Investigation Of The Current Situation Of Depression And Anxiety Symptoms In The Disabled Elderly In The Community And The Construction Of Psychological Nursing Intervention Scheme

Objective:1.To investigate the current status and influencing factors of depression and anxiety symptoms among the disabled elderly in the community,2.To explore the needs of psychological nursing interventions for the disabled elderly in the community3.To construct psychological nursing intervention scheme to provide reference and basis for promoting the mental health of disabled elderly in the community.Method:1.From August 2021 to March 2022,325 disabled elders from 8 communities in Xi’an were selected by convenience sampling as the research subjects.A cross-sectional survey was conducted applying the general data questionnaire,15-item Geriatric Depression Scale,Generalized Anxiety Disorder 7-item,Herth hope index,Rosenberg self-esteem scale and Social Support Rate Scale.Chi-square test and Fisher’s exact test were used for univariate analysis,and binary logistic regression was performed for multivariate analysis,so as to acquire the present situation and influencing factors of depression and anxiety symptoms in the disabled elderly in the community.2 Disabled elders with depression and anxiety symptoms in the preliminary research were selected as the research objects through purposive sampling.Data were collected through one-on-one qualitative interviews.The Colaizzi 7-step analysis method was used to collate and analyze the interview data.The needs of psychological nursing interventions for disabled elderly people were analyzed,which provided a framework for program construction.3.Based on the scheme framework constructed in the above two stages,combined with relevant guidelines and literature at home and abroad,a psychological nursing intervention program for the disabled elderly people in the community was preliminarily constructed.The first draft was revised through an expert meeting to form a final version.Results1.Quantitative research(1)Among the 325 participants,119 experienced depressive symptoms,accounting for36.6%.Multivariate logistic regression showed that high degree of disability(OR=2.613,95%CI: 1.402～4.873)and self-rated poor health(OR=1.583,95%CI: 1.003～2.498)were risk factors for depressive symptoms in the disabled elderly in the community,while high levels of hope(OR=0.176,95%CI: 0.085～0.365),high self-esteem(OR=0.262,95%CI:0.152～0.450)and high level of social support(OR=0.395,95%CI: 0.174～0.900)were protective factors.(2)There were 35 participants with anxiety symptoms,accounting for 10.8%.Multivariate logistic regression showed that female(OR=2.498,95%CI: 1.093～5.711),non-married(OR=2.298,95%CI: 1.017～5.192),and poor sleep(OR=1.682,95%CI: 1.042～2.717)were risk factors for anxiety symptoms among community elders with disability,while high levels of hope(OR=0.180,95%CI: 0.084～0.385)was the protective factor.2.Qualitative researchThrough qualitative interviews with 20 disabled elderly people,the psychological nursing intervention needs were summarized as health care(life care,medical care),social participation(outdoor activities,social interaction),self-improvement and support(family support,social support).3.Scheme constructionSix guidelines and 16 articles were included.Combining quantitative and qualitative findings,the first draft consisted of 4 modules,9 themes and 37 interventions,which were revised by 11 experts through expert meetings.The authoritative coefficient of the expert is0.895,and the positive coefficient is 100%.The resulting psychological nursing intervention scheme consists of 4 intervention frameworks,9 intervention themes,and 32 interventions.Conclusion:1.A high proportion of disabled elderly people in the community have symptoms of depression and anxiety Attention should be paid to women,non-married elderly and older adults with a high degree of disability,poor self-reported health,and poor sleep.At the same time,active psychological interventions should be applied to improve the level of hope,selfesteem and social support of disabled older people,thereby improving their mental health.2.The psychological nursing intervention program for the disabled elderly in the community was constructed through quantitative research,qualitative research,literature review and expert meeting.It covers four major aspects: health care,social participation,social support and spiritual comfort,which is highly scientific and feasible.It provides a reference and basis for promoting the mental health of disabled elderly in the community.