Research Of The Current Situation And Influencing Factors Of Successful Aging Among The Elderly In Urban And Rural Communities Based On The Mid-Range Nursing Theory

Objective:Based on the mid-range theory of nursing,this study aimed to test the applicability of the Chinese version of the successful aging inventory among the elderly in urban and rural communities,and to increase empirical research on this scale;to evaluate the status quo of successful aging and its influencing factors,and to comparatively analyze the differences between urban and rural areas;to test the role of environmental factors on successful aging,and to explore the changeable factors,so as to provide some basis for researchers and professionals to formulate more effective health education programs and interventions.Methods:Through a cross-sectional survey research,from May to October 2019,convenient sampling was used to select 7 urban communities in Jinan City and 5 rural communities in Tai’an City.A one-on-one questionnaire survey was conducted on 435 elderly who met the standards in the form of on-site interviews.The content of the questionnaire included general information,Mini-Mental State Examination,the Physical Activity Scale for the Elderly,social support assessment scale,10-item Connor-Davidson Resilience Scale,environmental field in the World Health Organization Quality of Life Scale and successful aging inventory were used to measure social demography,health status,lifestyle,cognitive function,physical activity,social support,psychological resilience,environment and successful aging.The SPSS 23.0 software was used for data input and analysis,and the normality and homogeneity of variance tests were carried out first.The sample characteristics of community and rural areas were compared using the Chi-square test and the independent sample t-test;the single factor analysis of successful aging used the independent sample t-test,t’-test,one-way ANOVA and Pearson correlation analysis;the multiple factor analysis used multiple linear regression analysis.Results:1.This study included 232 elderly in rural communities and 203 elderly in urban communities.The age of the elderly in rural communities was 71.36±8.04 years old,the vast majority were women(57.8%);the age of the elderly in the urban communities was 71.34±7.08 years old,the vast majority were women(56.2%);there were statistical differences(P<0.05)in education level,marriage status,number of children,diet habits,vision status,self-assessed health status,self-conscious of successful aging,cognitive function,social support,psychological resilience and environment between the two.2.In this study,the retest reliability of the Chinese version of the successful aging scale for 2 to 4 weeks was 0.934,and Cronbach’s a was 0.892.The scores of successful aging of the elderly in urban and rural communities were 48.76±7.44 and 45.51±7.63;there were statistical differences in the total score of successful aging,the dimension of "Intrapsychic factors and existential meaning" "Functional performance mechanisms" and "Spirituality"(P<0.05),but there was no statistical significance in the dimension of "Gerotranscendence" and "Sense of generativity"(P>0.05).3.Single factor analysis of successful aging showed that there were significant differences in gender,education level,marital status,diet habits,hearing status,participation in social activities,self-assessed health status and self-conscious of successful aging between the community and rural elderly(P<0.05),but there was no significant difference in the number of children,smoking habits and sleep status(P>0.05).The successful aging of the elderly in rural communities was also affected by age,drinking habits,vision status,chronic diseases,and the elderly in urban communities were also affected by the way of living.The cognitive function,subjective and objective support,psychological resilience,leisure and domestic activities,and environment of the elderly in urban and rural communities were positively correlated with successful aging.In addition,the dimension of"environmental pollution/noise/scenery/climate conditions" showed that there was no significant difference between the elderly of the two(P>0.05);but in "social sefety","home environment","finance sources","medical services and social security","access to new information knowledge and skills","opportunities and participation in leisure and entertainment activities" and "transport conditions",the difference was statistically significant(P<0.05).4.Multiple linear regression analysis of successful aging showed that the common influencing factors were psychological resilience,self-conscious of successful aging,participation of social activity,environment,subjective and objective support;the successful aging of the elderly in rural communities was also affected by hearing status,marital status and domestic activities,while it was also affected by cognitive function in the elderly of the urban communities.The Goodness of Fit of the successful aging model reached 70.6%and 71.7%among the elderly in urban and rural communities.Conclusions:1.The reliability and validity of the Chinese version of successful aging inventory was verified again,and it can be used for the assessment of successful aging of the community elderly in China.2.Compared with other studies,the scores of successful aging among the elderly in urban and rural communities were at a low level.The scores of successful aging and two dimensions("Intrapsychic factors and existential meaning" and"Functional performance mechanisms")of the community elderly were higher than those in the rural communities,while the scores of the "Spirituality" dimension were lower than those in the rural communities.3.The effect of age on successful aging was double,both negative and positive;Compared with women,widowed and hearing loss,men,marriage and normal hearing were protective factors for successful aging;Education,self-assessed health status and self-conscious of successful aging can predict successful aging.Dietary nutrition was a major determinant of successful aging;In terms of chronic diseases,the level of successful aging of the elderly in urban communities was not affected by chronic diseases,which proved that the realization of successful aging was not necessarily restricted by diseases.4.In addition to the regular exercise reported in previous studies,that is,leisure activities had a positive effect on successful aging,it also proved that housekeeping activities can also have a positive effect on successful aging;psychological resilience was a factor with the highest correlation with successful aging,which was a predictor and key determinant of successful aging;cognitive function should be used as a predictor of successful aging,not a component.5.In terms of environmental factors,it was verified that it was related to successful aging,and there are differences in urban and rural community population;In addition to the dimension of "environmental pollution/noise/scenery/climate conditions",the situation of the elderly in urban communities was better than that in rural communities in other dimensions.