Feasibility of a family-centered intervention for depressed older men in primary care.
Feasibility of a family-centered intervention for depressed older men in primary care.
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对初级保健中抑郁的老年男性进行以家庭为中心的干预的可行性。
DOI：
10.1002/gps.5196
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发表时间：
2019
影响因子：
4
通讯作者：
Unutzer,Jurgen
中科院分区：
文献类型：
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作者：
Hinton,Ladson;LaFrano,Erika;Harvey,Danielle;Alfaro,EduardoDelgadillo;Kravitz,Richard;Smith,Andrew;Apesoa-Varano,EsterCarolina;Jafri,Asma;Unutzer,Jurgen
目的 家庭为许多患有抑郁症的老年人提供了大量支持，但很少有干预研究试图将他们纳入其中。家庭参与抑郁症治疗符合老年男性的偏好，老年男性是接受治疗的抑郁症高危人群。本研究探讨了在初级保健机构中对老年男性进行以家庭为中心的抑郁症干预的可行性。方法临床试验在加利福尼亚州中央山谷的联邦合格健康中心 (FQHC) 进行。抑郁的老年男性（50 岁及以上）被分配到由有执照的临床社会工作者提供的抑郁心理教育或以家庭为中心的抑郁干预措施加强的常规护理。从招募、保留和家庭参与程度方面评估了干预的可行性。 PHQ-9 在基线、1、3 和 6 个月时进行。结果 6 个月以上，45 名男性被转介参加研究； 31 人符合纳入标准，23 人成功入组，20 人（88%）参加了一次以上的治疗。总体而言，参与干预的男性中，85%（13 人中的 11 人）与家庭成员进行了超过或等于一次的干预，54%（13 人中的 7 人）与家庭成员进行了超过或等于 3 次的干预。虽然两组男性早期都表现出 PHQ-9 分数显着下降的证据，并随着时间的推移而减弱，但组间差异不显着。结论我们以家庭为中心的抑郁症干预措施在各种参数的基础上显示出可接受的可行性。未来对基于家庭的方法的研究可能会受益于更长的持续时间和更强化的治疗以及克服招募障碍的额外策略。
ObjectiveFamilies provide considerable support to many older adults with depression, yet few intervention studies have sought to include them. Family participation in depression treatment aligns with the preferences of older men, a group at high risk for depression under treatment. This study examined the feasibility of a family‐centered depression intervention for older men in a primary care setting.MethodsA clinical trial was conducted in a Federally Qualified Health Center (FQHC) in California's Central Valley. Depressed older men (age 50 and older) were allocated to usual care enhanced by depression psychoeducation or a family‐centered depression intervention delivered by a licensed clinical social worker. Intervention feasibility was assessed in terms of recruitment, retention, and extent of family engagement. The PHQ‐9 was administered at baseline, 1, 3, and 6 months.ResultsFor more than 6 months, 45 men were referred to the study; 31 met the inclusion criteria, 23 were successfully enrolled, and 20 (88%) participated in more than or equal to one treatment sessions. Overall, 85% (11 of 13) of men allocated to the intervention engaged a family member in more than or equal to one session and 54% (7 of 13) engaged the family member in more than or equal to three sessions. While men in both groups showed evidence of a significant decline in PHQ‐9 scores early on, which attenuated over time, there were no significant between group differences.ConclusionsOur family‐centered depression intervention showed acceptable feasibility on the basis of a variety of parameters. Future research on family‐based approaches may benefit from longer duration and more intensive treatment as well as additional strategies to overcome recruitment barriers.