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Zhang Y, Zang W, Tian M, Zhang Y. The impact of preventive behaviors on self-rated health, depression symptoms, and daily functioning among middle-aged and elderly Chinese: An empirical study. PLoS One 2024; 19:e0305672. [PMID: 39012873 PMCID: PMC11251623 DOI: 10.1371/journal.pone.0305672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 06/03/2024] [Indexed: 07/18/2024] Open
Abstract
INTRODUCTION With the intensifying issue of an aging population, the health of middle-aged and elderly individuals garners increased attention. Preventive behaviors are pivotal in enhancing life quality and extending healthy living. This study examines the effects of preventive behaviors on self-rated health, depression, and daily functioning among these populations. MATERIALS AND METHODS Drawing on data from the China Health and Retirement Longitudinal Study (CHARLS), this research applies a panel ordered probability model to scrutinize the influence of preventive behaviors on health outcomes among middle-aged and elderly populations. It utilizes self-rated health, depression, and daily functioning as pivotal health indicators to assess the effects. RESULTS Preventive behaviors exert a significant impact on self-assessed health and daily functioning among middle-aged and elderly populations. Engagement in social activities effectively reduces depression symptoms. Primary preventive measures, including physical and social activities, enhance health outcomes through medical consultations. Conversely, secondary preventive actions, such as undergoing physical examinations, facilitate early detection of diseases, enabling timely intervention and health advisories. It is noteworthy that individuals with higher incomes derive lesser benefits from these physical or social endeavors. CONCLUSION Sociodemographic determinants such as age, income, and educational attainment significantly modulate the efficacy of preventive behaviors on the health outcomes of middle-aged and elderly populations. This research underscores the pivotal role of physical examination services within primary healthcare frameworks and advocates for the tailoring of health promotion strategies to the accessible social needs and engagements of economically and educationally disadvantaged seniors.
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Affiliation(s)
- Yuehong Zhang
- School of Public Administration, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
| | - Wenbin Zang
- School of Public Administration, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
| | - Manxia Tian
- School of Public Administration, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
- Hebei Aademy of Social Sciences, Shijiazhuang, Hebei, China
| | - Yumiao Zhang
- School of Public Administration, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
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2
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Wang Q, Huang X, Liu M, Wang C, Sun Z, Huang C, Tang S. Prevalence and risk factors of depression among elderly people in nursing homes from 2012 to 2022: a systematic review and meta-analysis. Aging Ment Health 2024:1-12. [PMID: 38952191 DOI: 10.1080/13607863.2024.2367044] [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: 04/24/2023] [Accepted: 02/20/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES To determine a pooled prevalence of depression and its influencing factors among nursing home residents. METHOD PsycINFO, PubMed, Embase, and Web of Science were searched for studies investigating the prevalence and risk factors of late-life depression among nursing home residents between January 2012 and November 2022. Two reviewers independently completed the literature screening, data extraction and quality assessment. A random-effects model was utilized to pool the prevalence of depression and summarize the influencing factors. RESULTS This meta-analysis included 48 studies involving 28,501 participants. The pooled prevalence of depressive mood and major depressive disorder was 53% and 27%, respectively. The rate of depressive mood is higher in lower-middle-income countries (60.0%), compared with high- (53.0%) and upper-middle-income countries (44.0%). The rate of depressive mood (35.0%) is higher among females than male (19.0%). Depression was influenced by factors, including male (OR = 0.28), insufficient income (OR = 3.53), comorbidities (OR = 2.66), pain (OR = 2.67; r = 0.31), functional disability (r = 0.33), loneliness (r = 0.43), number of chronic health problems (r = 0.18), social support (r = -0.28), activities of daily living (r = -0.43), subjective health (r = -0.28), autonomy (r = -0.41), environment (r = -0.50) and physical (r = -0.57) and psychological health (r = -0.65). CONCLUSION The prevalence of depressive mood is high among nursing home residents, especially in lower-middle-income countries. It is influenced by factors including gender, income, social support, daily activities, environment, physical and psychological health and autonomy. Understanding those factors can provide evidence-based recommendations for improved awareness, prevention and better management of late-life depression.
