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Fealy S, McLaren S, Nott M, Seaman CE, Cash B, Rose L. Psychological interventions designed to reduce relocation stress for older people transitioning into permanent residential aged care: a systematic scoping review. Aging Ment Health 2024; 28:1197-1208. [PMID: 38634443 DOI: 10.1080/13607863.2024.2340731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES This study aimed to identify and evaluate psychological interventions or strategies designed to reduce relocation stress in older people making the permanent transition into residential aged care. METHOD A scoping review following the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was conducted. An electronic search of nine databases and the search engine google scholar was completed in December 2022. Article screening and quality appraisal was undertaken independently by at least two reviewers. RESULTS Eight full-text articles were included for review, from which four psychological interventions were identified: 1) Resident peer support; 2) Life review; 3) Mental Health Service for Older Adults; 4) The Program to Enhance Adjustment to Residential Living. No interventions were implemented before transitioning into care; all were implemented within three months of resident relocation into an aged care facility. CONCLUSION The transition to residential aged care is an inherently distressing experience. The absence of interventions implemented during the pre- and mid-transition phases presents a gap in the literature and suggests an opportunity for early intervention. As population ageing continues to increase, there is a pressing need for the development and implementation of interventions aimed at reducing symptoms of depression and anxiety for older people undertaking this major life transition.
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Affiliation(s)
- Shanna Fealy
- Ageing Well in Rural and Regional Australia Research Group, Charles Sturt University, Port Macquarie, NSW, Australia
- College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Suzanne McLaren
- Ageing Well in Rural and Regional Australia Research Group, Charles Sturt University, Port Macquarie, NSW, Australia
- School of Psychology, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Melissa Nott
- Ageing Well in Rural and Regional Australia Research Group, Charles Sturt University, Port Macquarie, NSW, Australia
- Three Rivers Department of Rural Health, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Claire Ellen Seaman
- Ageing Well in Rural and Regional Australia Research Group, Charles Sturt University, Port Macquarie, NSW, Australia
- Three Rivers Department of Rural Health, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Belinda Cash
- Ageing Well in Rural and Regional Australia Research Group, Charles Sturt University, Port Macquarie, NSW, Australia
- School of Social Work and Arts, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Lorraine Rose
- Division of Library Services, Charles Sturt University, Port Macquarie, NSW, Australia
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Pel-Littel RE, Buurman BM, Minkman MM, Scholte Op Reimer WJM, Twisk JWR, van Weert JCM. The influence of health literacy, anxiety and education on shared decision making and decisional conflict in older adults, and the mediating role of patient participation: A video observational study. PATIENT EDUCATION AND COUNSELING 2024; 124:108274. [PMID: 38547640 DOI: 10.1016/j.pec.2024.108274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 02/23/2024] [Accepted: 03/21/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To explore the relationship between personal characteristics of older adults with multiple chronic conditions (MCCs) and perceived shared decision making (SDM) resp. decisional conflict. METHODS In a video-observational study (N = 213) data were collected on personal characteristics. The main outcomes were perceived level of SDM and decisional conflict. The mediating variable was participation in the SDM process. A twostep mixed effect multilinear regression and a mediation analysis were performed to analyze the data. RESULTS The mean age of the patients was 77.3 years and 56.3% were female. Health literacy (β.01, p < .001) was significantly associated with participation in the SDM process. Education (β = -2.43, p = .05) and anxiety (β = -.26, p = .058) had a marginally significant direct effect on the patients' perceived level of SDM. Education (β = 12.12, p = .002), health literacy (β = -.70, p = .005) and anxiety (β = 1.19, p = .004) had a significant direct effect on decisional conflict. The effect of health literacy on decisional conflict was mediated by participation in SDM. CONCLUSION Health literacy, anxiety and education are associated with decisional conflict. Participation in SDM during consultations plays a mediating role in the relationship between health literacy and decisional conflict. PRACTICE IMPLICATIONS Tailoring SDM communication to health literacy levels is important for high quality SDM.
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Affiliation(s)
- Ruth E Pel-Littel
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; Vilans, Centre of expertise for long-term care, Utrecht, the Netherlands.
| | - Bianca M Buurman
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; ACHIEVE, Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Mirella M Minkman
- Vilans, Centre of expertise for long-term care, Utrecht, the Netherlands; TIAS School for Business and Society, Tilburg University, Tilburg, the Netherlands
| | | | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Julia C M van Weert
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, the Netherlands
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3
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Mathews G, Li X, Wilkinson H. The role and impact of therapeutic counselling on the emotional experience of adults living with dementia: A systematic review. DEMENTIA 2024; 23:882-902. [PMID: 38626888 PMCID: PMC11163847 DOI: 10.1177/14713012241233765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Introduction There is limited psychological support available to help people living with dementia to deal with the emotional consequences of their condition. Anxiety and depression are commonly experienced in this population, yet the use of counselling and psychotherapeutic interventions is not well documented. Aim This systematic review sought to understand the current knowledge on the role and impact of therapeutic counselling on the emotional experience of adults living with dementia. Methods Qualitative and quantitative research designs were accepted for review. A comprehensive search of the main biomedical, nursing and other specialist databases was performed to access articles published between 2015 and 2022. Trial registers and academic journals were also searched. 43 original studies were included: qualitative (n = 15); RCTs (n = 9); other designs (n = 19); plus eight systematic reviews. Results The majority of studies were conducted in Europe, the United Kingdom in particular, although a range of countries from across the globe were represented. The combined evidence from the different study designs suggest a range of ways that people living with different stages of dementia can participate in, and gain emotional benefit from, therapeutic counselling. Key themes identified: (1) The emotional and well-being benefits of therapeutic counselling; (2) No one size fits all - relational and tailored approaches driven by person-centred values; (3) Training, supervision and building community for counsellors; (4) Involvement of people with dementia in therapeutic interventions. Conclusions Our findings from this systematic review show that different therapeutic approaches have been tested with people at different stages of a dementia diagnosis. The results suggest the value of therapeutic counselling as a supportive medium to help with the processing and coping of difficult emotions and feelings across the trajectory of a dementia illness.
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Affiliation(s)
- Gill Mathews
- Edinburgh Centre for Research on the Experience of Dementia (ECRED), School of Health in Social Science, University of Edinburgh, UK
| | - Xiaoyang Li
- Edinburgh Centre for Research on the Experience of Dementia (ECRED), School of Health in Social Science, University of Edinburgh, UK
| | - Heather Wilkinson
- Edinburgh Centre for Research on the Experience of Dementia (ECRED), School of Health in Social Science, University of Edinburgh, UK
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Atchison K, Toohey AM, Ismail Z, Goodarzi Z. Understanding the Barriers to and Facilitators of Anxiety Management in Residents of Long-Term Care. Can J Aging 2024; 43:57-74. [PMID: 37665029 DOI: 10.1017/s0714980823000417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
Older adults, 65 years of age and older, living in long-term care (LTC) commonly experience anxiety. This study aimed to understand care providers' perspectives on the barriers to and facilitators of managing anxiety in residents of LTC. Ten semi-structured interviews with care providers in LTC were completed. Framework analysis methods were used to code, thematically analyze, designate codes as barriers or facilitators, and map the codes to the Theoretical Domains Framework. Themes were categorized as acting at the resident, provider, or system level, and were labelled as either barriers to or facilitators of anxiety care. Key barriers to anxiety care at each level were resident cognitive impairment or co-morbidities; lack of staff education, staff treatment uptake and implementation; as well as the care delivery environment and access to resources. There is a need to prioritize measurement-based care for anxiety, have increased access to non-pharmacological treatments, and have a care delivery environment that supports anxiety management to improve the care for anxiety that is delivered to residents.
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Affiliation(s)
- Kayla Atchison
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Ann M Toohey
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Brenda Strafford Centre on Aging, University of Calgary, Calgary, AB, Canada
| | - Zahinoor Ismail
- Department of Psychiatry, University of Calgary and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Zahra Goodarzi
- Department of Medicine, University of Calgary, Calgary, AB, Canada
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Craig S, Cao Y, McMahon J, Anderson T, Stark P, Brown Wilson C, Creighton L, Gonella S, Bavelaar L, Vlčková K, Mitchell G. Exploring the Holistic Needs of People Living with Cancer in Care Homes: An Integrative Review. Healthcare (Basel) 2023; 11:3166. [PMID: 38132056 PMCID: PMC10743280 DOI: 10.3390/healthcare11243166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
Up to 26% of individuals residing in care homes are impacted by cancer. This underscores the importance of understanding the holistic needs of care home residents living with cancer to enhance the quality of their care. The primary objective of this integrative literature review was to consolidate the available evidence concerning the comprehensive needs of people living with cancer in care home settings, providing valuable insights into addressing their diverse needs. An integrative literature review was conducted using a systematic approach. Extensive searches were conducted in three databases, complemented by a thorough examination of grey literature and reference lists of relevant papers. The review focused on literature published between 2012 and 2022. The screening process involved two independent reviewers, with a third reviewer resolving any discrepancies. The review identified twenty research papers that met the eligibility criteria. These papers shed light on three primary themes related to the holistic needs of care home residents with cancer: physical, psychological, and end-of-life needs. Physical needs encompassed pain management, symptom control, and nutrition, while psychological needs involved social support, emotional well-being, and mental health care. End-of-life needs addressed end-of-life care and advance care planning. These themes highlight the multifaceted nature of cancer care in care homes and underscore the importance of addressing residents' holistic needs in a comprehensive and integrated manner. Improving care home education about cancer and integrating palliative and hospice services within this setting are vital for addressing the diverse needs of residents with cancer.
