We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
SIX-MONTH POSTINTERVENTION DEPRESSION AND DISABILITY OUTCOMES OF IN-HOME TELEHEALTH PROBLEM-SOLVING THERAPY FOR DEPRESSED, LOW-INCOME HOMEBOUND OLDER ADULTS.
- Authors
Choi, Namkee G.; Marti, C. Nathan; Bruce, Martha L.; Hegel, Mark T.; Wilson, Nancy L.; Kunik, Mark E.
- Abstract
Background Despite their high rates of depression, homebound older adults have limited access to evidence-based psychotherapy. The purpose of this paper was to report both depression and disability outcomes of telehealth problem-solving therapy (tele-PST via Skype video call) for low-income homebound older adults over 6 months postintervention. Methods A 3-arm randomized controlled trial compared the efficacy of tele-PST to in-person PST and telephone care calls with 158 homebound individuals who were aged 50+ and scored 15+ on the 24-item Hamilton Rating Scale for Depression (HAMD). Treatment effects on depression severity (HAMD score) and disability (score on the WHO Disability Assessment Schedule [WHODAS]) were analyzed using mixed-effects regression with random intercept models. Possible reciprocal relationships between depression and disability were examined with a parallel-process latent growth curve model. Results Both tele-PST and in-person PST were efficacious treatments for low-income homebound older adults; however the effects of tele-PST on both depression and disability outcomes were sustained significantly longer than those of in-person PST. Effect sizes ( dGMA-raw) for HAMD score changes at 36 weeks were 0.68 for tele-PST and 0.20 for in-person PST. Effect sizes for WHODAS score changes at 36 weeks were 0.47 for tele-PST and 0.25 for in-person PST. The results also supported reciprocal and indirect effects between depression and disability outcomes. Conclusions The efficacy and potential low cost of tele-delivered psychotherapy show its potential for easy replication and sustainability to reach a large number of underserved older adults and improve their access to mental health services.
- Subjects
THERAPEUTICS; MENTAL depression; HEALTH outcome assessment; PROBLEM solving; HOMEBOUND persons; MENTAL health of older people; PSYCHOTHERAPY
- Publication
Depression & Anxiety (1091-4269), 2014, Vol 31, Issue 8, p653
- ISSN
1091-4269
- Publication type
Article
- DOI
10.1002/da.22242