老年人公寓居住者抑郁症状及其影响因素

目的：调查老年人公寓居住者抑郁症状的发生率及其影响因素。 方法：于2004—09／2005-01以哈尔滨市大型、设有医疗卫生系统的老年人公寓作为调查单位。选择市属和省属老年人公寓各1所，以在此生活的年龄≥60岁者为观察对象。人组241人。采用老年抑郁量表筛查老年抑郁症状；采用团体用心理社会应激调查表中的生活事件、积极应对方式、消极应对方式3个应激因素作为调查因素；采用WHO生存质量测定量表简表中的G4健康状况满意度、F1．4疼痛的影响、F11．4医疗的依赖性、F18．1自我感觉的经济能力、F9．1行动能力、F10．3甘常生活能力满意度、F11．3居住条件满意度项目作为调查因素；主观社会支持由WHO生存质量测定量表中有关社会支持的满意度方面项目测得；采用酒精依赖疾患识别测验筛查该人群的饮酒问题。自编问卷调查个人情况：包括性别、年龄、宗教信仰、婚姻状况、有无子女、收入多少、文化程度、人住时间、机构养老意愿、吸烟饮酒状况、疾病状况等因素。统一调查方法和指导语，以老年人公寓楼层为单位采取人户方式进行普查。能笔答者自行填写笔答问卷，统一发放，统一回收；无法笔答者则由调查员根据口答问卷逐项询问回答。调查问卷回收后复核，如有遗漏问题及时补调。评估标准：老年抑郁量表1～10分为无抑郁，11—20分为轻度抑郁，21-30分为中重度抑郁。 结果：发放问卷241份，回收241份，剔除无效问卷20份，有效问卷为221份，有效率91．7％。（1）老年人公寓居住者抑郁症状发生率24．9％（55人），其中轻度抑郁为17．2％（38人），中重度抑郁为7．7％（17人）。（2）单因素Logistic回归显示抑郁症状发生的影响因素有：健康因素（是否患病、疾病严重性、患病感受、疼痛的影响、健康状况满意度、医疗的依赖性、行动能力、日常生活能力满意度）；心理社会因素（有无子女、收入、生活事件、积极应对、消极应对、自我感觉的经济能力、主观社会支持）；老年人公寓相关因素（养老意愿、服务评价、居住条件满意度）。多因素Logistic逐步回归筛选出影响抑郁症状发生的因素是机构养老意愿、消极应对、健康状况满意度、自我感觉的经济能力。（3）单因素Logistic回归显示抑郁症状加重的影响因素有：日常生活能力满意度、消极应对、服务评价、医疗的依赖性。多因素Logistic逐步回归筛选出影响抑郁症状加重的因素是服务评价、日常生活能力满意度。 结论：老年人公寓居住者抑郁症状的发生率与社区老年人群相近．低于国外一些国家的老年护理院人群，健康因素、心理社会因素及公寓相关因素对抑郁症状的发生和加重有明显影响，应针对这些影响因素实施预防、康复干预。     

初产妇分娩前后焦虑抑郁状况及其影响因素

目的：探讨初产妇分娩前后心理状况、焦虑抑郁状况及其相关的因素，为提出相应的干预措施提供理论依据。方法：对山东省千佛山医院产科病房的200例健康初产妇采用自制问卷、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)分别于产前、产后1周进行评定。结果：分娩前有抑郁症状的71例(35．5％)；有焦虑症状的62例(31．0％)；分娩后有焦虑的51例(25．0％)；有抑郁的58例(29．0％)、HAMA总分在产前、产后差异均有显著性意义(t=2．076．P=0．038)、分娩前后产妇心理状况与父母关系、情绪控制、陪同分娩、新生儿性别、产后出血、新生儿哭闹、丈夫对婴儿态度及对产妇的关心、产后亲友支持等因素存在明显相关性(r=0．143～0．224．P均&;lt;0．05)．结论：分娩前焦虑抑郁较分娩后的发生率高，分娩前有焦虑抑郁的产妇，产后出现焦虑抑郁的危险性明显增加；针对易感因素作好孕产期的心理咨询与指导，予以早期干预，会明显的降低孕产期及其产后精神症状的发生率。     