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Affiliation(s)
- Stephanie Craig
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Yanting Cao
- The Shanghai Medical College, Fudan University, Shanghai 200437, China;
- Stellar Care NW Ltd., Ellesmere Port CH65 1A, UK
| | - James McMahon
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Tara Anderson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Patrick Stark
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Christine Brown Wilson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Laura Creighton
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Silvia Gonella
- Direction of Health Professions, City of Health and Science University Hospital of Torino, Corso Bramante 88-90, 10126 Turin, Italy;
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy
| | - Laura Bavelaar
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | | | - Gary Mitchell
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
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Dangerfield HJ, Scott JM, Zohn JH, Segal DL, Benton MJ. Relationship between anxiety and quality of life among older adults with self-reported polypharmacy in long-term care: A cross-sectional study. J Adv Nurs 2023; 79:3559-3568. [PMID: 37161612 DOI: 10.1111/jan.15691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/24/2023] [Accepted: 04/23/2023] [Indexed: 05/11/2023]
Abstract
AIMS To investigate the relationship between anxiety and quality of life among older adults with self-reported polypharmacy living in the long-term care setting. DESIGN A cross-sectional design was used. METHODS Between July 2021 and August 2022, 92 older adults living in long-term care completed an anonymous one-time questionnaire packet. Polypharmacy was measured as self-reported five or more medications daily. Anxiety was measured using the Geriatric Anxiety Scale-Long Term Care tool. Quality of life was measured as health-related quality of life using two global questions from the RAND-36 and as medication-related quality of life using the Medication-Related Quality of Life Scale. RESULTS The prevalence of polypharmacy was 89%. Among participants with polypharmacy, average age was 80.1 ± 7.9 years. The majority were female (70%) and white (85%). There was a moderate-to-strong correlation between anxiety and quality of life. Specifically, anxiety was negatively related to current health-related quality of life, perceived change in health-related quality of life and medication-related quality of life. Overall, anxiety explained 27-31% of the variance in both health-related and medication-related quality of life. CONCLUSION The results of this study indicate that as anxiety increases, health-related and medication-related quality of life decreases in older adults living in long-term care who report consuming five or more medications daily. Advanced practice nurses can use these findings to guide practice, tailor interventions and improve care for these long-term care residents. IMPLICATIONS Multiple medications are increasingly prescribed to treat multiple comorbidities in older adults. As a result, the prevalence of polypharmacy (≥5 medications per day) is rising and problematic. The main findings of this study highlight the negative relationship between anxiety and quality of life in this population and the need for adequate assessment of anxiety by advanced practice nurses in order to personalize care. REPORTING METHOD In preparing the manuscript, the authors have adhered to relevant EQUATOR guidelines and the STROBE checklist for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution outside of participation in the actual study for purposes of data collection.
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Affiliation(s)
- Hannah J Dangerfield
- Department of Nursing, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
- Agape Healthcare, Greenwood Village, Colorado, USA
| | - Judith M Scott
- Department of Nursing, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
| | - Jennifer H Zohn
- Department of Nursing, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
| | - Daniel L Segal
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
| | - Melissa J Benton
- Department of Nursing, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
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Wright E, Pagliaro C, Page IS, Diminic S. A review of excluded groups and non-response in population-based mental health surveys from high-income countries. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1265-1292. [PMID: 37212903 PMCID: PMC10423166 DOI: 10.1007/s00127-023-02488-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/30/2023] [Indexed: 05/23/2023]
Abstract
National mental health surveys play a critical role in determining the prevalence of mental disorders in a population and informing service planning. However, current surveys have important limitations, including the exclusion of key vulnerable groups and increasing rates of non-response. This review aims to synthesise information on excluded and undersampled groups in national mental health surveys. We conducted a targeted review of nationally representative adult mental health surveys performed between 2005 and 2019 in high-income OECD countries. Sixteen surveys met our inclusion criteria. The response rate for included surveys ranged between 36.3% and 80.0%. The most frequently excluded groups included people who were homeless, people in hospitals or health facilities and people in correctional facilities. Males and young people were the most commonly underrepresented groups among respondents. Attempts to collect data from non-responders and excluded populations were limited, but suggest that mental health status differs among some of these cohorts. The exclusion of key vulnerable groups and high rates of non-response have important implications for interpreting and using the results of national mental health surveys. Targeted supplementary surveys of excluded or hard-to-reach populations, more inclusive sampling methodologies, and strategies aimed at improving response rates should be considered to strengthen the accuracy and usefulness of survey findings.
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Affiliation(s)
- Eryn Wright
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia.
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia.
| | - Claudia Pagliaro
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia
| | - Imogen S Page
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia
| | - Sandra Diminic
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia
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Ding S, Liu G, Xu F, Ji K, Zhao L, Zheng X, Benjamin O, Wang Z, Yang S, Chen R. The satisfaction of elderly people with elderly caring social organizations and its relationship with social support and anxiety during the COVID-19 pandemic: a cross-sectional study. BMC Public Health 2023; 23:1206. [PMID: 37344834 DOI: 10.1186/s12889-023-15951-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/22/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND With the deepening of China's aging population, higher demands have been placed on the supply of elderly care services. As one of the main sources of providing elderly care services, the quality of service provided by elderly caring social organizations (SOs) directly affects the quality of life of the elderly. In recent years, mental health issues among the elderly have become increasingly prominent, especially with the onset of the COVID-19 pandemic. Necessitating the need to pay much more attention to the social support and mental health of this population. This study, therefore, explores the mediating role of institutional satisfaction between the social support and anxiety levels of elderly people in Chongqing's elderly caring SOs. METHOD This study employed a multi-stage stratified random sampling method to survey 1004 service recipients in elderly caring social organizations from July to August 2022. The self-made sociodemographic questionnaire, institutional satisfaction questionnaire, MSPSS, and GAD-7 were used to collect data on sociodemographic characteristics, institutional satisfaction, social support, and anxiety levels of older adults. Exploratory Factor Analysis and Cronbach's alpha were used to test construct validity and scale reliability, respectively. Data features were described with One-Way Analysis of Variance, while Multiple Linear Regression and Structural Equation Modeling were used to evaluate relationships between social support, institutional satisfaction, and anxiety levels. RESULTS The average institutional satisfaction score for elderly people in elderly caring SOs was 48.14 ± 6.75. Specifically, the satisfaction score for environmental quality and the satisfaction score for service quality were 16.63 ± 2.56 and 31.52 ± 4.76, respectively. In terms of socio-demographic variables, the presence of visits from relatives, personal annual average income, and self-rated health status all have significant effects on anxiety. Elders who receive visits from relatives have lower levels of anxiety compared to those who do not. Personal annual average income and self-rated health status are negatively correlated with anxiety levels. Social support had significant positive effect on institutional satisfaction, while institutional satisfaction had significant negative effect on anxiety. Institutional satisfaction partially mediated the relationship between social support and anxiety. CONCLUSIONS Our research demonstrates that improving the quality of organizational services in elderly caring SOs and increasing institutional satisfaction among the elders has significant potential for reducing anxiety levels among the elderly. Additionally, the social support by visits from family members cannot be overlooked. We encourage increasing the frequency of family visits through various means to enhance the support provided to elderly individuals.
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Affiliation(s)
- Shuo Ding
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Guoqing Liu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Fuqin Xu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Kai Ji
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Lanlan Zhao
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Xin Zheng
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Otsen Benjamin
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
- Registrars' Department, University of Cape Coast, Cape Coast, Ghana
| | - Zhengsheng Wang
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Shufan Yang
- School of Computing, Engineering and Built Environment, Edinburgh Napier University, Edinburgh, UK
- Research Department of Orthopaedics and Musculoskeletal Science, University College London, UCL, London, UK
| | - Ren Chen
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China.
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Jain N, Wang Y, Zhang Y, Jacobsen E, Andreescu C, Snitz BE, Chang CCH, Ganguli M. It goes both ways: The relationship between anxiety and mild cognitive impairment. Int J Geriatr Psychiatry 2023; 38:e5899. [PMID: 36855309 DOI: 10.1002/gps.5899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/19/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To investigate the relationship between anxiety and mild cognitive impairment (MCI), and whether it is mediated by perceived stress, at the population level. METHOD AND DESIGN In a longitudinal study of 368 adults aged 65+ from a population-based cohort, we annually assessed anxiety symptoms (GAD-7), perceived stress (PSS-4), and ratings on the Clinical Dementia Rating (CDR®), where CDR = 0.5 was operationalized as MCI. Examining data from three consecutive assessment waves, we first determined the associations between anxiety at the first wave with MCI at the third wave, and vice versa. We then used mediation analyses to determine whether the pathways in both directions were mediated by perceived stress at the second wave, adjusting for demographics and other relevant covariates. RESULTS We confirmed significant bidirectional longitudinal associations between anxiety and MCI. Perceived stress was detected as a significant mediator for both pathways between anxiety and MCI, explaining 37.1% of the total effect (TE) of anxiety on incident MCI while conversely explaining 27.1% of the TE of MCI on anxiety. CONCLUSIONS A bidirectional relationship with a 2-year lag between anxiety and MCI was mediated through perceived stress. Clinicians should be sensitive both to potential consequent anxiety when patients present with cognitive impairment, and to potential incipient MCI when the presenting complaint is anxiety. Managing stress may help mitigate adverse outcomes.
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Affiliation(s)
- Neha Jain
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Yueting Wang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Yingjin Zhang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Erin Jacobsen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Chung-Chou H Chang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.,Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
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10
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Detecting Anxiety in Long-Term Care Residents: A Systematic Review. Can J Aging 2023; 42:92-101. [PMID: 35659789 DOI: 10.1017/s0714980822000101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Anxiety is common in long-term care (LTC), but it is unclear which anxiety detection tools are accurate when compared to a reference standard for residents of LTC. Four databases and grey literature sources were searched using the search concepts "anxiety" and "LTC". Included studies evaluated the diagnostic accuracy of an anxiety detection tool compared to a reference standard in LTC residents. Diagnostic accuracy measures were extracted. Four articles out of 4,620 met the inclusion criteria. Despite limited evidence and poorly reported study procedures and characteristics, the Geriatric Anxiety Inventory (sensitivity: 90.0%, specificity: 86.2%) and the Hospital Anxiety and Depression Scale-Anxiety (sensitivity: 90.0%, specificity: 80.6%) had the best performance when detecting generalized anxiety disorder. We identified four anxiety detection tools appropriate for use in LTC; a critical first step to diagnosing and managing anxiety in residents of LTC. Non-generalized anxiety disorders and tool feasibility must be further evaluated.
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11
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Davison TE, McCabe MP, Busija L, Graham A. Program to Enhance Adjustment to Residential Living (PEARL): Effect on Adjustment, Anxiety, Quality of Life, and Stress. Clin Gerontol 2022; 45:1117-1129. [PMID: 35856170 DOI: 10.1080/07317115.2022.2100729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The Program to Enhance Adjustment to Residential Living (PEARL) is a five session intervention primarily designed to address high rates of depression in newly admitted residents. This study reports the efficacy of PEARL on secondary outcomes of resident adjustment, symptoms of anxiety, quality of life, and stress. METHODS A cluster randomized controlled trial was conducted with 219 newly admitted nursing home residents (M age = 85.5 years) from 42 nursing homes. Outcomes were assessed at baseline, post-intervention, and at two and six month post-intervention follow-up, compared to a standard care condition. RESULTS There was a significant overall condition by time interaction for adjustment (p = .027) and quality of life (p = .015), but not for stress (p = .309). While the overall condition by time interaction was not significant for anxiety (p = .221), there was a significant interaction contrast six-month post-intervention, indicating a greater decrease in anxiety scores in the intervention group relative to control (p = .039). CONCLUSIONS This study demonstrates the broad effects of PEARL on the wellbeing of newly admitted residents. CLINICAL IMPLICATIONS PEARL is a brief intervention that may be feasible for routine use in nursing homes to facilitate adjustment and improve residents' quality of life.
