老年慢性病共病患者及照护者老老照护能力与自我忽视的相关性分析

doi:10.3761/j.issn.0254-1769.2026.09.011

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (9): 1230-1236.DOI: 10.3761/j.issn.0254-1769.2026.09.011

老年慢性病共病患者及照护者老老照护能力与自我忽视的相关性分析

杨明霞¹(), 安冉², 臧金凤³, 李春梅⁴^,^*()

¹ 山东第一医科大学附属省立医院奥体院区保健消化科济南市 250021
² 山东第一医科大学附属省立医院奥体院区保健心血管科济南市 250021
³ 臧金凤山东第一医科大学附属省立医院奥体院区保健神经科山东第一医科大学附属省立医院奥体院区保健神经科济南市 250021
⁴ 山东第一医科大学附属省立医院奥体院区老年医学科济南市 250021

收稿日期:2025-12-04 出版日期:2026-05-10 发布日期:2026-04-30
*通讯作者: 李春梅，E-mail：1330485516@qq.com
作者简介:杨明霞：女，硕士，主管护师，E-mail：924164968@qq.com
第一联系人：作者贡献声明
杨明霞：研究选题与设计、资料收集与数据分析整理、论文撰写与修改；安冉：研究选题、资料收集与数据整理、论文审阅与修改；臧金凤：问卷调查、资料收集与数据整理、论文审阅；李春梅：研究指导、研究选题与设计、论文审阅和修改

Correlation analysis between elderly-to-elder care capacity and self-neglect among older adults with chronic comorbidities and their caregivers

YANG Mingxia¹(), AN Ran², ZANG Jinfeng³, LI Chunmei⁴^,^*()

¹ Healthcare Gastroenterology Department， Shandong Provincial Hospital Affiliated to Shandong First Medical University， Jinan 250021， China
² Healthcare Cardiovascular Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University， Jinan 250021， China
³ Healthcare Neurology Department， Shandong Provincial Hospital Affiliated to Shandong First Medical University， Jinan 250021， China
⁴ Department of Geriatrics， Shandong Provincial Hospital Affiliated to Shandong First Medical University， Jinan 250021， China

Received:2025-12-04 Online:2026-05-10 Published:2026-04-30
* Corresponding author: LI Chunmei，E-mail：1330485516@qq.com

摘要/Abstract

摘要：

目的基于主客体互倚模型探讨老年慢性病共病患者及其老年照护者老老照护能力与自我忽视的关系，为制订临床干预方案提供参考依据。方法采用便利抽样法，于2025年3—10月选取山东省济南市某三级甲等医院住院的437对老年慢性病共病患者及其老年照护者为调查对象，采用一般资料调查问卷、老年人自我护理能力量表、老老照护能力量表、老年人自我忽视量表进行调查，并构建老老照护能力与自我忽视的主客体互倚模型。结果回收有效问卷411对。患者自我照护能力得分为（54.51±11.69）分，照护者老老照护能力得分为（115.67±18.85）分；患者自我忽视得分为（12.44±11.56）分，照护者自我忽视得分为（10.09±10.27）分；主客体互倚模型显示，患者自我照护能力与照护者老老照护能力均对自身自我忽视具有负向预测作用（β₁=-0.193、β₂=-0.242，均P<0.001），即主体效应显著。双方照护能力对对方自我忽视同样具有负向预测作用（β₁=-0.271，P₁<0.001；β₂=-0.145，P₂=0.003），即客体效应显著。结论老年慢性病共病患者及其照护者之间的照护能力与自我忽视存在二元交互影响。护理实践中应重视患者-照护者二元整体协同干预，通过提升双方照护能力，共同预防和减少自我忽视行为。

关键词: 老年人, 慢性病共病, 老老照护, 自我忽视, 主客体互倚模型, 二元应对, 护理

Abstract:

