Depression Self-Management and Women with Disabilities

描述(申请人提供)：抑郁症是一种常见的继发性疾病 与原发残疾相关的状况。高得不成比例的是 与男性相比，抑郁症似乎在 残疾妇女。尽管所有人患抑郁症的风险 残疾人的比例似乎高于一般人， 与男性相比，残疾女性可能面临更大的风险 对应者，然而文献没有报道治疗方式 这是对患有功能性抑郁症的女性的独特需求的回应 限制。该项目的目的是开发和测试一种创新的、 有针对性的、理论驱动的团体干预旨在改善 肢体残疾女性中的抑郁症。假设(A) 参加抑郁症自我管理小组的残疾妇女 干预将报告较低水平的抑郁和较高水平的自我 治疗后抑郁、自我效能感和社会联系的管理 干预和三个月的随访，与那些参与的人相比 只接受抑郁症教育干预；以及，(B)自我管理 抑郁、自我效能感和社会联系将在关系中起中介作用 在肢体残疾妇女中，残疾与抑郁结局之间的关系。 本研究采用随机分组和组间前后检验的方法 设计，并进行三个月的随访。干预将在以下时间实施 当地公立和私立慢性护理诊所，有154名身体健康的妇女 残疾人将被随机分配参加自我- 管理干预或仅供教育的比较工作坊。的分数 两组在抑郁自我管理、自我效能感、 社会连通性和抑郁症将被比较。这些评估将 在干预期前后的三个时间点进行 并进行为期三个月的随访。形成性和总结性评价，使用 将采用定性和定量的方法。这项研究是 设计成可推广到物理医学和临床实践中 康复，为残疾妇女提供心理健康服务； 有关提供精神健康服务的公共卫生政策 残疾人。

DESCRIPTION (provided by applicant): Depression is a common secondary condition associated with a primary disability. Disproportionately high among women compared to men, depression appears to be even more prevalent among women with disabilities. Although the risk for depression among all persons with disabilities appears to be higher than that among people in general, women with disabilities may be at even greater risk comparied to their male counterparts, yet the literature fails to report on a therapeutic modality that is responsive to the unique needs of depressed women with functional limitations. The purpose of this project is to develop and test an innovative, targeted, and theory-driven group intervention designed to ameliorate depression in women with physical disabilities. It is hypothesized that (a) women with disabilities who participate in a depression self-management group intervention will report lower levels of depression and higher levels of self- management of depression, self-efficacy, and social connectedness after the intervention and at a three-month follow-up, compared to those who participate in a depression education-only intervention; and, (b) self-management of depression, self-efficacy, and social connectedness will mediate the relation of disability to depression outcomes among women with physical disabilities. This study uses a randomized with-groups and between-groups pre/post-test design with a three-month follow-up. The intervention will be implemented at local public and private chronic care clinics with 154 women with physical disabilities who will randomly be assigned to participate in either the self- management intervention or education-only comparison workshop. The scores of the two groups on measures of self-management of depression, self-efficacy, social connectedness, and depression will be compared. These assessments will be conducted at three time points, before and after the intervention period and at a three-month follow-up. Formative and summative evaluations, using qualitative and quantitative methodologies, will be conducted. This study is designed to be generalizable for clinical practice in physical medicine and rehabilititation, for mental health services for women with disabilities, and for public health policy governing the delivery of mental health services to people with disabilities.