| Objective:The purpose of this study is to translate and revise the English version of sense of community index scale and make it suitable to be used as an assessment tool for sense of community of community-dwelling elderly in our country,and to investigate sense of community,participation and health status of community seniors,and explore the relationship between the three and the factors influencing health status,analyze the mediating role of participation in the relationship between sense of community and health status based on the International Functional Disability Health Classification Model(ICF),which would provide a scientific basis for the development of health interventions for community-dwelling elderly.Methods:1.After obtaining the authorization of the author of the original scale,the original English scale was translated,retranslated,and cross-culturally adapted according to the principle of Brislin translation.351 senior citizens from Bengbu were selected to test the reliability and validity of Chinese revised sense of community index scale.The Cronbach'? and the split-half reliability coefficient of Guttman were used to test its reliability.The validity of the scale was tested by content validity and construct validity.2.In this study,577 elderly community-dwelling elderly in Bengbu were selected as the research subjects by convenient sampling method.The questionnaire included:community-dwelling elderly general information,Chinese revised sense of community index scale,elderly participation questionnaire,health status scale(SF-12).SPSS20.0was used for statistical description,non-parametric analyses,multiple stepwise linear regression,Spearman correlation analysis and mediating effect test.Results:1.The Chinese version of SCI included 16 items and 4 factors were extracted by factor analysis,which could explain 66.619% of the total variance.The confirmatory factor analysis(CFA)indicated that the value of CMIN/DF,GFI,CFI,IFI,TLI,RMSEA,RMR and the standardization regression coefficient were 1.644,0.902,0.941,0.942,0.926,0.060,0.040,0.542~0.798 respectively.The combined reliability(CR)of each dimension is 0.726~0.825,and the Average Variance Extracted(AVE)is 0.401~0.541.The Cronbach'? and the split-half reliability coefficient of Guttman the whole scale were 0.854 and 0.811,respectively.The Cronbach'? of each dimension were 0.852,0.822,0.767,0.818.2.The sense of community average score of community-dwelling elderly was3.55±0.48,which was in a medium or above level.The dimension scores by descending order are:Emotional Connection(3.86 ± 0.71),Needs Fulfillment(3.78 ± 0.67),Membership(3.59±0.72),Influence(2.98±0.71).3.Among the 15 activities,the top three activities with high participation rate of the elderly were walking(95.1%),visiting relatives and friends(83.7%),and paying attention to current affairs(82.8%).The latter three activities with low frequency of participation were sports activities(17.0%),cultural activities(23.6%),volunteer services(25.6%).4.The overall score of health status of community-dwelling elderly was136.71±36.66,which was above the average level,the score of general health dimension was 37.44±23.02,which was at a low level.5.Different demographic characteristics of sense of community of community seniors' score was statistically significant.In genders,marital status,educational level,residential status,housing nature,number of years of community residence,previous occupation,household income per capita,income source(endowment insurance),and number of chronic diseases between groups were statistically difference(P<0.05).The scores of participation of community-dwelling old adults in different gender,age,religion,marital status,education level,residence status,number of children,housing nature,past occupation,household income per capita,income source(endowment insurance,government funding)were statistically significant(P<0.05).The scores of Results:health status of community-dwelling old adults were statistically significant in terms of gender,education level,living condition,number of children,housing nature,previous occupation,household income per capita,income source(children's provision,endowment insurance),number of chronic diseases,and ability of daily life activities(P<0.05).6.Correlation analysis showed that there was a positive correlation between sense of community and health status of community-dwelling elderly,and the correlation coefficient was 0.195(P<0.01).There was a positive correlation between sense of community and participation of community-dwelling elderly,with a correlation coefficient of 0.324(P<0.01).The participation of community-dwelling elderly was positively correlated with health status with a correlation coefficient of 0.134(P<0.01).7.The multivariate stepwise regression analysis was conducted on the health status of community-dwelling elderly.Variables entering the regression equation were daily activity ability,number of chronic diseases,emotional connection dimension of sense of community,gender,education level,endowment insurance and walking.The seven variables can effectively explain 44% variation of health status.8.Participation of community-dwelling elderly plays a partial mediating role between sense of community and health status.Conclusion:1.The Chinese version of sense of community index scale is of sound reliability and validity,and could be used as a tool for evaluating and researching sense of community of community seniors.2.The sense of community of community-dwelling elderly is above the average level,and the score of influence is the lowest.It should focus on improving the participation rate of the elderly in community work and enhancing the awareness of the importance of self-perception.3.Community elderly participation activities are mainly activities that are easy to participate,cost small,and consume less energy,such as walking,visiting relatives and friends,and paying attention to current affairs.4.The health status of the elderly in the community is at the lower middle level.The emotional connection dimension of sense of community and the significant positive predictive effect of walking on health status.5.Participation as a mediator,by enhancing their sense of community,promote the improvement of the level of participation so as to improve the heath status of community-dwelling elderly. |
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