Jean Vézina

Étude psychométrique de l'Échelle de dépression gériatrique

The object of the present research is to validate a French version of the Geriatric Depression Scale (GDS). The version entitled “Echelle de depression geriatrique” (EDG) was administered to a sample of 643 elderly Francophones from the provinces of New Brunswick and Quebec. The psychometric characteristics indicate that the EDG is a valid and reliable scale. The utility of the EDG as a screening measure for geriatric depression is discussed.

Understanding the outcomes of a psycho-educational group intervention for caregivers of persons with dementia living at home: A process evaluation

This qualitative process evaluation study aimed to identify the primary processes of a psycho-educational group for caregivers of persons with dementia, in order to better understand intervention outcomes. Semi-structured interviews were conducted with 30 participants recruited from the experimental group of a randomised controlled trial. At pre-test, participants reported their expectations of the group. At post-test, they described their group experience, the most/least helpful aspects of the intervention, their most useful learning and their responses during a recent episode of disturbing behaviour by their relative. Results showed that the group delivered both educational and support processes. Support processes complemented educational processes. Participants learned coping strategies, with reframing playing a more important role than problem-solving or seeking social support. Daughters benefited more than spouses from educational processes. This study of group processes contributes to our understanding of the reported reduction in frequency of disturbing behaviours and of the change in caregivers’ behaviours.

Older Husbands as Caregivers Factors Associated With Health and the Intention to End Home Caregiving

The purpose of this study, based on Pearlin et al.s model, was to determine the factors associated with the health of older husband caregivers and with their intention to end home caregiving for their wives. The results showed subjective stressors to be associated with outcomes. Role overload was linked to psychological distress and to lower self-perceived health, whereas role captivity was associated with psychological distress and the intention to end home caregiving. The likelihood of ceasing home caregiving increased when caregivers reported high relational deprivation. A high percentage of the variance in psychological distress was explained (51%). The quality of prior husband-wife relationships, the frequency of disruptive behaviors, family conflicts, and self-efficacy were associated with this variable. Selfefficacy had a mediating effect between subjective stressors and psychological distress, whereas the number of services received had a moderating effect on the intention to end home caregiving among husbands with high role captivity. This study provides avenues for interventions sensitive to male caregivers.

Reducing verbal agitation in people with dementia: evaluation of an intervention based on the satisfaction of basic needs.

Objectives: Positive results have been reported with psychosocial interventions used to reduce verbal agitation (VA) in people with dementia, but there is no clear information regarding the proportion of persons who demonstrate significant behavioural improvement with such treatments. The main objectives of this pilot study are (a) to identify the proportion of persons with dementia who demonstrate significant behavioural improvement with a need-based intervention to reduce VA and (b) to further evaluate the effectiveness of this type of intervention. Method: A single-group repeated measures design was used (N = 26). An individualized multicomponent intervention addressing needs for comfort, social interaction and sensory stimulation was applied by a therapist during 30 min sessions during the time of day when VA was most severe. The frequency and duration of VA were measured through computer-assisted direct observation several times before, during and after the intervention. Results: A statistically significant reduction of the duration of VA during the intervention phase relative to other phases of the protocol was found. This effect was limited to the period during which the treatment is being applied. Half of the participants (54%) demonstrated considerable behavioural improvement during the intervention (50% reduction of symptoms) and those whose functioning is best preserved showed the best response to the intervention. Conclusion: This need-based intervention appears promising for improving the behaviour of a considerable proportion of patients.

Questionnaire de Dépression de Beck: Etude psychométrique auprès d'une population âgée francophone

Psychometric properties of the Beck Depression Inventory are questionable for elderly francophones. Consequently, the aim of this study is to assess the reliability and the validity of the French version of the BDI (Questionnaire de Depression de Beck: Bourque & Beaudette, 1982) for this group. Six hundred and forty-three French-speaking elders from Quebec and New-Brunswick answered the BDI. The reliability coefficients showed satisfactory internal consistency (.85), split-half reliability (.76) and test-retest correlation (.74). A principal-components analysis yielded three factors (somatic complaints, negative view of the self, and helplessness) accounting for 46.9 per cent of the total variance. The choice of an optimal cut-off score and the use of the BDI with the elderly are also discussed in this study.

