| Objective:1.To describe the current situation and characteristics of relapse in late-life depr ession（LLD）,compare whether there is a difference in clinical characteristics bet ween first-episode and relapsing elderly patients with depression,and discuss theinfluencing factors of relapse in elderly patients with depression.2.To construct nursing intervention program for the controllable factors in the ri sk factors of late-life depression recurrence.Methods:Part I: Analysis of risk factors for relapse in elderly patients with depression.The electronic medical record system was used to query the medical record infor mation of elderly patients with depression aged ≥60 years who were hospitalizedin Anhui Mental Health Center from January 2018 to December 2020.The clin ical data of 380 senile inpatients with first-episode and recurrent depression wereretrospectively analyzed,and the differences in general data,clinical characterist i cs and routine laboratory indicators were compared between the two groups.Univ ariate analysis（T test,Chi-square test and rank-sum test）and multivariate logisti c regression analysis were performed according to different types of data.Part Ⅱ: The construction of evidence-based nursing intervention for the preventi on of senile depression recurrence.In view of the controllable risk factors for the first part of the study found that,from the perspective of nursing retrieval database intervention measures related literature at home and abroad,based on evidence-based original resources and integrate resources retrieval,the retrieval of literature filtering,quality evaluation and classification of evidence,the formation of prevention of senile depression relapse nursing intervention plan draft of evidence-based practice.Using Delphi expert letter consultation,according to expert opinions,the first draft of evidence-based practice intervention program for prevention of senile depression recurrence was revised and formed into the final draft.Results:Part I: Among the 380 subjects,164 recurrent cases（up to 43.16%）were inclu ded in the recurrent group,and 216 first-episode cases（56.84%）were included i n the first-episode group.Multivariate Logistic regression analysis showed that th e long course of disease（OR=1.104,95%CI:1.070～1.140）,a history of suicide（OR=1.903,95%CI: 1.054～3.435）,decreased activity（OR=2.847,95%CI: 1.114～7.278）,decreased eating（OR=2.800,95%CI: 1.576～4.974）may be risk facto rs for relapse in LLD,and good medication compliance（OR=0.542,95%CI: 0.338～0.867）may be a protective factor for relapse in LLD.Part Ⅱ: Based on 22 evidence-based suggestions,an evidence-based intervention program for preventing the recurrence of depression in the elderly was constructe d,including 9 aspects,including team management,intervention form,interventio n evaluation,diet and nutrition,exercise and rehabilitation training,medication co mpliance guidance,social psychological intervention,cognitive-behavioral group p sychological counseling and effect evaluation.The authority coefficient of expert s in Delphi expert letter consultation was 0.87,and the positive coefficient of ex perts in the two rounds of letter consultation was 85.71% and 100% respectively.One new item was added and 14 items were modified.Conclusion:1.There is a high proportion of relapse cases in elderly inpatients with depressio n,so we should focus on patients with long course of disease,history of suicide,poor medication compliance,reduced activity and food intake,so as to take tar geted intervention to prevent their recurrence.2.Evidence-based nursing intervention program for the prevention of senile depres sion recurrence has high authority,strong consistency of expert opinions,and all indicators are important,which can meet the needs of senile depression inpatientsfor the prevention of recurrence. |
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