摘要
目的探讨家庭医生团队干预对空巢老人抑郁孤独状况、幸福感及生存质量的影响。方法调查深圳市福田区≥60岁居民空巢老人情况,将轻中度抑郁空巢老人158例,随机分成试验组(80例)和对照组(78例)。试验组予家庭医生团队综合服务干预方案,对照组予常规干预方案,干预时间为18个月。将干预前后试验组与同期对照组、无抑郁组(867例)的抑郁、孤独、幸福感及生存质量进行比较。采用SPSS17.0统计软件,计量资料两组间比较采用t检验,计数资料组间比较采用χ2检验,P<0.05为差异有统计学意义。结果深圳市福田区空巢老人检出率22.60%(1 035/4 580),空巢老人抑郁检出率16.23%(168/1 035)。有抑郁症状者GDS(t=42.33,P=0.00);UCLA(t=55.38,P=0.00)评分高于无抑郁组,差异有统计学意义。MUNSH(t=-48.89,P=0.00);WHOQOL-BREF(t=-36.46,P=0.00)评分低于无抑郁组,差异有统计学意义。试验组干预6、12、18个月GDS、UCLA评分低于干预前,差异有统计学意义(P<0.01),MUNSH、WHOQOL-BREF评分高于干预前,差异有统计学意义(P<0.01)。对照组干预18个月GDS、UCLA评分高于干预前,差异有统计学意义(P<0.05)。试验组干预6、12、18个月的GDS、UCLA评分低于同期对照组,差异有统计学意义(P<0.05),MUNSH、WHOQOL-BREF评分高于同期对照组,差异有统计学意义(P<0.01)。试验组干预前后与无抑郁组比较,GDS、UCLA评分均高于无抑郁组,差异有统计学意义(P<0.01),MUNSH、WHOQOL-BREF评分均低于无抑郁组,差异有统计学意义(P<0.01)。干预18个月后,试验组抑郁(χ2=39.212,P<0.01);孤独(χ2=47.997,P<0.01)与干预前同期对照组比较,差异均有统计学意义。结论家庭医生团队干预模式可有效改善空巢老人抑郁孤独状态,提高幸福感及生存质量,但干预后结果仍未达到无抑郁空巢老人的水平。
Objective To discuss the effect of intervention by family doctors on the depression,loneliness,happiness and quality of life of isolated elderly in community. Methods A total of 158 isolated elderly aged60 and older with mild-to-moderate depression were randomly divided into two groups.80 were given comprehensive intervention services by family doctors,while 78 received traditional services as controls for 18 months.Geriatric depression scale（GDS）,UCLA Loneliness Scale（UCLA）,Memorial university of Newfoundland happiness scale（MUNSH）and World Health Organization Quality of life Measurement（WHOQOL-BREF）were used to assess the depression,loneliness,happiness and quality of life of the study subjects.T test and chi-square test were used for data statistical analysis. Results Overall,1 035 out of4 580（22.60%）elderly were socially isolated and 16.23% of them were depressed.The scores of GDS and UCLA were higher among depressed seniors compared with those without depression,while the scores of MUNSH and WHOQIL-BREF were lower,the differences were both significant（t= 42.33,55.38,-48.89,-36.46,P=0.00）.The scores of GDS and UCLA decreased after the intervention and were significantly lower compared with control groups,while the scores of MUNSH and WHOQOL-BREF increased and significantly higher（P〈0.01）.The GDS and UCLA scores were both higher before and after the intervention among depressed elderly compared to those without depression,while MUNSH and WHOQOL-BREF scores were lower（P〈0.01）.After 18 months intervention,the differences of depression and loneliness were statistically significant（χ2=39.212,47.997,P〈0.01）. Conclusions The intervention of family doctors can effectively reduce the depression and loneliness of isolated elderly in community and elevate their happiness and quality of life.However,the overall outcome of intervention still needs to be improved.
出处
《中国预防医学杂志》
CAS
2016年第8期587-592,共6页
Chinese Preventive Medicine
基金
深圳市福田区卫生公益性科研项目(FTWS2014022)
关键词
空巢老人
抑郁
孤独
幸福感
生存质量
家庭医生
Isolated elderly
Depression
Loneliness
Happiness
Quality of life
Family doctor