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Affiliation(s)
- Qing Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoting Huang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Minhui Liu
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Chunyu Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Zaiqing Sun
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Chongmei Huang
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
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Zhang Z, Chen L, Lu Y, Pan X, Xiao H. Development and evaluation of a narrative therapy program combined with a solution-focused approach for nursing home residents: A quasi-experimental study. Geriatr Nurs 2024; 58:310-317. [PMID: 38865785 DOI: 10.1016/j.gerinurse.2024.06.011] [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: 03/08/2024] [Revised: 05/25/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024]
Abstract
The transition from the family home to a nursing home can be an emotionally stressful experience for older adults. This study aimed to examine the feasibility and effects of a narrative therapy combined with a solution focus (NTCSF) program on the psychological adjustment, depression, and self-efficacy of nursing home residents. A non-random concurrent controlled trial was conducted in Fujian, China that involved 81 participants (intervention = 41, comparison = 40) from four separate nursing homes. The control group received routine institutional care, while the intervention group underwent a three-week NTCSF program in addition to receiving routine care. In the variance analyses, significant differences were found in "psychological adjustment" (T = 4.007, P < 0.001) and "self-efficacy" (T = 3.204, P = 0.002), compared to the control group. There was no significant difference in "depression" (t = -1.550, P = 0.125) between the groups at the baseline, but the experimental group showed a significant decrease in depression (t = -2.204, P = 0.033) after the intervention. The NTCSF program was found to be effective in improving the psychological adjustment of nursing home residents. Trial registration This study was registered on the Chinese Clinical Trial Registry (Registration No: ChiCTR-2100042767).
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Affiliation(s)
- Zhefu Zhang
- School of Nursing, Fujian Medical University, No. 1 Xuefu North Road, University Town, Fuzhou, Fujian, China
| | - Liangying Chen
- School of Nursing, Putian University, No. 2121, Zixiao East Road, Xitianwei Town, Licheng District, Putian, Fujian, China
| | - Yuanfeng Lu
- School of Nursing, Fujian Medical University, No. 1 Xuefu North Road, University Town, Fuzhou, Fujian, China
| | - Xiaohui Pan
- School of Nursing, Fujian Medical University, No. 1 Xuefu North Road, University Town, Fuzhou, Fujian, China
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, No. 1 Xuefu North Road, University Town, Fuzhou, Fujian, China.
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Bareeqa SB, Samar SS, Masood Y, Husain MM. Prevalence of Suicidal Behaviors in Residents of Long-Term Care Facilities: A Systematic Review and Meta-Analysis. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231176309. [PMID: 37247610 DOI: 10.1177/00302228231176309] [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: 05/31/2023]
Abstract
BACKGROUND Long-term care facilities (LTC) plays a pivotal role in caring for geriatric population. However, the risk of suicide in long-term care institutions among older individuals is little understood (e.g., nursing homes, assisted living facilities). OBJECTIVE The purpose of this systematic review is to pool and meta-analyze the data on prevalence of suicidal behaviors in geriatric population residing in long-term care facilities. METHODS We have conducted the systematic review in accordance with the PRISMA guidelines. The utilized databases are Pubmed, Medline, Google scholar and Scopus. The Meta-analysis was done using OpenMeta [analyst] software. Subgroup analysis was also performed. RESULTS After running an analysis on pooled data from twenty cross-sectional studies with 3,023,224 participants, the prevalence of suicidal behavior is 6.4% (95% CI = 5.7-7) in LTC. CONCLUSION This meta-analysis shows pooled prevalence of suicidal behavior among geriatric residents of LTC was found to be moderately high all over the world.
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Affiliation(s)
| | | | - Yasir Masood
- Department of Social Sciences, Washington University in St. Louis, St Louis, MO, USA
| | - Mustafa M Husain
- Department of Psychiatry, Neurology and Medicine, UT Southwestern Medical Centre, Dallas, TX, USA
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Dewitte L, Hill PL, Vandenbulcke M, Dezutter J. The longitudinal relationship between meaning in life, depressive symptoms, life satisfaction, and cognitive functioning for older adults with Alzheimer's disease. Eur J Ageing 2022; 19:1155-1166. [PMID: 36692743 PMCID: PMC9729662 DOI: 10.1007/s10433-022-00689-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 01/26/2023] Open
Abstract
Studies show the importance of the personal experience of meaning in life for older adults, but adults with dementia have been largely excluded from this research. The current study examined the longitudinal predictive effect of meaning in life for the psychological and cognitive functioning of older adults with Alzheimer's disease and whether cognitive decline predicted presence of meaning in life. On three yearly measurement occasions, presence of meaning in life, depressive symptoms, life satisfaction, and cognitive functioning were assessed in structured interviews with a convenience sample of 140 older adults with Alzheimer's disease from nine nursing homes in Belgium. Cross-lagged panel and latent growth curve models were used to analyze the longitudinal relationships between the variables. Over the three measurement waves, participants with higher presence of meaning reported lower depressive symptoms one year later. Presence of meaning and life satisfaction predicted each other over time, but only between the first and second wave. The analyses showed no strong evidence for a longitudinal association between meaning in life and cognitive functioning in either direction. The findings emphasize the importance of the experience of meaning in life for the psychological functioning of older adults with Alzheimer's disease. The lack of evidence for associations between meaning and cognitive functioning questions the prevailing view that intact cognitive abilities are a necessity for experiencing meaning. More attention to the potential of meaning interventions for persons with dementia is warranted.
