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An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms

BACKGROUND: Depressive symptoms in older home care clients are common but poorly recognized and treated, resulting in adverse health outcomes, premature institutionalization, and costly use of health services. The objectives of this study were to examine the feasibility and acceptability of a new si...

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Autores principales: Markle-Reid, Maureen, McAiney, Carrie, Forbes, Dorothy, Thabane, Lehana, Gibson, Maggie, Browne, Gina, Hoch, Jeffrey S, Peirce, Thomas, Busing, Barbara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019952/
https://www.ncbi.nlm.nih.gov/pubmed/24886344
http://dx.doi.org/10.1186/1471-2318-14-62
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author Markle-Reid, Maureen
McAiney, Carrie
Forbes, Dorothy
Thabane, Lehana
Gibson, Maggie
Browne, Gina
Hoch, Jeffrey S
Peirce, Thomas
Busing, Barbara
author_facet Markle-Reid, Maureen
McAiney, Carrie
Forbes, Dorothy
Thabane, Lehana
Gibson, Maggie
Browne, Gina
Hoch, Jeffrey S
Peirce, Thomas
Busing, Barbara
author_sort Markle-Reid, Maureen
collection PubMed
description BACKGROUND: Depressive symptoms in older home care clients are common but poorly recognized and treated, resulting in adverse health outcomes, premature institutionalization, and costly use of health services. The objectives of this study were to examine the feasibility and acceptability of a new six-month interprofessional (IP) nurse-led mental health promotion intervention, and to explore its effects on reducing depressive symptoms in older home care clients (≥ 70 years) using personal support services. METHODS: A prospective one-group pre-test/post-test study design was used. The intervention was a six-month evidence-based depression care management strategy led by a registered nurse that used an IP approach. Of 142 eligible consenting participants, 98 (69%) completed the six-month and 87 (61%) completed the one-year follow-up. Outcomes included depressive symptoms, anxiety, health-related quality of life (HRQoL), and the costs of use of all types of health services at baseline and six-month and one-year follow-up. An interpretive descriptive design was used to explore clients’, nurses’, and personal support workers’ perceptions about the intervention’s appropriateness, benefits, and barriers and facilitators to implementation. RESULTS: Of the 142 participants, 56% had clinically significant depressive symptoms, with 38% having moderate to severe symptoms. The intervention was feasible and acceptable to older home care clients with depressive symptoms. It was effective in reducing depressive symptoms and improving HRQoL at six-month follow-up, with small additional improvements six months after the intervention. The intervention also reduced anxiety at one year follow-up. Significant reductions were observed in the use of hospitalization, ambulance services, and emergency room visits over the study period. CONCLUSIONS: Our findings provide initial evidence for the feasibility, acceptability, and sustained effects of the nurse-led mental health promotion intervention in improving client outcomes, reducing use of expensive health services, and improving clinical practice behaviours of home care providers. Future research should evaluate its efficacy using a randomized clinical trial design, in different settings, with an adequate sample of older home care recipients with depressive symptoms. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT01407926.
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spelling pubmed-40199522014-05-15 An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms Markle-Reid, Maureen McAiney, Carrie Forbes, Dorothy Thabane, Lehana Gibson, Maggie Browne, Gina Hoch, Jeffrey S Peirce, Thomas Busing, Barbara BMC Geriatr Research Article BACKGROUND: Depressive symptoms in older home care clients are common but poorly recognized and treated, resulting in adverse health outcomes, premature institutionalization, and costly use of health services. The objectives of this study were to examine the feasibility and acceptability of a new six-month interprofessional (IP) nurse-led mental health promotion intervention, and to explore its effects on reducing depressive symptoms in older home care clients (≥ 70 years) using personal support services. METHODS: A prospective one-group pre-test/post-test study design was used. The intervention was a six-month evidence-based depression care management strategy led by a registered nurse that used an IP approach. Of 142 eligible consenting participants, 98 (69%) completed the six-month and 87 (61%) completed the one-year follow-up. Outcomes included depressive symptoms, anxiety, health-related quality of life (HRQoL), and the costs of use of all types of health services at baseline and six-month and one-year follow-up. An interpretive descriptive design was used to explore clients’, nurses’, and personal support workers’ perceptions about the intervention’s appropriateness, benefits, and barriers and facilitators to implementation. RESULTS: Of the 142 participants, 56% had clinically significant depressive symptoms, with 38% having moderate to severe symptoms. The intervention was feasible and acceptable to older home care clients with depressive symptoms. It was effective in reducing depressive symptoms and improving HRQoL at six-month follow-up, with small additional improvements six months after the intervention. The intervention also reduced anxiety at one year follow-up. Significant reductions were observed in the use of hospitalization, ambulance services, and emergency room visits over the study period. CONCLUSIONS: Our findings provide initial evidence for the feasibility, acceptability, and sustained effects of the nurse-led mental health promotion intervention in improving client outcomes, reducing use of expensive health services, and improving clinical practice behaviours of home care providers. Future research should evaluate its efficacy using a randomized clinical trial design, in different settings, with an adequate sample of older home care recipients with depressive symptoms. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT01407926. BioMed Central 2014-05-10 /pmc/articles/PMC4019952/ /pubmed/24886344 http://dx.doi.org/10.1186/1471-2318-14-62 Text en Copyright © 2014 Markle-Reid et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Markle-Reid, Maureen
McAiney, Carrie
Forbes, Dorothy
Thabane, Lehana
Gibson, Maggie
Browne, Gina
Hoch, Jeffrey S
Peirce, Thomas
Busing, Barbara
An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms
title An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms
title_full An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms
title_fullStr An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms
title_full_unstemmed An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms
title_short An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms
title_sort interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019952/
https://www.ncbi.nlm.nih.gov/pubmed/24886344
http://dx.doi.org/10.1186/1471-2318-14-62
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