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中国癌症女性患者抑郁状况的变化及影响因素研究:基于中国健康与养老追踪调查(CHARLS)面板数据的分析

Study on the changes and influencing factors of depression in Chinese women with cancer: an analysis based on CHARLS panel data.

作者信息

Wang Na, Chang Mengran, Liu Shidong, Chen Bing

机构信息

Gynecology Department, First Affiliated Hospital of Bengbu Medical University, Bengbu, China.

China Cooperative Research Institute, Anhui University of Finance and Economic, Bengbu, China.

出版信息

Front Public Health. 2025 Jan 16;12:1485196. doi: 10.3389/fpubh.2024.1485196. eCollection 2024.

DOI:10.3389/fpubh.2024.1485196
PMID:39886394
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11780894/
Abstract

BACKGROUND

The social problems caused by depressive disorders and psychological behaviors in women are increasingly prominent, with extreme incidents occurring from time to time. Therefore, the issue concerning "how to prevent and resolve the risk of depression in women" is gaining significant attention across various sectors. However, previous studies have largely focused on teenage girls, perimenopausal women, or women during pregnancy and the postpartum period, neglecting the adverse effects of major diseases, which is detrimental to enhancing the psychological well-being of women with cancer.

OBJECTIVE

Based on cancer impacts, this study aims to clarify the depressive state, development trends, and influencing factors in Chinese women with cancer, a group particularly susceptible to depression, to provide decision-making references for improving their psychological well-being.

METHODS

Using follow-up panel data from five waves of China Health and Retirement Longitudinal Study (CHARLS), Chinese women with cancer who had complete observed values were selected as research subjects. After data cleaning, a balanced short panel dataset containing 1,030 samples was obtained. The depression characteristics and development trends in women with cancer were analyzed using the panel statistical method, and the influence of socio-demographic factors was examined using a panel stochastic trend model.

RESULTS

The overall depression of Chinese women with cancer has deteriorated, putting them at risk of moderate depressive disorder. The development trend shows an inverted "U" curve, with significant differences observed among various groups based on urban and rural residency, educational levels, and regional locations. Specifically, urban women with cancer show milder depressive symptoms than those in rural areas, and women in the eastern region, those with higher educational levels, and those with non-reproductive system cancers show milder depressive symptoms than those in the central and western regions, those with lower educational levels, and those with reproductive system cancers. Regression analysis indicates that socio-demographic factors significantly influence depression in women with cancer. Among these influencing factors, age, having a spouse, high educational level, good performance in the activity of daily living (ADL), frequent visits to neighbors, and regular exercise are protective factors against depression, while diabetes, dyslipidemia, frequent outpatient visits, frequent hospitalizations, smoking, and low life satisfaction are risk factors for depression.

CONCLUSION

The depressive state among Chinese women with cancer is alarming. In view of this, there is an urgent need for introducing more supportive policies aimed at improving psychological health, developing tailored measures to address the specific needs of different groups, intensifying efforts to standardize the diagnosis and treatment of depression, particularly for those in rural areas, central and western regions, and among individuals with lower educational levels. Additionally, the role of social participation activities, such as visiting neighbors and exercising, should be given full play to alleviate depressive symptoms.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecaf/11780894/ace972c7d5fe/fpubh-12-1485196-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecaf/11780894/ace972c7d5fe/fpubh-12-1485196-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecaf/11780894/ace972c7d5fe/fpubh-12-1485196-g001.jpg
摘要

背景

女性抑郁症及心理行为引发的社会问题日益突出,极端事件时有发生。因此,“如何预防和化解女性抑郁风险”问题受到各界广泛关注。然而,以往研究多聚焦于少女、围绝经期女性或孕期及产后女性,忽视了重大疾病的不利影响,不利于提升癌症女性的心理健康水平。

目的

基于癌症影响,本研究旨在明确中国癌症女性这一特别易患抑郁症群体的抑郁状态、发展趋势及影响因素,为改善其心理健康提供决策参考。

方法

利用中国健康与养老追踪调查(CHARLS)五轮追踪面板数据,选取有完整观测值的中国癌症女性作为研究对象。经过数据清理,获得包含1030个样本的平衡短面板数据集。采用面板统计方法分析癌症女性的抑郁特征及发展趋势,运用面板随机趋势模型考察社会人口学因素的影响。

结果

中国癌症女性总体抑郁状况恶化,存在中度抑郁障碍风险。发展趋势呈倒“U”形曲线,在城乡居住、教育水平和地区位置等不同群体间存在显著差异。具体而言,城市癌症女性抑郁症状较农村女性轻,东部地区女性、教育水平较高女性以及非生殖系统癌症女性的抑郁症状较中部和西部地区女性、教育水平较低女性以及生殖系统癌症女性轻。回归分析表明,社会人口学因素对癌症女性抑郁有显著影响。在这些影响因素中,年龄、有配偶、高教育水平、日常生活活动能力良好(ADL)、经常走访邻居和经常锻炼是预防抑郁的保护因素,而糖尿病、血脂异常、频繁门诊就诊、频繁住院、吸烟和低生活满意度是抑郁的危险因素。

结论

中国癌症女性的抑郁状态令人担忧。鉴于此,迫切需要出台更多旨在改善心理健康的支持性政策,制定针对不同群体特殊需求的针对性措施,加大力度规范抑郁症的诊断和治疗,特别是针对农村地区、中西部地区以及教育水平较低人群。此外,应充分发挥走访邻居和锻炼等社会参与活动在缓解抑郁症状方面的作用。

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