Testing the relationship between a self-management intervention for recurrent depression and health outcomes

Health-related quality of life of people with depression: pre-post intervention compared with age-matched general population in Vietnam

BACKGROUND

In Vietnam, there is a paucity of health-related quality of life (HRQoL) research on people with depression as well as a lack of evidence on supported self-management (SSM) intervention for depression on HRQoL. This study aimed to compare the HRQoL of people with depression and age-matched people in the Vietnamese population, evaluate the effects of Tele-SSM intervention on HRQoL, and examine the association between the changes in HRQoL score and mental health well-being (depression, anxiety, and stress).

METHODS

This study was a pre- and post-study involving Vietnamese adults aged 18-64 who had depression symptoms (score ≥ 5 points in the PHQ-9). Participants (N = 58) completed Tele-SSM-a supported self-management intervention incorporating cognitive behavioral therapy and non-violent communication and using a task-shifting approach. To compare with the general population, we conducted a 1-to-1 matching by age with an EQ-5D-5L valuation study with a nationally representative sample of the Vietnamese general population.

RESULTS

HRQoL was significantly impaired in people with depression compared to the age-matched general population. Regarding health profile, participants reported the most difficulties in usual activities, pain/discomfort, and anxiety/depression dimensions. Significant improvements were observed in HRQoL scores post-intervention compared to pre-intervention in both EQ-VAS scores (from 59.84 to 79.48) and utility scores (from 0.79 to 0.90). These results remained lower than the age-matched general population (EQ-VAS score = 83.28, utility score = 0.96). Depression was associated with lower HRQoL while controlling for stress, anxiety symptoms and sociodemographic characteristics.

CONCLUSIONS

These results indicate that HRQoL is significantly impaired in people with depression and contribute to providing empirical evidence of Tele-SSM intervention in improving HRQoL. Further randomized controlled trials should be conducted to evaluate the effectiveness and cost-effectiveness of the Tele-SSM intervention.

Self-management of depression among Chinese community individuals: A cross-sectional study using the transtheoretical model

PURPOSE

To investigate the self-management of depression among members of a Chinese community.

DESIGN AND METHODS

A cross-sectional survey was conducted in Wuhan. The Depression Prevention and Management Survey was used to identify 429 participants' stage of change, perceived benefits, process of change and self-efficacy, based on the transtheoretical model perspective.

FINDINGS

A majority of participants (69.0%) were at the inactive stage of depression self-management. The mean score of the process of change was 87.62 (SD = 24.83). ANOVA analysis showed gender, education, and family function were significant influencing factors in the process of change.

PRACTICE IMPLICATIONS

Mental health nurses need to target their approach to the level of the individual based on the transtheoretical model to assist them to enhance their awareness and motivation. More consideration should be given to gender, education, and family function in the context of depression self-management.

"Upgrading self-esteem: Effectiveness of cognitive enhancement package among psychiatric inpatients."

OBJECTIVE

To assess and compare the self-esteem before and after administration of cognitive enhancement package among psychiatric inpatients.

DESIGN & METHOD

Quantitative approach, Non-Equivalent control group pre-test and post-test design under quasi experimental research design was used for study. Total 60 psychiatric inpatients whose scores came out to be 25 and less in Rosenberg Self-esteem scale were enrolled in the study. Samples were selected by using purposive sampling method. Total four sessions of intervention were provided with 80 to 100 min for overall tasks. Interventions comprised of total three sub-tasks and each task was followed by daily assessment of progression with the help of self-care activities checklist for self-care activities, Ferrara Group Experience scale for group interaction and Mini-Mental Status Examination for cognitive functioning. Post-test was taken on fifth day of intervention.

RESULTS

The results showed that mean score of self-esteem (14.17 ± 2.00), self-care activities (3.83 ± 2.34) and group interaction (20.83 ± 7.42) along with cognitive functioning (18.23 ± 6.07) in pre-test were in lower level comparatively than in post-test after administration of Cognitive Enhancement Package which is self-esteem(20.17 ± 3.24), self-care activities (6.82 ± 2.31), group interaction (37.90 ± 5.71) and cognitive functioning (24.80 ± 4.12) at the 0.05 level of significance (p ≤ 0.05). However, the score remained same or decreased in case of comparison group who only received routine hospital care.

