Abstract
BACKGROUND: China has become an aging country. The subjective well-being of the older people is one of the important indicators to measure the health and quality of life of the older people, and it is a concentrated reflection of the overall spiritual life of the older people. Therefore, to achieve successful aging, this study aimed to examine the sequential multiple mediating effects of social participation and sleep quality between urinary incontinence and subjective well-being in the Chinese older people population. METHODS: Based on the 2018 China Longitudinal Health and Longevity Survey (CLHLS) dataset, a total of 10,068 Chinese seniors aged 65 and above were selected. First, the basic socio-demographic characteristics of the sample population were described. Second, Spearman correlation analysis was conducted to examine the associations among urinary incontinence, social participation, sleep quality, and subjective well-being in older adults. Finally, sequential multiple mediation analysis was performed using the SPSS macro PROCESS 4.0 to assess the potential mediating roles of social participation and sleep quality. RESULTS: Urinary incontinence, social participation, sleep quality, and subjective well-being were significantly correlated (P < 0.01). Urinary incontinence is not only directly associated with the subjective well-being of the older people (effect = 0.9195;) Standard error = 0.1572; 95%CI: LL = 0.6115, UL = 1.2276), and also through the independent mediating effect of social participation (effect = 0.1508; Standard error = 0.0180; 95%CI: LL = 0.1178, UL = 0.1880), the independent mediating effect of sleep quality (effect = 0.2046; Standard error = 0.0495; 95%CI: LL = 0.1067, UL = 0.3004), the chain mediating effect between social participation and sleep quality (effect = 0.3670; Standard error = 0.0531; 95%CI: LL = 0.2601, UL = 0.4720) was associated with subjective well-being. CONCLUSIONS: Studies have shown that the social participation and sleep quality of older people in China can mediate the connection between urinary incontinence and subjective well-being. Therefore, it is necessary to pay timely attention to and intervene in the social participation and sleep quality of older patients with urinary incontinence to improve their subjective well-being.