Department of Health Systems and Outcomes (LNG), School of Nursing, and Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD 21205, USA.
Am J Geriatr Psychiatry. 2012 Nov;20(11):973-84. doi: 10.1097/JGP.0b013e31825463ce.
To examine older African American's recognition of and beliefs about depressive symptoms, preferred symptom management strategies, and factors associated with willingness to use mental health treatments. Differences between the depressed and nondepressed and men and women were examined.
Cross-sectional survey.
Home, senior center.
A total of 153 senior center members (56 male, 97 female) 55 years and older.
Using a depression vignette, participants indicated if the person was depressed and their endorsement of items reflecting beliefs, stigma, symptom management, and willingness to use treatments (yes/no). A 9-item Patient Health Questionnaire assessed current symptomatology.
Overall, 24.2% reported depressive symptoms (≥5); 88.2% correctly identified the person in the vignette as depressed. Most (≥75%) endorsed active symptom management strategies, preference for treatment in physician and therapist offices, and willingness to take medications, seek therapy, see doctor, and attend support groups; less than 33% viewed depression as stigmatizing, whereas 48% viewed depression as normal aging. Logistic regressions revealed lower education, higher physical function, and feeling okay if community knew of depression diagnosis were associated with willingness to see physician if feeling depressed; being married and believing antidepressant medications are beneficial were related to willingness to use medications. Different associations emerged for depressed/nondepressed and men and women.
Overall, this older African American sample had positive attitudes and beliefs and endorsed traditional treatment modalities suggesting that beliefs alone are unlikely barriers to underutilization of mental health services. Because different factors were associated with willingness to seek physician help and use medications and factors differed for depressed/nondepressed and by sex, interventions should be tailored.
探讨老年非裔美国人对抑郁症状的识别和看法、对首选症状管理策略的信念，以及与使用心理健康治疗意愿相关的因素。考察了抑郁组与非抑郁组、男性与女性之间的差异。
横断面调查。
家庭、老年人活动中心。
共有 153 名老年人活动中心成员（56 名男性，97 名女性），年龄在 55 岁及以上。
使用抑郁个案研究，参与者判断个案中的人是否抑郁，并对反映信念、耻辱感、症状管理和使用治疗意愿的项目表示赞同（是/否）。使用 9 项患者健康问卷评估当前的症状。
总体而言，24.2%的人报告有抑郁症状（≥5）；88.2%的人正确识别出个案中的人抑郁。大多数人（≥75%）认可积极的症状管理策略，首选在医生和治疗师办公室接受治疗，愿意服用药物、寻求治疗、看医生和参加支持小组；不到 33%的人认为抑郁是耻辱的，而 48%的人认为抑郁是正常衰老。逻辑回归显示，教育程度较低、身体功能较高，以及如果社区知道抑郁诊断，感觉良好与感到抑郁时愿意看医生有关；已婚和认为抗抑郁药物有益与愿意使用药物有关。抑郁/非抑郁组和男性与女性之间的关联不同。
总体而言，这个老年非裔美国人样本对治疗有积极的态度和信念，并认可传统的治疗方式，这表明仅仅是信念不太可能成为心理健康服务利用不足的障碍。由于寻求医生帮助和使用药物的意愿与不同因素相关，且这些因素因抑郁/非抑郁组和性别而异，因此干预措施应因人而异。
