2.50
Hdl Handle:
http://hdl.handle.net/10755/163621
Category:
Abstract
Type:
Presentation
Title:
Assessing rural elders for mental health disorders
Author(s):
Fisher, Kathleen; Copenhaver, Valerie
Author Details:
Kathleen Fisher, Pennsylvania State University, Milton S. Hershey Medical Center, Hummelstown, Pennsylvania, USA, email: kmf103@psu.edu; Valerie Copenhaver
Abstract:
Study Purpose: Failure to recognize mental health disorders in the elderly is a common problem, creating a situation of under diagnosed mental health disorders, under treatment and ultimately unnecessary suffering. Rural elders are at added risk since treatment resources are scarce in rural areas. Research Question: What is the prevalence of mental health disorders among rural elders living in a subsidized housing facility? What scales can nurses use to assess for these disorders? Framework: Long & Weinert's conceptual basis for rural nursing, including: work ethic, self-reliance, and a lack of anonymity, outsider/insider, old timer/newcomer and distance; provided the theoretical foundation for this study. Sample: The elder housing facility is located in a county with a long history of poverty that is designated as 78% rural by recent census data. Sixty apartments compromised the study site. There were 53 elderly residing in this government-subsidized housing complex. The Institutional Review Board of the University approved this study. All subjects gave informed consent. Methods: The nurses conducted interviews and utilized the following survey instruments: The PRIME MD(Spitzer et al, 1994), a basic screening diagnostic tool to assess the presence of affective disorders, anxiety disorders, substance abuse disorders and eating disorders. The Short Form Health Survey (SF-36) (Ware & Sherbourne, 1992), a 36-item scale that assesses eight domains, and the 10-item Montgomery-Asberg Depression Rating Scale (Montgomery & Asberg, 1979). The Mini-Mental Status Exam (Folstein et al, 1975) was used to assess cognition. Nurses evaluated the overall functioning of residents by utilizing the Global Assessment Scale (GAS) (Luborsky, 1962). Data were tabulated and analyzed using SPSS software. Results: Twenty rural elders participated, which represented 53% of the population of this public housing facility. Mean age was 72, and 70% were female. Ninety-five percent were Caucasian. Fifty percent suffered from depressive disorders: major depression (25%), minor depression (20%) and dysthymia (5%). Identified individuals were referred to their primary care providers for mental health services. The assessment instruments used to identify mental health disorders were accurate, reliable, and appropriate. The PRIME MD correlated significantly with the Montgomery-Asberg Depression Rating Scale (r = 0.89, p< 0.00001), the Mental Health Scale (r = 0.75, p =0.00015); and the Global Assessment Scale (r = 0.80, p=0.00002). The PRIME MD correlated with 6 of the 8 scales of the SF-36 including: mental health (r=0.75, p=0.00015) role emotional (r=0.88, p< 00001), body pain (r=0.46, p=0.04), energy (r=0.622, p=0.0034), general health (r=0.48, p=0.03), and social functioning (r=0.74, p=0.0001) subscales. Identification of depressive disorders by the PRIME MD did not correlate significantly with church membership or family support as rated by the respondents. Twenty-five percent had a MMSE score less than or equal to 23, and 15% had MMSE scores of 16 or less. Global Assessment Scale correlated with MMSE (r = 0.43, p =0.057). Nursing Implications: The need for nurses to assess rural elderly for mental health disorders, especially depression, has been identified and supported by this study. The data suggests that rates of depressive disorder and cognitive impairment in rural public housing facilities are quite high. The scales used were highly reliable and appropriate for this population and for use by nurse raters. The presence of depressive disorders did not correlate with membership in Churches or by the elders rating of family support. This would suggest that nursing interventions would be more effective than peer support or support from faith based organizations.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleAssessing rural elders for mental health disordersen_GB
dc.contributor.authorFisher, Kathleenen_US
dc.contributor.authorCopenhaver, Valerieen_US
dc.author.detailsKathleen Fisher, Pennsylvania State University, Milton S. Hershey Medical Center, Hummelstown, Pennsylvania, USA, email: kmf103@psu.edu; Valerie Copenhaveren_US
dc.identifier.urihttp://hdl.handle.net/10755/163621-
dc.description.abstractStudy Purpose: Failure to recognize mental health disorders in the elderly is a common problem, creating a situation of under diagnosed mental health disorders, under treatment and ultimately unnecessary suffering. Rural elders are at added risk since treatment resources are scarce in rural areas. Research Question: What is the prevalence of mental health disorders among rural elders living in a subsidized housing facility? What scales can nurses use to assess for these disorders? Framework: Long & Weinert's conceptual basis for rural nursing, including: work ethic, self-reliance, and a lack of anonymity, outsider/insider, old timer/newcomer and distance; provided the theoretical foundation for this study. Sample: The elder housing facility is located in a county with a long history of poverty that is designated as 78% rural by recent census data. Sixty apartments compromised the study site. There were 53 elderly residing in this government-subsidized housing complex. The Institutional Review Board of the University approved this study. All subjects gave informed consent. Methods: The nurses conducted interviews and utilized the following survey instruments: The PRIME MD(Spitzer et al, 1994), a basic screening diagnostic tool to assess the presence of affective disorders, anxiety disorders, substance abuse disorders and eating disorders. The Short Form Health Survey (SF-36) (Ware & Sherbourne, 1992), a 36-item scale that assesses eight domains, and the 10-item Montgomery-Asberg Depression Rating Scale (Montgomery & Asberg, 1979). The Mini-Mental Status Exam (Folstein et al, 1975) was used to assess cognition. Nurses evaluated the overall functioning of residents by utilizing the Global Assessment Scale (GAS) (Luborsky, 1962). Data were tabulated and analyzed using SPSS software. Results: Twenty rural elders participated, which represented 53% of the population of this public housing facility. Mean age was 72, and 70% were female. Ninety-five percent were Caucasian. Fifty percent suffered from depressive disorders: major depression (25%), minor depression (20%) and dysthymia (5%). Identified individuals were referred to their primary care providers for mental health services. The assessment instruments used to identify mental health disorders were accurate, reliable, and appropriate. The PRIME MD correlated significantly with the Montgomery-Asberg Depression Rating Scale (r = 0.89, p< 0.00001), the Mental Health Scale (r = 0.75, p =0.00015); and the Global Assessment Scale (r = 0.80, p=0.00002). The PRIME MD correlated with 6 of the 8 scales of the SF-36 including: mental health (r=0.75, p=0.00015) role emotional (r=0.88, p< 00001), body pain (r=0.46, p=0.04), energy (r=0.622, p=0.0034), general health (r=0.48, p=0.03), and social functioning (r=0.74, p=0.0001) subscales. Identification of depressive disorders by the PRIME MD did not correlate significantly with church membership or family support as rated by the respondents. Twenty-five percent had a MMSE score less than or equal to 23, and 15% had MMSE scores of 16 or less. Global Assessment Scale correlated with MMSE (r = 0.43, p =0.057). Nursing Implications: The need for nurses to assess rural elderly for mental health disorders, especially depression, has been identified and supported by this study. The data suggests that rates of depressive disorder and cognitive impairment in rural public housing facilities are quite high. The scales used were highly reliable and appropriate for this population and for use by nurse raters. The presence of depressive disorders did not correlate with membership in Churches or by the elders rating of family support. This would suggest that nursing interventions would be more effective than peer support or support from faith based organizations.en_GB
dc.date.available2011-10-27T11:10:48Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:10:48Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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