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2324篇,最终纳入14篇,总样本量为8313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。
Objective 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 pa-tients 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 de-pression in family caregivers of AD patients.Sensitivity analysis and publication bias assessment were also performed on the results.Results A total of 2324 articles were retrieved,and ultimately 14 articles were included,with a total sam-ple size of 8313 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 associat-ed 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 signifi-cant publication bias.However,publication bias was observed in the influencing factors for depression,which were pa-tients'high degree of dementia and patients'low scores on Activities of Daily Living Scale.Conclusions The inci-dence 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.
作者
刘星宇
杨支兰
崔丽萍
贾铭
史宏睿
赵慧敏
延芝丽
LIU Xingyu;YANG Zhilan;CUI Liping;JIA Ming;SHI Hongrui;ZHAO Huimin;YAN Zhili(School of Nursing,Shanxi University of Chinese Medicine,Jinzhong,Shanxi 030619,China;Shanxi Bethune Hospital,Taiyuan,Shanxi 030032,China)
出处
《预防医学》
2024年第4期322-327,共6页
CHINA PREVENTIVE MEDICINE JOURNAL
基金
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)。
关键词
阿尔茨海默病
家庭照顾者
抑郁
影响因素
系统评价
Alzheimer's disease
family caregiver
depression
influencing factor
systematic review
