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鼓励积极,有价值的生活计划 (PEARLS) 减少抑郁症的有效性:多州评估
Matthew Lee Smith1,2,3, Lesley E Steinman4, Carol N Montoya5
1Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, United States.
Frontiers in public health
|June 26, 2023
概括
鼓励活跃,有价值的生活计划 (PEARLS) 有效地减少了老年人的抑郁症状. 这项以社区为基础的计划改善了获得护理的机会,并提高了患有抑郁症的老年人的生活质量.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 精神病学是一个精神病学.
背景情况:
- 在美国,晚年抑郁症影响了大约15%的社区老年人.
- 鼓励活跃,有价值的生活计划 (PEARLS) 是一种基于证据的协作护理模式,旨在管理老年人的抑郁症.
- 珍珠由社区组织提供,以提高获得优质抑郁症护理的机会.
研究的目的:
- 评估PEARLS计划在减少老年人抑郁症状方面的有效性.
- 用PHQ-9仪器评估临床结果,包括抑郁症严重程度,缓解和反应.
- 在现实世界中分析从基线到最终会议的抑郁症状的变化.
主要方法:
- 在2015-2021年期间,利用了来自四个州的1,155名PEARLS参与者的数据.
- 采用通用估计方程 (GEE) 模型来检查PHQ-9分数的变化,并根据人口和临床共变量进行调整.
- 使用Cox比例危险回归来估计临床缓解或反应的危险比率.
主要成果:
- 从基线到最后一次会议,PHQ-9分数显著改善 (平均差异 = -5.67,p < 0.001).
- 大约35%的参与者实现了临床缓解 (PHQ-9 < 5),而73%的参与者基于核心症状实现了缓解.
- 近49%的参与者表现出临床反应 (PHQ-9分数下降≥50%).
结论:
- 在社区环境中,PEARLS计划有效改善老年人的抑郁症状.
- 珍珠为患有抑郁症的老年人提供了一个可访问的选择,特别是那些传统临床护理服务不足的人.
- 这些发现支持PEARLS作为一种有价值的干预措施,用于管理不同人群中晚年抑郁症.
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