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住院痴呆老年患者互动与抑郁症状的性别差异

Gender differences in interactions and depressive symptoms among hospitalized older patients living with dementia.

作者信息

Paudel Anju, Ann Mogle Jacqueline, Kuzmik Ashley, Resnick Barbara, BeLue Rhonda, Galik Elizabeth, Liu Wen, Behrens Liza, Jao Ying-Ling, Boltz Marie

机构信息

Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA.

Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA.

出版信息

J Women Aging. 2023 Sep-Oct;35(5):476-486. doi: 10.1080/08952841.2022.2146972. Epub 2022 Nov 26.

Abstract

Alzheimer's disease or a related dementia (ADRD) disproportionately affects women with two-thirds of individuals with ADRD comprised of women. This study examined gender-related differences in the quality of staff-patient interactions and depressive symptoms among hospitalized older patients living with dementia. This secondary analysis utilized baseline data of 140 hospitalized older patients with dementia who participated in the final cohort of a randomized controlled trial (ClinicalTrials.gov identifier: NCT03046121) implementing Family centered Function-focused Care (Fam-FFC). On average, the participants (male = 46.1%, female = 52.9%) were 81.43 years old ( = 8.29), had positive interactions with staff and lower depressive symptoms based on Quality of Interaction Schedule (QUIS) scores and Cornell Scale for Depression in Dementia (CSDD) scores, respectively. Although males had more positive interactions (male = 6.06,  = 1.13; female = 5.59,  = 1.51) and lesser depressive symptoms (male = 7.52,  = 4.77; female = 8.03,  = 6.25) than females, no statistically significant gender differences were observed in linear models with appropriate covariates or multivariant analysis of covariant (MANCOVA). However, the multigroup regression conducted to further probe marginally significant moderation effect of gender and pain on staff-patient interactions demonstrated that greater pain was significantly related to lower quality or less positive staff-patient interactions for females compared to males ( (1) = 4.84, = .03). Continued evaluation of gender differences is warranted to inform care delivery and interventions to improve care for hospitalized older patients with dementia.

摘要

阿尔茨海默病或相关痴呆症(ADRD)对女性的影响尤为严重,患ADRD的个体中有三分之二为女性。本研究调查了住院痴呆老年患者中,医护人员与患者互动质量及抑郁症状方面的性别差异。这项二次分析利用了140名住院痴呆老年患者的基线数据,这些患者参与了一项实施以家庭为中心的功能聚焦护理(Fam-FFC)的随机对照试验的最终队列研究(ClinicalTrials.gov标识符:NCT03046121)。参与者平均年龄为81.43岁(标准差=8.29),男性占46.1%,女性占52.9%,根据互动质量量表(QUIS)得分和康奈尔痴呆抑郁量表(CSDD)得分,他们与医护人员有积极互动且抑郁症状较轻。尽管男性的互动更积极(男性=6.06,标准差=1.13;女性=5.59,标准差=1.51),抑郁症状也比女性少(男性=7.52,标准差=4.77;女性=8.03,标准差=6.25),但在包含适当协变量的线性模型或协变量多变量分析(MANCOVA)中,未观察到显著的性别差异。然而,为进一步探究性别和疼痛对医护人员与患者互动的边际显著调节作用而进行的多组回归分析表明,与男性相比,女性中更大的疼痛与更低质量或更不积极的医护人员与患者互动显著相关(F(1)=4.84,p=.03)。有必要持续评估性别差异,以为改善住院痴呆老年患者护理的护理提供和干预措施提供依据。

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