检验，提出改善老年人心理状况、促进老年人心理健康的对策建议。方法：使用2018年中国健康与养老追踪调查(CHARLS)数据，运用二元logistic回归对隔代照料与老年人心理状况间的影响关系展开研究并通过中介效应检验分析影响机制。结果：本研究共纳入60岁及以上老年人4726名，提供隔代照料的老年人有2267人，占比47.97%。单因素检验结果显示，在所选变量中，性别、婚姻状况、户口情况、疼痛数量、残疾情况、慢性病情况、睡眠情况、活动参与情况、生活满意度以及隔代照料对老年人心理健康状况的差异有统计学意义(p < 0.001)。logistic回归分析结果显示，提供隔代照料、参与社会活动、对生活满意度高、睡眠充足是老年人心理健康状况的促进因素；女性、农村户口、疼痛数量为2处及以上、残疾、患慢性病是老年人心理健康的抑制因素。在对各种混杂因素进行控制的前提下，提供隔代照料能够提高老年人的心理健康发生的几率(OR = 1.43, 95%CI: 1.158~1.780)。结论：我国一半左右的老年人会由于各种原因负责照料孙辈，提供隔代照料有助于提高老年人心理健康发生的概率。从机制分析结果来看，隔代照料通过(未来老年人的失能风险发生后)子孙辈的照料对老年人的心理健康产生影响。

Abstract: Objectives: To understand the current situation of intergenerational care and psychological health of the elderly in China, explore the relationship between them and other factors affecting psychological health, and propose countermeasures to improve the psychological condition and promote the psychological health of the elderly through mechanism testing. Methods: Using data from the 2018 China Health and Aging Tracking Survey (CHARLS), we analyzed the relationship between intergenerational care and the psychological status of older adults using binary logistic regression and analyzed the mechanism of influence through a mediation effect test. Results: A total of 4726 older adults aged 60 and above were included in this study, and 2267 (47.97%) of them provided intergenerational care. The results of univariate tests showed that among the selected variables, gender, marital status, household status, number of pain, disability, chronic disease, sleep, activity participation, life satisfaction, and intergenerational care had statistically significant differences on the mental health status of older adults (p < 0.001). Logistic regression analysis showed that the provision of intergenerational care, participation in social activities, satisfaction with high life satisfaction, and adequate sleep were the contributing factors to the mental health status of the elderly; female, rural household, number of pains of 2 or more, disability, and having chronic diseases were the inhibiting factors to the mental health of the elderly. Providing intergenerational care improved the odds of mental health occurrence among older adults, controlling for various confounding factors (OR = 1.43, 95%CI: 1.158~1.780). Conclusions: About half of the elderly in China will be responsible for caring for their grandchildren for various reasons, and providing intergenerational care can help increase the probability of mental health occurrence among the elderly. The results of the mechanistic analysis suggest that intergenerational caregiving has an impact on the mental health of older adults through the care of their children and grandchildren (after the risk of future disability of older adults).