髋部骨折后,更好的心理健康和更少的抑郁症状与更强的心理弹性有关

Taylor McClennen, Hari Sharma, Douglas P Kiel, Richard H Fortinsky, Camelia P Guild, Denise Orwig, Jay Magaziner, Ellen F Binder, Sarah D Berry
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摘要

背景:高心理弹性与老年人髋部骨折后功能恢复的改善有关。本研究的目的是确定老年女性髋部骨折后心理恢复能力增强的相关因素。方法对129例年龄≥65岁近期手术修复髋部骨折的女性进行运动和睾酮治疗试验。简要弹性量表(BRS)测量基线弹性,分为低(BRS<4)和高(BRS≥4)。社会人口学(如教育)、医学和神经心理因素(如Short Blessed Test的认知、全球心理健康评分(promisi - gmh)的心理健康和老年抑郁评分(GDS)的抑郁症状)被视为独立变量。采用双变量回归评估个体因素与心理弹性的相关性,p≤0.10的显著性水平进入年龄调整后的多变量logistic回归模型。结果57名女性(44%)报告了高弹性。教育和认知都与恢复力无关。在调整后的模型中,较低的GDS和较好的promise - gmh得分与高弹性相关。GDS每恶化1点,高恢复力与低恢复力的调整优势比(AOR)为0.76 (95% CI 0.61,0.93)。在GDS、promise - gmh和年龄的模型中,积极的心理健康仍然与更高的恢复力显著相关(AOR 1.34, 95% CI 1.14,1.58)。结论老年女性髋部骨折后抑郁症状较少,心理健康状况较好,心理弹性较高。从髋部骨折中恢复时解决整体心理健康问题有助于提高心理弹性,从而最大限度地提高恢复潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Better mental health and fewer depressive symptoms are associated with greater psychological resilience after hip fracture
Background High psychological resilience is associated with improved functional outcomes for older adults recovering from hip fracture. The objective of this study was to identify factors associated with increased psychological resilience in older women after hip fracture. Methods 129 women aged ≥65 years with recent surgically-repaired hip fracture were enrolled in a trial of exercise and testosterone therapy. The Brief Resilience Scale (BRS) measured baseline resilience, and was categorized as low (BRS&lt;4) or high (BRS≥4). Sociodemographic (e.g., education), medical, and neuropsychological factors (e.g., cognition by Short Blessed Test, mental health by a Global Mental Health Score (PROMIS-GMH), and depressive symptoms by Geriatric Depression Score (GDS)) were considered as independent variables. Individual factors were evaluated for their association with resilience using bivariate regression, and those having a significance level of p≤0.10 were entered into age-adjusted multivariate logistic regression models. Results 57 women (44%) reported high resilience. Neither education nor cognition was significantly associated with resilience. Lower GDS and better PROMIS-GMH scores were associated with high resilience in adjusted models. For every one-point worsening in GDS, the adjusted odds ratio (AOR) for high vs. low resilience was 0.76 (95% CI 0.61,0.93). In a model with GDS, PROMIS-GMH, and age, positive mental health remained significantly associated with higher resilience (AOR 1.34, 95% CI 1.14,1.58). Conclusions In older women after hip fracture, fewer depressive symptoms and better mental health were associated with higher psychological resilience. Addressing overall mental health when recovering from hip fracture could contribute to increasing psychological resilience thereby maximizing recovery potential.
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