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A systematic review of older adults’ attitudes towards depression and its treatment
- Authors:
- NAIR Pushpa, et al
- Journal article citation:
- Gerontologist, 60(1), 2020, pp.e93-e104.
- Publisher:
- Oxford University Press
Background and Objectives: Late-life depression is a major societal concern, but older adults’ attitudes toward its treatment remain complex. This review aimed to explore older adults’ views regarding depression and its treatment. Research Design and Methods: A systematic review and thematic synthesis of qualitative studies that explored the views of older community-dwelling adults with depression (not actively engaged in treatment), about depression and its treatment. The review searched 7 databases (inception–November 2018) and 2 reviewers independently quality-appraised studies using the CASP checklist. Results: Out of 8,351 records, researchers included 11 studies for thematic synthesis. Depression was viewed as a normal reaction to life stressors and ageing. Consequently, older adults preferred self-management strategies (e.g., socialising, prayer) that aligned with their lived experiences and self-image. Professional interventions (e.g., antidepressants, psychological therapies) were sometimes considered necessary for more severe depression, but participants had mixed views. Willingness to try treatments was based on a balance of different judgements, including perceptions about potential harm and attitudes based on trust, familiarity, and past experiences. Societal and structural factors, including stigma, ethnicity, and ageism, also influenced treatment attitudes. Discussion and Implications: Supporting older adults to self-manage milder depressive symptoms may be more acceptable than professional interventions. Assisting older adults with accessing professional help for more severe symptoms might be better achieved by integrating access to help within familiar, convenient locations to reduce stigma and increase accessibility. Discussing treatment choices using narratives that engage with older adults’ lived experiences of depression may lead to greater acceptability and engagement. (Edited publisher abstract)
Working through interpreters in old age psychiatry: a literature review
- Authors:
- FAROOQ Saeed, KINGSTON Paul, REGAN Jemma
- Journal article citation:
- Mental Health Review Journal, 20(1), 2015, pp.36-47.
- Publisher:
- Emerald
Purpose: A systematic appraisal of the effect of use of interpreters for mental health problems in old age. The primary objective of the review is to assess the impact of a language barrier for assessment and management in relation to mental health problems in the old age. The secondary objectives are to assess the effect of the use of interpreters on patient satisfaction and quality of care, identify good practice and make recommendations for research and practice in the old age mental health. Design/methodology/approach: The following data sources were searched for publications between 1966 and 2011: PubMed, PsycINFO, CINAHL and Cochrane Library. The authors also conducted a search of the World Wide Web using Google Scholar, employing the search term Medical Interpreters and Mental Health. The search included literature in all languages. Findings: Only four papers met the inclusion and exclusion criteria and present original research in the field of “old age”, “psychiatry” and “interpreting”. None of these papers present UK-based research. The studies are from Australia, Canada, a paper describing community interpreting in a Belgian old home and an American case study. Practical implications: Interviewing older patients for constructs like cognitive function and decision-making capacity through interpreters can pose significant clinical and legal problems. There is urgent need for training mental health professionals for developing skills to overcome the language barrier and for interpreters to be trained for work in psychogeriatrics. Social implications: Further studies are needed to understand the extent of problem and how effective interpreting and translating services can be provided in the routine clinical practice. It is also essential to develop a standard of translation services in mental health that can be measured for their quality and also efficiency. At present such a quality standard is not available in the UK (Edited publisher abstract)