The caregiver's perception of behavioral disturbance in relatives with schizophrenia: a stress-coping approach.

This article suggests some theoretical orientations in studying behavioral disturbance from a stress-coping perspective. First, an overview of Lazarus and Folkmans cognitive theory of stress is presented. Secondly, some linkages are proposed between the rating scales used to measure behavioral disturbance and the concepts of this theory. Future research directions are then suggested to further explore the affective, cognitive and behavioral responses related to the management of disturbing behaviors.

Differences in appraisal and coping between elderly coronary artery disease patients high and low in depressive symptoms

Coronary artery disease (CAD) is frequently found in the elderly and many CAD patients present depressive symptoms. The purpose of this study was to determine if elderly CAD patients high and low in depressive symptoms differ on how they appraise stressors associated with angina pectoris and how they cope with these stressors. Twenty elderly CAD patients high in depressive symptoms and 35 elderly CAD patients low in depressive symptoms identified their most severe chronic stressor attributed to angina and reported their appraisal and coping in relation with this stressor. Groups did not differ on sociodemographic, health-related or stressor-related characteristics. Compared with CAD patients low in depressive symptoms, CAD patients high in depressive symptoms reported appraisal of more harm to their own physical well-being and more threat to their self-esteem and a loved ones well-being. CAD patients high in depressive symptoms also reported using more escape-avoidance coping. These results suggest that ...

Spousal Loss: Depression, Anxiety and Well-Being after Grief Periods of Varying Lengths

A total of 59 bereaved elderly persons and 20 married elderly persons were asked to complete a series of questionnaires on depression, anxiety and well-being. The bereaved elderly persons were divided into three groups based on the length of time elapsed since the death of the spouse. The results showed that bereaved subjects were more depressed and anxious and that their well-being was generally inferior to their married counterparts; further, their emotional reactions persisted after many months of mourning and finally some of the bereaved seemed more at risk than others. These issues should be examined more thoroughly using longitudinal studies.

Impact of caregivers' behaviors on resistiveness to care and collaboration in persons with dementia in the context of hygienic care: an interactional perspective.

BACKGROUND The role played by various physical and verbal behaviors of professional caregivers in the onset of resistiveness to care (RTC) and collaborative behaviors of nursing home residents with dementia was assessed in a daily hygienic care routine context. METHODS Two hundred and forty hygienic care routines, observed in eight nursing home residents, were analyzed with a video-assisted systematic observation methodology and a sequential statistical analysis strategy. RESULTS Caregiver and care recipient behaviors are interdependent in the hygienic care routine context. Physical instrumental behavior, neutral, negative and positive statements, positive and negative instructions, and verbal distraction emitted by caregivers are significantly and moderately associated with the onset of RTC in persons with dementia (PWD), but the strength of relationships observed depends on the care recipients behavior prior to the caregivers action. Positive instructions are moderately associated with the onset of collaboration in residents with preserved language abilities. However, for residents with severe language impairment, these same instructions were linked to RTC behaviors. CONCLUSIONS Although antecedents to RTC can be identified, the risk that caregiver behaviors trigger resistive responses is higher when care recipients are already exhibiting RTC, and is low when no particular behavior or collaboration is shown. Antecedents to collaboration are also identified and discussed. Although different caregiver behaviors may be more or less likely to elicit resistiveness or collaboration, it is the pre-existing state of the care recipient that will determine its reaction to the caregivers behavior. Clinical implications emerging from these influential findings are elaborated.

Instruments Measuring Behavioral Disturbance in Relatives with Schizophrenia

This article presents a review of 16 instruments measuring behavioral disturbance of persons with schizophrenia as perceived by their family members. Information about the domain, the types of rating scales, and the psychometric properties of these instruments are provided. Future directions in the study of behavioral disturbance are proposed.