健康与遗传心理学研究室知识库

目的研究分析新型冠状病毒肺炎疫情前和疫情期间老年人焦虑状况差异及影响因素,为突发公共卫生事件下老年人心理干预提供科学依据。方法于2020年4至5月采取方便抽样方法在2019年实施全国老年人心理关爱项目的818个社区中,从完成心理健康状况评估的188 407名65岁及以上常住老年居民中抽取6 467名作为调查对象。采用结构化问卷随访调查疫情期间焦虑状况以及影响因素。数据录入与管理采用该项目专门开发的"老年人心理关爱项目信息管理系统"完成。采用McNemar检验比较老年人疫情前（2019年10月至2020年1月23日）和疫情期间（2020年4至5月）焦虑症状检出率的差异,采用χ2检验比较不同特征老年人焦虑症状检出率的差异,采用多因素logistic回归模型分析疫情前和疫情期间焦虑症状的影响因素。结果调查的老年人群焦虑症状检出率在疫情前为4.95%（95%CI:4.42%～5.48%）,疫情期间为10.10%（95%CI:9.36%～10.83%）,差异有统计学意义（P<0.05）,疫情期间调查人群的焦虑症状检出率较疫情前增长了约1倍。疫情前存在焦虑症状的危险因素是患一种疾病（OR=1.57,95%CI:1.05～2.37）、患两种及以上疾病（OR=3.10,95%CI:2.13～4.51）,而有兴趣爱好、子女关系好、配偶关系好、有积极老化态度、心理韧性好则是保护性因素（均P<0.05）。疫情期间新发生焦虑症状的危险因素有:居住在农村（OR=1.77,95%CI:1.42～2.20）、平时参加社会活动（OR=1.23,95%CI:1.02～1.48）、朋友关系好（OR=1.42,95%CI:1.11～1.82）、本人或身边有人被医学隔离（OR=2.80,95%CI:1.90～4.13）。结论新型冠状病毒肺炎流行导致老年人群焦虑症状检出率较往常成倍增长,应重点关注农村以及本人或身边有人被医学隔离的老年人的心理状态。

Objective: To compare the prevalence of anxiety among old people before and during the COVID-19 epidemic in China, and to provide scientific evidence for psychological intervention of the elderly during public health emergencies.Methods: In 2019, the National Psychological Care Project for the Elderly was launched, covering 818 communities across the country, and 188 407 subjects received psychological assessment. In April and May 2020, a convenient sample of 6 467 aged 65 and above subjects were followed up on the anxiety status and its influencing factors during the epidemic period by using structurized questionnaire. Data collection and management were carried out using the national elderly psychological care project data collection platform. McNemar test was used to compare the difference of the prevalence of anxiety among elderly before (October 2019 to January 23, 2020) and during the epidemic (April-May 2020). The difference of the prevalence of anxiety among elderly with different characteristics was compared by chi square test. The influencing factors of anxiety before and during the epidemic situation were analyzed by multivariate logistic regression model.Results:The prevalence of anxiety symptoms in the elderly population was 4.95% (95 %CI: 4.42%-5.48%) before the outbreak of COVID-19, and 10.10% (95 %CI: 9.36%-10.83%) during the epidemic which was twice as high as before the outbreak. The difference was statistically significant ( P<0.05). Multivariate logistic regression analysis showed that the risk factors of anxiety symptoms before the outbreak were with one underlying disease ( OR=1.57, 95 %CI: 1.05-2.37), with two or more underlying diseases ( OR=3.10, 95 %CI: 2.13-4.51), and the protective factors were with hobbies, good relationship between children, good relationship with spouse, positive aging attitude and good psychological resilience (all P<0.05). The risk factors of developing anxiety symptoms during the epidemic were living in rural areas ( OR=1.77, 95 %CI: 1.42-2.20), participating in social activities regularly ( OR=1.23, 95 %CI: 1.02-1.48), having a good relationship with friends ( OR=1.42, 95 %CI: 1.11-1.82) and were quarantined or people around were quarantined for medical observation ( OR=2.80, 95% CI: 1.90-4.13). Conclusion: The COVID-19 epidemic leads to a double increase in anxiety among the elderly. We should pay more attention to the psychological state of the elderly in rural area and who is being quarantined or people around being quarantined for medical observation.