中国中老年人的孤独感对心脑血管疾病的影响
文献类型：学位论文
| 作者 | 黄妍 |
| 答辩日期 | 2022-06 |
| 文献子类 | 硕士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 李娟 |
| 关键词 | 孤独感的纵向变化 心脑血管疾病 心脏病 中风 中介作用 |
| 学位名称 | 理学硕士 |
| 学位专业 | 发展与教育心理学 |
| 其他题名 | The effects of loneliness on cardiovascular diseases in Chinese middle-aged and older adults |
| 中文摘要 | Considering the population aging in China, the mental and physical health of the middle-aged and older adults should receive more attention. As cardiovascular diseaseis one of the most common health issues in this age group, it is much important to investigate possible influence factors of cardiovascular diseases in order to improve the life quality of them and reduce the burdens of their families and the society. Loneliness is one kind of modifiable social connections factor, and its relationships with cardiovascular diseases have not been fully explored. Previous research has found that loneliness could predict a higher risk of cardiovascular diseases, but such results were not always consistent. A possible reason is that the intra-individual loneliness may change in a longitudinal period, and that different change patterns of loneliness have distinct relationships with health. Thus, it is necessary to investigate the effects of the longitudinal change of loneliness on cardiovascular diseases in the middle-aged and older adults. On the base of that, to explore possible pathways linking the longitudinal change of loneliness to cardiovascular diseases can provide empirical evidence for the theory of how loneliness influences health. The present study, using a nationally representative longitudinal sample for the middle-aged and older adults from the China Health and Retirement Longitudinal Survey (CHARLS), conducted three studies to investigate the impacts of the longitudinal change of loneliness on cardiovascular diseases and the possible mediation effects in those relationships in the Chinese population aged 45 years and above. Study 1 explored the patterns of the longitudinal change of loneliness and its correlates. With four waves from 2011 to 2018 from CHARLS, I carried out group-based trajectory modelling (GBTM) to describe possible trajectories of the longitudinal change of loneliness and multinomial logistic regression models to examine the effects of sociodemographic variables, social connections variables, and health status variables in 2011 on the longitudinal change of loneliness. Results showed that the longitudinal change of loneliness can be fitted as three different trajectories, i.e., no loneliness, low loneliness increasing, high loneliness increasing, and that sociodemographic variables, social connections variables, and health status variables in 2011 were significantly associated with the longitudinal change of loneliness. Study 2 investigated the impacts of the longitudinal change of loneliness on cardiovascular diseases. I carried out binary logistic regression models to examine whether the trajectories of the longitudinal change of loneliness in Study 1 could predict the risk of developing heart diseases and stroke in 2018 independently of social connections variables, sociodemographic variables, and health behaviors and health factors variables in 2011. Results showed that the longitudinal change of loneliness was independently associated with the incidence of heart diseases and stroke in 2018. To be specific, compared with no