Background: Depression affected 5.7% of people aged 60 years and over prior to the pandemic and has increased by approximately 28%. The aim of this study is to identify and describe factors associated with depressive symptoms, the diagnostic assessment instruments and interventions used to evaluate and treat depression in adults aged 60 years and older since the onset of the COVID‐19 pandemic. Methods: Four electronic databases were systematically searched to identify eligible studies published since the beginning of the COVID‐19 pandemic. A total of 832 articles were screened, of which 53 met the inclusion criteria. Results: Factors contributing to depressive symptoms in older adults prior to the pandemic were grouped into the following categories: sociodemographic characteristics (i.e., being female); loneliness and weak social support; limitations in daily functioning, physical activity and neurocognitive impairment; and clinical factors. The following groups of factors directly related to the pandemic were found: stress‐related factors and feelings or worries related to the pandemic; information access (e.g., receiving news about COVID‐19 through the media); factors directly related to COVID‐19 (e.g., having infected acquaintances); and factors related to the measures that were taken to reduce the spread of COVID‐19 (e.g., confinement measures). The most frequently used instrument to assess depressive symptoms was the Geriatric Depression Scale Short Form (GDS‐SF). Four studies implemented interventions during the pandemic that led to significant reductions in depressive symptoms and feelings of loneliness. Conclusions: Improved understanding of pandemic‐associated risk factors for depression can inform person‐cantered care. It is important continued mental healthcare for depression for older adults throughout crises, such as the COVID‐19 pandemic. Remote delivery of mental healthcare represents an important alternative during such times. It is crucial to address depression in older adults (which often causes disability), since the pandemic situation has increased depressive symptoms in this population.
People have specific and unique individual and contextual characteristics, so healthcare should increasingly opt for person-centered care models. Thus, this review aimed to identify and synthesize the indicators for the care process of the person with depression and/or anxiety disorders, based on patient-centered care, going through the stages of diagnostic assessment and care planning, including intervention. An integrative literature review with research in seven scientific databases and a narrative analysis were carried out. Twenty articles were included, with indicators for diagnostic evaluation and care/intervention planning being extracted. Care planning focused on people with depression and/or anxiety disorder must be individualized, dynamic, flexible, andparticipatory. It must respond to the specific needs of the person, contemplating the identification of problems, the establishment of individual objectives, shared decision making, information and education, systematic feedback, and case management, and it should meet the patient’s preferences and satisfaction with care and involve the family and therapeutic management in care. The existence of comorbidities reinforces the importance of flexible and individualized care planning in order to respond to the specific health conditions of each person.
The COVID-19 pandemic has contributed to mental health problems worldwide. Nurses are particularly prone to stress because they directly care for individuals with suspected or confirmed cases of COVID-19. The aims of this study were (a) to explore the association between the mental health promotion strategies used by nurses during the COVID-19 outbreak and their symptoms of depression, anxiety, and stress; (b) to compare the symptoms of depression, anxiety, and stress of mental health nurses to those of non-mental health nurses; and (c) to compare the frequency of use of mental health strategies of mental health nurses to those of non-mental health nurses. A cross-sectional study was conducted with a sample of 821 nurses. Univariate and multivariate regression models were developed to identify potential protective factors of depression, anxiety, and stress. The chi-square test was also used to compare the use of strategies among mental health and non-mental health nurses. Portuguese nurses demonstrated high symptoms of depressive symptoms, stress, and anxiety. Healthy eating, physical activity, rest between shifts, maintaining social contacts, verbalizing feelings/emotions, and spending less time searching for information about COVID-19 were associated with better mental health. Mental health nurses had less depression, anxiety, and stress, and used more strategies to promote mental health than other nurses. We consider it important to promote nurses’ mental health literacy by encouraging them to develop skills and strategies aimed at improving their resilience and ability to deal with difficult situations while caring for the population.
