Two hundred participants aged 65 and older recruited from 4 different family medicine clinics rated the acceptability of 3 different treatments for geriatric depression: (a) cognitive therapy (CT), (b) cognitive bibliotherapy (CB), and (c) antidepressant medication (AM). Results showed that the acceptability of the treatments is a function of the severity of the symptoms of the depressed patient to whom they would be applied. CT and CB were rated as more acceptable than AM when patient symptoms were mild to moderate. However, CT was more acceptable than both CB and AM when patient symptoms were described as severe. Acceptability ratings were not related to the raters' own depressive symptoms. The practical implications of these results are discussed.
Background: Caregiver burden differs according to the amount of care, but no study has really focused on that point. This study compares the evolution of burden of two groups of caregivers of people with a recent stroke who returned home after discharge from two different types of health care facilities. Methods: Burden was assessed at 3 weeks and 3 and 6 months after discharge. The two groups of people with stroke and their caregivers were recruited from acute care (n = 69) and rehabilitation facilities (n = 89). Caregivers completed a questionnaire with three dimensions. In addition to sociodemographic characteristics, we assessed variables pertaining to the clinical, physical and cognitive functioning of the people with stroke. Results: Differences in burden were noted. The best predictors of burden were the caregivers’ characteristics, i.e. gender (female), occupation (retired), schooling (low), age (older) and hours of care given, and the stroke survivors’ characteristics, i.e. depressive symptoms, poor motor function (leg), verbal comprehension deficits, difficulty walking and neurological deficits. Conclusion: These results reinforce the view that services (information, training and support) should be tailored to the needs of caregivers, depending on whether or not the recipient of care has received rehabilitation services.
Few studies have been conducted on strategies to promote the implementation of complex interventions in nursing homes (NHs). This article presents a pilot study intended to assess the strategies that would enable the optimal implementation of a complex intervention approach in NHs based on the meanings of screams of older people living with Alzheimer's disease. An action research approach was used with 19 formal and family caregivers from five NHs. Focus groups and individual interviews were held to assess different implementation strategies. A number of challenges were identified, as were strategies to overcome them. These latter included interactive training, intervention design, and external support. This study shows the feasibility of implementing a complex intervention to optimize older people's well-being. The article shares strategies that may promote the implementation of these types of interventions in NHs.
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