Development and validation of an instrument to detect depression in nursing homes. Nursing homes short depression inventory (NH-SDI).

ABSTRACT

UNLABELLED Depression is often overlooked in elderly nursing home residents because symptoms may be masked or dismissed as an inevitable consequence of ageing. Current tools for the detection of depression in institutionalised older people are not always specific. AIMS: To construct and verify an instrument with which to detect depression in elderly nursing home residents (NH-SDI). METHOD: Firstly for the construction, 328 elderly people were selected at random from the residents of 17 nursing homes in France, and examined by a single investigator. The examination included a psychiatric assessment, an evaluation of cognitive function using the MMSE, an evaluation of depressive state using four different instruments (mini-GDS, Goldberg, DMAS, CSDD), and assessment of any changes in behaviour in those suffering from dementia, using the NPI. A second stage was to confirm NH-SDI in 99 institutionalised subjects. RESULTS: Following the selection of items, we created a scale of 16 dichotomous items (NH-SDI). The internal consistency was satisfactory (α Cronbach = 0.85), as was its reliability with a sensitivity of 85.1% and a specificity of 86.5% for a cut-off score above 5. CONCLUSIONS: The NH-SDI appears to be a useful instrument for the detection of depression in nursing homes and can easily be applied by healthcare staff as part of routine procedures.