Outcomes of bereavement care among widowed older adults with complicated grief and depression.
Outcomes of bereavement care among widowed older adults with complicated grief and depression.
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DOI：
10.1177/2150131913481231
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发表时间：
2013-10
影响因子：
3.6
通讯作者：
Duan N
中科院分区：
文献类型：
--
作者：
Ghesquiere A;Shear MK;Duan N
丧亲之痛在老年人中很常见，可能导致严重抑郁或复杂悲伤（CG）。人们对医生治疗这些疾病的有效性知之甚少。我们研究了在患有CG和/或重度抑郁症的老年人中，使用医生支持是否与减轻悲伤、抑郁或焦虑严重程度有关。结果与团体和宗教支持进行了比较。我们分析了来自老年夫妇生活变化研究（CLOC）的数据，这是一项对底特律地区已婚夫妇的前瞻性队列研究。追踪配偶死亡超过5年，并在丧偶后6个月（第一波）和18个月（第二波）对丧偶参与者进行随访访谈。分析仅限于那些有寻求支持数据的CG或抑郁症患者（加权n = 89）。“是”/“否”项目询问参与者在第一波之前是否见过每个提供悲伤帮助的人。CLOC研究人员开发了一套包含19个条目的悲伤严重程度量表。流行病学研究中心抑郁量表有20个项目，用来衡量抑郁的严重程度。症状检查表90 -修订版评估焦虑严重程度。回归分析表明，在第一阶段寻求家庭医生的支持与第二阶段焦虑、抑郁或悲伤严重程度的变化无关（P < 0.05）。然而，支持团体的使用与悲伤严重程度的减轻有关（β = - 8.46, P < 0.05），宗教领袖寻求支持与抑郁严重程度的减轻有关（β = - 10.12, P < 0.01）。研究结果表明，医生对悲伤的护理可能无效，而支持小组转诊可能有所帮助。医生可以从识别和适当转诊丧亲相关痛苦的培训中获益。
Bereavement is common among older adults and may result in major depression or complicated grief (CG). Little is known about the effectiveness of physician care for these conditions. We examined whether, among older adults with CG and/or major depression, using physician support was associated with reductions in grief, depression, or anxiety severity. Outcomes were compared to group and religious support. We analyzed data from the Changing Lives of Older Couples (CLOC) Study, a prospective cohort study of married couples in the Detroit area. Spousal death was tracked over 5 years, and follow-up interviews conducted with widowed participants at 6 months (wave 1) and 18 months (wave 2) post loss. Analyses were limited to those with CG or depression with support-seeking data (weighted n = 89). Yes/no items asked whether participants had seen each provider for help with grief up until wave 1. A 19-item grief severity measure was developed by CLOC researchers. The 20-item Center for Epidemiologic Studies Depression scale measured depression severity. The Symptom Checklist 90–Revised assessed anxiety severity. Regressions indicated that seeking support from a family doctor at wave 1 was not associated with changes in anxiety, depression, or grief severity at wave 2 (P > .05). However, support group use was associated with reductions in grief severity (β = −8.46, P < .05), and religious leader support-seeking associated with reductions in depression severity (β = −10.12, P < .01). Findings imply that physician care for grief may not be effective, and support group referral may be helpful. Physicians may benefit from training in recognizing and appropriate referring for bereavement-related distress.