残疾儿童照护者抑郁状态及影响因素

doi:10.3969/j.issn.1006-9771.2021.10.006

Abstract

Abstract:

Objective To investigate the depression status of caregivers of children with disabilities and analyze the influencing factors.Methods From August to September, 2020, a one-to-one interview was conducted using a convenience sampling method to determine the depression status of 334 caregivers of children with disabilities in Shanghai. Patient Health Questionnaire 9 Item (PHQ-9) was used to evaluate the depression status. The data were analyzed with univariate analysis from three aspects: caregiver, care recipient and environment. Then, the statistically significant variables were included in a dichotomous logistic regression.Results The depression rate of 334 caregivers of children with disabilities was 35.9%. Among the caregiver factors, female caregivers had a higher risk of depression than male (OR = 2.193, 95%CI 1.131 to 4.254, P = 0.002). Among the care recipient factors, poor sleep quality (OR = 1.942, 5%CI 1.113 to 3.386, P < 0.05), emotional instability (OR = 17.456, 95%CI 2.534 to 120.240, P < 0.05) and types of disability (OR_intelligence = 5.401, 95%CI 1.995 to 14.624; OR_mental = 3.712, 95%CI 1.615 to 8.530; OR_physical = 2.913, 95%CI 1.330 to 6.379; P < 0.05) were associated with the depression of caregivers. Among the environmental factors, caregivers in rented housing had a higher risk of depression than those in owner-occupied housing (OR = 1.727, 95%CI 1.135 to 2.627, P < 0.05).Conclusion The depression status of caregivers of children with disabilities is not optimistic, with higher rates of reported depression among female caregivers, caregivers in rented housing; caregivers of children with intellectual, mental and physical disabilities, and poor sleep quality and emotional instability.

Key words: children with disabilities, caregivers, depression, influencing factors

CLC Number:

TANG Lei,CHEN Gang,LÜ Jun,SUN Mei,XIA Cong,ZHENG Hong-ying,LI Xiao-hong,WANG Xiao-qian. Depression and Its Influencing Factors of Caregivers for Children with Disabilities[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(10): 1159-1166.

Figures/Tables 5

References 34

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变量		n	抑郁情况〔n(%)〕
变量		n	无	轻度	中度	重度
性别	男	83	66(79.5)	15(18.1)	0(0.0)	2(2.4)
	女	251	148(59.0)	68(27.0)	25(10.0)	10(4.0)
家庭角色	父亲	55	43(78.2)	11(20.0)	0(0.0)	1(1.8)
	母亲	183	107(58.5)	51(27.9)	18(9.8)	7(3.8)
	爷爷	17	14(82.4)	2(11.8)	0(0.0)	1(5.9)
	奶奶	37	20(54.1)	12(32.4)	3(8.1)	2(5.4)
	外公	11	9(81.8)	2(18.2)	0(0.0)	0(0.0)
	外婆	24	16(66.7)	3(12.5)	4(16.7)	1(4.2)
	其他	7	5(71.4)	2(28.6)	0(0.0)	0(0.0)
残疾类型	听力言语	82	65(79.3)	17(20.7)	0(0.0)	0(0.0)
	视力残疾	14	12(85.7)	1(7.1)	1(7.1)	0(0.0)
	肢体残疾	63	35(55.6)	20(31.7)	4(6.3)	4(6.3)
	智力残疾	34	14(41.2)	12(35.3)	5(14.7)	3(8.8)
	精神残疾	50	25(50.0)	15(30.0)	8(16.0)	2(4.0)
	多重残疾	28	17(60.7)	7(25.0)	2(7.1)	2(7.1)
	未定残	63	46(73.0)	11(17.5)	5(7.9)	1(1.6)
合计		334	214(64.1)	83(24.8)	25(7.5)	12(3.6)

变量		n	抑郁情况〔n(%)〕		χ²值	P值
变量		n	无抑郁	抑郁	χ²值	P值
性别	男	83	66(79.5)	17(20.5)	11.447	0.001
	女	251	148(59.0)	103(41.0)	11.447	0.001
家庭角色	父亲	55	43(78.2)	12(21.8)	7.532	0.023
	母亲	183	107(58.5)	76(41.5)
	祖辈及其他	96	64(66.7)	32(33.3)
年龄(岁)^a	< 30	25	14(56.0)	11(44.0)	1.003	0.909
	30~< 40	158	101(63.9)	57(36.1)
	40~< 50	62	41(66.7)	21(33.3)
	50~< 60	40	25(62.5)	15(37.5)
	≥ 60	48	32(66.7)	16(33.3)
婚姻状况	已婚	319	206(64.6)	113(33.8)	0.787	0.375
	其他	15	8(53.3)	7(46.7)	0.787	0.375
就业状态	全职工作	130	95(73.1)	35(26.9)	10.847	0.004
	非全职工作	27	20(74.1)	7(25.9)
	无工作	177	99(55.9)	78(44.1)
患病状况	有疾病	96	53(55.2)	43(44.8)	4.598	0.032
	无疾病	238	161(67.6)	77(32.4)	4.598	0.032
照护时间(年)	≤ 5	261	172(65.9)	89(34.1)	8.047	0.018
	> 5~10	59	38(64.4)	21(35.6)
	> 10	14	4(28.6)	10(71.4)
日均照护时长(h)	≤ 6 h	127	92(72.4)	35(27.6)	7.248	0.027
	> 6~12	101	63(62.4)	38(37.6)
	> 12	106	59(55.7)	47(44.3)

