scholarly journals Universal prevention of depression in women postnatally: cluster randomized trial evidence in primary care

2010 ◽  
Vol 41 (4) ◽  
pp. 739-748 ◽  
Author(s):  
T. S. Brugha ◽  
C. J. Morrell ◽  
P. Slade ◽  
S. J. Walters
Keyword(s):  
Primary Care ◽  
Postnatal Depression ◽  
Outcome Measure ◽  
Psychological Intervention ◽  
Short Form ◽  
Intervention Group ◽  
Depression Scale ◽  
Cluster Randomized Trial ◽  
Stress Index ◽  
Control Group

BackgroundTo test whether receiving care from a health visitor (HV) trained in identification and psychological intervention methods prevents depression 6–18 months postnatally in women who are not depressed 6 weeks postnatally.MethodThe study was a prospective cluster trial, randomized by GP practice, with follow-up for 18 months in 101 primary care teams in the Trent area of England. The participants were women scoring <12 on the postal Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks postnatally (1474 intervention and 767 control women). Intervention HVs (n=89, 63 clusters) were trained in identifying depressive symptoms using the EPDS and face-to-face clinical assessment and in providing psychologically orientated sessions based on cognitive behavioral or person-centered principles. The control group comprised HVs (n=49, 37 clusters) providing care as usual (CAU). The primary outcome measure was the proportion of women scoring ⩾12 on the EPDS at 6 months postnatally. Secondary outcomes were mean EPDS score, Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM) score, State–Trait Anxiety Inventory (STAI), 12-item Short Form Health Survey (SF-12) and Parenting Stress Index Short Form (PSI-SF) scores at 6, 12 and 18 months.ResultsAfter adjusting for individual-level covariates, living alone, previous postnatal depression (PND), the presence of one or more adverse life events and the 6-week EPDS score, the odds ratio (OR) for EPDS ⩾12 at 6 months was 0.71 [95% confidence interval (CI) 0.53–0.97, p=0.031] for the intervention group (IG) women compared with the control (CAU) group women. Two subgroups were formed by baseline severity: a ‘subthreshold’ subgroup with a 6-week EPDS score of 6–11 (n=999) and a ‘lowest severity’ subgroup with a 6-week EPDS score of 0–5 (n=1242). There was no difference in psychological effectiveness by subgroup (interaction term: z=−0.28, p=0.782).ConclusionsThis study provides new evidence of a universal, enduring preventive effect for depression in women who screen negative for depression postnatally.

Feeding and Growth in Infants With Cleft Lip and/or Palate: Relationships With Maternal Distress

2020 ◽  
pp. 105566562095687
Author(s):  
Lauren L. Madhoun ◽  
Canice E. Crerand ◽  
Meghan O’Brien ◽  
Adriane L. Baylis
Keyword(s):  
Postnatal Depression ◽  
Cleft Lip ◽  
Edinburgh Postnatal Depression Scale ◽  
Short Form ◽  
Medical Center ◽  
Academic Medical Center ◽  
Depression Scale ◽  
Maternal Distress ◽  
Stress Index ◽  
Control Group

Objective: To examine relationships between early feeding and growth and maternal distress in infants with and without cleft lip and/or palate (CL/P). Design: Cross-sectional. Setting: Pediatric academic medical center in the Midwestern United States. Participants: Mothers of infants 1 to 12 weeks old with CL/P (n = 30) and without CL/P (control group, n = 30) were recruited at craniofacial clinic or pediatrician appointments. Main Outcome Measure(s): Maternal responses on the Feeding/Swallowing Impact Survey (FS-IS), Parenting Stress Index, Fourth Edition, Short Form (PSI-4-SF), and Edinburgh Postnatal Depression Scale. Infant feeding history and growth measurements were obtained. Results: Having an infant with CL/P revealed greater impact on maternal health-related quality of life due to feeding problems ( F = 4.83, P = .03). Mothers of infants with CL/P reported average range Total Stress scores on the PSI-4-SF, which were higher than controls ( F = 4.12, P = .05). Edinburgh Postnatal Depression Scale scores did not differ between groups. Compared to controls, infants with cleft palate had lower percentiles for weight ( t = 4.13, P = .04) and length ( t = 2.93, P = .01). Higher FS-IS scores were associated with longer feeding duration ( r = 0.32, P = .01) and lower weight ( r = −0.31, P = .02) and length ( r = −0.32, P = .02). Conclusions: Despite receiving early team care and feeding interventions, mothers of infants with CL/P reported higher stress and more challenges with feeding and growth. Future studies should examine targeted psychosocial interventions to improve feeding and growth outcomes in infants with CL/P.

