Please wait a minute...
文章检索
预防医学  2024, Vol. 36 Issue (4): 322-327    DOI: 10.19485/j.cnki.issn2096-5087.2024.04.011
  疾病控制 本期目录 | 过刊浏览 | 高级检索 |
阿尔茨海默病患者家庭照顾者抑郁发生率及影响因素的Meta分析
刘星宇1, 杨支兰1, 崔丽萍2, 贾铭1, 史宏睿1, 赵慧敏1, 延芝丽1
1.山西中医药大学护理学院,山西 晋中 030619;
2.山西白求恩医院,山西 太原 030032
Incidence and influencing factors of depression in family caregivers of Alzheimer's disease patients: a meta-analysis
LIU Xingyu1, YANG Zhilan1, CUI Liping2, JIA Ming1, SHI Hongrui1, ZHAO Huimin1, YAN Zhili1
1. School of Nursing, Shanxi University of Chinese Medicine, Jinzhong, Shanxi 030619, China;
2. Shanxi Bethune Hospital, Taiyuan, Shanxi 030032, China
全文: PDF(855 KB)  
输出: BibTeX | EndNote (RIS)      
摘要 目的 系统评价阿尔茨海默病(AD)患者家庭照顾者抑郁发生率及影响因素,为AD患者家庭照顾者抑郁防治提供参考依据。方法 检索中国知网、万方数据知识服务平台、PubMed等数据库自建库至2023年6月15日发表的AD患者家庭照顾者抑郁相关研究,采用美国卫生保健研究和质量机构推荐的评价标准和纽卡斯尔-渥太华量表分别对横断面研究和队列研究的文献质量进行评价。采用Stata 16.0和RevMan 5.4软件对AD患者家庭照顾者抑郁发生率及影响因素进行Meta分析,并对结果进行敏感性分析和发表偏倚评价。结果 检索获得文献2 324篇,最终纳入14篇,总样本量为8 313人;其中高质量文献6篇,中等质量文献8篇。Meta分析结果显示,AD患者家庭照顾者抑郁发生率为37.5%(95%CI:30.2%~45.1%);患者痴呆程度高(OR=1.718,95%CI:1.059~2.789)、患者日常生活活动能力量表评分低(OR=1.344,95%CI:1.059~1.706)、患者精神行为异常(OR=1.248,95%CI:1.155~1.348)、照顾时间较长(OR=1.998,95%CI:1.637~2.437)、家庭成员分担照顾工作少(OR=1.597,95%CI:1.237~2.061)、照顾者受教育程度较低(OR=1.191,95%CI:1.044~1.359)、照顾者护理技能掌握差(OR=3.060,95%CI:2.257~4.149)、照顾者自评健康状况差(OR=2.536,95%CI:1.114~5.771)和照顾者有社会支持(OR=0.424,95%CI:0.232~0.774)是发生抑郁的影响因素。抑郁发生率结果稳定性良好,无明显发表偏倚;抑郁影响因素中的患者痴呆程度高、患者日常生活活动能力量表评分低存在发表偏倚。结论 AD患者家庭照顾者抑郁发生率为30.2%~45.1%,主要受到患者症状严重程度、自理能力,以及照顾者的受教育程度、护理技能、健康状况、照顾时间和社会支持的影响。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
刘星宇
杨支兰
崔丽萍
贾铭
史宏睿
赵慧敏
延芝丽
关键词 阿尔茨海默病家庭照顾者抑郁影响因素系统评价    
AbstractObjective To systematically evaluate the incidence and influencing factors of depression in family caregivers of Alzheimer's disease (AD) patients, so as to provide the basis for the prevention and treatment of depression among the family caregivers of AD patients. Methods Publications pertaining to depression in family caregivers of AD patients were retrieved from CNKI, Wanfang Data, PubMed and other databases from the time of their establishment to June 15, 2023. The evaluation criteria recommended by the Agency for Healthcare Research and Quality (AHRQ) and the Newcastle-Ottawa Scale were used to assess the quality of cross-sectional and cohort studies, respectively. Stata 16.0 and Revman 5.4 softwares were used to conduct a meta-analysis on the incidence and influencing factors of depression in family caregivers of AD patients. Sensitivity analysis and publication bias assessment were also performed on the results. Results A total of 2 324 articles were retrieved, and ultimately 14 articles were included, with a total sample size of 8 313 individuals. There were 6 high-quality articles