Recognition of depression among elderly recipients of home care services
Recognition of depression among elderly recipients of home care services
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DOI：
10.1176/appi.ps.54.2.208
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发表时间：
2003-02-01
影响因子：
3.8
通讯作者：
Bruce, ML
中科院分区：
文献类型：
--
作者：
Brown, EL;McAvay, G;Bruce, ML
目的：老年家庭护理患者的抑郁症是普遍的，但治疗不足。本研究的目的是调查家庭保健护士正确识别老年患者抑郁症的能力，并描述护士和患者的特点与更准确的评估抑郁症。研究方法：42名护士进行了调查，抑郁症状的患者中已被评估，独立的抑郁障碍的研究人员使用结构化临床访谈。轴I DSM-IV障碍。新入院的家庭健康样本。从1997年12月至1999年12月，每周随机选择65岁或以上的护理患者进行评估。结果如下：在403名接受评估的患者中，97名（24%）被发现患有重度抑郁症（64名患者）或轻度抑郁症（33名患者）。97例抑郁患者中有44例（敏感性为45.4），306例非抑郁患者中有230例（特异性为75.2）。护士对抑郁症的评估与抑郁症诊断的总体一致性的Kappa系数为19。有较多老年护理经验的护士更容易正确识别抑郁症。结论：家庭保健护士很难准确评估老年家庭护理患者的抑郁症。不准确。在评估抑郁症的家庭保健护士是一个显着的障碍，以治疗这一老年人的家庭人口。
Objective: Depression among older home care patients is prevalent but undertreated. The purpose of this study was to investigate the ability of home health nurses to correctly identify depression among older patients and to describe nurse and patient characteristics associated with more accurate assessment of depression. Methods: Forty-two nurses were surveyed about the presence of depressive symptoms among patients who had been evaluated, independently for depressive disorders by research staff using the Structured Clinical Interview. for Axis I DSM-IV Disorders. A sample of newly admitted home health. care patients who were aged 65 years or older was randomly selected for this evaluation on a weekly basis from December 1997 to December 1999. Results: Of 403 patients who were evaluated, 97 (24 percent) were found to have either major depressioin (64 patients) or minor depression (33 patients). The nurses correctly identified depression among 44 of the 97 patients who were depressed (sensitivity of 45.4) and 230 of the 306 patients who were not depressed (specificity of 75.2). The kappa coefficient measuring overall agreement between the nurses' assessment and the diagnosis of depression was 19. Nurses who had more geriatric nursing experience were more likely to correctly identify depression. Conclusions: Home health nurses have difficulty making accurate assessments of depression among older home care patients. Inaccuracy. in assessment of depression by home health nurses is a significant barrier to treatment in this elderly homebound population.