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Plangger B, Unterrainer C, Kreh A, Gatterer G, Juen B. Psychological Effects of Social Isolation During the COVID-19 Pandemic 2020. GEROPSYCH 2022. [DOI: 10.1024/1662-9647/a000283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract. The SARS-CoV2 pandemic meant considerable restrictions in the social life of many people. Older people belong to the high-risk group for a severe to fatal course of the SARS-CoV2 disease, which is why these groups received special protection. This protection included drastic restrictions on their personal and social contacts, including the suspension of psychosocial therapies. This study examines the cognitive and emotional effects of social isolation on older people. A group of 49 participants who lived in nursing homes was tested before and after social isolation in 2020. The results of the present study provide empirical evidence for the negative effects of social isolation of older people in nursing homes regarding cognitive performance, anxiety, depressive symptoms, and quality of life.
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Affiliation(s)
| | | | - Alexander Kreh
- Department of Psychology, University of Innsbruck, Austria
| | - Gerald Gatterer
- Department of Psychology, Sigmund Freud Private University, Vienna, Austria
| | - Barbara Juen
- Department of Psychology, University of Innsbruck, Austria
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2
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Li YP, Lin CY, Hu FW, Shih SA. Short versions of the Geriatric Depression Scale (GDS) among widowed older people in Taiwan: Comparing their psychometric properties. Australas J Ageing 2021; 40:e294-e300. [PMID: 33724655 DOI: 10.1111/ajag.12942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/08/2021] [Accepted: 02/03/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the psychometric properties of different short versions of the Geriatric Depression Scale (GDS) among community-dwelling widowed older people. METHODS A cross-sectional design was conducted between February 2018 and August 2019 in southern Taiwan (n = 330). The GDS short versions included Hoyl et al's 5-item version, Molloy et al's 5-item version and van Marwijk et al's 4-item version. RESULTS All GDS short versions had satisfactory internal consistency (α = 0.83-0.90), with strong item loading embedded in the same construct of depression (0.43-0.72). The activity of daily living (ADL) scores had strong associations with van Marwijk et al's 4-item version (absolute standardised coefficient [|β|] = 0.15-0.59), Hoyl et al's 5-item version (|β| = 0.16-0.45) and Molloy et al's 4-item version (|β| = 0.09-0.40). CONCLUSIONS Hoyl et al's 5-item version was found to be more suitable than the other two versions of the GDS to assess the precise construct of depression. Meanwhile, van Marwijk et al's 4-item version can be used when the focus is on ADL performance. However, the conclusion should be interpreted with caution since the results were derived only from a widowed population in Taiwan. More research on this topic among other populations is thus needed to corroborate our conclusion.
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Affiliation(s)
- Yueh-Ping Li
- Department of Nursing, National Tainan Junior College of Nursing, Tainan City, Taiwan, ROC
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fang-Wen Hu
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan, ROC
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Sandvoll AM, Grov EK, Simonsen M. Nursing home residents' ADL status, institution-dwelling and association with outdoor activity: a cross-sectional study. PeerJ 2020; 8:e10202. [PMID: 33133784 PMCID: PMC7580574 DOI: 10.7717/peerj.10202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 09/27/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction The Norwegian regulations for nursing homes consider access to meaningful activities to be an indicator for the quality of nursing homes. Activities of daily living (ADL) provide important basic self-care skills for nursing home residents. Due to the physical changes caused by ageing and comorbidities, nursing home residents may experience functional decline over time, which may affect their ability to perform meaningful ADL, such as outdoor activity, which is considered a valuable and meaningful activity in Norwegian culture. This study aimed to investigate the association between ADL status, institution-dwelling and outdoor activity among nursing home residents. Methods This cross-sectional study included 784 residents aged >67 years living in 21 nursing homes in 15 Norwegian municipalities between November 2016 and May 2018. The Barthel Index was used to assess the nursing home residents' ADL status. Other variables collected were age, gender, body weight and height, visits per month, institution, ward, and participation in weekly outdoor activities. Descriptive statistics were used to provide an overview of the residents' characteristics. A Poisson regression model was used to test the association between the outdoor activity level as the dependent variable and ADL score, institution, and other control variables as independent variables. Results More than half (57%) of the nursing home residents in this sample did not go outdoors. More than 50% of the residents had an ADL score <10, which indicates low performance status. Further, we found that residents' ADL status, institution, ward, and number of visits had an impact on how often the residents went outdoors. Discussion The nursing home residents in this study rarely went outdoors, which is interesting because Norwegians appreciate this activity. Differences in the number of visits might explain why some residents went outdoors more often than other residents did. Our findings also highlight that the institutions impact the outdoor activity. How the institutions are organized and how important this activity is considered to be in the institutions determine how often the activity is performed. Conclusion The low frequency of the outdoor activities might be explained by a low ADL score. More than 50% of the residents had an ADL score <10, which indicates low performance status. Despite regulations for nursing home quality in Norway, this result suggests that organizational differences matter, which is an important implication for further research, health policy and practice.
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Affiliation(s)
- Anne Marie Sandvoll
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Ellen Karine Grov
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Morten Simonsen
- Department of Environmental Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
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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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Drageset J, Taasen SE, Espehaug B, Kuven BM, Eide WM, André B, Rinnan E, Haugan G. Associations Between Nurse-Patient Interaction and Sense of Coherence Among Cognitively Intact Nursing Home Residents. J Holist Nurs 2020; 39:16-28. [PMID: 32700622 PMCID: PMC8041445 DOI: 10.1177/0898010120942965] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: To investigate the association between nurse-patient interaction and sense of coherence among cognitively intact nursing home residents. Method: In a cross-sectional design, data were collected in 2017 and 2018 using the Nurse-Patient Interaction Scale (NPIS) and the 13-item Sense of Coherence Scale (SOC-13). Of the 204 cognitively intact nursing home residents who met the inclusion criteria, 188 (92%) participated, representing 27 nursing homes. Multiple regression in a general linear model estimated the possible effects of the 14 NPIS items on SOC-13 sum score, the possible effects of the NPIS (sum score) on SOC-13 (sum score) as well as on the subdimensions of SOC-13, comprehensibility, meaningfulness, and manageability (both without and with adjusting for sex and age). Results: Four of the 14 NPIS items revealed highly significant correlations with SOC-13 (sum score; unadjusted and adjusted for age and gender). Furthermore, the analysis adjusted for age and gender showed significant associations for NPIS (sum score) with SOC-13 (sum score), manageability, and comprehensibility. The correlation between NPIS and meaningfulness was not statistically significant. Conclusion: Nurse-patient interaction is significantly associated with SOC-13 and its subdimensions of comprehensibility and manageability but not meaningfulness. Nurse-patient interaction might be an important resource in relation to residents' sense of coherence and its subdimensions.
