Study On The Healthy Aging And Its Influencing Factors Of Empty-nest Community-dwelling Elderly Based On The Health Ecological Model

ObjectiveThis study used a cross-sectional survey to investigate the current status of healthy ageing of empty-nest elderly in the community.The influencing factors of empty-nest elderly’s healthy aging were analyzed from five aspects,which included personal characteristics,psychology and behavior,interpersonal networks,working and living conditions,and policy environment based on the healthy ecological model.The structural equation model of the influencing factors of healthy aging of empty-nest elderly in the community was established to analyze the acting pattern of each influencing factor on healthy aging in the model,and thus provided a theoretical basis for relevant departments and community staff to formulate measures to promote healthy aging.MethodsIn this study,we selected 580 empty-nest elderly aged 60 and above from 6 community health service centers in Qingdao from July 2020 to December 2020 by stratified cluster sampling method.Data was collected using a general information questionnaire,Social support Rating Scale,Connor and Davidson resilience scale,Geriatric Depression Scale and elderly Self-Neglect Scale,Health Aging Instrument.SPSS24.0,AMOS24.0 software and PROCESS program were used for data entry and statistical analysis.Independent sample t test and one-way ANOVA were used to conduct univariate analysis on the influencing factors of healthy aging of empty-nest elderly in community,and hierarchical linear regression analysis was used for multivariate analysis.Pearson and Spearman correlation analysis were used to analyze the correlation between social support,resilience,depression,self-neglect and healthy aging.The structural equation model was established and verified to clarify the acting pattern of each influencing factor.Results1.The total score of healthy aging of empty-nest elderly was(125.00±20.60),which was in the medium level.The dimensional scores from high to low in turn were: accepting aging,having social relationships and support,managing stress,self-sufficiency and living simply,making merit and good deeds,staying physically active,practicing self-care and self awareness,staying cognitively active,participating socially.2.Univariate analysis showed that different age,the number of chronic diseases,drinking status,exercise habit,perceived health status,depression status,self-neglect status,resilience status,and the number of children,social support status,educational level,pre-retirement occupation,living condition,monthly income,medical insurance form had statistically significant effect on the healthy aging among empty-nest community-dwelling elderly(P<0.05);Hierarchical linear regression analysis showed that the number of chronic diseases,drinking status,exercise habit,depression status,self-neglect status,resilience status,social support status,monthly income and medical insurance form were the influencing factors of healthy aging in empty-nest community-dwelling elderly(P<0.05).3.Correlation analysis showed that social support was positively correlated with resilience and healthy aging(r=0.544,P<0.01;r=0.697,P<0.01),was negatively correlated with depression and self-neglect(r=-0.504,P<0.01;r=-0.648,P<0.01);resilience was positively correlated with healthy aging(r=0.760,P<0.01),was negatively correlated with depression and self-neglect(r=-0.502,P<0.01;r=-0.534,P<0.01);depression was positively correlated with self-neglect(r=0.609,P<0.01),was negatively correlated with healthy aging(r=-0.648,P<0.01);self-neglect was negatively correlated with healthy aging(r=-0.768,P<0.01).4.The structural equation model showed that social support not only directly affected healthy aging(β=0.142,P<0.05),and could indirectly affect healthy aging through the chain mediating effects of resilience,depression and self-neglect(β=0.583,P<0.05);resilience not only directly affected healthy aging(β=0.479,P<0.05),and could also indirectly affect healthy aging through the chain mediating effect of depression and self-neglect(β=0.148,P<0.05);depression not only directly affected healthy aging(β=-0.183,P<0.05),can also indirectly affect healthy aging through the mediating effect of self-neglect(β=-0.107,P<0.05);self-neglect directly affected healthy aging(β=-0.335,P<0.05).The total effect of social support on healthy aging was the largest,and the direct effect of psychological resilience was the largest.Conclusions1.The status of healthy aging of empty-nest community-dwelling elderly was at a medium level and needed to be improved.Based on the health ecological model.The influencing factors of healthy aging of empty-nest elderly included the number of chronic diseases,drinking status,exercise habit,depression status,self-neglect status,resilience status,social support status,monthly income and medical insurance form.2.The higher scores of social support and resilience,the higher the healthy aging level of empty-nest community-dwelling elderly.The higher scores of depression and self-neglect,the lower the healthy aging level of empty-nest elderly in the community.3.The total effects of social support on healthy aging of empty-nest community-dwelling elderly were the largest,suggesting that the support and assistance for empty-nest elderly and the ability to use resources should be fully increased to improve their healthy aging.Resilience had the greatest direct effect on healthy aging.Therefore,more attention should be paid to the resilience of empty-nest elderly and the training of this ability should be strengthened in various ways to promote healthy aging.