Desenvolvimento de um manual de terapia em grupo para prevenção da depressão maior em idosos com sintomas depressivos clinicamente significativos

Abstract

The Major Depressive Disorder (MDD) is associated with a series of losses for older adults as well as their families and for society. There are evidences of pharmacological and psychotherapeutic interventions to treat MDD, but there is a paucity of interventions focused on prevention of MDD in the Brazilian older population. These interventions must be adapted to the specific needs of this population in order to be effective. This study aimed to develop a group therapy manual to prevent MDD in the aged, adapted to the Brazilian population. The manual was developed using an exploratory qualitative methodology, based on the Stage Model for Behavior Intervention Development. In order to structure the intervention manual it was performed a meeting with specialists from Psychology and Psychogeriatrics, considering data acquired from the literature review. A preliminary version of the manual was developed based on data collected from the Thematic Analysis of the transcriptions of this meeting. The perception of health professionals about the viability of implementation of this manual in primary care institutions was later evaluated in a set of meetings. The intervention manual was then refined considering the Thematic Analysis of these meetings. It was found 13 studies with interventions that aimed to prevent MDD in older adults. During the development of the manual`s structure, the experts gave informations that was grouped into four themes: "Selection of interventions and structuring of the manual", "Adaptations of interventions to compose the manual", "Pragmatic aspects of the project" and " Manual construction process". The analysis of meetings with health professionals generated three themes: "Sociocultural Aspects", "Proposed Adaptations" and "Feasibility". From these data was created a manual with ten sessions, with combined therapeutic approaches, for the prevention of depression. Future studies should evaluate the perception of the elderly and the feasibility of this protocol in pilot groups.