Treatment Considerations for Depression Research in Older Married Couples: A Dyadic Case Study

A Systematic Review: Factors Related to Happiness and Quality of Life in the Elderly Depression

BACKGROUND: Depression is frequent in elderly population. Recognizing the predisposing factors that trigger depression in the elderly is the right step to prevent the worsening prognosis of depression in the elderly. AIM: This study tried to identify essential comprehensively factors contributing to increasing happiness and quality of life (QoL) in the elderly depression. METHODOLOGY: A systematically article abstracts search from EBSCO, ProQuest, Science Direct, Willey Online Library, Scopus, and SINTA. This method of writing was carried out and reported by the guidelines of diagram Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Risk of bias in included studies assessed by Cochrane systematic reviews of intervention. RESULTS: Twenty-five studies were eligible for inclusion in the review from 993 screening process records identified through database searching, duplicates removed, and full-text articles excluded with reasons. Essential factors influencing the QoL in the elderly depression are lack of developmental tasks stimulation, religious belief, satisfaction regarding the QoL, suffering from more chronic disease, experiencing an adverse event, and lack of ability to take self-care. The most influential factor in increasing happiness in the elderly is a feeling of satisfaction with life achievement. CONCLUSION: Clear understanding of the depression predisposing factors in the elderly is critical to better and effectively achieving happiness. The elderly perception about the QoL and how it contributes to their lives is essential information for providing practical nursing interventions in geriatric settings.

Challenges and Lessons Learned Tailoring a Behavioral Intervention for Stroke Survivor-Care Partner Dyads

INTRODUCTION

Research is increasingly exploring interventions for patient-care-partner dyads, but little has been reported regarding challenges of implementing dyad-focused interventions. This article reports the lessons learned in a pilot feasibility study of problem-solving therapy versus stroke education in stroke survivor-care partner dyads.

CHALLENGES AND LESSONS LEARNED

Challenges arose in numerous aspects of intervention delivery. These ranged from personalizing the intervention to meet individual needs and balancing participation between dyad members to maintaining focus, managing conflict, and addressing ethical concerns, all of which required attention from the nurse researcher. These anticipated and unanticipated challenges were addressed using a variety of solutions, including engagement, active listening, redirection, and structured adaptation.

IMPLICATIONS FOR PRACTICE

The knowledge gained and lessons learned in this study may be applied to other patient-care-partner dyads and other behavioral therapies. Nurses may also identify opportunities to increase inclusion of care partners in other interventions. Awareness of these challenges may lead to greater success in working with dyads.

CONCLUSIONS

Dyad-focused behavioral interventions hold promise for use with stroke survivors and their care partners. They also present unique implementation challenges compared with survivor-only interventions.

Longitudinal Associations Between Cognitive Functioning and Depressive Symptoms Among Older Adult Spouses in the Cardiovascular Health Study

OBJECTIVE

To examine the bidirectional associations between older adult spouses' cognitive functioning and depressive symptoms over time.

DESIGN

Longitudinal, dyadic path analysis with the actor-partner interdependence model.

SETTING

Data were from visit 5 (1992/1993), visit 8 (1995/1996), and visit 11 (1998/1999) of the Cardiovascular Health Study, a multisite, longitudinal, observational study of risk factors for cardiovascular disease in adults 65 years or older. Demographic information was from the 1989/1990 original and 1992/1993 African American cohort baseline visits.

PARTICIPANTS

Husbands and wives from 1,028 community-dwelling married couples (N = 2,065).

MEASUREMENTS

Cognitive functioning was measured with the Modified Mini-Mental State Exam. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale. Age, education, and disability (activities of daily living and instrumental activities of daily living) were included as covariates.

RESULTS

Cross-partner associations (partner effects) revealed that one spouse's greater depressive symptoms predicted the other spouse's lower cognitive functioning, but a spouse's lower cognitive functioning did not predict the other spouse's greater depressive symptoms over time. Within-individual associations (actor effects) revealed that an individual's lower cognitive functioning predicted the individual's greater depressive symptoms over time, but greater depressive symptoms did not predict lower cognitive functioning over time. Effects did not differ for husbands and wives.

CONCLUSION

Having a spouse who is depressed may increase one's risk of cognitive decline as well as one's risk of depression. Interventions for preventing cognitive decline and depression among older adults may be enhanced by considering the marital context.

Actor-partner interdependence analysis in depressed patient-caregiver dyads: Influence of emotional intelligence and coping strategies on anxiety and depression

OBJECTIVE

Major depressive disorder (MDD) is a leading cause of suffering for both patients and their natural caregivers. A preliminary study highlights the association of emotional intelligence (EI) and coping strategies with quality of life. However, there is a lack of studies concerning dyadic (i.e., patient and natural caregiver) characteristics' impact on anxious and depressive symptoms. In a sample of MDD patients-caregivers dyads, we explored the influence of EI and coping strategies on anxious and depressive symptoms using the actor-partner interdependence model (APIM).

METHODS

The cross-sectional study included 79 MDD patient-caregiver dyads. Self-reported data, completed by patients and their primary caregivers, were collected including socio-demographic, EI using TEIQue-SF, coping strategies using BriefCope, depressive symptoms using Beck Depression Inventory, anxious symptoms using STAI. The APIM was used to test the dyadic effects of EI and coping strategies on anxious and depressive symptoms, using structural equation modelling.

RESULTS

Patients and caregivers reported both anxious and depressive symptoms. Coping strategies, such as problem solving, positive thinking and avoidance, exhibited evidence of actor (degree to which the individual's coping strategies are associated with their own anxiety or depression level) and partner effect (degree to which the individual's coping strategies are associated with the anxiety or depression level of the other member of the dyad). The caregivers' EI was associated with a decrease of their own depression level contrary to patients for which the results were not significant. The patients' and caregivers' EI was associated with a decrease of their own level of anxiety.

CONCLUSION

EI and coping strategies were moderately associated with anxious and depressive symptomatology among MDD patient-caregiver dyads. These results suggest that targeted interventions could be proposed to both patients and caregivers.