ABSTRACT
BACKGROUND/OBJECTIVES: Hospitalization due to acute illness in older patients is often associated with anxiety or depressive symptoms. In these circumstances, given that pharmacologic treatment should be avoided to reduce interactions with ongoing medication regimes, psychotherapy techniques should be considered. The purpose of this study was to evaluate the effectiveness of group reminiscence therapy (RT) on the reduction of anxiety and depressive symptoms in acutely hospitalized older patients. METHODS: Controlled and prospective study conducted on the Acute Geriatric Unit of a university hospital. Patients included in the intervention group (RT Group) attended a group session focused on RT, whereas those included in the control group (UC) received usual hospital care. Exclusion criteria were severe cognitive impairment, impossibility to mobilize, and clinical/hemodynamic instability. The intervention was based on a multi-task daily group session of reminiscence activities. The severity of anxiety (Hamilton Anxiety Rating Scale, HAM-A), depressive symptoms (15-item Geriatric Depression Scale, GDS-15), loneliness (ESTE-II social loneliness scale), and fear of death (Collet-Lester scale) was assessed at admission and discharge in both groups. RESULTS: The intervention was effective in reducing the proportion of patients with anxiety and depressive symptoms during hospitalization. The proportion of patients with moderate-severe anxiety at discharge was 32.1% in the UC and 13.4% in the RT Group (p < 0.001), whereas the proportion of patients with depressive symptoms at discharge was 49.1% in the UC and 19.5% in the RT Group (p < 0.001). The intervention was independently associated with benefits on anxiety levels (RR 2.45, 95% CI 1.83-3.28) and depression (RR 3.71, 95% CI 2.22-6.19) at discharge. No differences were found in loneliness or fear of death. CONCLUSIONS: A group reminiscence activity reduces the proportion of patients with anxiety and depressive symptoms during hospitalization for an acute disease. Absolute changes in both anxiety and depression scores, even though significant, were relatively small.
Subject(s)
Depression , Psychotherapy , Humans , Aged , Depression/psychology , Prospective Studies , Psychotherapy/methods , Anxiety/therapy , HospitalizationABSTRACT
La valoración del paciente geriátrico requiere un abordaje multidimensional que cobra especial importancia a la hora de decidir si un paciente con enfermedad crítica es candidato a recibir un tratamiento activo, entendiéndose por tal el conjunto de medidas destinadas a resolver una patología aguda. Presentamos la evolución de 4 pacientes ancianos que ingresaron desde el Servicio de Urgencias habiéndose optado exclusivamente por un manejo sintomático (morfina y/o midazolam) de su patología aguda. Durante su ingreso en la Unidad de Agudos de Geriatría, dada la mejoría clínica objetivada, se inició tratamiento activo con actitud expectante. Todos ellos fueron dados de alta tras una evolución clínica favorable
Clinical evaluation of elderly patients must include a comprehensive geriatric assessment. This is vital when deciding if a patient with a demonstrated critical disease should receive an active treatment, defined as the set of measures to treat an acute disease. The clinical outcomes are presented of four elderly patients who were admitted from the Emergency Department and whose severe acute diseases were treated with Comfort Measures Only. During their admission in the Geriatrics Acute Unit, and due to a reported clinical improvement, an active treatment was provided. All patients were discharge from the hospital after a favourable clinical course
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Acute Disease , Clinical Decision-Making , Geriatric Assessment , Emergency Service, HospitalABSTRACT
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Subject(s)
Humans , Female , Aged , Encephalitis, Viral/virology , Influenza, Human/diagnosis , Betainfluenzavirus , Encephalitis, Viral/diagnosis , Fatal Outcome , Encephalitis, Viral/therapyABSTRACT
Clinical evaluation of elderly patients must include a comprehensive geriatric assessment. This is vital when deciding if a patient with a demonstrated critical disease should receive an active treatment, defined as the set of measures to treat an acute disease. The clinical outcomes are presented of four elderly patients who were admitted from the Emergency Department and whose severe acute diseases were treated with Comfort Measures Only. During their admission in the Geriatrics Acute Unit, and due to a reported clinical improvement, an active treatment was provided. All patients were discharge from the hospital after a favourable clinical course.
