CAJ | 학술논문

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畅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畅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。目的：探討開展社區心理衛生服務對社區老年人心理健康狀況的影響。方法從上海市徐彙區龍華街道整群隨機抽取4箇居委選取研究對象併完成全程研究者共1431名，其中觀察組692例對照組739例，對觀察組開展一繫列的社區心理衛生服務，分彆在基線時、6月末、12月末進行病人健康問捲抑鬱量錶（PHQ －9）、焦慮篩查問捲（GAD－7）、總體倖福感量錶（GWB）評分。結果（1）GWB評分組內比較髮現，觀察組除瞭對情感和行為控製因子分（ F＝0．32，P＝0．63）差異無統計學意義外，其餘的5箇因子分差異均有統計學意義（P ＜0．01）。對照組中對健康的擔心因子分（F ＝4．33，P ＝0暢02）及鬆弛和緊張（焦慮）因子分（F ＝154．26，P ＜0．01）差異有統計學意義。（2）GWB評分組間比較，在6月末時，對健康的擔心、憂鬱和愉快的心境因子分，觀察組明顯優于對照組，差異有統計學意義（ P ＜0．01）。在12月末時，對生活滿足和興趣、對健康的擔心、憂鬱和愉快的心境、鬆弛和緊張（焦慮）因子評分，觀察組優于對照組，差異有顯著統計學意義（P＜0．01）。（3）觀察組在基線、6月末和12月末PHQ －9總分（F＝1603．27）及GAD－7總分（F＝653．68）下降，GWB總分（F＝2158．86）上升，在榦預前後差異有統計學意義（P ＜0．01）。而對照組（F ＝0．42，P ＝0．57；F ＝1．29，P ＝0．28；F ＝3暢69，P ＝0．06）差異均無統計學意義（P ＞0．05）。（3）基線時組間PHQ －9、GAD －7、GWB評分差異無統計學意義（P ＞0．05），而6月末及12月末時組間評分比較，差異均有統計學意義（P ＜0．01）。結論開展社區心理衛生服務對社區老年人心理健康狀況有改善，其中心理健康宣教是經濟有效的方法之一，但對于持續開展的效果有待進一步探索。
목적：탐토개전사구심리위생복무대사구노년인심리건강상황적영향。방법종상해시서회구룡화가도정군수궤추취4개거위선취연구대상병완성전정연구자공1431명，기중관찰조692례대조조739례，대관찰조개전일계렬적사구심리위생복무，분별재기선시、6월말、12월말진행병인건강문권억욱량표（PHQ －9）、초필사사문권（GAD－7）、총체행복감량표（GWB）평분。결과（1）GWB평분조내비교발현，관찰조제료대정감화행위공제인자분（ F＝0．32，P＝0．63）차이무통계학의의외，기여적5개인자분차이균유통계학의의（P ＜0．01）。대조조중대건강적담심인자분（F ＝4．33，P ＝0창02）급송이화긴장（초필）인자분（F ＝154．26，P ＜0．01）차이유통계학의의。（2）GWB평분조간비교，재6월말시，대건강적담심、우욱화유쾌적심경인자분，관찰조명현우우대조조，차이유통계학의의（ P ＜0．01）。재12월말시，대생활만족화흥취、대건강적담심、우욱화유쾌적심경、송이화긴장（초필）인자평분，관찰조우우대조조，차이유현저통계학의의（P＜0．01）。（3）관찰조재기선、6월말화12월말PHQ －9총분（F＝1603．27）급GAD－7총분（F＝653．68）하강，GWB총분（F＝2158．86）상승，재간예전후차이유통계학의의（P ＜0．01）。이대조조（F ＝0．42，P ＝0．57；F ＝1．29，P ＝0．28；F ＝3창69，P ＝0．06）차이균무통계학의의（P ＞0．05）。（3）기선시조간PHQ －9、GAD －7、GWB평분차이무통계학의의（P ＞0．05），이6월말급12월말시조간평분비교，차이균유통계학의의（P ＜0．01）。결론개전사구심리위생복무대사구노년인심리건강상황유개선，기중심리건강선교시경제유효적방법지일，단대우지속개전적효과유대진일보탐색。
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 12th 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 dimen‐sions of worries about health ,doldrums or pleasant mood (both P < 0 .01) .At the end of the 12th 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 12th months ,the totalPHQ -9score(F= 1603.27)andtotalGAD-7score(F= 653.68)weredecliningwhilethetotal 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 signifi‐cant 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 12th months (P< 0 .01) .Conclusions This large-scale study showed that com‐munity 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 .