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Affiliation(s)
- Laura Dewitte
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Patrick L Hill
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, USA
| | | | - Jessie Dezutter
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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Hafford-Letchfield T, Hanna JR, Ellmers TJ, Rasmussen S, Cogan N, Gleeson H, Goodman J, Martin S, Walker P, Quaife M. Talking really does matter: Lay perspectives from older people on talking about suicide in later life. Front Psychol 2022; 13:1009503. [PMID: 36467190 PMCID: PMC9709258 DOI: 10.3389/fpsyg.2022.1009503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/06/2022] [Indexed: 09/19/2023] Open
Abstract
Background The cumulative body of research on suicidality in later life describes its unique and complex features in older people when compared with that in other population groups. Yet significant gaps exist in how research informs the further development of suitable interventions. The perspectives of older people are also limited in research findings. Aims Therefore, this exploratory study aimed to (1) identify potential barriers and enablers in discussing suicidal thoughts and their expression in later life from the perspectives of lay older people and (2) explore where opportunities might occur in approach, place, relationships, and language with older people to discuss suicidal thoughts and their expression. Method We conducted in-depth qualitative individual interviews with 15 people aged 70-89 years. This method helped explore older peoples' own lay perspectives on suicidal thoughts in later life and how these are expressed, and their understanding of where and how people might seek support. Results A total of three themes were generated from the dataset: (1) intergenerational and socio-cultural differences in suicide expression, (2) the normalization of suicidal thoughts in later life, and (3) the importance and difficulties of everyday discussion and opportunities to express suicidal thoughts. Conclusion Suicidal thoughts and their expression appear commonly and are normalized in later life yet remain taboo and hidden. The participants revealed how such thoughts and behaviors are typically expressed through colloquial or "off-hand" remarks and comments and the importance of authentic listening. The findings highlight the importance of more informal discussions around these topics and how care professionals, practitioners, and providers might frame opportunities for dialogue with people who may want to access support. Further engagement with community-informed participatory research methods in which older people provide their own perspectives and experiences is important in addressing these gaps. There is a need for co-designing in developing screening, assessment, and signposting outside of clinical settings that can be used in everyday caring relationships with people in later life.
