Angevaare Milou J, van Hout Hein P J, Smalbrugge Martin, Blankenstein Annette H, Hertogh Cees M P M, Twisk Jos W R, Joling Karlijn J
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
Front Psychiatry. 2022 Apr 4;13:811252. doi: 10.3389/fpsyt.2022.811252. eCollection 2022.
Resilience incorporates the presence of a positive response to some type of stressor. To properly explore resilience, it is important to systematically identify relevant stressors. We aimed to identify (combinations of) stressors with the strongest relationship with observer-reported and self-reported mood outcomes in older residents of long-term care facilities (LTCFs) in The Netherlands.
We included 4,499 older (≥60) residents of 40 LTCFs who participated in the Dutch InterRAI-LTCF cohort between 2005 and 2018. The association of possible stressors (single stressors, number of stressors, and combinations of two stressors) in this population with observer-reported (Depression Rating Scale) and self-reported mood outcomes was analyzed using multilevel tobit models and logistic regressions.
Major life stressor ["experiences that (threatened to) disrupt(ed) a person's daily routine and imposed some degree of readjustment"] and conflict with other care recipients and/or staff were most strongly associated with both mood outcomes. Furthermore, conflict was a particularly prevalent stressor (24%). Falls, fractures, and hospital visits were more weakly or not associated at all. Overall, the associations were similar for the mood outcomes based on observer-report and self-report, although there were some differences. Multiple stressors were more strongly associated with both mood outcomes than one stressor.
Major life stressor and conflict emerged as important stressors for resilience research within the psychological domain in LTCF residents. Further (longitudinal) research is necessary to determine the directionality and relevance of the strong association of conflict with mood for LTCF practice.
心理韧性包含对某种类型压力源的积极反应。为了恰当地探究心理韧性，系统地识别相关压力源很重要。我们旨在识别与荷兰长期护理机构（LTCF）老年居民中观察者报告和自我报告的情绪结果关系最密切的压力源（组合）。
我们纳入了40所LTCF的4499名年龄≥60岁的老年居民，他们在2005年至2018年期间参与了荷兰InterRAI-LTCF队列研究。使用多水平 Tobit 模型和逻辑回归分析了该人群中可能的压力源（单一压力源、压力源数量以及两种压力源的组合）与观察者报告（抑郁评定量表）和自我报告的情绪结果之间的关联。
重大生活压力源[“那些（有可能）扰乱一个人的日常生活并需要一定程度重新调整的经历”]以及与其他护理对象和/或工作人员的冲突与两种情绪结果的关联最为密切。此外，冲突是一种特别普遍的压力源（24%）。跌倒、骨折和住院就诊的关联较弱或根本没有关联。总体而言，基于观察者报告和自我报告的情绪结果的关联相似，尽管存在一些差异。多种压力源与两种情绪结果的关联比单一压力源更强。
重大生活压力源和冲突成为LTCF居民心理领域心理韧性研究的重要压力源。有必要进行进一步的（纵向）研究，以确定冲突与情绪的强关联对LTCF实践的方向性和相关性。
