COMMUNITY LTC SERVICE AND OUTCOMES--BURDEN OF DEPRESSION

描述(申请者摘要)：这项研究解决了基本问题 在社区长期护理方面：确保适当的服务，以应对 广泛的客户需求和与服务相关的理解因素 结果。预计会有不成比例的公共CLTC客户端 由于抑郁而有心理健康服务需求，因为抑郁症是 与身体依赖和低收入有关。但实际上没有 研究已经解决了CLTC中老年人的抑郁程度，也没有 抑郁对社区精神卫生服务使用和结果的影响。此外，人们对此知之甚少。 关于客户对精神健康服务的态度或 心理健康中心在满足心理健康需求方面的潜在作用。研究目标为1) 估计首次入住公共社区中心的长者的抑郁程度及 确定与抑郁相关的因素；2)确定服务需求 可归因于抑郁症的CLTC；3)确定抑郁症老年人 与非抑郁的老年人相比，体验从CLTC中获益更少；4)检查如何 CLTC对客户的心理健康需求做出回应。 拟议的研究将对进入和通过一年的老年人进行调查 在密苏里州公共资助的社区长期护理系统中提供服务。学习 参加者年龄为60岁或以上，并有资格参加公共课程 由于低收入和功能残疾，儿童无法获得医疗和医疗服务。通过一个 电话筛选面试，我们将评估1500名新的CLTC客户， 记录抑郁症的程度和类型。我们将跟踪300个沮丧的人 以及随机抽样的300名非抑郁症老年人在一年内 CLTC服务使用率。受试者将接受采访，服役记录将被 以确定可归因于抑郁症的服务需求和 心理健康中心在多大程度上是获得心理健康服务的门户。结果： 维护社区护理、生活质量、生活满意度和 消费者对家庭护理的满意度)六个月和一年将是 比较抑郁和非抑郁的客户，以确定程度 哪种抑郁会影响CLTC服务的结果。 社区长期护理是一个快速发展的服务部门，其规模不断扩大 家庭和社区护理是发展长期护理的优先事项 政策。该项目有可能影响计划和政策 Cltc的发展。调查结果将为下一步测试干预措施提供信息 将CLTC和精神健康服务整合在一起。

DESCRIPTION (Applicant's Abstract): This study addresses fundamental concerns in community long-term care: ensuring appropriate service in response to a broad range of client needs and understanding factors associated with service outcomes. It is expected that a disproportionate number of public CLTC clients have mental health service needs due to depression, given that depression is associated with both physical dependency and low income. Yet virtually no research has addressed the extent of depression among elders in CLTC nor the impact of depression on CLTC service use and outcomes. Further, little is known about the attitudes of CLTC clients regarding mental health services nor the potential role of CLTC in meeting mental health needs. Study aims are to 1) estimate the extent of depression among elders first entering public CLTC and identify factors associated with depression; 2) determine the service demand in CLTC attributable to depression; 3) determine whether depressed elders experience less benefit from CLTC than do non-depressed elders; 4) examine how CLTC responds to the mental health needs of its clients. The proposed research will survey elders at entry to and through one year of service in Missouri's publicly funded, community long-term care system. Study participants will be 60 years of age or older and eligible for public CLTC services because of low income and functional disabilities. Through a telephone-screening interview, we will assess 1,500 new CLTC clients, documenting the extent and type of depression. We will follow 300 depressed elders as well as a random sample of 300 non-depressed elders though one year of CLTC service use. Subjects will be interviewed and service records will be abstracted to determine the service demand attributable to depression and the extent to which CLTC serves as a gateway to mental health services. Outcomes of CLTC (maintenance in community care, quality of life, life satisfaction, and consumer satisfaction with home care) at six months and one year will be compared for depressed and non-depressed clients to determine the extent to which depression affects the outcomes of CLTC services. Community long-term care is a rapidly growing service sector, and the expansion of home and community care is a priority in the development of long-term care policy. This project has the potential to influence program and policy developments in CLTC. Findings will inform the next step testing interventions that integrate CLTC and mental health services.