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Affiliation(s)
- Trish Hafford-Letchfield
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Jeffrey R. Hanna
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Toby J. Ellmers
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Susan Rasmussen
- School of Psychological Sciences and Health, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Nicola Cogan
- School of Psychological Sciences and Health, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Helen Gleeson
- School of Mental Health and Social Work, School of Education, Middlesex University, London, United Kingdom
| | | | - Sophie Martin
- School of Psychological Sciences and Health, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Patrick Walker
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Matthew Quaife
- School of Mental Health and Social Work, School of Education, Middlesex University, London, United Kingdom
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Wand AP, Browne R, Jessop T, Peisah C. A systematic review of evidence-based aftercare for older adults following self-harm. Aust N Z J Psychiatry 2022; 56:1398-1420. [PMID: 35021912 DOI: 10.1177/00048674211067165] [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: 11/15/2022]
Abstract
OBJECTIVE Self-harm is closely associated with suicide in older adults and may provide opportunity to intervene to prevent suicide. This study aimed to systematically review recent evidence for three components of aftercare for older adults: (1) referral pathways, (2) assessment tools and safety planning approaches and (3) engagement and intervention strategies. METHODS Databases PubMed, Medline, PsychINFO, Embase and CINAHL were searched from January 2010 to 10 July 2021 by two reviewers. Empirical studies reporting aftercare interventions for older adults (aged 60+) following self-harm (including with suicidal intent) were included. Full text of articles with abstracts meeting inclusion criteria were obtained and independently reviewed by three authors to determine final studies for review. Two reviewers extracted data and assessed level of evidence (Oxford) and quality ratings (Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative and Attree and Milton checklist for qualitative studies), working independently. RESULTS Twenty studies were reviewed (15 quantitative; 5 qualitative). Levels of evidence were low (3, 4), and quality ratings of quantitative studies variable, although qualitative studies rated highly. Most studies of referral pathways were observational and demonstrated marked variation with no clear guidelines or imperatives for community psychiatric follow-up. Of four screening tools evaluated, three were suicide-specific and one screened for depression. An evidence-informed approach to safety planning was described using cases. Strategies for aftercare engagement and intervention included two multifaceted approaches, psychotherapy and qualitative insights from older people who self-harmed, carers and clinicians. The qualitative studies identified targets for improved aftercare engagement, focused on individual context, experiences and needs. CONCLUSION Dedicated older-adult aftercare interventions with a multifaceted, assertive follow-up approach accompanied by systemic change show promise but require further evaluation. Research is needed to explore the utility of needs assessment compared to screening and evaluate efficacy of safety planning and psychotherapeutic approaches.
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Affiliation(s)
- Anne Pf Wand
- Specialty of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,Older Peoples Mental Health Service, Jara Ward, Concord Centre for Mental Health, Sydney Local Health District, Concord, Australia
| | - Roisin Browne
- School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,ForeFront Motor Neuron Disease & Frontotemporal Dementia Clinic, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Capacity Australia, Sydney, NSW, Australia
| | - Tiffany Jessop
- School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,Capacity Australia, Sydney, NSW, Australia
| | - Carmelle Peisah
- School of Psychiatry, Faculty of Medicine, University of NSW (UNSW) Sydney, NSW, Australia.,Capacity Australia, Sydney, NSW, Australia
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8
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Abstract
OBJECTIVES Rates of suicide in older adults may be higher than reported due to poor understandings of presentation of suicide ideation in this group. The objectives of this paper were to (i) review current measurement tools designed for older adults to detect suicide ideation and (ii) assess their psychometric properties. DESIGN We used a systematic review approach to identify measurement tools developed specifically for older adults without cognitive decline or impairment. RESULTS Ten articles that reported on a total of seven different measurement tools were identified. These included tools that focused on resiliency to suicide and those that measured risk of suicide behavior. There was wide variation across the articles: some were adaptations of existing scales to suit older populations, others were developed by authors; they varied in length from four to 69 items; a range of settings was used, and there was a mix of self-report and clinician-administered measures. Most displayed good psychometric properties, with both approaches showing similar quality. Limitations in terms of samples, settings, and measurement design are discussed. CONCLUSION The case for specific measures for older adults is clear from this review. There appear to be unique factors that should be considered in understanding suicide ideation and behavior among older adults that may not be directly assessed in non-specific measurements. However, there is a need to expand the diversity of individuals included in measurement development to ensure they are appropriate across gender, culture and minority status, and for the views of professionals to be considered.
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Hedna K, Fastbom J, Jonson M, Wilhelmson K, Waern M. Psychoactive medication use and risk of suicide in long-term care facility residents. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5684. [PMID: 35142388 PMCID: PMC9306521 DOI: 10.1002/gps.5684] [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: 08/30/2021] [Accepted: 01/26/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To investigate psychoactive medication use and risk of suicide in long-term care facility (LTCF) residents aged 75 and above. A second aim was to investigate the role of psychiatric and medical conditions in the occurrence of suicide in LTCF residents. METHODS A Swedish national register-based cohort study of LTFC residents aged ≥75 years between 1 January 2008 and 31 December 2015, and followed until 31 December 2016 (N = 288,305). Fine and Gray regression models were used to analyse associations with suicide. RESULTS The study identified 110 suicides (15.8 per 100,000 person-years). Half of these occurred during the first year of residence. Overall, 54% of those who died by suicide were on hypnotics and 45% were on antidepressants. Adjusted sub-hazard ratio (aSHR) for suicide was decreased in those who were on antidepressants (aSHR 0.64, 95% confidence interval 0.42-0.97), even after the exclusion of residents who had healthcare contacts for dementia or were on anti-dementia drugs. The aSHR for suicide was more than two-fold higher in those who were on hypnotics (2.20, 1.46-3.31). Suicide risk was particularly elevated in those with an episode of self-harm prior to LTCF admittance (15.78, 10.01-24.87). Specialized care for depression was associated with increased risk, while medical morbidity was not. CONCLUSIONS A lower risk of suicide in LTCF residents was found in users of antidepressants, while elevated risk was observed in those on hypnotics. Our findings suggest that more can be done to prevent suicide in this setting.
