Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, New York, USA.
Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, USA.
J Aging Soc Policy. 2019 Jan-Feb;31(1):30-48. doi: 10.1080/08959420.2018.1485394. Epub 2018 Jul 12.
This study aimed to examine racial and ethnic differences in significant depressive symptoms among long-term nursing home residents. We analyzed the 2014 national Minimum Data Set linked to a nursing home file and estimated multivariable logistic regressions to determine the associations of race and ethnicities with significant depressive symptoms (score ≥ 10 on the 9-item Patient Health Questionnaire [PHQ-9] scale) and whether associations were explained by resident and nursing home covariates. Stratified analyses further determined independent associations in subgroups of residents. We found that the prevalence rate of PHQ-9 scores ≥ 10 was 8.8% among non-Hispanic White residents ( = 653,031) and 7.4%, 6.9%, and 6.6% among Black ( = 97,629), Hispanic ( = 39,752), and Asian ( = 16,636) residents, respectively. The reduced likelihoods of significant depressive symptoms for minority residents compared to non-Hispanic Whites persisted after sequential adjustments for resident and nursing home covariates, as well as in stratified analyses. The persistently lower rate of significant depressive symptoms among racial and ethnic minority residents suggests that training of nursing home caregivers for culturally sensitive depression screening is needed for improved symptom recognition among minority residents.
本研究旨在探讨长期居住在养老院的居民中，种族和民族差异与重度抑郁症状之间的关系。我们分析了 2014 年全国最小数据集与养老院档案的关联，并估计了多变量逻辑回归，以确定种族和民族与重度抑郁症状（9 项患者健康问卷 [PHQ-9] 量表得分≥10）之间的关联，以及这些关联是否可以通过居民和养老院协变量来解释。分层分析进一步确定了居民亚组中独立的关联。我们发现，非西班牙裔白人居民中 PHQ-9 得分≥10 的患病率为 8.8%（=653031 人），黑人（=97629 人）、西班牙裔（=39752 人）和亚裔（=16636 人）居民的患病率分别为 7.4%、6.9%和 6.6%。与非西班牙裔白人居民相比，少数族裔居民出现重度抑郁症状的可能性较低，这种关联在对居民和养老院协变量进行连续调整后仍然存在，并且在分层分析中也是如此。少数族裔居民中重度抑郁症状的持续较低发生率表明，需要对养老院护理人员进行文化敏感性抑郁筛查培训，以提高少数族裔居民的症状识别能力。
