老年慢性病共病患者身体复原力现状及影响因素的混合研究

doi:10.3761/j.issn.0254-1769.2026.14.011

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (14): 1954-1961.DOI: 10.3761/j.issn.0254-1769.2026.14.011

老年慢性病共病患者身体复原力现状及影响因素的混合研究

刘艾红¹(), 朝阳², 张志霞³, 常红娟¹^,^*()

¹ 武汉科技大学医学部护理系武汉市 430065
² 华中科技大学同济医学院附属协和医院综合科武汉市 430002
³ 武汉科技大学附属天佑医院护理部武汉市 430081

收稿日期:2026-01-20 出版日期:2026-07-20 发布日期:2026-07-17
*通讯作者: 常红娟，E-mail：changhj0812@126.com
作者简介:刘艾红：女，本科（硕士在读），主管护师，E-mail：liuah0825@163.com
第一联系人：作者贡献声明
刘艾红：研究设计、问卷调查、数据/资料整理与分析、统计学分析、论文撰写；朝阳：问卷调查、数据/资料整理与分析；张志霞：研究指导；常红娟：研究指导、论文审阅与修改

The current status and influencing factors of physical resilience in elderly patients with chronic comorbidities： a mixed-methods study

LIU Aihong¹(), ZHAO Yang², ZHANG Zhixia³, CHANG Hongjuan¹^,^*()

¹ Department of Nursing， School of Medicine，Wuhan University of Science and Technology， Wuhan 430065， China
² Department of General Medicine， Union Hospital Affiliated to Tongji Medical College，Huazhong University of Science and Technology， Wuhan 430002， China
³ Nursing Department， Tianyou Hospital Affiliated to Wuhan University of Science and Technology， Wuhan 430081， China

Received:2026-01-20 Online:2026-07-20 Published:2026-07-17
* Corresponding author: CHANG Hongjuan，E-mail：changhj0812@126.com

摘要/Abstract

摘要：

目的探讨老年慢性病共病患者的身体复原力现状及其影响因素，为临床制订针对性干预方案提供参考。方法采用解释性序列混合研究设计，采用便利抽样法，选取武汉市某三级甲等医院于2025年4—6月住院的349例老年慢性病共病患者为调查对象，采用一般资料调查表、简体中文版老年人身体复原力量表、中文版衰弱筛查量表、简版老年抑郁量表、中文版领悟社会支持量表、中文版积极老龄量表进行调查分析；于2025年7—9月，采用目的抽样法，对量性研究中的15例老年慢性病共病患者进行半结构式访谈，使用传统内容分析法分析访谈资料，采用联合展示法整合量性和质性研究结果。结果量性研究结果显示，老年慢性病共病患者的身体复原力得分为47.0（37.0，57.0）分，多元线性回归分析结果显示，年龄、合并慢性病数量、衰弱、领悟社会支持、积极老龄化是老年慢性病共病患者身体复原力的影响因素（P<0.05）。质性研究结果基于社会生态系统理论提炼出3个主题：个体微观层面为生理功能受限与行为调节的双重作用；家庭-社会中观层面为社会支持的结构性与功能性的双重作用；文化环境宏观层面为社会文化环境因素的双调节作用。混合结果显示量性研究结果与质性研究结果表现为收敛、互补和拓展。结论老年慢性病共病患者身体复原力处于中等偏下水平，受多层级因素交互影响，建议医护人员根据其影响因素制订个性化的干预措施。

关键词: 慢性病共病, 身体复原力, 社会生态系统理论, 混合研究, 老年人护理

Abstract:

Objective To explore the status of physical resilience among older adults with multimorbidity and to identify its influencing factors，so as to provide evidence for developing targeted clinical interventions. Methods An explanatory sequential mixed-methods design was adopted. A total of 349 hospitalized older adults with multimorbidity were recruited by convenience sampling from a tertiary hospital in Wuhan between April and June 2025. Data were collected using a general information questionnaire，the Physical Resilience Scale for Older Adults，the Chinese version of the Frailty Scale，the Chinese version of the Depression Scale，the Chinese version of the Perceived Social Support Scale，and the Chinese version of the Positive Aging Scale. From July to September 2025，purposive sampling was used to select 15 participants from the quantitative phase for semi-structured interviews. Traditional content analysis was applied to analyze qualitative data，and a joint display method was used to integrate quantitative and qualitative findings. Results The quantitative results showed that the median physical resilience score of older adults with multimorbidity was 47.0（37.0，57.0） points. Multiple linear regression analysis indicated that age，number of chronic diseases，frailty，perceived social support，and positive aging were significant influencing factors of physical resilience in elderly patients with chronic multimorbidity（P<0.05）. Based on social ecological system theory，3 themes were identified from the qualitative analysis：（1）individual（microsystem） level：the dual role of impaired physiological function and behavioral regulation；（2）family-social（mesosystem） level：the bidirectional effects of structural and functional social support；（3）cultural-environmental（macrosystem） level：the dual regulatory role of sociocultural environmental factors. The mixed-methods integration demonstrated convergence，complementarity，and expansion between quantitative and qualitative findings. Conclusion The physical resilience of older adults with chronic multimorbidity is at a moderately low level and is influenced by multilevel interacting factors. Healthcare professionals should develop individualized intervention strategies based on these influencing factors.

