Study protocol for ELders AT Ease (ELATE): a cluster randomised controlled trial of cognitive behaviour therapy to reduce depressive symptoms in aged care residents

BMC Geriatrics

Study Protocol

Rachel Milte¹  Julie Ratcliffe¹  Stephen Quinn²  Joanna M. Waloszek³  Deborah Koder³  Mark Silver³  Rebecca Collins³  Sunil Bhar³  Jennifer Linossier³  Sofie Dunkerley³  Penelope Schofield⁴  Tanya E. Davison⁵ 

[1] Caring Futures Institute, Flinders University, Adelaide, SA, Australia;Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia;Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, 3122, Hawthorn, VIC, Australia;Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, 3122, Hawthorn, VIC, Australia;Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC, Australia;Health Services Research and Implementation Sciences, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia;Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia;Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, PO Box 218, H99, 3122, Hawthorn, VIC, Australia;Silverchain, Osborne Park, WA, Australia;

关键词: Depression;    Anxiety;    Suicide ideation;    Cognitive behavior therapy;    Nursing home;    Residential aged care facility;   

DOI  :  10.1186/s12877-023-04257-7

 received in 2023-01-22, accepted in 2023-08-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThis protocol describes a study of the effectiveness of cognitive behaviour therapy (CBT) for reducing depressive symptoms in older adults living in residential aged care (RAC) facilities in Australia. Depressive symptoms are highly prevalent in this population, yet the benefits of CBT for reducing such symptoms in RAC facilities have not been widely investigated. Elders at Ease (ELATE) is a 16-session CBT intervention designed for implementation in RAC facilities. The intervention includes cognitive, behavioural and reminiscence strategies and is delivered by mental health trainees (MHTs) in collaboration with RAC facility staff and residents’ family.Methods and analysisELATE will be evaluated using a cluster randomised trial comparing outcomes for residents who participate in the intervention with those living in usual care control facilities. The participants are RAC residents aged 65 years or above, with depressive symptoms (Patient Health Questionnaire-2 ≥ 3) and normal cognition or mild cognitive impairment (Standardised Mini Mental Status Examination ≥ 21). They are assessed at four time points: baseline prior to randomisation (T1), mid-treatment (T2; 2.5 months post randomisation), post-treatment (T3; 5 months post-randomisation) and 3-month follow-up (T4; 8 months post randomisation). The primary outcome is change in depressive symptoms between T1 and T3. Secondary outcomes are depressive symptoms at T4, anxiety, suicide ideation, sleep problems, quality of life, staff and family knowledge of late-life depression, stress levels and efficacy in caring for residents, and MHT levels of geropsychology competencies. Residents receiving the intervention are hypothesised to report a greater decrease in depressive symptoms between T1 and T3 compared to residents receiving usual care. The primary analysis is a regression, clustered over site to account for correlated readings, and independent variables are condition and depressive symptoms at T1. A cost-utility analysis is also undertaken.DiscussionELATE is a comprehensive CBT intervention for reducing depressive symptoms in RAC residents. It is designed to be implemented in collaboration with facility staff and residents’ families, individually tailored to residents with normal cognition to mild cognitive impairment and delivered by trainee therapists. ELATE offers a model that may be widely applicable across the RAC sector.Trial registrationTrial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number ACTRN12619001037190, prospectively registered on 22 July 2019.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

13690_2023_1170_Article_IEq16.gif

Fig. 1

13690_2023_1170_Article_IEq124.gif

Fig. 9