| Objectives:To explore the epidemiological characteristics of elderly injuries and impact factors, and provide the basis for the injury prevention and control among the elderly people.1. To explore the epidemiological characteristics of elderly abuse, ageism and injuries and related impact factors in urban areas of Chenzhou city.2. To explore the epidemiological characteristics of elderly suicidal ideation and related impact factors in rural areas of Chenzhou city.Methods:1. Subjects and sampling methodsA cross-sectional survey method was conducted and a multistage clustered random sampling was adopted to select the elderly people in Chenzhou’s rural and urban areas. The questionnaire was used.2Research content and tools(1) The scales of the Social SSRS, SF-36, Elderly Abuse Questionnaire, Subjective Feeling Scale of Age Discrimination, and Accident Injuries Questionnaire were completed by the elderly people in urban areas to assess social support, quality of life, abuse, subjective feeling of age discrimination, and accident injuries occurrence.(2) The scales of HPLP-II, chronic diseases questionnaire, UCLA-LS, GDS-15, and SIOSS were completed by the elderly people in the rural areas to assess health promoting lifestyle, prevalence of chronic diseases.loneliness, depression and suicidal ideation.3. Statistical analysisSPSS18.0was used for general statistical analysis, and AMOS (Analysis of Moment Structures)7.0software for structural equation modeling (SEM).Results:1The main results about elderly people in urban area are as follows:(1) Social support score was (39.061±8.081), subjective support score was (22.132±5.401), objective support score was (9.123±3.114), the use of support score was (7.708±1.942). (2) The quality of life total score (SF-36) was (517.12±137.35), physical function (PF) score was (71.741±21.998), role physical (RP)scores was (52.168±40.859), body pain (BP) score was (64.201±20.196), general health (GH) score was (61.477±23.106), vitality (VT) score was (66.685±16.235), social function (SF) score was (67.222±21.009), role emotional (RE) score was (63.301±37.224), mental health (MH) score was (70.381±15.508).(3) The total incidence rate of elderly abuse was35.6%. And among all kinds of elderly abuses, the occurring rate in elderly people decreased in emotional abuse (19.9%), neglectful in caring(16.9%), physical abuse(6.5%) and economic exploitation (1.5%). The chi square test showed that the differences were statistically significant (P<0.05) between different groups’gender, age, education, marital status, habitation way, family income, life care personnel, self-care ability and social support level. Logistic regression showed that female (OR=1.346,5%CI:1.028-1.762,^=0.031), non marital status (OR=1377,5%CI:1.093-1.735, P=0.007) low personal income of family per month (OR=0.S41,5%CI:0.765-0.938,P=0.001), self-care ability deficits (OR=1.810,5%CI:1.315-2.493, P=0.000), poor health status (<97?=1.511,5%CI:1.264-1.805,P=0.000).000), and less social support (OR=0.355,5%CI:0.246-0.514,P=0.000) were risk factors for elderly abuse. Speaman correlation analysis showed that elderly abuse has a significant negative correlation with social support and quality of life (P<0.001).(4) The age discrimination of score subjective feeling scale was (3.00±0.59) and the chi square test showed that the differences were statistically significant between different age group, education level, marital status, living pattern, family income, self-care ability and social support level(P<0.05). Pearson correlation analysis showed that the age discrimination of score subjective feeling scale was negatively correlated with quality of life and social support (P<0.001).(5)The accident injury incidence rate was25.5%and the top five accident injury incidence rate were falls18.7%, burns3%, sharp instrument injury1.4%, extrusion and collision injury1%and animal damage0.6%. The chi square test showed that the differences of accident injury incidence rate were statistically significant (P<0.05) between different gender, age, education, marital status, family income, and self-care ability. Logistic regression showed that female (OR=1.498,5%CI:1.110-2.022,P=0.008),aged (OR=1.145,5%CI:1.028-1.274, P=0.013), lower education level (OR=0.799,5%CI:0.685-0.932, P=0.004), lower personal income in family(O/?=1.880,5%CI:0.784-0.989, P=0.032), changing of healthy status in the past12months (OR=1.608,5%CI:1.322-1.955,P=0.000) and physical abuse (OR=2.986,5%CI:1.755-5.083, P-0.000) were risk factors for elderly accident injury.(6) Speaman correlation analysis showed that accident injuries was negatively correlated with the age discrimination score of subjective feeling scale, but it was positively correlated with incidence rate of elderly abuse, physical abuse and emotional abuse (P<0.001).