Objective: To analyze the mediating effects of coping styles and activities of daily living on social support and depressive symptoms among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide evidence for promoting mental health in elderly T2DM patients. Methods: From March 2019 to June 2020, elderly T2DM patients aged ≥60 years were selected from 11 community health service centers in Taijiang and Gulou Districts, Fuzhou City using a multi-stage sampling method. Basic information such as gender and age was collected through self-designed questionnaires. Social support, depressive symptoms, coping styles (positive coping style and negative coping style), and activities of daily living (physical self-care ability and instrumental activities of daily living) were assessed using the Social Support Rating Scale, the Geriatric Depression Scale (Chinese version), the Simplified Coping Style Questionnaire, and the Activities of Daily Living Scale, respectively. The mediating effects of coping styles and activities of daily living on social support and depressive symptoms were analyzed using Process macro 4.1, and the significance of mediating effects was tested using the Bootstrap method. Results: A total of 2 013 elderly T2DM patients were surveyed, including 910 males (45.21%) and 1 103 females (54.79%). The scores of social support, positive coping style, negative coping style, physical self-care ability, and instrumental activities of daily living were (38.56±7.17), (30.93±6.81), (16.52±4.74), (6.20±1.10), and (8.71±2.50), respectively. The score of depressive symptoms was (8.14±4.97), and 622 cases were detected with depressive symptoms, with a detection rate of 30.90%. Mediating effect analysis showed that social support could directly affect depressive symptoms (β=-0.048, 95%CI: -0.063-0.033), and could also indirectly affect depressive symptoms through positive coping style (β=-0.014, 95%CI: -0.020-0.009), negative coping style (β=0.005, 95%CI: 0.002-0.009), and instrumental activities of daily living (β=0.002, 95%CI: 0.000-0.004), respectively. The mediating effects of positive coping style, negative coping style, and instrumental activities of daily living accounted for 25.45%, -9.09%, and -3.63% of the total effect, respectively. Conclusions Higher level of social support can directly reduce the risk of depressive symptoms among elderly T2DM patients, and also exert effects through indirect pathways of increasing positive coping, reducing negative coping, and delaying the decline of instrumental activities of daily living.

Objective To investigate the rates of depression and its risk factors in elderly hypertensive patients and healthy residents in Fuzhou.Methods 882 elderly primary hypertensive patients aged 60 years and over and 1230 healthy elderly residents were assessed by the geriatric depression scale (GDS) and a self-made general information questionnaire, and SPSS 16.0 was used to analyze data.Results The average score of depression and the incidence of depression were higher in elderly hypertensive patients than in healthy elderly residents [(12.43±5.01) vs.(11.53±5.13), 64.4％ vs.55.3％, t=-3.849, x2=16.386, P＜0.01].Compared with healthy controls, scores of depression were higher for all age groups in elderly married male patients, with low levels of education (junior middle school or below), a monthly income less than 2000 yuan, and partial or no medical insurance coverage (P＜ 0.05 for all).Scores of depression were higher in elderly hypertensive patients who had smoking or drinking habits, social activity, hobby, or physical exercise than in healthy controls, (P＜0.05 for all).Scores of depression were also higher in elderly hypertensive patients who had family support, barely enough or adequate family expenses or family support than in healthy controls, regardless of living conditions (P＜0.05 for all).Multiple stepwise regression analysis showed that risk factors for depression in elderly hypertensive patients were family support, age, medical insurance coverage, family expenses, living conditions, hobbies, and gender, while risk factors for depression in healthy elderly residents were family support, interests, medical insurance coverage, and age.Conclusions The incidence of depression is higher in elderly hypertensive patients than in health elderly people in communityin Fuzhou.Family support, hobbies, medical insurance coverage and age are the common risk factors for depression in both elderly hypertensive patients and healthy residents.Family expenses, living conditions and gender are important risk factors for depression in elderly hypertensive patients.

