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[按残疾程度划分的心理健康与健康意识梯度——德国具有代表性的GEDA调查结果]

[Gradients in Mental Health and Health Consciousness by the Degree of Disabilities - Results from representative GEDA-Survey in Germany].

作者信息

Rathmann Katharina, Nellen Cosima, Wetzel Lorena Denise

机构信息

Fachbereich Pflege und Gesundheit, Hochschule Fulda.

Qualitative Forschungsmethoden und strategische Kommunikation für Gesundheit, Inklusion und Teilhabe, Technische Universität Dortmund.

出版信息

Rehabilitation (Stuttg). 2020 Aug;59(4):223-230. doi: 10.1055/a-1119-2905. Epub 2020 Aug 26.

Abstract

PURPOSE

People with disabilities belong to a vulnerable population group, especially with regard to their economic and health situation. In the social-epidemiological research, hardly any studies on mental health and health awareness among people with disabilities are available using representative data, in particular not differentiated according to their degree of disability (DoD). Therefore, the aim of this study is to investigate 1) differences in mental health and health awareness between people with disabilities compared to people without disabilities. In addition, the study 2) shows differences mental health outcomes and health awareness, differentiated according to the DoD.

METHODS

Data is used from the representative study "Gesundheit in Deutschland Aktuell (GEDA) 2012" (N=19,294). Outcomes were self-reported health, health awareness, depression or depressive mood, mental discomfort, vitality and psychological well-being. The exposure variable used was the recognized disability (DoD≥50 vs. DoD<50 vs. no disability). Univariate and bivariate analyses were conducted using cross-tables and multivariate analyses using binary logistic regression models, controlled for socio-demographic, economic and health-related features.

RESULTS

People with disabilities often rate their mental health worse than people without disabilities. The bi- and multivariate analyses revealed a disability-specific gradient for all outcome measures according to the DoD (p<0,001). People with disabilities had a significantly higher likelihood of poor mental health compared to people without disabilities. People with severe disabilities (DoD≥50) had a more than 4,6-fold increased likelihood risk of poor self-reported health and 2,5-fold likelihood of depression or depressed mood compared to people without disabilities. A high level of health awareness was more prevalent in PWD than in those without disabilities.

CONCLUSION

The study highlights that People with disabilities more frequently reported mental health problems than people without disabilities. Targeted measures are necessary, which address in particular the target group of the people with disabilities. There is further need to strengthen access to health services and programs, assistive technologies and support services, and to make health of people with disabilities to the subject of research and health promotion in line with the WHO Action Plan on "Better health for all people with disabilities" (2014-2021).

摘要

目的

残疾人属于弱势群体,尤其是在经济和健康状况方面。在社会流行病学研究中,几乎没有使用代表性数据对残疾人的心理健康和健康意识进行的研究,特别是没有根据残疾程度(DoD)进行区分。因此,本研究的目的是调查:1)残疾人和非残疾人在心理健康和健康意识方面的差异。此外,该研究2)显示了根据残疾程度区分的心理健康结果和健康意识的差异。

方法

使用代表性研究“2012年德国当前健康状况(GEDA)”(N = 19,294)的数据。结果包括自我报告的健康状况、健康意识、抑郁或抑郁情绪、心理不适、活力和心理健康。使用的暴露变量是已确认的残疾(DoD≥50与DoD<50与无残疾)。使用交叉表进行单变量和双变量分析,并使用二元逻辑回归模型进行多变量分析,同时控制社会人口统计学、经济和健康相关特征。

结果

残疾人对其心理健康的评价往往比非残疾人差。双变量和多变量分析显示,根据残疾程度,所有结果指标都存在特定于残疾的梯度(p<0.001)。与非残疾人相比,残疾人心理健康状况不佳的可能性显著更高。与非残疾人相比,重度残疾人(DoD≥50)自我报告健康状况不佳的风险增加了4.6倍以上,抑郁或抑郁情绪的可能性增加了2.5倍。残疾人中健康意识水平高的情况比非残疾人更普遍。

结论

该研究强调,残疾人比非残疾人更频繁地报告心理健康问题。需要采取有针对性的措施,特别是针对残疾人这一目标群体。进一步需要加强获得卫生服务和项目、辅助技术和支持服务的机会,并使残疾人的健康成为符合世界卫生组织“为所有残疾人实现更健康生活”行动计划(2014 - 2021年)的研究和健康促进主题。

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