Dong XinQi, Bergren Stephanie, Simon Melissa A
Chinese Health, Aging, and Policy Program, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois.
Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
J Gerontol A Biol Sci Med Sci. 2017 Jul 1;72(suppl_1):S125-S130. doi: 10.1093/gerona/glx036.
Depression is a major public health concern among older adults and health care professionals play a vital role in screening and treatment. However, this process may be impeded by issues like lack of trust in physician (TIP). This study aims to examine the cross-sectional and longitudinal relationships between TIP and depressive symptoms among Chinese older adults in the Chicago area.
Data were collected through the Population Study of Chinese Elderly (PINE), a longitudinal cohort study of Chinese older adults in the greater Chicago area. A total of 2,713 Chinese older adults completed both waves of data collection. TIP was measured through the Trust in Physician scale from Anderson and Dedrick (Anderson LA, Dedrick RF. Development of the Trust in Physician scale: a measure to assess interpersonal trust in patient-physician relationships. Psychol Rep. 1990;67(3 Pt 2):1091-1100. doi:10.2466/pr0.1990.67.3f.1091) (range: 11-55). Depressive symptoms were measured through Patient Health Questionnaire-9.
Every one point higher in TIP is associated with being 2% less likely to have any depressive symptoms (odds ratio [OR] 0.98, 0.97-0.99) in cross-sectional analysis. Longitudinally, every one-point increase in TIP score was associated with a 2% lower risk of depressive symptoms at Wave 2 (OR 0.98, 0.97-0.99). Improved TIP over 2 years was associated with 25% decreased risk of having any depressive symptoms at Wave 2 (OR 0.75, 0.63-0.89). Additionally, highest tertile of TIP change was associated with a 31% decreased risk of any depressive symptoms compared to lowest tertile (OR 0.68, 0.55-0.84).
Improved TIP over 2 years is associated with less risk of experiencing depressive symptoms. Future research should examine possible pathways and routes of intervention to improve mental health among older adults.
抑郁症是老年人主要的公共卫生问题，医疗保健专业人员在筛查和治疗中发挥着至关重要的作用。然而，这个过程可能会受到诸如对医生缺乏信任（TIP）等问题的阻碍。本研究旨在探讨芝加哥地区中国老年人中TIP与抑郁症状之间的横断面和纵向关系。
数据通过中国老年人队列研究（PINE）收集，这是一项对大芝加哥地区中国老年人进行的纵向队列研究。共有2713名中国老年人完成了两波数据收集。TIP通过安德森和德德里克的医生信任量表进行测量（安德森LA，德德里克RF。医生信任量表的编制：一种评估医患关系中人际信任的测量方法。心理报告。1990；67(3 Pt 2):1091-1100。doi:10.2466/pr0.1990.67.3f.1091）（范围：11 - 55）。抑郁症状通过患者健康问卷-9进行测量。
在横断面分析中，TIP每升高1分，出现任何抑郁症状的可能性降低2%（优势比[OR]0.98，0.97 - 0.99）。纵向来看，TIP得分每增加1分与第2波时抑郁症状风险降低2%相关（OR 0.98，0.97 - 0.99）。2年内TIP的改善与第2波时出现任何抑郁症状的风险降低25%相关（OR 0.75，0.63 - 0.89）。此外，与最低三分位数相比，TIP变化的最高三分位数与任何抑郁症状的风险降低31%相关（OR 0.68，0.55 - 0.84）。
2年内TIP的改善与出现抑郁症状的风险降低相关。未来的研究应探讨改善老年人心理健康的可能途径和干预路线。
