Research Paper Volume 12, Issue 22 pp 22614—22625
The relationship between activities of daily living and suicidal ideation among Chinese rural older adults: a multiple mediation model through sleep quality and psychological distress
- 1 School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- 2 School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- 3 NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
Received: April 15, 2020 Accepted: July 21, 2020 Published: November 17, 2020
https://doi.org/10.18632/aging.103857How to Cite
Copyright: © 2020 Zhao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Few studies clarified the mechanisms underlying the relationship between activities of daily living and suicidal ideation among older adults. This study aimed to explore the multiple mediating roles of sleep quality and psychological distress between this relationship. A total of 3,243 rural older adults were included. Multiple mediation analysis was performed using Mplus 8.3. Activities of daily living was found to directly affect suicidal ideation (β=0.092, 95% CI=0.043−0.140) and through three significantly mediation pathways: (1) the path through sleep quality (β=0.019, 95% CI=0.007−0.031), which accounted for 9.79 % of the total effect; (2) the path through psychological distress (β=0.049, 95% CI=0.036−0.063), which accounted for 25.26 % of the total effect; (3) the path through sleep quality and psychological distress (β=0.034, 95% CI=0.026−0.042), which accounted for 17.53 % of the total effect. The total mediating effect was 52.58%. Attention should be paid to sleep quality and mental health among the Chinese rural older adults with activities of daily living limitation. For early detection and prevention of suicidal ideation, it is necessary to take sleep-based and positive psychological interventions for older adults with activities of daily living limitation.
Abbreviations
ADL: activities of daily living; SI: suicidal ideation; PPP: Posterior Predictive P-Value; CIs:: credible intervals; NCS: National Comorbidity Survey; PSQI: Pittsburgh Sleep Quality Index; K10: Kessler 10.