Lee Hochang Benjamin, Han Hae-Ra, Huh Bo-Yun, Kim Kim B, Kim Miyong T
a School of Medicine, Yale University , New Haven , CT , USA.
Aging Ment Health. 2014;18(1):102-9. doi: 10.1080/13607863.2013.814099. Epub 2013 Jul 26.
Korean Americans (KA) comprise the fourth largest Asian-American subgroup, with a population estimated at nearly 1.7 million, and the vast majority (up to 85%) of KA elders attends ethnic churches. Despite the rapid increase of the KA elderly population, data on mental health service utilization among KA elders are scarce.
Based on a cluster sampling method, the Memory and Aging Study among Koreans in Maryland (MASK-MD) recruited and assessed 630 KA elders (mean age: 70.9 ± 6.1 years; 68.9% female) in KA churches for depression, dementia, and level of mental health service utilization. The Korean versions of the Patient Health Questionnaire (PHQ-9K) and Mini-mental Status Examination (MMSE-KC) were administered by trained community health workers.
Of the 630 participants, 23.2% and 7.3% had PHQ-9 scores of 5 ('mild depression') or above and 10 or above ('clinical depression'), respectively. In addition, 7.0% scored below the age- and education-specific cutoff values for probable dementia based on the MMSE-KC. Of the 92 participants with 'clinical depression' or having thoughts of death or self-injury, only 16 (17%) reported utilizing mental health services. Likewise, of 56 participants with probable dementia, only 3 (7.3%) sought treatment from a health care provider.
The prevalence of depression and cognitive impairment are high in community-dwelling KA elders attending KA churches, but the rate of mental health service utilization among depressed or cognitively impaired Korean elders is low. Further research is warranted to identify barriers to and strategies for adequate mental health care for Korean immigrant elders.
韩裔美国人(KA)是亚裔美国人中第四大的亚群体,估计人口接近170万,绝大多数(高达85%)的韩裔美国老年人参加民族教会。尽管韩裔美国老年人的数量迅速增加,但关于韩裔美国老年人心理健康服务利用情况的数据却很少。
基于整群抽样方法,马里兰州韩裔美国人记忆与衰老研究(MASK-MD)在韩裔美国人教会中招募并评估了630名韩裔美国老年人(平均年龄:70.9±6.1岁;68.9%为女性),以了解他们的抑郁、痴呆情况以及心理健康服务利用水平。由经过培训的社区卫生工作者进行患者健康问卷(PHQ-9K)和简易精神状态检查表(MMSE-KC)的韩语版本调查。
在630名参与者中,分别有23.2%和7.3%的人PHQ-9得分在5分(‘轻度抑郁’)及以上和10分及以上(‘临床抑郁’)。此外,根据MMSE-KC,7.0%的人得分低于特定年龄和教育程度的可能痴呆症临界值。在92名有‘临床抑郁’或有死亡或自我伤害想法的参与者中,只有16人(17%)报告使用了心理健康服务。同样,在56名可能患有痴呆症的参与者中,只有3人(7.3%)寻求医疗保健提供者的治疗。
参加韩裔美国人教会的社区居住韩裔美国老年人中抑郁和认知障碍的患病率很高,但抑郁或认知受损的韩裔美国老年人心理健康服务利用率较低。有必要进行进一步研究,以确定韩裔移民老年人获得充分心理健康护理的障碍和策略。