scholarly journals Influence of Depression and Personality on Social Functioning in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 860-861
Author(s):  
David Freedman ◽  
George Lederer ◽  
Lauren Atlas ◽  
Richard Zweig ◽  
Dimitry Francois ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Social Functioning ◽  
Clinical Status ◽  
Psychiatric Inpatient ◽  
Secondary Analysis ◽  
Personality Pathology ◽  
Future Research ◽  
Assessment And Treatment ◽  
Inpatient Settings

Abstract Among older adults there is significant comorbodity between depression and personality pathology and both are associated with poorer social functioning. Personality pathology is associated with greater prevalence, poorer recovery, and a higher likelihood of recurrence of depression in older adults. This study is a secondary analysis examining the relationships between personality traits associated with personality pathology (i.e. high neuroticism and low agreeableness), depression, and social functioning across older adults surveyed in primary care and psychiatric inpatient settings (N = 227). Individual variable as well as interaction models were examined. Higher neuroticism (FChange [1,217] = 40.119, p < .001), lower agreeableness (FChange [1,217] = 20.614, p < .001), and clinical status (i.e. primary care vs. psychiatric inpatient) (FChange [1,217] = 19.817, p < .001) were associated with poorer social functioning. Clinical status moderated the relationships between neuroticism and social functioning (B = -.0147, p = . 0341) and between agreeableness and social functioning (B = .0268, p = .0015). Interaction effects were not observed between neuroticism and depression or agreeableness and depression as they relate to social functioning. However, depression severity was observed to mediate the relationship between neuroticism and social functioning [Indirect effect = .0212, 95% CI = .0141, .0289]. These findings highlight the importance of accounting for depression and clinical status in the assessment and treatment of older adults with personality pathology. Findings warrant future research focused upon mechanisms through which personality pathology and depression influence functional status in older adults.

Do GPs use motivational interviewing skills in routine consultations with patients living with mental-physical multimorbidity? An observational study of primary care in Scotland

2018 ◽  
pp. 174239531881596
Author(s):  
Kylie J McKenzie ◽  
David Pierce ◽  
Stewart W Mercer ◽  
Jane M Gunn
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Observational Study ◽  
Motivational Interviewing ◽  
Secondary Analysis ◽  
Future Research ◽  
Global Rating ◽  
Coding System ◽  
Interviewing Skills ◽  
Multimorbid Patients

Objectives To examine whether motivational interviewing is used by GPs in consultations with patients living with mental-physical multimorbidity. Methods Secondary analysis of selected videos from an existing database of routine general practice consultations with adult patients in Glasgow, Scotland. Consultations involving patients with mental-physical multimorbidity were selected and coded using the Motivational Interviewing Treatment Integrity (MITI) coding system. Results Sixty consultations were coded involving 32 GPs across 16 practices. Mean consultation length was 9.9 min. On average GPs asked 1.7 questions per minute and offered 1.2 pieces of information per minute. Using the MITI, five GPs met beginner proficiency for the relational global qualities of partnership and empathy; however, none of the GPs met beginner proficiency for the technical global rating of efforts made to encourage patients to discuss behaviour change. Simple reflections were observed in 67% of consultations and complex reflections in 28% of consultations. Confrontation, a technique inconsistent with motivational interviewing, was observed in 18% of consultations. Discussion MI was not evident in these consultations with patients living with mental-physical multimorbidity. This study provides information about the baseline motivational interviewing-consistent skills of GPs working with multimorbid patients and may be helpful in informing motivational interviewing training efforts and future research.

scholarly journals I’m the Only Son She Got Left: Male Caregivers’ Experiences Managing Older Adults’ Post-Acute Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 91-92
Author(s):  
Michael Bueno ◽  
David Russell ◽  
Jo-Ana Chase
Keyword(s):  
Older Adults ◽  
Acute Care ◽  
Home Health Care ◽  
Secondary Analysis ◽  
Future Research ◽  
Subjective Experiences ◽  
Acute Setting ◽  
Male Caregivers ◽  
Using Data ◽  
Post Acute Care

