Impact Of Disability On Anxiety Symptoms In The Empty Nesters: An Exploration Of The Mechanism Of Social Support

Objective:The purpose of this study is to explore the effect of disability among the empty nesters on anxiety symptoms and the mechanism of social support,based on understanding the overall situation of anxiety,disability and social support in empty nesters in Shanxi Province.To effectively promote the physical and mental health of the elderly,improve the quality of life and provide policy recommendations to promote the realization of“active aging”and“healthy aging”.Methods:A multi-stage random cluster sampling method was used in this study.A total of 11prefectures and cities in Shanxi Province were selected as sampling units.The research objects were 5,000 empty nesters aged 60 and over.Use the Social Support Rating Scale(SSRS)and Self-Rating Anxiety Scale(SAS)as evaluation tools,and use Chi-square test,t test and ANOVA to understand the overall situation of anxiety,disability,and social support in empty nest elderly in Shanxi Province.The decision tree model was used to analyze the effects of disability status on anxiety symptoms in empty nesters.Multiple linear regression and logistic regression were used to explore the effects of disability status,anxiety symptoms,and social support.The Bootstrap program and hierarchical regression were used to test the mediating and moderating effects of social support on the effects of disability on anxiety symptoms of the empty nesters.Results:Of the 4901 empty nesters surveyed in this study,2182 were detected with anxiety symptoms(44.5%).Chi-square test results showed that the empty nesters with different living areas,education level,marital status,monthly income,drinking status,exercise frequency,frequency of physical examination,attention to daily diet,relationship with children,husband-wife relationship,and chronic diseases had difference anxiety symptoms.The difference was statistically significant(P<0.05).There were 921 empty nesters(18.8%)with total and partial disability.The total score of social support was(37.22±7.79)points.The empty nesters had different disability status and social support in age,education level,marital status,monthly income,drinking status,exercise frequency,frequency of physical examination,attention to daily diet,participation in social activities,relationship with children,husband-wife relationship and chronic diseases(P<0.05).Apart from this,empty nesters without work had a significant higher disability rate than workers with empty nests,and had a higher social support score for empty nesters who have never smoked or have quit smoking(P<0.05).The results of the decision tree model on the effects of disability of empty nesters on anxiety symptoms showed that the model misclassification rate is 35.5%.The decision tree model showed that the most significant factors is self-care ability(c~2=266.767,P<0.001).The empty nesters who could not take care of themselves had the highest detection rate of anxiety symptoms,which was 85.0%.Logistic regression analysis also found that disability was a risk factor for anxiety symptoms in the empty nesters(OR=7.282,P<0.001);multiple linear regression results showed that the relationship between self-care ability and social support was significant(b=0.074,P<0.001);the relationship between social support and anxiety symptoms was also significant(OR=0.969,P<0.001).The Bootstrap mediation effect test found that social support had a mediation effect on the effects of disability on anxiety symptoms among the empty nesters.The size of the mediation effect is-0.848,which accounts for 13.11%of the total effect and 15.09%of the direct effect.However,there was no moderating effect on the anxiety symptoms of empty nesters.Conclusions:The detection rate of anxiety symptoms of empty nesters in Shanxi Province was44.5%,with a moderate level of social support,and the disability rate was 18.8%.Under the control of other factors,the relationship between the self-care ability,social support level and anxiety symptoms of the empty nesters was significant.Disability is the most important risk factor affecting the anxiety symptoms of empty nesters;the level of social support for empty nesters who cannot take care of themselves is significantly lower than that of empty nesters who take care of themselves;people with high levels of social support have lower detection rates of anxiety symptoms.In addition,social support had some mediating effects on the anxiety symptoms of empty nesters,but there is no moderating effect.