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Affiliation(s)
- Tanya E Davison
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.,Research & Innovation, Silverchain, Melbourne, Australia
| | - Marita P McCabe
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Ljoudmila Busija
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Annette Graham
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.,Mitchell Institute, Victoria University, Footscray Park, Australia
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12
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Atchison K, Watt JA, Ewert D, Toohey AM, Ismail Z, Goodarzi Z. Non-pharmacologic and pharmacologic treatments for anxiety in long-term care: a systematic review and meta-analysis. Age Ageing 2022; 51:6691375. [PMID: 36057989 DOI: 10.1093/ageing/afac195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND older adults living in long-term care (LTC) commonly suffer from anxiety symptoms and disorders. We completed a systematic review and meta-analysis to identify efficacious treatments for anxiety symptoms for older adults living in LTC. METHODS we searched five electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials) to identify treatments for anxiety that have been trialled in LTC. Included studies had to be randomised trials, include residents of LTC, and measure anxiety symptoms as an outcome. RESULTS the electronic search returned 6,617 articles, 519 were reviewed in full text, and 80 were included in the descriptive synthesis. Limited studies were meta-analysed (n = 10) due to differences in described treatment and comparator conditions. Limited clinically relevant evidence supporting the use of pharmacologic treatments for symptoms of anxiety in LTC was identified. Of the treatments trialled, music compared with usual care (standardised mean difference, SMD: -0.82; 95% confidence interval (CI): -1.31, -0.34), music compared with social interaction (SMD: -0.41; 95% CI: -0.72, -0.10) and massage compared with usual care (SMD: -4.32; 95% CI: -7.44, -1.19) were found to improve anxiety symptoms, however, significant heterogeneity was detected in two comparisons. CONCLUSIONS a range of non-pharmacologic treatments that improved anxiety symptoms were identified for use in LTC. Although limited evidence exists to support the use of particular treatments, most non-pharmacologic treatments were low-risk interventions that may be readily implemented. Further research is required to assess the treatment effect on residents of LTC with anxiety disorders or clinically relevant symptoms at baseline.
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Affiliation(s)
- Kayla Atchison
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer A Watt
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Delaney Ewert
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Ann M Toohey
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Brenda Strafford Centre on Aging, Calgary, Alberta, Canada
| | - Zahinoor Ismail
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Zahra Goodarzi
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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13
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Stojanov T, Perquier F, Boiteux C, Soudani MLN, Château N, Perozziello A, Gallarda T. From psychiatric hospitals to residential facilities: Characteristics of patients who benefited from an institutional partnership. Int J Geriatr Psychiatry 2022; 37. [PMID: 35775628 DOI: 10.1002/gps.5772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/09/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The population of older adults is growing fast, especially in Europe and Northern America. Old age is often associated with mental health comorbidities. Moreover, life expectancy of people suffering from psychiatric disorders has increased, but with age-related difficulties, such as loss of independence. This represents a challenge for public health policies, as this population requires specific care and living conditions. As a response, a convention was signed between living facilities for dependent elderly (EHPAD) and the GHU Paris Psychiatry and Neurosciences. The agreement included dedicated places in EHPAD for older patients with psychiatric disorders. The aim of the study was to describe the sociodemographic and clinical characteristics of those patients. METHODS We conducted a cross-sectional study among patients who applied for an EHPAD admission. RESULTS Between 2016 and 2019, 163 patients applied for placement in an EHPAD, and 117 were admitted (72%). Applicants were 71 years old on average. Admitted patients were older than non-admitted and lived in different Parisian sectors. Among admitted patients, nine in 10 were single, divorced or widowed, and 64.3% were childless. Almost half of them were schizophrenic or had delusional disorders (46.9%), and 65.3% were considered as moderately dependent. At the time of the study, 89 patients still lived in EHPAD. Almost half of them had anxiety and depressive disorders (48.3%), 19.1% had cognitive disorders, and 42.7% manifested agitation. CONCLUSIONS Our study highlighted older psychiatric patients' specificities regarding their admission status into long-term living facilities.
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Affiliation(s)
- Thomas Stojanov
- Cellule épidémiologie, GHU Paris Psychiatrie et Neurosciences, Paris, France.,Centre d'Action Sociale de la Ville de Paris, Paris, France
| | - Florence Perquier
- Cellule épidémiologie, GHU Paris Psychiatrie et Neurosciences, Paris, France
| | | | | | - Naïssa Château
- Cellule épidémiologie, GHU Paris Psychiatrie et Neurosciences, Paris, France
| | - Anne Perozziello
- Cellule épidémiologie, GHU Paris Psychiatrie et Neurosciences, Paris, France
| | - Thierry Gallarda
- Centre d'Évaluation des Troubles Psychiques et du Vieillissement (CEPTV), GHU Paris Psychiatrie et Neurosciences, Paris, France
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14
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Cameron N, Fetherstonhaugh D, Rayner JA, McAuliffe L. Loss, Unresolved Trauma and Gaps in Staff Knowledge: A Qualitative Study on Older Adults Living in Residential Aged Care. Issues Ment Health Nurs 2022; 43:748-754. [PMID: 35235481 DOI: 10.1080/01612840.2022.2043496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Despite the prevalence of mental health concerns among those who live in residential aged care, many residential aged care facilities (RACFs) provide little by way of psychological support. Drawing on qualitative data obtained from interviews with residents from across 15 RACFs in Victoria, Australia, this article adds to understandings about the diversity and impact of mental health challenges experienced by residents, and gaps in the knowledge of staff about how to address such. Thus, it also offers evidence of the urgent need for RACFs to provide residents both better access to specialist mental health practitioners and training to care staff on mental health issues.
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Affiliation(s)
- Nadine Cameron
- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Australia
| | | | - Jo-Anne Rayner
- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Australia
| | - Linda McAuliffe
- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Australia
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- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Australia
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15
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Baxter R, Lövheim H, Björk S, Sköldunger A, Edvardsson D. Exploring changes to resident thriving and associated factors in Swedish nursing homes: A repeated cross-sectional study. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5731. [PMID: 35584280 PMCID: PMC9325443 DOI: 10.1002/gps.5731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/27/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to explore changes to resident thriving in Swedish nursing homes over a 5-year period and describe changes in associated factors. METHODS Cross-sectional data were collected from a randomised sample of Swedish nursing homes in 2013/2014 (baseline) and 2018/2019 (follow-up). Descriptive statistics, independent samples t-tests, and chi squared tests were used to statistically evaluate differences between the samples. Simple and multiple linear regression analyses were used to explore associations between thriving and the study variables. RESULTS Resident characteristics were relatively consistent between the full baseline (N = 4831) and follow-up (N = 3894) samples. Within a sub-sample of nursing homes that participated in both data collections mean thriving scores were found to have increased from 152.9 to 155.2 (p ≤ 0.003; d =0.09) and overall neuropsychiatric index scores had decreased from 16.0 to 14.3 (p ≤ 0.004; d =0.09), as had the prevalence of several neuropsychiatric symptoms. Thriving was found to have a positive association with the neuropsychiatric symptom of elation/euphoria, and negative associations with the symptoms of aggression/agitation, depression/dysphoria, apathy, and irritability. CONCLUSIONS The results show an increase in overall thriving scores and a decrease in overall neuropsychiatric scores between baseline and follow-up. This study confirmed associations between thriving and certain neuropsychiatric symptoms and established comparative knowledge regarding changes in resident thriving, characteristics, and symptom prevalence. These findings could inform future care and organisational policies to support thriving in nursing homes, particularly among residents at risk of lower thriving due to cognitive impairment or neuropsychiatric symptoms.
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Affiliation(s)
- Rebecca Baxter
- Department of NursingUmeå UniversityUmeåSweden,Center for Collaborative Palliative CareDepartment of Health and Caring SciencesLinnaeus UniversityVäxjöSweden
| | - Hugo Lövheim
- Department of Community Medicine and RehabilitationGeriatric MedicineUmeå UniversityUmeåSweden
| | - Sabine Björk
- Department of NursingUmeå UniversityUmeåSweden,Department of Public Health and Clinical MedicineSection of Sustainable HealthUmeå UniversityUmeåSweden
| | | | - David Edvardsson
- Department of NursingUmeå UniversityUmeåSweden,School of Nursing and MidwiferyLa Trobe UniversityMelbourneVictoriaAustralia
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16
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Carden KD, McDuffie DL, Murry K, Bui C, Allen RS. Minority stress process among older Black Americans: the role of age, perceived discrimination, and anxiety. Aging Ment Health 2022; 26:852-859. [PMID: 33836631 DOI: 10.1080/13607863.2021.1904380] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Prolonged experiences of discrimination can be a major source of physical and health-related stress, particularly in older Black Americans. However, there is limited information on the relation between discrimination and anxiety, particularly within the context of other constructs that influence the manifestation of anxiety symptoms. For example, several studies have suggested that ethnic identification may provide psychological and social resources to deal with the effects of discrimination. This study aims to further understand these processes.Method: This study utilized structural equation modeling (SEM) to examine predictors of anxiety symptom severity in a sample of African American and Afro-Caribbean adults aged 55 and older from the National Survey of American Life (N = 1,032).Results: The final structural regression model revealed acceptable fit indices, and was successful in measuring latent anxiety symptom severity, showing that more experienced discrimination was related to higher anxiety and anxiety was directly related to mental health rating. While higher experience of discrimination was associated with higher anxiety, it was not directly related to mental health rating. However, contrary to expectation, ethnic identification did not serve as a protective factor between experienced discrimination and anxiety. As individuals aged, they experienced less discrimination and reported poorer self-rated mental health.Conclusions: While age served as a protective factor for perceived discrimination and anxiety symptom severity, ethnic identification did not. Implications for those working to reduce anxiety symptoms among Black Americans are discussed.