西安市城市社区老年人抑郁症状发生率及危险因素研究

[目的]研究西安城市社区老年抑郁症状的发生率及其危险因素。[方法]采取分层随机整群抽样方法,应用老年抑郁量表及自行编制的危险因素调查表对西安市6个社区1950名≥60岁的老年人进行问卷调查。[结果]老年抑郁症状发生率为24.9%,不同年龄、性别、职业、文化、家庭状态(丧偶、独居)之间抑郁症状发生率有统计学意义(P<0.05),年龄、经济收入、是否独居是老年抑郁症状发生的危险因素。[结论]城市社区老人心理健康状况不容乐观,贫困弱势群体是老年抑郁症状发生的高危人群,应作为重点干预对象。     

初产妇分娩前后焦虑抑郁状况及其影响因素

目的:探讨初产妇分娩前后心理状况、焦虑抑郁状况及其相关的因素,为提出相应的干预措施提供理论依据。方法:对山东省千佛山医院产科病房的200例健康初产妇采用自制问卷、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)分别于产前、产后1周进行评定。结果:分娩前有抑郁症状的71例(35.5%);有焦虑症状的62例(31.0%);分娩后有焦虑的51例(25.0%);有抑郁的58例(29.0%)。HAMA总分在产前、产后差异均有显著性意义(t=2.076,P=0.038)。分娩前后产妇心理状况与父母关系、情绪控制、陪同分娩、新生儿性别、产后出血、新生儿哭闹、丈夫对婴儿态度及对产妇的关心、产后亲友支持等因素存在明显相关性(r=0.143～0.224,P均<0.05)。结论:分娩前焦虑抑郁较分娩后的发生率高,分娩前有焦虑抑郁的产妇,产后出现焦虑抑郁的危险性明显增加;针对易感因素作好孕产期的心理咨询与指导,予以早期干预,会明显的降低孕产期及其产后精神症状的发生率。     

影响老年抑郁症患者预后的多因素分析

目的：探讨老年抑郁症患预后的影响因素。方法：选取2001-03／2002-03河南省驻马店市精神病医院住院的老年抑郁症患。以标准化评定工具(生活事件量表、社会支持量表、大体功能量表)在其出院后2年时进行随访评定，以大体功能量表评分作为评估预后的指标，并以此分为预后好组、预后坏组，同时分析影响老年抑郁症患预后的有关因素。并以随访时实际预后为因变量，以与预后有关的因素为自变量，进行多元逐步回归分析。结果：按实际病例分析，75例患进入结果分析。①随访时实际预后：老年抑郁症预后差占35％(26／75)，预后好占65％(49／75)。②单因素分析显示预后好及预后差两组的起病形式，与邻居关系、生活事件、治疗是否恰当、伴精神病性症状、伴躯体疾病、家族史、治疗依从性等差异显。③逐步回归分析显示影响老年抑郁症患预后的主要因素依次为：伴精神病性症状、治疗依从性、生活事件、伴躯体疾病和社会支持。结论：老年抑郁症患的预后受生物、心理、社会等多种因素的影响，对心理、社会因素进行干预，可以改善患的预后。     

不同群体类型师范大学生抑郁发生率及相关因素分析

目的：探讨师范专业大学生抑郁症状的发生情况及影响因素，为高校开展心理健康教育工作提供依据。方法：于2003-09／10用抑郁自评量表作为测量工具，以班为单位，用匿名的方式对河南省某师范院校的师范专业大学生的抑郁症状及相关因素进行调查。抑郁自评量表标准分〈50者为“无抑郁”症状，≥50，但〈60者为“轻度抑郁”，≥60，但〈70者为“中度抑郁”，≥70者为“重度抑郁”。获回答、规范问卷1351份，其中，1年级498名，2年级441名，3年级412名；男577名，女774名。结果：所获得的1351份问卷的数据均进入结果分析。不同群体间抑郁自评量表均值的比较分析：①性别间的比较：男女学生的评分接近（48．44&;#177;11．20，48．85&;#177;10．39）。②年级间比较：一、二、三年级学生抑郁自评量表得分接近（48．76&;#177;10．39，49．22&;#177;11．12，47．99&;#177;10．74）。③不同学习成绩学生之间的比较：学习成绩优、良的学生的抑郁自评量表标准分均值比学习成绩中、差的学生低（46．62&;#177;10．17，47．71&;#177;10．51，49．42&;#177;10．83．51．75&;#177;10．41）。④不同人际关系学生的比较：人际关系较好的学生，其抑郁自评量表标准分均值显著低于人际关系一般的学生、较差的学生（46．62&;#177;11．04，49．34&;#177;10．32，54．80&;#177;12．42）；人际关系一般的学生其抑郁自评量表标准分均值明显低于人际关系较差的学生。抑郁症状检出率分析：①抑郁症状检出率比较分析：师范专业大学生抑郁症状检出率较高，轻度及以上者占45．5％，而且具有2．8％的重度抑郁症患者。②不同群体间抑郁症状检出率比较分析：年级、性别间学生抑郁的不同检出率无差异，而人际关系（F=16．04，P〈0．01）、学习成绩（F=5．83，P〈0．01）之间差异显著。结论：师范专业大学生抑郁症状检出率高。性别及年级对抑郁发生率无明显影响，而学习成绩、人际关系是影响师范专业大学生心理健康的重要因素。     