变量		n	抑郁发生情况〔n(%)〕		χ²值	P值
变量		n	无抑郁	抑郁	χ²值	P值
性别	男	206	130(63.1)	76(36.9)	0.271	0.641
	女	128	84(65.6)	44(34.4)	0.271	0.641
是否独生子女	是	214	134(62.6)	80(37.4)	0.548	0.459
	否	120	80(66.7)	40(33.3)	0.548	0.459
年龄(岁)^a	0~< 6	209	145(69.4)	64(30.6)	9.377	0.009
	6~< 12	100	58(58.0)	42(42.0)
	12~18	24	10(41.7)	14(58.3)
致残原因	先天	138	89(64.5)	49(35.5)	0.018	0.893
	后天	196	125(63.8)	71(36.2)	0.018	0.893
残疾类型	听力言语	82	65(79.3)	17(20.7)	27.429	< 0.001
	视力残疾	14	12(85.7)	2(14.3)
	肢体残疾	63	35(55.6)	28(44.4)
	智力残疾	34	14(41.2)	20(58.8)
	精神残疾	50	25(50.0)	25(50.0)
	多重残疾	28	17(60.7)	11(39.3)
	未定残	63	46(73.0)	17(27.0)
睡眠质量	有睡眠问题	94	46(48.9)	48(51.1)	13.019	< 0.001
	无睡眠问题	240	168(70.0)	72(30.0)	13.019	< 0.001
情绪稳定性	稳定	47	39(83.0)	8(17.0)	14.555	0.001
	一般稳定	278	173(62.2)	105(37.8)
	不稳定	9	2(22.2)	7(77.8)
集体游戏参与	0次	146	79(54.1)	67(45.9)	12.260	0.007
	1~2次	57	43(75.4)	14(24.6)
	3~4次	34	22(64.7)	12(35.3)
	≥ 5次	97	70(72.2)	27(27.8)
伙伴数量	0个	142	78(54.9)	64(45.1)	11.047	0.026
	1个	36	24(66.7)	12(33.3)
	2个	53	35(66.0)	18(34.0)
	3个	29	20(69.0)	9(31.0)
	≥ 4个	74	57(77.0)	17(23.0)

变量		n	抑郁发生情况〔n(%)〕		χ²值	P值
变量		n	无抑郁	抑郁	χ²值	P值
家庭人均月收入	< 3000元	28	13(46.4)	15(53.6)	57.971	0.047
	3000~< 5000元	76	44(57.9)	32(42.1)
	5000~< 10000元	98	63(64.3)	35(35.7)
	≥ 10000元	132	94(71.2)	38(28.8)
住房性质^a	自有房屋	262	176(67.2)	86(32.8)	4.535	0.003
	租住房屋	71	38(53.5)	33(46.5)	4.535	0.003
社会态度^b	不友好	146	84(57.5)	62(42.5)	5.663	0.060
	一般	54	39(72.2)	15(27.8)
	友好	132	91(68.9)	41(31.3)
总体无障碍建设^b	不满意	78	44(56.4)	34(43.6)	2.899	0.235
	一般	174	116(66.7)	58(33.3)
	满意	80	54(67.5)	26(32.5)

维度	变量(参照变量)	B	S.E.	χ²值	P值	OR	95%CI
照护者	性别(男)	0.785	0.338	5.396	0.020	2.193	1.131~4.254
被照护者	睡眠质量(无睡眠问题)	0.663	0.284	5.467	0.019	1.942	1.113~3.386
	残疾类型(听力言语)			19.335	0.004
	视力残疾	-0.400	0.929	0.185	0.667	0.671	0.109~4.139
	肢体残疾	1.069	0.400	7.149	0.008	2.913	1.330~6.379
	智力残疾	1.687	0.508	11.012	0.001	5.401	1.995~14.624
	精神残疾	1.312	0.425	9.544	0.002	3.712	1.615~8.530
	多重残疾	0.509	0.537	0.899	0.343	1.664	0.581~4.769
	未定残	0.443	0.430	1.062	0.303	1.558	0.670~3.620
	情绪稳定性(稳定)			8.708	0.013
	一般稳定	0.789	0.463	2.904	0.088	2.201	0.888~5.454
	不稳定	2.860	0.985	8.435	0.004	17.456	2.534~120.240
环境	住房性质(自有房屋)	0.546	0.214	6.516	0.011	1.727	1.135~2.627
常量		-4.144	0.783	27.979	< 0.001	0.016

Depression and Its Influencing Factors of Caregivers for Children with Disabilities

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