Research projects

A randomised, controlled, final stage evaluation of the beyondblue depression training program for professional carers

Principal Researchers

Associate Professor David Mellora, Dr Tanya Davisona, Professor Marita McCabea, Dr Kuruvilla Georgeb, Dr Gery Kartantzasa

Institution

a School of Psychology, Deakin University

b Aged Persons’ Mental Health, Eastern Health

Funding

$92,833

Award Type

beyondblue Victorian Centre of Excellence

Project completion year

2009

Project brief

The program was developed in response to previous findings that the recognition rate for late-life depression among aged care recipients is poor.  Poor recognition is associated with a lack of formal training for carers in understanding and responding to depression in their clients.

A pilot study showed that training in depression increases the knowledge and self-efficacy of professional carers working with depressed older people.  Following the pilot study, a randomised controlled trial was performed to determine whether the beyondblue Depression Training Program:

  • increased professional carers’ knowledge about late-life depression
  • improved their skills and self-efficacy in detecting depression among care recipients
  • improved communication with senior staff and medical professionals regarding carers’ observations and the mental health needs of care recipients. 

The participants were 244 professional carers working in either community (53 participants) or residential care (191 participants).  They were randomised to the training program or a waitlist group, which then received training after the original group.  A modified version of a questionnaire developed by McCabe, Davison and Mellor (2006) assessed carers’ knowledge about late-life depression, their self-efficacy in detecting signs of depression and their attitudes toward late-life depression before, immediately after and three months after the training period. 

For low-level carers (direct carers and patient care attendants), training consisted of four 90-minute sessions covering the nature of depression in the elderly, how to recognise indicators of depression in older adults, how to respond to care recipients with symptoms of depression and how to refer and manage people with depression on a day-to-day basis. 

An advanced training program for high-level carers (registered nurses and care managers) consisted of two extra sessions and included training in the use of two validated screening tools, liaising with health professionals and implementing treatment strategies.

Key findings

The study found that the beyondblue Depression Training Program was effective in increasing carers’ knowledge of depression, improved self-efficacy in detecting depression, and was effective in reducing the barriers to care at both post-test and six-month follow-ups.

Direct carers and personal care assistants who completed the training program:

  • had a significant increase in knowledge about depression, which declined to below baseline at three months follow-up
  • had a significant increase in self-efficacy in working with depressed aged care recipients
  • had a significant reduction in negative attitudes towards depression
  • had a significant improvement in attitudes towards working with depressed aged care recipients.

Direct carers and personal care assistants who completed the training program had a non-significant increase in knowledge about depression, but this declined to below baseline at three months follow-up.

Care managers and registered nurses who completed the training program:

  • had a significant increase in knowledge about depression, which declined to below baseline at three months follow-up
  • had a significant increase in self-efficacy in conducting assessments and liaising with health professionals
  • had a significant reduction in negative attitudes towards depression
  • had no change in attitudes towards working with depressed aged care recipients.

There was a substantial drop-out rate over the course of the study.

Implications for policy, practice and further research

Training in depression leads to an initial increase in carers’ knowledge and self-efficacy, but these decline over time.  It is recommended that all professional carers working in aged care should receive training in depression and refresher training sessions.  Further research is required to determine whether this leads to better outcomes for depressed aged care recipients.

References

McCabe MP, Russ S, Mellor D, Davison TE and George K. 2008.  Effectiveness of a training program for carers to recognize depression among older people. International Journal of Geriatric Psychiatry. 23: 1290–1296.

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