Analysis On The Status And Influencing Factors Of Self-neglect Among The Elderly In Community

BackgroundAt present,population aging has become a global social problem.In recent years,the Party Central Committee and the State Council have issued documents such as the"Healthy China 2030"Planning Outline,requesting to actively promote the development of elderly care and elderly care services,and promote the realization of healthy aging.Self-neglect refers to the behavior of the elderly who intentionally or unintentionally fails to take care and protection of themselves,thereby causing personal health,safety and public safety to be threatened.Self-neglect has an impact on the life,economy and personal safety of the elderly,and seriously endangers the physical and mental health of the elderly.ObjectsInvestigating the status quo of self-neglect of the elderly in three communities in Zhengzhou.Explore the influencing factors of self-neglect of the elderly in the community.Constructing the relationship path model of elderly self-neglect and social support,anxiety and depression,cognitive function and self-care ability,to provide a basis for the development of elderly self-neglect intervention measures in the future.Methods1.This is a Cross-sectional study.From March 2020 to March 2021,216 elderly people who met the criteria for inclusion and exclusion were selected from the three communities in Zhengzhou City,Henan Province by the convenience sampling method.2.The general information questionnaire,the Chinese version of the Elder Self Neglect Assessment,Patient Health Questionnaire for Depression and Anxiety,the Lubben Social Network Scale,Mini-Mental State Examination,and the Barthel Index were used as research tools to conduct the survey.3.SPSS 21.0 was used for data analysis and for the measurement data.Count data are described by frequency and composition ratio.T test,single factor analysis data were compared for differences in self-neglect among older people in communities with different characteristics.Correlations before different variables were analysed using Spearman’s correlation.Multiple linear regression equation analysis of the community elderly self-neglect of the main factors.AMOS21.0 software was used for structural equation model to construct the path of influencing factors of self-neglect in the elderly.P<0.05was considered statistically significant.ResultsA total of 216 questionnaires were issued in this study,of which 207 valid questionnaires were returned,and the effective response rate was 95.83%.1.The self-neglect score of the elderly in the community is(12.22±5.54)points.The life style/condition dimension score is(5.96±3.36)points,the medical care behavior score is(4.39±2.31)points,and the living environment hygiene score is(1.87±2.04)points.The score of Mini-Mental State Examination is 26(23,29),the directional force dimension score is 9(8,10),memory ability dimension score is 3(2,3),memory dimension score is 3(3,3),language ability dimension score is 8(6,9),and attention computational force dimension score is 4(3,5).The score of the Lubben Social Network Scale is 25(18,33),family network dimension score is 11(9,13),friend network dimension score is 6(2,10),confidant relationship dimension score is 3(2,5),and other dimensions score is 6(5,7).The score of Barthel Index is 100(80,100);The score of the Patient Health Questionnaire is 3(1,5).2.The univariate analysis revealed showed that the self-neglect scores of the elderly in the community were statistically significant in gender,age,spouse,monthly income,regular physical examination and combined chronic diseases.(P<0.05).3.Spearman correlation analysis showed that self-neglect score was positively correlated with anxiety and depression score(r=0.207,P<0.01),and negatively correlated with self-care ability score,cognitive function score and social support score(r=-0.462,r=-0.473,r=-0.441,P<0.01).Self-care ability was negatively correlated with anxiety and depression(r=-0.434,P<0.01),and positively correlated with cognitive function and social support(r=0.710,r=0.562,P<0.01).Cognitive function was positively correlated with social support(r=0.458,P<0.01),and negatively correlated with anxiety and depression(r=-0.404,P<0.01).Social support was negatively correlated with anxiety and depression(r=-0.381,P<0.01).4.The total self-neglect was divided into dependent variables,and the independent variables with statistical significance(P<0.05)were gender,age,spouse,presence,monthly income,regular physical examination and combined chronic disease types,self-care ability,social support,cognitive function,anxiety and depression.Multivariate stepwise regression analysis showed that 35.7%of the total variation could be explained by four variables including self-care ability,social support,cognitive function,monthly income and age into the regression equation.5.Based on literature review and theoretical model fitting structural equation model,the interaction mechanism between self-neglect and self-care ability,social support,cognitive function,anxiety and depression of the elderly in community was explored to clarify the path relationship among the influencing factors of self-neglect.Fit index:χ~2/df=0.764,GFI=0.996,AGFI=0.978,CFI=1.000,RFI=0.977,NFI=0.993,RMSEA=0.000,the model fit degree is good.The results showed that cognitive function and social support had a direct effect on self-neglect and cognitive function,while self-care ability had a direct effect on self-neglect,anxiety and depression and cognitive function.In addition,cognitive function may partially mediate self-neglect through social support.Conclusions1.The level of self-neglect of the elderly in the community is moderately low.2.The protective factors of self-neglect of the elderly in the community include self-care ability,social support,monthly income and cognitive function,age is risk factors.Other factors that affect the self-neglect of the elderly in the community are:gender,spouse,regular physical examination,combination of chronic diseases,anxiety and depression Anxiety and depression are the risk factors for self-neglect of the elderly in the community.3.On the one hand,cognitive function has a direct effect on the self-neglect of the elderly in the community,and on the other hand it plays a part of mediating role in social support and self-neglect.