Education for Depression
| Author Year Country Research Design PEDro Score Total Sample Size |
Methods | Outcome |
|---|---|---|
| Zemper et al., (2003) USA RCT PEDro=4 NInitial=67 NFinal=43 |
Population: Participants recruited from an outpatient clinic or Center for Independent living. Intervention group was more educated and had fewer retirees despite random assignment. SCI: Mean age=47 yr; Gender: males=30, females=13; Level of injury: paraplegia=42%, tetraplegia=39%, ambulatory=3%; Mean time since injury=14 yr; Marital status: single=28%, married=23%, divorced=8%. Intervention: A series of six 4 hr workshop sessions held over a 3 mo period, promoting health and wellness. Sessions included lifestyle management, physical activity, nutrition, preventing secondary conditions, individual coaching sessions, follow-up phone calls during the 4 mo following the workshops. Controls participated in pre/post assessment but received no intervention. Outcome Measures: Health Promoting Lifestyle Profile II (HPLP II), Secondary Conditions Scale (SCS), Self-rated Abilities for Health Practices Scale (SAHP), Physical Activities with Disabilities Scale (PADS) |
1 . The intervention group showed statistically significant improvement after intervention in several areas as compared to the control group: SAHP: (p<0.05) HPLP-II: (p<0.001). Nutrition HPLP-II subscale: improvement in nutritional awareness and behaviour (p <0.05) Stress HPLP-II subscale: Increased use of stress management techniques and decreases in perceived stress (p=.001). 1. SCS: fewer and less serious secondary conditions (p<0.001) Depression was less though did not reach significance. |
| Federici et al., (2019) Italy Pre-Post N=11 |
Population: Mean age: males=50.4±7.3 yr, females=41.5±11.26 yr; Gender: males=5, females=6; Time since injury=30.1±9.4 yr; Level of injury: tetraplegia=3, paraplegia=4, no paraplegia/tetraplegia=4; Severity of injury: complete=5, incomplete=2, none=4. Intervention: Participants were 4 couples (one with SCI and one without) and 3 singles with SCI who took part in a sexual health psychoeducational intervention in which 4 couples and 3 singles met every two weeks for 12 meetings of a growth group and reported the results of their love lives and persona lives. Outcome Measures: Sexual interest and satisfaction scale (SIS), Beck depression inventory – II (BDI-II) and Beck anxiety inventory (BAI). |
1. All participants improved significantly on item 5 of the SIS scale “How are your opportunity and your ability to enjoy sexuality yourself?” (p<0.01), SIS scale total score (p<0.05) and BAI scores (p<0.05). 2. No difference was found for SIS scale’s general satisfaction after injury or for BDI (p>0.05). 3. Significant effect found on item 5 of the SIS scale “How are your opportunity and your ability to enjoy sexuality yourself?” for both individuals and partners (p<0.05 for both). |
| Dunn et al., (2000) USA PCT NInitial=371 NFinal=371 |
Population: Gender: mixed group-with more males; Mean time since injury=18.44 yr. Intervention: Follow-up after initial rehabilitation was completed addressing the secondary conditions post-SCI as well as the primary effects of their spinal cord injury. The focus is wellness, health promotion, and illness prevention through a continuum of coordinated care. Outcome Measures: Secondary Conditions Scale (SCS); Check Your Health Questionnaire (CYHQ). |
1. An overall difference between the two groups was found (p=0.0004). 2. Medical Follow-up group reported a significantly higher subjective rating than did the No-F/U group on 3 variables: Health (p=0.0068), Independence (p=0.005), Absence of depression (p<0.0001). (Fisher’s protected least significant diff. test). 3. A MANOVA showed a main effect on education on health, independence and absence of depression (p=0.0098). Further analysis showed that as education increased subjects reported greater health, and independence and lower depression. |
Discussion
Three studies evaluated the effect of education program in reducing symptoms of depression post SCI (Dunn et al. 2000; Federici et al. 2019; Zemper et al. 2003). Two programs involved education regarding wellness and health promotion (Dunn et al. 2000; Zemper et al. 2003). Zemper (2003) found no significant improvement in depressive symptoms, while Dunn (2000) found that the intervention resulted in decreased depressive symptoms. Federici et al. (2019) provided sexual health psychoeducation over 12 sessions and found no significant improvement in depressive symptoms.
Conclusion
There is conflicting evidence for the effectiveness of education programs in reducing depressive symptoms post SCI (Dunn et al. 2000; Federici et al. 2019; Zemper et al. 2003).
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