and 8 moderate-quality articles. Meta-analysis showed that the incidence of depression in family caregivers of AD patients was 37.5% (95%CI: 30.2%-45.1%). Factors associated with depression included patients' high degree of dementia (OR=1.718, 95%CI: 1.059-2.789), patients' low scores on Activities of Daily Living Scale (OR=1.344, 95%CI: 1.059-1.706), patients' psychobehavioral abnormalities (OR=1.248, 95%CI: 1.155-1.348), long duration of caregiving (OR=1.998, 95%CI: 1.637-2.437), less involvement of other family members in caregiving (OR=1.597, 95%CI: 1.237-2.061), low educational level (OR=1.191, 95%CI: 1.044-1.359), poor caregiving skills (OR=3.060, 95%CI: 2.257-4.149), poor self-rated health (OR=2.536, 95%CI: 1.114-5.771) and social support (OR=0.424, 95%CI: 0.232-0.774). The results of depression incidence demonstrated good stability with no significant publication bias. However, publication bias was observed in the influencing factors for depression, which were patients' high degree of dementia and patients' low scores on Activities of Daily Living Scale. Conclusions The incidence of depression in family caregivers of AD patients ranges from 30.2% to 45.1%. It is primarily influenced by the severity of patients' symptoms and ability to perform daily activities, and caregivers' educational level, caregiving skills, health status, caregiving duration and social support.
Key wordsAlzheimer's disease    family caregiver    depression    influencing factor    systematic review
收稿日期: 2023-11-24      修回日期: 2024-02-14      出版日期: 2024-04-10
中图分类号:  R749.4  
基金资助:山西省高等学校科技创新项目(2023L191); 山西中医药大学2023年研究生创新创业项目(2023CX051)
作者简介: 刘星宇,硕士研究生在读,老年护理专业
通信作者: 杨支兰,E-mail:3173627973@qq.com   
引用本文:   
刘星宇, 杨支兰, 崔丽萍, 贾铭, 史宏睿, 赵慧敏, 延芝丽. 阿尔茨海默病患者家庭照顾者抑郁发生率及影响因素的Meta分析[J]. 预防医学, 2024, 36(4): 322-327.
LIU Xingyu, YANG Zhilan, CUI Liping, JIA Ming, SHI Hongrui, ZHAO Huimin, YAN Zhili. Incidence and influencing factors of depression in family caregivers of Alzheimer's disease patients: a meta-analysis. Preventive Medicine, 2024, 36(4): 322-327.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2024.04.011      或      http://www.zjyfyxzz.com/CN/Y2024/V36/I4/322
[1] 王浩,李娜,俞佳男,等.2003—2017年浙江省阿尔茨海默病发病和死亡趋势分析[J].预防医学,2022,34(3):227-231,239.
[2] World Health Organization.Global status report on the public health response to dementia[EB/OL].[2024-02-14].https://www.who.int/publications/i/item/9789240033245.
[3] 吴淑琳,宋洁,肖萍,等.老年痴呆病人家庭照顾者照顾体验的研究现状[J].护理研究,2020,34(15):2685-2688.
[4] 姜倩倩,宋洁,肖萍,等.痴呆病人家庭照顾者照顾负担及网络干预的研究进展[J].护理研究,2021,35(5):870-873.
[5] LIU S,LI C H,SHI Z H,et al.Caregiver burden and prevalence of depression,anxiety and sleep disturbances in Alzheimer's disease caregivers in China[J].J Clin Nurs,2017,26(9/10):1291-1300.