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Affiliation(s)
- Jorunn Drageset
- Western Norway University of Applied Sciences.,University of Bergen
| | | | | | | | | | | | - Eva Rinnan
- Norwegian University of Science and Technology
| | - Gørill Haugan
- Norwegian University of Science and Technology.,Nord University
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Haugan G, Kuven BM, Eide WM, Taasen SE, Rinnan E, Xi Wu V, Drageset J, André B. Nurse-patient interaction and self-transcendence: assets for a meaningful life in nursing home residents? BMC Geriatr 2020; 20:168. [PMID: 32381032 PMCID: PMC7203905 DOI: 10.1186/s12877-020-01555-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/13/2020] [Indexed: 12/12/2022] Open
Abstract
Background Due to the shift to an older population worldwide and an increased need for 24-h care, finding new and alternative approaches to increase wellbeing among nursing home (NH) residents is highly warranted. To guide clinical practice in boosting wellbeing among NH residents, knowledge about nurse-patient interaction (NPI), inter- (ST1) and intra-personal (ST2) self-transcendence and meaning-in-life (PIL) seems vital. This study tests six hypotheses of the relationships between NPI, ST1, ST2 and PIL among cognitively intact NH residents. Methods In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH residents representing 27 NHs responded to NPI, ST, and the PIL scales. Inclusion criteria were: (1) municipality authority’s decision of long-term NH care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations between the latent constructs were tested through structural equation modeling (SEM) using Stata 15.1. Results The SEM-model yielded a good fit (χ2 = 146.824, p = 0.021, df = 114, χ2/df = 1.29 RMSEA = 0.040, p-close 0.811, CFI = 0.97, TLI = 0.96, and SRMR = 0.063), supporting five of the six hypothesized relationships between the constructs of NPI, ST1, ST2 and PIL. Conclusion NPI significantly relates to both ST1, ST2 and PIL in NH residents. ST revealed a fundamental influence on perceived PIL, while NPI demonstrated a significant indirect influence on PIL, mediated by ST.
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Affiliation(s)
- Gørill Haugan
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway. .,NORD University, Faculty of Nursing and Health Science, Levanger, Norway.
| | - Britt Moene Kuven
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Wenche Mjanger Eide
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Siv Eriksen Taasen
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Eva Rinnan
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Trondheim Municiaplity, Trondheim, Norway
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, The National University of Singapore, Singapore, Singapore
| | - Jorunn Drageset
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway.,Department of Global Health and Primary Care, University of Bergen, Bergen, Norway
| | - Beate André
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
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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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Haugan G, Eide WM, André B, Wu VX, Rinnan E, Taasen SE, Kuven BM, Drageset J. Joy-of-life in cognitively intact nursing home residents: the impact of the nurse-patient interaction. Scand J Caring Sci 2020; 35:208-219. [PMID: 32200564 DOI: 10.1111/scs.12836] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 01/12/2020] [Accepted: 02/11/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The nursing-home population is at a high risk of declined well-being and quality of life. Finding approaches to increase well-being among older adults in nursing-homes is highly warranted. Responding to this need, the approach framed 'Joy-of-Life-Nursing-Homes' (JoLNH) was developed in Norway. AIM To investigate the association between nurse-patient interaction and joy-of-life in the nursing-home population. METHODS Cross-sectional data were collected in 2017 and 2018 using the Nurse-Patient Interaction Scale and the Joy-of-Life Scale. A total of 204 cognitively intact nursing-home residents met the inclusion criteria and 188 (92%) participated. A structural equation model (SEM) of the relationship between nurse-patient interaction and joy-of-life was tested by means of STATA/MP 15.1. Ethical approval was given and each participant provided voluntarily written informed consent. RESULTS The SEM-model yielded a good fit with the data (χ2 = 162.418, p = 0.004, df = 118, χ2 /df = 1.38, RMSEA = 0.046, p-close 0.652, CFI = 0.97, TLI = 0.96, and SRMR = 0.054). As hypothesised, nurse-patient interaction related significantly with joy-of-life (γ1,1 = 0.61, t = 7.07**). LIMITATIONS The cross-sectional design does not allow for conclusions on causality. The fact that the researchers visited the participants to help fill in the questionnaire might have introduced some bias into the respondents' reporting. CONCLUSION Relational qualities of the nurse-patient interaction should be essential integral aspects of nursing-home care. Consequently, such qualities should be emphasised in clinical practice, and research and education should pay more attention to nurse-patient interaction as an important, integral part of the caring process promoting joy-of-life and thereby well-being.
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Affiliation(s)
- Gørill Haugan
- NTNU Center for Health Promotion Research, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Wenche Mjanger Eide
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway
| | - Beate André
- NTNU Center for Health Promotion Research, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Eva Rinnan
- Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Siv Eriksen Taasen
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway
| | - Britt Moene Kuven
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway
| | - Jorunn Drageset
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway.,University of Bergen, Department of Global Public Health and Primary Care, Bergen, Norway
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Psychophysical Health Factors and Its Correlations in Elderly Wheelchair Users Who Live in Nursing Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051706. [PMID: 32150994 PMCID: PMC7084309 DOI: 10.3390/ijerph17051706] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/26/2020] [Accepted: 03/03/2020] [Indexed: 11/17/2022]
Abstract
Background: The aging is a multi-faceted process comprising both-the physical and mental alterations. Thus, the aim of the study was to evaluate the variables affecting the psychophysical state of the elderly people using wheelchairs and living in nursing homes (NH). Methods: 165 older wheelchair users were included in the study after meeting the inclusion criteria and expressing written consent. The assessment involved cognitive functioning, depression, body balance and flexibility, lung capacity and upper limbs dexterity, strenght and endurance. The results showed negative correlation between depression and balance, upper limb dexterity and endurance and shoulder flexion. A positive correlation between cognitive functioning and balance, upper limb dexterity, strenght and endurance, lung capacity and joint mobility was determined. Also, the study proved positive correlation between daily functioning and functional fitness, muscle strength and endurance, body flexibility, joint mobility. The regression analysis showed that better scores in balance test and joint mobility implied with higher scores in cognitive functioning. The most important determinants of functional fitness were balance, hand grip strenght and joint mobility. Conclusion: The future study should be focused on developing interventions aimed at senior wheelchair users living in NHs to prevent the deterioration of their mental and physical fitness.
