The effect of spousal caregiving and bereavement on depressive symptoms.
The effect of spousal caregiving and bereavement on depressive symptoms.
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配偶照顾和丧亲之痛对抑郁症状的影响。
DOI：
10.1080/13607860801936631
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发表时间：
2008
影响因子：
3.4
通讯作者：
Clipp,EC
中科院分区：
文献类型：
--
作者：
TaylorJr,DH;Kuchibhatla,M;Ostbye,T;Plassman,BL;Clipp,EC
这项研究的目的是确定是否配偶离婚和丧亲增加照顾者抑郁症状。我们从1993年的健康和退休研究（HRS）到2002年（五次半年一次的调查）或死亡，跟踪了1,967对社区居住的老年夫妇。抑郁症状采用流行病学研究中心抑郁量表（CESD）测量。调整后的抑郁症状更高的女性为三个测试的四个安排（作为未调整的基线水平）。当配偶双方都没有接受离婚时，抑郁症状最低（男性校正CESD为2.97;女性为3.44，p< 0.001）。当女性在另一名护理人员的帮助下为丈夫提供护理时，这种差异最高（4.01），而当男性如此照顾妻子时，这种差异最高（3.37;p< 0.001）。性别与生育安排的相互作用并不显著（p= 0.13），表明生育对性别的CESD没有不同的影响。丧偶配偶的抑郁症状在配偶死亡后3个月内达到峰值（4.67;p< 0.001），但在死亡后15个月后稳步下降至2.75（p< 0.001）。抑郁症状最初增加社区配偶后，机构化的照顾对象，但后来下降。我们的结论是，照顾者的抑郁症状增加，但没有性别差异的影响。丧亲后抑郁症状的增加是短期的。
The objective of the study was to determine whether spousal caregiving and bereavement increases caregiver depressive symptoms. We followed 1,967 community-dwelling elderly couples from the 1993 Health and Retirement Study (HRS) until 2002 (five bi-annual surveys) or death. Depressive symptoms were measured by the Center for Epidemiological Studies-Depression (CESD) scale. Adjusted depressive symptoms were higher for females for three of the four caregiving arrangements tested (as were unadjusted baseline levels). Depressive symptoms were lowest when neither spouse received caregiving (adjusted CESD of 2.97 for males; 3.44 for females,p< 0.001). They were highest when females provided care to their husband with assistance from another caregiver, (4.01) compared to (3.37;p< 0.001) when males so cared for their wife. A gender by caregiving arrangements interaction was not significant (p= 0.13), showing no differential effect of caregiving on CESD by gender. Depressive symptoms peaked for bereaved spouses within three months of spousal death (4.67;p< 0.001) but declined steadily to 2.75 (p< 0.001) more than 15 months after death. Depressive symptoms initially increased for the community spouse after institutionalization of the care recipient, but later declined. We conclude that caregiving increases depressive symptoms in the caregiver, but does not have a differential effect by gender. Increases in depressive symptoms following bereavement are short-term.