Gallo Joseph J, Bogner Hillary R, Straton Joseph B, Margo Katherine, Lesho Pat, Rabins Peter V, Ford Daniel E
Department of Family Practice and Community Medicine, University of Pennsylvania, Philadelphia 19104, USA.
Int J Psychiatry Med. 2005;35(1):41-57. doi: 10.2190/K5B6-DD8E-TH1R-8GPT.
An important component of generalizing study results to patients is the extent to which study participants adequately represent individuals targeted for the study. The Spectrum study of depression in older primary care patients was utilized to consider patient characteristics associated with nonparticipation.
Interviewers utilized a validated questionnaire to screen adults aged 65 years and older for depression who presented to one of the participating primary care practices in the Baltimore, Maryland area. Screening interviews included information about sociodemographic factors, functioning, health, and attitudes about depression and its treatment in order to compare participants with persons who declined.
In all, 2,560 adults aged 65 years and older were screened. Comparison of the characteristics of the patients who were eligible for the study (n = 773) with patients who participated fully in the in-home evaluation (n = 355) found that the study sample included proportionately more persons who: 1) were less than 80 years old; 2) completed high school; and 3) reported two or more visits to the practice site within six months of the interview. Among patients who were depressed, no significant differences were found in the characteristics of those who met study eligibility criteria and those who agreed to participate.
Persons over the age of 80 years of age or those with less than a high school education may require tailored strategies for recruitment even when approached by a trained interviewer in a primary care doctor's office.
将研究结果推广至患者的一个重要组成部分是研究参与者对研究目标个体的代表性程度。利用老年初级保健患者抑郁症的光谱研究来考量与未参与相关的患者特征。
访谈者使用经过验证的问卷,对在马里兰州巴尔的摩地区参与研究的初级保健机构就诊的65岁及以上成年人进行抑郁症筛查。筛查访谈包括社会人口学因素、功能、健康状况以及对抑郁症及其治疗的态度等信息,以便将参与者与拒绝者进行比较。
总共对2560名65岁及以上成年人进行了筛查。对符合研究条件的患者(n = 773)与完全参与家庭评估的患者(n = 355)的特征进行比较发现,研究样本中比例较高的人群具有以下特点:1)年龄小于80岁;2)完成高中学业;3)在访谈前六个月内到医疗机构就诊两次或更多次。在抑郁症患者中,符合研究资格标准的患者与同意参与的患者在特征上未发现显著差异。
80岁以上或未完成高中学业的人群可能需要量身定制的招募策略,即使是在初级保健医生办公室由经过培训的访谈者进行招募时也是如此。