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居家老年抑郁症患者:问题解决疗法及个人和社会的应变能力

Depression in homebound older adults: problem-solving therapy and personal and social resourcefulness.

机构信息

University of Texas at Austin, Austin, TX 78712-0358, USA.

出版信息

Behav Ther. 2013 Sep;44(3):489-500. doi: 10.1016/j.beth.2013.04.002. Epub 2013 Apr 16.

Abstract

The goal of problem-solving therapy is to teach patients systematic coping skills. For many homebound older adults, coping skills must also include both personal and social (help-seeking) resourcefulness. This study aimed to examine the relationship between perceived resourcefulness and depressive symptoms at postintervention and potential mediating effect of the resourcefulness among 121 low-income homebound older adults who participated in a pilot randomized controlled trial testing feasibility and preliminary efficacy of telehealth-PST. Resourcefulness Scale for Older Adults was used to measure personal and social resourcefulness. Only personal resourcefulness scores were significantly associated with depression outcomes at postintervention, and neither resourcefulness scores were significantly associated with group assignment. Analysis found no mediation effect of resourcefulness. The findings call for further research on potential mediators for the potentially effective depression treatment that could be sustained in the real world for low-income homebound older adults who have limited access to psychotherapy as a treatment modality.

摘要

问题解决治疗的目标是教给患者系统的应对技能。对于许多居家的老年患者来说,应对技能还必须包括个人和社会(寻求帮助)方面的机智。本研究旨在调查 121 名参与了一项测试远程医疗问题解决治疗(PST)可行性和初步疗效的试点随机对照试验的低收入居家老年患者在干预后的感知应变能力与抑郁症状之间的关系,以及应变能力在其中的潜在中介作用。老年人应变能力量表用于测量个人和社会应变能力。只有个人应变能力评分与干预后的抑郁结果显著相关,而应变能力评分与分组均无显著相关性。分析未发现应变能力的中介作用。这些发现呼吁进一步研究潜在的中介因素,对于作为治疗方式的心理治疗,低收入居家老年患者获得机会有限,对于他们来说,这种可能有效的抑郁治疗在现实世界中能够持续下去。

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