Kim Mina, Lee Young-Hoon
Department of Nursing, Graduate School, Chonnam National University, Gwangju, Korea.
Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
Chonnam Med J. 2021 May;57(2):118-125. doi: 10.4068/cmj.2021.57.2.118. Epub 2021 May 24.
This study aimed to identify and assess the differences in psychological health problems between families living with stroke survivors (FwSS) and the general population without stroke families (GwoSF). A total of 4,514 cases of FwSS were selected for analysis from the 2013 Korea Community Health Survey. In order to determine control groups in GwoSF, propensity scores were generated based on the sociodemographic characteristics of age, gender, residential region, marital status, educational level, monthly household income, and employment status. Each FwSS was matched to 3 controls of GwoSF (13,542 controls) using a greedy matching algorithm with 8 to 1 digit matching. After propensity score-matching, the proportion of usual stress (30.2% vs 24.6%), depressive mood (7.1% vs 6.1%), and suicidal ideation (13.0% vs 11.1%) in FwSS were all significantly higher than those in GwoSF (<0.05). Compared to GwoSF, the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for psychological health problems in FwSS were calculated using multiple logistic regression analysis. The aORs for usual stress (aOR 1.32, 95% CI 1.21-1.42), depressive mood (aOR 1.14, 95% CI 0.99-1.31; borderline significance), and suicidal ideation (aOR 1.17, 95% CI 1.05-1.30) were significantly higher among FwSS than GwoSF. Moreover, the psychological health problems of FwSS were more evident in females than in males. This study shows that FwSS have poorer psychological health outcomes than GwoSF with similar sociodemographic characteristics. Community-based strategies and family support programs, especially for female family members of stroke survivors, are essential to improve the psychological health of stroke families.
本研究旨在识别和评估中风幸存者家庭（FwSS）与无中风家庭的普通人群（GwoSF）在心理健康问题上的差异。从2013年韩国社区健康调查中选取了4514例FwSS进行分析。为了确定GwoSF中的对照组，根据年龄、性别、居住地区、婚姻状况、教育水平、家庭月收入和就业状况等社会人口学特征生成倾向得分。使用贪婪匹配算法，以8到1位数字匹配，将每个FwSS与3名GwoSF对照（13542名对照）进行匹配。倾向得分匹配后，FwSS中经常感到压力（30.2%对24.6%）、抑郁情绪（7.1%对6.1%）和自杀意念（13.0%对11.1%）的比例均显著高于GwoSF（<0.05）。与GwoSF相比，使用多元逻辑回归分析计算FwSS心理健康问题的调整优势比（aORs）及其95%置信区间（CIs）。FwSS中经常感到压力（aOR 1.32，95%CI 1.21 - 1.42）、抑郁情绪（aOR 1.14，95%CI 0.99 - 1.31；临界显著性）和自杀意念（aOR 1.17，95%CI 1.05 - 1.30）的aORs显著高于GwoSF。此外，FwSS的心理健康问题在女性中比在男性中更明显。本研究表明，具有相似社会人口学特征的FwSS的心理健康状况比GwoSF更差。基于社区的策略和家庭支持项目，特别是针对中风幸存者的女性家庭成员，对于改善中风家庭的心理健康至关重要。
