2.50
Hdl Handle:
http://hdl.handle.net/10755/159777
Type:
Presentation
Title:
Predictors of a New Depression Diagnosis in Nursing Home Residents
Abstract:
Predictors of a New Depression Diagnosis in Nursing Home Residents
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2009
Author:Phillips, Lorraine, PhD, RN, FNP-BC
P.I. Institution Name:University of Missouri - Columbia
Contact Address:S414 MU Sinclair School of Nursing, Columbia, MO, 65211, USA
Contact Telephone:573-882-0218
Co-Authors:L.J. Phillips, M.J. Rantz, Sinclair School of Nursing, University of Missouri, Columbia, MO; G.F. Petroski, Medical Research Office, University of Missouri, Columbia, MO;
Depression is problematic for nursing home (NH) residents, with prevalence rates ranging from 20% to 55%. Despite its prevalence, depression frequently goes unrecognized in clinical practice. The purpose of this study was to develop a predictive model of depression in NH residents age 65 or older. Factors associated with a new diagnosis of depression during any quarter of nursing home residence, excluding the first quarter, were examined. Analyses were based on Minimum Data Set (MDS) data collected between January 1, 2003 and March 31, 2005. Excluding residents under age 65 with severe cognitive impairment or comatose, 13,588 residents were identified as not depressed at baseline. The sample was largely Caucasian, female, and widowed, with a mean age of 85 years (SD 8.0 years). MDS data collected in the next quarter identified 1,315 (9.68%) residents that had acquired a diagnosis of depression. Candidate predictors were screened individually for an association with new depression diagnosis. Statistically significant variables were entered in a multiple logistic regression analysis using forward selection. Factors predictive of depression were weight loss (OR 1.68, CI 1.40-2.01), verbally abusive behavior (OR 1.44, CI 1.18-1.76), moderate pain (OR 1.43, CI 1.20-1.71), and moderate impairment in activities of daily living (OR 1.35, CI 1.15-1.58). Resident characteristics associated with lower incidence of depression were never married (OR 0.66, CI 0.52-0.83), age equal to or greater than 95 (OR 0.70, CI 0.58-0.86), and frequent urinary incontinence (OR 0.70, CI 0.59-0.83). The area under the curve was 0.591. The lower odds of depression in residents with frequent urinary incontinence may reflect a concomitant debilitation that hinders depression detection. Nurses and other health care professionals may consider NH residents who match this profile to have an increased risk for depression. Future MDS analysis incorporating change scores and facility-level factors may increase the sensitivity and specificity of the model.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePredictors of a New Depression Diagnosis in Nursing Home Residentsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159777-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Predictors of a New Depression Diagnosis in Nursing Home Residents</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Phillips, Lorraine, PhD, RN, FNP-BC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Missouri - Columbia</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">S414 MU Sinclair School of Nursing, Columbia, MO, 65211, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">573-882-0218</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">phillipslo@missouri.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">L.J. Phillips, M.J. Rantz, Sinclair School of Nursing, University of Missouri, Columbia, MO; G.F. Petroski, Medical Research Office, University of Missouri, Columbia, MO;</td></tr><tr><td colspan="2" class="item-abstract">Depression is problematic for nursing home (NH) residents, with prevalence rates ranging from 20% to 55%. Despite its prevalence, depression frequently goes unrecognized in clinical practice. The purpose of this study was to develop a predictive model of depression in NH residents age 65 or older. Factors associated with a new diagnosis of depression during any quarter of nursing home residence, excluding the first quarter, were examined. Analyses were based on Minimum Data Set (MDS) data collected between January 1, 2003 and March 31, 2005. Excluding residents under age 65 with severe cognitive impairment or comatose, 13,588 residents were identified as not depressed at baseline. The sample was largely Caucasian, female, and widowed, with a mean age of 85 years (SD 8.0 years). MDS data collected in the next quarter identified 1,315 (9.68%) residents that had acquired a diagnosis of depression. Candidate predictors were screened individually for an association with new depression diagnosis. Statistically significant variables were entered in a multiple logistic regression analysis using forward selection. Factors predictive of depression were weight loss (OR 1.68, CI 1.40-2.01), verbally abusive behavior (OR 1.44, CI 1.18-1.76), moderate pain (OR 1.43, CI 1.20-1.71), and moderate impairment in activities of daily living (OR 1.35, CI 1.15-1.58). Resident characteristics associated with lower incidence of depression were never married (OR 0.66, CI 0.52-0.83), age equal to or greater than 95 (OR 0.70, CI 0.58-0.86), and frequent urinary incontinence (OR 0.70, CI 0.59-0.83). The area under the curve was 0.591. The lower odds of depression in residents with frequent urinary incontinence may reflect a concomitant debilitation that hinders depression detection. Nurses and other health care professionals may consider NH residents who match this profile to have an increased risk for depression. Future MDS analysis incorporating change scores and facility-level factors may increase the sensitivity and specificity of the model.</td></tr></table>en_GB
dc.date.available2011-10-26T22:19:29Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:19:29Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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