Relationships between health status, depression and cognitive functions of institutionalized male veterans

The Impact of Engagement with the PARO Therapeutic Robot on the Psychological Benefits of Older Adults with Dementia

OBJECTIVES

This study aimed to examine the effect of 8-weeks of a 60-minute PARO intervention to reduce depressive symptoms and loneliness in older adults with dementia and investigated changes in their emotional or behavioral expressions and level of engagement with the PARO robot.

METHODS

This was a quasi-experimental study with a repeated measures design. The outcome measures were evaluated at four time-points: before the intervention, week 4, immediately after the intervention, and one month after the PARO intervention.

RESULTS

Fifty-two participants were recruited. The age of the participants ranged from 65 to 96 years, with a mean age of 81.81 years (SD = 8.54) in the PARO group and 79.08 years (SD = 7.71) in the control group. Using a mixed between-within subjects' analysis of variance, the results showed that there were significant interaction effects between the groups and time-periods for depression (p < .000), loneliness (p < .000), and engagement (p < .000).

CONCLUSIONS

The PARO intervention alleviated depression and loneliness for older adults. Furthermore, the process of engagement with PARO may play an important role in the PARO effects.

CLINICAL IMPLICATIONS

A tailored PARO intervention of at least 4 weeks could engender positive psychological benefits for older adults.

Cognitive and psychological improvements following CogSMART in veterans with mental health diagnoses

INTRODUCTION

The present study examined the efficacy of a CogSMART-based program in improving cognitive and emotional functioning in a clinic-based sample of Veterans presenting with cognitive concerns and history of mental health diagnoses.

METHOD

Forty Veterans (Mage = 61.2 years, 85% male) completed a weekly CogSMART-based group program as well as a battery of neuropsychological and psychological measures at both pre- and post-group evaluations. Participants met DSM-5 criteria for at least one mental health diagnosis.

RESULTS

Significant improvements on global cognition as well as measures of learning/memory and attention were observed from pre- to post-group (p < .05, cohen's d range = .48-1.01). As many as 33.3% of participants showed significant improvement, depending on the cognitive domain. Significant overall improvements were observed in depression symptoms and life satisfaction (p < .01, cohen's d = .67 and .59, respectively). Over one-third of the sample demonstrated a reliable improvement in depressive symptoms, 25% in anxiety symptoms, and 18% in life satisfaction.

CONCLUSIONS

Among individuals with mental health diagnosis but without major neurocognitive disorders, CogSMART-based interventions may be an effective treatment for improving aspects of cognition, depression, and life satisfaction.

The effect of problem-solving and assertiveness training on self-esteem and mental health of female adolescents: a randomized clinical trial

BACKGROUND

Children and adolescents are the assets of the society and their mental and physical health ensures the future health of next generations. The aim of the current study was to evaluate the effect of problem-solving and assertiveness skill training on improving self-esteem and mental health in high school female students of Isfahan city in 2019.

METHODS

This study was a randomized clinical trial. The target population was 10th grade female high school students in Isfahan city of Iran. 96 students of a female public high school were included in  the study, allocated to two groups, 32 for intervention group and 64 for control group. Six 90-min sessions were considered for problem-solving and assertiveness skill training which included lectures, question and answer, movie displaying, brainstorming and role-play. The Coopersmith Self-esteem Inventory Questionnaire (CSEI) and General Health Questionnaire (GHQ) were used in order to evaluate the variables of the study before and one month after the intervention.

RESULTS

Mean scores of the self-esteem variable changed significantly in the intervention group compared to control group before (25.2 ± 2.905) and after (29.9 ± 4.155) the intervention (p < 0.05). Mean scores of mental health also changed significantly before (27.67 ± 5.42) and after (19.033 ± 4.9) the intervention in comparison with the control group (p < 0.05).

CONCLUSION

The findings of the present study showed that educational intervention based on problem-solving and assertiveness can  enhance self-esteem and mental health in students. Future studies are needed to confirm and determine the structure of these associations. Trial Registration IRCT Code: IRCT20171230038142N9. Registration Date: 07/07/2019. Ethics Code: IR.MUI.MED.REC.1398.130.

Development of the psychometric property of a Minimum Data-Set-Based Depression Rating Scale for use in long-term care facilities in Taiwan

OBJECTIVES

Our aim is to develop the psychometric property of the Minimum Data-Set-Based Depression Rating Scale (MDS-DRS) to ensure its use to assess service needs and guide care plans for institutionalized residents.

