Many patients often struggle with depression, and antidepressant medications are commonly used to treat the condition. However, antidepressants are not the only solution. There is a wide range of therapies that can be provided to patients to decrease their chances of getting depression and/or manage their condition. One such therapy that has gained significant interest in recent years is physical exercise. A wide range of studies has examined the benefits of physical exercise for patients with depression ( Azizan & Justine, 2015, Belvederi et al., 2019; Gerber et al., 2019). However, the majority of these studies focus on patients with depression. There is a limitation of research on the benefits of physical exercises among ordinary patients. This study seeks to determine the effectiveness of physical exercise as a therapy for reducing the incidence of depression among ordinary patients. This includes patients with illnesses other than depression and the aging population.
Search Strategy
A well-detailed search strategy was developed and reviewed properly for the following database: PubMed. The Halle Library was used to conduct the literature search. The search was limited to research studies that were completed between 2015 and 2020. Any study that preceded 2015 was ignored. In addition, the search was limited to clinical trials and randomized clinical trials to ensure only primary research articles are generated. The availability of literature on the use of physical exercises to decrease the incidence of depression among patients necessitated the use of PubMed. Besides, keywords were selected carefully as they impact on search results. The primary keywords for the literature search were “physical exercises as a therapy for reducing the incidence of depression.” Other keywords that were used include sedentary life and depression management. The words “physical exercises,” “exercises,” “aerobic exercises,” and “resistance exercises” were used interchangeably to ensure that the search results include literature that uses the word “exercises.” Boolean operators “AND” and “OR” were used interchangeably to either expand or narrow down the search results.
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First, the keywords “physical exercises” and “Depression” resulted in 803 results. To narrow the search results, “exercises,” “sedentary life,” and “depression” were used as the keywords. The search was also limited to clinical trials and randomized clinical trials so as to generate primary research articles. As a result, 28 articles were generated. One article was then selected from the final pool of articles. The article that was identified is the 2015 article written by Azizan and Justine, titled “Effects of behavioral and exercise program on depression and quality of life in community-dwelling older adults: a controlled, quasi-experimental study.” This article is published in the Journal of Gerontological Nursing.
Reasons for Selecting the Article
I selected the article written by Azizan and Justine for several reseasons. First, the article is written by two highly-respected university professors, namely Azilyana Azizan and Maria Justine. Secondly, the article is a primary research article and addresses my research question best. Lastly, the article is peer-reviewed as it is published in a peer-reviewed journal. In particular, the article written by Azizan and Justine is published in the Journal of Gerontological Nursing. Besides, the Critical Appraisal Skills Programme (CASP) checklist was used to the validity of the study.
Article Analysis
Azizan, A., & Justine, M. (2015). Effects of a behavioral and exercise program on depression and quality of Life in community-Dwelling older adults: A Controlled, Quasi-Experimental study. Journal of Gerontological Nursing , 42 (2), 45-54.
Purpose of the Study
The aim of the study was to investigate the effectiveness of behavioral and exercise program in reducing depression among older adults.
Independent and Dependent Variables
The independent variable is the depression score and health-related quality of life (HRQOL), which was measured by the Geriatric Depression Screen (GDS-15) and SF-12 health survey, respectively. The dependent variable is age—the study comprised of participants age 60 and above.
Hypothesis
The researchers hypothesized that combining behavioral programs and exercise programs will significantly reduce the incidences of depression among older adults.
Theoretical Framework
The researchers employed the Transtheoretical Model (TTM) of change developed by Prochaska and Velicer as a framework for conducting their study.
Literature Review
Before conducting their primary research, the researchers conducted a systematic review to provide the foundation of knowledge on their research topic as well as identify gaps in research. Based on their literature review, a wide range of literature hypothesized that behavioral and exercise programs could prevent and reduce depressive symptoms in older adults (Mortazavi et al., 2012, as cited by Azizan and Justine, 2015). However, only a few studies investigated the effects of combining behavioral programs and exercise programs. For this reason, Azizan and Justine conducted this study to determine the effectiveness of behavioral and exercise program in reducing the incidence of depression among older adults.
Type of Study
The type of study conducted by the researchers is quantitative research. The researchers collected and analyzed numerical data using the GDS-15 to test the relationships between behavioral and exercise programs and depression.
Research Design
The researchers employed a controlled quasi-experimental research design to conduct their research. This research design is often employed by quantitative researchers to determine the causal impact of a given intervention on a target population. In this study, the target population was the aged population.
Instruments Used
The researchers used the GDS-15 and the SF-12 health survey instruments to measure the level of depression and HRQOL, respectively.
Sample
The researchers recruited the participants using convenience sampling. The participants were recruited from three different villages in Malaysia: Kampung Bukit Cherakah, Kampung Felda Checrakah, and Kampung Telok Gadong. After the recruitment process, the participants were then divided into three groups, namely, (a) exercise and behavioral program (EBG; n=18), (b) exercise only (EG; n=23), (c) control group (CG; n=22)” (Azizan and Justine, 2015). The participants were divided into these three groups according to their villages. The G-Power software was used to calculate the sample size. Using this software, a minimum of 17 participants were required for each group. The inclusion criteria were: (a) age 60 years and above, (b) have the ability to perform exercises, (c) have the ability to understand English, (d) be close to the setting of the study, and (e) no cognitive impairment (Azizan and Justine 2015). The study recruited a total of 63 participants; (EBG; n=18; EG; n=23; and CG; n=22).
Data Analysis
The researchers used version 20.0 of the SPSS software to perform statistical analysis. In particular, the researchers assessed the statistical significance using a significance level of 0.5. To analyze the differences in the level of depression and HRQOL among the three groups before and after the intervention, the researchers used the analysis of covariance (ANCOVA).
Primary Findings
From their study, the researchers found that exercise programs are very effective when it comes to preventing or reducing depression. However, the researchers noted that older adults often experience behavioral problems which affect their adherence to exercise programs. According to the researchers, a combination of behavioral and exercise programs may help prevent or reduce depressive symptoms among older adults.
Limitations of the Study
The study had a number of limitations. The study used convenience sampling to recruit the participants, which is the weakest sampling approach acceptable in qualitative research. The researchers used a homogenous sample. In other words, all the participants had a similar background. Future studies ought to use a strong sampling approach as well as non-homogenous samples.
Conclusion/Implications of the Study
The researchers concluded that a combination of behavioral and exercise programs is effective in preventing or reducing incidences of depression among older adults. Health care experts can use the findings of this study to promote healthy aging by delivering the effective intervention, such as behavioral and exercise programs.
References
Azizan, A., & Justine, M. (2015). Effects of a behavioral and exercise program on depression and quality of Life in community-Dwelling older adults: A Controlled, Quasi-Experimental study. Journal of Gerontological Nursing , 42 (2), 45-54.
Belvederi Murri, M., Ekkekakis, P., Magagnoli, M., Zampogna, D., Cattedra, S., Capobianco, L., ... & Amore, M. (2019). Physical exercise in major depression: reducing the mortality gap while improving clinical outcomes. Frontiers in psychiatry , 9 , 762.
Gerber, M., Beck, J., Brand, S., Cody, R., Donath, L., Eckert, A., ... & Imboden, C. (2019). The impact of lifestyle Physical Activity Counselling in IN-PATients with major depressive disorders on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers: study protocol for a randomized controlled trial. Trials , 20 (1), 1-21
