【摘要】 目的 探讨开展社区心理卫生服务对社区老年人心理健康状况的影响。方法 从上海市徐汇区龙华街道整群随机抽取4个居委选取研究对象并完成全程研究者共1431名,其中观察组692例对照组739例,对观察组开展一系列的社区心理卫生服务,分别在基线时、6月末、12月末进行病人健康问卷抑郁量表(PHQ-9)、焦虑筛查问卷(GAD-7)、总体幸福感量表(GWB)评分。结果 (1)GWB评分组内比较发现,观察组除了对情感和行为控制因子分(F=0.32,P=0.63)差异无统计学意义外,其余的5个因子分差异均有统计学意义(P<0.01)。对照组中对健康的担心因子分(F=4.33,P=0.02)及松弛和紧张(焦虑)因子分(F=154.26,P<0.01)差异有统计学意义。(2)GWB评分组间比较,在6月末时,对健康的担心、忧郁和愉快的心境因子分,观察组明显优于对照组,差异有统计学意义(P<0.01)。在12月末时,对生活满足和兴趣、对健康的担心、忧郁和愉快的心境、松弛和紧张(焦虑)因子评分,观察组优于对照组,差异有显著统计学意义(P<0.01)。(3)观察组在基线、6月末和12月末PHQ-9总分(F=1603.27)及GAD-7总分(F=653.68)下降,GWB总分(F=2158.86)上升,在干预前后差异有统计学意义(P<0.01)。而对照组(F=0.42,P=0.57;F=1.29,P=0.28;F=3.69,P=0.06)差异均无统计学意义(P>0.05)。(3)基线时组间PHQ-9、GAD-7、GWB评分差异无统计学意义(P>0.05),而6月末及12月末时组间评分比较,差异均有统计学意义(P<0.01)。结论 开展社区心理卫生服务对社区老年人心理健康状况有改善,其中心理健康宣教是经济有效的方法之一,但对于持续开展的效果有待进一步探索。更多还原

【Abstract】 Objective The aim of this study was to investigate the effects of community mental health services on the mental health of elderly community residents in China.Methods Elderly residents(1431)were randomly selected and assigned to either an intervention(692) or control group(739).The Patient Health Questionnaire(PHQ—9),Generalized Anxiety Disorder 7 —item scale(GAD—7),and General Well—Being Schedule(GWB) were used to evaluate the mental health of the subjects at baseline and at the end of 6th and 12 th months,respectively.Results(1)Intra—group comparison of the GWB scores indicated that in the observation group,all the 5 dimensions had significant statistical differences(P < 0.01) except the control of the emotions and behavior(F = 0.32,P = 0.63),while in the control group,only worries about health(F = 4.33,P = 0.02) and relaxation and tension(anxiety)(F =154.26,P < 0.01) had significant statistical differences.(2)Inter— group comparison of the GWB scores indicated that at the end of the 6th month,the observation group had significantly better scores in dimensions of worries about health,doldrums or pleasant mood(both P < 0.01).At the end of the 12 th month,scores of satisfaction and interest in life,worries about health,doldrums or pleasant mood,and relaxation and tension(anxiety) were significantly better in the observation group than the control group(all P < 0.01).(3)In the observation group,from base line to the ends of the 6th and 12 th months,the total PHQ—9 score(F = 1 603.27) and total GAD—7 score(F = 653.68) were declining while the total GWB score(F=653.68) was increasing,and these were significant differences between before and after the interventions(all P < 0.01).However,in the control group,there was no significant difference in these scores(F = 0.42,P = 0.57;F= 1.29,P = 0.28;F = 3.69,P = 0.06).(4)There was no significant differences on the scores of PHQ—9,GAD —7,and GWB found between the two groups(P >0.05) at the baseline,but there were significant differences on all these scores between the two groups at the ends of the 6th and 12 th months(P<0.01).Conclusions This large—scale study showed that community mental health services could effectively improve the mental health of elderly residents,mental health education is one of the effective ways.Prolonged community mental health services could result in even better outcomes.更多还原