Pot Anne Margriet, Deeg Dorly J H, Twisk Jos W R, Beekman Aartjan T F, Zarit Steven H
Netherlands Institute on Mental Health and Addiction Program on Aging, P. O. 725, 3500 AS Utrecht, The Netherlands.
Gerontologist. 2005 Jun;45(3):359-69. doi: 10.1093/geront/45.3.359.
The aim of this study was to estimate the longitudinal relationship between transitions in the use of long-term care and older adults' depressive symptoms and to investigate whether this relationship could be explained by markers of older adults' underlying health, or other variables including demographics, personality, and partner status.
Data were from the Longitudinal Aging Study Amsterdam, which consists of a random, community-based sample of 3,107 older Dutch people (55-85 years of age) stratified by age and gender. The use of informal care, professional home care, and institutional care was recorded, and respondents were screened on depressive symptoms. Follow-up measurements took place at 3 and 6 years.
Longitudinal analyses showed significant associations between the enduring use of professional long-term care and an increase in depressive symptoms. Transitions to professional home care or institutional care were also associated with considerably more depressive symptoms after 3 years, whereas transitions from professional home care or institutional care to no care or informal care only were not associated with a change in depressive symptoms. Most of the associations remained significant after indicators of underlying health and other covariates were adjusted for, and also after the data were reanalyzed for respondents with and without functional limitations.
This study does not involve a controlled experiment of professional long-term care among older adults. However, the findings suggest the possibility that receiving professional long-term care could introduce new stressors and increase the risk of depressive symptoms. Our analyses illuminate the concerns of elders regarding their use of professional long-term care and may help in planning for more effective delivery of this type of care.
本研究旨在评估长期护理使用情况的转变与老年人抑郁症状之间的纵向关系，并调查这种关系是否可以由老年人潜在健康状况的指标或其他变量（包括人口统计学、性格和伴侣状况）来解释。
数据来自阿姆斯特丹纵向老龄化研究，该研究由3107名荷兰老年人（55 - 85岁）组成的基于社区的随机样本，按年龄和性别分层。记录了非正式护理、专业家庭护理和机构护理的使用情况，并对受访者进行了抑郁症状筛查。随访测量在3年和6年时进行。
纵向分析显示，持续使用专业长期护理与抑郁症状增加之间存在显著关联。在3年后，向专业家庭护理或机构护理的转变也与更多的抑郁症状相关，而仅从专业家庭护理或机构护理转变为无护理或非正式护理与抑郁症状的变化无关。在对潜在健康指标和其他协变量进行调整后，以及对有和没有功能限制的受访者重新分析数据后，大多数关联仍然显著。
本研究未涉及对老年人专业长期护理的对照实验。然而，研究结果表明，接受专业长期护理可能会引入新的压力源并增加抑郁症状的风险。我们的分析阐明了老年人对使用专业长期护理的担忧，并可能有助于规划更有效的此类护理服务。
