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The effectiveness of a minimal psychological intervention on self-management beliefs and behaviors in depressed chronically ill elderly persons
 — a randomized controlled trial
Author(s)Catherina C M Jonkers, Femke Lamers, Hans Bosma
Journal titleInternational Psychogeriatrics, vol 24, no 2, February 2012
Pagespp 288-297
Sourcehttp://www.journals.cambridge.org/ipg
KeywordsDepression ; Chronic illness ; Psychiatric treatment ; Attitude ; Theory ; Clinical surveys ; Netherlands.
AnnotationChronically ill patients often develop symptoms of depression. A minimal psychological intervention (MPI) has been developed to break through the spiral by applying principles of self-management and cognitive behavioural therapy. This Netherlands study examines the effects of the MPI on self-efficacy, anxiety, daily functioning and social participation. A randomised controlled trial compared the MPI with usual care in 361 primary care patients. Nurses visited patients at home over a period of three months. Patients were aged 60 years and older, had minor depression or mild to moderate major depression, and either type 2 diabetes mellitus (DM) or chronic obstructive pulmonary disease (COPD). Outcomes were measured at baseline and at one week, three months, and nine months after the intervention period. At nine months after treatment, the MPI was associated with less anxiety (mean difference 2.5; 95% CI 0.7-4.2) and better self efficacy skills (mean difference 1.8; 95% CI 3.4-0.2), daily functioning (mean difference 1.7; 95% CI 0.6-2.7), and social participation (mean difference 1.3; 95% CI 0.4-2.2). Effect sizes for these outcomes were small to medium (0.29-0.40). Differences were primarily due to a stabilization of outcomes in the intervention group and deterioration in the control group. No major differences were observed between DM and COPD patients. The intervention appears to be reasonably effective in improving care for chronically ill elderly people. We recommend further evaluation of the MPI, including emphasis on detection and watchful waiting. (RH).
Accession NumberCPA-120821001 A
ClassmarkENR: CI: LP: DP: 4D: 3G: 76H

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