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Do you think you suffer from depression? Reevaluating the use of a single item question for the screening of depression in older primary care patients
- Authors:
- AYALON Liat, GOLDFRACHT Margalit, BECH Per
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(5), May 2010, pp.497-502.
- Publisher:
- Wiley
The majority of older adults prefer to receive their mental health treatment in primary care. However, despite efforts to integrate depression treatment into primary care, depression often remains undetected. There is therefore a need to identify appropriate screening tools for depression. The goal of this study was to compare a single item screening for depression to 3 existing depression screening tools. The participants were a cross sectional sample of 153 older primary care patients in 2 clinics in Israel who completed the following depression-screening measures: a single depression screen, Patient Health Questionnaire-9, Major Depression Inventory, Visual Analogue Scale. The measures were evaluated against a depression diagnosis made by the Structured Clinical Interview for DSM-IV. The results showed that overall 3.9% of the sample was diagnosed with depression. The most notable finding was that the single-item question, ‘Do you think you suffer from depression?’ had as good or better sensitivity (83%) than all the other screens. Nonetheless, its specificity of 83% suggested that it has to be followed up by a thorough diagnostic interview. Additional sensitivity analyses concerning the use of a single depression item taken directly from the depression screening measures supported this finding.
Using mixed methods to evaluate the use of a caregiver strain measure to assess outcomes of a caregiver support program for caregivers of older adults
- Authors:
- HYUCK Magaret Hellie, AYALON Liat, YODER Judy
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(2), February 2007, pp.160-165.
- Publisher:
- Wiley
Many assessment tools have been developed for evaluating caregiving programs, but the majority are too cumbersome for ongoing use. This study reports on a brief assessment tool used to monitor strain among family members caring for an impaired elder. Participants were enrolled in the SeniorCare program, a program funded by the Administration on Aging to provide care to family caregivers. The Caregiver Risk Screen (CRS) is a 12-item measure of strain, initially developed as part of an in-home assessment procedure. Its utility for use in practice settings over time was assessed using both quantitative and qualitative methodology. Chronbach alpha levels for the CRS were 0.85 at intake and 0.84 at first follow-up. At the first follow-up, the overall index score and five of the 12 items showed statistically significant lessened strain. In subsequent follow-up evaluations, the average improvements were maintained but there was no additional decrease in strain. Individual variations in changes over time were identified by combining quantitative and qualitative information. Themes that emerged in qualitative data served to modify the measure for future use. The brief Caregiver Risk Screen tool appears to be a reliable and valid tool for use in practice settings. It is acceptable to clients and professional staff. Modifications have been made that may further enhance the suitability of this measure for other settings.