a Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig , Leipzig , Germany.
b Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University , Mannheim , Germany.
Aging Ment Health. 2018 Aug;22(8):1032-1039. doi: 10.1080/13607863.2017.1328480. Epub 2017 May 19.
This study aims at examining the distribution of unmet environmental, physical, social and psychological care needs in a sample of the oldest old primary care patients with different levels of depression severity. Furthermore, the objective of this study was to analyze the association between specific unmet care needs and severity of depression.
The sample of patients aged 75 years (n = 202) and more was derived from the multicenter prospective cohort study AgeMooDe ('Late-life depression in primary care: Needs, health care utilization and costs'). Patients were assessed via structured clinical interviews containing the German version of the Camberwell Assessment of Need for the Elderly (CANE) and the German Hospital Anxiety and Depression Scale (HADS-D). Descriptive statistics, Spearman correlation coefficients and binary logistic regression analyses were computed.
Unmet needs appeared to be substantially higher in the patient group with higher levels of depression severity according to the HADS-D score. Overall, there was weak positive linear correlation between depression and CANE total unmet needs. Except of the physical unmet needs category, all other CANE care categories showed little to moderate positive linear correlations with depression according to the HADS-D score. Depression and psychological unmet needs showed the strongest of all correlations, followed by social unmet needs. The binary logistic regression analysis revealed that patients having psychological unmet needs were 4.8 times more likely diagnosed with a probable depression.
Systematic needs assessment, especially psychological needs, may play a crucial role in the course of prevention and effective treatment of late-life depression in the primary care context.
本研究旨在调查不同抑郁严重程度的老年初级保健患者样本中未满足的环境、身体、社会和心理护理需求的分布情况。此外，本研究的目的是分析特定未满足的护理需求与抑郁严重程度之间的关系。
该 75 岁及以上（n=202）患者样本来自多中心前瞻性队列研究 AgeMooDe（初级保健中的老年期抑郁症：需求、卫生保健利用和成本）。通过包含德国版老年坎贝尔评估需求量表（CANE）和德国医院焦虑和抑郁量表（HADS-D）的结构化临床访谈对患者进行评估。计算了描述性统计数据、Spearman 相关系数和二元逻辑回归分析。
根据 HADS-D 评分，抑郁程度较高的患者组未满足的需求明显更高。总体而言，抑郁与 CANE 总未满足需求之间存在弱正线性相关。除身体未满足需求类别外，根据 HADS-D 评分，CANE 的所有其他护理类别与抑郁均呈弱到中度正线性相关。抑郁和心理未满足需求与所有其他相关因素相比相关性最强，其次是社会未满足需求。二元逻辑回归分析表明，有心理未满足需求的患者被诊断为可能患有抑郁症的可能性是没有心理未满足需求患者的 4.8 倍。
系统的需求评估，尤其是心理需求，在初级保健环境中预防和有效治疗老年期抑郁症的过程中可能发挥关键作用。
