Journal of East-West Nursing Vol. 22 No.

2 November 2016 ISSN: 1226-4938

Journal of East-West Nursing Research 2016; 22(2): 96-103 www. ewnri . or.kr
https://doi.org/10.14370/jewnr.2016.22.2.96

Effects of Reality Therapy Program for the Depressed Elderly

Jinju Kim One · Wise 2

One Associate Professor, School of Nursing, Kyungdong University, 2 Ajou University College of Nursing

The Effects of a Reality Therapy Program for the Elderly with Depressive Disorder

Kim, Jinju One · Hyun, Myung Sun 2

One Associate Professor, Department of Nursing, Kyungdong University, Wonju; 2 Professor, College of Nursing, Ajou University · Institute of Nursing Science, Suwon, Korea

Purpose: The purpose of this study is to develop a Reality Therapy program for the elderly with depressive disorder, and then examine the effects of the developed program.
Methods: This study used'non-equivalence control group pretest-posttest design'. The participants were forty-eight elderly who were on medication treatment with depressive
disorder. Twenty-two participants were assigned to the experimental group and twenty-six ones were assigned to the control group. A 10-session Reality Therapy program
was provided to the experimental group. The data were collected from September to December in 2012.Dependent variables were self-esteem, internal control, and depres-
sion. Results: The scores of self-esteem for the experimental group were significantly increased compared to the control group (t=-4.87,

p< . 001). The scores of depression for the experimental group were significantly decreased compared to the control group (t=3.61,
p= . 001). However, there was no significant change on the scores of internal control between the two groups. Conclusion: The results of this study indicate that the Reality
Therapy program is effective in increasing self-esteem and decreasing depression for the elderly with de- pressive disorder.

Key Words: Reality Therapy, Elderly, Depression, Self-esteem, Internal control

Introduction It is due to the increase in national medical expenses due to the increase in use[ 2]. In

spite of the severe depression in old age, it is often accepted as a natural phenomenon

1. Necessity of research due to aging or confused with social prejudice and dementia for mental illness, leading to

Old age is different Physical weakness, loss of role, decreased ability, social isolation, treatment failure[ 3].

compared to the age group The likelihood of becoming depressed due to the death of a spouse, Age

The prevalence of depression increases as it increases. Korean Longitudinal Study on Health and The risk factors for depression in old age are reported as women, low income, low education

Aging(KLoSHA) According to the elderly depression Prevalence is major depression 5.0%, Mild level, health status, low self-esteem, and lack of social support. Also, in older age, secondary

depression 4.8%, Subclinical depression 8.4% On the back appear[ One]. To individuals and society depression caused by external stress is higher than other age groups[ 4]. Therefore, it is

due to old age depression Affecting Looking at the impact, the ability to control the surroundings is necessary to pay attention to the psychological factors of the elderly because the elderly's own

reduced, the quality of life and Decreased self-esteem, Increased risk of suicide, internal medicine perception and evaluation process of the environment given in old age affects the degree of

and Department of Mental Health depression.

Key words: Reality therapy, the elderly, depression, self-esteem, internal control

* This article is based on a part of the first author's doctoral thesis from Ajou University.

Address reprint requests to: Hyun, Myung Sun

Professor, College of Nursing, Ajou UniversityInstitute of Nursing Science, 164, World cup-ro, Yeongtong-gu, Suwon 16499, Korea Tel: +82-31-219-7014 Fax:

+82-31-219-7020 E -mail: mhyun@ajou.ac.kr Received: 1 September 2016 Revised: 30 October 2016 Accepted: 2 November 2016

96
 Effects of Reality Therapy Program for the Depressed Elderly 97

In this It is emphasized. Low among psychological factors Self-esteem is a sign of depression in 3. Research hypothesis

old age. important It is known as a predictor. The elderly with high self-esteem life About events Actively The hypothesis of this study is as follows.