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Affiliation(s)
- Keisha D Carden
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA.,Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA.,Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - Danielle L McDuffie
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA.,Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Kaleb Murry
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA.,Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Chuong Bui
- Alabama Life Research Institute, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Rebecca S Allen
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA.,Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
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17
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Cortés Zamora EB, Mas Romero M, Tabernero Sahuquillo MT, Avendaño Céspedes A, Andrés-Petrel F, Gómez Ballesteros C, Sánchez-Flor Alfaro V, López-Bru R, López-Utiel M, Celaya Cifuentes S, Plaza Carmona L, Gil García B, Pérez Fernández-Rius A, Alcantud Córcoles R, Roldán García B, Romero Rizos L, Sánchez-Jurado PM, Luengo Márquez C, Esbrí Víctor M, León Ortiz M, Ariza Zafra G, Martín Sebastiá E, López Jiménez E, Paterna Mellinas G, Martínez-Sánchez E, Noguerón García A, Ruiz García MF, García-Molina R, Estrella Cazalla JDD, Abizanda P. Psychological and Functional Impact of COVID-19 in Long-Term Care Facilities: The COVID-A Study. Am J Geriatr Psychiatry 2022; 30:431-443. [PMID: 35123862 PMCID: PMC8782739 DOI: 10.1016/j.jagp.2022.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 11/27/2021] [Accepted: 01/12/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To analyze the psychological and functional sequelae of the COVID-19 pandemic among older adults living in long term care facilities (LTCFs). DESIGN Cohort longitudinal study SETTING ANT PARTICIPANTS: A total of 215 residents ≥ 65 years without moderate-to-severe cognitive impairment, living in five LTCFs in Albacete (Spain). MEASUREMENTS Baseline on-site data were collected between March - June 2020 and three-month follow-up between June to September 2020. Symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), and sleep disturbances were measured as psychological variables. Disability in basic activities of daily living (BADL), ambulation and frailty were assessed as functional variables. Differences were analyzed in relation to level of comorbidity and test positivity for COVID-19. RESULTS At baseline, residents with COVID-19 presented worse functionality, higher frailty levels and malnutrition risk compared to non-COVID-19 residents. At three-month follow-up, higher rates of clinically significant depressive symptoms (57.7%), anxiety symptoms (29.3%), PTSD symptoms (19.1%) and sleep disturbances (93.0%) were found among residents regardless of COVID status. Thus, among 215 residents, 101 (47%) experienced a decline in BADL from baseline to the 3-month follow-up (median functional loss = 5 points in Barthel Index). In multivariate analyses, COVID-19 status did not explain either the functional or the ambulation loss. By contrast, residents with low comorbidity and COVID-19 presented higher PTSD symptoms (effect 2.58; 95% CI 0.93 to 4.23) and anxiety symptoms (effect 2.10; 95% CI 0.48 to 3.73) compared to the low comorbidity/non-COVID19 group. CONCLUSION COVID-19 pandemic was associated, after three-months, with high psychological impact in older adults in LTCFs., specifically with higher post-traumatic stress and anxiety symptoms. Functional decline did not differ in relation to COVID-19 status but could be related to isolation strategies used for pandemic control.
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Affiliation(s)
- Elisa Belén Cortés Zamora
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Marta Mas Romero
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - María Teresa Tabernero Sahuquillo
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Almudena Avendaño Céspedes
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain,CIBERFES (AAC, LRR, PMSJ, JDEC, PA), Ministerio de Economía y Competitividad, Spain,Facultad de Medicina (AAC, LRR, PMSJ, CLM, PA), Universidad de Castilla-La Mancha, Albacete, Spain
| | - Fernando Andrés-Petrel
- Department of Statistics (FAP), Foundation of the National Paraplegics Hospital of Toledo, Toledo, Spain
| | - Cristina Gómez Ballesteros
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Victoria Sánchez-Flor Alfaro
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Rita López-Bru
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Melisa López-Utiel
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Sara Celaya Cifuentes
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Laura Plaza Carmona
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Borja Gil García
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Ana Pérez Fernández-Rius
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Rubén Alcantud Córcoles
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Belén Roldán García
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Luis Romero Rizos
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain,CIBERFES (AAC, LRR, PMSJ, JDEC, PA), Ministerio de Economía y Competitividad, Spain,Facultad de Medicina (AAC, LRR, PMSJ, CLM, PA), Universidad de Castilla-La Mancha, Albacete, Spain
| | - Pedro Manuel Sánchez-Jurado
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain,CIBERFES (AAC, LRR, PMSJ, JDEC, PA), Ministerio de Economía y Competitividad, Spain,Facultad de Medicina (AAC, LRR, PMSJ, CLM, PA), Universidad de Castilla-La Mancha, Albacete, Spain
| | - Carmen Luengo Márquez
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain,Facultad de Medicina (AAC, LRR, PMSJ, CLM, PA), Universidad de Castilla-La Mancha, Albacete, Spain
| | - Mariano Esbrí Víctor
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Matilde León Ortiz
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Gabriel Ariza Zafra
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Elena Martín Sebastiá
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Esther López Jiménez
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Gema Paterna Mellinas
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Esther Martínez-Sánchez
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Alicia Noguerón García
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - María Fe Ruiz García
- Vasco Núñez de Balboa Facility (MFRG, JDEC), Consejería de Bienestar Social de la Junta de Comunidades de Castilla La Mancha, Albacete, Spain
| | - Rafael García-Molina
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Juan de Dios Estrella Cazalla
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain,CIBERFES (AAC, LRR, PMSJ, JDEC, PA), Ministerio de Economía y Competitividad, Spain,Vasco Núñez de Balboa Facility (MFRG, JDEC), Consejería de Bienestar Social de la Junta de Comunidades de Castilla La Mancha, Albacete, Spain
| | - Pedro Abizanda
- Department of Geriatrics (EBCZ, MMR, MTTS, AAC, CGB, VSFA, RLB, MLU, SCC, LPC, BGG, APFR, RAC, BRG, LRR, PMSJ, CLM, MEV, MLO, GAZ, EMS, ELJ, GPM, EMS, ANG, RGM, JDEC, PA), Complejo Hospitalario Universitario de Albacete, Albacete, Spain; CIBERFES (AAC, LRR, PMSJ, JDEC, PA), Ministerio de Economía y Competitividad, Spain; Facultad de Medicina (AAC, LRR, PMSJ, CLM, PA), Universidad de Castilla-La Mancha, Albacete, Spain.
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18
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Srifuengfung M, Thana-udom K, Ratta-apha W, Chulakadabba S, Sanguanpanich N, Viravan N. Impact of the COVID-19 pandemic on older adults living in long-term care centers in Thailand, and risk factors for post-traumatic stress, depression, and anxiety. J Affect Disord 2021; 295:353-365. [PMID: 34488089 PMCID: PMC8397501 DOI: 10.1016/j.jad.2021.08.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 07/28/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is a lack of data concerning impact of COVID-19 among older adults (OA) living at long-term care (LTC) centers. This study investigated how COVID-19 has affected this population. The prevalence of and risk factors for post-traumatic stress, depression, and anxiety were investigated. METHODS A semi-structured interview to determine the effect of COVID-19 was conducted to 200 OA at two government LTC centers. The 17-item Post-traumatic Stress Disorder Checklist, the 9-item Patient Health Questionnaire, and the 7-item Generalized Anxiety Disorder Scale were used to evaluate post-traumatic stress, depression, and anxiety, respectively. RESULTS Most OA reported moderate or severe impact of COVID-19. The most impacted area was financial due to decreased support from outside the center. Seventy percent of OA reported no or mild psychological stress from COVID-19; however, 5.5% had post-traumatic stress, 7.0% had depression, and 12.0% had anxiety. Higher psychological stress from COVID-19 and having respiratory tract infection symptoms were independently associated with post-traumatic stress, depression, and anxiety. Receiving COVID-19 news via social media was independently associated with post-traumatic stress and depression. Having psychiatric comorbidity was independently associated with depression. CONCLUSIONS OA living in LTC centers reported moderate or severe impact from COVID-19, especially financial, but relatively low psychological stress. Psychological stress from COVID-19, having respiratory tract infection symptoms, and receiving COVID-19 news via social media were risk factors for psychological disorders. LIMITATIONS The data reflected the post-outbreak period. There is limitation in the generalizability of the results for other countries with different health care systems.
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Affiliation(s)
| | | | | | | | | | - Natee Viravan
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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19
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Brown Wilson C. Supporting older people experiencing anxiety through non-pharmacological interventions. Nurs Older People 2021; 33:35-42. [PMID: 34730298 DOI: 10.7748/nop.2021.e1331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 11/09/2022]
Abstract
Anxiety is a debilitating condition that adversely affects people's quality of life. It is challenging to differentiate anxiety from other physical and mental health conditions in older people, particularly those with co-morbid dementia or depression. The coronavirus 2019 pandemic has compounded social isolation and loneliness in older people, causing increased levels of anxiety. Nurses need to be able to detect and assess anxiety in older people and offer short, low-intensity interventions to support older people's mental health or refer them to specialist assessment and treatment. While research on anxiety in older people is lacking, cognitive behavioural therapy, mindfulness, yoga, music therapy and pleasant activities have shown potential as non-pharmacological interventions for alleviating anxiety in older people. This article explores the role of nurses in identifying when an older person may be experiencing anxiety and then choosing the optimal non-pharmacological intervention to support them.
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20
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Towers AM, Smith N, Allan S, Vadean F, Collins G, Rand S, Bostock J, Ramsbottom H, Forder J, Lanza S, Cassell J. Care home residents’ quality of life and its association with CQC ratings and workforce issues: the MiCareHQ mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2021. [DOI: 10.3310/hsdr09190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background
Care home staff have a critical bearing on quality. The staff employed, the training they receive and how well they identify and manage residents’ needs are likely to influence outcomes. The Care Act 2014 (Great Britain. The Care Act 2014. London: The Stationery Office; 2014) requires services to improve ‘well-being’, but many residents cannot self-report and are at risk of exclusion from giving their views. The Adult Social Care Outcomes Toolkit enables social care-related quality of life to be measured using a mixed-methods approach. There is currently no equivalent way of measuring aspects of residents’ health-related quality of life. We developed new tools for measuring pain, anxiety and depression using a mixed-methods approach. We also explored the relationship between care home quality, residents’ outcomes, and the skill mix and employment conditions of the workforce who support them.
Objectives
The objectives were to develop and test measures of pain, anxiety and depression for residents unable to self-report; to assess the extent to which regulator quality ratings reflect residents’ care-related quality of life; and to assess the relationship between aspects of the staffing of care homes and the quality of care homes.
Design
This was a mixed-methods study.
Setting
The setting was care homes for older adults in England.
Participants
Care home residents participated.
Results
Three measures of pain, anxiety and low mood were developed and tested, using a mixed-methods approach, with 182 care home residents in 20 care homes (nursing and residential). Psychometric testing found that the measures had good construct validity. The mixed-methods approach was both feasible and necessary with this population, as the majority of residents could not self-report. Using a combined data set (n = 475 residents in 54 homes) from this study and the Measuring Outcomes in Care Homes study (Towers AM, Palmer S, Smith N, Collins G, Allan S. A cross-sectional study exploring the relationship between regulator quality ratings and care home residents’ quality of life in England. Health Qual Life Outcomes 2019;17:22) we found a significant positive association between residents’ social care-related quality of life and regulator (i.e. Care Quality Commission) quality ratings. Multivariate regression revealed that homes rated ‘good/outstanding’ are associated with a 12% improvement in mean current social care-related quality of life among residents who have higher levels of dependency. Secondary data analysis of a large, national sample of care homes over time assessed the impact of staffing and employment conditions on Care Quality Commission quality ratings. Higher wages and a higher prevalence of training in both dementia and dignity-/person-centred care were positively associated with care quality, whereas high staff turnover and job vacancy rates had a significant negative association. A 10% increase in the average care worker wage increased the likelihood of a ‘good/outstanding’ rating by 7%.
Limitations
No care homes rated as inadequate were recruited to the study.
