| BackgroundChronic diseases headed by hypertension threaten the mental health of Chinese residents,and have become a major problem affecting social development.Compared with other people,patients with hypertension are more likely to have problems,resulting in chronic poor control of blood pressure.With the improvement of urbanisation and ageing in China,the prevalence of hypertension among the elderly in rural areas has increased year by year,and the mental health of elderly patients with hypertension in rural areas is not optimistic.As various changes in social life encountered by people in daily life,negative life event can cause individual tension and even threats.When individuals face negative life event,it is easy to produce negative emotional experiences,and have emotional disorders and other problems,thus affecting the individual’s mental health.Self-efficacy and social capital,as protective factors for mental health,affect the emotions,attitudes,thoughts and behaviours of individuals,and are closely related to the physical and mental health of individuals.Although the previous literature has confirmed that negative life event is a risk factor for individual mental health,few studies have focussed on the elderly patients with hypertension in rural areas to discuss the relationship and the potential action path of self-efficacy and social capital between negative life event and mental health.ObjectivesTo understand the current situation of negative life event,self-efficacy,social capital and mental health in elderly patients with hypertension in rural Shandong Province,explore the relationship between negative life event and the mental health of elderly patients with hypertension,explore the mediating role of self-efficacy and the moderating role of social capital between them,and put forward targeted suggestions for improving the mental health status of elderly patients with hypertension.MethodsThe data came from "the path research on the impact of social capital on the quality of life of rural elderly patients with hypertension(ZR2019MG013)".Using multi-stage stratified random sampling,953 elderly patients with hypertension from 36 villages in three cities in Shandong Province(Heze Shan county,Jinan Laiwu and Weihai Rushan)were selected as the research subjects.The questionnaire mainly includes the basic situation questionnaire(sociodemographic information,healthy living behavior and disease-related characteristics),negative life event questionnaire,General Self-Efficacy Scale,social capital scale and Kessler10.Epidata 3.1 software was used for data input,and SPSS 25.0 software was used for descriptive statistics,independent sample t test,single factor variance analysis,nonparametric tests,Spearman correlation analysis and multiple linear regression.The mediating and moderating effect test were examined using SPSS plugin,Process 3.5.ResultsThis study found that the score of mental health of elderly patients with hypertension in rural areas of Shandong Province was 18.07±7.79(full score of 50),and can still be improved.There were significant differences between mental health in gender,education level,annual family income,physical exercise,comorbidity(P<0.05).Negative life event and the score of self-efficacy,social capital were negatively correlated(r=-0.238,r=-0.169,P<0.01),a significant positive correlation between negative life event and the score of mental health(r=0.432,P<0.01).A significant positive correlation between the score of self-efficacy and social capital(r=0.156,P<0.01),and a significant negative correlation between the score of self-efficacy and mental health(r=-0.449,P<0.01).And the score of social capital and mental health(r=-0.255,P<0.01)were negatively correlated.Self-efficacy of the elderly patients with hypertension played a partial mediating role between negative life event and mental health,accounting for 12.68%of the total effect.Social capital moderated the relationship between negative life event and mental health.Specifically,the higher the social capital,the weaker the positive predictive effect of negative life event on the mental health of elderly patients with hypertension,and vice versa.Social capital also regulates the second half of the mediating model,that is,the higher the level of social capital,the weaker the negative predictive effect of self-efficacy on the mental health of elderly patients with hypertension,and vice versa.Conclusion and SuggestionThe mental health status of rural elderly patients with hypertension in Shandong Province is in general healthy level.Negative life event can not only directly predict the mental health of elderly hypertension patients in rural areas,but also indirectly predict their mental health through the mediating effect of self-efficacy.Social capital has a moderating effect on the relationship between negative life event and mental health,and also on the relationship between self-efficacy and mental health(the second half of the mediating effect).That is,there was a moderating mediating effect model in this study.Therefore,we recommend that:(1)Reduce the incidence of negative life event,and improve the mental health of elderly patients with hypertension in rural areas.(2)Enhance self-efficacy,and improve the mental health level of elderly patients with hypertension in rural areas.(3)Improve the level of social capital,and promote the health status of elderly people with hypertension in rural areas. |