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Major depressive disorder in Chinese persons with speech disability: High rates of prevalence and perceived need for mental health care but extremely low rate of use of mental health services. J Affect Disord 2020; 263:25-30. [PMID: 31818785 DOI: 10.1016/j.jad.2019.11.123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 10/21/2019] [Accepted: 11/29/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND In recent years, there has been increasing awareness on the importance of mental health services for persons with disability in China, but data on mental health of persons with speech disability (PwSD) are scarce. This study examined prevalence and correlates of major depressive disorder (MDD) among Chinese PwSD, as well as their perceived need for and utilization of mental health services. METHODS A total of 227 community-residing adult PwSD were successfully recruited by using multi-stage sampling approach, and interviewed with the Mini-international Neuropsychiatric Interview 5.0. Depressed PwSD's perceived need for and utilization of mental health services were also measured. RESULTS 29.5% of the PwSD suffered from MDD during the month before the interview and, of the depressed PwSD, 44.8% perceived a need for mental health care but only 1.5% had sought help from mental health specialists. Factors significantly associated with MDD included female gender (OR=2.42), marital status of "non-married" (OR=2.27), having the disability during childhood (OR=4.60) and adulthood (OR=10.99) (vs. at birth), co-occurring other types of disabilities (OR=2.29), major medical conditions (OR=2.62), and impaired ability of activities of daily living (OR=3.23). LIMITATIONS Findings can only be generalized to PwSD who register with the Disabled People's Federation (DPF) in China, because the sampling frame was based on the registration system of DPF. CONCLUSIONS There is a large unmet need for mental health services among Chinese PwSD. It is urgently needed to integrate the management of MDD and other common mental disorders into the services system for PwSD in China.
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Lee C, Tseng H, Wu L, Chuang Y. Multiple brief training sessions to improve nurses’ knowledge, attitudes, and confidence regarding nursing care of older adults with depression in long‐term care facilities. Res Nurs Health 2019; 43:114-121. [DOI: 10.1002/nur.21997] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 11/13/2019] [Indexed: 01/28/2023]
Affiliation(s)
- Chia‐Chi Lee
- Foryu Postpartum Nursing Care CenterTaipei Taiwan
- School of Nursing, College of NursingTaipei Medical UniversityTaipei Taiwan
| | - Huei‐Chi Tseng
- Department of NursingTaipei Medical University‐Shuang Ho HospitalNew Taipei City Taiwan
| | - Lee‐Pin Wu
- Department of NursingWan Fang Hospital, Taipei Medical UniversityTaipei Taiwan
| | - Yeu‐Hui Chuang
- School of Nursing, College of NursingTaipei Medical UniversityTaipei Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice ApplicationWan Fang Hospital, Taipei Medical UniversityTaipei Taiwan
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Abstract
OBJECTIVE Multimorbidity is a robust predictor of disability in aging adults, but the mechanisms by which multimorbidity is disabling are not clear. Most existing research focuses on disease-specific phenomena, such as diminished lung capacity in chronic obstructive pulmonary disease, which can result in functional limitations. This review takes a different approach by highlighting the potential role of a biological process-inflammation-that is common to many chronic medical conditions and thus, from a medical perspective, relatively disease nonspecific. METHOD Beginning with a description of inflammation and its measurement, this paper will provide an overview of research on inflammation as a predictor of disease risk in healthy adults and of adverse outcomes (e.g., disability) in those with multimorbidity. RESULTS The discussion of inflammation is then situated in the context of biopsychosocial influences on health, as inflammation has been shown to be sensitive to a wide range of social and psychological processes that are thought to contribute to healthy aging, including successful adaptation to multimorbidity and reduced risk of disability. CONCLUSIONS Finally, implications of this broader perspective for interventions to improve outcomes in aging adults with multimorbidity are briefly considered. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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13
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Hu SH, Chuang YH, Ting YF, Lin KY, Hsieh CJ. Prevalence of depressive symptoms in older nursing home residents with intact cognitive function in Taiwan. Res Nurs Health 2018; 41:292-300. [PMID: 29574780 DOI: 10.1002/nur.21873] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 02/24/2018] [Indexed: 12/21/2022]
Abstract
The investigators aimed to explore the prevalence of depressive symptoms and associated factors among older residents with intact cognitive function in nursing homes in Taiwan. A cross-sectional descriptive and correlational research design was used. A convenience sample of 178 older residents without cognitive impairment was recruited from 36 nursing homes in Southern Taiwan. The questionnaires included demographic data; the Barthel Index, which assesses the ability to perform activities of daily living; and the Geriatric Depression Scale Short Form. Among older residents in nursing homes with intact cognitive function, 39.3% had depressive symptoms. Age, religion, previous living status, previous working status, being totally dependent in physical function, and being severely dependent in physical function were significant predictors of depressive symptoms among cognitively intact older residents. The findings highlight the critical mental healthcare issues among older residents with intact cognitive function in nursing homes. Practical strategies for preventing the occurrence of depressive symptoms and caring for those who have depressive symptoms should be developed, especially for younger or dependent older residents or residents who have never been employed, have no religious beliefs, or have lived alone before they moved into an institution.
