Choi Namkee G, Wyllie Richard J, Ransom Sandy
School of Social Work, University of Texas, Austin, Texas 78712-0358, USA.
J Gerontol Soc Work. 2009 Oct;52(7):668-85. doi: 10.1080/01634370802609155.
The in-depth qualitative interviews with 25 nursing home staff members were done to examine (a) their perceptions and experiences of risk factors for residents' depression, (b) current depression intervention programs, and (c) specific needs for staff training. The interviewees identified the residents' sense of loss and grief and feelings of isolation and loneliness as the causes of their depression and in-house activities and contract mental health services as current services aimed at reducing depression. They also pointed out the following barriers to providing effective depression interventions: too much dependence on antidepressant medication, low Medicaid reimbursement rate, staff shortage, residents' attitudes, and nursing home culture. The types of training that the staff members desired were: skills to monitor nonverbal signs and changes and to systematically screen different types of depression; education about antidepressants and their effects, side effects, and interaction effects with other medication; and systematic training in different types of psychosocial and behavioral interventions for late-life depression in residents with various levels of physical disabilities and cognitive impairments.
对25名养老院工作人员进行了深入的定性访谈，以考察：(a) 他们对居民抑郁风险因素的认知和经历；(b) 当前的抑郁干预项目；以及(c) 员工培训的具体需求。受访者将居民的失落感、悲痛感以及孤独感视为其抑郁的成因，并将院内活动和合同制心理健康服务视为当前旨在减轻抑郁的服务。他们还指出了提供有效抑郁干预的以下障碍：过度依赖抗抑郁药物、医疗补助报销率低、人员短缺、居民态度以及养老院文化。工作人员期望的培训类型包括：监测非语言信号和变化以及系统筛查不同类型抑郁的技能；关于抗抑郁药物及其作用、副作用以及与其他药物相互作用的教育；以及针对身体残疾和认知障碍程度各异的老年居民的不同类型心理社会和行为干预的系统培训。
