Hammar Isabelle Ottenvall, Berglund Helene, Dahlin-Ivanoff Synneve, Faronbi Joel, Gustafsson Susanne
The Frail Elderly Research Support Group, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
The Gothenburg University Centre for Ageing and Health, Gothenburg, Sweden.
Health Psychol Res. 2018 Nov 29;6(1):7577. doi: 10.4081/hpr.2018.7577. eCollection 2018 May 8.
Exercising self-determination in daily life is highly valued by older people. However, being in the hands of other people may challenge the older people's possibilities to exercise self-determination in their daily life. Among frail older people living in Sweden, risk for depression is highly predominant. There is a knowledge gap regarding if, and how having a risk of depression affects older people's self-determination. The objective was, therefore, to explore if, and in that case how, frail older people's self-determination is affected by the risk of depression. In this cross-sectional, secondary data analysis, with 161 communitydwelling frail older people, simple logistic regression models were performed to explore the association between self-determination, the risk of depression and demographic variables. The findings showed that risk for depression and reduced self-determination were significantly associated in the dimensions: use of time (P=0.020), social relationship (P=0.003), help and support others (P=0.033), and the overall self-determination item (P=0.000). Risk for depression significantly affected self-determination in use of time (OR=3.04, P=0.014), social relationship (OR=2.53, P=0.011), and overall self-determination (OR=6.17, P0.000). This point out an increased need of strengthening healthcare professionals' perspectives, and attitudes towards a self-determined, friendly, and person-centred dialogue.
在日常生活中行使自主决定权受到老年人的高度重视。然而,处于他人掌控之下可能会挑战老年人在日常生活中行使自主决定权的可能性。在瑞典生活的体弱老年人中,抑郁症风险非常普遍。关于抑郁症风险是否以及如何影响老年人的自主决定权,存在知识空白。因此,本研究的目的是探讨体弱老年人的自主决定权是否以及在何种情况下会受到抑郁症风险的影响。在这项横断面二次数据分析中,研究对象为161名居住在社区的体弱老年人,采用简单逻辑回归模型来探讨自主决定权、抑郁症风险与人口统计学变量之间的关联。研究结果表明,在时间利用(P = 0.020)、社会关系(P = 0.003)、帮助和支持他人(P = 0.033)以及总体自主决定权项目(P = 0.000)等维度上,抑郁症风险与自主决定权降低显著相关。抑郁症风险在时间利用(OR = 3.04,P = 0.014)、社会关系(OR = 2.53,P = 0.011)和总体自主决定权(OR = 6.17,P = 0.000)方面对自主决定权有显著影响。这表明,越来越需要强化医护人员对于自主、友好和以患者为中心对话的认知和态度。