| Objectives:Based on Rowe&Kahn's model about successful aging,this study aimed to make some adjustments considering the special characteristics of Chinese elders living in nursing homes,to estimate the prevalence of successful aging,to identify factors related to successful aging,and to compare the differences between Chinese urban and rural nursing homes.Methods:Data for this cross-sectional study were collected in 15 urban nursing homes and 5 rural nursing homes.A total of 394 elders aged 60 years and above were asked to answer a series of questionnaires on basic information,chronic diseases,physical and cognitive function,healthy lifestyle,mental health,social support and resilience.SPSS 21.0 and Stata 11.0 were used to analyze data.This study used descriptive analysis to describe the prevalence of successful aging among urban and rural nursing homes,correlation analysis to describe the correlation of successful aging and its components in both urban and rural nursing homes,random effect logistic regression model to acquire the gender-age-adjusted odds ratios of successful aging for urban elders in reference to rural elders,and multivariate logistic regressions to show different related factors of successful aging in urban and rural nursing homes.Results:1.The average age of the 189 elders living in urban nursing homes was 78.47 ±9.27.There are 77 males and 112 females.Most urban participants did not smoke,drink and exercise regularly.Their average scores of social support and resilience were 60.35 ± 13.48 and 29.22±6.67 respectively.The average age of the 205 elders living in rural nursing homes was 77.31 ±7.86.There are 95 males and 110 females.Most rural participants did not smoke,drink and exercise regularly.Their average scores of social support and resilience were 50.69 ± 11.56 and 26.40 ± 9.74 respectively.2.According to our operational definition of successful aging,the prevalence was 19.0%in urban nursing homes,and 17,6%in rural nursing homes.The respective prevalence of "few chronic diseases" "good physical and cognitive functioning""good mental health" and "active social engagement" in urban nursing homes were 77.8%,29.6%,73.0%,and 48.7%.In the rural nursing homes,the respective prevalence were 59.5%,28.8%,71.2%,59.0%.3.In regression models adjusted by age and gender,there was no significant difference on the prevalence of successful aging between urban and rural elders living in nursing homes.However,urban elders were more likely to have few chronic diseases than rural elders(OR = 2.557,P<0.05).4.Among elders living in urban nursing homes,being married(OR = 4.122,P<0.05),better financial status(OR = 3.972,P<0.05),alcohol-drinking(OR = 9.256,P<0.05),and better resilience(OR = 2.690,P<0.01)were associated with higher likelihood of successful aging.Age(OR = 0.796,P>0.05),gender(OR = 1.549,P>0.05),education(OR = 5.376,P>0.05),smoking(OR = 0.399,P>0.05),exercise(OR-1.372,P>0.05)and social support(OR = 0.891,P>0.05)were not significantly related to successful aging.5.Among elders living in rural nursing homes,younger age(OR = 0.366,P<0.05),female(OR = 0.154,P<0.05),being married(OR = 6.301,P<0.05),better education(OR = 3.759,P<0.05),smoking(OR = 0.399,P>0.05),and better resilience(OR = 2.623,P<0.01)were associated with higher likelihood of successful aging.Financial status(OR = 0.462,P>0.05),alcohol-drinking(OR = 5.446,P>0.05),exercise(OR = 1.657,P>0.05)and social support(OR = 2.378,P>0.05)were not significantly related to successful aging.Conclusions:1.This study provided the first comparison on successful aging between elders living in urban and rural nursing homes.The prevalence of successful aging among elders living in urban and rural nursing homes were 19.0%and 17.6%based on a multidimensional construct composed of(1)few chronic diseases,(2)good physical and cognitive functioning,(3)good mental health,and(4)active social engagement.The number 19.0%was bigger than 17.6%,but there was no significant difference on the prevalence of successful aging between urban and rural nursing homes.This result might be caused by the unbalanced development in urban and rural areas and the diminishing urban-rural gap.2.Because of the different social contexts,there were some urban-rural gaps in the relationships between sociodemographic variables and successful aging.Being married and better financial status were protective factors of successful aging among elders living in urban nursing homes.However,among elders living in rural nursing homes,age,gender,marital status and education were significantly associated with successful aging.3.Among elders living in urban nursing homes,there was no relationship between smoking and successful aging,which might be caused by the rough classification.Because of the cross-sectional design and the influence of psychological variables,smoking was one of protective factors of successful aging among elders living in rural nursing homes.4.After accounting for the confounding effect of other variables,and the different social support between institutional elders and other populations,social support was not independently associated with successful aging.Good resilience was a protective factor of successful aging among elders living in both urban and rural nursing homes.5.Successful aging is a challenge for the elders involved,nursing homes,and relevant administrative bodies.In order to cope with the serious population aging,we should promote successful aging by improving the public health system and the eldercare services,strengthening the construction of nursing homes,fostering healthy lifestyles among both young and old men,improving elders' psychological nursing,and improving their social support and resilience. |
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