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The global ageing population faces rising depression rates due to social, economic, and health changes. Depression in older adults, often linked to isolation and health issues, requires comprehensive care. Psychotherapeutic interventions could be effective in reducing symptoms, offering personalized and holistic support. Particularly low-threshold interventions, such as those offered in community-dwelling older adults, which older adults can easily access and which may reduce stigma, promise to close the treatment gap. This review examines community-based psychotherapeutic interventions for older adults with depression. Methods: This review investigates psychotherapeutic interventions for reducing depressive symptoms in older adults in a community setting. RCTs were assessed using Joanna Briggs Institute tools. The following databases were searched: CINAHL Plus with Full Text, MedicLatina, MEDLINE with Full Text, and the Psychology and Behavioral Sciences Collection. Results: A meta-analysis of 13 studies with 1528 participants showed a medium, significant pooled effect size at post-intervention (Hedges' g = −0.36, p < 0.001) and substantial heterogeneity. Follow-up analysis of studies indicated a small, non-significant effect (Hedges' g = −0.17, p = 0.27). Group interventions, particularly the "reminiscence protocol", had the largest significant effect. Discussion: This systematic review and meta-analysis found that in community-dwelling older adults' group psychotherapeutic interventions, particularly the "reminiscence protocol" and "modified behavioral activation treatment" are most effective for reducing depressive symptoms. Individual psychotherapeutic interventions like "prevention of suicide in primary care elderly" and "behavioral activation" also show effectiveness, with group psychotherapeutic interventions being generally more effective than when these treatments are offered in individual psychotherapeutic interventions. Conclusion: Group and individual psychotherapeutic interventions reduce depressive symptoms in community-dwelling older adults, with group psychotherapeutic interventions being more effective. [ABSTRACT FROM AUTHOR]

Background: The increasing number of institutionalized older individuals worldwide stresses the need to evaluate the association between the functional profile of institutionalized older adults and their quality of life (QoL), depressive symptoms and feelings of loneliness. Methods: A cross-sectional study was conducted in 19 residential facilities in Alentejo, Portugal. Between March and September 2023, all individuals aged ≥65 years were invited to complete a structured questionnaire (n = 1303). Sociodemographic and clinical data were collected, and validated scales for the Portuguese older population were used. Linear regression and unconditional binary logistic models were computed. Results: The highest level of dependence was observed in the self-care dimension (mean (SD) = 2.93 (1.21)), with 40% of participants exhibiting levels of dependence requiring daily care or total replacement. QoL was inversely associated with functionality in all dimensions, as well as with severe or complete dependence, even after adjusting for sex, age and education. Participants with depressive symptoms and feelings of loneliness were, respectively, three and two times more likely to be dependent on care (adjusted OR = 3.69, 95% CI: 1.80–7.52; adjusted OR = 2.04, 95% CI: 1.07–3.87). Conclusions: Public policies and interventions should include social and emotional support strategies alongside traditional medical interventions. [ABSTRACT FROM AUTHOR]

Background: Europe's aging population presents challenges such as a shrinking labor force, pressure on health services, and increased demand for long-term care. This study assesses the functional profile, depressive symptoms, and quality of life of older adults in the Central Alentejo region of Portugal. Methods: A cross-sectional, descriptive study was conducted with a convenience sample of 868 older adults in Portuguese long-term care facilities across the Évora district. A structured questionnaire collected sociodemographic data, elderly nursing core set patient information, a health questionnaire with nine responses, and WHO Quality of Life Assessment (short version) scores. Results: Nearly half of the participants needed assistance with care. Women (OR = 1.46) and those with cognitive impairment (OR = 10.83) had higher impaired functionality, while education (OR = 0.52) and being overweight (OR = 0.52) were inversely related to functional dependence. Quality of life scores ranged from 56.4 (physical) to 66.6 (environmental). Moderate depressive symptoms were found in 17.1% of participants, with 9% having moderately severe to severe symptoms. Higher dependence doubled the likelihood of depressive symptoms (OR = 2.18). Discussion and Conclusions: High rates of depression and functional dependence correlate with a low perception of quality of life, highlighting the need for research to promote and protect the health of older adults. [ABSTRACT FROM AUTHOR]

