| Object:Based on the framework of health ecology theory and the main effects model of social support,this study aims to understand the current situation of depression in rural elderly people in China,explore the influencing factors of depression in rural elderly people,focus on the correlation between social support and depression,to analyse the differences in the factors influencing depression by gender and the influence factors of different depression severity.So as to provide theoretical reference for improving the quality of life of the elderly in rural areas and developing and implementing relevant intervention measures.Methods:This study uses the data of China Health and Retirement Longitudinal Survey(CHARLS)in 2018,selects the rural elderly aged 60 and above as the research object,and constructs the analysis database according to the inclusion and exclusion criteria.Based on health ecology theory,the factors influencing depression were explored at five aspects: Personal traits,Behaviour,Interpersonal network,Type of work and income,and Social policies.The software SPSS 26.0 was used for general statistical description using composition ratio(%)and mean ± standard deviation((?)±s);Chi-square test and unconditional binary stratified logistic regression analysis were used to explore the influencing factors of depression in rural elderly people;Spearman correlation was used to explore the correlation between variables;Model 4 in the Process 4.0 program was used to explore the simpe mediating effects between variables.Multiple ordered logistic regression was used to analyze the influencing factors of depression of different severity.Results:1.A total of 5660 rural elderly people in China were included in this study,and 2331(41.18%)were detected as depressed,the average score of depression scale was 9.21±6.772 points.Among them,the detection rate of male depression was 33.05%,the detection rate of female depression was 49.47%.The detection rate of depression was 40.32% between 60 and 69 years old,43.48% between 70 and 79 years old,and 38.92% for ≥80 years old.2.The average age of the subjects was(67.90±5.999)years old,3775(66.70%)were aged 60-69,1603(28.32%)were aged 70-79,282(4.98%)were aged ≥80,2856(50.46%)were male,2804(49.54%)were female,and 3,267(57.72%)were illiterate.3.The results of a univariate study of factors influencing depression among older people in rural China showed that: Personal traits: gender,number of chronic diseases,health satisfaction,daily activity.Behaviour: smoking and drinking.Interpersonal network: children visit and contact parents,marital satisfaction and parents’ satisfaction to their children;Played ma-jong,played chess,played cards,or went to community club,Went to a sport,social,or other kind of club,Internet;Community sports facilities,Organizations for helping the elderly association.Type of work and income: education level and monthly household expenditure had statistically significant effects on depression in rural elderly(P<0.05).4.The results of the mediating effect study showed that daily activity ability played a partial mediating role(17.26%)in the relationship between the number of chronic diseases and depressive symptoms among the elderly in rural China,and the mediating effect was(95%CI: 0.1287～0.1935).5.The results of the multi-factor study on the influencing factors of depression among the elderly in rural China show that: Personal traits: female(OR=1.406,95%CI: 1.170～1.689),with ≥3 chronic diseases(OR=1.736,95%CI: 1.447～2.082)and limited daily living activity(OR=1.968,95%CI: 1.726～2.244)are more likely to develop depression.Interpersonal network: parents who received visits from their children(OR=0.769,95%CI: 0.649～0.913),and participated in dancing or other fitness organizations(OR=0.662,95%CI: 0.480～0.913)were less likely to have depression.Dissatisfaction with marital status(OR=2.978,95%CI: 2.304-3.849)and parental ratings of their children as “not at all satisfied”(OR=3.640,95%CI:1.736 to 7.635)were more likely to be depressed.Type of work and income: high school and above(OR=0.737,95%CI: 0.544～0.999),monthly household expenditure >2000yuan(OR=0.757,95%CI:0.635～0.902)were less likely to have depression.6.The results of the multifactorial study on the factors influencing depression by gender showed that:Older female who receive visits from children(OR=0.639,95%CI: 0.494～0.828),provide financial support to children(OR=0.705,95%CI: 0.537～0.925),and residence has organizations that help older people(OR=0.700,95%CI: 0.554 to 0.883)were less likely to have depression.Older male who participate in fitness and other activities(OR=0.395,95%CI: 0.189～0.828)and participation in Internet(OR=0.535,95%CI: 0.309～0.928)were less likely to have depression.7.The results of the orderly multi-classification study on influencing factors of different depre ssion severity showed that: depression severity was less severe in monthly household expenditure >2000yuan(OR=0.793,95%CI: 0.634～0.952),parents who received visits from their children(OR=0.801,95%CI: 0.648～0.954),organizations for helping the elderly association(OR=0.844,95%CI: 0.689～0.999).Depression severity was greater in female(OR=1.342,95%CI: 1.173～1.510),with ≥3 ch ronic diseases(OR=1.702,95%CI: 1.534～1.871)and limited daily living activity(OR=1.914,95%C I: 1.794～2.033),dissatisfaction with marital status(OR=2.622,95%CI: 2.414～2.830).Conclusion:1.The detection level of depression in rural elderly population in China is relatively high,which should be paid attention to.Family support for the elderly in rural areas is still the main source of social support,but the participation rate of social activities is low and the accessibility of community support is relatively poor.2.Daily activity ability plays a partial mediating role in the relationship between chronic diseases and depressive symptoms of the elderly in rural China.3.Based on the theoretical framework of health ecology,Personal traits: female,suffering from multiple chronic diseases,limited ability of daily activities,poor self-rated health satisfaction;Interpersonal network: no child visit/month,no financial support for children,no financial support for children,poor marriage satisfaction,poor satisfaction for children,no physical exercise;Living and working conditions:lower education level and lower monthly household expenditure increase the likelihood of depressive symptoms and the severity of depression in rural elderly people. |
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