Objective To explore the relationship between elderly caregivers’ care capacity and self-neglect in older adults with chronic comorbidities and their caregivers using an actor-partner interdependence model，to provide references for developing clinical intervention strategies. Methods Using convenience sampling，437 pairs of elderly patients with chronic comorbidities and their caregivers admitted to a tertiary A hospital in Jinan City，Shandong Province，were selected as research subjects from March to October 2025. Data were collected via questionnaires on general information，the Self-Care Ability Scale for the Elderly，the Elder-to-Elder Care Capacity Scale，and the Self-Neglect Scale for the Elderly. An actor-partner interdependence model linking elder-to-elder care capacity and self-neglect was constructed. Results A total of 411 valid questionnaires were collected. Patients’ self-care ability scores were（54.51±11.69） points，while caregivers’ elder-to-elder caregiving ability scores were（115.67±18.85） points. Patients’ self-neglect scores were（12.44±11.56） points，while caregivers’ self-neglect scores were（10.09±10.27） points. The actor-partner interdependence model revealed that both the patient’s self-care ability and the caregiver’s elderly-to-elderly care ability negatively predicted self-neglect（β₁=-0.193，β₂=-0.242；all P<0.001），indicating a significant actor’ effect. Both parties’ caregiving capacity also negatively predicted the other’s self-neglect（β₁=-0.271，P₁<0.001；β₂=-0.145，P₂=0.003），indicating a significant partner’ effect. Conclusion A significant dual interaction exists between caregiving capacity and self-neglect among elderly patients with chronic comorbidities and their caregivers. In nursing practice，it should be emphasized on dual-system collaborative interventions for patients and caregivers，enhancing both parties’ caregiving capacity to jointly prevent and reduce self-neglect behaviors.

Key words: Aged, Chronic Comorbidities, Elderly-to-Elderly Care, Self-Neglect, Actor-Partner Interdepen-dence Model, Dual Coping, Nursing Care

杨明霞, 安冉, 臧金凤, 李春梅. 老年慢性病共病患者及照护者老老照护能力与自我忽视的相关性分析[J]. 中华护理杂志, 2026, 61(9): 1230-1236.

YANG Mingxia, AN Ran, ZANG Jinfeng, LI Chunmei. Correlation analysis between elderly-to-elder care capacity and self-neglect among older adults with chronic comorbidities and their caregivers[J]. Chinese Journal of Nursing, 2026, 61(9): 1230-1236.

图/表 3

表1 老年慢性病共病患者（n=411）

Table 1 General demographic characteristics of elderly patients with chronic diseases（n=411）

表2 老年慢性病共病患者照顾者的一般资料

Table 2 General demographic characteristics of caregivers for elderly chronic disease comorbidities

图1 老年慢性病共病患者及其照护者老老照护能力与自我忽视的主客体互倚模型 1）为P<0.001；2）为P=0.003。

Figure 1 Actor-partner interdependence model of elderly-to-elder care capa-city and self-neglect among older adults with chronic comorbidities and their caregivers

