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四、结论

上海市第一社会福利院的设施非常好,日常对老人的照料和护理很专业,饮食和娱乐活动的安排非常丰富,而且收费很低,均没有超出老人的担负能力。受访的 15 位老人都是自己或子女负担养老院的费用,没有申请国家或者社区的资助。老人们对福利院的硬件设施非常满意,这也是我们访谈的老人自评幸福度较高的重要的因素。在访谈中,老人最多提到的生活中不满意的客观方面就是需要与别人合住,生活习惯和爱好的不同会导致生活中的不方便和摩擦。

以往的定量研究显示,经济状况是影响自评幸福度的重要因素(如:Pinquart & Sorensen, 2000)。但是在我们的访谈中,只有一位老人表示不敢生病,担心生病看不起医生(这位老人的收入相比其他老人要低很多)。其他 14 位老人均对自己的经济状况表示满意,他们的退休金够用,除了缴纳福利院的固定费用后,都足够看病、吃药、购物等,大都不需要子女的资助,而且很多老人入住养老院后,将自己的住房转给了子女。他们都有子女,子女的经济情况也大都不错,不需要老人操心,在老人需要的时候都可以给以资助。由于受访老人在社会经济水平上的差异很小,所以我们的研究不能直接揭示经济状况对老年人自评幸福度的影响。但是在老人们的叙述中,他们都暗示了这样的事实:由于经济上的富足,他们不需要再担心经济问题,能够安享晚年。

本研究中家庭支持对自评幸福度的影响和以往的定量研究的结论一致。家庭支持对老年人的生活满意度和积极情感没有显著影响,但是家庭支持的缺位或者不足会使老人感到孤独(消极情感)(Drageset, 2002,2004)。本研究中的老人大都有不止一个子女,子女经常来探望老人,有的甚至天天来看望老人。因此在老人的叙述中,他们对子女的探望采取比较平静的态度,没有使用“开心”和“高兴”这样的语言表达对子女来探望自己的感受,而只是客观地叙述。但是子女不能常来探望却会使老人感到孤独。

本研究中的老人的身体状况均不是很好,很多老人的视力和听力都有非常明显的退化,同时患有几种慢性病,有的甚至患过癌症,但是在老人的叙述中,健康状况和他们的自评幸福度没有任何联系,没有老人因为身体状况不好而感到幸福度很低。他们接受自己身体功能退化的现实,觉得这很正常。这和定量分析中社区高龄老人的健康状况显著影响老年人的自评幸福度的结论有差异。这可能是由于福利院的老人健康状况相对都比较差,能够接受我们访谈的老人的健康状况和认知能力在福利院中处于比较好的水平,在和健康状况非常差的老人比较后,受访老人认为自己的健康水平是可以接受的,因此健康水平不会困扰这些老人,进而影响他们的自评幸福度。

在福利院养老的老人离开自己的房子和家人,会失去家庭归属感和个人的私密性,这些会影响老人的自评幸福度(如:Hicks et al., 2000)。在我们的研究中,这样的负面影响存在,但是效果不严重。受访老人基本能接受与他人合住,能努力调整自己来适应环境。甚至有老人指出,福利院的生活规律、活动丰富、有同龄人陪伴、有人照顾衣食住行,比在家独居要好得多。

总的来说,入住条件比较好的福利院的老人的自评幸福度比较高。而且由于客观环境比较优越,影响老人自评幸福度的主要因素来自比较、自我接受度和自我调节能力(Baltes & Bates, 1991; Diener et al., 2006;George, 2000; Smith & Gersdorf, 2004; Windle & Woods, 2004)。尽管老人的健康状况不佳,但是老人在比较了同住养老院的其他健康状况更差的老人后,能够接受自己的健康水平。自评幸福度非常高的老人在受访过程中基本不谈及不如意的地方,他们更多关注生活中快乐和高兴的方面。自评幸福度一般的老人即使谈到生活中一些不满意的地方,也以比较平和的口吻来叙述,并且说到要接受和容忍,强调心态要好,显示出他们在努力自我调节来适应环境。我们的研究显示,高龄老人的自我调节能力是非常强的,并没有随身体及技能的退化而下降,反而随着年龄的增长而增强,他们能够进行对自己有利的比较,对自己和生活状况的接受度很高,这也是老年人智慧的一个表现。

