Sumaira H. Malik

How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review

Background: The benefits of physical exercise in reducing clinically defined depression in the general population have been established, although a review of the evidence for older adults is needed. Objectives: To assess the efficacy of physical exercise for the treatment of depressive symptoms in older adults (>60 years). Data sources: We searched: MEDLINE (1966—May 2008); EMBASE (1980—May 2008); Cumulative Index to Nursing & Allied Health Literature (CINAHL; 1982—May 2008); PsycINFO (1966—May 2008), The Cochrane Library (Issue 2, 2008), and National Research Register (NRR; Issue 2, 2008). Review methods: Randomized controlled trials and quasi-experimental studies of physical exercise interventions for depression were included where 80% or more of participants were >60 years. Abstracts were assessed to determine whether they met specified inclusion criteria. Primary analysis focused on the prevalence of diagnosable depressive disorder following intervention. Secondary outcome was depression or mood scores on standardized scales. Results: Eleven randomized controlled trials with a total of 641 participants were included in the review. Short-term positive outcome for depression or depressive symptoms was found in nine studies, although the mode, intensity and duration of intervention varied across studies. Medium- to long-term effects of intervention were less clear. Conclusion: Physical exercise programmes obtain clinically relevant outcomes in the treatment of depressive symptoms in depressed older people. Exercise, though not appropriate for all in this population, may improve mood in this group. Further research is needed to establish medium- to long-term effects and cost-effectiveness.

Gender differences in computer-mediated communication: a systematic literature review of online health-related support groups.

OBJECTIVE Previous research has contended that the unique characteristics of the Internet might remove some of the gender differences that exist in face-to-face healthcare. The aims of the present study were to systematically review studies that have examined gender differences in communication within online health communities. METHODS A literature search was conducted to identify studies addressing gender differences in messages posted to online health-related support groups. Out of the 1186 articles identified, twelve were retrieved for review. RESULTS Half of the studies examined gender differences by comparing male and female cancer discussion boards. The literature review revealed that some gender differences were observed in these studies. However, for studies that analysed mixed-gender communities, gender differences were less evident. CONCLUSION Results seemed to reveal gender differences in communications in single-sex online health support groups, and similarities in communication patterns in mixed-sex online health support groups. However, findings should be treated with caution due to the diversity in studies and methodological issues highlighted in the present review. PRACTICE IMPLICATIONS There is a need for health care professionals to take into account a range of situational and contextual factors that may affect how men and women use online health support groups. However, more robust research is needed before concrete guidelines can be developed to help health care professionals develop effective online support interventions.

Coping with infertility online: An examination of self-help mechanisms in an online infertility support group

OBJECTIVE To examine communication within an online infertility support group. METHODS A content analysis of 3500 messages posted to infertility bulletin boards. RESULTS The most frequently used self-help mechanisms were support or empathy (45.5%) and sharing personal experiences (45.4%), followed by the provision of information and advice (15.9%), gratitude (12.5%), friendship (9.9%), chit-chat (9.4%), requests for information or advice (6.8%) and universality (4.8%), with negative statements (0.3%) and creative expressions (0.2%) being the least frequent categories. CONCLUSION These findings suggest that online support groups can provide a viable alternative source of support for couples dealing with infertility. PRACTICE IMPLICATIONS Health care professionals interested in developing online support interventions should look to tailor support resources to the specific needs of patients at different stages of the infertility journey.

‘Do as I say, but not as I do’: Are next generation nurses role models for health?

