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首页> 外文期刊>BMC Palliative Care >Prevalence and risk factors of depressive symptoms in a Canadian palliative home care population: a cross-sectional study
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Prevalence and risk factors of depressive symptoms in a Canadian palliative home care population: a cross-sectional study

机译：加拿大姑娘家庭护理人群中抑郁症状的患病率和风险因素：横断面研究

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Background Depression in palliative care patients is important because of its intrinsic burden and association with elevated physical symptoms, reduced immunity and increased mortality risk. Identifying risk factors associated with depression can enable clinicians to more readily diagnose it, which is important since depression is treatable. The purpose of this cross-sectional study was to determine the prevalence of depressive symptoms and risk factors associated with them in a large sample of palliative home care patients. Methods The data come from interRAI Palliative Care assessments completed between 2006 and 2012. The sample (n?=?5144) consists of adults residing in Ontario (Canada), receiving home care services, classified as palliative, and not experiencing significant cognitive impairment. Logistic regression identified the risk factors associated with depressive symptoms. The dependent variable was the Depression Rating Scale (DRS) and the independent variables were functional indicators from the interRAI assessment and other variables identified in the literature. We examined the results of the complete case and multiple imputation analyses, and found them to be similar. Results The prevalence of depressive symptoms was 9.8%. The risk factors associated with depressive symptoms were (pooled estimates, multiple imputation): low life satisfaction (OR?=?3.01 [CI?=?2.37-3.82]), severe and moderate sleep disorders (2.56 [2.05-3.19] and 1.56 [1.18-2.06]), health instability (2.12 [1.42-3.18]), caregiver distress 2.01 [1.62-2.51]), daily pain (1.73 [1.35-2.22]), cognitive impairment (1.45 [1.13-1.87]), being female (1.37 [1.11-1.68]), and gastrointestinal symptoms (1.27 [1.03-1.55]). Life satisfaction mediated the effect of prognostic awareness on depressive symptoms. Conclusions The prevalence of depressive symptoms in our study was close to the median of 10-20% reported in the palliative care literature, suggesting they are present but by no means inevitable in palliative patients. Most of the factors associated with depressive symptoms in our study are amenable to clinical intervention and often targeted in palliative care programs. Designing interventions to address them can be challenging, however, requiring careful attention to patient preferences, the spectrum of comorbid conditions they face, and their social supports. Life satisfaction was one of the strongest factors associated with depressive symptoms in our study, and is likely to be among the most challenging to address.
机译：由于其内在负担和与升高的身体症状，降低和增加的死亡风险，姑息治疗患者的背景抑郁症是重要的。鉴定与抑郁症相关的风险因素可以使临床医生能够更容易诊断，这是重要的，因为抑郁症是可治疗的。这种横截面研究的目的是确定在大型姑息家庭护理患者中的抑郁症状和危险因素的患病率。方法数据来自2006年至2012年之间完成的伊迪德姑息治疗评估。样品（N？=？5144）由居住在安大略省（加拿大）的成人组成，接受家庭护理服务，分类为姑息，并没有经历显着的认知障碍。 Logistic回归鉴定了与抑郁症状相关的风险因素。从属变量是抑郁额定尺度（DRS），独立变量是来自IRRIDAI评估的功能指标和文献中识别的其他变量。我们检查了完整案例和多重撤销分析的结果，并发现它们是相似的。结果抑郁症状的患病率为9.8％。与抑郁症状相关的危险因素是（汇总估计，多重归因）：低寿命满意度（或？= 3.01 [CI？2.37-3.82]），严重和中度睡眠障碍（2.56 [2.05-3.19]和1.56 [1.18-2.06]），健康不稳定（2.12 [1.42-3.18]），照顾者遇险2.01 [1.62-2.51]），每日疼痛（1.73 [1.35-222]），认知障碍（1.45 [1.13-1.87]），是女性（1.37 [1.11-1.68]）和胃肠道症状（1.27 [1.03-1.55]）。生活满意度介导预后意识对抑郁症状的影响。结论我们研究中抑郁症状的患病率接近姑息治疗文学中报告的10-20％的中位数，表明它们存在，但绝不是姑息患者的不可避免。在我们研究中与抑郁症状相关的大多数因素都适用于临床干预，并且通常针对姑息治疗计划。然而，设计干预措施可能具有挑战性，但需要仔细关注患者偏好，他们面临的合并条件的频谱及其社会支持。生活满意度是我们研究中与抑郁症状相关的最强烈因素之一，并且可能是对地址最具挑战性的。

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