Abstract Family caregivers (FCGs) play an integral role supporting older adults transitioning to post-acute care following a hospitalization. FCGs function as advocates, information agents, and most importantly, care managers and providers. Although, caregiving has been traditionally seen as a female role, men are increasingly undertaking these roles and responsibilities. This research addresses a gap in the existing literature by exploring the subjective experiences of male FCGs of older adults in the post-acute setting. Using data from two parent qualitative studies on caregiving in the post-acute setting (N=40), we conducted a qualitative secondary analysis using conventional content analysis of male caregiver participants’ interview data (n=11). Interviews explored the subjective experiences of male caregivers’ interactions with home health care supportive personnel and conducting medical/nursing tasks for older adults. Five themes emerged: areas of abandonment, financial needs, masculinity, organization of care, and preparation. These themes highlighted areas of both confidence and struggle for male FCGs and captured their unique experiences managing the care of an older adult in the post-acute setting. Furthermore, the themes illustrate male FCGs’ feelings of guilt, financial impact, work disruptions, and the perceived effect of masculinity on their caregiving role. Findings can inform clinicians’ provision of focused and tailored resources to meet the specific needs of male FCGs. Future research should explore the evolving experiences of male FCGs over time, particularly those FCGs of older adults with chronic illnesses.

scholarly journals Identifying Factors Associated With Mobility Decline Among Hospitalized Older Adults

2016 ◽  
Vol 27 (1) ◽  
pp. 81-104 ◽  
Author(s):  
Jo-Ana D. Chase ◽  
Alicia Lozano ◽  
Alexandra Hanlon ◽  
Kathryn H. Bowles
Keyword(s):  
Older Adults ◽  
Secondary Analysis ◽  
Length Of Hospital Stay ◽  
International Classification Of Functioning ◽  
Future Research ◽  
Personal Factors ◽  
Mobility Function ◽  
Younger Age ◽  
Hospitalized Older Adults

Hospitalization can negatively affect mobility among older adults. Early detection of older patients most at risk for mobility decline can lead to early intervention and prevention of mobility loss. This study’s purpose was to identify factors from the International Classification of Functioning, Disability, and Health associated with mobility decline among hospitalized elders. We conducted a secondary analysis of data from 959 hospitalized adults age 65 and older. We estimated the effects of health conditions and environmental and personal factors on mobility decline using logistic regression. Almost half of the sample declined in mobility function during hospitalization. Younger age, longer length of hospital stay, having a hearing impairment, and non-emergency admit type were associated with mobility decline, after adjusting for covariates. Findings may be used to develop an evidence-based, risk-determination tool for hospitalized elders. Future research should focus on individual, environmental, and policy-based interventions promoting physical activity in the hospital.

The Edinburgh Primary Care Depression Study: Personality Disorder and Outcome

1995 ◽  
Vol 167 (3) ◽  
pp. 324-330 ◽  
Author(s):  
Douglas A. Patience ◽  
Ralph J. McGuire ◽  
Allan I. F. Scott ◽  
Christopher P. L. Freeman
Keyword(s):  
Primary Care ◽  
Personality Disorder ◽  
Social Functioning ◽  
Depressive Illness ◽  
Substantial Improvement ◽  
Personality Pathology ◽  
Major Depressive ◽  
Maximum Improvement ◽  
The Uk ◽  
The Impact

BackgroundLittle is known about the impact of personality pathology on the treatment outcome of major depressive illness in primary care in the UK.MethodPatients meeting criteria for DSM–III major depressive disorder were randomly allocated to one of four treatments each lasting 16 weeks, then followed up for 18 months. Assessments were made of depressive symptoms, personality and social functioning. Personality was assessed at maximum improvement or 16 weeks.ResultsThe prevalence of personality disorder (PD) in the sample of 113 patients was 26%. Patients with a PD were significantly younger and rated more depressed at entry than patients with no personality disorder (NoPD). On completion of treatment patients with a PD were significantly more depressed and had poorer social functioning than the NoPD group. After 18 months there were no differences in ratings of depression or social functioning between the groups.ConclusionsThere was substantial improvement in both the PD and NoPD groups. The presence of personality pathology delays recovery from major depressive illness.