北京市某社区200名老年人抑郁症状调查及其影响因素分析

目的 :调查社区老年人抑郁症状的发生情况并分析其影响因素。方法 :采用横断面调查法,使用自行编制的一般资料调查表和老年抑郁量表(GDS)对北京市某社区200名年龄在60岁及以上的老年人进行调查。结果:社区老年人抑郁症状的发生率为8.5%,年龄、自评健康状况、自评心境以及近期生活事件的发生是老年人抑郁症状发生的影响因素。结论 :抑郁症状作为社区老年人的心理健康问题之一,受到多种因素的影响。本研究重点关注老年人的自我认识以及近期生活事件的发生与抑郁症状的相关性,为未来进一步研究和干预提供了新的参考依据。     

西安市部分社区老年人抑郁症状的流行病学调查

目的探讨西安市部分市社区老年人抑郁症状的发生情况,了解老年人群的心理健康状况。方法采取分层随机整群抽样方法,应用老年抑郁量表（the geriatric depression scale,GDS）及自行编制的危险因素调查表,对西安市3个行政区8个社区1950名≥60岁的老年人进行问卷调查。所得资料用卡方检验和非条件Logistic回归方法进行统计处理。结果老年抑郁症状发生率为24．9％。不同性别、年龄、文化程度、职业、月收入及是否丧偶、独居、有无社会保障的老年人群抑郁症状的发生率有显著差异（P〈0．05）。月收入1000元以下、独居是老年抑郁症状发生的危险因素（OR〉1．5）,而70～79岁年龄组抑郁症状发生可能性较60～64岁年龄组低（OR〈0．7）。结论城市社区老年人抑郁症状发生率较高,应引起足够的重视,并给予及时干预和积极疏导,以改善老年人的生活质量,减轻其精神痛苦,维护其良好的社会功能和独立生活能力。     

影响老年人睡眠质量的相关因素研究

我国老龄人口是世界上绝对数最多的国家,目前已经超过我国人口总数的10％以上。如何适应新的医学挑战,解决庞大群体的医疗卫生、健康保健等是我们要考虑的主要问题。睡眠障碍是老年人中常见的健康问题,蒋平等报道59．4％的老年人有睡眠障碍。而睡眠是一种最基本的生理需要,它对人的体力、精力的恢复具有非常重要的作用。长期失眠会给老年人的身心健康带来困扰,严重者可导致中枢神经系统的活动失调,从而并发一系列的其他疾病。而睡眠质量好坏不足用时问长短来判断的,应以是否消除了疲劳、精力是否充沛来评判。本研究中我们应用汤慈美等。睡眠状况调查量表,调查老年人的睡眠质量和影响因素,旨在为更好地解决老年人的睡眠问题提供依据。     

福州市鼓山镇城乡结合部老年人抑郁症状及影响因素调查

目的 探讨福州市鼓山镇城乡结合部老年人抑郁症状及其影响因素.方法 采用横断面调查法对该地区60岁及以上老年人进行抑郁症状调查和体格检查.结果 该地区老年人抑郁症状的发生率为15.3%;性别、ADL功能受损情况、患病种数是影响老年人抑郁症状发生率的主要因素.结论 福州市城乡结合部老年人的心理健康问题不容忽视,其抑郁症状的发生率受多方面因素的影响.老年女性、ADL功能受损、高患病种数者是老年人中的高危人群,是社区精神卫生保健的重点对象.     

