Activity scheduling as a core component of effective care management for late-life depression.
Activity scheduling as a core component of effective care management for late-life depression.
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活动安排是晚年抑郁症有效护理管理的核心组成部分。
DOI：
10.1002/gps.3784
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发表时间：
2012
影响因子：
4
通讯作者：
Vannoy,Steven
中科院分区：
文献类型：
--
作者：
Riebe,Genevieve;Fan,Ming-Yu;Unutzer,Jurgen;Vannoy,Steven
背景活动安排是初级保健中晚年抑郁症循证治疗的一个既定组成部分。我们检查了改善情绪促进协作治疗 (IMPACT) 试验的参与者记录，以确定在成功的抑郁症护理管理 (CM) 背景下使用的活动安排策略、活动安排与自我报告的活动参与度以及抑郁结果的关联。 方法本研究使用观察性混合方法分析了 IMPACT 试验干预组 597 名参与者的 4335 份 CM 会议记录。使用扎根理论从 CM 笔记中识别出 17 种不同的活动类别。 Logistic 回归用于评估 12 个月时的活动安排、活动参与度和抑郁结果之间的关联。所有相关机构审查委员会都批准了研究方案。结果生成了 17 个不同的活动类别。大多数患者在治疗过程中至少进行一项社交活动和一项单独活动。常见的活动类别包括体力活动（32%）、药物管理（22%）、主动非体力活动（19%）和被动活动（14%）。我们发现活动安排、12 个月时自我报告的活动参与度和 12 个月时的抑郁结果之间存在显着的正相关关系。 结论 CM 中因抑郁症而进行的老年初级保健患者参加了广泛的活动。与强调社交活动的抑郁症理论一致，数据表明有意识的社交参与比被动的社交和孤独活动更有好处。护理管理者应鼓励患者平衡工具性活动（例如，处理医疗问题）和针对直接人际参与的社交活动。版权所有 © 2012 约翰·威利父子有限公司
BackgroundActivity scheduling is an established component of evidenced‐based treatment for late‐life depression in primary care. We examined participant records from the Improving Mood‐Promoting Access to Collaborative Treatment (IMPACT) trial to identify activity scheduling strategies used in the context of successful depression care management (CM), associations of activity scheduling with self‐reported activity engagement, and depression outcomes.MethodsThis study used observational mixed methods analysis of 4335 CM session notes from 597 participants in the intervention arm of the IMPACT trial. Grounded theory was used to identify 17 distinct activity categories from CM notes. Logistic regression was used to evaluate associations between activity scheduling, activity engagement, and depression outcomes at 12 months. All relevant institutional review boards approved the research protocol.ResultsSeventeen distinct activity categories were generated. Most patients worked on at least one social and one solitary activity during their course of treatment. Common activity categories included physical activity (32%), medication management (22%), active–non‐physical (19%), and passive (14%) activities. We found significant, positive associations between activity scheduling, self‐reported engagement in activities at 12 months, and depression outcomes at 12 months.ConclusionOlder primary care patients in CM for depression worked on a wide range of activities. Consistent with depression theory that has placed emphasis on social activities, the data indicate a benefit for intentional social engagement versus passive social and solitary activities. Care managers should encourage patients to balance instrumental activities (e.g., attending to medical problems) with social activities targeting direct interpersonal engagement. Copyright © 2012 John Wiley & Sons, Ltd.