Aim: Promoting healthy lifestyles plays a key role in professional nursing yet nurses do not always practice what they preach. Efforts are currently being made to improve the health of NHS staff, yet little is known about the health and lifestyle behaviours of pre-registration nurses in the UK although these individuals are our next generation of NHS employees. The aim of this study was to investigate the health behaviours and wellbeing of pre-registration nurses based at an acute NHS teaching hospital in England. Methods: In this cross-sectional questionnaire survey, 325 pre-registration nurses (50% response rate) completed a health and lifestyle questionnaire, measuring levels of physical activity, smoking and alcohol behaviour, dietary practices and general health. Results: Age ranged from 19-53 years, and 96% of the sample was female. More than half of the sample did not meet public health recommendations for physical activity. Just under one-fifth were current smokers and over three-quarters did not consume five servings of fruit/vegetables per day. Two-thirds reported exceeding the recommended maximum daily alcohol intake and around one third were classified as either overweight or obese. Those who were physically inactive were less likely to report good general health, good dietary practices and more sleep, and were more likely to report cigarette smoking and alcohol consumption than their active counterparts. Conclusions: This study indicates that the health profile of pre-registration nurses is relatively poor, and that those who are sedentary engage in other negative lifestyle behaviours also. Despite significant education relating to health promotion and health behaviours of patients being targeted at pre-registered nurses, it seems that this knowledge is not always transferred to their own behaviour. There is a need for timely intervention to establish healthy lifestyle behaviours amongst nurses early in their career.

‘They all supported me but I felt like I suddenly didn't belong anymore’: an exploration of perceived disadvantages to online support seeking

In recent years, there has been a significant rise in the number of online support communities dedicated to issues surrounding infertility. The aim of this study was to focus on investigating the perceived disadvantages of online infertility support communities from the perspective of those who access and participate in them. A total of 295 participants completed an online questionnaire about their use of online support communities. Responses were analysed using inductive content analysis. Since the majority of respondents were women, the results of the study largely reflect the experiences of the female population. Over half of the sample (57.9%) reported experiencing disadvantages to online support. Content analysis revealed that the most commonly cited disadvantages were reading about negative experiences (10.9%), reading about other peoples pregnancies (8.8%), inaccurate information (7.8%) and its addictive (5.8%). These results suggest that there are many perceived disadvantages to online infertility support communities. While some of these disadvantages reflect fears commonly cited in the literature, there are also unique disadvantages associated with the experience of infertility and its treatment. The study highlights a number of important areas in which health professionals and community moderators could intervene to better support and improve the online experiences of patients experiencing infertility.

The therapeutic potential of the internet: exploring self-help processes in an internet forum for young people with inflammatory bowel disease.

The Internet has provided new opportunities for young people with inflammatory bowel disease to access diverse information and support, and communicate with fellow sufferers through the means of online patient support groups. The study presented in this article is the first to examine communication processes in an online support group for young people with inflammatory bowel disease. The purpose of the study was to examine the frequency and use of self-help mechanisms in communication within the online group. Content analysis was performed on a sample of 1,505 messages posted to the online support group. Results revealed that similar to face-to-face support groups, the online group offered patients the opportunity to utilize a variety of self-help mechanisms. Specifically, the group seemed to provide a unique avenue through which participants could connect with other young people suffering from inflammatory bowel disease and share personal experiences and information related to their condition. These findings suggest that online support groups may provide a novel and beneficial medium through which young people with inflammatory bowel disease can fulfill their support needs, and those involved in their care, such as nurses, may play an important role in discussing the advantages or disadvantages of this increasingly popular form of support. Further research is needed to examine the psychosocial effects of accessing such groups.

A comparison of lurkers and posters within infertility online support groups.

&NA; Current research shows that online support groups can offer people affected by infertility a unique and valuable source of social support. However, to date most research has focused on the experiences of people who post messages to online infertility support groups; in comparison, little is known about how “lurkers” (ie, those individuals who read messages but do not post messages) use and benefit from online infertility support groups. The purpose of the present study was to compare the use and experience of online infertility support groups between lurkers and posters. A total of 295 participants who were recruited from several online infertility support groups completed an online questionnaire containing questions about their use and experience of online support groups and measures of loneliness, social support, marital satisfaction, and perceived infertility‐related stress. Differences between lurkers and posters were analyzed using Mann‐Whitney U and &khgr;2 or Fisher exact tests. Results revealed that compared with posters, lurkers visited the online support groups less often and scored significantly lower in overall satisfaction with the online support group. However, both lurkers and posters reported gaining a range of unique benefits from access to an online support group. Furthermore, there were no significant differences in loneliness, social support, infertility‐related stress, and marital satisfaction between lurkers and posters. These findings suggest that reading messages posted to online support groups may be as beneficial as interacting with the group.