CONCLUSION

All in all, present study concluded that different innovative psychological approaches like Cognitive Enhancement Package can be incorporated along with usual psychopharmacology in order to promote the overall wellbeing and better rehabilitation for the psychiatric inpatients.

Prevalence and Influencing Factors of Depression Self-Management Among Chinese Community Residents: A Cross-Sectional Study

Objective: This study aimed to investigate the current status of depression self-management (DSM), and to identify influencing factors of DSM among Chinese community residents. Methods: Stratified random sampling methodology was adopted in this cross-sectional survey. Respondents completed a collection of self-administered questionnaires Results: The majority of participants were female (72.2%), having a mean age of 39 years (SD = 17.3). The total mean score on the DSSM was low (31.63 ± 4.69). Using multiple linear regression analysis, age ranging from 25 to 64 years old (Beta = -0.176, p = 0.008), having personal stigma (Beta = -0.143, p = 0.020) and perceived stigma (Beta = 0.127, p = 0.037), and having a nuclear family structure (Beta = -0.313, p = 0.046), good family function (Beta = 0.278, p < 0.001) and good help-seeking attitude (Beta = 0.159, p = 0.008) were associated with DSSM-knowledge. Older age (≥65 years) (Beta = -0.152, p = 0.034), higher CES-D scores (Beta = -0.162, p = 0.005), having a father with a bachelor's degree or higher level of education (Beta = -0.134, p = 0.047), being female (Beta = 0.147, p = 0.012), indicating a religious preference (Beta = 0.145, p = 0.017) and having good family function (Beta = 0.247, p = 0.001) were significantly associated with DSSM-activities. Conclusions: Reducing stigma related to depression and enhancing help-seeking attitudes may be potential strategies for managing depressive symptoms among Chinese community residents.

Correlates of distress in young people with cystic fibrosis: the role of self-efficacy and metacognitive beliefs

OBJECTIVES

While significantly elevated distress is repeatedly found amongst young people with cystic fibrosis, their determinants remain largely unknown. This study explored whether metacognitive beliefs and self-efficacy for emotion regulation were associated with anxiety and depression after control for physical functioning, age and gender.

DESIGN

Cross-sectional study using a 110-item online questionnaire.

METHODS

An online survey was undertaken by 147 young people with CF aged 10-18 from five countries. Associations of Hospital Anxiety and Depression Scale scores with gender, age, physical functioning, Metacognitive Beliefs Questionnaire for Children (MCQ-C) subscales and Self-Efficacy for Emotion Regulation (SE-ER) were examined using hierarchical multiple linear regressions.

RESULTS

Physical functioning, gender and age accounted for 31% of the variance in anxiety and 39% in depression. The MCQ-C and SE-ER added another 45% to the variance of anxiety and 32% to depression. At the final step of both analyses, physical functioning, SE-ER, MCQ-C Negative Meta-Worry and Superstition, Punishment & Responsibility contributed significantly. Older age was also significantly associated with depression.

CONCLUSIONS

Self-efficacy for emotion regulation, concern about worrying and shame may be particularly important foci for interventions aimed at ameliorating anxiety and depression in young people with CF.

Steps to Develop a Mobile App for Pain Assessment of Cancer Patients: A Usability Study

Health-related mobile apps have the potential to allow patients and providers to proactively and responsibly manage pain together. However, there is a gap between the science of pain and current mobile apps. To develop a prototype science-based pain assessment mobile app (PainSmart) for Android smartphones, pain assessment tasks were extracted from a clinical guideline. These tasks were then converted to activity diagrams and became the logic of PainSmart. Five participants diagnosed with breast cancer evaluated usability of PainSmart with the System Usability Scale. Patient experience was recorded using Camtasia Studio Version 9 software. The five participants were able to explore the pain app after only 20 minutes of training. Using the System Usability Scale with comments, participant mean usability score was 77.5; above 68 is considered an above average system. A prototype of a pain assessment mobile app for cancer patients demonstrated high usability and will be refined based on participant feedback.