Does neighborhood violence lead to depression among caregivers of children with asthma?
Does neighborhood violence lead to depression among caregivers of children with asthma?
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DOI：
10.1016/j.socscimed.2008.02.028
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发表时间：
2008-07-01
影响因子：
5.4
通讯作者：
Diette, Gregory B.
中科院分区：
文献类型：
--
作者：
Tonorezos, Emily S.;Breysse, Patrick N.;Diette, Gregory B.
先前的研究将社区暴力与儿童抑郁症联系起来，但很少有研究探讨成年人之间的这种关系。我们假设，受害，意识和对邻里暴力的恐惧会增加哮喘儿童的成年照顾者患抑郁症的几率。我们调查了美国巴尔的摩儿童哮喘室内环境研究（BIESAK）的护理人员。主要结果是流行病学研究中心抑郁指数筛查阳性。我们评估了受害，意识和对邻里暴力的恐惧，并进行了空间分析，确定在500英尺的凶杀案，以验证邻里暴力的调查措施。一个多水平logistic模型，通过邻域聚类估计比值比和95%置信区间。调查显示，如果住宅距离凶杀案发生地500英尺以内，那么人们对邻里暴力的恐惧就会得到强烈的预测。在150名哮喘儿童的照顾者中，49%的人知道邻里暴力事件，36%的人害怕邻里暴力，22%的人报告受害，27%的人在离家500英尺内发生过凶杀案。在我们的多层次模型中，对暴力的恐惧使抑郁的几率增加了6.7。受害与抑郁症的可能趋势有关，对邻里暴力的认识并没有增加抑郁症的几率。根据我们的研究结果，与邻里暴力的个人经验可能比简单的意识更重要。卫生保健工作者应考虑对遭受社区暴力的患者进行抑郁症筛查。(C)2008爱思唯尔有限公司保留所有权利。
Prior studies have related community violence to depression among children, but few studies have examined this relationship among adults. We hypothesized that victimization, awareness, and fear of neighborhood violence would increase the odds of depression among adult caregivers of children with asthma. We surveyed caregivers in the Baltimore Indoor Environment Study of Asthma in Kids (BIESAK), USA. The primary outcome was screening positive for depression on the Center for Epidemiological Studies Depression index. We assessed victimization, awareness, and fear of neighborhood violence, and conducted spatial analysis identifying subject homes within 500 ft of a homicide to validate survey measures of neighborhood violence. A multilevel logistic model with clustering by neighborhood estimated odds ratios and 95% confidence intervals. Survey responses about fear of neighborhood violence were strongly predicted by having a home within 500 ft of a homicide. Of 150 caregivers of children with asthma, 49% were aware of a neighborhood violent event, 36% were fearful of neighborhood violence, 22% reported victimization, and 27% had a homicide within 500 ft of the home. In our multilevel model, fear of violence increased the odds of depression by 6.7. Victimization was associated with a possible trend towards depression, and awareness of neighborhood violence did not increase the odds of depression. Based on our findings, personal experience with neighborhood violence may be more important than simple awareness. Health care workers should consider screening for depression among patients exposed to community violence. (C) 2008 Elsevier Ltd. All rights reserved.