Care Setting
Community care
Evidence Base for Practice
This practice example was a piot project informing evidence base.
Quality assurance/impact of practice
RESULTS
KEY: D-DEPRESSION A-ANXIETY S-STRESS
RATING SCALE
Depression Anxiety Stress
NORMAL 0 - 9 0 - 7 0 - 14
Mild 10 - 13 8 - 9 15 - 18
Moderate 14 - 20 10 - 14 19 - 25
Severe 21 - 27 15 - 19 26 - 33
Extremely Severe 28+ 20+ 34+
For graphs see additional information
The initial scores were:
Carer 1: D-0, A-1, and S-4
Carer 2: D-4, A-1, and S-4
Carer 3: D-2, A-5, and S-22
The scores after the six weeks were:
Carer 1: D-1, A-1, and S-1
Carer 2: D-5, A-0, and S-1
Carer 3: D-31, A-5, and S-11
DISCUSSION
The graphs above show the data obtained for the three individual carers participating within the group. This allowed us to see the comparison of participant scores at week 1 and again at week 6. The changes observed in carers 1 & 2 from weeks 1 to week 6 were very minimal; a one-point increase was noted in the depression scale for both these carers, however, this was within ‘normal’ range. A three-point reduction in carer 1 and 2’s stress levels also occurred. For the anxiety scale, carer 1 stayed the same at 1, whilst carer 2 showed a one-point reduction showing that they did not feeling anxious at all. These results proved that to some degree, these two carers did indeed benefit from the support group.
The only carer whose DASS scores did show the most dramatic and noticeable changes was carer 3. As you can see, their depression score had increased by 29 points to 31 indicating that this was extremely severe. Carer 3’s score for anxiety had stayed the same, whilst the stress levels had halved to 11, yet, these two scores still fell within the ‘normal range’. It is therefore suggested that the overall results obtained for carer 3 weren’t felt to give a true indication of how this individual was after the 6-week group had concluded. This could be due to a number of reason, namely; the DASS was not administered on the final day (week 6), but instead this was done some four weeks later at the first review.
Practice Summary
INTRODUCTION
The Cosmos group held at the Cosmos Centre in St Andrews is a 6-8 week programme offering support and education to both the Client with dementia and their partner/carer.
Practice Detail
The Group was set up following several discussions between Dr Gary Stevenson (Consultant for Old Age Psychiatry) and Dr Tracy Ryan (SpR to Dr Stevenson) regarding some of their clients who had been recently diagnosed with dementia (early stages). The idea was to provide a service to both parties, which looked at them venting their feeling and frustrations but at the same time offering them a support network. Dr’s Stevenson and Ryan believed that there was a lack of service provision out there for people in this situation, therefore, felt that a group of this nature would be most beneficial.
Certain criteria had to be met before anyone was referred i.e.
• MMSE 20
• Sociable (communication important)
• Newly diagnosed
• Should have a carer
• Have to be physically mobile (due to stairs at Cosmos Centre)
Referrals were sent directly to Dr Ryan who then disseminated them accordingly. A total of six couple were referred, with only four actually willing to partake. Due to bereavement, numbers reduced further to just three couple attending.
An Occupational Therapist, a CPN, a Psychologist and a member of staff from Alzheimer’s Scotland facilitated the group. Cares and client were separated into their respective groups with OT and Psychology working with the clients and CPN and Alzheimer’s working with the carer.
OUTCOME MEASURE
The outcome measure used was the Depression Anxiety Stress Scale (DASS). The DASS is a 42-item self-report measure of anxiety, depression and Stress developed by Lovibond and Lovibond (1995), which is increasingly used in diverse settings. The DASS consists of three self-report scales containing statements to which the carer indicates the degree of distress experienced. It is designed to measure the negative emotional state of depression, anxiety and stress. Each of the three DASS scales contains 14 items, divided into subscales of 2-5 items with similar content........
For full text please contact contributor.