Conclusions
The most dependent residents gain the most from homes rated ‘good/outstanding’. However, measuring the needs and outcomes of these residents is challenging, as many cannot self-report. A mixed-methods approach can reduce methodological exclusion and an over-reliance on proxies. Improving working conditions and reducing staff turnover may be associated with better outcomes for residents.
Future work
Further work is required to explore the relationship between pain, anxiety and low mood and other indicators of care homes quality and to examine the relationship between wages, training and social care outcomes.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 19. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ann-Marie Towers
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Nick Smith
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Stephen Allan
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Florin Vadean
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Grace Collins
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Stacey Rand
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | | | | | - Julien Forder
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
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21
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Bhar S, Stargatt J, Collins R, Bhowmik J, Silver M. Preliminary evidence for the impact of digital life stories about aged care residents on staff knowledge and understanding regarding those residents; A single arm trial. J Clin Nurs 2021; 31:2252-2258. [PMID: 34605590 DOI: 10.1111/jocn.16043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/10/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to examine the impact of digital stories about aged care residents on staff knowledge and understanding regarding those residents. BACKGROUND More than a quarter of a million older Australians live in residential aged care facilities. This living arrangement can inhibit the expression of a person's sense of identity. Without objects and cues that reflect the person's selfhood, it can be difficult for a person to express their uniqueness. Staff may not sufficiently appreciate the resident's individuality and therefore may not be able to customise care for the resident. DESIGN This study used a single-arm trial design. METHODS The study was conducted in four residential aged care facilities. Short digital life stories (3-4 min) of eight residents were constructed by student volunteers over 6 months. Participants (n = 53 care staff) completed a self-report measure of their knowledge and understanding of a resident before and after watching the resident's story. The study adhered to guidelines for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) (see Appendix S1). RESULTS Pre- and post-test scores of the measure were compared using paired samples t-tests. These scores changed significantly, showing an improvement of knowledge and understanding regarding residents. CONCLUSIONS Watching digital life stories were associated with improvements in knowledge and understanding by staff, and hence have the potential to foster a greater level of understanding of residents by such staff, and more person-centred care practices within residential aged care facilities. RELEVANCE TO CLINICAL PRACTICE Digital stories about aged care residents are quick and efficient methods for improving aged care staff members' knowledge and understanding of the residents under their care. With such understanding, staff may be able to better customise care for residents, thereby validating residents' sense of identity and elevating residents' quality of life.
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Affiliation(s)
- Sunil Bhar
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jennifer Stargatt
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Rebecca Collins
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jahar Bhowmik
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Mark Silver
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
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22
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Brimelow RE, Thangavelu K, Beattie R, Dissanayaka NN. Feasibility of Group-Based Multiple Virtual Reality Sessions to Reduce Behavioral and Psychological Symptoms in Persons Living in Residential Aged Care. J Am Med Dir Assoc 2021; 23:831-837.e2. [PMID: 34454923 DOI: 10.1016/j.jamda.2021.07.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/07/2021] [Accepted: 07/18/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To assess the feasibility of using group-based fully immersive virtual reality (VR) across multiple sessions to reduce behavioral and psychological symptoms (BPSs), including depression, anxiety, and agitated behaviors, in cognitively diverse aged care residents. DESIGN A 6-session feasibility trial was conducted within a residential aged care facility using convenience sampling to recruit N = 25 residents of varying cognitive capacity. Groups of 5 residents viewed 360-degree videos on a wireless head-mounted display to provide fully immersive VR experiences. SETTING AND PARTICIPANTS Half of the participants recruited from the 160-bed facility had a diagnosis of dementia (48%), whereas assessment with the Psychogeriatric Assessment Scale for cognitive impairment revealed that 64% experienced cognitive impairment (mild 20%, moderate 16%, and severe 28%). Additionally, 32% of participants had an existing anxiety or depression diagnosis. MEASURES The Cornell Scale for Depression in Dementia, Generalized Anxiety Disorder 7-item, and Cohen Mansfield Agitation Inventory-Short were used to assess changes in persisting BPS pre- to postintervention period. The Person-Environment Apathy Rating apathy subscale, Observed Emotions Rating Scale, and a visual analog scale (Smileometer) were used to assess immediate mood responses from residents at every VR session. VR tolerability and resident feedback was also recorded. RESULTS Pleasure (z = -5.892, P < .001) and general alertness (z = -2.455, P = .014) of participants improved at VR sessions, whereas apathy diminished (z = -5.275, P < .001). Compared to baseline, post-intervention depression was significantly lowered (z = -2.60, P = .009), whereas agitation increased (z = -2.98, P = .003). No significant changes in anxiety were observed. The quality of 360-degree videos and the device used did not induce any major VR-related negative side effects. CONCLUSIONS AND IMPLICATIONS Overall group-based VR reduced depressive symptoms and apathy, and induced a positive emotional response in most residents, with few observed side effects. Results indicate feasibility of group-based VR technological innovation within RAC.
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Affiliation(s)
- Rachel E Brimelow
- UQ Centre for Clinical Research, Royal Brisbane & Women's Hospital, Faculty of Medicine, University of Queensland, Herston, Brisbane, Queensland, Australia
| | - Karthick Thangavelu
- UQ Centre for Clinical Research, Royal Brisbane & Women's Hospital, Faculty of Medicine, University of Queensland, Herston, Brisbane, Queensland, Australia
| | - Romana Beattie
- Wesley Mission Queensland, Chermside, Brisbane, Queensland, Australia
| | - Nadeeka N Dissanayaka
- UQ Centre for Clinical Research, Royal Brisbane & Women's Hospital, Faculty of Medicine, University of Queensland, Herston, Brisbane, Queensland, Australia; Department of Neurology, Royal Brisbane & Women's Hospital, Herston, Brisbane, Queensland, Australia; School of Psychology, University of Queensland, St Lucia, Brisbane, Queensland, Australia.
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23
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Kelly J, Davison TE, McCabe MP. A psychological needs-based intervention to facilitate adjustment and improve wellbeing in newly admitted aged care residents: three illustrative case studies. CLIN PSYCHOL-UK 2021. [DOI: 10.1080/13284207.2021.1909419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Julie Kelly
- Health & Ageing Research Group, Swinburne University of Technology, Melbourne, Australia
| | - Tanya E. Davison
- Health & Ageing Research Group, Swinburne University of Technology, Melbourne, Australia
| | - Marita P. McCabe
- Health & Ageing Research Group, Swinburne University of Technology, Melbourne, Australia
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24
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Rexand-Galais F, Pithon L, Le Goff J. Assessment of Borderline Personality Disorder in Geriatric Institutions. Front Psychol 2021; 12:629571. [PMID: 33868094 PMCID: PMC8044763 DOI: 10.3389/fpsyg.2021.629571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/15/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Franck Rexand-Galais
- BePsyLab and Spaces and Societies Research Team, Department of Psychology, University of Angers, Angers, France
| | - Lucas Pithon
- Korian Bollée-Chanzy Nursing Home, Le Mans, France.,St Vincent de Paul Nursing Home, Yvré-L'Évêque, France.,BePsyLab, University of Angers, Angers, France
| | - Johane Le Goff
- Gerontological Center of Lucien Hussel Hospital Center, Vienne, France.,Research Center in Psychopathology and Clinical Psychology, University of Lyon 2, Lyon, France
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25
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Bhar S, Koder D, Davison T, Kelly J, Jayaram H, Silver M, Linossier J, Collins R. A clinician's quick guide of evidence‐based approaches: Psychological treatments for depression and anxiety with older adults living in residential aged care facilities. CLIN PSYCHOL-UK 2021. [DOI: 10.1111/cp.12229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sunil Bhar
- Swinburne University of Technology, Melbourne, Victoria, Australia,
| | - Deborah Koder
- Swinburne University of Technology, Melbourne, Victoria, Australia,
| | - Tanya Davison
- Swinburne University of Technology, Melbourne, Victoria, Australia,
| | | | | | - Mark Silver
- Swinburne University of Technology, Melbourne, Victoria, Australia,
| | - Jenny Linossier
- Swinburne University of Technology, Melbourne, Victoria, Australia,
| | - Rebecca Collins
- Swinburne University of Technology, Melbourne, Victoria, Australia,
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26
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Mansbach WE, Mace RA, Tanner MA. A New Tool for Detecting COVID-19 Psychological Burden Among Postacute and Long-term Care Residents (Mood-5 Scale): Observational Study. JMIR Aging 2021; 4:e26340. [PMID: 33640866 PMCID: PMC8081160 DOI: 10.2196/26340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/26/2021] [Accepted: 02/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Older adults are at high risk for developing serious somatic and psychological symptoms associated with COVID-19. Currently available instruments may not be sensitive to the concerns about COVID-19 in postacute and long-term care and their applications in telehealth remain to be clarified. OBJECTIVE We investigated the psychometric properties of the Mood-5 Scale (M5) as a rapid self-assessment of the COVID-19 psychological burden among postacute and long-term care residents. METHODS Residents (N=131), aged 50 years and above, from 20 postacute and long-term care facilities in Maryland, USA, were evaluated in-person or via telehealth (43/131, 32.8%) across a 4-week period (May 11 to June 5, 2020) during the COVID-19 pandemic. The COVID-19 psychological burden experienced by the residents was rated by geriatric psychologists who independently reviewed their clinical documentation. Psychometric analyses were performed on the M5 in relation to psychological tests, COVID-19 psychological burden, and diagnostic data collected during the evaluation. RESULTS The M5 demonstrated acceptable internal consistency (Cronbach α=.77). M5 scores were not confounded by demographic variables or telehealth administration (P>.08). Convergent validity for the M5 was established via positive associations with anxiety (r=0.56, P<.001) and depressive (r=0.49, P<.001) symptoms. An M5 cutoff score of 3 demonstrated strong sensitivity (0.92) and adequate specificity (0.75) for identifying COVID-19 psychological distress among postacute and long-term care residents (area under the curve of 0.89, positive predictive value=0.79, negative predictive value=0.91). CONCLUSIONS The M5 is a reliable and valid tool for self-assessment of mood that can help identify postacute and long-term care residents with significant psychological burden associated with COVID-19. It can be completed in less than 1 minute and is appropriate for use in both in-person and virtual visits.
