在 COVID-19 大流行期间成年人的抑郁和焦虑症状以及未满足的医疗保健需求：来自加拿大老龄化纵向研究的横断面研究。
Symptoms of depression and anxiety, and unmet healthcare needs in adults during the COVID-19 pandemic: a cross-sectional study from the Canadian Longitudinal Study on Aging.
机构信息
Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St. West, Hamilton, Ontario, L8S 4L8, Canada.
Applied Research Division, Center for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, K0A 0K9, Canada.
出版信息
BMC Public Health. 2022 Dec 1;22(1):2242. doi: 10.1186/s12889-022-14633-4.
BACKGROUND
The COVID-19 pandemic disrupted access to healthcare services in Canada. Research prior to the pandemic has found that depression and anxiety symptoms were associated with increased unmet healthcare needs. The primary objective of this study was to examine if mental health was associated with perceived access to healthcare during the pandemic METHODS: A cross-sectional study was conducted using data from 23,972 participants (aged 50-96) in the Canadian Longitudinal Study on Aging COVID-19 Exit Survey (Sept-Dec 2020). We used logistic regression to estimate how the presence of depression and anxiety symptoms, defined using scores of ≥10 on the Center for Epidemiologic Studies Depression Scale and ≥10 on the Generalized Anxiety Disorder Scale, were associated with the odds of reporting: 1) challenges accessing healthcare, 2) not going to a hospital or seeing a doctor when needed, 3) experiencing barriers to COVID-19 testing. Models were adjusted for sex, age, region, urban/rural residence, racial background, immigrant status, income, marital status, work status, chronic conditions, and pre-pandemic unmet needs.
RESULTS
The presence of depressive (aOR=1.96; 95% CI=1.82, 2.11) and anxiety symptoms (aOR=2.33; 95% CI=2.04, 2.66) compared to the absence of these symptoms were independently associated with higher odds of challenges accessing healthcare. A statistically significant interaction with sex suggested stronger associations in females with anxiety. Symptoms of depression (aOR=2.88; 95% CI=2.58, 3.21) and anxiety (aOR=3.05; 95% CI=2.58, 3.60) were also associated with increased odds of not going to a hospital or seeing a doctor when needed. Lastly, depressive (aOR=1.99; 95% CI=1.71, 2.31) and anxiety symptoms (aOR=2.01; 95% CI=1.58, 2.56) were associated with higher odds of reporting barriers to COVID-19 testing. There was no significantly significant interaction with sex for the latter two outcomes.
CONCLUSION
The presence of depression and anxiety symptoms were strongly associated with perceived unmet healthcare needs during the COVID-19 pandemic. Interventions to improve healthcare access for adults with depression and anxiety during the pandemic may be necessary.
背景
COVID-19 大流行扰乱了加拿大的医疗服务获取。大流行前的研究发现，抑郁和焦虑症状与未满足的医疗需求增加有关。本研究的主要目的是研究在大流行期间心理健康是否与感知到的医疗保健机会相关。
方法
使用 2020 年 9 月至 12 月加拿大老龄化纵向研究 COVID-19 退出调查（23972 名参与者，年龄在 50-96 岁）中的数据进行了一项横断面研究。我们使用逻辑回归来估计抑郁和焦虑症状（使用流行病学研究中心抑郁量表得分≥10 和广泛性焦虑障碍量表得分≥10 定义）的存在与报告以下情况的几率之间的关联：1）获取医疗保健的挑战，2）在需要时不去医院或看医生，3）在 COVID-19 检测中遇到障碍。模型调整了性别、年龄、地区、城乡居住、种族背景、移民身份、收入、婚姻状况、工作状况、慢性疾病和大流行前未满足的需求。
结果
与不存在这些症状相比，存在抑郁（调整后的优势比[aOR]=1.96；95%置信区间[CI]=1.82，2.11）和焦虑症状（aOR=2.33；95%CI=2.04，2.66）与获得医疗保健的机会更高的几率独立相关。与性别存在统计学显著交互作用，表明女性的焦虑症状相关性更强。抑郁症状（aOR=2.88；95%CI=2.58，3.21）和焦虑症状（aOR=3.05；95%CI=2.58，3.60）也与需要时不去医院或看医生的几率增加有关。最后，抑郁（aOR=1.99；95%CI=1.71，2.31）和焦虑症状（aOR=2.01；95%CI=1.58，2.56）与报告 COVID-19 检测障碍的几率更高相关。后两个结果与性别之间没有显著的交互作用。
结论
抑郁和焦虑症状的存在与 COVID-19 大流行期间感知到的未满足的医疗保健需求密切相关。在大流行期间，可能需要采取干预措施来改善患有抑郁和焦虑症的成年人的医疗保健机会。
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