scholarly journals Improvement of Family Care Ability for Elderly with Depression through Psychoeducation Intervention Program

2020 ◽  
Vol 8 (1) ◽  
pp. 80-89
Author(s):  
Ni Made Riasmini
Keyword(s):  
Older People ◽  
Intervention Program ◽  
Short Form ◽  
Intervention Group ◽  
Depression Scale ◽  
The Elderly ◽  
T Test ◽  
Control Group ◽  
Control Group Design ◽  
Family Behavior

The increase in the incidence of depression in the elderly can affect the elderly and their families' quality of life. Depression in the elderly is mostly caused by a lack of knowledge, attitudes, and family behavior caring for the elderly. It has an impact on the increasing cases of older people with depression in the community. To prevent increasing depression cases, it is necessary to empower family potential and social support. This study aims to obtain a description of the Psychoeducation Intervention Program (PIP) on families' ability to care for older people with depression in the community. The research method used is a Quasi-experiment with control group design. The sample is families who have elderly with depression by screening using the Geriatric Depression Scale Short Form (GDS-SF). The number of samples was 68 for the intervention group and 68 for the control group—statistical test using dependent t-test, independent t-test, and Mancova test. The results showed an increase in knowledge, attitudes, and family behavior in caring for the elderly before and after PIP. There were differences in the family's ability to care for the depressed elderly between the intervention and control groups. The resulting psycho-educational intervention program can serve as a basis for policymakers and health service managers to carry out various interventions related to family empowerment.

Group interpersonal psychotherapy for maternal depression an exploratory randomized control trial

2016 ◽  
Vol 33 (S1) ◽  
pp. S413-S414 ◽  
Author(s):  
H. Nusrat ◽  
N. Zehra ◽  
B. Amir ◽  
C. Nasim ◽  
K. tayyeba ◽  
...  
Keyword(s):  
Maternal Depression ◽  
Low Income ◽  
Postnatal Depression ◽  
Intervention Group ◽  
Depression Scale ◽  
Interpersonal Psychotherapy ◽  
Self Esteem ◽  
Control Group ◽  
Treatment As Usual ◽  
Significant Difference

IntroductionThe global burden of depression is high for women in both high income and low-and-middle income countries WHO. Depression is particularly common during pregnancy and in the postnatal period and phenomenology said to be the same as in non-child bearing age. Despite high prevalence of prenatal and postnatal depression in Pakistan, research on the effectiveness of psychological interventions is limited.AimsThis study aimed to assess the feasibility of group interpersonal psychotherapy (IPT) intervention for maternal depression in Karachi, Pakistan.MethodsA total of 50 mothers aged 18 years and above with children below 3 years of age, and experiencing mild to moderate depression were recruited. Assessments were done using Edinburgh Postnatal Depression Scale (EPDS) Rosenberg's Self-Esteem Scale and EuroQol-5D at baseline, 3 months, and 6 months. Rosenberg's Self-Esteem Scale and EQ-5D were also used to measure self-esteem and health related quality of life. Participants were randomly assigned into IPT plus treatment as usual (TAU) and TAU groups. Ten sessions of group IPT were delivered to intervention group.ResultsResults indicated significant difference between intervention and control group on EPDS. The mean score at baseline for the IPT group (mean = 14.76) reduced to (mean = 6.40) (P < 0.000) at 3-month and to (mean = 6.64) (P < 0.001) at 6-month intervals as compared to TAU (mean = 11.44) (P < 0.000) at 3-month and to (mean = 11.08) at 6-month (P < 0.001) after randomisation.ConclusionIPT is a successful fit for women with maternal depression in low-income areas and IPT can be the appropriate treatment option as it is time limited, specific, and evidence based.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Psychological Intervention and Nursing Analysis of Gynecological Malignant Tumors during Chemotherapy

