生活事件在老年抑郁症与慢性躯体疾病之间的中介效应及护理对策

Mediating effect of life events between elderly depression and chronic somatic disease and thieir nursing countermeasures

[目的]探讨生活事件在老年抑郁症与慢性躯体疾病之间的解释作用。[方法]采用方便抽样方法抽取十堰市4个社区500名老年人,采用老年精神状况量表(GMS)、老年健康状况和相关因素调查表进行问卷调查,并对调查结果进行统计学分析。[结果]老年抑郁症与慢性躯体疾病个数之间的联系显著(B=1.298,P<0.01),当生活事件个数被同时加到中介效应模型中,老年抑郁症与慢性躯体疾病个数的联系强度B为0.937,降低了27.81%,但老年抑郁症与慢性躯体疾病个数之间的联系仍然显著(B=0.332,P<0.01),表明生活事件在老年抑郁症与慢性躯体疾病之间起着部分中介效应。深入分析发现,在老年抑郁症与慢性躯体疾病之间起部分中介作用的为"经济困难"事件和"健康恶化"事件。此外,慢性躯体疾病个数与"自评经济困难"事件(r=0.158,P<0.01)和"自评健康恶化"事件(r=0.266,P<0.01)呈正相关。[结论]一些生活事件在老年抑郁症与躯体疾病之间起部分中介效应,应采取多种措施防治老年抑郁症,减少老年抑郁症病人合并更多慢性躯体疾病。

Objective：To probe into the explaining function of life events between elderly depression and chronic somatic disease.Methods：A total of 500 old peoples were selected by using the convenient sampling method,and they received the questionnaire investigation by using geriatric mental status scale（GMS）,elderly health status and related factors questionnaire,then to do statistical analysis for the survey results.Results：Elderly depression had a significant correlation with the number of chronic somatic diseases（B=1.298,P〈0.01）,when the number of life events was also added to the mediating effect model,the correlation strength between elderly depression and chronic somatic diseases changed to 0.937,which reduced 27.81%,but the correlation between elderly depression and number of chronic somatic diseases remained significant（B=0.332,P〈0.01）,which showed that the life events played a partial mediating effect between the elderly depression and chronic somatic diseases.In-depth analysis found that the＂economic difficulties＂and ＂health deterioration＂event had partial mediating effect between the elderly depression and chronic somatic diseases.In addition,the number of chronic somatic diseases had positively correlation with the＂self assessment of economic difficulties＂event（r=0.158,P〈0.01）and＂self rating health deterioration＂event（r=0.266,P〈0.01）.Conclusion：Some life events played a partial mediating effect between the elderly depression and chronic somatic diseases,we should take various measures to prevent elderly depression,reduce the elderly depression patients complicating with more chronic somatic diseases.