失能老人和配偶照顾者健康素养与自我效能对生活质量的交互作用

doi:10.16460/j.issn1008-9969.2023.13.001

摘要/Abstract

摘要： 目的探讨失能老人和配偶照顾者的健康素养、自我效能与生活质量的关系。方法采用便利抽样法,于2020年12月—2022年6月对我国7个省(自治区)的1086对失能老人与配偶照顾者进行问卷调查,调查工具包括日常生活功能指数量表、慢性病病人健康素养量表、一般自我效能感量表、中文版生活质量量表,通过主客体互倚模型分析失能老人和配偶照顾者的健康素养、自我效能与生活质量的路径关系。结果失能老人和配偶照顾者的健康素养、自我效能与生活质量的中位数分别为79.00、20.00、378.33,85.00、20.00、548.11。模型结果显示,双方的健康素养与自我效能均能够正向预测自身的生活质量,即主体效应显著（β=0.389,β=0.267,β=0.340,β=0.222;均P<0.05）;客体效应,失能老人的健康素养正向预测配偶照顾者的生活质量（β=0.138,P<0.001）,配偶照顾者的健康素养对失能老人的生活质量预测作用不显著（β=0.050,P=0.078）;双方的自我效能对对方生活质量的预测作用不显著（β=0.034,P=0.259;β=0.032,P=0.276）。结论失能老人和配偶照顾者的生活质量受自身健康素养和自我效能的影响,失能老人的健康素养与配偶照顾者的生活质量存在一定的交互作用。提示我们应将失能老人和配偶照顾者视为一个整体,进行“捆绑式”健康赋能以提升他们的健康素养和自我效能水平,提高他们的生活质量。

关键词: 失能老人, 配偶照顾者, 健康素养, 自我效能, 生活质量, 主客体互倚模型

Abstract: Objective To explore the relationship among health literacy (HL), self-efficacy, and quality of life (QoL) among disabled elders and their spouse caregivers. Methods Convenience sampling was adopted to selected 1,086 disabled elders and their spouse caregivers in 7 provinces in China from December 2020 to June 2022 to conduct the questionnaire survey. The survey tools included the Katz Activities of Daily Living (ADL) Scale, Health Literacy Scale for Chronic Patients, General Self-Efficacy Scale, and Short Form-36 Health Survey. The relationship among HL, self-efficacy, and QoL of disabled elders and their spouse caregivers were analyzed by the Actor-Partner Interdependence Model（APIM）. Results The median for HL, self-efficacy, and QoL of disabled elders and their spouse caregivers was 79.00, 20.00, 378.33, 85.00, 20.00, and 548.11 respectively. In terms of actor-effect, the HL and self-efficacy of disabled elders and their spouse caregivers had significant effects on their own QoL (β=0.389, β=0.267, β=0.340, β=0.222, all P<0.05). In terms of partner effect, the HL of disabled elders had a significant effect on the QoL of the spouse caregivers (β=0.138, P<0.001), while the HL of the spouse caregivers had no significant effect on QoL of the disabled elders (β=0.050, P=0.078). Self-efficacy of disabled elders and their spouse caregivers had significant effects on QoL (β=0.034, P=0.259; β=0.032, P=0.276). Conclusion The QoL of disabled elders and their spouse caregivers was affected by their own HL and self-efficacy, and the HL of disabled elders had a certain interaction with the QoL of their partners. To improve their QoL, disabled elders and their spouse caregivers should be viewed as a unit, and "bundling" health empowerment strategies to strengthen HL and self-efficacy should be implemented to improve their QoL.

Key words: disabled elder, spouse caregiver, health literacy, self-efficacy, quality of life, actor-partner interdependence model

中图分类号:

张咪, 吴艳妮, 黄秀娥, 杨晶, 王润, 杨玲莉, 赵慧慧, 周春兰. 失能老人和配偶照顾者健康素养与自我效能对生活质量的交互作用[J]. 护理学报, 2023, 30(13): 1-5.

ZHANG Mi, WU Yan-ni, HUANG Xiu-e, YANG Jing, WANG Run, YANG Ling-li, ZHAO Hui-hui, ZHOU Chun-lan. Interaction of health literacy and self-efficacy on quality of life in disabled elders and spouse caregivers[J]. Journal of Nursing, 2023, 30(13): 1-5.

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