Quality of life and related factors among elderly nursing home residents in Southern Taiwan

This study explored subjectively perceived quality of life and related factors of elderly nursing home residents. In this study, 161 residents aged 65 and older were selected from 10 nursing homes in Southern Taiwan. The results showed: (1) the mean score of quality of life was 15.86 and the standardized score was 52.87, a medium rating for the overall sample; (2) different educational levels, and socioeconomic status were significantly different in the quality of life, the other sociodemographic variables were not significantly different in the quality of life. (3) length of residence in the nursing home was significantly negative relative to the quality of life. Physical function, activities of daily living, social support from nurses, social support from nursing aides, social support from families, and frequency of family interaction were significantly positive relative to the quality of life. (4) Activities of daily living, social support from nurses, socioeconomic status, and physical function were the significant predictors in the quality of life, which explained 40.1% of the total amount of variance. Activities of daily living, social support from nursing aids, socioeconomic status, physical function and frequency of interaction with family were the significant predictors in the quality of life, which explained 39.5% of the total amount of variance. Results generated from this study may act as a reference for the staff of nursing homes to understand the quality of life and related factors among elderly residents. This study also acts as a reference for future intervention programs in this field.     

Prevalence and associated factors of dysphagia in nursing home residents

Dysphagia is a major health care problem in nursing homes. It can lead to fatal complications including aspiration pneumonia and even death. The aims of this study were to evaluate the prevalence of dysphagia in nursing home residents in South Korea and to identify factors associated with dysphagia. The study was conducted in two urban nursing homes and a total of 395 older adults (aged 65–103 years old, 76.5% female) were enrolled. The presence of dysphagia was evaluated using the Gugging Swallowing Screen (GUSS) test. Out of 395 older adults, the prevalence of dysphagia was 52.7%. The following were all risk factors associated with dysphagia: Aged 75 years or older, male gender, history of dementia, feeding time longer than 20 min, severe dependent functional status, solid meal type, high nutritional risk, and underweight. To prevent complications from dysphagia in nursing home residents, systematic screening and evaluation programs for dysphagia are needed.     

养老机构老年人跌倒发生流行特征与危险因素分析

目的 了解养老机构老年人跌倒发生现状及存在的主要危险因素,为开展针对性干预提供依据.方法 选择2地区5所养老机构370例60岁及以上老年人为调查对象,应用自行设计的调查表,采用面访方式了解调查对象在2012年11月至2013年10月期间的跌倒发生情况及相关因素.结果 养老机构老年人跌倒发生率为12.97％,主要发生地点为卧室和楼梯/过道,发生跌倒的主要自身原因为腿软、头晕和未保持平衡,主要环境因素为路滑和路面不平;跌伤发生率为5.95％,主要伤及下肢和头部,17.24％为骨折,24.14％需住院治疗,10.34％留有残疾.单因素分析显示年龄(OR=1.044),骨质疏松症(OR=18.488)、眩晕症(OR=5.571)、总体健康评价差(OR=1.608)、有既往跌倒史(OR =20.173),担心跌倒减少活动(OR=2.192)为养老机构老年人跌倒的危险因素;经多因素logistic回归分析,患有骨质疏松症(OR=19.394)和有既往跌倒史(OR=26.751)进入主效应模型.结论 跌倒威胁养老机构老年人的身心健康,应采用综合性干预措施预防跌倒发生.     

Self‐worth therapy for depressive symptoms in older nursing home residents

Title. Self‐worth therapy for depressive symptoms in older nursing home residents. Aim. The aim of this study is to report the effects of self‐worth therapy on depressive symptoms of older nursing home residents. Background. Depression in older people has become a serious healthcare issue worldwide. Pharmacological and non‐pharmacological therapies have been shown to have inconsistent effects, and drug treatment can have important side‐effects. Method. A quasi‐experimental design was used. Older people were sampled by convenience from residents of a nursing home in northern Taiwan between 2005 and 2006. To be included in the study participants had to: (i) have no severe cognitive deficits; (ii) test positive for depressive status and (iii) take the same anti‐depressant medication in the previous 3 months and throughout the study. Participants in the experimental group (n = 31) received 30 minutes of one‐to‐one self‐worth therapy on 1 day a week for 4 weeks. Control group participants (n = 32) received no therapy, but were individually visited by the same research assistant, who chatted with them for 30 minutes on 1 day/week for 4 weeks. Depressive status, cognitive status and functional status were measured at baseline, immediately after the intervention and 2 months later. Data were analysed by mean, standard deviations, t‐test, chi‐squared test and univariate anova . Findings. Self‐worth therapy immediately decreased depressive symptoms relative to baseline, but not relative to control treatment. However, 2 months later, depressive symptoms were statistically significantly reduced relative to control. Conclusion. Self‐worth therapy is an easily‐administered, effective, non‐pharmacological treatment with potential for decreasing depressive symptoms in older nursing home residents.     