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Affiliation(s)
| | - Ryan A Mace
- Mansbach Health Tools, LLC, Simpsonville, MD, United States
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27
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Molinari V, Edelstein B, Gibson R, Lind L, Norris M, O'Shea Carney K, Bush SS, Heck AL, Moye J, Gordon BH, Hiroto K. Psychologists in Long-Term Care (PLTC) Guidelines for Psychological and Behavioral Health Services in Long-Term Care Settings. PROFESSIONAL PSYCHOLOGY-RESEARCH AND PRACTICE 2021; 52:34-45. [PMID: 33867651 PMCID: PMC8052097 DOI: 10.1037/pro0000298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To address concerns about limited training of psychologists working in long-term care (LTC) facilities, the Psychologists in Long-Term Care (PLTC) organization published Standards for Psychological Services in Long-Term Care Facilities (Lichtenberg et al., 1998). The expanding evidence base for knowledge and skills, the increasing diversity of LTC residents, and the complexity of presenting problems have compounded the guidance psychologists need when providing services in this setting. In this article, the PLTC Guidelines Revision Task Force presents PLTC guidelines based on the original prescriptive PLTC Standards. The content of the PLTC Standards was updated and the format changed from prescriptive standards to aspirational guidelines. We begin with general guidelines regarding knowledge and skills in LTC (education and training. understanding of LTC systems. end-of-life care), followed by specific guidelines covering the basic psychological service activities in LTC (referral, assessment, treatment, ethical issues, and advocacy). The PLTC Guidelines are designed to provide direction for psychologists who work, or plan to work, in LTC and to guide continuing education pursuits.
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Affiliation(s)
| | | | - Robert Gibson
- Edgemoor Distinct Part Skilled Nursing facility, Santee, California
| | | | | | | | | | | | - Jennifer Moye
- Geriatric Research Education and Clinical Center, Bedford Massachusetts, and Harvard Medical School
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28
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Chan P, Bhar S, Davison TE, Doyle C, Knight BG, Koder D, Laidlaw K, Pachana NA, Wells Y, Wuthrich VM. Characteristics and effectiveness of cognitive behavioral therapy for older adults living in residential care: a systematic review. Aging Ment Health 2021; 25:187-205. [PMID: 31707790 DOI: 10.1080/13607863.2019.1686457] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Cognitive behavioral therapy (CBT) for depression and anxiety for older adults living in residential aged care facilities (RACFs) needs to accommodate the care needs of residents and the circumstances of RACFs. This systematic review examines the delivery and content characteristics of these interventions, in relation to participant satisfaction, staff appraisal, uptake rate, attrition rate, and treatment effectiveness. Such a review could provide important information for the development of future CBT-based interventions. METHOD Studies that examined the application of CBT for depression or anxiety in RACFs were identified by systematically searching a number of relevant databases. Reference lists of all included studies were examined, and citation searches on the Web of Science were conducted. Two independent reviewers were involved in screening articles and in extracting data and assessing methodological quality of the selected studies. RESULTS Across the 18 studies included in this review, the most common therapeutic strategy was pleasant activities scheduling. Studies varied on treatment duration (2-24 weeks), number of sessions (6-24), and length of sessions (10-120 min). Residents and staff members were satisfied with the CBT interventions. The average uptake rate was 72.9%. The average attrition rate was 19.9%. Statistically significant results were reported in 8 of the 12 randomized controlled trials (RCTs). In these eight RCTs, CBT was characterized by psychoeducation, behavioral activation, and problem-solving techniques; further, the therapists in six of these studies had training in psychology. CONCLUSION CBT interventions for depression and anxiety are acceptable to RACF residents and judged positively by staff members. Effective studies differed from non-effective studies on content and training characteristics, but not on other delivery features.
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Affiliation(s)
- Phoebe Chan
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Sunil Bhar
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Tanya E Davison
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Colleen Doyle
- National Ageing Research Institute, Royal Melbourne Hospital, Parkville, Australia
| | - Bob G Knight
- School of Psychology and Counselling, University of Southern Queensland, Toowoomba, Australia
| | - Deborah Koder
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Ken Laidlaw
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Yvonne Wells
- Lincoln Centre for Research on Ageing, Australian Institute for Primary Care and Ageing (AIPCA), La Trobe University, Bundoora, Australia
| | - Viviana M Wuthrich
- Centre for Emotional Health, Department of Psychology, Macquaire University, Sydney, Australia
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29
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Amare AT, Caughey GE, Whitehead C, Lang CE, Bray SC, Corlis M, Visvanathan R, Wesselingh S, Inacio MC. The prevalence, trends and determinants of mental health disorders in older Australians living in permanent residential aged care: Implications for policy and quality of aged care services. Aust N Z J Psychiatry 2020; 54:1200-1211. [PMID: 32746615 DOI: 10.1177/0004867420945367] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Mental health disorders are a major health concern in older people and are associated with a higher risk of disability, frailty and early mortality. This study aimed to conduct a contemporary population-based assessment of the prevalence, trends and factors associated with mental health disorders in individuals who are living in permanent residential aged care (PRAC) in Australia. METHODS A retrospective cross-sectional study was conducted using national data from the Registry of Senior Australians, a national cohort of older Australians who had aged care eligibility assessment and entered PRAC between 2008 and 2016. Stepwise multivariate logistic regression modeling was applied to identify factors associated with mental health disorders. RESULTS Of 430,862 individuals included in this study, 57.8% had at least one mental health disorder. The prevalence of depression, phobia/anxiety and psychosis were as follows: 46.2% (95% confidence interval = [46.0%, 46.3%]), 14.9% (95% confidence interval = [14.8%, 15.0%]) and 9.7% (95% confidence interval = [9.6%, 9.8%]), respectively. The likelihood of having a mental health disorder was higher for those who were (adjusted odds ratio [95% confidence interval]) relatively younger, specifically for every 10-year increment in age, the odds of having mental health disorders was 44.0% lower (0.56, [0.55, 0.56]); female (1.33 [1.32, 1.35]); having increasing numbers of physical health comorbidities, 6-10 (1.26 [1.24, 1.29]) or 11-15 (1.48 [1.45, 1.51]) or more than 15 (1.64 [1.58, 1.71]) compared to people having less than five comorbidities; having limitations related to health care tasks (1.05 [1.04, 1.07]), meals (1.04 [1.02, 1.05]) or social and community participation (1.10 [1.08, 1.12]). CONCLUSION The burden of mental health disorders in older Australians living in PRAC was high and individuals with these conditions tend to be younger, with several physical comorbidities and/or functional limitations. Understanding the profile of individuals with mental health disorders at entry into PRAC can be used as evidence for baseline resource allocation for this population and evaluation of future needs of mental health services.
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Affiliation(s)
- Azmeraw T Amare
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre and National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Gillian E Caughey
- Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Craig Whitehead
- Department of Rehabilitation, Aged and Extended Care, School of Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Catherine E Lang
- Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Sarah Ce Bray
- Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | | | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre and National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Discipline of Medicine, The University of Adelaide, Adelaide, SA, Australia
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia
| | - Steve Wesselingh
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Maria C Inacio
- Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
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Stargatt J, Bhar SS, Davison TE, Pachana NA, Mitchell L, Koder D, Hunter C, Doyle C, Wells Y, Helmes E. The Availability of Psychological Services for Aged Care Residents in Australia: A Survey of Facility Staff. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12244] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jennifer Stargatt
- Faculty of Health, Arts and Design, Swinburne University of Technology,
| | - Sunil S. Bhar
- Faculty of Health, Arts and Design, Swinburne University of Technology,
| | | | - Nancy A. Pachana
- School of Psychology and Counselling, University of Southern Queensland,
| | - Leander Mitchell
- School of Psychology and Counselling, University of Southern Queensland,
| | | | | | - Colleen Doyle
- Faculty of Health Sciences, Australian Catholic University,
| | - Yvonne Wells
- Lincoln Centre for Research on Ageing, La Trobe University,
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31
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Davison TE, Koder D, Helmes E, Doyle C, Bhar S, Mitchell L, Hunter C, Knight B, Pachana N. Brief on the Role of Psychologists in Residential and Home Care Services for Older Adults. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12209] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Deborah Koder
- Specialist Mental Health Services for Older People, Royal Prince Alfred Hospital,
| | | | - Colleen Doyle
- Australian Catholic University, Villa Maria Catholic Homes,
| | - Sunil Bhar
- Department of Psychological Sciences, Swinburne University of Technology,
| | | | | | - Bob Knight
- School of Psychology and Counselling, University of Southern Queensland,
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Tseng YT, Chen IH, Lee PH, Lin PC. Effects of auricular acupressure on depression and anxiety in older adult residents of long-term care institutions: A randomized clinical trial. Geriatr Nurs 2020; 42:205-212. [PMID: 32921508 DOI: 10.1016/j.gerinurse.2020.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/12/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023]
Abstract
The current study was a single-blind clinical trial that evaluated the effect of auricular acupressure on older adults' depression and anxiety. Forty-seven older adults in long-term care institutions were randomly divided into two groups using block randomization. In the experimental group, patches with magnetic beads were pasted onto the auricular Shenmen acupoints for 14 days. In the control group, blank patches were used. Among the older adults in the study institutions, 82.09% scored ≥5 points on the Geriatric Depression Scale (GDS). Significant differences in GDS scores were observed between the two groups after both 7 and 14 days of treatment (p < 0.05). There was no significant difference (p < 0.05) in anxiety scores between the two groups at 7 days, but there was a significant difference after 14 days of the intervention (p < 0.05). Our results suggest that acupressure can reduce depression and anxiety among older adults in long-term care institutions.
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Affiliation(s)
- Yen-Ting Tseng
- Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - I-Hui Chen
- Associate Professor, School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Pi-Hsia Lee
- Professor, School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Pi-Chu Lin
- Professor, Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Pifer MA, Segal DL, Jester DJ, Molinari V. Assessment of Anxiety in Long-Term Care Residents: Issues and Strategies. Int J Aging Hum Dev 2020; 93:807-833. [PMID: 32790476 DOI: 10.1177/0091415020943321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The experience of clinically significant anxiety and anxiety disorders represent significant and often debilitating problems for many residents in long-term care (LTC) settings. However, anxiety problems often go undetected and untreated in this growing population. The purposes of this paper are to examine the prevalence and impact of anxiety problems among residents in LTC facilities, describe the efficacy of the current instruments that are used to detect anxiety in these settings, and provide clinical guidance for the thorough assessment of anxiety. Regarding measurement tools, the GAI, GAI-SF, GAS-LTC, and the BADS are the only self-report measures designed for older adults that have been successfully validated for use with older adults living in LTC settings. Clinicians should focus on ways to educate LTC directors and staff to emphasize the importance of screening and assessing for anxiety, using validated measures, to improve the assessment and treatment of anxiety in their residents.
