| Background: With China's population aging and retirement patterns of social-oriented development, more and more elderly people select the nursing homes to spend the rest of their lives, then mental health services of the elderly are increasingly attracted much more attention, As geriatric depression is the most common precursors of mental disorders, it has occurred at high risk of severe depression, it harmed seriously but the symptoms are concealed.Objective: The study is to explore geriatric depression in nursing homes in Xi'an and analysis its related risk factors on the basis of epidemiological investigation. Then it targeted prevention of depressive symptoms, provided a scientific basis for further improving the quality of life of the elderly, meanwhile supported the reasonable proposals for nursing homes to improve health services and enhance the capable of health security.Methods:1.investigation study: we selected 20 nursing homes from 83 nursing homes which were registered by the department of Civil Affairs,adopting to a randomly whole flock sample.473 senile persons of twenty nursing homes in xi'an were investigated with questionnaires ,then 464 questionnaires were utility(98.1%).GDS,SF-36,SSRS and self-development questionnaires were used to analysis the incidence of geriatric depression and explore the risk factors. Data were recorded and constructed the database with Epidata3.0 software, Data were analysis with SPSS13.0 software, description analysis, x2 test and Logistic regression analysis were used.2.A case-control study: on the basis of investigation on current situation in geriatric depression, the 145 older persons with depression syndrome were selected as the case, and the 145 non-depression elders in nursing homes in Xi'an was conducted as the controls by 1:1 match methods. The cases and controls were matched for the same age and the difference in sex less then two years. Data were analyzed by SPSS 13.0 software, then universe conditional logistic regression and multiple factor conditional logistic regression analysis were used.Results:1. Sample characteristicsIn the sample male were 223(48.1%),female were 241(51.9%);The mean age was 78.0 years old (SD=8) with a range of 65-103.99.3% were Han people. Marriage status: currently married were 114(24.6%).Education: 118 elders (25.4%)were illiteracy, elementary school 102(22 %),middle school 107( 23.1% ) ,secondary school 82 ( 23.1% ) ,more than university 55(11.9%),Examining the occupation of the elderly, 33.8% of the elderly were workers, Leaders 104(22.4%),technologists 54(11.6%),unemployment 149(32.1%); the income of 38.8% of the elderly were 500～1000 Yuan . the income of 176(37.9%)were less than 500 Yuan, and others 108(23.3%)were more than 1000 Yuan. 2. Cross-sectional investigation in geriatric depression in nursing homes in Xi'an displayed that the general incidence rate of the elderly depression was 31.3%, that of male was 26.0% and that of female was 36.1%. There is a significant difference between genders.In the health behaviors no fancy,gain the knowledge of health protection initiatively,regular life,abnormal sleeping time,physical activity,optimistic;poor self–evaluation of economy,social class,life state,children and reside circumstances;in the disease the number of diseases and medical cost; economy earning in recent two years,unhappy experience,worse health,have negative life affairs and the number of negative life affairs;in social support the low scores of social support,social objective support and social subjective support; the low scores of PF,RP,BP,GH,VT,SF,RE and MH in QOL had significant influence on the incidence of depression(P<0.05).3.The 1:1 matched case-control study showed that after eliminating the effects of age and gender,the elders with optimistic,unhappy experience in recent two years,poor self-evaluation of social status,the lower scores of general health and mental health had still significant influence on the incidence of depression(P<0.05)。Then these five factors all were risk factors of the elderly depression, and OR and 95%CI were as follows: 2.267(95%CI=1.229～5.614),4.700(95%CI=1.949～11.331),8.438(95%CI=2.626～27.120),5.585(95%CI=2.840～10.983),8.743(95%CI=3.582～21.338).Conclusion: The incidence rate of the elderly depression in nursing homes in Xi'an was very high, and the psychological health of the elders is not optimistic. the administrators of nursing homes should organize all kinds of recreational activities positively,cultivate elders'hobby,guide reasonable exercise,carry out health knowledge education about frequent chronic disease,promote communication between elders,enhance the mental health.Meanwhile,we should advance government to add investment to promote soft and hard ware construction, emphasis on the training and educating the attendants for the old and satisfy the elderly versatility requirement .Finally we could achieve the healthy ageing.
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