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Further evidence of attention bias for negative information in late life depression
- Authors:
- BROOMFIELD Niall M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(3), March 2007, pp.175-180.
- Publisher:
- Wiley
Pilot research using the manual (card based) emotional Stroop paradigm shows depressed elders selectively attend negative words, whereas dementia patients do not. The present study aimed to confirm this effect, using a more controlled, computerised, emotional Stroop paradigm, and accounting for co-morbid anxiety. Nineteen depressed (DEP) and twenty non depressed control participants (CON) completed a computerised Emotional Stroop task. This task involves colour naming individually presented negative, positive and neutral words. Mean participant age was 72.25 years. All participants were free of significant cognitive impairment. Consistent with hypotheses, analysis of variance revealed a general cognitive slowing amongst DEP, and a specific interference effect for negative words, in this group, suggesting attention bias. Previous pilot data are confirmed. The emotional Stroop paradigm may have clinical potential for distinguishing geriatric depression and dementia, although as yet this is far from clear. Detailed development work including comparison with depressed and non depressed Alzheimer's patients, will be necessary to demonstrate diagnostic validity.
Caring for dignity: a national report on dignity in care for older people while in hospital
- Author:
- HEALTHCARE COMMISSION
- Publisher:
- Healthcare Commission
- Publication year:
- 2007
- Pagination:
- 64p., bibliog.
- Place of publication:
- London
Publishing a national report on dignity in care, the independent watchdog is warning NHS trusts of further checks, including unannounced visits, where there are clusters of evidence suggesting a problem at a hospital or on a ward. The Commission says that overall it was encouraged by signs that the trusts were generally getting the right systems in place. But there was work to do to offer dignity in care to all of the people all of the time and evidence showed this was not always the case. The national report draws on assessments at 23 NHS hospitals, Commission surveys of 80,000 NHS inpatients and nearly 130,000 NHS staff, the Commission's analysis of 10,000 complaints and National Patient Safety Agency information on safety incidents. The report also highlights eight other trusts identified as providing dignity in care in line with best practice.
The role of patient personality in the identification of depression in older primary care patients
- Authors:
- McCRAY Laura W., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(11), November 2007, pp.1095-1100.
- Publisher:
- Wiley
The aim was to evaluate whether personality factors significantly contribute to the identification of depression in older primary care patients, even after controlling for depressive symptoms. The authors examined the association between personality factors and the identification of depression among 318 older adults who participated in the Spectrum study. High neuroticism (unadjusted Odds Ratio (OR) 2.36, 95% Confidence Interval (CI) [1.42, 3.93]) and low extraversion (adjusted OR 2.24, CI [1.26, 4.00]) were associated with physician identification of depression. Persons with high conscientiousness were less likely to be identified as depressed by the doctor (adjusted OR 0.45, CI [0.22, 0.91]). Personality factors influence the identification of depression among older persons in primary care over and above the relationship of depressive symptoms with physician identification. Knowledge of personality may influence the diagnosis and treatment of depression in primary care.
Capturing the concealed: Interprofessional practice and older patients' participation in decision-making about discharge after acute hospitalization
- Authors:
- HUBY Guro, et al
- Journal article citation:
- Journal of Interprofessional Care, 21(1), January 2007, pp.55-67.
- Publisher:
- Taylor and Francis
The aim of this paper is to investigate ways in which the dynamics of interprofessional work shaped older patients' “participation” in decision-making about discharge from acute hospital care in a medical directorate of a District General Hospital in Scotland. Twenty-two purposively selected older patients and their key professional hospital carers in three different ward environments participated in the study. An ethnographic approach was adopted, involving semi-structured interviews with patients and staff combined with rigorous observation of the practical context for staff and patient interactions during the discharge planning process over a 5-month period. Patients' and staff's understanding of “decision-making” and their priorities for discharge were different, but patients' perspectives fragmented and became invisible. Care routines, which centred around assessments and the decisions that flowed from these tended to exclude both staff and patients from active decision-making. Research and practice on patient involvement in discharge decision-making needs to focus on the organizational context, which shapes patients', unpaid carers' and staff's interactions and the dynamics by which some views are privileged and others excluded. Procedurally driven care routines and their impact on patients', carers' and staff's opportunity to actively engage in decision-making should be re-considered from an empowerment perspective.
National evaluation of partnerships for older people projects: interim report of progress: briefing paper: cost-effectiveness: measuring effects: emergency bed-day use
- Author:
- UNIVERSITY OF HERTFORDSHIRE
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2007
- Pagination:
- 7p.
- Place of publication:
- London
This is an interim report of an ongoing evaluation of the National POPP programme. It is a statement of progress providing very early findings, lessons learnt and key messages from the experience of the POPP pilots to date.
Patient views of social service provision for older people with advanced heart failure
- Authors:
- GOTT Merryn, et al
- Journal article citation:
- Health and Social Care in the Community, 15(4), July 2007, pp.333-342.