本研究所选取的上海市第一社会福利院是属于示范性的养老机构,客观环境优越,而且参加访谈的老人不存在认知缺损,相对比较乐观,愿意和陌生人接触,因此这些老人的自评幸福度都比较高。如果能够继续访谈一些设施和护理水平一般或较差的养老机构的老人,来比较访谈结果,本研究会更丰富一些。

参考文献

[1] Baltes P B, Baltes M M. 1991. Psychological perspective on successful aging: The model of selective optimization with compensation//Baltes P B, Baltes M M. Successful aging:Perspectives from the behavioral sciences. Cambridge: Cambridge University Press.

[2] Birren J E, Lubben J E, Rowe J C. 1991. The concept and measurement of quality of life in the frail elderly. San Diego, CA: Academic Press.

[3] Bondevik M, Skogstad A. 1998. The oldest old, ADL, social network, and loneliness.Western Journal of Nursing Research, 20(3): 325-343.

[4] Bradburn N M. 1969. The structure of psychological well-being. Chicago: Alpine Publising.

[5] Diener E, Suh E M, Lucas R E. 1999. Subjective well-being: Three decades of progress.Psychological Bulletin, 125(2): 276-302.

[6] Diener E, Lucas R E, Scollon C N. 2006. Beyond the hedonic treadmill: Revising the adaptation theory of well-being. American Psychologist, 61: 305-314.

[7] Drageset J. 2002. Loneliness at a nursing home— does a network have any importance for loneliness among nursing home occupants? Vard I Norden Nursing Science and Research in the Nordic Countries, 22(2): 9-14.

[8] Drageset J. 2004. The importance of activities of daily living and social contact for loneliness: a survey among residents in nursing homes.Scandinavian Journal of Caring Sciences, 18 (1): 65-71.

[9] Drageset J, Kirkevold M, Espehaug B. 2011. Loneliness and social support among nursing home residents without cognitive impairment: A questionnaire survey. International journal of nursing studies, 48(5): 611-619.

[10] Fries, Brant E, et al. 2000. Accelerated Dysfunction Among the Very Oldest-Old in Nursing Homes. The Journal of Gerontology Series A: Biological Sciences and Medical Sciences, 55: M336-M341.

[11] Gerstorf D, Ram N, Mayraz G, et al. 2010. Late-life decline in well-being across adulthood in Germany, the United Kingdom, and the United States: Something is seriously wrong at the end of life. Psychology and Aging, 25(92): 477-485.

[12] George L K. 2000.Well-being and the sense of self: What we know and what we need to know//Schaie K W, Hendricks J. The evolution of the aging self: The societal impact on the aging process. New York: Springer Publ. Comp. Inc.

[13] Hicks Jr. T J. 2000. What is your life like now? Loneliness and elderly individuals residing in nursing homes. Journal of Gerontological Nursing, 26 (8): 15-19.

[14] Isaacowitz D M, Smith J. 2003. Positive and negative affect in very old age. Journals of Gerontology series B-psychological sciences and social sciences. 58(3): 143-152.

[15] Kahn R L. 2002. On “successful aging and well-being: self-rated compared with Rowe and Kahn”. The Gerontologist, 42(6): 725-726.

[16] Kane R A, Kling K C, Bershadsky B, et al. 2003. Quality of life measures for nursing home residents. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 58(3): 240-248.

[17] Kozma A, Stone M J. 1980. The measurement of happiness: Development of Memorial University of Newfoundland Scale of Happiness(MUNSH). Journal of Gerontology, 35:906-912.

