新乡市社区老年人抑郁状况及影响因素分析

Analysis of depression status and influencing factors of elderly people in community of Xinxiang

目的调查新乡市社区老年人抑郁状况并分析其影响因素。方法 2017年4月至2017年9月采用随机整群抽样方法抽取新乡市翟坡、大召营、小冀、朗公庙、七里营5个村和卫河家属院、农灌所家属院、临二十四中社区等3个社区≥60岁的常住城乡居民510人为调查对象,采用一般情况调查表收集观察对象的人口社会学特征资料、生活习惯和社会心理状况,采用老年抑郁量表(GDS)评估调查对象的抑郁情绪,采用社会支持评定量表(SSRS)从主观支持、客观支持、对支持的利用度3个维度评估调查对象的社会支持。根据GDS评分将调查对象分为抑郁组和非抑郁组,分析人口社会学特征、生活习惯和社会心理状况与老年抑郁的关系。结果最终纳入观察的488人中,GDS总分为7. 06±5. 28,其中GDS≥11分者116人(抑郁组),抑郁检出率为23. 8%。锻炼情况、是否旅游、体检情况、有心理问题可能采取的方法等与抑郁有关(χ~2=13. 486、9. 384、15. 387、54. 432,P <0. 05);饮酒、吸烟、作息习惯、爱好、患病处理方式等与抑郁无关(χ~2=2. 490、2. 904、4. 905、0. 791、1. 449,P> 0. 05)。睡眠质量、附近有无噪声、身体状况、生活自理情况、躯体疾病、子女个数等与老年抑郁有关(χ~2=9. 969、8. 572、11. 791、5. 581、5. 506、18. 739,P <0. 05)。性别、户口类型、居住时间、文化程度、宗教信仰、婚姻状况、同住者、职业性质、具体职业、月收入、收入来源、精神疾病家族史、睡眠时间、与子女距离、子女探望频率等与老年抑郁无关(χ~2=0. 235、0. 850、1. 085、3. 377、0. 741、2. 215、0. 191、0. 355、3. 202、0. 891、6. 312、0. 506、3. 962、1. 572、0. 020,P> 0. 05)。对与子女相处方式、子女婚姻、人际关系、居住条件、经济情况、生活状况等的满意程度及是否担心子女、有无自杀想法等社会心理与抑郁有关(χ~2=17. 606、22. 070、17. 608、32. 434、25. 888、20. 844、8. 785、16. 107,P <0. 05),性格与抑郁无关(χ~2=0. 460,P> 0. 05)。抑郁组受试者客观支持、主观支持、对支持等的利用度及社会支持总分均显著低于对照组(t=-4. 487、-4. 235、-3. 353、-5. 166,P <0. 05)。抑郁组受试者GDS评分与对支持利用度、社会支持呈显著负相关(r=-0. 215、-0. 231,P <0. 05),与客观支持、主观支持无相关性(r=-0. 170、-0. 160,P> 0. 05)。多元逐步线性回归分析显示,生活自理能力、体检情况、对生活满意情况、对经济满意情况、有心理问题采取的方法、精神疾病阳性家族史与老年抑郁有关(t=-7. 620、-3. 127、-3. 755、-2. 273、2. 480、2. 351,P <0. 05),这些因素共同解释老年抑郁变异的53. 7%(F=21. 106,P=0. 000)。结论新乡市老年人抑郁的影响因素较多,社会支持水平低,需社会、家庭积极共同参与,改善不利因素,提高老年人的心理素质。

Objective To investigate the depression status of the elderly people in community of Xinxiang and analyze the influencing factors. Methods A total of 510 inhabitants over 60 years old in five villages of Zhaipo,Dazhaoying,Xiaoji,Langgongmiao,Qiliying and 3 communities of Weihe,Agricultural irrigation institute and the twenty-fourth middle school in Xinxiang city from April 2017 to September 2017 were selected by random cluster sampling. The data of demographic and sociological characteristics,living habits and psychosocial status of the subjects were collected by the general situation questionnaire. The depressive status of the elderly was assessed by the geriatric depression scale( GDS). The subjective support,objective support and utilization of support were evaluated by social support rating scale( SSRS). The subjects were divided into depression group and non-depression group according to the GDS score. The relationship between demographic sociological characteristics,living habits,psychosocial status and senile depression were observed. Results A total of 488 subjects were included in the study,the total GDS score of the subjects was 7. 06 ± 5. 28. The 116 patients with GDS > 11 were assigned to depression group,the detection rate of depression was 23. 8%. The exercising,traveling,physical examination,possible approaches to psychological problems were related to the depression( χ~2= 13. 486,9. 384,15. 387,54. 432;P <0. 05). The drinking,smoking,work and rest habits,preference,and ways of dealing with diseases were not related to the depression( χ~2= 2. 490,2. 904,4. 905,0. 791,1. 449;P > 0. 05). The sleep quality,nearby noise,physical condition,selfcare,physical disease and the number of children were related to the depression( χ~2= 9. 969,8. 572,11. 791,5. 581,5. 506,18. 739;P < 0. 05). The gender,type of household registration type,residence time,educational level,religious belief,marital status,cohabitants,occupational nature,specific occupation,monthly income,sources of income,family history of mental illness,sleep time,distance from children and visiting frequency of children were not related to the depression( χ~2= 0. 235,0. 850,1. 085,3. 377,0. 741,2. 215,0. 191,0. 355,3. 202,0. 891,6. 312,0. 506,3. 962,1. 572,0. 020;P > 0. 05). The way of getting along with children and the satisfaction with children’s marriage,interpersonal relationship,living conditions,economic situation and living conditions,worrying about their children and suicidal thought were related to the depression( χ~2= 17. 606,22. 070,17. 608,32. 434,25. 888,20. 844,8. 785,16. 107;P < 0. 05);but the character was not related to the depression( χ~2= 0. 460,P > 0. 05). The scores of objective support,subjective support,support utilization and the total score of social support in the depression group were significantly lower than those in the control group( t =-4. 487,-4. 235,-3. 353,-5. 166;P < 0. 05). The GDS score was negatively correlated with the support utilization and social support in depression group( r =-0. 215,-0. 231;P < 0. 05),but it was not related to objective support and subjective support( r =-0. 170,-0. 160;P > 0. 05). The multivariate stepwise linear regression analysis showed that self-care,physical examination,satisfaction with life,satisfaction with economy,possible approaches to psychological problems and positive family history of psychosis were related to senile depression( t =-7. 620,-3. 127,-3. 755,-2. 273,2. 480,2. 351;P < 0. 05). These factors accounted for 53. 7% of the variation of senile depression( F = 21. 106,P = 0. 000). Conclusion There are many factors influencing the depression of the elderly in Xinxiang city,and the social support level of elderly is low. It needs the common participation of the society and family to improve the unfavorable factors,so as to improve the psychological quality of the elderly. At the same time,health education should be strengthened to find and treat early so as to improve the prognosis. At the same time,the health education should be strengthened,early detection and treatment should be carried out to improve the prognosis.