METHODS

378 residents were recruited from the Haoran Senior Citizen Home in northern Taiwan. The MDS-DRS and GDS-SF were used to identify observable features of depression symptoms in the elderly residents.

RESULTS

A total of 378 residents participated in this study. The receiver operating characteristic (ROC) curve indicated that the MDS-DRS has a 43.3% sensitivity and a 90.6% specificity when screening for depression symptoms. The total variance, explained by the two factors 'sadness' and 'distress,' was 58.1% based on the factor analysis.

CONCLUSIONS

Reliable assessment tools for nurses are important because they allow the early detection of depression symptoms. The MDS-DRS items perform as well as the GDS-SF items in detecting depression symptoms. Furthermore, the MDS-DRS has the advantage of providing information to staff about care process implementation, which can facilitate the identification of areas that need improvement. Further research is needed to validate the use of the MDS-DRS in long-term care facilities.

Effectiveness of group reminiscence therapy for depressive symptoms in male veterans: 6-month follow-up

OBJECTIVE

The purpose of this study was to use group reminiscence therapy (GRT) as a nursing intervention to evaluate the post-test, 3-month and 6-month effects on depressive symptoms for institutionalised male veterans after a 4-week intervention.

METHODS

A quasi-experimental design and purposive sampling was conducted at a veteran's nursing home in Northern Taiwan. A total of 21 male veterans were studied to measure the effect of GRT. Eleven participants were in the experimental group and 10 in the control group. The experimental group activity was held twice weekly for 4  weeks. The Taiwan Geriatric Depression Scale was used to assess depressive symptoms and geriatric depression among male veterans. The generalised estimating equation was used for data analysis.

RESULTS

The male veterans in this study had a mean age of 82  years (SD = 5.8); 47.62% were between 70 and 79  years old, 61.90% were illiterate and 90.48% were without a partner. After 4  weeks of GRT, the experimental group significantly improved their depressive symptoms and geriatric depression in the post-test, 3-month and 6-month follow-up data compared with the control group. These activities can reduce their depressive symptoms following the intervention.

CONCLUSION

A 4-week, eight-session GRT can effectively reduce depressive symptoms among institutionalised male veterans for a 6-month period.

Factors affecting the physician-patient relationship of older veterans with inadequate health literacy: an observational study

BACKGROUND

In Taiwan, older veterans typically match the characteristics of a high prevalence of inadequate health literacy, which is a major barrier to effective communication in delivering proper health care. A good physician-patient relationship increases patients' trust and willingness to communicate, so an awareness of the factors that influence this relationship could improve it over time and enhance patients' health.

AIM

To explore factors related to the physician-patient relationship among older veterans with inadequate health literacy in Taiwan.

DESIGN AND SETTING

Observational study in veterans' homes.

METHOD

Data were collected using self-report questionnaires in face-to-face interviews. Patients with a Test of Functional Health Literacy in Adults score <60 (defined as inadequate health literacy) were recruited. Demographic characteristics, the Geriatric Depression Scale-Short Form, Multidimensional Health Locus of Control, and Perceived Involvement in Care Scales were used to identify related factors. Multiple regression and bootstrapping were used for data analyses.

RESULTS

A total of 256 older individuals were defined as having inadequate health literacy. Patients' perceived involvement in health care partially mediated the relationship between Health Locus of Control and the physician-patient relationship. Perceived Involvement in Care, depression score, and Health Locus of Control were predictors of the physician-patient relationship.

CONCLUSION

Older patients with inadequate health literacy had difficulty becoming actively involved in health care. The GP is in an ideal position to become a key person in helping such patients become involved in health care, and appropriately treating their depression may improve the physician-patient relationship.

The association between participation in social activity and depressive symptoms in institutionalized elders in Taiwan

Depression can be a significant predictor of rapid health decline in institutionalized elders. Non-pharmacologic interventions for depression may include meaningful and enjoyable social activities. This cross-sectional, descriptive correlational study was to examine the associations between three components (frequency, meaningfulness and enjoyment) of nine types of social activities and depressive symptoms in a sample of Taiwanese elders living in long-term care facilities. Results indicated that meaningful and enjoyable activities were associated with fewer depressive symptoms among institutionalized elders. Clinically depressed elders (GDS score ≥ 6) were significantly less likely to report a sense of meaning in 6 of 9 social activities, or to report as enjoyable 7 of 9 social activities investigated. Findings suggest that elders' contemplate assignation of meaning of their subjective experiences with social activities, and it would behoove clinical nurses to pay attention to the essential purpose and perceived benefit of the designed social activities.