[18] Kunzmann U, Little T D, Smith J. 2000. Is age-related stability of subjective well-being a paradox? Cross-sectional and longitudinal evidence from the Berlin Aging Study.Psychology and Aging, 15(3): 511-526.

[19] Landau R, Litwin J. 2001. Subjective well-being among the old-old: the role of health, personality, and social support. International Journal of Aging and Human Development, 52: 265-280.

[20] Lawton M P. 1975. The Phialadephia Geriatric Center Morale Scale: A review. Journal of Gerontology, 30: 85-89.

[21] Lawton M P. 1991. A multidimensional view of quality of life in frail elders//Birren J E, Lubben J E, Rowe J C, et al. The concept and measurement of quality of life in the frailty elderly. San Diego, CA: Academic Press.

[22] Neugarten B L, Havighurst R J, Tobin S S. 1961. The measurement of life satisfaction.Journal of Gerontology, 16: 134-143.

[23] Pinquart M, Sorensen S. 2000. Influence of socioeconomic status, social network, and competence on subjective well-being in later life: A meta-analysis. Psychology and Aging, 15: 187-224.

[24] Porter E J. 2005. A phenomenological perspective on older widow’s satisfactions with their lives. Research on Aging, 27(1): 80-115.

[25] Rotter J B. 1966. Generalized expectancies for internal versus external control of reinforcement. Psychological Monographs: General and Applied, 80: 1-28.

[26] Rowe J W, Kahn R L. 1987. Human aging: Usual and successful. Science, 237:143-149.

[27] Rowe J W, Kahn R L. 1997. Successful aging. The Gerontologist, 37(4): 433-440.

[28] Scocco P, Rapattoni M, Fantoni G, et al. 2006. Nursing home institutionalization:a source of eustress or distress for the elderly? International Journal of Geriatric Psychiatry, 21(3): 281-287.

[29] Shenk D, Kuwahara K, Zablotsky D. 2004. Older women’s attachments to their home and possessions. Journal of Aging Studies, 18: 157-169.

[30] Smith J, Borchelt M, Maier H, Jopp Daniela. 2002. Health and well-being in the young old and oldest old. Journal of Social Issues, 4: 715-732.

[31] Smith J, Fleeson W, Geiselmann B, et al. 1999. Sources of well-being in very old age.//Baltes P B, Mayer K U. The Berlin Aging Study: Aging from 70 to 100. New York:Cambrige University Press.

[32] Smith J, Gersdorf D. 2004. Ageing differently: Potential and limits//Daatland S O,Biggs S. Ageing and diversity: Multiple pathways.

[33] Victor C, Scambler S, Bowling A, et al. 2005. The prevalence of and risk factors for loneliness in old age: a review and model refinement.Ageing and Society, 16: 333-358.

[34] Windle G, Woods R T. 2004. Variations in subjective wellbeing: The mediating role of a psychological resource. Ageing and Society, 24: 583-602.

[35] Zeng Yi, Vaupel J W, Xiao Zhenyu, Zhang Chunyuan, Liu Yuzhi. 2002.Sociodemographic and health profiles of the oldest old in China. Population and Development Review, 28(2): 251-273.

[36] 李强,Gerstorf D, Smith J. 2004. 高龄老人的自评完好及其影响因素. 中国人口科学(2004 年增刊):55-62.

[37] 李德明,陈天勇,吴振云. 2008. 中国老年人的生活满意度及其影响因素. 中国心理卫生杂志,22(7):543-549.

[38] 孟琛,孟家眉,Luszcz M. 1996. 北京市老年人自评幸福度状况及影响因素的分析. 老年医学与保健,2(2):84-87.

[39] 秦瑶. 2011. 对目前我国机构养老现状的思考. 中国集体经济(19):187. qmbb80xhDfujSeR6bWAimsB54hLlT5mEO1YhG2WiAC/IevNfJc55kep437CH4GOL

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