Association Between Self-worth And Resourcefulness And Postretirement Depression Among Urban Retired Young-old

Objectives To explore the prevalence of postretirement depression and its influencing factors among urban retired young-old.To clarify the associations between self-worth,resourcefulness and postretirement depression,and to evaluate and visualize a risk prediction model to provide effective intervention to reduce postretirement depression.Methods From September 2020 to April 2021,a stratified random sampling method was adopted to invite retired elderly within the jurisdiction of the Community Health Service Center of Tangshan Gongren Hospital in Hebei Province as the research participants.The elderly aged 60 to 74 years without depressive symptoms before retirement were enrolled by face-to-face interview using a general condition questionnaire,Self-worth Scale,Resourcefulness Scale and Geriatric Depression Scale.Software SAS 9.4 was used for statistical analysis.The measurement data of normal distribution were expressed as mean±standard deviation,and Student’s t-test and one-way ANOVA were used to compare groups.Median(P₂₅,P₇₅)was used for non-normal distribution,and Wilcoxon rank-sum test was used for comparison between groups and the Kruskal-Wallis test.Count data were presented as numbers（%）,and a chi-square test was used to compare groups.The Spearman correlation method was used to analyze the correlation between self-worth,resourcefulness and postretirement depression,and the generalized linear model was used to analyze the influence of self-worth,resourcefulness on depression.The mediating role of resourcefulness between self-worth and postretirement depression was examined using a counterfactual framework.Hierarchical regression analysis was used to examine the resourcefulness’s moderating role in the relationship between self-worth,and postretirement depression.The dependent variables were divided into two categories according to whether the depression score was≥6.According to the average value,resourcefulness and self-worth were divided into high and low levels.Finally,the study participants were categorized into low resourcefulness&low self-worth,low resourcefulness&high self-worth,high resourcefulness&low self-worth,high resourcefulness&high self-worth by the cross combination state of resourcefulness and self-worth.Logistic regression was adopted to analyze the joint effect of resourcefulness and self-worth on the risk of postretirement depression.On this premise,the R software was used to analyze the predictive efficiency of postretirement depression and compare resourcefulness and self-worth to traditional risk factors.Results 1 The prevalence of postretirement depression among retired young-old:the prevalence of postretirement depression in the retired young-old is 20.96%.2 The association between self-worth,resourcefulness and postretirement depression in retired young-old:The results showed that self-worth,resourcefulness and postretirement depression were bivariate correlated,and both had negative predictive effects on postretirement depression.Resourcefulness played a mediating role in the relationship between self-worth and postretirement depression,with a total effect of-0.137,and the mediation effect accounted for 23.13%.Resourcefulness moderates the association between self-worth and postretirement depression,and the interaction coefficient is statistically significant（（33）=0.203,P=0.002）,indicating that resourcefulness enhances the positive effect of self-worth on postretirement depression.According to the moderating effect diagram,increased self-worth had a greater impact on postretirement depression when low resourcefulness was present.3 The joint effect of resourcefulness and self-worth on postretirement depression:Compared to the low resourcefulness&low self-worth group,the OR for the risk of postretirement depression in the low resourcefulness&high self-worth,high resourcefulness&low self-worth and high resourcefulness&high self-worth groups was 0.482（95%CI:0.173-1.342）,0.321（95%CI:0.147-0.699）,0.225（95%CI:0.106-0.478）,respectively.The risk of postretirement depression was lower when both resourcefulness and self-worth were high than when either self-worth（OR=0.608,95%CI:0.256-1.445）or resourcefulness（OR=0.448,95%CI:0.215-0.932）were high alone.4Construction of postretirement depression risk prediction model:The area under the ROC curve was 0.878 when the prediction model was built with only traditional risk factors,while the area under the ROC curve was 0.891 when the model incorporated self-worth&resourcefulness.The difference was statistically significant when the two models were compared（P=0.019）,indicating that adding resourcefulness&self-worth was a better predictor of the risk of postretirement depression.Conclusions 1 The prevalence of postretirement depression in the retired young-old is at a high level.2 Both self-worth and resourcefulness could negatively predict the scores of postretirement depression among retired young-old,and resourcefulness played mediating and moderating roles in the association between self-worth and postretirement depression.3 The joint effect of self-worth and resourcefulness on the risk of postretirement depression is greater than the effect of each factor alone.4 The joint effect of self-worth and resourcefulness improved the predictive ability of the risk prediction model on postretirement depression compared with traditional risk factors.Figure 6;Table 18;Reference 130...