Key words: Chronic Multimorbidity, Physical Resilience, Social Ecological System Theory, Mixed-Methods Research, Geriatric Nursing

刘艾红, 朝阳, 张志霞, 常红娟. 老年慢性病共病患者身体复原力现状及影响因素的混合研究[J]. 中华护理杂志, 2026, 61(14): 1954-1961.

LIU Aihong, ZHAO Yang, ZHANG Zhixia, CHANG Hongjuan. The current status and influencing factors of physical resilience in elderly patients with chronic comorbidities： a mixed-methods study[J]. Chinese Journal of Nursing, 2026, 61(14): 1954-1961.

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参考文献 26

[1]	潘晔, 刘志辉, 胡倩倩, 等. 中国老年人慢性病多病共存模式的研究[J]. 中国全科医学, 2023, 26(29):3608-3615. DOI
	Pan Y, Liu ZH, Hu QQ, et al. Patterns of coexistence of multiple chronic conditions among Chinese elderly[J]. Chin Gen Pract, 2023, 26(29):3608-3615.
[2]	Chowdhury SR, Chandra Das D, Sunna TC, et al. Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis[J]. eClinical Medicine, 2023, 57:101860.
[3]	刘晓红, 卢雨轩, 陈赟, 等. 社区老年慢性病患者多病共存管理困境的质性研究[J]. 中华护理杂志, 2025, 60(14):1764-1769. DOI
	Liu XH, Lu YX, Chen Y, et al. A qualitative study on the management dilemma of coexisting chronic diseases among elderly patients in the communities[J]. Chin J Nurs, 2025, 60(14):1764-1769. DOI
[4]	WHO. World report on ageing and health[EB/OL]. (2015)[2025-12-01].https://www.who.int/publications/i/item/9789241565042.
[5]	Whitson HE, Duan-Porter W, Schmader KE, et al. Physical resilience in older adults:systematic review and development of an emerging construct[J]. J Gerontol Ser A Biol Sci Med Sci, 2016, 71(4):489-495. DOI URL
[6]	Li JT, Chhetri JK, Ma LN. Physical resilience in older adults: potential use in promoting healthy aging[J]. Ageing Res Rev, 2022, 81:101701. DOI URL
[7]	徐婷婷, 申雪花, 柳秋实, 等. 社区老年人身体复原力现状及影响因素分析[J]. 中国医药导报, 2025, 22(14):30-34,40.
	Xu TT, Shen XH, Liu QS, et al. Current status and influencing factors of physical resilience of the elderly in community[J]. China Med Her, 2025, 22(14):30-34,40.
[8]	孙倩, 朱文娟. 社会生态系统理论视角下老年人躯体复原力研究进展[J]. 护理研究, 2024, 38(20):3670-3674.
	Sun Q, Zhu WJ. Research progress of physical resilience in the elderly from the perspective of society ecosystems theory[J]. Chin Nurs Res, 2024, 38(20):3670-3674.
[9]	McLeroy KR, Bibeau D, Steckler A, et al. An ecological perspective on health promotion programs[J]. Health Educ Q, 1988, 15(4):351-377. DOI PMID
[10]	胡雁, 荆凤. 护理领域混合方法研究的设计要点及典型问题分析[J]. 中华护理杂志, 2024, 59(3):261-266. DOI
	Hu Y, Jing F. Analysis of design type,data integration and common problems of mixed method research in nursing studies[J]. Chin J Nurs, 2024, 59(3):261-266.
[11]	Nguyen H, Manolova G, Daskalopoulou C, et al. Prevalence of multimorbidity in community settings:a systematic review and meta-analysis of observational studies[J]. J Comorb, 2019,9: 2235042X19870934.
[12]	李佳欣, 柳杰, 刘子薇, 等. 简体中文版老年人身体复原力量表的修订及信效度检验[J]. 军事护理, 2024, 41(10):48-51.
	Li JX, Liu J, Liu ZW, et al. Revision of Simplified Chinese Version of the Physical Resilience Instrument for Older Adults and its reliability and validity test[J]. Mil Nurs, 2024, 41(10):48-51.
[13]	卫尹, 曹艳佩, 杨晓莉, 等. 老年住院患者衰弱综合征现状及影响因素[J]. 复旦学报(医学版), 2018, 45(4):496-502.