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Yaning Liu ◽  
Yan Zhang ◽  
Xiaoying Wang ◽  
Xinjuan Yang
Keyword(s):  
Malignant Tumor ◽  
Psychological Intervention ◽  
Intervention Group ◽  
Depression Scale ◽  
Nursing Intervention ◽  
The Self ◽  
Anxiety And Depression ◽  
Control Group ◽  
Self Rating ◽  
Significant Difference

Objectives: To explore the clinical effect of psychological intervention and nursing during the chemotherapy of gynecological malignant tumor. Methods: 120 patients with gynecologic malignancies were selected as subjects. According to the nursing method, these patients were divided into intervention group and control group, with 60 cases in each group. The patients in the control group were given routine care, and the patients in the observation group were given psychological intervention care on the basis of routine nursing. Before and after treatment, the anxiety and depression of the two groups were compared using the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). The satisfaction and adverse reactions of the two groups were compared. The results were statistically analyzed. Results: After nursing intervention, the anxiety and depression scores of the intervention group were lower than those of the control group (P<0.05). The incidence of nausea, vomiting and fatigue in the intervention group was significantly lower than that in the control group (P<0.01). There was no significant difference in the symptoms of diarrhea between the two groups (P>0.05). After the treatment, the satisfaction of the intervention group was significantly higher than that of the control group (P<0.05). Conclusions: During the chemotherapy of gynecological malignant tumor patients, psychological intervention nursing can alleviate the anxiety and depression of patients, improve the complications, and improve the satisfaction of patients. It is worthy of clinical application.

scholarly journals Research on Mental Stress Recognition of Depressive Disorders in Patients With Androgenic Alopecia Based on Machine Learning and Fuzzy K-Means Clustering

2021 ◽  
Vol 12 ◽  
Author(s):  
Yulong Li ◽  
Baojin Wu ◽  
Xiujun Li ◽  
Qin Zhou ◽  
Xin Yang ◽  
...  
Keyword(s):  
Feature Selection ◽  
Heuristic Algorithm ◽  
Classification Accuracy ◽  
Psychological Intervention ◽  
Intervention Group ◽  
Depression Scale ◽  
Control Group ◽  
Psychological Interventions ◽  
Androgenic Alopecia ◽  
Self Rating

Under the new trend of industry 4.0 software-defined network, the value of meta heuristic algorithm was explored in the recognition of depression in patients with androgenic alopecia (AGA), and there was an analysis on the effect of comprehensive psychological interventions in the rehabilitation of AGA patients. Based on the meta heuristic algorithm, the Filter and Wrapper algorithms were combined in this study to form a new feature selection algorithm FAW-FS. Then, the classification accuracy of FAW-FS and the ability to identify depression disorders were verified under different open data sets. 54 patients with AGA who went to the Medical Cosmetic Center of Tongji Hospital were selected as the research objects and rolled into a control group (routine psychological intervention) and an intervention group (routine + comprehensive psychological interventions) according to different psychological intervention methods, with 27 cases in each group. The differences of the self-rating anxiety scale (SAS), self-rating depression scale (SDS), Hamilton depression scale (HAMD), and physical, psychological, social, and substance function scores before and after intervention were compared between the two groups of AGA patients, and the depression efficacy and compliance of the two groups were analyzed after intervention. The results showed that the classification accuracy of FAW-FS algorithm was the highest in logistic regression (LR), decision tree (DT), K-nearest neighbor (KNN) algorithm, support vector machine (SVM) algorithm, and random forest (RF) algorithm, which was 80.87, 79.24, 80.42, 83.07, and 81.45%, respectively. The LR algorithm had the highest feature selection accuracy of 82.94%, and the classification accuracy of depression disorder in RF algorithm was up to 73.01%. Besides, the SDS, SAS, and HAMD scores of the intervention group were lower sharply than the scores of the control group (p &lt; 0.05). The physical function, psychological function, social function, and substance function scores of the intervention group were higher markedly than those of the control group (p &lt; 0.05). In addition, the proportions of cured, markedly effective, total effective, full compliance, and total compliance patients in the intervention group increased obviously in contrast to the proportions of the control group (p &lt; 0.05). Therefore, it indicated that the FAW-FS algorithm established in this study had significant advantages in the recognition of depression in AGA patients, and comprehensive psychological intervention had a positive effect in the rehabilitation of depression in AGA patients.

