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居家养老的失能老人的心理困扰及其相关因素

Psychological distress and its correlates in older care-dependent persons living at home.

作者信息

Thygesen Elin, Saevareid Hans Inge, Lindstrom Torill Christine, Engedal Knut

机构信息

University of Agder, Kristiansand, Norway.

出版信息

Aging Ment Health. 2009 May;13(3):319-27. doi: 10.1080/13607860802534591.

Abstract

OBJECTIVES

This study examined psychological distress in older people receiving home nursing care. The influence of risk factors and personal resources on their perceived psychological distress was also examined.

METHOD

A linear regression analysis was applied in a cross-sectional sample of 214 patients aged 75 years and older. Psychological distress was measured using the General Health Questionnaire (GHQ). The independent variables were sex, education, age, living arrangement, household composition, reported illnesses, Barthel ADL Index, self-rated health, Subjective Health Complaints, Clinical Dementia Rating Scale, Sense of Coherence and Revised Social Provision Scale.

RESULTS

Of the 214 participants, 23 (10.7%) reported experiencing psychological distress using a cutoff point of 4 or more on a GHQ case score. Sense of coherence, education and subjective health complaints were the only factors that were significantly related to psychological distress in the multivariate analysis.

CONCLUSION

The general level of psychological distress was low. Low psychological distress was related to an inner strength conceptualized as sense of coherence. Commonly reported risk factors such as sex, household composition and perceived social support, and objective measures of somatic and mental health and bodily dysfunctions were not related to psychological distress. Suggested reasons for this are greater acceptance of bodily and functional shortcomings and of changes related to goal achievement in old age, according to the model of selective optimization with compensation.

摘要

目的

本研究调查了接受家庭护理的老年人的心理困扰情况。同时还研究了风险因素和个人资源对他们感知到的心理困扰的影响。

方法

对214名75岁及以上患者的横断面样本进行线性回归分析。使用一般健康问卷(GHQ)测量心理困扰。自变量包括性别、教育程度、年龄、居住安排、家庭构成、报告的疾病、巴氏日常生活活动指数、自评健康状况、主观健康抱怨、临床痴呆评定量表、连贯感量表和修订的社会支持量表。

结果

在214名参与者中,23人(10.7%)报告在GHQ病例评分中达到4分或更高,表明经历了心理困扰。在多变量分析中,连贯感、教育程度和主观健康抱怨是与心理困扰显著相关的唯一因素。

结论

心理困扰的总体水平较低。低心理困扰与一种被概念化为连贯感的内在力量有关。常见的风险因素,如性别、家庭构成和感知到的社会支持,以及躯体和心理健康及身体功能障碍的客观测量指标与心理困扰无关。根据选择性优化与补偿模型,对此的建议原因是老年人对身体和功能缺陷以及与目标达成相关变化的更大接受度。

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