Stein Janine, Pabst Alexander, Weyerer Siegfried, Werle Jochen, Maier Wolfgang, Miebach Lisa, Scherer Martin, Stark Anne, Kaduszkiewicz Hanna, Wiese Birgitt, Moor Lilia, Bock Jens-Oliver, König Hans-Helmut, Riedel-Heller Steffi G
Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.
Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.
J Affect Disord. 2016 Nov 15;205:182-189. doi: 10.1016/j.jad.2016.07.001. Epub 2016 Jul 5.
Research showed that the perception of unmet needs may differ between patients, caregivers and professionals. Lacking agreement with regard to unmet needs between raters involved may have a negative impact on treatment of late-life depression.
As part of the multicenter German study "Late-life depression in primary care: needs, health care utilization and costs" (AgeMooDe), n=1188 primary care patients aged 75-98 with and without depression, relatives (n=366) and general practitioners (GPs, n=1152) were assessed using the German version of the Camberwell Assessment of Need for the Elderly (CANE) in order to identify patients' unmet needs from different perspectives. Kappa coefficients were computed to determine level of agreement between perspectives. Penalized likelihood logistic regression models were run in order to assess the association between depression severity and disagreement between perspectives with regard to unmet needs.
The prevalence of unmet needs was higher in depressive patients. Kappa coefficients were on average higher for depressive patients ranging from poor to substantial. Severity of depression was significantly associated with disagreement regarding unmet needs between perspectives.
The cross-sectional design of the study limits the results. Only a part of caring relatives was able to participate.
Perceptions of unmet needs in the oldest old primary care patients suffering from depression strongly differ between raters. Severity of depression seems to exacerbate the discrepancy between involved perspectives. The negative impact that depression severity may have on the perception and assessment of unmet needs requires greater attention by GPs.
研究表明，患者、照料者和专业人员对未满足需求的认知可能存在差异。参与评估者之间在未满足需求方面缺乏共识可能会对老年抑郁症的治疗产生负面影响。
作为多中心德国研究“初级保健中的老年抑郁症：需求、医疗保健利用和成本”（AgeMooDe）的一部分，使用德语版的老年人坎伯韦尔需求评估量表（CANE）对1188名年龄在75至98岁之间、患有或未患有抑郁症的初级保健患者、亲属（n = 366）和全科医生（n = 1152）进行评估，以便从不同角度识别患者未满足的需求。计算卡帕系数以确定不同角度之间的一致程度。运行惩罚似然逻辑回归模型，以评估抑郁症严重程度与不同角度在未满足需求方面的分歧之间的关联。
抑郁症患者中未满足需求的患病率更高。抑郁症患者的卡帕系数平均较高，范围从差到中等。抑郁症的严重程度与不同角度在未满足需求方面的分歧显著相关。
该研究的横断面设计限制了研究结果。只有一部分照料亲属能够参与。
患有抑郁症的最年长初级保健患者对未满足需求的认知在评估者之间存在很大差异。抑郁症的严重程度似乎会加剧相关角度之间的差异。抑郁症严重程度可能对未满足需求的认知和评估产生的负面影响需要全科医生给予更多关注。
