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Clinical Trial
. 2011 Aug 25:11:50.
doi: 10.1186/1471-2318-11-50.

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

Maureen F Markle-Reid  1 , Carrie McAiney, Dorothy Forbes, Lehana Thabane, Maggie Gibson, Jeffrey S Hoch, Gina Browne, Thomas Peirce, Barbara Busing
Affiliations
Clinical Trial

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

Maureen F Markle-Reid et al. BMC Geriatr. .

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.

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Figures

Figure 1
Figure 1
Study Flow Diagram.
Figure 2
Figure 2
Graphical Depiction of Intervention and Measurements. Squares represent fixed elements. Circles represent activities that are flexible. Measurements are bolded. This graphical method was proposed by Perera et al. [134].
See this image and copyright information in PMC

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