[6] HUANG S S.Depression among caregivers of patients with dementia:associative factors and management approaches[J].World J Psychiatry,2022,12(1):59-76.
[7] STANG A.Critical evaluation of the Newcastle-Ottawa Scale for the assessment of the quality of nonrandomized studies in meta-analyses[J].Eur J Epidemiol,2010,25(9):603-605.
[8] 曾宪涛,刘慧,陈曦,等.Meta分析系列之四:观察性研究的质量评价工具[J].中国循证心血管医学杂志,2012,4(4):297-299.
[9] 翟金盛,王晓玲,徐格林,等.居家老年性痴呆患者配偶的抑郁焦虑状况及影响因素[J].医学研究生学报,2010,23(3):263-266.
[10] 李鹏,林萍.痴呆患者主要照料者焦虑抑郁状态的相关危险因素分析[J].中华危重症医学杂志(电子版),2016,9(6):404-406.
[11] 武海燕,张守字,马丽,等.阿尔茨海默病照料者抑郁症危险因素分析[J].北京医学,2018,40(12):1134-1136,1140.
[12] 房燕. 首次住院老年痴呆患者主要照顾者心理健康状况及影响因素[J].职业与健康,2017,33(11):1504-1508.
[13] 姚春娟,乔凌亚,徐小林.阿尔茨海默病照料者焦虑、抑郁和睡眠现况及其影响因素分析[J].护士进修杂志,2018,33(13):1155-1159.
[14] HASEGAWA N,HASHIMOTO M,KOYAMA A,et al.Patient-related factors associated with depressive state in caregivers of patients with dementia at home[J].J Am Med Dir Assoc,2014,15(5):e15-e18.
[15] CHOI S S W,BUDHATHOKI C,GITLIN L N.Impact of three dementia-related behaviors on caregiver depression:the role of rejection of care,aggression,and agitation[J].Int J Geriatr Psychiatry,2019,34(7):966-973.
[16] BARRERA-CABALLERO S,ROMERO-MORENO R,DEL SEQUEROS PSDROSO-CHAPARRO M,et al.Stress,cognitive fusion and comorbid depressive and anxiety symptomatology in dementia caregivers[J].Psychol Aging,2021,36(5):667-676.
[17] PUGA F,WANG D,RAFFORD M,et al.The relationship between daily stressors,social support,depression and anxiety among dementia family caregivers:a micro-longitudinal study[J].Aging Ment Health,2023,27(7):1291-1299.
[18] COVINSKY K E,NEWCOMER R,FOX P,et al.Patient and caregiver characteristics associated with depression in caregivers of patients with dementia[J].J Gen Intern Med,2003,18(12):1006-1014.
[19] MAHONEY R,REGAN C,KATONA C,et al.Anxiety and depression in family caregivers of people with Alzheimer disease:the LASER-AD study[J].Am J Geriatr Psychiatry,2005,13(9):795-801.
[20] SHUA-HAIM J R,HAIM T,SHI Y,et al.Depression among Alzheimer's caregivers:identifying risk factors[J].Am J Alzheimers Dis Other Demen,2001,16(6):353-359.
[21] CHENG Y,WANG Z Q,YANG T T,et al.Factors influencing depression in primary caregivers of patients with dementia in China:a cross-sectional study[J].Geriatr Nurs,2021,42(3):734-739.
[22] ALFAKHRI A S,ALSHUDUKHI A W,ALQAHTANI A A,et al.Depression among caregivers of patients with dementia[J].Inquiry,2018,55:1-6.
[23] CHANG C C,WANG W F,LI Y Y,et al.Using the Apriori algorithm to explore caregivers' depression by the combination of the patients with dementia and their caregivers[J].Risk Manag Healthc Policy,2021,14:2953-2963.
[24] 孔琳姝,李明津,麻珂,等.老年慢性病患者照顾者负担的影响因素分析[J].预防医学,2022,34(7):700-704,709.
[25] 井滕滕,段嘉宜,魏绍辉.痴呆病人家庭照顾者自我同情、照顾负担与抑郁的相关性[J].护理研究,2023,37(15):2820-2825.
