| ?Objective?1. To explore the bereavement risk, physical and mental health status of widowed elderly in different stages and their influencing factors, in order to provide a theoretical basis for the implementation of widowed elderly people's bereavement services and health management for nurses in hospital and community.2. To put forward effective health intervention suggestions, according to the status of widowed elderly people's bereavement, physical and mental health status changes, in order to reduce the bereavement risk, improve health and quality of life, and promote healthy aging for the widowed elderly people. ?Methods?1.Documentation method The questionnaire of widowed elderly people's bereavement risk and health conditions was customized by documentation method.2. Investigation method and longitudinal research methods The bereavement risk and health conditions of 108 recently widowed elderly were tracked with questionnaire survey method at three stages which were widowed within 3 months(recently widowed),4 to 6 months(early widowed),7 to 12 months(middle widowed).3. Statistical methods All data was analyzed with SPSS21.0 software. Frequency and percentage were used to describe the demographic characteristics and the other count data, x ±s to describe scale score and the other measurement data. Repeated measures design analysis of variance and multiple sample rate compared with the chi square test were used to analyze the repeated measurement data of bereavement risk and health conditions of widowed elderly at three stages of widowed, in order to investigate the bereavement risk, physical and mental health conditions of widowed elderly in different stages. Single factor analysis such as two independent sample t test and analysis of variance and multi factor analysis such as stepwise regression analysis were used to analyze influencing factors of the bereavement risk, physical and mental health conditions of elderly in different widowed stages. Pearson correlation analysis was used to analyze the correlation between the widowed elderly people's bereavement risk score and health score. ?Results?1. The scores of widowed elderly people's bereavement risk scale were 98.72± 6.56?90.03 ± 5.39?79.42 ± 4.23 in three stages. Repeated measures analysis of variance showed that the difference of scores of widowed elderly people's bereavement risk in different stages was statistically significant(P<0.01). With the extension of widowed, elderly people's bereavement risk decreased gradually. Stepwise regression analysis indicated that the bereavement risk of recently widowed elderly people was affected by age, ways of bereavement, education, ways of living and categories of chronic diseases(P<0.01), Pearson correlation analysis also showed that recently widowed elderly people's bereavement risk was positively correlated with loneliness(UCLA)and depression-anxiety-stress(DASS-21)(P<0.05). The bereavement risk of early widowed elderly people was affected by age, ways of bereavement, incomes, ways of living and categories of chronic diseases(P<0.01).2. The scores of widowed elderly people's ADL scale were 11.31 ± 0.61 ?11.38 ± 0.55?11.68 ± 0.49,and scores of IADL scale were 11.51 ± 0.69?11.57 ± 0.71?12.00 ± 0.47 in three stages. The difference of scores of widowed elderly people's ADL and IADL in different stages were statistically significant(P<0.01). With the extension of widowed, the scores of ADL and IADL of elderly people increased gradually. Stepwise regression analysis indicated that ADL of recently widowed elderly people was affected by age, education, categories of chronic diseases(P<0.05), IADL was affected by age, being the main caregivers, education, categories of chronic diseases(P<0.05).3. The scores of widowed elderly people's UCLA scale were 47.76±2.17?45.48±2.17?42.69±2.39, and scores of DASS-21 scale were 42.79±2.49?41.55±2.25?38.40±2.27 in three stages. The difference of scores of widowed elderly people's UCLA and DASS-21 scale in different stages were statistically significant(P<0.01). With the extension of widowed, both elderly people's loneliness and depression-anxiety-stress decreased gradually. Stepwise regression analysis indicated that loneliness of elderly people in recently widowed stage was affected by ways of bereavement, incomes, categories of chronic diseases(P<0.01), and in early widowed stage was affected by age, ways of bereavement, categories of chronic diseases(P<0.05). Depression-anxiety-stress of elderly people in recently widowed stage was affected by ways of bereavement, education, categories of chronic diseases(P<0.01), and in early widowed stage was affected by ways of bereavement, incomes, ways of living and categories of chronic diseases(P<0.05). ?Conclusion?1. The scores of elderly people's bereavement risk scale were above moderate level in recently and early widowed stages, especially in recently widowed stage. With the extension of widowed, elderly people's bereavement risk decreased gradually. Age, ways of bereavement, ways of living and categories of chronic diseases were common factors of the recently and early widowed elderly people's bereavement risk. In addition, early widowed elderly people's bereavement risk was also affected by incomes.The bereavement risk of recently and early widowed elderly people especially low age, spouse was unexpected to die, low incomes, living alone and suffering from a variety of chronic diseases should be given more attention by family, hospital and community nurses, society and government. To carry out targeted bereavement intervention in order to reduce levels of bereavement risk of widowed elderly people.2. The scores of elderly people's ADL were above moderate level and IADL were worse in different widowed stages. With the extension of widowed, the levels of ADL and IADL of elderly people increased gradually. Both ADL and IADL were affected by age, education, categories of suffering from chronic diseases in recently widowed stage. In addition, widowed elderly people's IADL was also affected by being the main caregivers. ADL and IADL of recently widowed elderly people especially old age, low educational levels, suffering from a variety of chronic diseases and not being the main caregivers should be managed and intervened by family, hospital and community nurses, society and government. To carry out physical health intervention in order to improve the health levels of widowed elderly people.3. Both levels of loneliness and depression-anxiety-stress in elderly people were above moderate level in different widowed stages. With the extension of widowed, both elderly people's loneliness and depression-anxiety-stress decreased gradually. Both loneliness and depression-anxiety-stress of recently and early widowed elderly people were commonly affected by ways of bereavement and categories of suffering from chronic diseases. In addition, loneliness was also affected by age, and depression-anxiety-stress was affected by incomes and ways of living in early widowed stage. Loneliness and depression-anxiety-stress of recently and early widowed elderly people especially old age, spouse was unexpected to die, low incomes, living alone and suffering from a variety of chronic diseases should be given more attention by family, hospital and community nurses, society and government. To carry out mental health intervention in order to improve the psychological health levels of widowed elderly people. |
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