Impact of COVID-19 on loneliness, mental health, and health service utilisation: a prospective cohort study of older adults with multimorbidity in primary care.
Impact of COVID-19 on loneliness, mental health, and health service utilisation: a prospective cohort study of older adults with multimorbidity in primary care.
复制标题
DOI：
10.3399/bjgp20x713021
复制
发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Mercer SW
中科院分区：
文献类型：
--
作者：
Wong SYS;Zhang D;Sit RWS;Yip BHK;Chung RY;Wong CKM;Chan DCC;Sun W;Kwok KO;Mercer SW
COVID-19 大流行影响了患有多种疾病的老年人的心理健康和卫生服务利用，他们尤其脆弱。描述 COVID-19 大流行爆发前后孤独感、心理健康问题以及定期医疗护理就诊情况的变化。对初级保健中现有的患有多种疾病的老年人群进行电话调查。使用配对 t 检验、Wilcoxon 符号秩检验和 McNemar 检验，将心理健康和卫生服务利用结果与香港 COVID-19 爆发之前的结果进行比较。孤独感是通过德容·吉维尔德孤独量表来衡量的。次要结局（焦虑、抑郁和失眠）通过 9 项患者健康问卷、7 项广泛性焦虑症工具和失眠严重指数来测量。预约出勤数据是从计算机化医疗记录系统中提取的。通过线性回归和广义估计方程检查与结果变化相关的社会人口因素。数据收集自 583 名老年人（≥60 岁）。 COVID-19 爆发后，孤独、焦虑和失眠的情况显着增加。疫情爆发后，三个月内错过医疗预约的比例从一年前的 16.5% 上升至 22.0%。在调整分析中，女性、独居和患有超过 4 种慢性病与孤独感增加独立相关。女性更容易焦虑和失眠。 COVID-19 爆发后，患有多种疾病的老年患者的心理社会健康状况显着恶化，错过医疗预约的情况大幅增加。
The COVID-19 pandemic has impacted the psychological health and health service utilisation of older adults with multimorbidity, who are particularly vulnerable. To describe changes in loneliness, mental health problems, and attendance to scheduled medical care before and after the onset of the COVID-19 pandemic. Telephone survey on a pre-existing cohort of older adults with multimorbidity in primary care. Mental health and health service utilisation outcomes were compared with the outcomes before the onset of the COVID-19 outbreak in Hong Kong using paired t-tests, Wilcoxon’s signed-rank test, and McNemar’s test. Loneliness was measured by the De Jong Gierveld Loneliness Scale. The secondary outcomes (anxiety, depression, and insomnia) were measured by the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder tool, and the Insomnia Severity Index. Appointments attendance data were extracted from a computerised medical record system. Sociodemographic factors associated with outcome changes were examined by linear regression and generalised estimating equations. Data were collected from 583 older (≥60 years) adults. There were significant increases in loneliness, anxiety, and insomnia, after the onset of the COVID-19 outbreak. Missed medical appointments over a 3-month period increased from 16.5% 1 year ago to 22.0% after the onset of the outbreak. In adjusted analysis, being female, living alone, and having >4 chronic conditions were independently associated with increased loneliness. Females were more likely to have increased anxiety and insomnia. Psychosocial health of older patients with multimorbidity markedly deteriorated and missed medical appointments substantially increased after the COVID-19 outbreak.