Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
Centre for Rehabilitation Research in Oxford, University of Oxford, UK.
Gerontologist. 2018 May 8;58(3):438-447. doi: 10.1093/geront/gnx041.
Forty percent of residents living in care homes in the United Kingdom have significant depressive symptoms. Care homes can appear to be depressing places, but whether the physical environment of homes directly affects depression in care home residents is unknown. This study explores the relationship between the physical environment and depressive symptoms of older people living in care homes.
In a prospective cohort study the physical environment of 50 care homes were measured using the Sheffield Care Environment Assessment Matrix (SCEAM) and depressive symptoms of 510 residents measured using the Geriatric Depression Scale (GDS-15). The study was supplemented with semi-structured interviews with residents living in the care homes. Quantitative data were analyzed using multi-level modeling, and qualitative data analyzed using a thematic framework approach.
The overall physical environment of care homes (overall SCEAM score) did not predict depressive symptoms. Controlling for dependency, social engagement, and home type, having access to outdoor space was the only environmental variable to significantly predict depressive symptoms. Residents interviewed reported that access to outdoor space was restricted in many ways: locked doors, uneven foot paths, steep steps, and needing permission or assistance to go outside.
We provide new evidence to suggest that access to outdoor space predicts depressive symptoms in older people living in care home. Interventions aimed at increasing access to outdoor spaces could positively affect depressive symptoms in older people.
英国 40%居住在养老院的居民有明显的抑郁症状。养老院可能看起来令人沮丧，但养老院的物理环境是否直接影响养老院居民的抑郁状况尚不清楚。本研究探讨了养老院老年人的物理环境与抑郁症状之间的关系。
在一项前瞻性队列研究中，使用谢菲尔德护理环境评估矩阵（SCEAM）测量了 50 家养老院的物理环境，使用老年抑郁量表（GDS-15）测量了 510 名居民的抑郁症状。研究还对居住在养老院的居民进行了半结构化访谈。使用多层次模型分析定量数据，使用主题框架方法分析定性数据。
养老院的整体物理环境（整体 SCEAM 评分）并不能预测抑郁症状。在控制依赖程度、社会参与度和家庭类型后，能够进入户外空间是唯一能显著预测抑郁症状的环境变量。接受访谈的居民报告说，进入户外空间受到多种方式的限制：上锁的门、不平坦的步道、陡峭的台阶，以及需要许可或帮助才能外出。
我们提供了新的证据表明，进入户外空间可以预测养老院老年人的抑郁症状。旨在增加进入户外空间机会的干预措施可能会对老年人的抑郁症状产生积极影响。
