Abstract:

Objective To explore the impact and threshold effect of productive engagement on the elderly patients with chronic diseases with demoralization syndrome，and to provide theoretical basis for further improving the elderly patients with chronic diseases with demoralization syndrome. Methods A total of 350 elderly patients with chronic diseases from July to December 2024 in a tertiary hospital in Hefei were selected as the research subjects by convenience sampling method，and the general information questionnaire，Productive Engagement Scale and Demoralization Scale-Ⅱ were used for investigation. Using multiple stratified regression analysis to explore the impact of participation in productive activities on dementia syndrome in elderly patients with chronic diseases，and conducting threshold effect analysis. Results 341 valid questionnaires were collected. The score of demoralization syndrome in elderly patients with chronic diseases was 14.00（11.00，17.00），and the score of productive engagement was 37.00（29.50，46.00）. Stratified regression analysis showed that productive engagement could independently explain 8.7% of the variance（P<0.05）. Curve fitting and threshold effect analysis showed that the degree of demoralization syndrome was not affected when the score of productive engagement of elderly patients with chronic diseases was ≤27 points（P>0.05），and it was decreased with the increasing of productive engagement score >27 points（P<0.001）. Conclusion The demoralization syndrome of elderly patients with chronic diseases were in the middle level，and productive engagement is negatively correlated with demoralization syndrome. Healthcare professionals can improve the level of demoralization syndrome by encouraging elderly patients with chronic diseases to actively participate in productive engagement activities.

Key words: Aged, Chronic Disease, Demoralization Syndrome, Productive Engagement, Threshold Effect, Nursing Care

摘要：

目的 探讨参与生产性活动对老年慢性病患者失志综合征的影响及阈值效应，为进一步改善老年慢性病患者失志综合征提供理论依据。方法 采取便利抽样法，选取合肥市某三级甲等医院2024年7月—12月住院的350例老年慢性病患者为调查对象，采用一般资料调查表、生产性参与量表、失志综合征量表Ⅱ进行调查。采用多元分层回归分析探究参与生产性活动对老年慢性病患者失志综合征的影响，并进行阈值效应分析。结果 共回收有效问卷341份。老年慢性病患者失志综合征量表Ⅱ得分为14.00（11.00，17.00）分，生产性参与量表得分为37.00（29.50， 46.00）分。多元分层回归分析显示，参与生产性活动可独立解释老年慢性病患者失志综合征8.7%的变异度（P<0.05）。曲线拟合及阈值效应分析显示，当老年慢性病患者生产性参与量表得分≤27分时，失志综合征不受影响（P>0.05）；生产性参与量表得分>27分时，失志综合征程度随参与生产性活动程度的增加而下降（P<0.001）。结论 老年慢性病患者失志综合征处于中等水平，参与生产性活动和失志综合征呈负相关，医护人员可通过鼓励老年慢性病患者积极参与生产性活动，改善其失志综合征水平。

关键词: 老年人, 慢性病, 失志综合征, 生产性参与, 阈值效应, 护理