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一项相互康复干预对社区居住的老年抑郁症成年人心理健康影响的试点研究。

Effects of a mutual recovery intervention on mental health in depressed elderly community-dwelling adults: a pilot study.

作者信息

Wang Chao, Hua Yujie, Fu Hua, Cheng Longfeng, Qian Wen, Liu Junyang, Crawford Paul, Dai Junming

机构信息

School of Public Health, Health Communication Institute, Fudan University, Shanghai, China.

National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China.

出版信息

BMC Public Health. 2017 Jan 3;17(1):4. doi: 10.1186/s12889-016-3930-z.

Abstract

BACKGROUND

The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai.

METHODS

Recruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237) into either the intervention group (3 communities, n = 105) or to a wait-list control group (3 communities, n = 132). All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15). From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1), before intervention at 24 weeks (T2), and immediately after intervention at 32 weeks (T3). Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5) and the Self-administered Sleep Questionnaire (SSQ). Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects.

RESULTS

There was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there was no significant difference within the groups in terms of sleep, well-being, and depression at baseline and before the intervention. Mixed-model repeated measures ANOVAs detected a group × time interaction on depression, sleep, and well-being and showed a favorable intervention effect within groups immediately after the intervention.

CONCLUSIONS

The mutual recovery program could be a creative and effective approach to improve mental health in older community-dwelling adults with depressive symptom.

摘要

背景

全球范围内,老年人抑郁症的患病率呈上升趋势,而中国的人口老龄化使得抑郁症成为老年人的一个主要健康问题,给社会带来了巨大负担。应确定有效的干预措施,以提供解决该问题和改善现状的方法。本研究探讨了互助康复计划干预对上海社区居住的有抑郁症状的老年人抑郁症状、睡眠质量和幸福感的有效性。

方法

于2012年7月至2012年8月进行招募。采用整群随机等待列表对照设计,将6个社区(n = 237)随机分为干预组(3个社区,n = 105)或等待列表对照组(3个社区,n = 132)。所有参与者均符合抑郁症的纳入标准,该标准由老年抑郁量表(GDS - 15)定义。2013年3月至5月,干预组的参与者接受了为期2个月的互助康复计划干预。干预包括七个每周一次、每次90分钟的课程,课程基于标准化的自行设计时间表。在三个测量时间点将抑郁作为主要结局:基线(T1)、干预前24周(T2)和干预后32周即刻(T3)。将幸福感和睡眠质量作为次要结局,并根据世界卫生组织幸福指数(WHO - 5)和自填式睡眠问卷(SSQ)进行评估。最后,共有225名完成所有课程和三次测量的参与者进入最终分析。采用混合模型重复测量方差分析来估计干预效果。

结果

基线时,干预组和对照组在性别、婚姻状况、年龄结构、工作后类型和教育背景方面无显著差异。多变量方差分析表明,在基线和干预前,两组在睡眠、幸福感和抑郁方面无显著差异。混合模型重复测量方差分析检测到抑郁、睡眠和幸福感存在组×时间交互作用,并显示干预后组内即刻有良好的干预效果。

结论

互助康复计划可能是改善社区居住的有抑郁症状的老年成年人心理健康的一种创新且有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0625/5209883/21b220450706/12889_2016_3930_Fig1_HTML.jpg

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