(7) SEM showed that social support had directly negative effect on the events which led to physical and mental damage (β=-0.02, P<0.001) and The events led to physical and mental damage had direct negative effect on the quality of life (β=-731.229, P<0.001). Social support had indirect positive effect on the quality of life through the events which led to physical and mental damage(β=-0.02*-341.34=6.827, P<0.001).2The main results about elderly people in rural area are as follows:(1)Rural elderly residents’self-rating idea of suicide scale score was (9.36±4.08), and the despair factor score was (3.77±2.57), the optimistic actor score was(2.00±1.26), sleep factor score was(2.42±1.20) and the cover factor score was (1.15±0.88). The incidence rate of suicide ideation in the last year was26.01%and the chi square test showed that the differences were not statistically significant between different gender.but were statistically significant between different education level, marital status, living way, family income (P<0.05).(2)The prevalence rate of chronic diseases was81.07%, The score of UCLA Loneliness Scale was (42.45±8.615), The score of depression scale (GDS-15) was (5.59±3.363).(3)The health promoting lifestyle profile (LHHA-II) score was (112.048±18.714), the health responsibility score was(15.764±3.538), the nutrition score was (20.281±4.227), the stress management score was (20.314±4.307), the exercise score was(16.008±4.777), the interpersonal support score was (20.56±4.273) and the self actualization score was (18.93±4.859). The chi square test showed that the differences of LHHA-II score were not statistically significant between different gender and age but were statistically significant between different education level, marital status, living way, family income (P<0.05)(4) Logistic regression showed that non marital status (OR=1.842,5% CI:1.274-2.663, P=0.001), living alone (OR=1.800,5%CI:1.197-2.708,P=0.005), without children living in the same place (OR=1.843,5%CI:1.159-2.931, P=0.010), poor neighbor relationship (OK=0.647,5%CI:0.523-0.802, P<0.001), less children’s visitation (OR=1.267,5%CI:1.066-1.507, P=0.007), suffering from various chronic diseases (OK=1.347,5%CI:1.166-1.555, P<0.001), suffering from tumors (OR=8.613,5%CI:2.993-24.212,P<0.001), unhealthy lifestyle (OR=0.576,5%CI:0.395-0.840,P=0.004),severe loneliness(OR=1.758,5%CI:1.285-2.405, P<0.001), depression (OR=6A51,5%CI:4.362-9.541, P<0.001) were risk factors of elderly’ suicide ideation.(5) Speaman correlation analysis showed that the health promoting lifestyle was negatively correlated with the prevalence rate of chronic diseases, loneliness, depression and suicide ideation (P<0.001)(6) SEM showed that the health promoting lifestyle had direct negative effect on the suicide ideation (β=-1.88, P<0.001) and had direct negative effect on the physical and mental disease (β=-0.41, P<0.001). The physical and mental disease had negative effect on the suicide ideation (β=0.63, P<0.001). The health promoting lifestyle had indirect negative effect on the suicide ideation through the physical and mental disease (β=0.41*0.63=0.26, P<0.001).Conclusion1. The total incidence rate of elderly abuse was35.6%, and the risk factors for elderly abuse are female, non marital status, low personal income of family per month, self-care ability deficits, poor health status and less social support. The elderly abuse has a significant negative correlation with social support and quality of life.2. The elderly’age discrimination in Chenzhou’s urban area was on the average level,and gender, age, educational level, martial status, living pattern, family income, self-care ability and social support were related factors for the elderly’age discrimination. Moreover, the higher age discrimination level, the lower quality of life and social support; but the higher age discrimination level, the higher incidence rate of abuse.3. The accident injury incidence rate in Chenzhou’s urban area was25.5%, and the risk factors were female, aged, lower education level, lower personal income in family, changing of healthy status in the past12months and physical abuse. The accident injuries was negatively correlated with the age discrimination and was positively correlated with incidence rate of elderly abuse, physical abuse and emotional abuse.4. The social support had indirectly negative effect on the quality of life through the events which led to physical and mental damage, including abuse, age discrimination, accident injury.5. The incidence rate of elderly’suicide ideation in Chenzhou’s rural area was26.01%and the risk factors were non marital status, living alone, without children living in the same place, poor neighbor relationship, less children’s visitation, suffering from various chronic diseases, suffering from tumors, unhealthy lifestyle, severe loneliness and depression.6. The health promoting was negatively correlated with the prevalence rate of chronic diseases, loneliness, depression and suicide ideation in rural area of Chenzhou.7. The health promoting lifestyle had direct negative effect on the suicide ideation and the effect is through the physical and mental disease. |
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