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Affiliation(s)
- Khedidja Hedna
- AgeCap Center, Department of Psychiatry and NeurochemistryGothenburg UniversityGothenburgSweden,Statistikkonsulterna ABGothenburgSweden
| | - Johan Fastbom
- Aging Research CenterKarolinska Institute and Stockholm UniversityStockholmSweden
| | - Mattias Jonson
- AgeCap Center, Department of Psychiatry and NeurochemistryGothenburg UniversityGothenburgSweden,Neuropsychiatric Epidemiology Unit, Department of Psychiatry and NeurochemistrySahlgrenska Academy, University of GothenburgGothenburgSweden,Affective ClinicRegion Västra Götaland, Sahlgrenska University HospitalGothenburgSweden
| | - Katarina Wilhelmson
- AgeCap Center, Department of Psychiatry and NeurochemistryGothenburg UniversityGothenburgSweden,Department of Health and RehabilitationInstitute of Neuroscience and Physiology, Sahlgrenska Academy, University of GothenburgGothenburgSweden,Department of Acute Medicine and GeriatricsRegion Västra Götaland, Sahlgrenska University HospitalGothenburgSweden
| | - Margda Waern
- AgeCap Center, Department of Psychiatry and NeurochemistryGothenburg UniversityGothenburgSweden,Psychosis ClinicRegion Västra Götaland, Sahlgrenska University HospitalGothenburgSweden
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Mele B, Watt J, Wu P, Azeem F, Lew G, Holroyd–Leduc J, Goodarzi Z. Detecting depression in persons living in long-term care: a systematic review and meta-analysis of diagnostic test accuracy studies. Age Ageing 2022; 51:6540127. [PMID: 35231088 DOI: 10.1093/ageing/afac039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Depressive disorders are common in long-term care (LTC), however, there is no one process used to detect depressive disorders in this setting. Our goal was to describe the diagnostic accuracy of depression detection tools used in LTC settings. METHODS We conducted a systematic review and meta-analysis of diagnostic accuracy measures. The databases PubMed, EMBASE, PsycINFO and CINAHL were searched from inception to 10 September 2021. Studies involving persons living in LTC, assisted living residences or facilities, comparing diagnostic accuracy of depression tools with a reference standard, were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess risk of bias. RESULTS We identified 8,463 citations, of which 20 studies were included in qualitative synthesis and 19 in meta-analysis. We identified 23 depression detection tools (including different versions) that were validated against a reference standard. At a cut-off point of 6 on the Geriatric Depression Scale-15 (GDS-15), the pooled sensitivity was 73.6% (95% confidence interval (CI) 43.9%-76.5%), specificity was 76.5% (95% CI 62.9%-86.7%), and an area under the curve was 0.83. There was significant heterogeneity in these analyses. There was insufficient data to conduct meta-analysis of other screening tools. The Nursing Homes Short Depression Inventory (NH-SDI) had a sensitivity ranging from 40.0% to 98.0%. The 4-item Cornell Scale for Depression in Dementia (CSDD) had the highest sensitivity (67.0%-90.0%) for persons in LTC living with dementia. CONCLUSIONS There are 23 tools validated for detection of depressive disorders in LTC, with the GDS-15 being the most studied. Tools developed specifically for use in LTC settings include the NH-SDI and CSDD-4, which provide briefer options to screen for depression. However, more studies of both are needed to examine tool accuracy using meta-analyses.