responding to poor external conditions Also Old people with low self-esteem feel more loneliness One) My One Hypothesis: The experimental group participating in the reality treatment program

and are largely driven by external deficiencies while trying to find positive elements without will have a higher level of self-esteem than the control group.

frustration. Wound Receiving depression and I feel more suicidal thoughts[ 5]. It is also a 2) My 2 Hypothesis: The experimental group participating in the reality treatment program will

psychological factor Internal and external control over where individuals place their causes of have higher level of internal control than the control group.

success and failure Control material(統制所在, locus of control) Means My enemy controllers are In 3) My 3 Hypothesis: The experimental group participating in the reality treatment program will

a stressful situation, their way in an adaptive way Coping reaction While applying External have a lower level of depression than the control group.

controllers are No effort Because it shows an inadequate coping style, the control material Depressive

It can be said to be a vulnerable variable[ 6]. Research method

1. Research design

depression Old people Target The psychosocial treatment that was applied was cognitive This study applied a real-life treatment program to the elderly who are diagnosed and treated

behavioral therapy, Interpersonal Therapy, Diverse problem solving treatment, recall therapy, for depression in the community and designed before and after an inequality control group to

horticultural therapy, etc. arbitration There are treatments. double ' Reality therapy( Reality Therapy)' Blame
investigate its effects ( nonequivalent control group pretestposttest design) to be( Table 1).

me Without criticism Own To teach you how to cope effectively to meet your needs Focus is on[ 7].

1990 In Korea in the 1980s Various since introduction It was applied to the development of group

counseling programs. Reality therapy Looking at the applied research, from children to the elderly 2. Research Subject

and from normal people With health problems It has been applied to a wide range of subjects. The subject of this study K The elderly registered in the Mental Mental Health Center in Doo

Reality treatment Internal control property[ 8], Self-esteem[ 9], Coping with stress[ 10], depressed were selected as being diagnosed and treated with depression. The specific selection criteria 60 Age-old

and short-term depressed SGDS-K)

[11] Etc It is reported to be effective in various psychological variables. ever Reality Therapy 11], adult[ in 8 A point abnormality (depressed point of depression), taking antidepressant, Korean simple

8] Has been applied to Old people We studied the welfare center[ 12], Per route[ 13], In a nursing liver status test ( K-MMSE) in 18 Subjects who did not have cognitive impairment beyond the point

home Old people Most of the studies have been conducted. It also has mental health problems Old and agreed to participate in the study 60 Names were randomly expressed. The exposed subjects

people The study was conducted on depressive elderly people in the community. were assigned the center registration number of the subjects who agreed to the study in the order

of registration date, and the odd numbered list was assigned to the experimental group and the

[14] Just research. In other words Psychosocial treatment is mainly suspected of a healthy elderly even numbered list was assigned to the control list.

person or depressed Old people Selected and mediated studies are of a preventive level rather The sample size of the study G-POWER 3.1 Number of groups using the program 2, Effect

than a therapeutic intervention. Intervention Did. Therefore, this study developed a reality treatment size 0.8, Power . 80, Significance level . 05 Based on the each group 26 People. Effect size 0.8 The

program for the depressed elderly who are taking antidepressants in the community. By applying reason for this is as follows. Prior Research[ 14] The effect size calculated with reference to 1.58 Therefore,

that effect I wanted to verify. the number of samples required per group was calculated to be too small. 0.8 (large effect size) It

was decided to. For the final analysis, the experimental group excludes those who were

2. Purpose of the study eliminated due to personal circumstances during the application of the intervention program. 26 People,

example Research Purpose Being diagnosed and treated for depression in your community there control group were hospitalized and transferred, unfaithful respondents

is Old people Develop and apply reality treatment programs to targets Effect It is to clarify. The

specific research purpose is as follows same.

Table 1. Design for the Study

Pre-test Intervention Post-test

One) Depression Reality therapy program for the elderly who are diagnosed and treated Develop.

Experimental group Ye1 X Ye2

Control group Yc1 Yc2

2) Developed Reality treatment Verify the effectiveness of the program.

