影响农村社区马来老年人群心理健康问题患病率的因素：一项横断面研究
Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study.
作者信息
Abdul Manaf M Rizal, Mustafa Madihah, Abdul Rahman Mohd Rizam, Yusof Khairul Hazdi, Abd Aziz Noor Azah
机构信息
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
出版信息
PLoS One. 2016 Jun 9;11(6):e0156937. doi: 10.1371/journal.pone.0156937. eCollection 2016.
BACKGROUND AND PURPOSE
Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia.
METHODS
It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed.
RESULTS
The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress.
CONCLUSIONS
Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.
背景与目的
心理健康问题在老年人群中很常见，但常常未被发现和治疗。老年人的心理健康问题是社会、心理和生物因素复杂相互作用的结果。本研究的目的是确定马来西亚霹雳州一个农村社区中马来老年人群中心理健康问题（抑郁、焦虑和情绪压力）的患病率及其相关因素。
方法
这是一项横断面研究。通过方便抽样选取了60岁及以上的马来老年人，共230名受访者。使用抑郁、焦虑和压力量表（DASS - 21）来评估抑郁、焦虑和压力症状。采用卡方检验进行双变量分析，并进行多元逻辑回归分析以确定各因素与所评估的每种心理健康状况之间的关联。
结果
结果显示，老年受访者中抑郁、焦虑和压力的患病率分别为27.8%、22.6%和8.7%。抑郁的显著因素为单身老年人（调整后比值比 = 3.27，95%置信区间1.66，6.44）、与家人同住（调整后比值比 = 4.98，95%置信区间2.05，12.10）以及总体健康状况较差（调整后比值比 = 2.28，95%置信区间1.20，4.36）。与家人同住是焦虑的唯一显著因素（调整后比值比 = 2.68，95%置信区间1.09，6.57）。压力方面没有显著因素。
结论
农村社区中马来老年人的抑郁和焦虑情况令人十分担忧。应建立或加强更多的健康公平性，以增加识别、诊断和治疗有心理健康问题者的机会。农村社区的居住安排是影响抑郁和焦虑的一个重要因素。因此，建议进行进一步研究以获取更全面的信息，从而能够进行适当干预。
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