loneliness, low loneliness increasing was associated with 1.19 times the risk of developing heart diseases and 1.48 times the risk of developing stroke; and high loneliness increasing was associated with 1.38 times the risk of heart diseases and 1.71 times the risk of stroke. Study 3 explored the mediation effects of behavioral, psychological, and biological factors in 2015 between the longitudinal change of loneliness and cardiovascular diseases in 2018. I carried out multiple mediating analysis based on logistic regression models with Karlson/Holm/Breen (KHB) method. Models were adjusted for gender, age, education, and types of registered residence. Results showed that sleep duration and depressive symptoms partially mediated the association between the longitudinal change of loneliness and heart disease, and that depressive symptoms partially mediated the association between the longitudinal change of loneliness and stroke. To sum up, the present study described the trajectories of the longitudinal change of loneliness via a person-centered approach, which enriches the theory of the longitudinal change of loneliness from an empirical point of view. Also, this study also confirmed the stable prediction effect of the longitudinal change of loneliness on the risk of developing cardiovascular diseases in the future, and that has important practical significance for identifying the population in risk of cardiovascular diseases and preventing their occurrence. Finally, this study found that psychological and behavioral factors played a partial mediating role between the longitudinal changes of loneliness and cardiovascular diseases, which contributes to elucidating the mechanism of how loneliness influences cardiovascular diseases. |
| 英文摘要 | 在中国人口老龄化的背景下，中老年人的身心健康应得到更多关注。心脑血管疾病作为中老年期最为常见的健康问题之一，探索心脑血管疾病的影响因素以预防心脑血管疾病的发生对于改善中老年人的生活质量、减轻家庭和社会负担尤为重要。孤独感作为一种可干预的社会联系因素，与心脑血管疾病的关系还未得到充分探讨。过往研究发现孤独感可预测更高的心脑血管疾病风险，但是也存在一些不一致的结果，其背后的可能原因是个体内的孤独感在纵向时间上可能发生变化，不同变化模式的孤独感与健康之间可能存在不同的关系，因此有必要探讨孤独感的纵向变化对中老年人心脑血管疾病的预测作用。在此基础上，探讨孤独感作用于心脑血管疾病的可能路径可为孤独感影响健康的理论提供实证证据。 本研究使用了一个具有全国代表性的中国中老年人纵向追踪调查——中国健康与养老追踪调查（China Health and Retirement Longitudinal Survey, CHARLS），通过三个研究探究了，在中国 45 岁及以上的中老年人中，孤独感的纵向变化对心脑血管疾病的预测作用以及其中可能存在的中介作用机制。 研究一考察了孤独感的纵向变化模式及其预测因素。使用 2011 年至 2018 年共 4 次纵向调查的数据，采用了基于群体的增长模型（group-based trajectory odelling, GBTM）描述孤独感纵向变化的可能轨迹模式，并使用多项逻辑回归模型检验 2011 年的社会人口学变量、社会联系变量、健康状况变量对孤独感纵向变化的预测作用。结果发现孤独感的纵向变化可分为三条不同的轨迹，即从不孤独、低孤独上升和高孤独上升，且 2011 年社会人口学变量、社会联系变量、健康状况变量都可以显著预测孤独感的纵向变化。 研究二检验了孤独感的纵向变化对心脑血管疾病的预测作用。使用二元逻辑回归模型检验研究一所得到的孤独感纵向变化的三分类轨迹是否能独立于 2011年的社会联系变量、社会人口学变量和健康行为与健康因素变量预测 2018 年的心脏病发生和中风发生。结果发现孤独感的纵向变化可独立预测 2018 年心脏病和中风的发生：与从不孤独相比，低孤独上升可独立预测未来 1.19 倍的心脏病发生风险和 1.48 倍的中风发生风险，高孤独上升可独立预测未来 1.38 倍的心脏病发生风险和 1.71 倍的中风发生风险。 研究三探究了 2015 年的行为因素、心理因素、生物因素是否在孤独感的纵向 变 化 与 2018 年 心 脑 血 管 疾 病 发 生 之 间 起 中 介 作 用 。 采 用 基 于Karlson/Holm/Breen (KHB) 方法的逻辑回归模型进行多重中介效应分析，同时控制了 2011 年的性别、年龄、教育程度和户口类型。结果发现，睡眠时长和抑郁症状在孤独感的纵向变化与心脏病发生之间起部分中介作用，抑郁症状在孤独感的纵向变化与中风发生之间起部分中介作用。 综上所述，本研究使用以个体为中心的分析方式描述了中国中老年人的孤独感纵向变化轨迹，从实证的角度丰富了关于孤独感纵向变化的理论；本研究也证实了孤独感纵向变化对未来心脑血管疾病发生的稳定预测作用，这对识别心脑血管疾病的风险人群并预防心脑血管疾病的发生具有重要的实践意义；最后，本研究发现心理因素与行为因素在孤独感的纵向变化与心脑血管疾病之间可起到部分中介作用，为阐明孤独感影响心脑血管疾病的作用机制做出了贡献。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/43122]  |
| 专题 | 心理研究所_认知与发展心理学研究室 |
| 推荐引用方式 GB/T 7714 | 黄妍. 中国中老年人的孤独感对心脑血管疾病的影响[D]. 中国科学院心理研究所. 中国科学院大学. 2022. |
入库方式： OAI收割
来源：心理研究所
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