关键词: 社区老年人, 心理健康因子, 心理问题, 关联性分析, 心理健康干预

Abstract: Objective To systematically analyze the association between multi-dimensional mental health factors (cognition, emotion, adaptation, personality, and interpersonal relationship) and common psychological problems among community-dwelling elderly people, and quantify the influence intensity of each factor, so as to provide a theoretical basis for targeted mental health interventions. Methods A stratified multistage sampling method was used to select 570 elderly individuals from 8 communities in Shandong Province from January to June 2023. The revised Eysenck Emotional Stability Scale, the 3rd edition of the UCLA Loneliness Scale, and the Mental Health Scale for the Elderly were used for evaluation. Spearman rank correlation was used to screen factors significantly associated with psychological problems, and a stepwise multiple linear regression model was established to analyze the association characteristics and influence intensity between mental health factors and common psychological problems in the elderly. Results The detection rates of common psychological problems in the community-dwelling elderly were as follows: hypochondriasis (91.93%), guilt (90.88%), dependence (89.30%), obsessiveness (78.95%), depression (73.68%), inferiority (60.70%), and anxiety (38.95%). A total of 84.21% of the participants had moderate to high loneliness. Multiple linear regression showed that interpersonal factor was the only significant predictor for anxiety, guilt and obsessiveness (β=-0.23, -0.20, -0.14, all P<0.001), and also had significant protective effects on depression, hypochondriasis, inferiority and loneliness. Adaptation factor had the strongest effects on hypochondriasis (β=-0.20, P<0.001) and inferiority (β=-0.20, P<0.001), and could effectively alleviate loneliness. Emotional and personality factors significantly reduced dependence (β=0.15, 0.19, both P<0.001), and improved depression and inferiority. Cognitive factor was not included in any regression model and had no independent significant effect. Conclusions Psychological problems of community-dwelling elderly people are mainly characterized by health anxiety, self-deprecation, dependence and loneliness. Interpersonal factor is the core protective factor against negative psychological problems, and adaptation, emotion and personality factors also play important roles. A targeted and multi-level mental health intervention system should be constructed with interpersonal support as the core, adaptation training as the focus, and emotional and personality cultivation as the basis, so as to strengthen the balanced supply of urban and rural services and comprehensively improve the mental health of community-dwelling elderly people.

Key words: community-dwelling elderly, mental health factor, psychological problem, correlation analysis, mental health intervention