[26] 叶睿. 社区老年期痴呆患者精神行为症状的照顾困扰及应对策略[D].广州:南方医科大学,2023.
[27] 刘慧,李新月,丁嘉琳,等.2017年社区老年人照料者抑郁症状状况及影响因素研究[J].实用预防医学,2018,25(12):1501-1504.
[28] KHUSAIFAN S J,EL KESHKY M E S.Social support as a mediator variable of the relationship between depression and life satisfaction in a sample of Saudi caregivers of patients with Alzheimer's disease[J].Int Psychogeriatr,2017,29(2):239-248.
[29] 王莉,吴松起,施雁,等.居家老年痴呆患者家庭照顾者焦虑抑郁与社会支持状况的相关性分析[J].中华现代护理杂志,2022,28(17):2289-2295.
[1] 吴虹, 许珂, 张兴亮, 李西婷, 程伟. HIV/AIDS病例抗病毒治疗后免疫重建的影响因素研究[J]. 预防医学, 2024, 36(4): 277-282.
[2] 周梦姣, 李美琳, 孔利萍. 老年2型糖尿病患者社会疏离感的影响因素研究[J]. 预防医学, 2024, 36(4): 292-295.
[3] 邹泉, 赵信星, 陈洪恩, 吴兰兰, 梁晓峰, 吴静, 王长义. 南山区脑卒中患者住院费用的影响因素分析[J]. 预防医学, 2024, 36(4): 328-332,337.
[4] 钟庆, 熊越华, 梅欣, 黄远霞, 李毅琳, 张志峰. 武汉市高中学生电子烟使用情况调查[J]. 预防医学, 2024, 36(4): 355-358.
[5] 祖丽皮耶·吐尔逊, 米也萨·阿迪力, 王艳杰, 向阳. 新疆基层精神卫生防治人员心理健康素养调查[J]. 预防医学, 2024, 36(4): 288-291.
[6] 陈金兰, 熊艺, 王聪, 王奇, 徐利. 原发性肛门瘙痒患者焦虑抑郁情绪、睡眠质量及生活质量分析[J]. 预防医学, 2024, 36(4): 314-316.
[7] 张媛, 史凌云, 吴瑞凯, 黄思莹, 韩正风. 老年病科住院患者轻度认知功能障碍的影响因素分析[J]. 预防医学, 2024, 36(4): 299-303.
[8] 李星云, 陈建治. 我国老年人牙齿缺失的影响因素研究[J]. 预防医学, 2024, 36(4): 308-313.
[9] 李清, 钟碧华, 孙嘉瑞, 戴锋坡, 丁艺娜, 缪湘卿, 傅亚仙, 屠玉燕, 谈文娟, 俞银飞. 萧山区0~36月龄婴幼儿发育状况分析[J]. 预防医学, 2024, 36(3): 255-259.
[10] 张伟文, 范玉玺, 霍婷婷, 吴刚, 赵忠年, 吴德. 克拉玛依市居民健康素养分析[J]. 预防医学, 2024, 36(3): 260-263.
[11] 张露, 江流, 曹慧, 林芳. 60岁及以上人群骨质疏松症的影响因素分析[J]. 预防医学, 2024, 36(3): 235-238.
[12] 徐一梅, 陈亚妮, 胡锦峰, 陈婉君. 2013—2022年上城区新报告HIV/AIDS病例晚发现及影响因素分析[J]. 预防医学, 2024, 36(3): 243-246.
[13] 陈桂儿, 周金英. 单胎妊娠自发性早产的影响因素研究[J]. 预防医学, 2024, 36(3): 251-254.
[14] 周梓萌, 洪忻. 心血管病高危人群预测模型研究[J]. 预防医学, 2024, 36(3): 211-214.
[15] 肖琼, 刘丽梅, 伍晨婵, 徐璐. 中老年人群黄斑变性的影响因素研究[J]. 预防医学, 2024, 36(3): 228-231.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed