闵行区老年行为精神症状患者家庭照顾者的流行病学调查

陆佩丽; 朱宏; 蒋怡华; 付永军; 邓延峰; 康华; 陈治华; 刘瑾; 曹广文

doi:10.19428/j.cnki.sjpm.2019.18794

闵行区老年行为精神症状患者家庭照顾者的流行病学调查

Epidemiological survey of mental symptoms in elderly patients and their family carers in Minhang District

摘要

摘要:
目的了解上海市社区老年人的行为和精神症状及其主要家庭照顾者的心理健康状况。
方法采用多阶段随机整群抽样的方法，将上海某区年龄≥65岁自愿参加调查的老年人及其主要家庭照顾者作为研究对象，开展神经精神问卷(NPI)和日常生活能力量表(ADL)的现况调查；对老年人的主要家庭照顾者开展匹兹堡睡眠指数量表(PQSI)、病人健康问卷-9(PHQ-9)、广泛性焦虑量表(GAD-7)、简明健康调查(SF-36)的现况调查。
结果社区老年人的家庭主要照顾者主要由夫妻和子女照顾。老年人神经精神问卷异常的有831人，阳性率为38.26%；日常生活能力异常的老年人有226人，阳性率为10.41%；神经精神问卷异常且日常生活能力异常的老年人有115人，阳性率为5.29%。在老年人“总体”“神经精神问卷异常”“日常生活能力异常”和“神经精神问卷异常且日常生活能力异常”这四个条件下，照顾者PHQ-9有抑郁症状的比例分别为1.79%、2.25%、4.35%、5.66%。有焦虑症状在被照顾者“日常生活能力异常”时占比最高，为2.90%；其次为“神经精神异常且日常生活能力异常”时，占比2.83%，“神经精神异常”时占比1.72%。主要家庭照顾者“睡眠情况很差和睡眠还行”在“日常生活能力异常”时占比较高；“睡眠一般”占比较高的是“神经精神异常且日常生活能力异常”时，占比24.53%。照顾者SF-36的情感职能、社会功能、精神健康、一般健康状况、总分>60在“神经精神异常且日常生活能力异常”时评分最高；生理机能、生理职能、精力在“神经精神异常”时最高；而身体疼痛在“总体”情况下最高。
结论在老年人“日常生活能力异常”时主要家庭照顾者的焦虑症状占比最高；在老年人“神经精神异常且日常生活能力异常”时照顾者出现抑郁症状占比最高；在老年人“日常生活能力异常”“神经精神异常且日常生活能力异常”时，其照顾者的睡眠问题最为严重。

Abstract:
Objective To investigate the behavioral and psychiatric symptoms of the elderly in Shanghai community and the mental health status of their main family caregivers.
MethodsIn this study, the elderly and their main family caregivers who were ≥65 years old and willing to participate in the survey were included by multistage random cluster sampling.Surveys were conducted on the status of NPI and ADL for older persons and on the status of PQSI, PHQ-9, GAD-7, and SF-36 for the main family caregivers of the elderly.
Results The main caregivers for the elderly in the community were mainly their spouses or their children.There were 831 elderly people with NPI abnormalities in questionnaire, the positive rate being 38.26%.There were 226 elderly people with abnormal ADL, the positive rate being 10.41%.There were 115 elderly people with abnormal NPI and abnormal ADL, the positive rate being 5.29%.Under the four conditions of "overall", "NPI abnormality", "ADL abnormality" and "NPI abnormality and ADL abnormality", the proportion of caregiver PHQ-9 with depressive symptoms was 1.79%, 2.25%, and 4.35%, and 5.66%, respectively.The anxiety symptoms were the highest in the "ADL abnormalities" of the care recipients, which was 2.90%;The second was "NPI anomaly and ADL anomaly", accounting for 2.83%;"NPI anomaly" accounted for 1.72%.The main family caregivers had poor sleep and sleep was still relatively high in "ADL abnormalities"; when sleep was generally high, "NPI and ADL abnormalities" accounted for 24.53%.The caregiver SF-36′s RE, SF, MH, GH, and total score >60 scored the highest in "NPI abnormalities and ADL abnormalities"; RF, RP, and VT were highest in "NPI abnormalities"; and BP was the highest in "overall".
Conclusion The main family caregivers have the highest proportion of anxiety symptoms in the elderly with "ADL abnormalities"; "NPI abnormalities and abnormal ADL", the caregivers have the highest proportion of depressive symptoms; "ADL abnormalities", "NPI abnormalities and ADL abnormalities", and the caregiver′s sleep problems are the most serious.

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