scholarly journals Collaborative care for depression in UK primary care: a randomized controlled trial

2007 ◽  
Vol 38 (2) ◽  
pp. 279-287 ◽  
Author(s):  
D. A. Richards ◽  
K. Lovell ◽  
S. Gilbody ◽  
L. Gask ◽  
D. Torgerson ◽  
...  
Keyword(s):  
Primary Care ◽  
Collaborative Care ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cluster Randomized Trial ◽  
Phase Iii ◽  
Control Group ◽  
Randomized Control ◽  
Cluster Randomized

BackgroundCollaborative care is an effective intervention for depression which includes both organizational and patient-level intervention components. The effect in the UK is unknown, as is whether cluster- or patient-randomization would be the most appropriate design for a Phase III clinical trial.MethodWe undertook a Phase II patient-level randomized controlled trial in primary care, nested within a cluster-randomized trial. Depressed participants were randomized to ‘collaborative care’ – case manager-coordinated medication support and brief psychological treatment, enhanced specialist and GP communication – or a usual care control. The primary outcome was symptoms of depression (PHQ-9).ResultsWe recruited 114 participants, 41 to the intervention group, 38 to the patient randomized control group and 35 to the cluster-randomized control group. For the intervention compared to the cluster control the PHQ-9 effect size was 0.63 (95% CI 0.18–1.07). There was evidence of substantial contamination between intervention and patient-randomized control participants with less difference between the intervention group and patient-randomized control group (−2.99, 95% CI −7.56 to 1.58, p=0.186) than between the intervention and cluster-randomized control group (−4.64, 95% CI −7.93 to −1.35, p=0.008). The intra-class correlation coefficient for our primary outcome was 0.06 (95% CI 0.00–0.32).ConclusionsCollaborative care is a potentially powerful organizational intervention for improving depression treatment in UK primary care, the effect of which is probably partly mediated through the organizational aspects of the intervention. A large Phase III cluster-randomized trial is required to provide the most methodologically accurate test of these initial encouraging findings.

scholarly journals Effectiveness of Pediatric Teleconsultation to Improve Skin Conditions in Infants and to Reduce Parenting Stress in Mothers: Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Tomohisa Ando ◽  
Rintaro Mori ◽  
Kenji Takehara ◽  
Mari Asukata ◽  
Shuichi Ito ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Atopic Dermatitis ◽  
Parenting Stress ◽  
Short Form ◽  
Controlled Trial ◽  
Intervention Group ◽  
Well Being ◽  
Stress Index ◽  
Control Group ◽  
Randomized Controlled