A core set of International Classification of Functioning, Disability and Health codes was used to ascertain general profiles of functionality as a function of biological and sociodemographic characteristics and to develop structured nursing interventions in accordance with self care deficits identified by studying self care behavior for elderly people living in both extensively and sparsely populated rural areas. Data were collected by health professionals in the participants’ houses. An exploratory factor analysis enabled reduced data dimensions, and factorial validity was assessed by a confirmatory factor analysis. An ordinal regression model was built to identify general profiles of functionality as a function of age. A bar graph was used as a measurement tool for nursing care needs as a function of self care behavior and functional profile level. No functional problems were expected among people under the age of 74 years, while mild functionality problems were expected among people older than 74 years. Regarding nursing care needs, the results of the constructed model suggested that the functional concept “Support and Relationships” is associated with higher levels of functional problems and thus a greater need for self care interventions and that people aged 85 years and older always show therapeutic self care deficits.
Background. The mental health of university students has worsened over time, and it is young people who have suffered the most from the COVID-19 pandemic in terms of mental health. Anxiety and depression are the most common symptoms reported by university students and are often the cause of disabilities, either in academic performance or in other spheres of life. Aim. The aim of this study was to both assess the prevalence of depressive and anxiety symptoms in Portuguese university students and analyze the factors associated with these symptoms. Methods. A quantitative cross-sectional study with a sample of 3,399 university students from seven Portuguese higher education institutions was conducted. The following questionnaires were used: the generalized anxiety disorder assessment scale (GAD-7), the patient health questionnaire (PHQ-9), and a study-created sociodemographic questionnaire. The Kendall correlation coefficient, chi-square test of independence, Spearman correlation coefficient, Shapiro-Wilk test, Mann–Whitney-Wilcoxon test, and Kruskall-Wallis test were used to analyze the association between variables. The statistical analysis was done using the software R Statistics (Version 4.0.4), using a significance level of 0.05. Results. Mild to severe anxiety symptoms were reported by 75% of the participants, and 61.2% described mild to severe depressive symptoms. Of the sample, 19.5% reported a previous diagnosis of a mental disorder, with 38.7% diagnosed after the pandemic began. Additionally, 23% reported taking medication for mental health issues, and 26.7% had considered self-harm or harbored thoughts of being “better off dead.” The study found lower anxiety and depressive symptoms ( ) among men, students with higher socioeconomic status, those who frequently traveled home, individuals without prior mental health diagnoses, those with better academic performance, and those who avoided substances like coffee, tobacco, cannabis, and other illegal psychoactive substances. Interestingly, students in romantic relationships exhibited more anxiety symptoms ( ). Moreover, participants who believed they had experienced moral or sexual harassment displayed higher levels of anxiety and depressive symptoms ( ). Conclusions. There was a decrease in the mental health of university students after the pandemic compared to prepandemic studies, and the proportion of students with anxiety and depressive symptoms was alarming. There is an urgent need to implement programs in universities to promote students’ mental health.
About Me
César Fonseca has a Ph.D. in Nursing from the University of Lisbon, a Master's degree in Health Communication from the Open University, and a Postgraduate Specialization in Rehabilitation Nursing from the School of Health of the Portuguese Red Cross. He was Coordinator of the Clinical Research Center, Centro Hospitalar Lisboa Norte, and a Nurse in the same Hospital Center. He is currently an Adjunct Professor at the Nursing School São João de Deus, University of Évora, and a PhD Integrated Researcher at the Comprehensive Health Research Center, with excellent classification. He has clinical experience in the area of general and specialized rehabilitation nursing care, and has developed the following thematic areas: evidence-based practice, clinical decision making, clinical guidance standards, care needs assessment instruments, International Classification of Functioning, Pain Control and Eradication, reflection of clinical practices, organizational management of social equipment for the elderly, and long-term care health indicators and policies.
César Fonseca has a Ph.D. in Nursing from the University of Lisbon, a Master's degree in Health Communication from the Open University, and a Postgraduate Specialization in Rehabilitation Nursing from the School of Health of the Portuguese Red Cross. He was Coordinator of the Clinical Research Center, Centro Hospitalar Lisboa Norte, and a Nurse in the same Hospital Center. He is currently an Adjunct Professor at the Nursing School São João de Deus, University of Évora, and a PhD Integrated Researcher at the Comprehensive Health Research Center, with excellent classification. He has clinical experience in the area of general and specialized rehabilitation nursing care, and has developed the following thematic areas: evidence-based practice, clinical decision making, clinical guidance standards, care needs assessment instruments, International Classification of Functioning, Pain Control and Eradication, reflection of clinical practices, organizational management of social equipment for the elderly, and long-term care health indicators and policies.