老年人心理健康素养与焦虑症状的关系：失眠的作用路径

The relationship between mental health literacy and anxiety symptoms in older adults: the pathways of insomnia

投稿时间：2025-02-15 修订日期：2025-05-07

DOI：

英文关键词:Mental health literacy Anxiety Insomnia Older adults

基金项目:四川省医学科研课题计划资助（项目名称：慢性病对老年人焦虑的影响：有调节的中介模型；项目编号：S23049）

作者	单位	地址
曹智玥	川北医学院	四川省绵阳市游仙区涪江街道
杨先梅	绵阳市第三人民医院（四川省精神卫生中心）
彭旭梅	川北医学院
周女诗	川北医学院
杨从温	川北医学院
刘程程	川北医学院
姚静^*	绵阳市第三人民医院（四川省精神卫生中心）	四川省绵阳市游仙区剑南路东段

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中文摘要:

背景焦虑症状已成为影响老年群体身心健康的公共卫生问题。心理健康素养是老年人焦虑症状的预测因素，目前关于两者之间的作用路径的研究有限，探索心理健康素养与老年人焦虑症状的关系及作用机制对改善老年人心理健康有重要意义。目的探讨心理健康素养及其各维度对老年人焦虑症状的影响，分析失眠在其中的作用路径，为预防和干预老年人焦虑症状提供参考。方法于2021年8月—2022年12月，采用多阶段分层抽样法，选取四川省某市10 650名60岁及以上的老年人为研究对象。采用自编人口学问卷、失眠严重程度指数量表（ISI）、广泛性焦虑障碍量表（GAD-7）、国民心理健康素养问卷（NMHLQ）进行调查。采用Spearman相关分析考查各量表评分之间的相关性。采用SPSS 27.0 插件Process 4.1的模型4检验失眠在老年人心理健康素养及其各维度与焦虑症状之间的作用路径。结果共9 609名（90.23%）老年人完成有效问卷调查。检出1 680名（17.48%）老年人存在焦虑症状。老年人NMHLQ评分及知识、意识和技能维度评分均与GAD-7评分、ISI评分呈负相关（r=-0.054~-0.506，P均<0.01），ISI评分与GAD-7评分呈正相关（r=0.666，P<0.01）。失眠是老年人心理健康素养与焦虑症状之间的作用路径，间接效应值为-0.210(95% CI：-0.227~-0.193)，效应量为54.97%；失眠是心理健康素养知识与老年人焦虑症状之间的作用路径，间接效应值为-0.161(95% CI：-0.178~-0.144)，效应量为52.61%；失眠在心理健康素养意识与老年人焦虑症状之间的作用路径，间接效应值为-0.322(95% CI：-0.342~-0.302)，效应量为76.12%；失眠是心理健康素养技能与老年人焦虑症状之间的作用路径，间接效应值为-0.173(95% CI：-0.187~-0.159)，效应量为54.06%。结论老年人心理健康素养及知识、意识和技能维度不仅可直接影响焦虑症状，也可通过失眠的作用路径间接影响焦虑症状。

英文摘要:

Background Anxiety symptoms have become a public health problem affecting the physical and mental health of older adults. Mental health literacy is a predictor of anxiety symptoms in older adults, and there is limited research on the pathways between the two, so exploring the relationship between mental health literacy and anxiety symptoms in older adults and the mechanisms by which they work is important for improving the mental health of older adults.. Objective To explore the effects of mental health literacy and its dimensions on anxiety symptoms in older adults, to analyze the pathways of insomnia in this context, and to provide ideas for preventing and intervening in anxiety symptoms in older adults. Methods From August 2021 to December 2022, 9 609 older adults aged 60 years and above in a city in Sichuan Province were selected for the study using a multistage stratified sampling method. A self-administered demographic questionnaire, Insomnia Severity Index Scale (ISI), Generalized Anxiety Disorder Scale (GAD-7), and National Mental Health Literacy Questionnaire (NMHLQ) were used. Spearman correlation analysis was used to examine the correlation between the scores of the scales. Model 4 of SPSS 27.0 plug-in Process 4.1 was used to test the path of insomnia in the mental health literacy of older adults and between its dimensions and anxiety symptoms. Results 1,680 (17.48%) older adults had anxiety symptoms. Older adults' NMHLQ scores and scores of its dimensions (knowledge, awareness, and skills) were negatively correlated with GAD-7 scores and ISI scores (r=-0.054, -0.506, P<0.01), and ISI scores were positively correlated with GAD-7 scores (r=0.666, P<0.01). Insomnia was the pathway between mental health literacy and anxiety symptoms in older adults, with an indirect effect value of -0.210 (95% CI: -0.227~-0.193) and an effect size of 54.97%; insomnia was the pathway between knowledge of mental health literacy and anxiety symptoms in older adults, with an indirect effect value of -0.161 (95% CI: -0.178~-0.144) with an effect size of 52.61%; insomnia as a pathway of action between mental health literacy awareness and anxiety symptoms in older adults, with an indirect effect value of -0.322 (95% CI: -0.342~-0.302) and an effect size was 76.12%; and insomnia as a pathway of action between mental health literacy skills and anxiety symptoms in older adults, with an indirect effect value of -0.173 (95% CI: -0.187~-0.159), with an effect size of 54.06%. Conclusion Mental health literacy and its dimensions in older adults can affect anxiety symptoms not only directly but also indirectly through insomnia.

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