Objective To investigate the quality of life (QOL) in elderly patients with chronic diseases living at home and its influencing factors.Methods 1856 elderly patients with chronic diseases living at home were selected by random cluster sampling from two communities.All patients were investigated by SF-36 questionnaire and self-made questionnaire.Results The average QOL scores were (63.8±15.1) in elderly patients with chronic diseases living at home.Scores of SF-36's eight dimensions were respectively (67.8± 22.6) in physiological function,(47.3± 39.4) in role physical,(90.2±14.3) in bodily pain,(52.3±11.9) in general health,(64.1 ± 17.1) in vitality,(74.0 ± 20.9) in social function,(49.7 ± 39.5) in emotional function,(65.0 ± 16.9) in mental health.Scores of SF-36 in each dimension were lower in patients aged 75 years and above than in patients aged 60-74 years (all P＜0.05).Scores of SF-36's dimensions including physical function,bodily pain,vitality,social function and mental health in patients aged 75 years and above were lower in males than females (all P＜0.05).Multiple stepwise regression analysis showed that the major influencing factors for the QOL in elderly patients with chronic diseases living at home were movement,hobbies,age,caregivcr,family support,number of chronic diseases,education status,and alcohol consumption (all P＜0.05).Conclusions The major influencing factors for quality of life in elderly patients with chronic diseases living at home are included demographic,behavior and family factors,etc.Comprehensive community interventions should be taken to improve the quality of life in this elderly population.

Objective To find out the health status and community health care requirement of the elderly in urban Fuzhou and to provide suggestions on how to develop and consummate the community health care for elderly. Methods With the method of stratified random sampling, 3285 elderly people aged 60 years and over were surveyed by a questionnaire. Results The average quality of life of elderly people in urban Fuzhou was above the moderate level. But education level of the elderly was low. And the prevalence rate of chronic diseases was high. There were 2134 elderly people (65.0%) who had more than one chronic disease. The older the people, the higher proportion the coincidence of multiple diseases (P＜0.01). The first five chronic diseases in the elderly were hypertension, diabetes, coronary heart disease, arthropathy and stroke. The incidence rate of depression was high up to 60%. The requirement rate of community health care was 75.2%, and the older the people, the more items they needed(P＜0.05). The requirement of community health care at the first 5 rank position were regular physical examination, health education, regular home visiting, health direction and diet direction. Conclusions Elderly people have many health problems and requirements of community health care.We should provide more and more community health care, in order to improve the quality of life of elderly people.

ObjectiveTo investigate the status of depression and its relationship with quality of life in Fuzhou city community Methods With stratified random sampling method,3285 elderly people (age≥ 60 years) in 12 communities of Fuzhou city were investigated by SF-36 health survey questionnaire and Geriatric Depression Scale (GDS)Results The number of the elderly with depression was 1981 ( 60.3％).The incidence of depression in the female elderly was statistically higher than male(x2 =7.561,P＜0.01).The incidence of depression increased with age(P＜0.01),and declined with higher education ( P ＜ 0.01 ) and income ( P ＜ 0.05).The higher incidence of depression appeared in the elderly with no spouse,paying for medical expenses themselves,living alone(all P＜0.01).The scores of physiological functions (PF),physiological role (RP),body pain (BP),general health (GH),vigor (VT),social function (SF),emotional role (RE),mental health (MH) and quality of life in the elderly without depression (78.0± 19.2,62.7 ± 39.7,94.1 ± 12.3,57.9± 12.0,74.3 ± 14.9,83.0 ± 20.1,64.3 ± 39.1,73.8 ± 14.8,and 73.5 ± 13.6,respectively) were higher than in the elderly with depression (65.9±22.6,45.3±37.8,89.5±15.2,50.8±11.4,59.8 ± 15.9,70.5± 20.9,44.7 ± 37.8,60.6 ± 15.6 and 60.9 ± 14.0,respectively) (P＜0.01 ).All scores had significant differences among different levels of depression (P＜ 0.01 )and the dimension scores decreasedwithserious depression.Depression was negatively correlated with various dimensions of quality of life and total score(P＜0.01).ConclusionsThe incidence of depression of the elderly in Fuzhou city is high.There are negative correlations of depression with quality of life scores and total score of various dimensions.The community nursing service should emphasize on the elderly who are female,advanced age,no spouse,poor-education,low-income,no medical insurance and live alone,then take appropriate measures to reduce depression and improve quality of life of the elderly.