scholarly journals Effects of Personality and Emotion Regulation in Depressed Older Adult Inpatients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 456-456
Author(s):  
Wing Jin Mak ◽  
Ira Yenko ◽  
Avner Aronov ◽  
Hyunyoung Park ◽  
Helene Geramian ◽  
...  
Keyword(s):  
Older Adults ◽  
Emotion Regulation ◽  
Social Functioning ◽  
Social Adjustment ◽  
Thought Suppression ◽  
Statistical Significance ◽  
Personality Pathology ◽  
Clinical Samples ◽  
Functional Impairments ◽  
Expressive Suppression

Abstract Personality pathology and emotion dysregulation are associated with impaired psychological and functional outcomes in adults. However, much less is known about their relationship with depression, social functioning, and suicidal behaviors among older clinical samples. The aim of this study was to examine how the two impact depression, social adjustment, and suicidal behavior in an inpatient sample of depressed adults 55 to 89 years of age (N=52). Personality (agreeableness and neuroticism) and suppression strategies (expressive and thought suppression) were first investigated individually and then jointly as a combined predictive model. Results found lower agreeableness predicted poorer social adjustment (β = -2.871, p < .01), while higher neuroticism (β = 0.426, p<.01) and greater use expressive suppression (β =.253, p <.05) each predicted more severe depressive symptoms. Individuals high in neuroticism also evidenced greater use of both thought suppression and expressive suppression, while those who were more depressed endorsed poorer social functioning. Although not reaching the point of statistical significance, lower agreeableness, higher use of suppression strategies, and poor social functioning were found to be moderately associated with experience of recent suicidal ideation. Our findings demonstrated personality pathology and ineffective emotion regulation are promising potential pathways in the detection and intervention of psychological and functional impairments in depressed older adults. Our study also highlighted the need for more research examining the effects of personality pathology and emotional dysregulation from a functional perspective, which could enhance the focus of target problem areas in interventions for severely depressed older adults.

scholarly journals Perceived limitations of telemedicine from a phenomenological perspective

2020 ◽  
Author(s):  
Michael Knop ◽  
Marius Mueller ◽  
Henrik Freude ◽  
Caroline Ressing ◽  
Bjoern Niehaves
Keyword(s):  
Primary Care ◽  
Communication Technology ◽  
Primary Care Physicians ◽  
Secondary Analysis ◽  
Future Research ◽  
Structured Interviews ◽  
Technological Transformation ◽  
Holistic View ◽  
Phenomenological Perspective ◽  
Information And Communication

In the course of healthcare digitization, the roles of therapists and patients are likely to change. To shape a theoretical based process of technological transformation, a phenomenological perspective on Information and Communication Technology (ICT) is introduced. Therefore, this paper illustrates the benefit of a holistic view on patients and therapists to describe and explain phenomena concerning Human Technology Interaction (HTI). The differentiation between a measurable objective body and a habitual subjective body helps to evaluate and anticipate constituting factors of accepting telemedicine systems. Taking into account findings from a secondary analysis of semi-structured interviews we conducted with primary care physicians, we develop a phenomenological framework for HTI in healthcare. Our aim is to structure future research concerning design implications for ICT and the implementation of telemedicine systems in clinical and primary care.

The Recognition and Treatment of Late-Life Depression: A View from Primary Care

1996 ◽  
Vol 26 (2) ◽  
pp. 155-171 ◽  
Author(s):  
Christopher M. Callahan ◽  
Hugh C. Hendrie ◽  
William M. Tierney
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Primary Care Physicians ◽  
Late Life ◽  
Primary Care Providers ◽  
Future Research ◽  
Care Providers ◽  
Late Life Depression ◽  
Primary Care Patients

Objective: Efforts to improve the recognition and treatment of late-life depression in primary care are often based on the assumption that primary care physicians underutilize currently available and effective treatments. This article reviews the validity of this assumption and offers recommendations for future research. Methods: Clinical trials designed to improve the recognition and treatment of late-life depression in primary care are reviewed. Because studies limited to older adults are rare, we also include studies enrolling younger patients. These data are reviewed in the context of recent reviews on the prevalence of depression in primary care settings and the effectiveness of available treatments. Results: Although depressive symptoms are common among older adults, there is insufficient literature documenting the proportion of these patients who respond to currently available treatments. Patients with uncomplicated major depressive disorder constitute the minority of primary care patients with depressive symptoms. Nearly all available studies of treatment effectiveness of pharmacotherapy or psychotherapy focus on older adults with uncomplicated major depression. Currently available treatment options may apply to less than 15 percent of depressed primary care patients. Conclusions: More research is needed to help primary care providers manage their depressed patients with comorbid medical conditions, functional disability, or minor or chronic depressions. In addition, more research is needed to identify those patients who would benefit from specialized or interdisciplinary care.

