| Objectives:1.To screen the psychosocial factors that affect frailty in the community-dwelling elderly with sleep disorders.2.To preliminarily construct a path model of the effect of sleep disorders on the frailty of the community-dwelling elderly.3.To verify the pathway model of the effect of sleep disorders in the communitydwelling elderly on frailty,and to analyze the role of psychosocial factors in the path model,so as to provide empirical evidence for constructing the intervention program for the frailty of the community-dwelling elderly with sleep disorders.Methods:1.Literature research: Identified the factors affecting the frailty of the communitydwelling elderly through systematic review.Formulated Chinese and English search terms and search strategies,and search 8 electronic databases by computer.Screened the literature according to the inclusion criterias and exclusion criterias,the data extraction and the quality of the literature were evaluated.Identified the high-risk psychosocial factors affecting the frailty of the community-dwelling elderly.2.Theoretical research: Based on the stress process model,combined with stress coping theory,stress cognitive interaction theory,social support buffer model,and personality function theory and other theories,and combined with the results of the systematic review,constructed a path model of the effect of sleep disorders on the frailty of the community-dwelling elderly.3.Empirical research: A cross-sectional study was used to verify the pathway model of the effect of sleep disorders in the elderly in the community on frailty.Selected 585community-dwelling elderly people from 10 community health service centers in Fuzhou City as the research subjects.We used self-made questionnaires to investigate the general data of the research subjects,and used the Tilburg Frailty Indicator(TFI),Pitsburgh Sleep Quality Index(PSQI),General Self-Efficacy Scale(GSES),Simplified Coping Style Questionnaire(SCSQ),Social Science Research Solutions(SSRS)and Chinese Big Personality Inventory Brief Version(CBF-PI-B)in the neurotic part to measure the elderly’s frailty,sleep quality,self-efficacy,coping style,social support and neurotic personality characteristics.Statistical description,t-test,F-test,one-way analysis of variance,Pearson correlation analysis,and linear regression analysis were carried out through SPSS26.0 software.The mediation effect and moderating effect between variables were analyzed using AMOS26.0 software,and the influence paths between the variables were analyzed.Results:1.Literature research results: In the literature retrieval stage,a total of 21364 articles were retrieved,and 97 articles were finally included after preliminary screening and rescreening.The qualitative analysis results showed that the frailty factors of the elderly in the community mainly included demographic factors(n=10),physical factors(n=43),psychological factors(n=7),social factors(n=6),biological factors(n=20),lifestyle factors(n=10),dietary pattern factors(n=19),other health factors(n=8).According to the evaluation results of documentary evidence quality,cognitive function,depression,loneliness,self-efficacy and social support are the key psychosocial factors.2.Theoretical research results: Based on the stress process model,a conceptual framework for the effect of sleep disorders on the frailty in the community-dwelling elderly was initially constructed;combined with the results of the literature research,the psychosocial factors affecting the frailty of the community-dwelling elderly with sleep disorders were screened out,which were self-efficacy,negative coping,social support,and neuroticism.Finally,a path model of sleep disorders on frailty among the communitydwelling elderly was constructed.3.Empirical research results:(1)This study investigated a total of 585 communitydwelling elderly,with an average age of(71.14±7.00)years old,55.9% were women,the incidence of frailty was 62.74%,sleep disorders accounted for 58.46%,and the total mean score of the general self-efficiency scale was(2.65±0.04),the mean score of negative coping was(8.53±4.63),50.60% of the community elderly adopted negative coping styles,and the total mean score of social support scale was(35.04± 0.32),the total mean score of neuroticism score was(17.50±0.40);(2)Pearson correlation analysis results showed that: the variables in the study were correlated with each other,among which sleep disorders and frailty are positively correlated(r=0.513,P<0.01),There was a negative correlation between self-efficacy,social support and frailty((r=-0.539,P<0.01;r=-0.428,P<0.01),and a positive correlation between negative coping,neuroticism and frailty(r=0.517,P< 0.01;r=0.559,P<0.01);(3)Path analysis was used to explore the mechanism of sleep disorders,self-efficacy,negative coping,social support,neuroticism and frailty.The results showed that sleep disorders in the elderly in the community can directly and positively predict frailty,It can also predict frailty indirectly through three paths: a.through the mediation of self-efficacy;b.through the mediation of negative coping;c.through the chain-like mediating effect of self-efficacy and negative coping.Social support and neuroticism played a moderating role in the path of sleep disorders to the frailty in the community-dwelling elderly.Conclusion:1.There are many factors that affect the frailty of the community-dwelling elderly.Self-efficacy,negative coping,social support and neuroticism are psychosocial factors that affect the frailty of the elderly with sleep disorders.2.There is a chain intermediary effect between sleep disorders,self-efficacy,negative coping and frailty,social support,neuroticism play a moderating role in the pathway of sleep disorders to the frailty of the community-dwelling elderly. |
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