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行动起来,应对抑郁:改善养老院抑郁检测和治疗的护理方案评估。研究方案。

Act In case of Depression: the evaluation of a care program to improve the detection and treatment of depression in nursing homes. Study Protocol.

机构信息

Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public health, Radboud University Nijmegen Medical Centre, the Netherlands.

出版信息

BMC Psychiatry. 2011 May 20;11:91. doi: 10.1186/1471-244X-11-91.

Abstract

BACKGROUND

The aim of this study is evaluating the (cost-) effectiveness of a multidisciplinary, evidence based care program to improve the management of depression in nursing home residents of somatic and dementia special care units. The care program is an evidence based standardization of the management of depression, including standardized use of measurement instruments and diagnostical methods, and protocolized psychosocial, psychological and pharmacological treatment.

METHODS/DESIGN: In a 19-month longitudinal controlled study using a stepped wedge design, 14 somatic and 14 dementia special care units will implement the care program. All residents who give informed consent on the participating units will be included. Primary outcomes are the frequency of depression on the units and quality of life of residents on the units. The effect of the care program will be estimated using multilevel regression analysis. Secondary outcomes include accuracy of depression-detection in usual care, prevalence of depression-diagnosis in the intervention group, and response to treatment of depressed residents. An economic evaluation from a health care perspective will also be carried out.

DISCUSSION

The care program is expected to be effective in reducing the frequency of depression and in increasing the quality of life of residents. The study will further provide insight in the cost-effectiveness of the care program.

TRIAL REGISTRATION

Netherlands Trial Register (NTR): NTR1477.

摘要

背景

本研究旨在评估多学科、基于证据的护理方案在改善躯体和痴呆特殊护理单元养老院居民的抑郁管理方面的(成本)效益。该护理方案是对抑郁管理的基于证据的标准化,包括测量工具和诊断方法的标准化使用,以及心理社会、心理和药物治疗的方案化。

方法/设计:在一项采用逐步楔形设计的 19 个月纵向对照研究中,14 个躯体护理单元和 14 个痴呆特殊护理单元将实施该护理方案。所有在参与单元上表示同意的居民都将被纳入。主要结果是单元上的抑郁频率和单元上居民的生活质量。将使用多水平回归分析来估计护理方案的效果。次要结果包括常规护理中抑郁检测的准确性、干预组中抑郁诊断的患病率,以及接受治疗的抑郁居民的反应。还将从医疗保健角度进行经济评估。

讨论

预计该护理方案能有效降低抑郁频率并提高居民的生活质量。该研究将进一步提供关于护理方案的成本效益的见解。

试验注册

荷兰试验注册处(NTR):NTR1477。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f886/3123630/f716d087314a/1471-244X-11-91-1.jpg

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