X: Reality Therapy; Ye1,Ye2,Yc1,Yc2: Self-esteem, Internal locus of control, depression of
experimental and control group.
98 Journal of East-West Nursing 22(2), 2016 Jinju Kim and Myeongseon Hyun

Except 22 People 48 People. Period during which the last name is recognized[ 18], The program time is minimal to create an

atmosphere even if a single house is well formed by members and to complete the main theme. 60

3. Intervention: Reality Therapy Program Time per session of group therapy that requires minutes [ 19], The number of program sessions 10-14

example In research Reality treatment The process of developing the program is as follows. The most effective research results during the session [ 20] Based on this study, One hall 60 Minutely

program For development first Related literature on reality therapy[ 7,15,16] To review, The goals 10 Weekly gun 10 Circuit. Researchers were tested in each of the two groups. 15 Shotgun 30 A real

and objectives of the program were established. Also of the program Establishing an overall treatment program was conducted for Myung. One group every Tuesday K In the institutional

framework, The contents of the program were selected and organized. then next program To training room, one group every Thursday B It took place in the institutional training room. This

increase the validity of the content, ask a specialist It went through a review process. Reality program teaches mental health nursing, and was conducted by this researcher who has

therapists need to understand the purpose and stage of the program By target Activities Whether experience in providing programs for the elderly and performing nursing. This program Wubbolding

the contents were faithfully constructed based on reality therapy Validity Reviewed, Mental health [16] The stage of behavior change of reality treatment proposed by this WDEP) Phosphorus desire

nursing major professor Main theory Reviewed. Mental health specialist Therapeutic From the and wind search ( want), Behavior Search( doing), Self-evaluation

perspective Arbitration methods for each program's educational content and progress to the center Reviewed.

Then evaluate the adequacy of the program for Preliminary program It was carried out. Depression

in one apartment complex Elderly people being diagnosed and treated 12 With prior consent After (evaluation), Planning ( planning) And so on. Each session is divided into the introduction phase,

getting 10 Guns over the daytime 10 Meeting was conducted. Evaluation sessions for each session the development phase, and the closing phase. 3 Proceeded to step. The introduction phase,

and Participant responses After analyzing, correcting and supplementing the program, Confirmed. where the program begins, is a relationship-building phase, with the aim of forming trust among

example The number of members in the program is an interaction between intimate and receptive participants, increasing intimacy, and alleviating tension. The development stage was the core of

people. That is possible 5-15 Name Range[ 17] On the basis of this, in this study, 15 It was made one the program, and education and activities were conducted according to the theme planned each

by one. example The duration of the program is the effect of group counseling. time. The final closing stage required each person to present their thoughts during the day's

activities, and the facilitator tried to increase confidence and accountability by providing positive

feedback from one or more participants each time.

Table 2. Reality Therapy Program

Phase Session Topics Activity contents

Want One Self exploration ∙ Orientation about program

∙ Self introduction
∙ Psycho education about depression during the end of life

2 Understanding basic needs ∙ Understanding Choice theory and five basic needs

∙ My need exploration: recollect one's life,'want' exploration

3 Making good plan ∙ Identifying unsatisfying needs

∙ Recognizing the rule for making plan

∙ Making plan for meeting my need

Doing 4 Real world & good world ∙ Understanding real world and good world

∙ Understanding four components of human total behavior

Total behavior ∙ Conducting activity for differentiating real world and good world (Me who I know and Me whom other

people know)
5 Total behavior of coping in conflict situation ∙ Recognizing my total behavior of coping to the conflict situation

∙ Seeking alternative coping methods

Evaluation 6 Identifying unhealthy coping (ex: excuse) ∙ Throwing away'excuse' that is often used in my life

∙ Changing non realistic figure into real figure to the world

7 Positive communication skill ∙ Appraisal problem in my life

∙ Practice positive communication skill (I-message)

