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农村女性初级保健患者的婚姻状况、抑郁情绪与自评健康状况

Marital status, feeling depressed and self-rated health in rural female primary care patients.

作者信息

Rohrer James E, Bernard Matthew E, Zhang Yan, Rasmussen Norman H, Woroncow Halina

机构信息

Department of Family Medicine, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

J Eval Clin Pract. 2008 Apr;14(2):214-7. doi: 10.1111/j.1365-2753.2007.00835.x. Epub 2007 Dec 13.

Abstract

OBJECTIVE

To determine whether marital status and self-assessed mental health are independent risk factors for poor self-rated overall health among female primary care patients.

DESIGN

We conducted a cross-sectional survey of family medicine patients treated in a clinic in rural Minnesota. Complete responses were obtained from 723 women. Self-ratings of mental health, demographics and symptoms were used to predict self-rated overall health.

RESULTS

Women who were single, divorced or otherwise not married, or widowed had lower odds of good self-rated overall health (OR = 0.39, P = 0.004) compared with married women. Women who were 65 years of age and over (OR = 0.31, P = 0.017), women who rated themselves as depressed (OR = 0.54, P = 0.029), and women who reported more physical symptoms (OR = 0.78, P = 0.000) also were less likely to have good health, compared with younger women, women who did not feel depressed, and women with fewer physical symptoms, respectively. Education was not independently related to health in this sample. Worry was related to health in the univariate analysis but not after controlling for self-assessed depression.

CONCLUSIONS

In order to improve overall health among rural women seen in primary care settings, special attention may need to be directed at women who are single, are older, report more physical symptoms, and feel depressed. Programmes should include self-help materials, support groups and counselling services addressing social isolation, employment and financial hardship.

摘要

目的

确定婚姻状况和自我评估的心理健康状况是否为女性初级保健患者自我评定的总体健康状况不佳的独立危险因素。

设计

我们对明尼苏达州农村一家诊所治疗的家庭医学患者进行了横断面调查。从723名女性中获得了完整的答复。心理健康、人口统计学和症状的自我评定用于预测自我评定的总体健康状况。

结果

与已婚女性相比,单身、离异或其他未婚或丧偶的女性自我评定总体健康状况良好的几率较低(OR = 0.39,P = 0.004)。与年轻女性、不感到抑郁的女性以及身体症状较少的女性相比,65岁及以上的女性(OR = 0.31,P = 0.017)、自我评定为抑郁的女性(OR = 0.54,P = 0.029)以及报告身体症状较多的女性(OR = 0.78,P = 0.000)健康状况良好的可能性也较小。在这个样本中,教育程度与健康状况没有独立的关联。在单因素分析中,担忧与健康状况有关,但在控制自我评定的抑郁后则无关。

结论

为了改善在初级保健机构就诊的农村女性的总体健康状况,可能需要特别关注单身、年龄较大、报告身体症状较多且感到抑郁的女性。项目应包括自助材料、支持小组以及针对社会孤立、就业和经济困难的咨询服务。

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