| Aging of the population is a problem that almost all the countries are facing,and seriously influences the development and progress of the society.The arrival of Chinese aging population stage takes many problems to the society and the elderly themselves.In China,the speed of aging service cannot keep up with the accelerating aging progress;consequently,old people are troubled by the imperfection of corresponding measures and systems.Furthermore,due to the physiological characteristics of themselves,old people are vulnerable to physical disorders like chronic diseases,combined with the reduction of the social environment,the shortage of economic and family misfortune after the retirement,many psychological problems are inevitable.Subjective well-being of the elderly is an important index to measure the life quality of the aged.Exploring the status of the subjective well-being of the elderly,a special group with many problems,analyzing theinfluence factors and the path of actions from multiple perspectives,taking interventions which are positive and effective on several aspects,will make great significance to the improvement of subjective well-being of the elderly.Objective: This study took subjective well-being as a starting point,studied the present situation of subjective well-being of the community elderly,analyzed the influence factors of subjective well-being from seven aspects(including social demography,living habits,self-evaluation of health,anxiety,depression,social support and quality of life),built the structural equation model of subjective well-being around self-evaluation of health,anxiety,depression,social support and quality of life,revealed the path of the effect of physiological and psychological on subjective well-being,in order to provide data support and policy suggestions for the improvement of the elderly subjective well-being.Methods: This study used random sampling method.1350 elderly were investigated,a total of 1302 valid questionnaires were collected and the effective recovery rate was 96.4%.The survey adopted a combination of physical measurement and questionnaire survey.The questionnaire content mainly included six parts: individual basic information(such as gender,age,nationality,marital status,education,monthly income,number of children),personal habits(such as smoking,drinking,exercise frequency,diet balance and addicted to sugar),anxiety,depression,quality of life,social support and subjective well-being.Univariate analysis was performed by chi-square test,t-test and variance analysis.Multivariate linear regression equation or Logistic regression was used to analyze the multivariate analysis.On the basis of multivariate analysis,the maximum likelihood method was used for parameter estimation,and the influencing factors of subjective well-being were constructed.The influence path and mechanism of different factors on subjective well-being were analyzed.Results: In the aspect of community elderly subjective well-being status,the average score of the overall subjective well-being level was(35.78±8.81),the average score of Positive Affectivity(PA)was(7.73±2.42),the average score of generally Positive Experience(PE)was(10.21±2.95),the average score of Negative Affectivity(NA)was(2.09±2.42)and the average score of general Negative Experience(NE)was(3.98±3.37).Groups were divided by the level of subjective well-being,and there were a total of 716 Community elderly(accounted for 55.0%)whose subjective well-being was at a high level,570 subjects were at medium level(accounted for 43.8%),and 16 subjects were at low level(accounted for 1.2%).Among participants with different marital status,educational background and addiction to sugar,the differences of the scores of well-being were statistically significant(P<0.05),with higher score in those who were married,had higher education level and addiction to sugar.In the aspect of health self-evaluation and subjective well-being,549 subjects thought they were pretty healthy,accounted for 42.2%,753 subjects thought they were in worse healthy status,accounted for 57.8%;Gender was an independent factor of self-reported health status,and for males,the situation was more optimistic than female.Community elderly with different self-evaluation had different subjective well-being scores(P<0.001).In terms of anxiety,depression,and subjective well-being,anxiety accounted for 17.7%,no anxiety accounted for 82.3%,depression accounted for 40.3%,and no depression accounted for 59.7%.Multi-factor analysis showed that subjects with poor health self-evaluations were at higher risks of anxiety and depression,the risk of anxiety of smokers was lower than that of the non-smokers.Among community elderly with different situations of anxiety and depression,the difference of subjective well-being were statistically significant(P<0.001),and subjects with anxiety and depression had lower scores of subjective well-being.In terms of social support and subjective well-being,the total score of support in the family was 21.64±4.10,which was 42.23±7.67 outside the family,and social support score was 63.88±11.37.Multiple factors analysis showed that the elderly social support situation was related to the degree,exercise situation and depression.Community elderly with different social support had varied subjective well-being scores,and the difference was statistically significant(P<0.001),the higher the social support is,the higher the subjective well-being score is.In the aspect of life quality and subjective