参考文献 32

[1]	国家统计局人口和就业统计司. 人口总量降幅收窄人口素质持续提升[N]. 中国信息报,2025-01-22(001).
	Department of Population and Employment Statistics,National Bureau of Statistics. The total population has decreased,and high-quality development of the population has achieved effect[N]. China Information News,2025-01-22(001).
[2]	Wang SJ, Chen YL, Xiong LJ, et al. Multimorbidity measures asso-ciated with cognitive function among community-dwelling older Chinese adults[J]. Alzheimers Dement, 2024, 20(9):6221-6231.
[3]	周幺玲, 夏瑾燕, 刘雪, 等. 老老照护能力评估量表的研制和信效度检验[J]. 中华护理杂志, 2024, 59(10):1180-1186.
	Zhou YL, Xia JY, Liu X, et al. Development of an Assessment Scale of the Aged Care Aptitude for the Aged and test of its reliability and validity[J]. Chin J Nurs, 2024, 59(10):1180-1186.
[4]	王雨晴, 张慧超, 孙绪晗, 等. 家庭系统理论视角下慢性心力衰竭患者家庭照护的研究进展[J]. 中华护理杂志, 2023, 58(13):1659-1664.
	Wang YQ, Zhang HC, Sun XH, et al. Research progress on family care in patients with chronic heart failure from the perspective of family system theory[J]. Chin J Nurs, 2023, 58(13):1659-1664.
[5]	Ayaz CB, Gürsoy MY. Prevalence of self-neglect and related factors among older adults living in Western Turkey:a cross-sectional study[J]. BMC Geriatr, 2024, 24(1):1036.
[6]	Zhang M, Zhang XL. Self-neglect in older adults:an evolutio-nary concept analysis[J]. Int J Nurs Stud Adv, 2025, 8:100350.
[7]	Uçan Yamaç S, Yalçin Gürsoy M. Self-neglect,frailty and depres-sion among older women living in Southern Türkiye[J]. BMC Public Health, 2025, 25(1):1515.
[8]	Wang YQ, Wan BW, Xu XY, et al. Association between self-ne-glect and incident cognitive impairment among Chinese older adults and its subgroup differences[J]. Arch Gerontol Geriatr, 2025, 136:105893.
[9]	Jeong K, Jang D, Nam B, et al. The moderating effect of gender on the relationship between self-neglect and suicidal ideation in older adults of Korea[J]. J Prev Med Public Health, 2022, 55(5):436-443.
[10]	刘亮, 张慧琳, 黄玉婷, 等. 血液透析老年人心理需要满足与自我忽视:家庭复原力和心理弹性的链式中介作用[J]. 中华行为医学与脑科学杂志, 2024, 33(5):458-463.
	Liu L, Zhang HL, Huang YT, et al. Basic psychological needs satisfaction and self-neglect in older adults on maintenance hemodialysis:chain mediation of family resilience and psycho-logical resilience[J]. Chin J Behav Med Brain Sci, 2024, 33(5):458-463.
[11]	De Maria M, Lee CS, Matarese M, et al. Dyadic archetypes of patient self-care and caregiver contribution to self-care in dyads with multiple chronic conditions:an observational study[J]. J Appl Gerontol, 2023, 42(8):1809-1819.
[12]	Kenny DA, Ledermann T. Detecting,measuring,and testing dya-dic patterns in the actor-partner interdependence model[J]. J Fam Psychol, 2010, 24(3):359-366.
[13]	倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4):378-380.
	Ni P, Chen JL, Liu N. The sample size estimation hi quan-titative nursing research[J]. Chin J Nurs, 2010, 45(4):378-380.
[14]	Kenny DA, Kashy DA, Cook WL. Dyadic data analysis[M]. New York: Guilford Press, 2006.
[15]	Süderhamn O, Ek AC, Pürn I. The Self-Care Ability Scale for the Elderly[J]. Scand J Occup Ther, 1996, 3(2):69-78.
[16]	Söderhamn O. Health and the internal structure of the Self-Care Ability Scale for the Elderly(SASE)[J]. Scand J Occup Ther, 2001, 8(2):67-71.
[17]	郭丽娜. 老年人自我护理能力量表的本土化修订与验证[D]. 锦州: 锦州医科大学, 2016.
	Guo LN. Chinesization,evaluation and validation of the Self-Care Ability Scale for the Elderly[D]. Jinzhou: Jinzhou Medi-cal University, 2016.
[18]	Iris M, Conrad KJ, Ridings J. Observational measure of elder self-neglect[J]. J Elder Abuse Negl, 2014, 26(4):365-397.
