中国失能老年人疼痛现状及其影响因素

Pain and its influencing factors in the disabled elderly in China

摘要:

目的 探讨中国失能老年人的疼痛现状并分析其影响因素，为制订干预措施提供参考和依据。 方法 本研究所采用的数据来源于2020年中国健康与养老追踪调查（China Health and Retirement Longitudinal Study, CHARLS）。选取其中≥65岁的失能老年人2591名作为研究对象，采用工具性日常生活活动能力量表（Instrumental Activities of Daily Living Scale, IADL）评定老年人的失能状况，应用口述评分法(Verbal rating scales, VRS)疼痛评分评定老年人的疼痛情况，最终筛选罹患疼痛的失能老年人2075名，未罹患疼痛的失能老年人516名。应用 SPSS 29.0 统计软件进行数据分析。采用χ2检验探究老年人失能和疼痛之间的关系，分析比较罹患与未罹患疼痛的失能老年人在年龄、性别、居住地、受教育水平、婚姻状况、是否吸烟、是否饮酒、每年医疗支出、慢性病患病情况、健康自评情况、抑郁情况等11个不同变量中是否存在差异；采用二元logistic回归分析失能老年人是否罹患疼痛的影响因素。 结果 失能老年人疼痛罹患率为80.08%。老年人罹患疼痛与失能密切相关（χ2=634.521, P<0.001），失能老年人疼痛罹患率远高于非失能老年人（80.08% vs 50.91%）。失能老年人是否罹患疼痛在年龄（χ2=8.633, p=0.013）、性别（χ2=81.618, p<0.001）、受教育水平（χ2=25.139, p<0.001）、居住地（χ2=10.278, p<0.001）、健康自评情况（χ2=66.452, p<0.001）、慢性病患病情况（χ2=47.670, p<0.001）、抑郁情况（χ2=62.088, p<0.001）、每年医疗支出（χ2=17.945, p<0.001）的比较中存在显著的统计学差异（p<0.05）。二元logistic 回归分析结果显示，女性 （OR = 2.125, 95% CI: 1.725-2.617）、健康自评为不健康（OR = 1.859, 95% CI: 1.501-2.303）、存在慢性病（OR = 2.221, 95% CI: 1.639-3.010）、存在抑郁（OR = 1.619, 95% CI: 1.314-1.996） 、每年医疗支出1000~4999元（OR =1.531, 95% CI: 1.190-1.971）是失能老年人罹患疼痛的危险因素（p<0.05） 结论 中国失能老年人疼痛现况不容乐观，性别、健康自评情况、是否存在慢性病、是否存在抑郁、每年医疗费用支出金额是失能老年人是否罹患疼痛的重要影响因素。应尽早识别和干预相关影响因素，加强失能老年人的疼痛管理，制定相关公共卫生政策，以推动健康老龄化的实现。

Abstract:

Objective To investigate the current situation and influencing factors of pain in the disabled elderly in China, and it can provide some evidence support and help for the formulation of intervention measures. Methods Using 2020 China Health and Retirement Longitudinal Study (CHARLS 2020), Selecting 2591 disabled elderly individuals aged ≥65 as the study subjects, the Instrumental Activities of Daily Living Scale (IADL) was used to assess the disability status of the elderly, and the Visual Rating Scale (VRS) was used to evaluate their pain condition. Ultimately, 2075 disabled elderly individuals suffering from pain were identified, and 516 disabled elderly individuals without pain were screened. Data analysis was conducted using SPSS 29.0 statistical software. Using chi-square test to explore the relationship between disability and pain in elderly people, analyze and compare whether there are differences in 11 different variables, including age, gender, place of residence, education level, marital status, smoking, alcohol consumption, annual medical expenses, chronic disease prevalence, health self-assessment, and depression among disabled elderly people with and without pain Using binary logistic regression to analyze the influencing factors of disabled elderly people with or without pain. Results The prevalence of pain in disabled elderly individuals was 80.08%. Elderly people's suffering from pain was closely related to disability (χ2=634.521, P<0.001), and the prevalence of pain in disabled elderly people was much higher than that in non-disabled elderly people (80.08% vs 50.91%). Whether disabled elderly people suffering from pain was significantly different in age (χ2=8.633, p=0.013), gender (χ2=81.618, p<0.001), education level (χ2=25.139, p<0.001), residence (χ2=10.278, p<0.001), self-assessment of health (χ2=66.452, p<0.001), chronic disease (χ2=47.670, p<0.001), depression (χ2=62.088, p<0.001) and annual medical expenses (χ2=17.945, p<0.001). (P<0.05). Binary logistic regression analysis showed that women (OR=2.125, 95% CI: 1.725-2.617), unhealthy (OR=1.859, 95% CI: 1.501-2.303), presence of chronic diseases (OR=2.221, 95% CI: 1.639-3.010), depression (OR=1.619, 95% CI: 1.314-1.996), and annual medical expenses of 1000-4999 yuan (OR=1.531, 95% CI: 1.190-1.971) are risk factors for disabled elderly suffering from pain (P<0.05). Conclusion The current situation of pain among disabled elderly people in China was not optimistic. Gender, health status, presence of chronic diseases, depression, annual medical expenditure amount are significant influencing factors for disabled elderly people suffering from pain. Relevant influencing factors should be identified and intervened as early as possible, pain management for disabled elderly people should be strengthened, and relevant public health policies should be formulated to promote the realization of healthy aging.