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

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