养老机构老年人抑郁与情绪调节策略的病例对照研究

A Case-control Study on Depression and Emotion Regulation Strategies in the Elderly Care Institutions

目的探讨银川市养老机构老年人抑郁的影响因素及其与情绪调节策略的关系。方法采用整群抽样的方法,选择银川市5所养老机构505名老年人为研究对象,老年人抑郁调查采用老年抑郁量表(GDS),按照1∶4匹配病例对照研究的方法,将筛选出的中度抑郁老年人(GDS≥21分)47例为病例组,病例组GDS平均得分为(23.5±2.2)分;按性别、年龄±4岁选择同期调查的无抑郁老年人(GDS≤10分)188例为对照组,对照组GDS平均得分为(5.1±2.3)分。采用Cross情绪调节问卷(ERQ)和反刍思维量表(RRS)调查老年人情绪调节策略。结果组间均衡性检验显示,病例组和对照组在年龄、性别、民族、文化程度、既往职业和婚姻状况差异无统计学意义(P均>0.05)。单因素Logistic回归分析显示,兴趣爱好(OR=0.332,95%CI:0.168~0.655)、体育锻炼(OR=0.418,95%CI:0.195~0.896)、家庭支持(OR=0.205,95%CI:0.066~0.648)、负性生活事件(OR=14.063,95%CI:5.797~34.118)、慢性病数量(OR=1.916,95%CI:1.450~2.531)、认知重评(OR=0.874,95%CI:0.831~0.919)和反刍思维(OR=1.250,95%CI:1.138~1.373)是银川市养老机构老年人抑郁的影响因素。多因素Logistic回归分析显示,银川市养老机构老年人抑郁与认知重评情绪调节策略(OR=0.857,95%CI:0.752~0.976)、反刍思维情绪调节策略(OR=1.223,95%CI:1.093~1.368)以及负性生活事件(OR=6.617,95%CI:1.386~36.601)有关。结论多使用认知重评策略是银川市养老机构老年人抑郁的保护因素,多使用反刍思维策略和过去一年经历过负性生活事件是其危险因素。

Objective To explore the influencing factors of depression in the elderly and their relationship with mood regulation strategies. Methods Using the cluster sampling method,the 505 elderly people from 5 Pension institution in Yinchuan were selected as the research object,The geriatric depression scale（GDS）was used as a measurement tool. According to the 1∶ 4 matched case-control study,47 cases with moderate-to-severe depression（GDS≥21 points）were selected as the case group,and the average score of GDS in the case group was（23.5±2.2）points. According to sex,age±4 years old to choose the same period of investigation of the elderly without depression（GDS≤10 points）,188 cases as the control group. The emotional adjustment questionnaire（ERQ） and the rumination thought scale（RRS） were used to investigate the emotional regulation of the elderly. Results Inter-group balance tests showed there were no significant differences in age,sex,ethnicity,educational level,previous occupation and marital status between case group and control group（all P〈0.05）.Univariate conditional logistic regression analysis showed that,Interests（OR=0.332,95% CI： 0.168-0.655）,Physical exercise（OR=0.418,95% CI：0.195-0.896）,Family support（OR=0.205,95% CI：0.066-0.648）,Negative life events（OR=14.063,95% CI： 5.797-34.118）,The number of chronic diseases（OR=1.916,95% CI：1.450-2.531）,cognitive reappraisal（OR=0.874,95% CI：0.831-0.919）and Rumination（OR=1.250,95% CI ：1.138-1.373）. Multivariate conditional logistic regression analysis showed that depression in elderly was associated with cognitive reappraisal（OR=0.857,95% CI：0.752-0.976）,negative life events（OR=6.617,95% CI：1.386-36.601）,rumination（OR=1.223,95% CI：1.093-1.368）. Conclusion Cognitive reappraisal is a protective factor for depression in the elderly. Rumination and negative life events are the risk factors of depression in the elderly.