BACKGROUND Electronic health (eHealth) for infants and mothers is a current focus of attention, but its effectiveness has rarely been examined in Japan. For infants, skin problems, including atopic dermatitis (AD), which is known to lead to other allergic diseases, is one of the most common conditions. For mothers, parenting stress, which adversely affects mothers’ and children’s well-being, is one of the biggest problems in the postpartum period; this requires a national solution in Japan. OBJECTIVE To evaluate the effectiveness of pediatric teleconsultation for preventing atopic dermatitis in infants and reducing parenting stress in mothers in Japan. METHODS The study was an open-label, randomized, parallel-armed controlled trial. In total, 318 pairs of infants and mothers in Yokohama City Sakae Ward in Japan were recruited when they submitted birth cards to the ward, received the explanation, and completed online informed consent on the website for this trial. Eligible pairs of infant and mother were randomly assigned to the intervention group (n=140) or the control group (n=138). Participants in both the intervention and control groups received routine postnatal care from the local government services. In addition, participants in the intervention group had the option to use combined pediatric services with teleconsultation and email newsletters without any charge from the date of registration until the infant was 4 months of age. Primary outcomes were (i) the prevalence of AD in infants diagnosed based on the United Kingdom Working Party’s criteria; and (ii) parenting stress and mental status in mothers, assessed using the Parenting Stress Index-Short Form (PSI-SF) and General Health Questionnaire-12 (GHQ-12). Data were collected via the ward office staff and researcher at the 4-month checkup. RESULTS The prevalence of AD in infants was significantly lower in the intervention group than in the control group at the 4-month checkup (20% vs. 33%, P=.03; relative risk ratio, 0.614 [95% confidence interval, 0.406 to 0.927]). No significant differences were observed in the PSI-SF and GHQ-12 scores between the two groups. CONCLUSIONS This is the first randomized controlled trial demonstrating that a combined pediatric service with teleconsultation and email newsletters was effective in reducing the prevalence of AD in infants. Pediatric eHealth will become a new strategy for preventing AD. CLINICALTRIAL UMIN000029774; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034022

scholarly journals Effects of Self RehAbilitation Video Exercises (SAVE) on Functional Restorations in Patients with Subacute Stroke

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 565
Author(s):  
Seung-Hwan Jung ◽  
Eunhee Park ◽  
Ju-Hyun Kim ◽  
Bi-Ang Park ◽  
Ja-Won Yu ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Short Form ◽  
Intervention Group ◽  
Exercise Program ◽  
Berg Balance Scale ◽  
Control Group ◽  
Early Recovery ◽  
Subacute Stroke ◽  
Sf 36 ◽  
State Examination

Background: Additional exercise therapy has been shown to positively affect acute stroke rehabilitation, which requires an effective method to deliver increased exercise. In this study, we designed a 4-week caregiver-supervised self-exercise program with videos, named “Self rehAbilitation Video Exercises (SAVE)”, to improve the functional outcomes and facilitate early recovery by increasing the continuity of rehabilitation therapy after acute stroke. Methods: This study is a non-randomized trial. Eighty-eight patients were included in an intervention group (SAVE group), who received conventional rehabilitation therapies and an additional self-rehabilitation session by watching bedside exercise videos and continued their own exercises in their rooms for 60 min every day for 4 weeks. Ninety-six patients were included in a control group, who received only conventional rehabilitation therapies. After 4 weeks of hospitalization, both groups assessed several outcome measurements, including the Berg Balance Scale (BBS), Modified Barthel Index (MBI), physical component summary (PCS) and the mental component summary of the Short-Form Survey 36 (SF-36), Mini-Mental State Examination, and Beck Depression Inventory. Results: Differences in BBS, MBI, and PCS components in SF-36 were more statistically significant in the SAVE group than that in the control group (p < 0.05). Patients in the SAVE group showed more significant improvement in BBS, MBI, and PCS components in SF-36 as compared to that in the control group. Conclusions: This evidence-based SAVE intervention can optimize patient recovery after a subacute stroke while keeping the available resources in mind.

