Cognitive Behavioral Group Therapy For Depressed Latinas

描述(由申请人提供)：在美国，与非拉美裔白人相比，拉美裔美国人的抑郁水平更高，文化适应程度更高的拉美裔美国人的抑郁程度更高。拉丁裔女性的抑郁程度比男性更高。然而，尽管抑郁症状较高，但拉美裔人得到的心理健康服务比白人少，即使他们会说英语并有保险。接受治疗技术培训的护士在低收入拉丁裔妇女可能更容易获得治疗的社区环境中可能是有效的。 该提案培训方面的目标是获取知识、进行分析并参与评估和实施以下内容：a)与拉美裔人口心理健康干预有关的文化问题；b)认知行为疗法；c)激励性访谈；以及d)针对拉丁裔的符合文化背景的诊断性访谈。研究的具体目的是描述护士领导的、基于社区的认知行为团体疗法(CBGT)对60名患有严重或轻度抑郁症或恶劣心境的低收入第二代中美洲和墨西哥裔女性的可行性。可行性的描述因素将包括治疗的动机和障碍(通过定性方法获得)，以及罗德岛大学变化评估(URICA)量表衡量的妇女应对抑郁症状的准备阶段。最后，将进行一项初步研究，以描述护士指导的CBGT在8周内降低抑郁症的有效性，并描述女性内在力量因素与成功治疗抑郁症的关系。内在力量因子将通过修正的Wagnild&Young复原量表、修正的Pearlin&Schooler掌握量表和修正的Burns生活满意度测量。设计为一组准实验、前置、重复测量的研究。分析包括配对t检验；单样本配对非参数Wilcoxon符号等级检验；单样本比例检验；以及简单线性回归。关于动机和障碍的定性数据将用扎根理论技术进行分析。

DESCRIPTION (provided by applicant): Levels of depression are higher among Latinos compared to non-Latino whites in the US, and higher for more acculturated Latinos. Depression is higher in Latino women than men. However, despite higher symptoms of depression, Latinos receive fewer mental health services than whites even if they speak English and have insurance. Nurses trained in therapeutic techniques may be effective in community settings where treatment may be more accessible to low income Latina women. The goals of the training aspect of this proposal are to gain knowledge, perform analyses, and engage in evaluation and implementation of the following: a) cultural issues related to mental health interventions with Latino populations; b) cognitive behavioral therapy; c) motivational interviews; and d) culturally appropriate diagnostic interviews for Latinos. The specific aims for research are to describe the feasibility of nurse-led, community-based cognitive behavioral group therapy (CBGT) for 60 low income, second-generation women of Central American and Mexican descent who have major or minor depression or dysthymia. Descriptors of feasibility will include motivators and barriers to therapy (obtained through qualitative methodology) as well as women's stages of readiness to deal with depressive symptoms, measured by the University of Rhode Island Change Assessment (URICA) scale. Lastly, a pilot study will be done to describe the effectiveness of nurse-led CBGT in lowering depression over 8 weeks and to describe the relationship of women's intrinsic strength factors for successful treatment of depression. The intrinsic strength factors will be measured by the modified Wagnild & Young Resilience scale; the modified Pearlin & Schooler Mastery scale; and the modified Burns Life Satisfaction measure. The design is a one-group, quasi-experimental, pre-post, repeated measures study. The analysis includes paired t-tests; one-sample paired, non-parametric Wilcoxon Signed Rank test; one-sample test for proportions; and simple linear regression. Qualitative data on motivations and barriers will be analyzed with Grounded Theory techniques.