开心俱乐部活动对老年抑郁症状及生命质量的影响

2016年8-12月全科医生使用患者健康问卷(PHQ-9)筛选出上海市控江街道社区卫生服务中心324例轻中度抑郁障碍(PHQ-9评分5~14分)的老年患者,将其简单随机分为对照组和干预组,每组162例。对照组接受群体性健康教育,干预组在群体性健康教育的基础上参加开心俱乐部活动。在干预结束时及结束后12周,分别使用PHQ-9量表、12条目简短生命质量(SF-12)量表对干预组和对照组进行随访评估。在干预结束时和结束后12周,干预组的PHQ-9评分明显下降且均显著低于对照组结束时:(7.95±2.41)比(8.94±2.38)分,t=3.643,P<0.01);结束后12周:(6.44±2.27)比(8.92±2.76)分,t=7.734,P<0.01]。干预组结束后12周,SF-12生理总评分显著升高且高于对照组(49.74±8.80)比(47.71±6.77)分,t=2.001,P=0.04]。干预前后干预组SF-12心理总评分及对照组所有量表评分比较差异均无统计学意义(P>0.05)。且干预后,干预组运动频率高于对照组(P<0.05)。结果提示,开心俱乐部活动可以显著改善老年轻中度抑郁障碍患者的抑郁症状和生命质量,并能促进该类患者健康锻炼,但仍需进一步探索开心俱乐部活动的长期效应。

Effect of happy-club activities on depressive symptoms and quality of life in elderly community-dwellers with depression

The depressive status was screened with Patient Health Questionnaire-9(PHQ-9)by general practitioner among elderly residents in Shanghai Kongjiang community during August to October 2016.A total 324 patients were identified as mild-moderate depression(PHQ-9 score 5 to 14)and were randomly divided into the intervention group and the control group with 162 cases in each group.The control group only received regular health education,and the intervention group participated in happy-club activities on the basis of regular health education.A follow-up evaluation of depression status was conducted with PHQ-9 and the quality of life was assessed with 12-item Short Form Health Survey(SF-12)during the following up.At the end of the intervention,the follow-up evaluation showed that the PHQ-9 score of the intervention group was significantly lower than that of the control group(7.95±2.41)vs.(8.94±2.38),t=3.643,P<0.01].Twelve weeks after the intervention,the PHQ-9 score of the intervention group was significantly lower than that of the control group(6.44±2.27)vs.(8.92±2.76),t=7.734,P<0.01],the SF-12 MCS score(49.74±8.80)vs.(47.71±6.77),t=2.001,P=0.04]and the exercise frequency of the intervention group was significantly higher than that of the control group(P<0.01).Compared with the baseline,the PHQ-9 score at the end of the intervention and 12 weeks after the intervention significantly decreased,and the SF-12 MCS score at 12 weeks after the intervention increased significantly(P<0.05).Compared with the score at the end of intervention,the PHQ-9 score at the 12 weeks after intervention was significantly decreased(P<0.05).Happy-club activities can significantly improve the depression symptoms and the quality of life of the elderly with mild or moderate depression,and promote them to participate in healthy exercise.However,the long efficacy of happy-club activities still need to be studied further.