Ucwaningo lwathola ukuthi eqenjini leminyaka engu-50 nangaphezulu, isimo esiphansi senhlalakahle yezomnotho sasihlotshaniswa kakhulu nengozi eyengeziwe yokucindezeleka; Phakathi kwabo, ukubamba iqhaza okuphansi emisebenzini yomphakathi kanye nesizungu kudlala indima yokulamula ekuhlanganiseni okuyimbangela phakathi kokubili. Imiphumela yocwaningo yembula okokuqala ngqa indlela yokusebenza phakathi kwezici zokuziphatha kwengqondo kanye nesimo senhlalo-mnotho kanye nobungozi bokudangala kubantu asebekhulile, futhi inikeze ubufakazi obubalulekile besayensi bokusekela ukwakhiwa kokungenelela okuphelele kwezempilo yengqondo kubantu asebekhulile, ukuqedwa kwezinqumo zezenhlalakahle zezempilo, kanye nokusheshisa ukufezeka kwezinhloso zokuguga ezinempilo emhlabeni wonke.
Ukucindezeleka kuyinkinga ehamba phambili yezempilo yengqondo enomthelela emthwalweni wezifo emhlabeni wonke kanye nembangela ehamba phambili yokufa phakathi kwezinkinga zempilo yengqondo. I-Comprehensive Action Plan for Mental Health 2013-2030, eyamukelwa yi-WHO ngo-2013, igqamisa izinyathelo ezibalulekile zokuhlinzeka ngokungenelela okufanele kubantu abanokuphazamiseka kwengqondo, okuhlanganisa nalabo abanokucindezeleka. Ukucindezeleka kudlangile kubantu asebekhulile, kodwa ngokuvamile akuxilongwa futhi akulashwa. Ucwaningo luye lwathola ukuthi ukucindezeleka ekugugeni kuhlotshaniswa kakhulu nokuncipha kwengqondo kanye nobungozi besifo senhliziyo. Isimo senhlalo yezomnotho, umsebenzi womphakathi, kanye nesizungu kuye kwahlotshaniswa ngokuzimela nokuthuthukiswa kokucindezeleka, kodwa imiphumela yabo ehlangene kanye nezindlela ezithile azicacile. Esimweni sokuguga emhlabeni wonke, kunesidingo esiphuthumayo sokucacisa izici zezempilo yezenhlalakahle zokucindezeleka ekugugeni kanye nezindlela zabo.
Lolu cwaningo luyiqembu labantu, ucwaningo lweqembu elinqamula amazwe lisebenzisa idatha evela kuzinhlolovo ezinhlanu ezimele izwe lonke zabantu abadala asebekhulile emazweni angu-24 (olwenziwa kusukela ngoFebruwari 15, 2008 kuya kuFebruwari 27, 2019), okuhlanganisa Ucwaningo Lwezempilo Nomhlalaphansi, Ucwaningo lukazwelonke Lwezempilo kanye Nomhlalaphansi. I-HRS, i-English Longitudinal Study of Ageing, i-ELSA, Inhlolovo Yezempilo, Ukuguga Nokuthatha Umhlalaphansi eYurophu, Ucwaningo Lwezempilo, Ukuguga Nokuthatha Umhlalaphansi eYurophu, i-China Health and Retirement Longitudinal Study, The China Health and Retirement Longitudinal Study, CHARLS kanye ne-Mexican Health and Aging Study (MHAS). Ucwaningo lwaluhlanganisa abahlanganyeli abaneminyaka engu-50 nangaphezulu ngesikhathi sokuqala ababike ulwazi ngesimo sabo senhlalo-mnotho, imisebenzi yezenhlalakahle, kanye nemizwa yesizungu, futhi abaxoxwa okungenani kabili; Abahlanganyeli ababenezimpawu zokucindezeleka ekuqaleni, labo ababengekho idatha ngezimpawu zokucindezeleka kanye nama-covariates, nalabo ababelahlekile babengafakwanga. Ngokusekelwe emalini engenayo yekhaya, imfundo kanye nesimo sokuqashwa, indlela yokuhlaziya isigaba eyisisekelo yasetshenziswa ukuze kuchazwe isimo senhlalo-mnotho njengesiphezulu nesiphansi. Ukucindezeleka kwahlolwa kusetshenziswa i-Mexican Health and Aging Study (CES-D) noma i-EURO-D. Ukuhlobana phakathi kwesimo senhlalomnotho nokucindezeleka kwalinganiselwa kusetshenziswa imodeli yengozi elinganiselwe ye-Cox, futhi imiphumela ehlanganisiwe yokuhlola okuyisihlanu yatholwa kusetshenziswa imodeli yemiphumela engahleliwe. Lolu cwaningo lwabuye lwahlaziya imiphumela ehlangene nesebenzisanayo yesimo senhlalo-mnotho, imisebenzi yenhlalo kanye nesizungu ekucindezelekeni, futhi lwahlola imiphumela yokulamula yemisebenzi yomphakathi kanye nesizungu esimweni senhlalo-mnotho nokucindezeleka ngokusebenzisa ukuhlaziywa kwe-causal mediation.
Ngemuva kokulandelela okuphakathi kweminyaka engu-5, ababambiqhaza be-20,237 bahlakulela ukucindezeleka, ngesilinganiso sesigameko se-7.2 (95% isikhawu sokuzethemba 4.4-10.0) ngonyaka we-100 womuntu. Ngemva kokulungiswa kwezici ezihlukahlukene ezididayo, ukuhlaziya kwathola ukuthi ababambiqhaza besimo esiphansi senhlalakahle yezomnotho babe nengozi enkulu yokudangala uma kuqhathaniswa nabahlanganyeli besimo senhlalo nomnotho esiphezulu (okuhlanganisiwe HR = 1.34; 95% CI: 1.23-1.44). Ebudlelwaneni obuphakathi kwesimo senhlalo-mnotho nokucindezeleka, kuphela i-6.12% (1.14-28.45) kanye ne-5.54% (0.71-27.62) eyaxhunyaniswa nemisebenzi yomphakathi kanye nesizungu, ngokulandelana.
Ukusebenzelana kuphela phakathi kwesimo senhlalo-mnotho kanye nesizungu kwaqashelwa ukuthi kube nomthelela omkhulu ekucindezelekeni (okuhlanganisiwe ku-HR = 0.84; 0.79-0.90). Uma kuqhathaniswa nabahlanganyeli besimo senhlalonhle esiphezulu ababesebenza emphakathini futhi bengenaso isizungu, ababambiqhaza besimo esiphansi senhlalomnotho ababengasebenzi emphakathini futhi benesizungu babe sengozini enkulu yokucindezeleka (i-aggregate HR = 2.45; 2.08-2.82).
Ukungabi nalutho komphakathi kanye nesizungu kulamula kancane kancane inhlangano phakathi kwesimo senhlalo-mnotho nokucindezeleka, okusikisela ukuthi ngaphezu kokungenelela okuqondise ukuhlukaniswa nomphakathi kanye nesizungu, ezinye izinyathelo ezisebenzayo ziyadingeka ukuze kuncishiswe ingozi yokucindezeleka kubantu abadala asebekhulile. Ngaphezu kwalokho, imiphumela ehlanganisiwe yesimo senhlalakahle yezomnotho, umsebenzi womphakathi, kanye nesizungu igqamisa izinzuzo zokungenelela okudidiyelwe kanyekanye ukuze kuncishiswe umthwalo womhlaba wonke wokucindezeleka.
Isikhathi sokuthumela: Sep-07-2024