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Analysis of the influencing factors of death anxiety in rural elderly based on structural equation model

Objective To identify the key influencing factors of death anxiety in rural elderly and their mechanisms of action. Methods A total of 701 rural elderly individuals from 6 prefecture-level cities (prefectures) in Sichuan Province were selected for a questionnaire survey on death anxiety, health-related physical fitness, and subjective well-being. A structural equation model was constructed to thoroughly analyze the influencing factors of death anxiety and their mechanisms of action. Results Higher levels of health-related physical fitness, higher levels of subjective well-being, and having more children were the top three protective factors against death anxiety among elderly people in rural Sichuan, with effect values of ?0.392, ?0.287, and ?0.154, respectively. In contrast, suffering from chronic diseases was the leading risk factor for death anxiety, with an effect value of 0.127. Suffering from chronic diseases was the leading risk factor for death anxiety, with an effect value of 0.127. The structural equation model fitting results showed that the medical insurance type of rural elderly in Sichuan (β=?0.062, P=0.002), suffering from chronic diseases (β=0.127, P=0.001), hospitalization due to health reasons in the past year (β=0.086, P=0.002), and educational level (β=?0.067, P=0.001) had indirect effects on death anxiety through health-related physical fitness. Not seeking medical treatment due to financial difficulties in the past year had an indirect effect on death anxiety through subjective well-being (β=0.060, P=0.002). The number of children had both a direct effect on death anxiety (β=?0.119, P=0.004) and an indirect effect through subjective well-being (β=?0.034, P=0.001). Health-related physical fitness had both a direct effect on death anxiety (β=?0.278, P=0.001) and an indirect effect through subjective well-being (β=?0.114, P=0.002). Conclusion Multiple factors directly or indirectly affect the level of death anxiety in the rural elderly population. Health-related physical fitness, subjective well-being, and the number of children are important protective factors. Moreover, health-related physical fitness and subjective well-being act as mediating variables in the chain of effects of multiple factors on death anxiety.

風濕性心臟病二尖瓣和主動脈瓣膠原變化的研究

摘要 目的 研究風濕性心臟病二尖瓣和主動脈瓣瓣膜膠原含量及其類型對瓣膜成形術病例選擇的影響。方法 采用羥脯氨酸法測定瓣膜膠原含量的變化，并用十二烷基磺酸鈉-聚丙烯酰胺凝膠電泳(SDS-PAGE)分離法測定心瓣膜膠原的類型。結果 正常二尖瓣腱索的膠原含量較瓣葉高（Plt;0.01），主動脈瓣膠原含量較二尖瓣低（P＜0.01）。風濕性心臟病患者二尖瓣和主動脈瓣的膠原含量較正常瓣膜有顯著升高（P＜0.01）。正常瓣膜以Ⅰ型膠原為主，Ⅲ型膠原含量較少，而病變二尖瓣和主動脈瓣其Ⅰ型、Ⅲ型膠原均明顯增加，且以Ⅰ型膠原為主。有鈣化的二尖瓣腱索膠原含量高于無鈣化瓣膜（P＜0.05）。二尖瓣病變以狹窄為主的病例其二尖瓣腱索的膠原含量較以關閉不全為主的病例高（P＜0.01），且二尖瓣瓣葉及腱索的膠原含量與二尖瓣口面積呈負相關（r=-0.5431和r=-0.8819，P＜0.01）。結論 風濕性心臟病心瓣膜膠原含量和類型的變化與心瓣膜功能的改變密切相關，瓣膜有無鈣化以及二尖瓣病變的性質，可作為施行心瓣膜成形術的選擇條件。

COVID-19合并或繼發細菌感染的診治研究進展