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BMC Geriatrics
Published in: BMC Geriatrics 1/2011

Open Access 01-12-2011 | Study protocol

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention

Authors: Maureen F Markle-Reid, Carrie McAiney, Dorothy Forbes, Lehana Thabane, Maggie Gibson, Jeffrey S Hoch, Gina Browne, Thomas Peirce, Barbara Busing

Published in: BMC Geriatrics | Issue 1/2011

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Abstract

Background

Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services.

Methods/Design

This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation.

Discussion

Data collection began in May 2010 and is expected to be completed by July 2012. A collaborative nurse-led strategy may provide a feasible, acceptable and effective means for improving the health of older home care clients by improving the prevention, recognition, and management of depression in this vulnerable population. The challenges involved in designing a practical, transferable and sustainable nurse-led intervention in home care are also discussed.

Trial Registration

ClinicalTrials.gov: NCT01407926
Appendix
Available only for authorised users
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Metadata
Title
Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention
Authors
Maureen F Markle-Reid
Carrie McAiney
Dorothy Forbes
Lehana Thabane
Maggie Gibson
Jeffrey S Hoch
Gina Browne
Thomas Peirce
Barbara Busing
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2011
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/1471-2318-11-50

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