Xu Richard Huan, Zhou Ling-Ming, Wong Eliza Lai-Yi, Chang Jinghui, Wang Dong
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Front Psychiatry. 2022 Mar 9;13:751412. doi: 10.3389/fpsyt.2022.751412. eCollection 2022.
Depression is common among hospitalized patients and poses a significant threat to their quality of life. Patient engagement (PE) in healthcare has been shown to be associated with positive health outcomes. However, the relationship between PE and depression among hospitalized patients, with and without chronic conditions, has not yet been explored. This study aimed to investigate the association between patients' satisfaction with PE and self-reported depression in Chinese public hospitals.
A multi-centered, cross-sectional survey was conducted in seven tertiary-level public hospitals in Guangdong province, China. Twelve items from a patient-centered care questionnaire and the Patient Health Questionnaire 2-item version were used were used to assess patients' satisfaction with PE and self-reported depression, respectively. Propensity score matching (PSM) approach was used to reduce selection bias and potential baseline differences between patients with and without chronic conditions. The relationship between satisfaction with PE and depression was assessed, using univariate and multivariate logistic regression analyses, respectively.
A total of 1,974 hospitalized patients participated in the survey. After the PSM procedure, 604 patients were assigned to the chronic condition group, and another 604 patients were successfully matched in the comparison group with no differences in sex, age, educational level, and PE-related characteristics. Univariate logistic regression analysis indicated that high satisfaction with PE-related approaches significantly decreased the probability of developing depressive status. Multivariate logistic regression analysis further indicated that, after adjusting all PE-related approaches, "patient education" and "involvement in discharge planning" could significantly decrease the probability of patients developing depression.
Our results indicate that encouraging PE and improving patients' satisfaction with PE interventions in clinical practice led to improved mental health outcomes among hospitalized patients in China.
抑郁症在住院患者中很常见，对他们的生活质量构成重大威胁。医疗保健中的患者参与度（PE）已被证明与积极的健康结果相关。然而，患有和未患有慢性病的住院患者中，PE与抑郁症之间的关系尚未得到探讨。本研究旨在调查中国公立医院患者对PE的满意度与自我报告的抑郁症之间的关联。
在中国广东省的七家三级公立医院进行了一项多中心横断面调查。分别使用以患者为中心的护理问卷中的12个项目和患者健康问卷2项版本来评估患者对PE的满意度和自我报告的抑郁症。采用倾向得分匹配（PSM）方法来减少患有和未患有慢性病患者之间的选择偏倚和潜在基线差异。分别使用单变量和多变量逻辑回归分析评估对PE的满意度与抑郁症之间的关系。
共有1974名住院患者参与了调查。经过PSM程序后，604名患者被分配到慢性病组，另外604名患者在对照组中成功匹配，在性别、年龄、教育水平和与PE相关的特征方面没有差异。单变量逻辑回归分析表明，对与PE相关方法的高满意度显著降低了出现抑郁状态的概率。多变量逻辑回归分析进一步表明，在调整所有与PE相关的方法后，“患者教育”和“参与出院计划”可显著降低患者患抑郁症的概率。
我们的结果表明，在临床实践中鼓励PE并提高患者对PE干预的满意度可改善中国住院患者的心理健康结果。