	Wei Y, Cao YP, Yang XL, et al. Frailty syndrome in hospitalized geriatric patients and its risk factors[J]. Fudan Univ J Med Sci, 2018, 45(4):496-502.
[14]	唐丹. 简版老年抑郁量表(GDS-15)在中国老年人中的使用[J]. 中国临床心理学杂志, 2013, 21(3):402-405.
	Tang D. Application of Short Form Geriatric Depression Scale (GDS-15) in Chinese elderly[J]. Chin J Clin Psychol, 2013, 21(3):402-405.
[15]	姜乾金. 领悟社会支持量表[J]. 中国行为医学科学, 2001, 10(10):41-43.
	Jiang QJ. Perceived Social Support Scale[J]. Chin J Behav Med Sci, 2001, 10(10):41-43.
[16]	张建阁, 张艳, 史岩, 等. 中文版积极老龄量表信效度[J]. 中国老年学杂志, 2017, 37(21):5424-5426.
	Zhang JG, Zhang Y, Shi Y, et al. Reliability and validity of Chinese version of Active Age Scale[J]. Chin J Gerontol, 2017, 37(21):5424-5426.
[17]	Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs-principles and practices[J]. Health Serv Res, 2013, 48(6 Pt 2):2134-2156. DOI URL
[18]	Ghanei Gheshlagh R, Sayehmiri K, Ebadi A, et al. Resilience of patients with chronic physical diseases:a systematic review and meta-analysis[J]. Iran Red Crescent Med J, 2016, 18(7): e38562.
[19]	Hu FW, Lin CH, Lai PH, et al. Predictive validity of the physical resilience instrument for older adults(PRIFOR)[J]. J Nutr Health Aging, 2021, 25(9):1042-1045. DOI PMID
[20]	Hernández B, Voll S, Lewis NA, et al. Comparisons of disease cluster patterns,prevalence and health factors in the USA,Canada,England and Ireland[J]. BMC Public Health, 2021, 21(1):1674. DOI PMID
[21]	赵琪, 高俊平, 高凯霞, 等. 老年膀胱癌尿路造口患者躯体复原力现状及其影响因素分析[J]. 军事护理, 2024, 41(9):21-24.
	Zhao Q, Gao JP, Gao KX, et al. Status quo of physical resilience of elderly patients with urostomy for bladder cancer and its influencing factors[J]. Mil Nurs, 2024, 41(9):21-24.
[22]	Chhetri JK, Xue QL, Ma L, et al. Intrinsic capacity as a determinant of physical resilience in older adults[J]. J Nutr Health Aging, 2021, 25(8):1006-1011. DOI PMID
[23]	Xue QL, Laskow T, Alzahrani MK, et al. Multivariate profiling of physical resilience in older adults after total knee replacement surgery:results from a prospective observational study[J]. J Gerontol A Biol Sci Med Sci, 2025, 80(6):glaf032.
[24]	Duan-Porter W, Cohen HJ, Demark-Wahnefried W, et al. Physical resilience of older cancer survivors:an emerging concept[J]. J Geriatr Oncol, 2016, 7(6):471-478. DOI PMID
[25]	张瑞芹, 孙俊俊, 聂丽, 等. 基于健康生态学模型的农村慢性病共病老年人社会隔离影响因素[J]. 护理研究, 2025, 39(7): 1084-1093.
	Zhang RQ, Sun JJ, Nie L, et al. Influencing factors analysis of social isolation in rural elderly with chronic disease comorbidity based on health ecology model[J]. Chin Nurs Res, 2025, 39(7):1084-1093.
[26]	郭晓菡, 祝凯, 黄霞, 等. 社区老年人积极老龄化的潜在剖面分析及护理需求研究[J]. 中华护理杂志, 2024, 59(16):2014-2020. DOI
	Guo XH, Zhu K, Huang X, et al. Potential profile analysis of active aging among community older adults and its relationship with nursing needs[J]. Chin J Nurs, 2024, 59(16):2014-2020. DOI

老年慢性病共病患者身体复原力现状及影响因素的混合研究

The current status and influencing factors of physical resilience in elderly patients with chronic comorbidities： a mixed-methods study

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