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Affiliation(s)
- Bria Mele
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer Watt
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Pauline Wu
- Division of Geriatric Medicine, Department of Medicine, University of Calgary, Canada
| | - Feeha Azeem
- Business Management Masters Program, York University, Toronto, Ontario M3J 1P3, Canada
| | - Grace Lew
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jayna Holroyd–Leduc
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Calgary, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Calgary, Alberta, Canada
| | - Zahra Goodarzi
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Calgary, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Calgary, Alberta, Canada
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11
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Jain B, Hafford-Letchfield T, Ellmers T, Chandra C, Billings B, Teacher R, O'Farrell Pearce S, Clancy C. Dog-assisted interventions in care homes: A qualitative exploration of the nature, meaning and impact of interactions for older people. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1450-1460. [PMID: 33094892 DOI: 10.1111/hsc.13201] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/06/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
Dog-assisted interventions (DAI) have been shown to have a wide-range of potential benefits for older adults living in care homes. Yet, there is a lack of published qualitative research which explores the experiences of care home residents, staff and dog-owner volunteers involved in DAI to fully understand its meaning, impact and value. This study aimed to explore the impact of a DAI on the social and emotional wellbeing of older residents living in care homes. The research employed a qualitative study design comprising overt, naturalistic researcher observation of weekly DAI sessions with 54 older adult residents across four participating care homes in the South East region of England over 3 months in 2018. Data were also collected through focus groups with 12 care home staff and 7 dog-owner volunteers. The data from the observations and focus groups was individually coded followed by thematic analysis across the three data sources. Findings demonstrated there were clear benefits for older people who engaged with DAI, as well as for dog-owners and to some extent for care home staff members. Benefits included sensory, emotional stimulation and opportunities for social interaction, reminiscence on early life experiences and these were supported by the development of some new social relationships. While there were some environmental challenges to implementing DAI, the findings confirm its value for care home residents, with minimal drawbacks from an organizational standpoint. As a low cost intervention, adoption of DAI in care home settings appeared to strengthen relationships between residents and staff and enable wider relationships with an external community resource.
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Affiliation(s)
- Briony Jain
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
| | - Trish Hafford-Letchfield
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, UK
| | - Toby Ellmers
- Cognition and Neuroscience Research Group, College of Health and Life Sciences, Brunel University, London, UK
| | - Carl Chandra
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
| | - Barbara Billings
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
| | - Ruth Teacher
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
| | - Sioban O'Farrell Pearce
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
| | - Carmel Clancy
- Department of Mental Health and Social Work, School of Health and Education, Middlesex University, London, UK
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12
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Dewitte L, Vandenbulcke M, Schellekens T, Dezutter J. Sources of well-being for older adults with and without dementia in residential care: relations to presence of meaning and life satisfaction. Aging Ment Health 2021; 25:170-178. [PMID: 31729244 DOI: 10.1080/13607863.2019.1691144] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To explore what sources of well-being are rated meaningful by older adults in residential care and how they are related to two important well-being outcomes. METHOD Two cross-sectional questionnaire studies were conducted in a sample of care residents without cognitive disability (n = 329) and with Alzheimer's disease (n = 104). Structural equation modelling was used to test a hypothesized and exploratory model of different sources as predictors of presence of meaning in life (POM) and satisfaction with life (SWL). RESULTS Family and Health were rated most meaningful by residents with and without dementia. In both studies, the hypothesized model showed adequate fit with the data. For cognitively intact residents, Personal Growth, Spirituality/Religion, and Interpersonal Relationships predicted POM, while Family and Leisure predicted SWL. Exploratory testing identified Leisure as a possible additional predictor of POM. For residents with Alzheimer's disease, Personal Growth and Society/Community predicted POM, while Family predicted SWL. CONCLUSION For older adults in residential care, many sources of well-being remain highly meaningful and some are directly related to the experience of meaning and life satisfaction. Both for residents with and without dementia, continued or increased investment in moments that foster personal growth and family relationships might be especially valuable.