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Affiliation(s)
- Marissa A Pifer
- 14676 Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Daniel L Segal
- 14676 Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Dylan J Jester
- 7831 School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Victor Molinari
- 7831 School of Aging Studies, University of South Florida, Tampa, FL, USA
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Pifer MA, Segal DL. Geriatric Anxiety Scale: Development and Preliminary Validation of a Long-Term Care Anxiety Assessment Measure. Clin Gerontol 2020; 43:295-307. [PMID: 32036777 DOI: 10.1080/07317115.2020.1725793] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objectives: Anxiety is a significant problem for many individuals in various long-term care (LTC) settings and is often undetected and under-treated. This study examined the psychometric properties of a new quantitative anxiety screening measure specifically designed for use in long-term care settings, the Geriatric Anxiety Scale - Long Term Care Version (GAS-LTC).Method: Data were collected from LTC residents (N = 66; M age = 84.4 years, range = 59 to 100 years; 74.2% women) who completed the GAS-LTC, the Geriatric Anxiety Inventory (GAI), the Geriatric Depression Scale-15 (GDS-15), and the Prospective and Retrospective Memory Questionnaire (PRMQ).Results: The GAS-LTC demonstrated good internal consistency (α = .80), and good convergent validity with the GAI (r = .70, p < .01), the GDS-15 (r = .67, p < .01), and the PRMQ (r = .54, p < .01). Internal consistency on the GAS-LTC did not significantly vary between groups with high (α = .75) and low (α = .77) self-reported subjective memory impairment.Conclusions: The results from this study preliminarily indicate that the GAS-LTC is reliable and valid for use with older adults in LTC settings.Clinical Implications: Use of the GAS-LTC in LTC settings may help improve detection and treatment for individuals experiencing elevated anxiety in LTC.
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Affiliation(s)
- Marissa A Pifer
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
| | - Daniel L Segal
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
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Ulbricht CM, Hunnicutt JN, Hume AL, Lapane KL. Depression, Anxiety, and Pain among Newly Admitted Nursing Home Residents. THE JOURNAL OF NURSING HOME RESEARCH SCIENCES 2019; 5:40-48. [PMID: 33748657 DOI: 10.14283/jnhrs.2019.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Depression, anxiety, and pain are commonly experienced by older adults living in nursing homes. Objectives To describe the prevalence of depression, anxiety disorders, and pain among newly admitted nursing home residents in the United States and to describe the treatment of these disorders. Design Cross-sectional study of newly admitted residents. Setting Residents able to complete a pain assessment (n=783,826) living in Medicare- and Medicaid-certified nursing homes in the United States in 2011-2012. Measures Measures of sociodemographic, mood and behavior, pain, diagnoses, and functioning items from the Minimum Data Set (MDS) version 3.0. Results Approximately 36% of residents had a diagnosis of depression (other than bipolar disorder) and/or an anxiety disorder (n = 272,311). Of these residents, 25.2% had both depression and an anxiety disorder (95% CI = 25.0-25.4%), 54.3% (95% CI = 54.1-54.5%) had depression without an anxiety disorder, and 20.5% had an anxiety disorder without depression (95% CI = 20.3-20.6%). Fifteen percent had the triad of depression, anxiety, and pain at admission (95% CI = 9.3-23.3%). Depressive symptoms were more commonly reported by residents with pain than by those without pain. Receipt of psychological therapy (range: 0.9%-2.0%) or any psychiatric medication was lacking (range: 35.3%-48.5%), regardless of pain status. Participants reporting pain received a combination of scheduled, pro re nata (PRN)/as-needed, and non-medication pain interventions (range: 59.8% depression without anxiety to 62.9% depression and anxiety disorder). Conclusion Residents often suffer from combinations of depression, anxiety and pain at admission to nursing home. While treatment of pain is more common than treatment of psychiatric treatments, both psychiatric treatment and pain management may be suboptimal in nursing homes.
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Affiliation(s)
- Christine M Ulbricht
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA USA
| | - Jacob N Hunnicutt
- Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA USA
| | - Anne L Hume
- Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, RI USA
| | - Kate L Lapane
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA USA.,Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA USA
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Creighton AS, Davison TE, Kissane DW. The psychometric properties, sensitivity and specificity of the geriatric anxiety inventory, hospital anxiety and depression scale, and rating anxiety in dementia scale in aged care residents. Aging Ment Health 2019; 23:633-642. [PMID: 29470096 DOI: 10.1080/13607863.2018.1439882] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Limited research has been conducted into the identification of a valid and reliable screening measure for anxiety in aged care settings, despite it being one of the most common psychological conditions. This study aimed to determine an appropriate anxiety screening tool for aged care by comparing the reliability and validity of three commonly used measures and identifying specific cut-offs for the identification of generalized anxiety disorder (GAD). METHOD One-hundred and eighty nursing home residents (M age = 85.39 years) completed the GAI, HADS-A, and RAID, along with a structured diagnostic interview. RESULTS Twenty participants (11.1%) met DSM-5 criteria for GAD. All measures had good psychometric properties , although reliability estimates for the HADS-A were sub-optimal. Privileging sensitivity , the GAI cut-off score of 9 gave sensitivity of 90.0% and specificity of 86.3%; HADS-A cut-off of 6 gave sensitivity of 90.0% and specificity of 80.6%; and RAID cut-off of 11 gave sensitivity of 85.0% and specificity of 72.5%. CONCLUSION While all three measures had adequate reliability, validity, and cut-scores with high levels of sensitivity and specificity to detect anxiety within aged care, the GAI was the most consistently reliable and valid measure for screening for GAD.
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Affiliation(s)
- Alexandra S Creighton
- a School of Psychological Sciences , Monash University , Clayton , Victoria , Australia.,b Department of Psychiatry , Monash University , Clayton , Victoria , Australia
| | - Tanya E Davison
- b Department of Psychiatry , Monash University , Clayton , Victoria , Australia.,c Institute For Health & Ageing , Australian Catholic University , Melbourne , Victoria , Australia
| | - David W Kissane
- b Department of Psychiatry , Monash University , Clayton , Victoria , Australia
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Jester DJ, Rozek EK, McKelley RA. Heart rate variability biofeedback: implications for cognitive and psychiatric effects in older adults. Aging Ment Health 2019; 23:574-580. [PMID: 29381375 DOI: 10.1080/13607863.2018.1432031] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Two decades of heart rate variability (HRV) biofeedback research have focused on adolescent and adult populations with a variety of symptoms and conditions at the exclusion of older adults. This study explores HRV biofeedback as a novel treatment to decrease psychiatric symptoms and improve cognitive functioning in older adults. METHODS Participants enrolled in a three-week intervention that included six 30-min biofeedback sessions. Neuropsychological and psychiatric measures were administered before and after the intervention. RESULTS Decreases in depression (Cohen's d = 1.02, p < .001), state anxiety (Cohen's d = 0.82, p = .003), and trait anxiety (Cohen's d = 0.84, p = .002) were observed. An increase in attentional skills as measured by the Trail Making Test - Part A was seen (Cohen's d = 1.00, p = .001). Differences in executive skills as measured by the Trial Making Test - Part B and the Stroop Task did not reach statistical significance. CONCLUSION This study suggests that older adults may benefit from HRV biofeedback interventions much like the younger populations that have been studied for decades. Depression, anxiety, and attentional skills were positively affected. Several participants reported improved sleep quality and stress management. Future studies should corroborate these findings.
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Affiliation(s)
- Dylan J Jester
- a Department of Psychology , University of Wisconsin - La Crosse , La Crosse , WI , USA
| | - Ellen K Rozek
- a Department of Psychology , University of Wisconsin - La Crosse , La Crosse , WI , USA
| | - Ryan A McKelley
- a Department of Psychology , University of Wisconsin - La Crosse , La Crosse , WI , USA
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van der Wolf E, van Hooren SAH, Waterink W, Lechner L. Well-being in elderly long-term care residents with chronic mental disorder: a systematic review. Aging Ment Health 2019; 23:287-296. [PMID: 29266972 DOI: 10.1080/13607863.2017.1408773] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES One of the most important objectives of care for older long-term care residents with chronic mental disorders is to facilitate well-being. This review provides an overview of research literature on well-being in this population. METHOD A systematic review was conducted using Pubmed, PsycINFO and PsycARTICLES for all studies up until March 2016. Three reviewers independently assessed the eligibility of the publications and made a selection. RESULTS From a total of 720 unique search results, ten studies were deemed eligible. Specialized care, specifically the presence of mental health-workers was associated with increased well-being outcomes. Perceived amount of personal freedom was also related to higher well-being, whereas stigmatization and depression were related to reduced well-being. Size of residence, single or group-accommodation or moving to another locationdid not, however, seem to have an impact on well-being. CONCLUSION Specialized care, aimed at psychiatric disorders and extra attention for depressed residents are useful tools to promote well-being. Additionally, themes like personal freedom and stigmatization should be taken into consideration in the care for older long-term care residents with chronic mental disorder. However, as very little research has been conducted on this topic, conclusions should be interpreted with caution. More research is highly desirable.
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Affiliation(s)
- Elja van der Wolf
- a Laurens , Geriatric Residental Care Center 'De Oudelandse Hof' , Berkel en Rodenrijs , The Netherlands.,b Faculty of Psychology and Educational Sciences , Open University , Heerlen , The Netherlands
| | - Susan A H van Hooren
- b Faculty of Psychology and Educational Sciences , Open University , Heerlen , The Netherlands.,c Faculty of Healthcare , Zuyd University of Applied Sciences , Heerlen , The Netherlands.,d KenVaK , Research Center for Arts Therapies , Heerlen , The Netherlands
| | - Wim Waterink
- b Faculty of Psychology and Educational Sciences , Open University , Heerlen , The Netherlands
| | - Lilian Lechner
- b Faculty of Psychology and Educational Sciences , Open University , Heerlen , The Netherlands
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Chan P, Bhar S, Davison TE, Doyle C, Knight BG, Koder D, Laidlaw K, Pachana NA, Wells Y, Wuthrich VM. Characteristics of Cognitive Behavioral Therapy for Older Adults Living in Residential Care: Protocol for a Systematic Review. JMIR Res Protoc 2018; 7:e164. [PMID: 29973335 PMCID: PMC6053602 DOI: 10.2196/resprot.9902] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 04/30/2018] [Accepted: 05/08/2018] [Indexed: 11/16/2022] Open
Abstract
Background The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. Objective The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. Methods This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. Results Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. Conclusions In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed. Trial Registration PROSPERO 42017080113; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=80113 (Archived by WebCite at http://www.webcitation.org/70dV4Qf54) Registered Report Identifier RR1-10.2196/9902
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Affiliation(s)
- Phoebe Chan
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Sunil Bhar
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Tanya E Davison
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Colleen Doyle
- Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Bob G Knight
- School of Psychology and Counselling, University of Southern Queensland, Toowoomba, Australia
| | | | - Kenneth Laidlaw
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Yvonne Wells
- Lincoln Centre for Research on Ageing (Australian Institute for Primary Care and Ageing), La Trobe University, Bundoora, Australia
| | - Viviana M Wuthrich
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
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40
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The assessment of anxiety in aged care residents: a systematic review of the psychometric properties of commonly used measures. Int Psychogeriatr 2018; 30:967-979. [PMID: 29223175 DOI: 10.1017/s1041610217002599] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED ABSTRACTBackground:Assessing anxiety among residential aged care facility (RACF) residents is challenging, and it cannot be assumed that valid and reliable measures used within the community are also appropriate for this setting. This review systematically examined the literature to identify which anxiety measures were most commonly used with older adults in RACFs, and determine whether psychometric data support their use within this population. METHODS Using the PRISMA guidelines, five electronic databases were searched using key terms and subject headings. The search was limited to literature published in English. Eligible studies utilized an anxiety measure to assess anxiety symptoms among RACF residents. Based on the findings of this search, a critical review of the research into the reliability, validity, and administrative and respondent burden of the most commonly used measures (i.e. used in four or more studies) was conducted. RESULTS In total, 1,771 articles were identified, with 50 studies included in this review. Overall, 22 measures were used, with the majority of studies utilizing a clinician-administered or self-report measure. The RAID, HADS, STAI, and GAI were the most commonly used measures. While overall there is a lack of research and consensus into the psychometric properties of these measures within RACFs, strongest evidence of reliability and validity was found for the GAI. CONCLUSION Commonly used measures of anxiety within aged care populations are not well validated for this complex subsample of older adults. Strengths and weaknesses of each measure with regards to their usefulness in aged care settings are discussed, with future research areas highlighted.
