A qualitative evaluation of an inpatient nursing intervention for depressed elderly: the Systematic Activation Method.

PURPOSE: This article describes the evaluation of the implementation of a nursing intervention, that is, the Systematic Activation Method (SAM), among inpatients with late life depression (LLD). METHODS: A qualitative study in four clinical units for old age psychiatry. RESULTS: We identified facilitators and barriers relating to patient and nurse characteristics, as well as to contextual factors, from the perspective of mental health nurses. The nature of the LLD and the quality of the therapeutic relationship were major aspects that affected the implementation of the SAM. PRACTICE IMPLICATIONS: Given the complexity of the implementation process, careful supervision and monitoring, with the active participation of management and the multidisciplinary team, are necessary

Unmet care needs, care provision and patient satisfaction in patients with a late life depression: a cross-sectional study

BACKGROUND: Research has shown that some 30% of total care needs in people with late-life depression (LLD) are unmet. It is not known to what extent patients actually don't receive any care for these needs or consider the care to be insufficient and their satisfaction with the provided care. AIM: The aim of this study is to obtain insight into the care provided in relation to the reported unmet care needs and satisfaction with the total care provided is examined. METHOD: A cross-sectional study of 99 people with LLD in an ambulatory setting. RESULTS: In 67% of patients, at least one unmet need was ascertained. In most cases (80%) care was actually provided for those needs by professionals and/or informal caregivers. Patients were satisfied with the care delivered for 81% of the reported care needs. Satisfaction was lowest for social care needs (67%). For six specific care needs it was demonstrated that dissatisfied patients were significantly more depressed than satisfied patients. CONCLUSION: Even though patients might receive care for certain needs, this does not mean that their needs are met. A substantial proportion of patients with LDD feel that they need additional help for unmet needs. KEYWORDS: Depression; late life; satisfaction; unmet need

Psychological treatment of depression in inpatients: A systematic review and meta-analysis

Research on psychological treatment of depression in inpatients is not conclusive, with some studies finding clear positive effects and other studies finding no significant benefit compared to usual care or structured pharmacotherapy. The results of a meta-analysis investigating how effective psychological treatment is for depressed inpatients are presented. A systematic search in bibliographical databases resulted in 12 studies with a total of 570 respondents. This set of studies had sufficient statistical power to detect small effect sizes. Psychological treatments had a small (g=0.29), but statistically significant additional effect on depression compared to usual care and structured pharmacological treatments only. This corresponded with a numbers-needed-to-be-treated of 6.17. Heterogeneity was zero in most analyses, and not significant in all analyses. There was no indication for significant publication bias. Effects were not associated with characteristics of the population, the interventions and the design of the studies. Although the number of studies was small, and the quality of many studies was not optimal, it seems safe to conclude that psychological treatments have a small but robust effect on depression in depressed inpatients. More high-quality research is needed to verify these results. © 2011 Elsevier Ltd