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身体残疾女性的抑郁症状:确定相关因素以指导实践。

Depressive symptoms in women with physical disabilities: identifying correlates to inform practice.

机构信息

Spinal Cord Injury and Disability Research Center, The Institute of Rehabilitation and Research-Memorial Herman, Houston, TX; Department of Physical Medicine and Rehabilitation, Center for Research on Women with Disabilities, Baylor College of Medicine, Houston, TX.

Spinal Cord Injury and Disability Research Center, The Institute of Rehabilitation and Research-Memorial Herman, Houston, TX; Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX.

出版信息

Arch Phys Med Rehabil. 2013 Dec;94(12):2410-2416. doi: 10.1016/j.apmr.2013.07.013. Epub 2013 Jul 31.

Abstract

OBJECTIVE

To examine correlates of depressive symptomatology in a sample of women with diverse physical disabilities to inform practice of modifiable risk factors that warrant attention and intervention.

DESIGN

Interview survey.

SETTING

Outpatient chronic care clinics.

PARTICIPANTS

Racially and ethnically diverse women (N=415) aged 18 to 64 years living with physical disabilities.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

Center for Epidemiologic Studies Depression Scale.

RESULTS

Depressive symptoms were high with more than half the women exceeding an established cutoff for clinically significant depressive symptomatology. In hierarchical multiple regression analyses, demographic, disability, and health variables explained significant variance in depressive symptoms; however, modifiable variables (pain interference, social support, abuse) contributed significantly to depression scores over and above demographic, disability, and health variables. Analyses examining predictors of depression classification revealed similar findings.

CONCLUSIONS

Depression is a significant problem for many women with physical disabilities. Modifiable contributors to depressive symptoms may provide intervention opportunities for researchers and clinicians. Clinicians need to attend closely to pain, particularly perceptions of pain interference; social support and social isolation; and abuse among women with physical disabilities. It may be valuable to include pain self-management, social networking and social skill development, and safety and abuse prevention training when designing depression intervention programs for this population.

摘要

目的

调查一组不同身体残疾女性的抑郁症状相关因素,为实践中需要关注和干预的可改变风险因素提供信息。

设计

访谈调查。

地点

门诊慢性病诊所。

参与者

年龄在 18 至 64 岁之间,患有身体残疾的不同种族和族裔的女性(N=415)。

干预措施

不适用。

主要观察指标

流行病学研究中心抑郁量表。

结果

抑郁症状较高,超过一半的女性超过了临床显著抑郁症状的既定标准。在分层多元回归分析中,人口统计学、残疾和健康变量解释了抑郁症状的显著差异;然而,可改变的变量(疼痛干扰、社会支持、虐待)在人口统计学、残疾和健康变量之外对抑郁评分有显著贡献。检查抑郁分类预测因素的分析也得出了类似的结论。

结论

抑郁是许多身体残疾女性的一个严重问题。抑郁症状的可改变因素可能为研究人员和临床医生提供干预机会。临床医生需要密切关注疼痛,特别是对疼痛干扰的感知;社会支持和社会隔离;以及身体残疾女性中的虐待问题。在为该人群设计抑郁干预计划时,可能有价值的是包括疼痛自我管理、社交网络和社交技能发展以及安全和虐待预防培训。

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