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Discuss about the Advantages and Limitations of Internet Interventions.

Evaluation of research

As per the Andersson & Titov (2014), mental health and especially depression is one of the major concerns for the healthcare authorities of Australia as in 2 in every 4 people is suffering from depression, anxiety and other mental health conditions nowadays. Therefore, this research question was chosen to determine the effectiveness of the intervention which is useful in reducing the symptoms related to depression within 2 months of period. In this aspect comparison between usual intervention and problem soling intervention will be carried out.

The primary research article which will be chosen for this aspect is by Stahl et al. (2014). The aim of the research was to conduct a study where problem solving therapy is applied with that of another effective therapy in older patients suffering from depression as the population is generally is resistant to antidepressant drugs (Garand et al., 2014). The research design which was undertaken for this assessment, is the two site randomized controlled trial and the selected population were people with 60 years and above and they were randomly assigned to a usual intervention and the problem solving intervention and they were assessed in week 3,6,9 and 12. In this research from 653 participants only 221 were selected for the analysis as they met the inclusion criteria and hence, on them the selected interventions were carried out (Cuijpers et al., 2014). After the research it was found that maximum rate of remission was achieved in the week 9 and 12 in the group on which problem solving intervention was carried out and the rate was 36.9% in week 9 and 45.6 % in week 12. The researchers followed the ethical consideration while conducting the research as they maintained the anonymity of the randomized control trail and eliminated the manual bias from the research process (Cuijpers et al., 2014). Besides the finding section of the article successfully summarized the complete research process and associated results in the section. Therefore, the paper successfully included each aspect of the primary research (Choi et al., 2014).

This systematic review paper deals with the problem solving intervention for the depression affected individual and hence, it is important to discuss the effectiveness of the problem solving intervention for depression and anxiety management. The research topic deals with the problem solving therapy and its effectiveness in helping people with mental illness (van der Aa et al., 2014). As per Keefe et al. (2014), t is a well-established and an evidence based intervention that helps people to get effective treatment and care as the primary target of the intervention is the anxiety and comorbid situation. As the research topic is comparison between a usual healthcare intervention and the problem solving interventions for patients affected with depression in controlling and managing the depression condition, Garand et al. (2014) mentions that this intervention is helpful in managing the patient condition than cognitive behavioral or pharmacological interventions as it helps to remove the doubts and concerns of patients.

Literature review

The problem solving session could have been of any format such as questionnaire or booklet using which people of the old age can understand use them to share their distress and tension with healthcare professionals around them (Keefe et al., 2014). Therefore, it provides an easy way to communicate the depression and stress to healthcare professionals, which the other healthcare professionals cannot provide to the patients. Further, in this intervention, it is easier to assess the patient improvement or any further scope of improvement, which is not possible for other healthcare or mental interventions for people affected with depression. Hence, this intervention was used as a research question for this assessment (Andersson & Titov, 2014).

In this literature review section, the three articles selected as the evidences to find the answer to the research question will be critically discussed with reference of other literatures (van der Aa et al., 2013). In this context it should be mentioned that there is very few evidences available over internet regarding the comparison study between the usual intervention and problem solving interventions for depression and hence, these three articles were selected for the literature review, having two randomized control trial related study and a comparative study so that the authenticity and reliability of the literature review could be increased (Garand et al., 2014).

The first article is by researchers Stahl et al. (2014), who aimed to find the effect of problem  solving interventions in increasing the participants ability to take part in their diet preparation session after being aware of the problem solving session (Moyer, 2013). Hence, the patients were more than 60 years of age and took part in the randomized control trial. For this process the researchers finalized more than 8 healthcare facilities with 18 primary care clinics and selected more than 1800 patients with age 60 and above to take part in the research (Stahl et al, 2014). The interventions they compare for patients was the problem solving therapy and a pharmacological therapy or medication such as antidepressant to make the patient condition better. It was found from the research that with diet management intervention was determined to the patients to improve their depression and pain management (Cuijpers et al., 2014).

