Jones Laura E, Doebbeling Caroline Carney
Roudebush VAMC HSR&D Center of Excellence on Implementing Evidence-Based Practice (CIEBP), Indianapolis, IN 46202, USA.
Gen Hosp Psychiatry. 2007 Nov-Dec;29(6):547-54. doi: 10.1016/j.genhosppsych.2007.08.004.
To describe the proportion of veterans with cancer screened for depression as compared to the general population (GenPop) of veterans.
Data were abstracted from electronic medical records (2000-2004) at a Midwestern Veterans Health Administration (VHA) facility and from the VHA External Peer Review Program (EPRP). Depression screening was assessed in the 12-month period following cancer diagnosis or in the 12-month period prior to EPRP medical record abstraction. Statistical analysis included multivariate logistic regression.
Annual depression screening among veterans with cancer improved from 42% in 2000 to 81% in 2003. Screening was 9-31% lower and 11-50% lower among veterans with cancer at the Midwestern facility, as compared to the GenPop of veterans nationwide and at the Midwestern facility, respectively. Of subjects with cancer at the Midwestern facility, 19% screened positive. Advanced disease [odds ratio (OR)=0.51; 95% confidence interval (CI(95)): 0.38-0.68] and respiratory cancers (OR=0.55; CI(95): 0.38-0.80) were associated with lower odds of screening receipt.
Screening for depression among veterans with cancer improved 39% but is considerably lower than the proportion of GenPop veterans screened nationally and at the local facility. Targeted interventions to improve screening in patients with cancer are required based on evidence that screening translates into increased provider recognition and treatment of depression.
描述与退伍军人总体人群（GenPop）相比，接受抑郁症筛查的患癌退伍军人的比例。
数据取自中西部退伍军人健康管理局（VHA）机构的电子病历（2000 - 2004年）以及VHA外部同行评审项目（EPRP）。在癌症诊断后的12个月内或EPRP病历提取前的12个月内评估抑郁症筛查情况。统计分析包括多变量逻辑回归。
患癌退伍军人的年度抑郁症筛查率从2000年的42%提高到了2003年的81%。与全国退伍军人总体人群以及中西部机构的退伍军人总体人群相比，中西部机构患癌退伍军人的筛查率分别低9 - 31%和11 - 50%。在中西部机构患癌的受试者中，19%筛查呈阳性。晚期疾病[比值比（OR）=0.51；95%置信区间（CI(95)）：0.38 - 0.68]和呼吸道癌症（OR = 0.55；CI(95)：0.38 - 0.80）与接受筛查的较低几率相关。
患癌退伍军人的抑郁症筛查率提高了39%，但仍远低于全国和当地机构对退伍军人总体人群的筛查比例。基于筛查能提高医疗服务提供者对抑郁症的识别和治疗这一证据，需要采取有针对性的干预措施来改善癌症患者的筛查情况。