8 Self evaluation ∙ Assessment my want and total behavior

∙ Practice & applying problem solving method

Planning 9 My life goal ∙ Making plan for my happy life

∙ Making positive new self-introduction

10 Lead my life ∙ Sharing the experiences for the program

∙ Closing ceremony
 Effects of Reality Therapy Program for the Depressed Elderly 99

bracket In session The approximate content you want to convey Table 2 Same as 9 The session focused on planning to be happy. In order to enhance his

One Session Motivation for participation Mental health education for depression and He presence and value, he made a self-introduction based on his positive

introduced the program and took time to introduce himself. appearance and set my life goals. The plan was to make a simple, concrete, and

process-oriented positive plan that the elderly could do immediately, so that they

2 Session human's Understand basic needs, understand your own needs and desires, Own could not make excuses or excuses.

The focus was on understanding that behavior is your choice. Theory of choice and human 5 Branch

Humans through education on basic needs Action It made me realize the concept of choice 10 The session was a time to finish, and was given a time to announce their testimony about

and the importance of choice. Last Life Looking forward to his own wishes Activity Did. the program, and held a completion ceremony. In addition, a follow-up investigation was

conducted at the end of the session.

3 Session Own needs The focus was on planning to meet. Fairytale In human Review 4. Research Tools

and explore basic needs and live Time to find each other's needs through my actions 1) Self-esteem

and others' actions Had. In order to feel that death is also a process, some anxiety Self-esteem refers to self-esteem, self-esteem, and value. 21]. Self-esteem

about death Dealt with. measurement tool

Rosenberg [21] Self-esteem scale of Self-Esteem Questionnaire, SEQ)

To Jon [22] This troubled one was used. gun 10 Each question is a question One In point 5 Dot
4 Session All actions( total behavior) Focused on understanding the concept of good Understanding

the world and understanding all actions through education It helped me understand the world. level Likert type And the score range is 10-50 It is a point, and the higher the score, the higher

About the real world and good world Understanding In the process, I will reflect on my past life the level of self-esteem. This tool is licensed for free. At the time of development, the reliability

and remind myself of a good world. Did. As an activity to know the difference between the of the tool Cronbach's α= .85 Was, Jon [22] In the study of the elderly . 62 It was. In this study . 63 Was.

desired world and the real world, I tried to look at what I know and what I see. In order to

increase self-esteem, I think that Advantages and Presented about my strengths that others feel.

(2) Internal control

5 Session As a session where you can take a look at all my actions in dealing with conflict Intrinsic control refers to the attitude that one believes that the degree to which one is

situations In society Negative experiences and potential experiences in relationships with people Conflictresponsible for a given outcome is more determined by the internal factors[ 23]. The internal

situation Express and control your own negative emotions there is Alternative They were given time control measure Rotter [23] Produced by Internal-External Control Scale of 29 Based on dog

to explore. questions Cha Etc[ 24] We used the internal and external control scales that were re-made to fit the

6 Session Own To deal with unhealthy actions (such as excuses) that are often used in situation in Korea. This tool is a gun 21 Fictional Questions 6 Save the dog 15 It is scored in response

life Focus on the task of checking, finding and discarding Act Check To evaluate It was to individual questions. Each question consists of two statements that indicate the tendency of

constructed. Mainly used by participants Excuses To announce After identifying the internal control and external control. The score range 1-15 The higher the score, the higher the

common excuses, one by one Put papers that you often use as excuses in the trash Crumpled level of internal control. Tool reliability at the time of development Cronbach's α= .70 Was, Cha Etc[ 24]

He shouted while throwing away. In the study of = . 84 It was. In this study . 60 Was.

7 Session In conflict In a situation where I feel, I am trying to solve it Or I To

determine whether it is a situation He worked to identify the problem-owning area.

