COMMUNITY LTC SERVICE AND OUTCOMES--BURDEN OF DEPRESSION

描述（申请人摘要）：本研究解决了基本问题 在社区长期护理：确保适当的服务， 广泛的客户需求和与服务相关的理解因素 结果。预计，不成比例的公共CLTC客户 有精神卫生服务需求，由于抑郁症， 与身体依赖和低收入有关。但实际上 研究已经解决了CLTC中老年人抑郁的程度， 抑郁症对CLTC服务使用和结果的影响。此外， 关于CLTC客户对心理健康服务的态度， CLTC在满足心理健康需求方面的潜在作用。研究目的：（1） 估计首次进入公立社区学习辅导中心的长者的抑郁程度， 确定与抑郁症相关的因素; 2）确定服务需求， CLTC归因于抑郁; 3）确定是否抑郁的老年人 经验较少的好处CLTC比没有抑郁症的老年人; 4）研究如何 CLTC回应其客户的心理健康需求。 拟议的研究将调查老年人进入和通过一年的 服务在密苏里州的公共资助，社区长期护理系统。研究 参加者将年满60岁，并有资格参加公共CLTC 服务，因为低收入和功能残疾。通过 通过电话筛选面试，我们将评估1，500名CLTC新客户， 记录抑郁的程度和类型我们将跟踪300名抑郁症患者 老年人以及随机抽样的300名非抑郁症老年人， 使用CLTC服务。受试者将接受采访，服务记录将 抽象，以确定归因于抑郁症的服务需求和 CLTC在多大程度上成为获得心理健康服务的门户。成果 CLTC（社区护理维持、生活质量、生活满意度和 消费者对家庭护理的满意度）， 比较抑郁和非抑郁的客户，以确定程度， 抑郁症会影响CLTC服务的结果。 社区长期护理是一个快速增长的服务部门， 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方案和政策 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和心理健康服务结合起来。

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.