残疾儿童照护者抑郁状态及影响因素

Depression and Its Influencing Factors of Caregivers for Children with Disabilities

目的了解残疾儿童照护者抑郁状态并分析相关的影响因素。方法2020年8至9月,采用方便抽样方法选取上海市残疾儿童照护者334例,进行一对一访谈调查,采用抑郁自评量表(PHQ-9)评价抑郁状态。从残疾儿童照护者、被照护者和环境3个方面进行单因素分析,将有统计学意义的变量纳入二分类Logistic回归,分析影响照护者抑郁状态的因素。结果334例残疾儿童照护者抑郁报告率为35.9%。在照护者因素上,女性照护者抑郁风险高于男性照护者(OR=2.193,95%CI 1.131~4.254,P=0.002);在被照护者因素上,被照护者的睡眠质量差(OR=1.942,95%CI 1.113~3.386,P<0.05)、情绪不稳定(OR=17.456,95%CI 2.534~120.240,P<0.05)和残疾类型(OR_(智力)=5.401,95%CI 1.995~14.624;OR_(精神)=3.712,95%CI 1.615~8.530;OR_(肢体)=2.913,95%CI 1.330~6.379;P<0.05)对照护者抑郁状态存在影响;在环境因素上,租住房屋的照护者抑郁风险高于自有房屋照护者(OR=1.727,95%CI 1.135~2.627,P<0.05)。结论残疾儿童照护者抑郁状态不容乐观。当照护者为女性、租住房屋;被照护者有睡眠问题,情绪不稳定,残疾类型为智力、精神和肢体残疾时,照护者的抑郁状态水平更高。

Objective To investigate the depression status of caregivers of children with disabilities and analyze the influencing factors.Methods From August to September,2020,a one-to-one interview was conducted using a convenience sampling method to determine the depression status of 334 caregivers of children with disabilities in Shanghai.Patient Health Questionnaire 9 Item(PHQ-9)was used to evaluate the depression status.The data were analyzed with univariate analysis from three aspects:caregiver,care recipient and environment.Then,the statistically significant variables were included in a dichotomous logistic regression.Results The depression rate of 334 caregivers of children with disabilities was 35.9%.Among the caregiver factors,female caregivers had a higher risk of depression than male(OR=2.193,95%CI 1.131 to 4.254,P=0.002).Among the care recipient factors,poor sleep quality(OR=1.942,5%CI 1.113 to 3.386,P<0.05),emotional instability(OR=17.456,95%CI 2.534 to 120.240,P<0.05)and types of disability(OR_(intelligence)=5.401,95%CI 1.995 to 14.624;OR_(mental)=3.712,95%CI 1.615 to 8.530;OR_(physical)=2.913,95%CI 1.330 to 6.379;P<0.05)were associated with the depression of caregivers.Among the environmental factors,caregivers in rented housing had a higher risk of depression than those in owner-occupied housing(OR=1.727,95%CI 1.135 to 2.627,P<0.05).Conclusion The depression status of caregivers of children with disabilities is not optimistic,with higher rates of reported depression among female caregivers,caregivers in rented housing;caregivers of children with intellectual,mental and physical disabilities,and poor sleep quality and emotional instability.