Prevalence and correlates of depressive symptoms in the elderly of rural communities in southern Taiwan

The purpose of this study was to determine the prevalence and level of depressive symptoms and the influence of demographic characteristics on depressive symptoms in elders residing in rural Taiwan. Also, the association was explored between depressive symptoms and life stressors in the Taiwanese Elderly Stress Inventory (TESI). A cross-sectional design utilizing face-to-face administered instruments was used. A total of 195 older community residents participated in the study. Levels of depressive symptoms wese measured by the Geriatric Depression Scale - Short Form (GDS-SF) while life stressors were assessed with the Taiwanese Elderly Stress Inventory (TESI). Overall, 57% of the subjects had a GDS-SF score of 7 or above (M = 7.58, SD = 3.89), indicating that the majority were depressed. Additionally, gender, educational level, marital status, living arrangements, and socioeconomic status (SES) were significant factors to depressive symptoms. Women were more likely to experience depression than men. Elders who had received no formal education, were separated from their spouse due to death or divorce, lived alone, or had lower SES were at higher risk of more severe depression. Also, significant correlations were found between depressive symptoms and 19 stressors identified in the TESI. These stressors mostly include events related to physical functioning and family issues. The findings of this study will provide community health professionals in Taiwan with a better recognition of depressive symptoms in rural elders and stressors that are associated with depressive symptoms. This information can be used to plan health-related services and interventions for rural elders.     

Prevalence of diabetes in care home residents

OBJECTIVE--To determine the prevalence of known and undetected diabetes diagnosed either by an elevated fasting baseline sample or by a 2-h post-glucose load sample in a group of residents of care homes in an urban-district setting. RESEARCH DESIGN AND METHODS--We completed individual interviews with patients and caregivers in 30 care homes (both residential and nursing homes) in two metropolitan districts of Birmingham, West Midlands, U.K. All care homes were under the supervision of primary care physicians (general practitioners). We carried out 75-g oral glucose tolerance tests (OGTTs) in consenting residents without previous known diabetes. Criteria for diagnosis of diabetes were obtained from the World Health Organization (1998) and the American Diabetes Association (1997). RESULTS--Of 636 residents available for study, 76 residents (12.0%) were known to have diabetes; of the 560 remaining residents, 286 either refused to participate or were deemed too ill or unavailable to undergo testing. Complete data on 274 OGTTs were obtained (median age 83 years, range 45-101). A total of 46 subjects were diagnosed as having diabetes and 94 as having impaired glucose tolerance. Allowing for subjects who refused or were unable to participate, the calculated total prevalence (which includes known and newly detected diabetes) was 26.7% (95% CI 21.9-32.0). The calculated overall prevalence of impaired glucose tolerance was 30.2% (25.2-35.6). CONCLUSIONS--In a group of care home residents not known to have diabetes and able to undergo testing, a substantial proportion have undetected diabetes based on a 2-h postglucose load. These residents warrant further study as they may be at higher cardiovascular risk and require an intervention.     

Concept analysis of feelings of loss among elderly nursing home residents

Loss is a phenomenon common to the human experience. Feelings of loss represent an emotional response to separation from subjectively important person(s) or things. Loss often leaves nursing home elderly residents feeling abandoned, insecure, lonely, and hopeless and may affect their perception of the meaning of life. Those who are unable to adjust may slip into a depressed mood, which may lead to suicidal ideations. No systematic analysis of loss has been conducted. The purpose of this paper is to expand understanding of the concept of loss. The authors intend to clarify the defining attributes of loss, identify the antecedents that influence the perception of loss and discuss the possible consequences of loss using Walker and Avant's (2005) concept analysis. A model case is used to demonstrate how loss is tied to these critical attributes. Borderline and contradictory cases are presented to differentiate between the concept of loss and other concepts. It is believed that this analysis will help nursing staff to gain a better understanding of the concept of loss and help them apply this knowledge in clinical practice.