The aim of this pilot study is to gain insight into the impact, feasibility and acceptability of an adapted LFM course for general practice.
ID
Source
Brief title
Condition
- Mood disorders and disturbances NEC
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary outcomes are the differences in depressive symptoms (primary
outcome), anxiety, psychological wellbeing and mastery (secondary outcomes) as
reported by the older adults before and after the LFM intervention. Another
important endpoint of this study is the feasibility and acceptability of the
adapted LFM course.
Secondary outcome
Therefore, secondary outcome measures in this study are:
- Anxiety symptoms, measured with the Hospital Anxiety Depression Scale-Anxiety
subscale (HADS-A).
- Psychological wellbeing, measured with the Dutch version of the Philidelphia
Geriatric Center Morale Scale (PFCMS) which consists of 17 items (Lawton,
1975).
- Mastery, measured with the Dutch version of the Pearling Mastery Scale
(Pearlin & Schooler, 1978) which consists of 5 items.
Background summary
Depression in older adults is a serious health problem. Having depressive
symptoms (DS) is an important risk factor for developing a clinical depression
in older adults. In the Netherlands, the mental health care nurse practitioners
(MHCNP) have an important role in signalling and providing easily accessible
and confined treatment for mental health problems. However, appropriate and
evidence-based interventions for older adults in this setting to be provided by
a MHCNP are lacking. Life review therapy (LR) is an intervention effectively
reducing DS that suits older adults and could very well be provided in general
practice by MHCNPs. A specific example of a LR intervention is the group course
*Looking for meaning* (LFM). LFM combines life review therapy with creative
therapy and has originally been developed for community dwelling older people
with DS to be provided by a psychologist and a creative therapist of a
prevention department of specialized mental health care organization.
Study objective
The aim of this pilot study is to gain insight into the impact, feasibility and
acceptability of an adapted LFM course for general practice.
Study design
A pilot study will be performed which exist of an impact study and a process
evaluation. Eight MHNCPs will be trained to carry out a total of eight LFM
courses. The researchers will interview all participants of these eight courses
(n=64) before and after the LFM course to gain insight in the acceptability,
feasibility and impact of LFM. Furthermore, in-depth interviews will be held
with all MHCNPs and one older adult per course group. During the intervention
MHCNPs will keep a log.
Intervention
Eight groups of eight participants will follow the weekly LFM course including
sensory and creative exercises provided by a MHCNP. The first part of the
course is mainly focused on the search for meaningful memories. The sensory
exercises include looking at images, hearing sounds, smells and tastes. These
experiences eminently stimulate autobiographical memory. Creative exercises are
used like making collages and paintings to let participants express themselves
without the need to verbalize their experiences.
Study burden and risks
Looking back on life can be threatening, especially for people of 65 years and
older, since an important part of life is already finished. Participants will
also be asked about depressive symptoms, which could make participants aware of
these symptoms. Course leaders will be trained to deal with upcoming emotions
and will comfort participants consistently by emphasizing that the right
choices were made under the given circumstances. Participants are well aware of
the content of the course and research and agreed to voluntarily participate.
The life-review course *Looking for Meaning* has previously resulted in a
reduction of depressive and anxiety symptoms and improved wellbeing of
participants. Therefore, we do not expect many burden for participants. Taken
all the above in account, we expect that the risk of the intervention and the
expected burden of the study is small in proportion to the potential value.
Da Costakade 45
Utrecht 3521VS
NL
Da Costakade 45
Utrecht 3521VS
NL
Listed location countries
Age
Inclusion criteria
* The participant is over 65 years old;
* The participant shows depressive symptoms (score ranging between 5-25 on the CES-D scale)
* The participant is community dwelling;
* The participant speaks the Dutch language;
* The participant is willing to sincerely participate in group activities including both reviewing life and participating in creative assignments.
Exclusion criteria
* Patients with signs of a major clinical depression (a score greater than or equal to 25 on the CES-D);
* Patients with too little depressive symptoms (CES-D score < 5);
* Patients who already receive psychotropic or psychological treatment for depression;
* Patients with major cognitive limitations;
* Patients who are suicidal;
* Patients with severe hearing and visual impairments despite the use of devices.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL61176.029.17 |