[19]	王航赛. 老年人自我忽视评估量表的汉化及其应用[D]. 杭州: 杭州师范大学, 2018.
	Wang HS. Research on Chinese version of the Elder Self-Neglect Assessment Scale and its application[D]. Hangzhou: Hangzhou Normal University, 2018.
[20]	Liu D, Gao YF, Su X. Self-care ability and associated factors in community-dwelling older adults living with oral frailty using the COM-B model[J]. J Oral Rehabil, 2024, 51(8):1530-1541.
[21]	石俊, 张青, 及勇静. 老年白内障患者自我护理能力、社会支持及视觉相关生活质量的影响因素[J]. 国际护理学杂志, 2025, 44(3):565-569.
	Shi J, Zhang Q, Ji YJ. Influencing factors of self-care ability,social support and vision-related quality of life in elderly cataract patients[J]. Int J Nurs, 2025, 44(3):565-569.
[22]	沈婷, 颜巧元, 武晓茹, 等. 老年慢性病住院患者老老照护者的照护能力现状研究[J]. 护理学杂志, 2024, 39(7):96-99.
	Shen T, Yan QY, Wu XR, et al. Care ability among informal older caregivers of elderly chronic inpatients[J]. J Nurs Sci, 2024, 39(7):96-99.
[23]	金立, 张一帆. 重症监护室老年存活者的老年照护者照护能力现状及其影响因素分析[J]. 全科护理, 2025, 23(22):4394-4397.
	Jin L, Zhang YF. Analysis on the present situation and in-fluencing factors of care ability of elderly caregivers of elderly survivors in intensive care unit[J]. Chin Gen Pract Nurs, 2025, 23(22):4394-4397.
[24]	吴寒斌, 陈伟嘉, 李春鸽. 生活空间对老年人自我忽视的影响[J]. 医学与哲学, 2023, 44(5):63-67.
	Wu HB, Chen WJ, Li CG. The influence of life space on self-neglect of the elderly[J]. Med Philos, 2023, 44(5):63-67.
[25]	王燕红, 洪倩, 倪进东, 等. 安徽城市社区老年人自我忽视现状研究[J]. 中国预防医学杂志, 2022, 23(8):616-621.
	Wang YH, Hong Q, Ni JD, et al. Elder self-neglect and rela-ted influencing factors among community-dwelling older resi-dents in Anhui[J]. Chin Prev Med, 2022, 23(8):616-621.
[26]	Weng YQ, Lin JL, Yang TB, et al. The dyadic relationship of supportive care needs with quality of life in lung cancer survivor and spousal caregiver couples[J]. Asia Pac J Oncol Nurs, 2023, 10(11):100300.
[27]	Motamed-Jahromi M, Kaveh MH, Vitale E. Mindfulness and self-regulation intervention for improved self-neglect and self-regulation in diabetic older adults[J]. Sci Rep, 2024, 14(1):13857.
[28]	骆雅萍, 于淑娟, 朱苗苗, 等. 社区老年糖尿病患者自我忽视的诠释性现象学研究[J]. 中华护理杂志, 2024, 59(2):203-209.
	Luo YP, Yu SJ, Zhu MM, et al. Self-neglect in elderly diabetic patients in the community:an interpretive phenomenological study[J]. Chin J Nurs, 2024, 59(2):203-209.
[29]	Wang YN, Song YT, Zhu YR, et al. Association of eHealth li-teracy with health promotion behaviors of community-dwelling older people:the chain mediating role of self-efficacy and self-care ability[J]. Int J Environ Res Public Health, 2022, 19(10):6092.
[30]	Cai YY, Zhang ZY, Ren XH, et al. Coping with chronic obs-tructive pulmonary disease together:a dyadic study of self-care and quality of life in patients and their caregivers[J]. J Clin Nurs, 2025, 34(8):3297-3306.
[31]	Xiong C, Li PWC, Yu DSF, et al. How the dyads of heart failure patients and their informal caregivers cope with the disease process:a qualitative evidence synthesis[J]. Int J Nurs Stud, 2025, 167:105065.
[32]	李婷, 张鑫月, 梅永霞, 等. 慢性病患者及其配偶的二元应对纵向研究进展[J]. 医学与哲学, 2022, 43(19):35-38.
	Li T, Zhang XY, Mei YX, et al. Progress of longitudinal research on dyadic coping of chronic disease patients and their spouses[J]. Med Philos, 2022, 43(19):35-38.

老年慢性病共病患者及照护者老老照护能力与自我忽视的相关性分析

Correlation analysis between elderly-to-elder care capacity and self-neglect among older adults with chronic comorbidities and their caregivers

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