Background/Objectives: Mental disorders in nursing students, although very common under normal circumstances, have worsened over time due to the COVID-19 pandemic. This study aimed to assess (1) what the prevalence of anxiety and depression symptoms in Italian nursing students was and (2) what factors were associated with them. Methods: In May 2023, a cross-sectional study was conducted on the bachelor's degree Nursing course in an Italian university. Levels of anxiety and stress were assessed using the Generalized Anxiety Disorder Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), respectively. In addition, socio-demographic variables and data on mental health, drug intake, and substance use were collected. Multiple binary logistic regression adjusted analyses were used to identify predictive factors. Results: A total of 148 nursing students completed the questionnaire. A total of 9.5% reported a previous diagnosis of a mental disorder, and, of these, 35.7% reported that it was diagnosed after the start of the COVID-19 pandemic. The mean GAD-7 and PHQ-9 score was 9.68 (SD = 5.2) and 8.37 (SD = 5.6), respectively. Protective factors for depressive symptoms included not having a previous diagnosis of a mental disorder (adjusted odds ratio = 0.10, 95% CI: 0.002–0.47, p < 0.001) and a perceived high (adjusted odds ratio = 0.03, 95% CI: 0.003–0.22 p < 0.001) or medium (adjusted odds ratio = 0.14, 95% CI: 0.03–0.82, p < 0.05) socioeconomic level, while the predictor of anxiety symptoms was returning home once a month for students studying away from their residence (adjusted odds ratio = 6.4, 95% CI: 1.01–40.8, p < 0.05). Conclusions: Urgent investments are needed in universities to implement mental health promotion programmes and to offer counselling services to reduce and prevent mental health problems among students. [ABSTRACT FROM AUTHOR]

The aim of the study is to assess the psychometric properties of the Portuguese version of the 18-items Dysfunctional Attitudes Scale (Form B) in a Portuguese sample of people aged 60 and over. Background: The 18-item Dysfunctional Attitudes Scale (Form B) is an instrument for assessing dysfunctional attitudes and can be useful as a predictor of depression for both initial episodes and relapses Methods: This was a one-stage cross-sectional survey of Portuguese-speaking people aged 60 years and over, able to read and write, functionally autonomous, and living in the community in their usual residences. The instrument was evaluated for its psychometric properties. Convergent validity with the Beck Depression Inventory-II was assessed. Results: The Portuguese version of the 18-item Dysfunctional Attitudes Scale (Form B) was structured into three factors, which explained a total of 58.95% of the total variance of the instrument. The exploratory factor analysis resulted in a modified model in which three factors were obtained with an eigenvalue greater than one (Kaiser's criterion). Three factors were obtained instead of two as in the original study. It showed an internal consistency (Cronbach's alpha = 0.770) and an interclass correlation coefficient ranging from 0.166 to 0.449, and the overall convergent validity with the Beck Depression Inventory-II was considered good; Conclusions: The Portuguese version of the Dysfunctional Attitudes Scale (DAS-18B) of people aged 60 and over demonstrated good psychometric properties. [ABSTRACT FROM AUTHOR]

Background: Delivering bad news is a sensitive and challenging aspect of nursing healthcare, requiring a holistic approach that respects patients' preferences, cultural values, and religious beliefs to promote adaptation to the person's state of health. Aim: We aim to map the evidence of the dimensions present in the communication and management of bad news by nurses to a person in a palliative situation, their caregivers, and their family members. Methods: Based on the Joanna Briggs Institute methodology, the search was conducted through MEDLINE Complete (EBSCOhost), CINAHL Complete (EBSCOhost), SciELO, and the Open Access Scientific Repository in Portugal. From a total of 756 articles, 14 were included, published between 2018 and 2023. Results: Structure components in bad news are influenced by the characteristics of the palliative patients, their caregivers, their family members, the nurses, and the organizational environment. Promoting the quality of the communication process is desirable through continuous and advanced training in end-of-life care, training in bad news, religiously and culturally sensitive nursing interventions centered on hope and maintaining faith, emotional management, and the utilization of a checklist protocol. Conclusions: Honest communication allows people to actively participate in the decision-making process and in the trajectory of the care plan that is focused on themselves and their preferences, which has outcomes in functional capacities and readaptation. [ABSTRACT FROM AUTHOR]