well-being,in eight dimensions of life quality,the score of physiological function(PF)dimension was 80.03±24.18,role physical(RP)dimension was 65.02±41.48,body pain(BP)dimension was 66.14±15.39,general health(GH)dimension was 57.91±18.81,vitality(VT)dimension was 74.41±18.27,social function(SF)dimension was 80.04±21.42,role emotional(RE)dimension was 71.84±39.43,mental health(MH)was 74.11±18.02,the total score of SF-36 was 116.81±14.31.Life quality was a positive factor,the elderly with higher life quality had higher subjective well-being scores..Quality of life was influenced by depression,anxiety and self-evaluation of health.The elderly with anxiety and depression had lower levels of life quality,and those who had good situations of health self-evaluation usually enjoyed their lives with better quality.Considering univariate and multivariate analysis of subjective well-being,using subjective well-being as the endogenous latent variable,and the four dimensions of the subjective well-being scale(MUNSH)(positive emotion PA,negative emotion NA,positive experience PE,negative experience NE)were used as indicating variables;using life quality as the endogenous latent variable,and the eight dimensions of life quality(SF-36)(physiological function RP,physiological function PF,physical pain BP,overall health GH,energy VT,social function SF,emotional function RE,mental health MH)were used as indicating variables;With anxiety,depression,social support and health self-evaluation status as obvious variables.A complex association model of subjective well-being factors that cover 16 obvious variables and 2 latent variables was constructed.According to the structural equation model,there were eight role paths that affected subjective well-being of community elderly: health self-evaluation? anxiety? depression? life quality? subjective well-being,health self-evaluation? anxiety? life quality? subjective well-being,health self-evaluation? life quality? subjective well-being,depression? social support? subjective well-being,health self-evaluation? subjective well-being,depression? subjective well-being,life quality? subjective well-being,social support? subjective well-being.Among these,health self-evaluation,depression,social support and life quality were directly related to subjective well-being,and the effect size were life quality(0.459)>depression(-0.243)>social support(0.186)>health self-evaluation(0.117),the effect were all positive except depression.Moreover,health self-evaluation,anxiety and depression had indirect relation with subjective well-being,and the effect size were anxiety(-0.482)>depression(-0.228)>health self-evaluation(-0.195).The total effect of each variables on subjective well-being was anxiety(-0.482)>depression(-0.471)>life quality(0.459)>social support(0.186)>health self-evaluation(-0.078),the effect were positive with life quality and social support,and others were negative.Conclusions: This study took the subjective well-being of the elderly as the starting point,analyzed the relationship between the influencing factors of subjective well-being,and drew the following main conclusions:(1)The elderly in Changchun Chaoyang community with low subjective well-beingaccounted for 45%,and the subjective well-being of the elderly need to be further improved.(2)Anxiety and depression are risk factors of subjective well-being of the elderly;social support and life quality are protective factors of it.(3)A complex association model of subjective well-being factors that cover 16 obvious variables and 2 latent variables was constructed.There were eight role paths that affected subjective well-being of community elderly.There were direct and indirect effects of health self-evaluation on subjective well-being,and dominated by indirect effects.There was a negative correlation between health self-evaluation and anxiety as well as depression.Anxiety and depression had larger impacts on subjective well-being,the influence of anxiety on subjective well-being was complete mediation effect,and depression was not only a direct variable but also an intermediary variable what influenced subjective well-being.Social support was a positive factor of subjective well-being,the elderly who obtain more social support tended to have higher subjective well-being levels.The impact of quality of life on subjective well-being was direct.(4)The order of total effect on subjective well-being was: anxiety>depression>life quality>social support> self-evaluation of health,and life quality had the biggest direct influence on subjective well-being.Innovation: First of all,this study centralized multiple perspectives,such as social demographic characteristics,life habit,self-evaluate situation of health,anxiety,depression,quality of life,social support and so on,comprehensively studied the influence factors of subjective well-being based on the analysis of their respective effects.Secondly,in order to discuss the functional path of various factors involved physiological,psychological and social factors,we used subjective well-being as a starting point,built structural equation models,which had certain innovation.Finally,after the comprehensive analysis of the influence factors and their mechanism for subjective well-being,we took the approach of developing intervention path graph,to improve the subjective well-being of the elderly and provide more intuitive and enforceable intervention strategies to relevant departments. |
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