scholarly journals The profile of older adults seeking chiropractic care: a secondary analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katie de Luca ◽  
Sheilah Hogg-Johnson ◽  
Martha Funabashi ◽  
Silvano Mior ◽  
Simon D. French
Keyword(s):  
Older Adults ◽  
Adult Patient ◽  
Older Patients ◽  
Secondary Analysis ◽  
Chiropractic Care ◽  
Future Research ◽  
Cross Sectional ◽  
Musculoskeletal Conditions ◽  
Common Diagnosis ◽  
Back Problem

Abstract Background Musculoskeletal conditions are the primary reason older adults seek general medical care, resulting in older adults as the highest consumers of health care services. While there is high use of chiropractic care by older adults, there is no recent, specific data on why older adults seek chiropractic care and how chiropractors manage conditions. Therefore, the purpose of this study was to describe the demographic characteristics of older adults seeking chiropractic care, and to report problems diagnosed by chiropractors and the treatment provided to older adults who seek chiropractic care. Methods A secondary data analysis from two, large cross-sectional observational studies conducted in Australia (COAST) and Canada (O-COAST). Patient encounter and diagnoses were classified using the International Classification of Primary Care, 2nd edition (ICPC-2), using the Australian ICPC-2 PLUS general practice terminology and the ICPC-2 PLUS Chiro terminology. Descriptive statistics were used to summarize chiropractor, patient and encounter characteristics. Encounter and patient characteristics were compared between younger (< 65 years old) and older (≥65 years old) adults using χ2 tests or t-tests, accounting for the clustering of patients and encounters within chiropractors. Results A total of 6781 chiropractor–adult patient encounters were recorded. Of these, 1067 encounters were for persons aged > 65 years (16%), from 897 unique older patients. The most common diagnosis within older adult encounters was a back problem (56%), followed by neck problems (10%). Soft tissue techniques were most frequently used for older patients (85 in every 100 encounters) and in 29 of every 100 encounters, chiropractors recommended exercise to older patients as a part of their treatment. Conclusions From 6781 chiropractor–adult patient encounters across two countries, one in seven adult chiropractic patients were > 65 years. Of these, nearly 60% presented with a back problem, with neck pain and lower limb problems the next most common presentation to chiropractors. Musculoskeletal conditions have a significant burden in terms of disability in older adults and are the most commonly treated conditions in chiropractic practice. Future research should explore the clinical course of back pain in older patients seeking chiropractic care and compare the provision of care to older adults across healthcare professions.

Telepractice for Adult Speech-Language Pathology Services: A Systematic Review

2020 ◽  
Vol 5 (1) ◽  
pp. 326-338 ◽  
Author(s):  
Kristen Weidner ◽  
Joneen Lowman
Keyword(s):  
Systematic Review ◽  
Primary Progressive Aphasia ◽  
Future Research ◽  
Service Delivery Model ◽  
Speech Language Pathology ◽  
Review Of The Literature ◽  
Research Designs ◽  
Assessment And Treatment ◽  
Language Pathology ◽  
Screening Assessment

Purpose We conducted a systematic review of the literature regarding adult telepractice services (screening, assessment, and treatment) from approximately 2014 to 2019. Method Thirty-one relevant studies were identified from a literature search, assessed for quality, and reported. Results Included studies illustrated feasibility, efficacy, diagnostic accuracy, and noninferiority of various speech-language pathology services across adult populations, including chronic aphasia, Parkinson's disease, dysphagia, and primary progressive aphasia. Technical aspects of the equipment and software used to deliver services were discussed. Some general themes were noted as areas for future research. Conclusion Overall, results of the review continue to support the use of telepractice as an appropriate service delivery model in speech-language pathology for adults. Strong research designs, including experimental control, across multiple well-described settings are still needed to definitively determine effectiveness of telepractice services.

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