背景：睡眠作为一项生理过程对机体起到重要的复愈作用，随着个体年龄的增长，睡眠的质量发生变化。在我国老龄化迅速发展的背景下，社会对于老年人的身心健康日益关注，睡眠作为老年人健康的重要因素之一也包含其中。虽已有大量有关老年人睡眠质量的研究，但国内取样主要集中在中东部经济发达地区，对西部地区的关注较少；社会心理因素常被作为控制变量而非主要研究变量进行探究。因此，本研究的主要目的是描述西北地区老年人睡眠质量的情况并探究社会心理因素与睡眠质量的关系。
方法：本研究的数据来自2011年5月完成的“城市社会救助检测项目”调查，调查采用了三阶段整群抽样的方法，在甘肃省兰州市、白银市和青海省西宁市三地收集了数据。调查运用匹兹堡睡眠指数量表（Pittsburgh sleep quality index, PSQI）测量睡眠质量，流调中心抑郁量表（Center for Epidemiologic Studies Depression Scale, CES-D）测量抑郁，主观健康评价（Subjective Health Assessment, SHA）测量主观健康，健康行为变量中所包括的饮酒、吸烟、身体锻炼分别由单个问题条目进行了测量。
数据分析采用了描述分析、单因素方差分析、卡方检验以及逻辑回归，统计分析软件为 StataMP14.1。
结果：（1）数据经清理、匹配、筛选后共得到2,329个老年人样本，平均年龄为71.4±6.9岁，其中男性1,010名（43.4%），汉族占91.7%，30.9%的老年人无伴侣且14.5%的老年人所在家庭为低保户。（2）西北地区老年人睡眠质量差的比例为61.7%，相比以往研究这一比例较高。（3）在社会心理因素中，老年人睡眠质量与抑郁、自评健康显著相关；健康行为变量中的“体育锻炼”在本研究中是睡眠质量的风险因子。（4）在社会人口信息以及其他控制变量中，西宁市、非汉族、无伴侣以及在四周内受伤或患病是老年人睡眠质量的风险因子。
结论：（1）西北地区老年人睡眠质量总体情况较差。（3）与老年人睡眠质量显著相关的社会人口以及其他控制变量如：民族、婚姻状况、四周内是否受伤或患病在日后的研究中应受到更多的关注。（2）抑郁、自评健康作为社会心理与老年人睡眠质量显著相关，研究结论为日后改善老年人睡眠质量的干预措施提供了一定理论支持。
关键词：睡眠质量，社会心理因素，老年人，西北地区
Study on sleep quality and the related psychological factors among older adults in northwest China
Abstract
Background: Sleep is an important physical process and contributes to the restorative function. Generally speaking, the quantity and quality of sleep changes with peoples’ age. With the intensification of aging situation, there is a growing concern about the physical and mental health of the elderly, and sleep has also been an important health issue among older people. Previous studies mainly focused on the elderly in China’s economically developed eastern region; psychosocial factors were regarded as control variables rather than research variables. This study aimed to investigate the sleep quality and its psychosocial factors among older adults in Northwest China.
Methods: The data in this study were derived from the Chinese Urban Social Protection Survey, which was conducted in May, 2011. Three-stage cluster sampling was used to selected households for survey in three northwest cities, including Lanzhou and Baiyin in Gansu province and Xining in Qinghai province. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI); The Chinese edition of the Center for Epidemiologic Studies Depression (CES-D) Scale was used to assess probable major depression; Subjective health was assessed by the Subjective Health Assessment (SHA); Also, health behaviors such as drinking, smoking and physical practices were assessed by single question.
Descriptive analyses, one-way analysis of variance, Chi-squared test and logistic regression were conducted by using the statistics software Stata MP 14.1.
Results: (1) 2,329 aged people were included in this study after cleaning, merging and filtering data, the average age was 71.4±6.9 years, 1,010 (43.4%) participates were male, 91.7% of the respondents were Han, 30.9% of the elderly were no spouse and members of the Dibao population accounted for 14.4% of all participates. (2) The prevalence of “poor sleep” was 61.7% among the elderly in northwest China, which was much higher than previous studies. (3) In the psychosocial factors, depression and subjective health were significantly associated with sleep quality, physical practices in health behaviors variables was a risk factor in this study. (4) Among the social demographics and control variables, people from Xining, non-Han, no spouse, injured or diseased in the past 4 weeks were significantly associated with poor sleep quality.
Conclusion: (1) Sleep quality among the older adults was generally in poor condition in northwest China. (2) Significant factors such as nationality, marital status, injured or diseased in the past 4 weeks should be paid more attention in the future. (3) Sleep quality was significantly associated with depression and subjective health, research conclusion provided theoretical supports for the intervention of improving sleep quality among the elderly.
KEY WORDS：Sleep Quality, Psychosocial factors, Older Adults, Northwest China