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Affiliation(s)
- Laura Dewitte
- KU Leuven, Leuven, Belgium.,Research Foundation Flanders, Brussels, Belg ium
| | - Mathieu Vandenbulcke
- Department of Neurosciences, KU Leuven, Leuven, Belgium.,University Psychiatric Centre KU Leuven, Leuven, Belgium
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13
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Monteiro C, Canário C, Ribeiro MÂ, Duarte AP, Alves G. Medication Evaluation in Portuguese Elderly Patients According to Beers, STOPP/START Criteria and EU(7)-PIM List - An Exploratory Study. Patient Prefer Adherence 2020; 14:795-802. [PMID: 32440104 PMCID: PMC7211315 DOI: 10.2147/ppa.s247013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/21/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The increase in drug prescription for the elderly raises the risk of the occurrence of potentially inappropriate medications (PIMs), thus increasing the incidence of drug-related problems. Likewise, potential prescribing omissions (PPOs) are also highly prevalent in the elderly. This study aimed at assessing the prevalence of PIMs in the elderly by using the EU(7)-PIM list, STOPP criteria version 2 and the Beers criteria version 2015, as well as the prevalence of PPOs by applying the START criteria version 2 in elderly nursing home residents and outpatients of the Eastern Central Region of Portugal. PATIENTS AND METHODS A descriptive cross-sectional study was carried out in a sample of 90 Portuguese elderly people. Age, gender, diagnoses and medication history were collected from the patients' clinical records. The prevalence of PIMs and PPOs was measured according to each of the criteria applied. RESULTS The patients' ages ranged from 65 to 103 years, with an average age of 84.15 years. In addition, the average number of medications prescribed was 7.6. The STOPP criteria identified 250 PIMs affecting 77 patients (85.5%), the EU(7)-PIM list detected 94 PIMs in 58 patients (64.4%) and the Beers criteria identified 69 PIMs in 51 patients (56.6%). Therefore, the STOPP criteria version 2 identified substantially more PIMs than the other two tools. Furthermore, by applying the START criteria 68 PPOs were detected in 52 patients (57.7%). CONCLUSION A high prevalence of PIMs and PPOs was observed, suggesting the need to implement actions aimed at reducing the phenomenon and thus help to improve the quality of care provided in nursing homes. The variations in prevalence with the different tools suggest the need to carefully choose the tool for medication review in the elderly.
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Affiliation(s)
- Cristina Monteiro
- UFBI – Pharmacovigilance Unit of Beira Interior, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Correspondence: Cristina Monteiro UFBI – Pharmacovigilance Unit of Beira Interior, Faculty of Health Sciences, University of Beira Interior, Covilhã6200-506, PortugalTel +35 1275329070 Email
| | - Catarina Canário
- CICS-UBI – Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- Associação de Socorros Mútuos-Mutualista Covilhanense, Covilhã, Portugal
| | | | - Ana Paula Duarte
- UFBI – Pharmacovigilance Unit of Beira Interior, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- CICS-UBI – Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Gilberto Alves
- UFBI – Pharmacovigilance Unit of Beira Interior, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- CICS-UBI – Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
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14
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Ivbijaro G, Kolkiewicz L, Goldberg D, Riba MB, N'jie INS, Geller J, Kallivayalil R, Javed A, Švab I, Summergrad P, Laher S, Enum Y. Preventing suicide, promoting resilience: Is this achievable from a global perspective? Asia Pac Psychiatry 2019; 11:e12371. [PMID: 31709743 DOI: 10.1111/appy.12371] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 12/13/2022]
Abstract
Suicide continues to be a major health concern globally despite many initiatives to identify risk factors and methods for suicide prevention. We have carried out a detailed narrative review of the literature from 2016 to 2019 using the headings of Personal resilience (P1), People (P2), Places (P3), Prevention (P4), Promoting collaboration (P5), and Promoting research (P6) in order to support an integrated approach to suicide prevention and the promotion of personal and population resilience. We have made 10 key recommendations on how this can be moved forward.
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Affiliation(s)
- Gabriel Ivbijaro
- Faculdade de Ciências Médicas, NOVA Medical School Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal.,Faculty of Management, Law and Social Sciences, University of Bradford, UK.,World Federation for Mental Health.,The World Dignity Project
| | - Lucja Kolkiewicz
- Faculdade de Ciências Médicas, NOVA Medical School Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal.,East London NHS Foundation Trust, London, UK
| | | | - Michelle B Riba
- Depression Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Jeffrey Geller
- World Federation for Mental Health.,American Psychiatric Association, USA.,Psychiatry, University of Massachusetts Medical School, USA
| | - Roy Kallivayalil
- World Association of Social Psychiatry.,Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Thiruvalla, Kerala, India
| | - Afzal Javed
- World Psychiatric Association.,Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | - Igor Švab
- Department of Family Medicine, Medical Faculty, University of Ljubljana, Slovenia
| | - Paul Summergrad
- Department of Psychiatry, Tufts University School of Medicine, USA.,Tufts Medical Center, Boston, MA, USA
| | - Sumaya Laher
- Department of Psychology, University of the Witwatersrand, South Africa
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