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| Mediating effects of loneliness and depressive symptoms on family function and life satisfaction among rural elderly patients with chronic diseases |
| LI Zhonglian1,2, MO Xiangang3, QIN Suxia1, ZHOU Quanxiang1, ZHU Yafen1, MO Caiyun1, YI Aijing1, CHEN Juhai4
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1. Department of Medicine, Qiannan Medical College for Nationalities, Duyun, Guizhou 558003, China;
2. School of Clinical Medicine, Guizhou Medical University, Guiyang, Guizhou 550004, China;
3. The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, China;
4. Guiyang Public Health Service Center, Guiyang, Guizhou 550004, China |
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Abstract Objective To analyze the mediating effects of loneliness and depressive symptoms on family functioning and life satisfaction among rural elderly patients with chronic diseases, so as to provide the basis for improving the life satisfaction of this population. Methods Rural elderly patients with chronic diseases aged ≥60 years in Qiannan Buyi and Miao Autonomous Prefecture, Guizhou Province were selected using a multi-stage stratified random cluster sampling method from June to September 2022. Basic information such as gender, age, and chronic diseases were collected. Family function, life satisfaction, loneliness and depressive symptoms were evaluated using Family Care Index Scale, the Satisfaction with Life Scale, the b-item Revised VCLA Loneliness Sale and the 15-item Geriatric Depression Scale, respectively. The structural equation model was constructed using Amos software to analyze the mediating effects of loneliness and depressive symptoms on the relationship between family function and life satisfaction. The Bootstrap method was employed to test the mediating effects. Results A total of 1 145 rural elderly patients with chronic diseases were recruited, including 517 males (45.15%) and 628 females (54.85%). Among the participants, 657 individuals (57.38%) were aged 60-<71 years, and 540 individuals (47.16%) had three or more chronic diseases. The scores for family function, life satisfaction, loneliness, and depressive symptoms were (3.90±1.18), (18.88±5.25), (12.88±2.99), and (6.65±2.26), respectively. Mediating effect analysis showed that family function had a direct positive effect on life satisfaction (β=0.179, 95%CI: 0.126-0.231). It also indirectly positively influenced the life satisfaction of rural elderly patients with chronic diseases through the independent mediating effect of depressive symptoms (β=0.035, 95%CI: 0.021-0.054) and the chained mediating effect of loneliness and depressive symptoms (β=0.021, 95%CI: 0.013-0.030). The mediating effect of depressive symptoms accounted for 14.89% of the total effect, while the chained mediating effect of loneliness and depressive symptoms accounted for 8.94% of the total effect. Conclusion Good family function can directly enhance the life satisfaction of rural elderly patients with chronic diseases and can also indirectly improve their life satisfaction by reducing loneliness and depressive symptoms.
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Received: 21 February 2025
Revised: 07 May 2025
Published: 24 June 2025
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[1] SU B B,LI D,XIE J Q,et al.Chronic disease in China:geographic and socioeconomic determinants among persons aged 60 and older[J].J Am Med Dir Assoc,2023,24(2):206-212.
[2] FRÍAS-LUQUE M D,TOLEDANO-GONZÁLEZ A.Determinants of quality of life and well-being in cognitively unimpaired older adults:a systematic review[J].PeerJ,2022,10:1-24.
[3] YANG L,ZHANG X.Research on the urban-rural differences and influencing factors of life satisfaction among elderly people in China[J].J Health Popul Nutr,2024,43(1):213-220.
[4] SHI Y Y,LIANG Z Q,ZHANG Y J,et al.The relationships among family function,psychological resilience,and social network of patients with chronic disease in the community[J].Geriatr Nurs,2024,60:52-58.
[5] CAO W W,CAO C L,REN B H,et al.Complex association of self-rated health,depression,functional ability with loneliness in rural community-dwelling older people[J].BMC geriatrics,2023,23(1):267-275.
[6] 杨红英,李链,潘凯杰,等.老年人抑郁焦虑症状的影响因素研究[J].预防医学,2024,36(11):926-930.
YANG H Y,LI L,PAN K J,et al.Influencing factors for depression and anxiety symptoms among the elderly[J]. China Prev Med J,2024,36(11):926-930.(in Chinese)
[7] AHADI B,HASSANI B.Loneliness and quality of life in older adults:the mediating role of depression[J].Ageing international,2021,46:337-350.
[8] WANG W L,CHEN K X,XIAO W W,et al.Determinants of health poverty vulnerability in rural areas of Western China in the post-poverty relief era:an analysis based on the Anderson behavioral model[J].BMC Public Health,2024,24(1):459-474.
[9] 曹红梅,何新羊.积极老龄化视域下社会活动参与对老年人健康的影响[J].江苏社会科学,2022(2):166-175.
CAO H M,HE X Y.The impact of social activity participation on the health of older adults from the perspective of active aging[J].Jiangsu Soc Sci,2022(2):166-175.(in Chinese)
[10] SMILKSTEIN G,ASHWORTH C,MONTANO D.Validity and reliability of the family APGAR as a test of family function[J].J Fam Pract,1982,15(2):303-311.
[11] DIENER E,EMMONS R A,LARSEN R J,et al.The Satisfaction with Life Scale[J].J Pers Assess,1985,49(1):71-75.
[12] WONGPAKARAN N,WONGPAKARAN T,PINYOPORNPANISH M,et al.Development and validation of a 6-item Revised UCLA Loneliness Scale(RULS-6)using Rasch analysis[J].Br J Health Psychol,2020,25(2):233-256.
[13] SHEIKH J I,YESAVAGE J A.Geriatric Depression Scale(GDS):recent evidence and development of a shorter version[M].London:Routledge,2014.
[14] ZHANG Y,LI X N,BI Y X,et al.Effects of family function,depression,and self-perceived burden on loneliness in patients with type 2 diabetes mellitus:a serial multiple mediation model[J].BMC Psychiatry,2023,23(1):636-644.
[15] AMIN S M,KHEDR M A,TAWFIK A F,et al.The mediating and moderating role of social support on the relationship between psychological well-being and burdensomeness among elderly with chronic illness:community nursing perspective[J].BMC Nurs,2025,24(1):156-170.
[16] NGUYEN T N B,ROSKE K,CHANCE P,et al.Relationships between adolescent perception of family functioning and affective symptomatology[J/OL].JAACAP Open,2024[2025-05-07].https://doi.org/10.1016/j.jaacop.2024.09.002.
[17] BAI Q,FU D D,CHEN S C,et al.Configurational effects of intergenerational support on older adults' depression:an empirical study from CHARLS data[J].BMC Public Health,2025,25(1):392-401.
[18] WANG X F,XIA F H,WANG G Q.Mediating effect of anxiety and depression between family function and hope in patients receiving maintenance hemodialysis:a cross-sectional study[J].BMC Psychol,2023,11(1):130-138.
[19] ZAID S M,HUTAGALUNG F D,ABD HAMID H S B,et al.The power of emotion regulation:how managing sadness influences depression and anxiety?[J].BMC Psychol,2025,13(1):38-49.
[20] 黎旭娇,欧阳泽平,罗雨星,等. 中小学生心理韧性、情绪调节在家庭累积风险与积极应对方式间的中介效应[J]. 预防医学,2024,36(11):941-944.
LI X J,OUYANG Z P,LUO Y X,et al.Mediating effects of resilience and emotion regulation on family cumulative risk and positive coping style among primary and middle school students[J]. China Prev Med J,2024,36(11):941-944.(in Chinese) |
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