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41
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Creighton AS, Davison TE, Kissane DW. The Factors Associated With Anxiety Symptom Severity in Older Adults Living in Nursing Homes and Other Residential Aged Care Facilities. J Aging Health 2018; 31:1235-1258. [DOI: 10.1177/0898264318767781] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study aimed to identify the biopsychosocial factors associated with anxiety among a residential aged care sample. Method: A total of 178 residents ( M age = 85.4 years, SD = 7.4 years) with mild cognitive impairment or normal cognition participated. Participants completed the Geriatric Anxiety Inventory (GAI) and a set of measures assessing cognition, depression, self-perceived health, mastery, attachment, perceived social support, social engagement, functional status, the experience of a fall, and other negative life events. Results: Unique correlates of GAI scores were depression, a preoccupied attachment style, lower mastery, cognitive impairment, and lower self-perceived health. Discussion: Most correlates that were uniquely associated with anxiety had little to do with the current environment. More variance was accounted for by stable and lifelong factors. This provides new insights into the characteristics of anxiety within aged care populations, and although preliminary, provides possible targets to prevent and treat anxiety within this setting.
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Affiliation(s)
| | - Tanya E. Davison
- Monash University, Clayton, Victoria, Australia
- Australian Catholic University, Melbourne, Victoria, Australia
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42
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Creighton AS, Davison TE, Kissane DW. The prevalence, reporting, and treatment of anxiety among older adults in nursing homes and other residential aged care facilities. J Affect Disord 2018; 227:416-423. [PMID: 29154158 DOI: 10.1016/j.jad.2017.11.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/29/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Little is known about anxiety in aged care populations, despite its increase in this frail population. This study investigated the prevalence, recording, and treatment rate of anxiety disorders among aged care residents. METHODS A cross-sectional, observational design was used to assess 180 elderly residents from 12 aged care facilities in Melbourne, Australia. Participants were assessed for threshold and subthreshold anxiety disorders and comorbid depression using the MINI for DSM-5. Medical files were also reviewed to determine whether there was any indication that anxiety had previously been detected, and what treatment those with a threshold/subthreshold diagnosis were receiving. RESULTS Overall prevalence of threshold and subthreshold anxiety disorders was 19.4% and 11.7%, respectively. Generalized anxiety disorder was the most common threshold disorder and agoraphobia was the most prevalent subthreshold anxiety disorder. While less than half of those with a threshold or subthreshold anxiety disorder had an indication of anxiety in their file, the majority received psychotropic medication. Cognitive impairment was not significantly associated with the prevalence or treatment of anxiety. CONCLUSIONS The prevalence of threshold and subthreshold anxiety in aged care settings is high, but remains under-reported by staff and GPs. Facility staff and GPs should ensure they are aware of how anxiety presents in elderly residents and routinely screen for this common mental health issue. This cohort had poor access to psychological treatments for their condition.
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Affiliation(s)
- Alexandra S Creighton
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Tanya E Davison
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia; Institute for Health & Ageing, Australian Catholic University, Melbourne, Victoria, Australia
| | - David W Kissane
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia.
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Scott KA, Ida M, Peterson VL, Prenderville JA, Moloney GM, Izumo T, Murphy K, Murphy A, Ross RP, Stanton C, Dinan TG, Cryan JF. Revisiting Metchnikoff: Age-related alterations in microbiota-gut-brain axis in the mouse. Brain Behav Immun 2017; 65:20-32. [PMID: 28179108 DOI: 10.1016/j.bbi.2017.02.004] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/02/2017] [Accepted: 02/03/2017] [Indexed: 02/07/2023] Open
Abstract
Over the last decade, there has been increased interest in the role of the gut microbiome in health including brain health. This is by no means a new theory; Elie Metchnikoff proposed over a century ago that targeting the gut by consuming lactic acid bacteria such as those in yogurt, could improve or delay the onset of cognitive decline associated with ageing. However, there is limited information characterising the relationship between the behavioural and physiological sequelae of ageing and alterations in the gut microbiome. To this end, we assessed the behavioural, physiological and caecal microbiota profile of aged male mice. Older mice (20-21months old) exhibited deficits in spatial memory and increases in anxiety-like behaviours compared to younger mice (2-3months old). They also exhibited increased gut permeability, which was directly correlated with elevations in peripheral pro-inflammatory cytokines. Furthermore, stress exacerbated the gut permeability of aged mice. Examination of the caecal microbiota revealed significant increases in phylum TM7, family Porphyromonadaceae and genus Odoribacter of aged mice. This represents a shift of aged microbiota towards a profile previously associated with inflammatory disease, particularly gastrointestinal and liver disorders. Furthermore, Porphyromonadaceae, which has also been associated with cognitive decline and affective disorders, was directly correlated with anxiety-like behaviour in aged mice. These changes suggest that changes in the gut microbiota and associated increases in gut permeability and peripheral inflammation may be important mediators of the impairments in behavioural, affective and cognitive functions seen in ageing.
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Affiliation(s)
- Karen A Scott
- APC Microbiome Institute, University College Cork, Cork, Ireland
| | - Masayuki Ida
- Suntory Wellness Limited, Suntory World Research Centre, Kyoto, Japan
| | - Veronica L Peterson
- APC Microbiome Institute, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | | | - Gerard M Moloney
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Takayuki Izumo
- Suntory Wellness Limited, Suntory World Research Centre, Kyoto, Japan
| | - Kiera Murphy
- Teagasc Moorepark Food Research Centre, Fermoy, Co. Cork, Ireland
| | - Amy Murphy
- Teagasc Moorepark Food Research Centre, Fermoy, Co. Cork, Ireland
| | - R Paul Ross
- Department of Science, Engineering and Food Science, University College Cork, Cork, Ireland
| | | | - Timothy G Dinan
- APC Microbiome Institute, University College Cork, Cork, Ireland; Department of Psychiatry & Neurobehavioural Science, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Institute, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
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Creighton AS, Davison TE, Kissane DW. The correlates of anxiety among older adults in nursing homes and other residential aged care facilities: a systematic review. Int J Geriatr Psychiatry 2017; 32:141-154. [PMID: 27753141 DOI: 10.1002/gps.4604] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 08/29/2016] [Accepted: 09/15/2016] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To synthesize and summarize the studies examining the correlates and predictors of anxiety in older adults living in residential aged care. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, five electronic databases were searched using key terms and subject headings, as well as reference lists of relevant papers. The search was limited to peer-reviewed literature published in English. Eligible studies examined the association between at least one correlate/factor and anxiety disorders or symptoms in aged care residents aged 50+ years. RESULTS A total of 3741 articles were identified, of which 34 studies (with a total of 1 543 554 participants) were included in this review. Correlates associated with anxiety included pain, use of anti-depressants/lithium, depression, and lower perceived quality of life. Less consistent and/or less studied variables included younger age, female gender, higher educational level, functional dependence, subjective health status, more prescribed medications, impaired vision, insomnia, external locus of control, fear of falling, attachment, hope, meaning in life, and the influence of social, environmental, and staff/policy correlates. CONCLUSIONS While several variables were found to have strong associations with anxiety in aged care residents, a number of factors have been examined by only one or two studies. Further research (preferably prospective studies) is therefore needed to reliably confirm findings and to help plan and develop preventative and intervention strategies. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Alexandra S Creighton
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Tanya E Davison
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - David W Kissane
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
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Pernambuco L, Espelt A, Góis ACB, de Lima KC. Voice Disorders in Older Adults Living in Nursing Homes: Prevalence and Associated Factors. J Voice 2017; 31:510.e15-510.e21. [PMID: 28069466 DOI: 10.1016/j.jvoice.2016.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 11/16/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To estimate the prevalence and the associated factors with voice disorders (VDs) in older adults living in nursing homes. STUDY DESIGN Cross-sectional. METHODS A sample of 117 Brazilian individuals of both sexes and preserved cognitive function, aged >59 years, living in 10 nursing homes, was studied. VDs were screened using the validated tool "Rastreamento de Alterações Vocais em Idosos" (RAVI-Screening for Voice Disorders in Older Adults). Associated factors included variables related to socioeconomic and demographic profile; nursing home; general health; ear, nose, and throat conditions; lifestyle; functionality; and psychosocial status. Bivariate analysis was performed by Pearson's chi-square or Fisher's exact test. Multivariate analysis was performed by multiple binomial regression. The significance level was 5%. RESULTS The prevalence of VDs was 39.3% (95% confidence interval [CI] = 30.4-48.1). There was no significant difference in prevalence according to age and sex. Multivariate analysis revealed that the prevalence of VDs were independently associated with anxiety symptoms (prevalence ratio [PR] = 1.97, 95% CI = 1.17-3.29), smoking (PR = 1.56, CI = 1.02-2.38), general daily inactivity (PR = 1.62, CI = 1.10-2.38), temporomandibular disorder (PR = 1.68, CI = 1.11-2.54), choking (PR = 1.53, CI = 1.06-2.20), and self-reported hearing loss (PR = 1.52, CI = 1.04-2.21). CONCLUSION VDs are common among older adults with preserved cognitive function living in nursing homes. The associated factors with VDs in this population can be prevented, diagnosed, controlled, or treated. Screening procedures and early intervention should be considered.
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Affiliation(s)
- Leandro Pernambuco
- Department of Speech, Language and Hearing Sciences, Federal University of Paraíba (UFPB), Paraíba, Brazil.
| | - Albert Espelt
- Customer Service and Drug Addiction Prevention, Public Health Agency of Barcelona (ASPB), Barcelona, Spain; School of Psychology, Department of Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona (UAB), Bellaterra, Spain; Carlos III Health Institute, CIBER in Epidemiology and Public Health, Madrid, Spain
| | - Amanda C B Góis
- Post-Graduate Program in Public Health (PPGSCol-UFRN), Federal University of Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
| | - Kenio Costa de Lima
- Post-Graduate Program in Public Health (PPGSCol-UFRN), Federal University of Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
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