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Affiliation(s)
- Sophia H Hu
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yeh-Feng Ting
- School of Nursing, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Yu Lin
- Furoto Medical and Welfare Co. Kaohsiung, Kaohsiung, Taiwan
| | - Chia-Jung Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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14
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Music Intervention With Reminiscence Therapy and Reality Orientation for Elderly People With Alzheimer Disease Living in a Nursing Home. Holist Nurs Pract 2018; 32:43-50. [DOI: 10.1097/hnp.0000000000000247] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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15
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Chun A, Reinhardt JP, Ramirez M, Ellis JM, Silver S, Burack O, Eimicke JP, Cimarolli V, Teresi JA. Depression recognition and capacity for self-report among ethnically diverse nursing homes residents: Evidence of disparities in screening. J Clin Nurs 2017; 26:4915-4926. [PMID: 28722775 DOI: 10.1111/jocn.13974] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To examine agreement between Minimum Data Set clinician ratings and researcher assessments of depression among ethnically diverse nursing home residents using the 9-item Patient Health Questionnaire. BACKGROUND Although depression is common among nursing homes residents, its recognition remains a challenge. DESIGN Observational baseline data from a longitudinal intervention study. METHODS Sample of 155 residents from 12 long-term care units in one US facility; 50 were interviewed in Spanish. Convergence between clinician and researcher ratings was examined for (i) self-report capacity, (ii) suicidal ideation, (iii) at least moderate depression, (iv) Patient Health Questionnaire severity scores. Experiences by clinical raters using the depression assessment were analysed. The intraclass correlation coefficient was used to examine concordance and Cohen's kappa to examine agreement between clinicians and researchers. RESULTS Moderate agreement (κ = 0.52) was observed in determination of capacity and poor to fair agreement in reporting suicidal ideation (κ = 0.10-0.37) across time intervals. Poor agreement was observed in classification of at least moderate depression (κ = -0.02 to 0.24), lower than the maximum kappa obtainable (0.58-0.85). Eight assessors indicated problems assessing Spanish-speaking residents. Among Spanish speakers, researchers identified 16% with Patient Health Questionnaire scores of 10 or greater, and 14% with thoughts of self-harm whilst clinicians identified 6% and 0%, respectively. CONCLUSION This study advances the field of depression recognition in long-term care by identification of possible challenges in assessing Spanish speakers. RELEVANCE TO CLINICAL PRACTICE Use of the Patient Health Questionnaire requires further investigation, particularly among non-English speakers. Depression screening for ethnically diverse nursing home residents is required, as underreporting of depression and suicidal ideation among Spanish speakers may result in lack of depression recognition and referral for evaluation and treatment. Training in depression recognition is imperative to improve the recognition, evaluation and treatment of depression in older people living in nursing homes.
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Affiliation(s)
- Audrey Chun
- Research Institute in Aging, The New Jewish Home, New York, NY, USA.,Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joann P Reinhardt
- Research Institute in Aging, The New Jewish Home, New York, NY, USA.,Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mildred Ramirez
- Research Division, Hebrew Home at Riverdale, RiverSpring Health, Riverdale, NY, USA.,Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Julie M Ellis
- School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
| | - Stephanie Silver
- Research Division, Hebrew Home at Riverdale, RiverSpring Health, Riverdale, NY, USA.,Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Orah Burack
- Research Institute in Aging, The New Jewish Home, New York, NY, USA
| | - Joseph P Eimicke
- Research Division, Hebrew Home at Riverdale, RiverSpring Health, Riverdale, NY, USA.,Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Verena Cimarolli
- Research Institute in Aging, The New Jewish Home, New York, NY, USA
| | - Jeanne A Teresi
- Research Division, Hebrew Home at Riverdale, RiverSpring Health, Riverdale, NY, USA.,Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA.,Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA
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Drageset J, Eide GE, Corbett A. Health-related quality of life among cognitively intact nursing home residents with and without cancer - a 6-year longitudinal study. PATIENT-RELATED OUTCOME MEASURES 2017; 8:63-69. [PMID: 28490913 PMCID: PMC5414721 DOI: 10.2147/prom.s125500] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Limited information exists regarding the natural development of health-related quality of life (HRQOL) and its determinants among mentally intact nursing home (NH) residents. We aimed to examine HRQOL over time during a 6-year period among residents of NHs, who are not cognitively impaired, and to examine whether sense of coherence and a diagnosis of cancer influence HRQOL. METHODS The study was prospective and included baseline assessment and 6-year follow-up. After baseline assessment of 227 cognitively intact NH residents (Clinical Dementia Rating score ≤ 0.5), we interviewed 52 living respondents a second time at the 5-year follow-up and 18 respondents a third time at the 6-year follow-up. We recorded data from the interviews using the Short Form-36 (SF-36) Health Survey and the Sense of Coherence Scale. To study different developments over time for residents without and with cancer, we tested interactions between cancer and time. RESULTS The subscores of physical functioning and role limitation-physical domains declined with time (P < 0.001 and P = 0.02, respectively). Having a diagnosis of cancer at baseline was negatively correlated with general health (P = 0.002). Sense of coherence at baseline was positively correlated with all the SF-36 subscores from baseline to follow-up (P < 0.001). CONCLUSION The study indicates that the HRQOL changed over time during the 6 years of follow-up, and the sense of coherence appeared to be an important component of the HRQOL. Finally, our results showed that having a diagnosis of cancer was associated with decline in the general health subdimension.