The second research was conducted by Reynolds et al. (2014) in which the researchers aimed to find out the effect of this intervention on patients who are back and white or of various ethnicity and for this purpose, they conducted the study on 153 white patients and 90 black patients who were selected from 653 people and took part in the randomized control trail and implemented intervention on them for 12 weeks. As the assessment was carried 3, 6 9 and 12th week, it was found that patients undergoing problem solving intervention in 9th and 12th week were able to show maximum remission and hence, determined the effectiveness of the intervention (Moyer, 2013). This result was effective as the patients who were provided with the intervention was resistant to anti-depressants and problem solving intervention was the only intervention that could have been employed in those patients. Hence, it was compared with such pharmacological intervention and provided a positive result as remission of 20% depression using the intervention was a big achievement for the researchers (Reynolds et al., 2014).

Recommendations for future research

The third research article chosen for this literature review was by the Choi et al. (2014) and the primary aim of this research was to find out the comparative result between two therapies such as the problem solving therapy and the reminiscence therapy while treating depression condition in older adults, who are homebound with age 60 and above. In this research the participants were assigned to these two interventions randomly and a control group with no implemented intervention was kept to compare the effectiveness of the intervention (Choi et al., 2014). The participants were first assessed for their pre-treatment and then after implementation of the intervention the follow up was taken after three months and after the complete research it was found that group who was having problem solving intervention as their depression management therapy shown maximum rate of remission from their chronic depression condition as compared to the control group (Cuijpers et al., 2014). Whereas, the group receiving the reminiscence therapy also shown growth in the depression condition however, the rate was quite lower than that of the problem solving intervention. Therefore, this lietarture review was able to provide justified answer to the research question (Reynolds et al., 2014).

The future research should assess the scope of amalgamation of healthcare interventions for primary and secondary health condition as using this the patient condition could be improved quickly. In the research by Stahl et al. (2014) patients of were affected with depression as well as a secondary health condition and hence, researchers had to leave one of the health condition untreated because it could affect the other health condition The second thing which could be recommended from the detailed study of these literature that the researchers should focus on the pattern of remission so that interventions could be designed as per the pattern and mode of remission to make it more easier and accessible to reach.

References

Andersson, G., & Titov, N. (2014). Advantages and limitations of Internet?based interventions for common mental disorders. World Psychiatry, 13(1), 4-11.

Choi, N. G., Marti, C. N., Bruce, M. L., Hegel, M. T., Wilson, N. L., & Kunik, M. E. (2014). Six?month postintervention depression and disability outcomes of in?home telehealth problem?solving therapy for depressed, low?income homebound older adults. Depression and anxiety, 31(8), 653-661.

Cuijpers, P., Karyotaki, E., Pot, A. M., Park, M., & Reynolds III, C. F. (2014). Managing depression in older age: psychological interventions. Maturitas, 79(2), 160-169.

Garand, L., Rinaldo, D. E., Alberth, M. M., Delany, J., Beasock, S. L., Lopez, O. L., ... & Dew, M. A. (2014). Effects of problem solving therapy on mental health outcomes in family caregivers of persons with a new diagnosis of mild cognitive impairment or early dementia: a randomized controlled trial. The American Journal of Geriatric Psychiatry, 22(8), 771-781.

Keefe, F. J., Porter, L., Somers, T., Shelby, R., & Wren, A. V. (2013). Psychosocial interventions for managing pain in older adults: outcomes and clinical implications. British journal of anaesthesia, 111(1), 89-94.

Moyer, V. A. (2013). Screening for intimate partner violence and abuse of elderly and vulnerable adults: US preventive services task force recommendation statement. Annals of internal medicine, 158(6), 478-486.

Reynolds III, C. F., Thomas, S. B., Morse, J. Q., Anderson, S. J., Albert, S., Dew, M. A., ... & Stack, J. A. (2014). Early intervention to preempt major depression among older black and white adults. Psychiatric services, 65(6), 765-773.

Stahl, S. T., Albert, S. M., Dew, M. A., Lockovich, M. H., & Reynolds III, C. F. (2014). Coaching in healthy dietary practices in at-risk older adults: a case of indicated depression prevention. American Journal of Psychiatry, 171(5), 499-505.

van der Aa, H. P., Van Rens, G. H., Comijs, H. C., Bosmans, J. E., Margrain, T. H., & van Nispen, R. M. (2013). Stepped-care to prevent depression and anxiety in visually impaired older adults–design of a randomised controlled trial. BMC psychiatry, 13(1), 209.

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