2017年埃塞俄比亚西北部心脏随访诊所心力衰竭患者抑郁相关因素：一项横断面研究
Factors Associated with Depression among Heart Failure Patients at Cardiac Follow-Up Clinics in Northwest Ethiopia, 2017: A Cross-Sectional Study.
作者信息
Yazew Kassahun Gebeyehu, Beshah Debrework Tesgera, Salih Mohammed Hassen, Zeleke Tadele Amare
机构信息
Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Department of Surgical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
出版信息
Psychiatry J. 2019 Jul 21;2019:6892623. doi: 10.1155/2019/6892623. eCollection 2019.
BACKGROUND
Depression is a comorbid disorder in patients with heart failure and it is a major public health problem worldwide. Little is known about the depression among heart failure patients in low-income countries, while, in Ethiopia, none was studied.
OBJECTIVE
This study is to assess the prevalence of depression and associated factors among heart failure patients at cardiac follow-up clinics at Amhara Region Referral Hospitals, Northwest Ethiopia, 2017.
METHODS
A hospital based cross-sectional study was conducted between March 30, 2017, and May 15, 2017, G.C., by using a systematic random sampling technique to select 422 of 1395 HF patients. Structured interviewer-administered questionnaires and patient card review with a checklist that incorporates the PHQ-9 tool for depression measurement were used. The collected data were checked, coded, and entered into Epi-info version 7 and exported to SPSS version 20. Bivariate logistic regression at p-value <0.2 was exported to multivariate logistic regressions and p-value <0.05 was considered statistically significant.
RESULTS
A total of 403 were included with a response rate of 95.5%. Among the participants, 51.1% had depressive symptoms. Factors associated with depressive symptoms were poor self-care behavior 1.60 [AOR (95% CI=1.01, 2.55)], poor social support 1.90 [AOR (95% CI=1.16, 3.12)], being female 2.70 [AOR (95% CI=1.44, 5.07)], current smoking history 4.96 [AOR (95% CI=1.54, 15.98)], and duration of heart failure (>1 year) 1.64 [AOR (95% CI=1.04, 2.59)].
CONCLUSIONS
Around half of the patients were depressive. The patients who had poor self-care behavior, were females, had poor social support, had a current history of smoking, and had duration of chronic heart failure >1 year need special attention. Therefore, all referral hospitals need efforts to focus on those problems and target improvements of depressive symptoms.
背景
抑郁症是心力衰竭患者的一种共病性疾病，是全球范围内的一个主要公共卫生问题。在低收入国家，关于心力衰竭患者中的抑郁症情况知之甚少，而在埃塞俄比亚，尚无相关研究。
目的
本研究旨在评估2017年埃塞俄比亚西北部阿姆哈拉地区转诊医院心脏随访诊所中心力衰竭患者的抑郁症患病率及相关因素。
方法
在2017年3月30日至2017年5月15日（埃塞俄比亚历）期间进行了一项基于医院的横断面研究，采用系统随机抽样技术从1395名心力衰竭患者中选取422名。使用由访谈员管理的结构化问卷以及结合用于抑郁症测量的PHQ - 9工具的清单进行患者病历审查。对收集到的数据进行检查、编码，并录入Epi - info 7版本，然后导出到SPSS 20版本。p值<0.2的二元逻辑回归被纳入多元逻辑回归，p值<0.05被认为具有统计学意义。
结果
共纳入403名患者，应答率为95.5%。在参与者中，51.1%有抑郁症状。与抑郁症状相关的因素包括自我护理行为差1.60 [调整后比值比（AOR）（95%置信区间=1.01，2.55）]、社会支持差1.90 [AOR（95%置信区间=1.16，3.12）]、女性2.70 [AOR（95%置信区间=1.44，5.07）]、当前吸烟史4.96 [AOR（95%置信区间=1.54，15.98）]以及心力衰竭病程（>1年）1.64 [AOR（95%置信区间=1.04，2.59）]。
结论
约一半的患者患有抑郁症。自我护理行为差、女性、社会支持差、有当前吸烟史以及慢性心力衰竭病程>1年的患者需要特别关注。因此，所有转诊医院需要努力关注这些问题并致力于改善抑郁症状。
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