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Affiliation(s)
- Jorunn Drageset
- Department of Nursing, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences.,Department of Public Health and Primary Health Care, University of Bergen
| | - Geir Egil Eide
- Centre for Clinical Research, Western Norway Health Region Authority.,Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Anne Corbett
- Institute of Health Research, Exeter University Medical School, University of Exeter, Exeter, UK
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Sackley CM, Walker MF, Burton CR, Watkins CL, Mant J, Roalfe AK, Wheatley K, Sheehan B, Sharp L, Stant KE, Fletcher-Smith J, Steel K, Barton GR, Irvine L, Peryer G. An Occupational Therapy intervention for residents with stroke-related disabilities in UK Care Homes (OTCH): cluster randomised controlled trial with economic evaluation. Health Technol Assess 2016; 20:1-138. [PMID: 26927209 DOI: 10.3310/hta20150] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Care home residents with stroke-related disabilities have significant activity limitations. Phase II trial results suggested a potential benefit of occupational therapy (OT) in maintaining residents' capacity to engage in functional activity. OBJECTIVE To evaluate the clinical effectiveness and cost-effectiveness of a targeted course of OT in maintaining functional activity and reducing further health risks from inactivity for UK care home residents living with stroke-related disabilities. DESIGN Pragmatic, parallel-group, cluster randomised controlled trial with economic evaluation. Cluster randomisation occurred at the care-home level. Homes were stratified according to trial administrative centre and type of care provided (nursing or residential), and they were randomised 1 : 1 to either the intervention or the control arm. SETTING The setting was 228 care homes which were local to 11 trial administrative centres across England and Wales. PARTICIPANTS Care home residents with a history of stroke or transient ischaemic attack, including residents with communication and cognitive impairments, not receiving end-of-life care. INTERVENTION Personalised 3-month course of OT delivered by qualified therapists. Care workers participated in training workshops to support personal activities of daily living. The control condition consisted of usual care for residents. MAIN OUTCOME MEASURES Outcome data were collected by a blinded assessor. The primary outcome at the participant level was the Barthel Index of Activities of Daily Living (BI) score at 3 months. The secondary outcomes included BI scores at 6 and 12 months post randomisation, and the Rivermead Mobility Index, Geriatric Depression Scale-15 and European Quality of Life-5 Dimensions, three levels, questionnaire scores at all time points. Economic evaluation examined the incremental cost per quality-adjusted life-year (QALY) gain. Costs were estimated from the perspective of the NHS and Personal Social Services. RESULTS Overall, 568 residents from 114 care homes were allocated to the intervention arm and 474 residents from another 114 care homes were allocated to the control arm, giving a total of 1042 participants. Randomisation occurred between May 2010 and March 2012. The mean age of participants was 82.9 years, and 665 (64%) were female. No adverse events attributable to the intervention were recorded. Of the 1042 participants, 870 (83%) were included in the analysis of the primary outcome (intervention, n = 479; control, n = 391). The primary outcome showed no significant differences between groups. The adjusted mean difference in the BI score between groups was 0.19 points higher in the intervention arm [95% confidence interval (CI) -0.33 to 0.70, p = 0.48; adjusted intracluster correlation coefficient 0.09]. Secondary outcome measures showed no significant differences at all time points. Mean incremental cost of the Occupational Therapy intervention for residents with stroke living in UK Care Homes intervention was £438.78 (95% CI -£3360.89 to £1238.46) and the incremental QALY gain was 0.009 (95% CI -0.030 to 0.048). LIMITATIONS A large proportion of participants with very severe activity-based limitations and cognitive impairment may have limited capacity to engage in therapy. CONCLUSION A 3-month individualised course of OT showed no benefit in maintaining functional activity in an older care home population with stroke-related disabilities. FUTURE WORK There is an urgent need to reduce health-related complications caused by inactivity and to provide an enabling built environment within care homes. TRIAL REGISTRATION Current Controlled Trials ISRCTN00757750. FUNDING This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 15. See the Health Technology Assessment programme website for further project information.
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Affiliation(s)
- Catherine M Sackley
- Academic Department of Physiotherapy, School of Bioscience Education, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Marion F Walker
- Division of Rehabilitation and Ageing, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | | | | | - Jonathan Mant
- Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Andrea K Roalfe
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
| | - Keith Wheatley
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Bart Sheehan
- Directorate of Acute Medicine and Rehabilitation, John Radcliffe Hospital, Oxford, UK
| | - Leslie Sharp
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Katie E Stant
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
| | - Joanna Fletcher-Smith
- Division of Rehabilitation and Ageing, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Kerry Steel
- Occupational Therapy, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Garry R Barton
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.,Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Lisa Irvine
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Guy Peryer
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
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18
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Drageset J, Eide GE, Hauge S. Symptoms of depression, sadness and sense of coherence (coping) among cognitively intact older people with cancer living in nursing homes-a mixed-methods study. PeerJ 2016; 4:e2096. [PMID: 27330859 PMCID: PMC4906642 DOI: 10.7717/peerj.2096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 05/09/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Symptoms of depression are often reported among patients with a cancer diagnosis. Strong sense of coherence (SOC) is shown to be associated with less depression in the general older population and among nursing homes (NH) residents in particular. Knowledge about mixed-methods perspectives that examine symptoms of depression and SOC among cognitively intact NH residents with cancer is scarce. AIM To investigate symptoms of depression and SOC among NH residents who are cognitively intact and have cancer. METHODS We used a quantitatively driven mixed-methods design with sequential supplementary qualitative components. We facilitated the collection of quantitative survey data of 60 NH residents (≥ 65 years) with cancer using the Geriatric Depression Scale (GDS) and SOC scale. The supplementary psychosocial component comprised qualitative research interviews about experiences related to depression with nine respondents from the same cohort. RESULTS In fully adjusted multiple regression analysis of the sociodemographic variables, the GDS was significantly correlated with SOC (P < 0.001). The experience of sadness was identified by the following theme: sadness. Coping with the experience of symptoms of depression was dominated by coping with sadness. CONCLUSION More than half the NH residents reported symptoms of depression, and the SOC was associated with reduced symptoms. A mixed-methods design contributed to nuanced and detailed information about the meaning of depression, and the supplementary component informs and supports the core component. To improve the situation of NH residents with cancer, more attention should be paid to the residents' experience of symptoms of depression and their SOC.
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Affiliation(s)
- Jorunn Drageset
- Faculity of Health and Social Science, Bergen University College, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Geir Egil Eide
- Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
- Centre for Clinical Research, Western Norway Health Region Authority, Bergen, Norway
| | - Solveig Hauge
- Faculty of Health and Social Studies and Centre for Caring Research–Southern Norway, Unversity College of Southeast, Porsgrunn, Norway
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19
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Review of the effect of music interventions on symptoms of anxiety and depression in older adults with mild dementia. Int Psychogeriatr 2015; 27:1661-70. [PMID: 25921299 DOI: 10.1017/s1041610215000393] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Treatment of anxiety and depression, the most common psychiatric symptoms in older adults with mild dementia, requires innovative approaches due to the high cost and significant side effects associated with traditional pharmacological interventions. Alternative non-pharmacological therapies, such as music, when used in conjunction with pharmacological treatment, have the potential to alleviate symptoms of anxiety and depression in older adults diagnosed with mild dementia. The purpose of this review was to examine the evidence of music's efficacy in improving symptoms of anxiety and depression in older adults with mild dementia. METHODS Four databases (Medline, CINAHL, PsychInfo, PubMed) were searched using the terms "music," "music therapy," "music intervention," "singing," "dementia," "anxiety," and/or "depression," identifying ten studies that met the inclusion and exclusion criteria. RESULTS The poor methodological rigor of the studies precluded reaching consensus on the efficacy of a music intervention in alleviating symptoms of anxiety and depression in older adults with mild dementia. CONCLUSIONS There was inconclusive evidence as to whether music interventions are effective in alleviating symptoms of anxiety and depression in older adults with mild dementia due to the poor methodological rigor. However, with improved designs guided by a deeper understanding of how music engages the aging brain, music may emerge as an important adjunct therapy to improving the lives of older adults with mild dementia.
