Swinburne University of Technology, Hawthorn, VIC, Australia.
Swinburne University of Technology, Hawthorn, VIC, Australia.
J Affect Disord. 2021 Mar 1;282:1067-1075. doi: 10.1016/j.jad.2020.12.087. Epub 2020 Dec 27.
Depression is common in nursing homes, particularly among newly admitted residents. This cluster randomised controlled trial evaluated the effectiveness of the Program to Enhance Adjustment to Residential Living (PEARL) in reducing depression in this group.
Participants were 219 newly-admitted residents (mean of 4.4 weeks since admission) in 42 nursing homes in Melbourne, Australia, with a mean age of 85.5 years (SD = 7.3). Nursing homes were randomly allocated to the intervention or standard care condition. Level of depressive symptoms was evaluated at baseline (T1), one week post- intervention (T2), 2 months post-intervention (T3, primary end point), and 6 months post-intervention (T4). Changes in depressive symptoms in the intervention and control groups over time were compared using a multilevel model, with nursing homes modelled as random intercept.
In intention to treat analyses, depressive symptoms reduced from T1 to T3 to a greater degree in the intervention condition (M=2.56, SD=5.71) than in the control (M=0.63, SD=5.25), with a significant, small-medium treatment effect size (p=.035; Cohen's d=0.36). The reduction in depressive symptoms from T1 to T4 was not significant (p=.369; Cohen's d=0.32).
The findings require replication, particularly comparing PEARL with an active control condition.
PEARL is a simple, brief program that was effective in reducing symptoms of depression in newly admitted nursing home residents.
抑郁症在养老院很常见，尤其是在新入住的居民中。这项整群随机对照试验评估了增强适应居住生活方案（PEARL）在减少这一群体中抑郁症状的有效性。
参与者为澳大利亚墨尔本 42 家养老院的 219 名新入住居民（入住后平均 4.4 周），平均年龄为 85.5 岁（SD=7.3）。养老院被随机分配到干预组或标准护理组。在基线（T1）、干预后一周（T2）、干预后 2 个月（T3，主要终点）和干预后 6 个月（T4）评估抑郁症状水平。采用多水平模型比较干预组和对照组随时间变化的抑郁症状变化，将养老院建模为随机截距。
在意向治疗分析中，干预组的抑郁症状从 T1 到 T3 减轻程度大于对照组（M=2.56，SD=5.71），M=0.63，SD=5.25），具有显著的中小治疗效果（p=.035；Cohen's d=0.36）。从 T1 到 T4 的抑郁症状减少不显著（p=.369；Cohen's d=0.32）。
需要复制这些发现，特别是要将 PEARL 与积极的对照组进行比较。
PEARL 是一种简单、简短的方案，可有效减轻新入住养老院居民的抑郁症状。
