The effectiveness of the Program to Enhance Adjustment to Residential Living (PEARL) in reducing depression in newly admitted nursing home residents
Open accessAbstract
Background Depression is common in nursing homes, particularly among newly admitted residents. This cluster randomised controlled trial evaluated the effectiveness of the Program to Enhance Adjustment to Residential Living (PEARL) in reducing depression in this group. Methods Participants were 219 newly-admitted residents (mean of 4.4 weeks since admission) in 42 nursing homes in Melbourne, Australia, with a mean age of 85.5 years (SD = 7.3). Nursing homes were randomly allocated to the intervention or standard care condition. Level of depressive symptoms was evaluated at baseline (T1), one week post- intervention (T2), 2 months post-intervention (T3, primary end point), and 6 months post-intervention (T4). Changes in depressive symptoms in the intervention and control groups over time were compared using a multilevel model, with nursing homes modelled as random intercept. Results In intention to treat analyses, depressive symptoms reduced from T1 to T3 to a greater degree in the intervention condition (M change =2.56, SD change =5.71) than in the control (M change =0.63, SD change =5.25), with a significant, small-medium treatment effect size (p=.035; Cohen's d=0.36). The reduction in depressive symptoms from T1 to T4 was not significant (p=.369; Cohen's d=0.32). Limitations The findings require replication, particularly comparing PEARL with an active control condition. Conclusions PEARL is a simple, brief program that was effective in reducing symptoms of depression in newl…
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Depression appears to increase the risk of admission to long-term residential care and is often present at entry to care.
“Depression appears to increase the risk of admission to longterm residential care and is o en present at the point of entry to care (Achterberg 2006;Boyle 2004;Davison 2021a;Dorenlot 2005;Hajek 2015; Ulbricht 2017).”
From Psychological therapies for depression in older adults residing in long-term care settings (2024) · cites this paper as Davison 2021a
Several longitudinal studies in long-term care settings have reported persistence of depressive symptoms.
“The persistence of depressive symptoms has been reported in several longitudinal studies in LTC settings (Barca 2010;Davison 2021a;Smalbrugge 2006;Sutcliffe 2007).”
From Psychological therapies for depression in older adults residing in long-term care settings (2024) · cites this paper as Davison 2021a
No eligible studies focused on reducing depression in newly admitted residents, so the effectiveness of psychological therapies for this group remains unknown.
“No eligible studies focused on reducing depression in newly admitted residents (e.g.those who had been residing in a facility for less than six months), despite the challenges of relocation to an LTC facility (Brownie 2014), and high rates of depression in newly admitted residents (Davison 2021a), and the effectiveness of psychological therapies for this group remains unknown.”
From Psychological therapies for depression in older adults residing in long-term care settings (2024) · cites this paper as Davison 2021a
The review team used an ICC of 0.03 for cluster-RCTs because none reported an ICC and estimates from other cluster-RCTs of depression interventions in LTC suggested this value, consistent with typical values lower than 0.05.
“We decided to use an ICC of 0.03, based on estimates from other cluster-RCTs of interventions to reduce symptoms of depression in LTC (Davison 2021b; Underwood 2013).”
From Psychological therapies for depression in older adults residing in long-term care settings (2024) · cites this paper as Davison 2021b
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References 46 · Cited by 10
- Authors
- Davison, T. E., McCabe, M. P., Busija, L., Graham, A., Camões-Costa, V., Kelly, J., & Byers, J.
- Affiliations
- Swinburne University of Technology (AU)
- Corresponding author
- Davison, Tanya E.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 282
- Pages
- 1067-1075
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W3114113387
- Cited by
- 10
- References
- 46
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 2
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Swinburne figshare (Swinburne University of Technology) (acceptedVersion, cc-by-nc-nd)
- Victoria University Research Repository (Victoria University) (submittedVersion)
- Figshare (submittedVersion, cc-by-nc-nd)
- Swinburne figshare (Swinburne University of Technology)
- Funders
- National Health and Medical Research Council (APP1102997)
- Topics
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- depression, nursing home residents, newly admitted residents, pearls, residential adjustment, older adults, depressive symptoms, intervention effectiveness, long-term care
- MeSH terms
- Aged, Aged, 80 and over, Australia, Depression, Homes for the Aged, Hospitalization, Humans, Nursing Homes
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