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20
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Drageset J, Dysvik E, Espehaug B, Natvig GK, Furnes B. Suffering and mental health among older people living in nursing homes-a mixed-methods study. PeerJ 2015; 3:e1120. [PMID: 26246967 PMCID: PMC4525699 DOI: 10.7717/peerj.1120] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 07/02/2015] [Indexed: 11/20/2022] Open
Abstract
Background. Knowledge about mixed-methods perspectives that examine anxiety, depression, social support, mental health and the phenomenon of suffering among cognitively intact NH residents is scarce. We aimed to explore suffering and mental health among cognitively intact NH residents. Methods. This study used a mixed-methods design to explore different aspects of the same phenomena of interest to gain a more comprehensive understanding. The qualitative core component comprised a qualitative interview from 18 nursing home residents (≥65 years) about experiences related to pain, grief and loss. The supplementary component comprised interview from the same respondents using the SF-36 Health Survey subscales, the Hospital Anxiety and Depression Scale and the Social Provisions Scale. Results. The individual descriptions reveal suffering caused by painful experiences during life. The quantitative results indicated that symptoms of anxiety and depression were related to mental health and symptoms of anxiety were related to bodily pain and emotional role limitations. Attachment and social integration were associated with vitality and social functioning. Discussion. To improve the situation, more attention should be paid to the residents’ suffering related to anxiety, depression and psychosocial relations.
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Affiliation(s)
- Jorunn Drageset
- Faculty of Health and Social Sciences, Bergen University College , Norway ; Department of Global Public Health and Primary Care, University of Bergen , Norway
| | - Elin Dysvik
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger , Norway
| | - Birgitte Espehaug
- Faculty of Health and Social Sciences, Bergen University College , Norway
| | - Gerd Karin Natvig
- Department of Global Public Health and Primary Care, University of Bergen , Norway
| | - Bodil Furnes
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger , Norway
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21
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Ogata S, Hayashi C, Sugiura K, Hayakawa K. Associations between Depressive State and Impaired Higher-Level Functional Capacity in the Elderly with Long-Term Care Requirements. PLoS One 2015; 10:e0127410. [PMID: 26035183 PMCID: PMC4452739 DOI: 10.1371/journal.pone.0127410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/22/2015] [Indexed: 01/22/2023] Open
Abstract
Depressive state has been reported to be significantly associated with higher-level functional capacity among community-dwelling elderly. However, few studies have investigated the associations among people with long-term care requirements. We aimed to investigate the associations between depressive state and higher-level functional capacity and obtain marginal odds ratios using propensity score analyses in people with long-term care requirements. We conducted a cross-sectional study based on participants aged ≥65 years (n = 545) who were community dwelling and used outpatient care services for long-term preventive care. We measured higher-level functional capacity, depressive state, and possible confounders. Then, we estimated the marginal odds ratios (i.e., the change in odds of impaired higher-level functional capacity if all versus no participants were exposed to depressive state) by logistic models using generalized linear models with the inverse probability of treatment weighting (IPTW) for propensity score and design-based standard errors. Depressive state was used as the exposure variable and higher-level functional capacity as the outcome variable. The all absolute standardized differences after the IPTW using the propensity scores were <10% which indicated negligible differences in the mean or prevalence of the covariates between non-depressive state and depressive state. The marginal odds ratios were estimated by the logistic models with IPTW using the propensity scores. The marginal odds ratios were 2.17 (95%CI: 1.13–4.19) for men and 2.57 (95%CI: 1.26–5.26) for women. Prevention of depressive state may contribute to not only depressive state but also higher-level functional capacity.
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Affiliation(s)
- Soshiro Ogata
- Support Office for Female Researchers, Osaka City University, Osaka, Japan
- * E-mail:
| | - Chisato Hayashi
- Department of Public Health Nursing, Graduated School of Nursing, Osaka City University, Osaka, Japan
| | - Keiko Sugiura
- Faculty of Nursing, Senri Kinran University, Osaka, Japan
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22
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Haugan G, Drageset J. The hospital anxiety and depression scale--dimensionality, reliability and construct validity among cognitively intact nursing home patients. J Affect Disord 2014; 165:8-15. [PMID: 24882171 DOI: 10.1016/j.jad.2014.04.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 04/14/2014] [Accepted: 04/15/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Depression and anxiety are particularly common among individuals living in long-term care facilities. Therefore, access to a valid and reliable measure of anxiety and depression among nursing home patients is highly warranted. AIM To investigate the dimensionality, reliability and construct validity of the Hospital Anxiety and Depression scale (HADS) in a cognitively intact nursing home population. METHODS Cross-sectional data were collected from two samples; 429 cognitively intact nursing home patients participated, representing 74 different Norwegian nursing homes. Confirmative factor analyses and correlations with selected constructs were used. RESULTS The two-factor model provided a good fit in Sample1, revealing a poorer fit in Sample2. Good-acceptable measurement reliability was demonstrated, and construct validity was supported. LIMITATIONS Using listwise deletion the sample sizes were 227 and 187, for Sample1 and Sample2, respectively. Greater sample sizes would have strengthen the statistical power in the tests. The researchers visited the participants to help fill in the questionnaires; this might have introduced some bias into the respondents׳ reporting. The 14 HADS items were part of greater questionnaires. Thus, frail, older NH patients might have tired during the interview causing a possible bias. CONCLUSION Low reliability for depression was disclosed, mainly resulting from three items appearing to be inappropriate indicators for depression in this population. Further research is needed exploring which items might perform as more reliably indicators for depression among nursing home patients.
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Affiliation(s)
- Gørill Haugan
- Sør-Trøndelag University College, Faculty of Nursing and Research Centre for Health Promotion and Resources, HIST, Norway.