- Publisher:
- Wiley
The objective of the present paper is to explore levels of social service provision, the barriers to receiving these services and the experiences of social service provision amongst older people with heart failure. Five hundred and forty-two people aged over 60 years with heart failure were recruited from UK general practices in four areas of the UK, and these subjects completed quality-of-life and service-use questionnaires every 3 months for 24 months, or until death. Forty patients participated in in-depth interviews. Data collection was conducted between September 2003 and March 2006. Only 24% (n = 127) of the 460 participants who had provided information about social services contact reported having received social services during the past 24 months. Significant associations between the level of social services contact and participant characteristics were identified, with women, participants over 75 years of age, participants living alone, and those with two or more comorbidities being more likely to report receipt of social services. The qualitative data identified key barriers to using social services, including: access problems; not wanting additional help; the negative experiences of friends; and carers substituting for statutory services. The few participants interviewed who had received social services reported mixed experiences, including problems with inappropriate and insufficient services. This study indicates that only a minority of older people with heart failure have contact with social services. Improving provision for this group involves tackling the barriers to access identified above, as well as ensuring that their views influence service planning and delivery.
Dignity in care for older people in hospital - measuring what matters
- Author:
- ELASWARAPU Rekha
- Journal article citation:
- Working with Older People, 11(2), June 2007, pp.15-19.
- Publisher:
- Emerald
The Heathcare Commission has recently been developing an approach to check whether NHS trusts are treating hospital patients with dignity and respect. This article outlines the challenges to make dignity in care work.
The temporal relationship between falls and fear-of-falling among Chinese older primary-care patients in Hong Kong
- Authors:
- CHOU Kee-Lee, CHI Iris
- Journal article citation:
- Ageing and Society, 27(2), March 2007, pp.181-193.
- Publisher:
- Cambridge University Press
Although the association between falls and fear-of-falling has been established by previous studies, the temporal ordering of the two is uncertain. Moreover, the common and unique risk factors that contribute to falls and to fear-of-falling have not been investigated in either primary health-care settings or Asian societies. The aims of this study were to examine the temporal sequencing of fear-of-falling and a fall, and to identify the risk factors associated with the two. A prospective cohort study with three six-month measurement waves was conducted in primary-care settings in Hong Kong. The sample was derived from the waiting list control group of a randomised clinical trial, and 321 respondents participated in the three waves. They were evaluated with the Minimum Data Set for Home Care. It was found that falls and fear-of-falling at baseline were not independent predictors of respectively developing a fear-of-falling and becoming a faller, but that age was a common independent predictor for falls and the onset of a fear-of-falling. Individuals with a fear-of-falling were at risk of both falling and a fear-of-falling at 12 months. The good news is that no vicious cycle of falls and fear-of-falling was found, and modifiable risk factors, including IADL limitations, environmental hazards, and fear-of-falling were identified, so that effective prevention programmes for falls and for fear-of-falling can be designed.
The meanings older people give to their rehabilitation experience
- Authors:
- WALLIN Marjo, et al
- Journal article citation:
- Ageing and Society, 27(1), January 2007, pp.147-164.
- Publisher:
- Cambridge University Press
Promoting older people's ability to manage at home is important both for themselves and for society, but few studies have explored whether geriatric rehabilitation actually meets the needs of this heterogeneous group. The purpose of this study was to investigate the meanings that older adults attribute to their geriatric rehabilitation experiences. A group of 27 older adults in inpatient rehabilitation were interviewed during the programme and after returning home. Semi-structured interviews were analysed using a qualitative method, which identified three categories of meaning. In the category ‘sense of confidence with everyday life’, rehabilitation was perceived as facilitating everyday living at home; in the category ‘sense of vacation’, rehabilitation was seen as a means of getting away from normal life and enjoying oneself; and in the category ‘sense of disappointment in the rehabilitation programme’, the participants expressed frustration with the limited opportunities to participate in the planning of their rehabilitation, and with the mismatch between the offered programme and what was needed. To promote older people's autonomy and to enhance their ability to live at home, professionals must involve their clients to a greater extent in the planning of the rehabilitation than is currently the case, and also individualise the rehabilitation regimen.
Validation of the Retardation Rating Scale for detecting depression in geriatric inpatients
- Authors:
- BONIN-GUILLAUME Sylvie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(1), January 2007, pp.69-76.
- Publisher:
- Wiley
Validation in the elderly of the Retardation Rating Scale (RRS), which includes items related to motor and mental retardation but not vegetative items, and may be particularly well-suited for the diagnosis of depression in the elderly. One hundred and sixty-five geriatric inpatients (105 depressed), aged 65 and over, without dementia, neuroleptic medication and increased risk of slowed mobility, were assessed with the RRS and three validated gold-standard scales for geriatric depression (Hamilton Depression Rating Scale, Montgomery and Asberg Depression Rating Scale, Geriatric Depression Scale). Factor analysis used varimax rotation, Cronbach's, Spearman's and Ferguson's coefficients and the Mann-Whitney U-test to evaluate construct and internal consistency. Convergent validity and Receiver Operating Characteristics curves were also analyzed. Factor analysis retained three interpretable domains: (1) motor items (45% of the variance); (2) mental items and (3) the cognitive items. Internal consistency was high ( = 0.91). Each item was strongly correlated with the total RRS score and associated with depression. The RRS showed good convergent validity and its total score increased with depression severity. A cut-off score of 10 yielded 79% sensitivity and 80% specificity, with 80% of the patients properly classified, that is 15% more than standard observer scales. RRS is a valid screening tool for depression and improves recognition of depression in geriatric inpatients.