Cognitive restructuring (CR) aims to get people to challenge and modify their cognitive distortions, generating alternative, more adaptive thoughts. Behavioral, emotional, and physiological responses are modified by analyzing and changing dysfunctional thoughts. The person must have the cognitive capacity to participate in the analysis of their thoughts. CR for people with depression has positive effects, although there is little research on how it should be structured and applied. CR is a thought modification technique presented in the Nursing Interventions Classification (NIC), but is not organized in a sequential approach, and there is no procedure for applying it in practice. This scoping review aims to identify the structure, contents and assessment instruments used in CR for people with depressive symptoms and to analyze the health outcomes of applying the CR technique in this population. Out of 515 articles, seven studies were included in the review, up to 2021 and without any time limitation. The studies were not guided by a consistent and sound framework of the CR technique and each study used its own framework, although they used similar techniques. We grouped CR into six steps. No specific studies were found regarding intervention by nurses. CR is effective in reducing depressive symptoms, so it is an important therapeutic tool that should be used on people with depression. With this scoping review, mental health nurses will have a more comprehensive idea of the techniques that can be used in the application of CR to patients with depressive symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Literacy of health professionals on patient safety aims to prevent and reduce risks and adverse events in healthcare. Objective: The objective of this study was to translate, adapt, and validate for Portugal of the World Health Organization Questionnaire to Assess the Implementation of the Multiprofessional Guide. Methodology: Following the cultural adaptation process, we carried out a psychometric analysis on a sample of 300 health professionals. The scale was tested for apparent and content validity. Psychometric properties were assessed using Cronbach's alpha coefficient (α) through exploratory and confirmatory factor analysis, convergent validity, and discriminant validity. Results: Exploratory factor analysis led to a tetra factor structure that accounted for 43.0% of the variance and had an overall alpha of 0.759. The hypothesized structure was submitted to confirmatory factor analysis, and the following items were eliminated from factors 1, 2, and 3 and the respective items: 7; 5; and 3, 4, 5, and 6, due to multicollinearity problems. Overall good-of-fit indexes are reliable. Conclusions: The "KIT TOOL-S2 TEXT" scale presents a factor structure with satisfactory validity and reliability results, adequately representing the constructs in question. [ABSTRACT FROM AUTHOR]

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 (p < 0.05) 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 (p < 0.05). Moreover, participants who believed they had experienced moral or sexual harassment displayed higher levels of anxiety and depressive symptoms (p < 0.001). 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. [ABSTRACT FROM AUTHOR]

Introduction: Depression is one of the most common psychological disorders in later life. Although psychological interventions are recommended by treatment guidelines, most older adults with depression remain untreated. The aim of this study is to evaluate the efficacy of the Portuguese version of Metacognitive Training for Depression in later life (MCT-Silver). Methods: This is a study protocol of an observer-blind, parallel-group, randomized controlled trial to compare the efficacy of MCT-Silver with a treatment as usual (TAU) control group among older adults (age 65 years and older) with depressive symptoms according to the Montgomery-Asberg Depression Scale. Participants will be tested at three assessment time points (baseline, immediately following the intervention [8 weeks], and 3 months after the intervention). The primary outcome is change in self-rated depression symptoms assessed by the Beck Depression Inventory (BDI-II). Secondary outcomes include clinician-rated depression, self-esteem, dysfunctional beliefs, metacognitive beliefs, ruminations, attitudes toward aging and quality of life. A self-designed subjective appraisal rating scale consisting of 21-items will be used to assess participant acceptance of MCT-Silver. Discussion: MCT-Silver is an innovative intervention, which aims to reduce dysfunctional thoughts as well as depression-related behaviors and coping strategies through the metacognitive perspective. Until now, the training has only been tested in Germany. It is expected that after 8 weeks of treatment and 3 months later, the experimental group will demonstrate significant reductions in depressive symptoms, metacognitive beliefs, dysfunctional attitudes and ruminative responses compared to the TAU group. Moreover, quality of life, selfesteem, and attitudes towards aging will be significantly improved in MCT-Silver compared to the TAU group. [ABSTRACT FROM AUTHOR]