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Bourgeois J, Elseviers MM, Van Bortel L, Petrovic M, Vander Stichele RH. The use of antidepressants in Belgian nursing homes: focus on indications and dosages in the PHEBE study. Drugs Aging 2013; 29:759-69. [PMID: 23018612 DOI: 10.1007/s40266-012-0003-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Since antidepressants are prescribed for multiple indications, the use of an antidepressant cannot be equated with a diagnosis of depression. OBJECTIVE The objective of this study was to examine the quality of antidepressant prescribing in Belgian nursing homes, with a critical evaluation of indications and dosages, to see whether depression was appropriately treated in terms of drug choice, the indications for which antidepressants were being prescribed and whether there was underdosing. METHODS This analysis was based on data obtained in the Prescribing in Homes for the Elderly in Belgium (PHEBE) study, a cross-sectional, descriptive study of a representative, stratified, random sample of 1,730 residents from 76 Belgian nursing homes. The PHEBE study investigated overall drug utilization in Belgian nursing homes in 2006. Clinical and medication data for the present study were obtained from this study. A 28-item checklist of clinical conditions was designed ad hoc for the PHEBE study and sent to the residents' general practitioners (GPs) to collect clinical information. We copied the residents' medication charts, classified the drugs using the Anatomical Therapeutic Chemical (ATC) classification system codes and transferred the drug names and dosages into a database. Information on indications was retrospectively obtained from the GPs, so that we could link the indication to each medication. Minimum effective doses (MEDs) of antidepressants to treat major depression were obtained from the literature to assess underdosing. RESULTS The overall use of antidepressants in nursing homes was 39.5 % (95 % CI 37.2, 41.8). The physicians classified 34.2 % (95 % CI 32.0, 36.4) of the residents as having depression, and 80.9 % of these patients were treated with an antidepressant. Indications among the single antidepressant users (n = 551) were depression (66.2 %), insomnia (13.4 %), anxiety (6.2 %) and neuropathic pain (1.6 %). In the indication of depression, 74.8 % used a selective serotonin reuptake inhibitor (SSRI), predominantly citalopram, sertraline and escitalopram. Venlafaxine was used by 10.7 % of the residents. Dosages for these antidepressants were equal to or higher than the MED. But when trazodone, amitriptyline or mirtazapine were used to treat depression, respectively, 92.3, 55.5 and 44.5 % of prescribed dosages were below the MED. In the indication of insomnia, most of the time, trazodone (90.5 %) or mirtazapine (5.4 %) were used, and in lower dosages than those required for depression treatment (<MED). Tricyclic antidepressants were predominantly used for the treatment of neuropathic pain and were also used at lower dosages. Of all the residents receiving a medication for anxiety, only 13.9 % received an antidepressant (mostly an SSRI), and the remaining received a benzodiazepine. CONCLUSIONS The number one indication for the use of an antidepressant was depression. Within this indication, mostly the recommended SSRIs were used, in dosages equal to or higher than the MED. Furthermore, we noticed that there was substantial use of sedative antidepressants for insomnia and that the physicians preferred to prescribe benzodiazepines over the recommended SSRIs to treat anxiety chronically.
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Alosco ML, Spitznagel MB, Cohen R, Sweet LH, Colbert LH, Josephson R, Hughes J, Rosneck J, Gunstad J. Reduced cognitive function predicts functional decline in patients with heart failure over 12 months. Eur J Cardiovasc Nurs 2013; 13:304-10. [PMID: 23754840 DOI: 10.1177/1474515113494026] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 03/20/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Occurrences of impaired activities of daily living (ADL) are common in heart failure (HF) patients and contribute to the elevated mortality and hospitalization rates in this population. Cognitive impairment is also prevalent in HF, though its ability to predict functional decline over time is unknown. AIMS This study examined the longitudinal pattern of activities of daily living (ADL) in HF persons and whether reduced baseline cognitive status predicts functional decline in this population. METHODS Altogether 110 persons with HF completed the Lawton-Brody Instrumental Activities of Daily Living (IADL) scale and were administered the Modified Mini-Mental Status Examination (3MS) at baseline and a 12-month follow-up. Three composite scores were derived from the Lawton-Brody scale, including total, instrumental, and basic ADL. RESULTS HF patients reported high rates of baseline impairments in instrumental ADL, including shopping, food preparation, housekeeping duties, laundry, among others. Repeated measures analyses showed significant declines in total and instrumental ADL from baseline to the 12-month follow-up in HF (p<0.05). Hierarchical regression analyses showed that poorer baseline performance on the 3MS predicted worse total ADL performance at 12-months (β=0.15, p=0.049), including greater dependence in shopping, driving, feeding, and physical ambulation (p<0.05 for all). CONCLUSION The current results show that HF patients report significant functional decline over a 12-month period and brief cognitive tests can identify those patients at highest risk for decline. If replicated, such findings encourage the use of cognitive screening measures to identify HF patients most likely to require assistance with ADL tasks.