Effect of Communication Skills Training Program for Oncologists Based on Patient Preferences for Communication When Receiving Bad News: A Randomized Controlled Trial

2014 ◽  
Vol 32 (20) ◽  
pp. 2166-2172 ◽  
Author(s):  
Maiko Fujimori ◽  
Yuki Shirai ◽  
Mariko Asai ◽  
Kaoru Kubota ◽  
Noriyuki Katsumata ◽  
...  
Keyword(s):  
Communication Skills ◽  
Patient Preferences ◽  
Controlled Trial ◽  
Intervention Group ◽  
Depression Scale ◽  
Skills Training ◽  
Control Group ◽  
Communication Skills Training ◽  
Communication Performance

Purpose The aim of this study was to identify the effects of a communication skills training (CST) program for oncologists, developed based on patient preferences regarding oncologists' communication. Participants and Methods Thirty oncologists were randomly assigned to either an intervention group (IG; 2-day CST workshop) or control group (CG). Participants were assessed on their communication performance during simulated consultation and their confidence in communicating with patients at baseline and follow-up. A total of 1,192 patients (response rate, 84.6%) who had consultations with the participating oncologists at baseline and/or follow-up were assessed regarding their distress using the Hospital Anxiety and Depression Scale, satisfaction with the consultation, and trust in their oncologist after the consultation. Results At the follow-up survey, the performance scores of the IG had improved significantly, in terms of their emotional support (P = .011), setting up a supportive environment (P = .002), and ability to deliver information (P = .001), compared with those of the CG. Oncologists in the IG were rated higher at follow-up than those in the CG in terms of their confidence in themselves (P = .001). Patients who met with oncologists after they had undergone the CST were significantly less depressed than those who met with oncologists in the CG (P = .027). However, the CST program did not affect patient satisfaction with oncologists' style of communication. Conclusion A CST program based on patient preferences is effective for both oncologists and patients with cancer. Oncologists should consider CST as an approach to enhancing their communication skills.

Effectiveness of a Primary Care Program to Increase Physical Activity in People With Dementia and Their Family Caregivers (AFISDEMYF Study).

2021 ◽  
Author(s):  
Elena DE DIOS-RODRIGUEZ ◽  
María C PATINO-ALONSO ◽  
Susana GONZÁLEZ-SÁNCHEZ ◽  
Joana RIPOLL ◽  
Olaya TAMAYO-MORALES ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Primary Care ◽  
Systolic Blood Pressure ◽  
Family Caregivers ◽  
Intervention Group ◽  
Care Program ◽  
Control Group ◽  
People With Dementia ◽  
The Family

Abstract Aim: To evaluate the effectiveness of an intervention in primary health care designed to increase physical activity in people with dementia and their family caregivers.Methods: A cluster-randomized multicentre clinical trial was carried out.Participants: 140 people with dementia (median age 82 years;63.6% women) and 176 caregivers (median age 62 years ;72.7% women). Seventy patients and 80 caregivers were assigned to the Control Group (CG) and 70 patients and 96 caregivers to the Intervention Group (IG). The physical activity was measured with the pedometer and with the IPAQ-SF questionnaire. The intervention consisted of applying in primary care the program promoting physical activity (PEPAF) for 3 months. The changes observed at 6 months were analyzed. Results:In people with dementia, in the pedometer assessment a decrease was observed in both groups, but it was larger in the CG both in the total number step/day lower in the IG than in the CG and in the aerobic steps / day (52.89 vs -615.93). The activity reported with the IPAQ-SF decreased more in IG, both in the MET/min/week (-258.470 vs -148.23) and in the MVPA min/week. In caregivers the pedometer assessment showed that total steps/day increased more in the IG, as did aerobic steps/day (356.91 vs -12.95). The IPAQ-SF a smaller increase in global activity was declared in the IG than in the CG (545.25 MET/min/week vs 609.55), but the increase in vigorous activity was greater. No differences were found in changes in the functional status and the cognitive performances of people with dementia nor in the mental health in the caregivers, but systolic blood pressure, the Family APGAR and overload in the IG did improve.Conclusions: The results suggest that the intervention carried out may be effective on physical activity in both patients and caregivers. It can also improve systolic blood pressure, the Family APGAR and overload in caregivers. This is the first study to implement a primary care intervention aimed at simultaneously increasing physical activity in people with dementia and their relatives. These results reinforce the importance of using objective measures in clinical trials in people with dementia.Trial registration number: NCT 02044887.

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