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BE-ACTIV: a staff-assisted behavioral intervention for depression in nursing homes
- Authors:
- MEEKS Suzanne, et al
- Journal article citation:
- Gerontologist, 48(1), February 2008, pp.105-114.
- Publisher:
- Oxford University Press
This article (a) describes a 10-week, behavioural, activities-based intervention for depression that can be implemented in nursing homes collaboratively with nursing home activities staff and (b) presents data related to its development, feasibility, and preliminary outcomes. BE-ACTIV, which stands for Behavioral Activities Intervention, was developed in two pilot study phases: a treatment development phase and a feasibility–outcome phase with a small, randomized trial. The intervention was piloted with five depressed residents in a single nursing home in collaboration with the social services and activities staff. In the second phase randomized 20 residents from six nursing homes to receive either the intervention or treatment as usual. The intervention was well received by residents, family, and staff members. Experience with the intervention and input from staff members resulted in modifications to streamline the intervention and improve implementation. Results suggest that BE-ACTIV reduced institutional barriers to participation in pleasant activities, increased resident control over activity participation, increased overall activity participation, and improved depressive symptoms. Despite low power, statistical and graphical comparisons suggest superiority of the intervention over treatment as usual. Because depression among nursing home residents is prevalent, heterogeneous, and often treatment resistant, there is a need for effective, low-cost interventions that are ecologically acceptable and efficient. BE-ACTIV is a promising intervention; it is brief, addresses institutional barriers, involves facility staff in treatment, and is acceptable to residents. As such, BE-ACTIV merits further evaluation to establish efficacy and effectiveness.
The Pleasant Events Schedule - Nursing Home Version: a useful tool for behavioral interventions in long-term care
- Authors:
- MEEKS Suzanne, SHAH Shruit N., RAMSEY Sarah K.
- Journal article citation:
- Aging and Mental Health, 13(3), May 2009, pp.445-455.
- Publisher:
- Taylor and Francis
Behavioural interventions for depression emphasize increasing engagement in pleasant events, requiring reliable and valid assessment of events. Versions of the Pleasant Events Schedule (PES) have been developed for this purpose. The goal of this study was to develop and evaluate a nursing home version of the PES. The PES-NH was developed on two samples of nursing home residents. First activity frequency and pleasantness for 10 residents of a large, urban facility in the US was sampled. Using these pilot data and PES-Alzheimer's Disease items, 37 more residents from the same facility were interviewed, yielding a comprehensive list of events that residents find pleasant. From the second sample of 48 residents, normative and psychometric data on the new scale are presented. A 30-item inventory was able to cover the content of daily activities available in nursing homes. Scales derived from these items were internally consistent and reliable over time. Frequency of event participation was related to perceptions of quality of life, depression and positive affect independent of the overall tendency to rate events as pleasantness. Event participation was unrelated to negative affect, suggesting that activity engagement is linked to depression through its impact on positive affect. Data from this study provide base rate information for planning pleasant event interventions in nursing homes. The PES-NH is a useful and valid tool for implementing behavioural interventions for depression in these settings.