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Affiliation(s)
| | - Mary Beth Spitznagel
- Department of Psychology, Kent State University, USA Department of Psychiatry, Akron City Hospital, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, University of Florida, USA
| | | | | | - Richard Josephson
- University Hospitals Case Medical Center, USA Case Western Reserve University School of Medicine, USA
| | - Joel Hughes
- Department of Psychology, Kent State University, USA Department of Psychiatry, Akron City Hospital, USA
| | - Jim Rosneck
- Department of Psychiatry, Akron City Hospital, USA
| | - John Gunstad
- Department of Psychology, Kent State University, USA Department of Psychiatry, Akron City Hospital, USA
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25
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Haugan G, Innstrand ST, Moksnes UK. The effect of nurse-patient interaction on anxiety and depression in cognitively intact nursing home patients. J Clin Nurs 2013; 22:2192-205. [DOI: 10.1111/jocn.12072] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Gørill Haugan
- Faculty of Nursing; Research Centre for Health Promotion and Resources; Sør-Trøndelag University College, HIST; Trondheim Norway
| | - Siw T Innstrand
- Research Centre for Health Promotion and Resources ; Norwegian University of Science and Technology, NTNU; Trondheim Norway
| | - Unni K Moksnes
- Faculty of Nursing; Research Centre for Health Promotion and Resources; Sør-Trøndelag University College, HIST; Trondheim Norway
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26
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Haugan G. Nurse-patient interaction is a resource for hope, meaning in life and self-transcendence in nursing home patients. Scand J Caring Sci 2013; 28:74-88. [PMID: 23461626 DOI: 10.1111/scs.12028] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 12/06/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Spiritual dimensions such as hope, meaning in life and self-transcendence have been found to be predictors of successful ageing, life satisfaction and well-being in older individuals. Connectedness and communicating with others have been seen to facilitate hope, meaning in life and self-transcendence among nursing home patients. AIMS This study aimed to investigate the associations between hope, meaning in life, self-transcendence and nurse-patient interaction in a nursing home population. DESIGN AND METHODS A cross-sectional design was employed, collecting data in 44 different Norwegian nursing homes (NHs) from 250 patients who met the inclusion criteria. Approval by all regulatory institutions dealing with research issues in Norway and the Management Unit at the 44 NHs was obtained. A sample of 202 cognitively intact nursing home patients responded to the Herth Hope Index, the Purpose in Life test, the Self-Transcendence Scale and the Nurse-Patient Interaction Scale. A structural equation model (SEM) of the hypothesized relationships between the constructs was tested. RESULTS The SEM model fit well with the present data. Significant direct relationships of nurse-patient interaction on hope, meaning in life and self-transcendence were displayed. Meaning and the interconnectedness dimension of hope appeared to be particularly dynamic resources, revealing significant influences on all the constructs in the SEM model tested. CONCLUSION Nurse-patient interaction influences hope, meaning in life and self-transcendence in cognitively intact nursing home patients and might be an important resource in relation to patients' health and global well-being. Thus, care providers are above all fundamental for nursing home patients. Advancing caregivers' interacting and communicating skills might facilitate patients' health and global well-being and inspire professional caregivers as they perform their daily care practices. More research of the effectiveness of such strategies is greatly needed. LIMITATIONS The SEM model tested comprised 20 variables, indicating a desirable sample size of n = 200, while the present effective sample was n = 187. Also, cross-sectional data do not allow making conclusion on the causality.
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Affiliation(s)
- Gørill Haugan
- Research Centre for Health Promotion and Resources HIST/NTNU, Faculty of Nursing, Sør-Trøndelag University College, Trondheim, Norway
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27
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Drageset J, Eide GE, Ranhoff AH. Anxiety and depression among nursing home residents without cognitive impairment. Scand J Caring Sci 2012; 27:872-81. [DOI: 10.1111/j.1471-6712.2012.01095.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 09/10/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Jorunn Drageset
- Faculty of Health and Social Sciences; Bergen University College; Bergen Norway
| | - Geir Egil Eide
- Centre for Clinical Research; Western Norway Health Region Authority and Research Group for Lifestyle Epidemiology; Department of Public, Health and Primary Health Care; University of Bergen; Bergen Norway
| | - Anette Hylen Ranhoff
- Kavli Research Centre for Ageing and Dementia; Haraldsplass Hospital and Institute for Internal Medicine; University of Bergen; Bergen Norway
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Drageset J, Eide GE, Kirkevold M, Ranhoff AH. Emotional loneliness is associated with mortality among mentally intact nursing home residents with and without cancer: a five-year follow-up study. J Clin Nurs 2012; 22:106-14. [DOI: 10.1111/j.1365-2702.2012.04209.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Saliba D, DiFilippo S, Edelen MO, Kroenke K, Buchanan J, Streim J. Testing the PHQ-9 interview and observational versions (PHQ-9 OV) for MDS 3.0. J Am Med Dir Assoc 2012; 13:618-25. [PMID: 22796361 DOI: 10.1016/j.jamda.2012.06.003] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 06/01/2012] [Accepted: 06/01/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To test the feasibility and validity of the Patient Health Questionnaire-9 item interview (PHQ-9) and the newly developed Patient Health Questionnaire Observational Version (PHQ-9 OV) for screening for mood disorder in nursing home populations. METHODS The PHQ-9 was tested as part of the national Minimum Data Set 3.0 (MDS 3.0) evaluation study among 3822 residents scheduled for MDS 2.0 assessments. Residents from 71 community nursing homes (NHs) in eight states were randomly included in a feasibility sample (n = 3258) and a validation sample (n = 418). Each resident's ability to communicate determined whether the PHQ-9 interview or the PHQ-9 OV was initially attempted. In the validation sample, trained research nurses administered the instruments. For residents in the validation sample without severe cognitive impairment (3 MS ≥30) agreement between PHQ-9 and the modified Schedule for Affective Disorders and Schizophrenia (m-SADS) was measured with weighted kappas (κ). For residents with severe cognitive impairment (3MS <30), agreement between PHQ-9 interview or PHQ-9 OV and the Cornell Scale for Depression in Dementia (Cornell Scale) was measured using correlation coefficients. Staff impressions were obtained from an anonymous survey mailed to all MDS assessors. RESULTS The PHQ-9 was completed in 86% of the 3258 residents in the feasibility sample. In the validation sample, the agreement between PHQ-9 and m-SADS was very good (weighted κ = 0.69, 95% CI = 0.61-0.76), whereas agreement between MDS 2.0 and m-SADS was poor (weighted κ = 0.15, 95% CI = 0.06-0.25). Likewise, in residents with severe cognitive impairment, PHQ correlations with the criterion standard Cornell Scale were superior to the MDS 2.0 for both the PHQ-9 (0.63 vs 0.34) and the PHQ-9 OV (0.84 vs 0.28). Eighty-six percent of survey respondents reported that the PHQ-9 provided new insight into residents' mood. The average time for completing the PHQ-9 interview was 4 minutes. DISCUSSION Compared with the MDS 2.0 observational items, the PHQ-9 interview had greater agreement with criterion standard diagnostic assessments. For residents who could not complete the interview, the PHQ-9 OV also had greater agreement with a criterion measure for depression than did the MDS 2.0 observational items. Moreover, the majority of NH residents were able to complete the PHQ-9, and most surveyed staff reported improved assessments with the new approach.
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Affiliation(s)
- Debra Saliba
- UCLA/Jewish Home Borun Center for Gerontological Research, Los Angeles, CA, USA.
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Gopinath B, Anstey KJ, Kifley A, Mitchell P. Olfactory impairment is associated with functional disability and reduced independence among older adults. Maturitas 2012; 72:50-5. [DOI: 10.1016/j.maturitas.2012.01.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 01/10/2012] [Accepted: 01/13/2012] [Indexed: 10/14/2022]
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