7.5.2 Involving older people in psychotherapy research - is age an issue? A reflective case study (396)

Claire Merritt, Community Psychiatric Nurse/Research Nurse, Ridgeway CMHT for Older adults, Oxfordshire & Buckinghamshire Mental Health NHS Trust, Oxon, United Kingdom claire.merritt@hotmail.co.uk

Abstract:

Background:

Within health care systems firmly rooted within evidence-based health care paradigms, research is playing an increasingly prominent role in informing health care policy and practice. Despite this, older people have gone under-represented within clinical trials.

Aims:

The aims of this study were to investigate ways in which age may be a factor which influences the involvement of older people in research. There was a particular emphasis on RCT’s, which investigate the efficacy of psychotherapy in the treatment of depression in late life.

Methods:

This study used a case study approach to ask: 1. What is the evidence that older people are under-represented within psychotherapy RCT’s? 2. Is there evidence to support claims that the under-representation of older people in research is an example of age discriminatory practices, or are there ageing-dependent factors which need to be taken into consideration within the design of research? Quantitative data, in the form of documentary evidence, was evaluated qualitatively, within a reflective framework (Borton, 1970).

Findings:

This paper will present data which supports claims that older people are under-represented within psychotherapy RCT’s. Arguments are put forward to suggest that, whilst there may be ageing-dependent factors to account for this, the empirical validity of these can be challenged. Discussion Evidence from this investigation would suggest that decisions made within the research process would appear to be largely based on chronological age, which is no measure of ability or need. This, it is argued, makes it difficult to dispute claims that the under-representation of older people in research is an example of age discriminatory practices.

Conclusion:

The paper concludes by suggesting that unless ageism is addressed within research it is difficult to see how a key policy initiative, to root out age discrimination within health care (Department of Health, 2001), can be achieved.

Biography:

As an RMN I have extensive experience of working within the field of Old Age Psychiatry, having worked within a variety of settings. These include In-Patient, Day Hospital, Memory Clinic and Community settings. The paper I am presenting outlines work undertaken for my Master of Science in Geratology dissertation, which I successfully completed in September 2006. At the time of writing this I was employed as a Research Nurse within a psychotherapy RCT, which, with the kind permission of the Chief Investigator, I was able to use as the ‘case’ for my case study. Since this time I have had the opportunity to gain further research experience, working as a research nurse within one of the local Dementia and Neurological Disorders Research Networks (DeNDRoN). This has provided me with an exciting opportunity to gain experience and skills in research, which is an interest of mine and to play a small part in helping to bring research more into the clinical arena.