Also I feel discomfort Feel To others I can tell you what I want to say without hurting positive
(3) Depression

Conversation I was configured to practice the B-pass method. Depression is a special emotional state marked by deep sorrow, decreased energy levels,

guilt, anxiety, and social atrophy [ 25]. Depression measurement tool Sheikh Etc[ 25] This developed

8 Session Discomfort Feel or When you are in conflict ' Doing now Action Does it short GDS To Bae Etc[ 26] This standardized scale( Short Form of Korean version of Geriatric

help? ' To ask the elderly about the wind, actions, plans Helped to self-evaluate. Depression Scale, SGDS-K) Was used. This tool is a gun 15 In question ' Yes ' The 0 point, ' no
100 Journal of East-West Nursing 22(2), 2016 Jinju Kim and Myeongseon Hyun

Five ' The One Give a dot, The score range 0-15 It is a point. Cutting point 8 Depressed above the Results
point Means [ 26], Score The higher the level, the higher the level of depression. example Tools Free

to use. Tool reliability at the time of development Cronbach's α= .94 Was, Bae Etc[ 26] Of elderly 1. Verification of the homogeneity of the subject's general characteristics

research The results of the homogeneity test for the general characteristics of the experimental and

Cronbach's α= .86 Was. The reliability of this study . 81 Was. control groups participating in the study Table 3 Same as Analyzing gender, age, education level,

marital status, marital status, religion, health coverage, subjective perception of health, and

5. How to collect data subjective appeal to determine homogeneity of the general characteristics of the experimental

example Research Prior to conducting this, first contact the head of the center, which is the and control groups As a result, there was no significant difference, and the result was a

place for data collection Researcher After explaining the purpose and procedure of the study, About Permission
homogeneous group.

received. after that Research assistants approached the subjects The purpose of this study is

provided by explaining the purpose and procedure of the study. To participate Agree Subject 2. Verification of a subject's homogeneity of dependent variables before intervention

received informed consent to participate in the study. Also, written consent Submitted A preliminary The results of the homogeneity test on the self-esteem, internal control, and depression, which

investigation was conducted on the subjects. And the follow-up investigation After finishing the are the dependent variables of the experimental group and the control group, before the

program It was conducted by a research assistant. material Collection 2012 year 9 From the month 12 It experimental treatment of the subjects Table 4 Same as Self-esteem, internal control, and depression were found to be ho

was until the month.

3. Hypothesis verification

6. Data analysis method The results of the effect of the reality treatment program on self-esteem, internal control, and

material Analysis SPSS 19.0 The program was analyzed as follows. The pre-homogeneity test depression for the subjects Table 5 Same as

for the general characteristics and dependent variables of the study subjects χ 2- test or Fisher's

exact test, independent t-test Was analyzed. In order to verify the effectiveness of the program, 1) First hypothesis

self-esteem, my control, Melancholy Preliminary investigation Between the two groups for the ' The experimental group participating in the reality treatment program will have a higher level

difference value of follow-up score The difference Independent sample t Verification( independent of self-esteem than the control group. ' The hypothesis is · The post-ego esteem score change was 6.50±4.27

t-test) It was analyzed using. theory For verification Significance level p<. 05 Was made. Dot, control - 0.64±5.87 It was a point, and it was supported by statistically significant differences ( t=-4.87,

p<. 001).

7. Ethical considerations 2) Second hypothesis

example Research A University Research Ethics Review Committee ( Institutional Review Board) ' The experimental group participating in the reality treatment program will have higher level of

of With approval It was carried out ( AJIRB-MED-MDB-12-214). Study subjects Ethical Side To internal control than the control group. ' The hypothesis is · The post-internal control score change

protect Research assistants conducted research before the study began. The overall purpose and was observed in the experimental group. 0.11±2.38 Dot, control - 0. 36±2.17 It was a point, and it

was not supported because there was no statistically significant difference ( t=-0.66, p=. 510).
content, It may arise from confidentiality and participation in research. there is Risks or benefits Explained.

Also, in the process of participating in this study, That we can stop Even if you stopped

participating in the study, That there will be no penalty Explained. Subjects are being diagnosed 3) Third hypothesis

with depression and being treated Although it is an elderly person, cognitive function screening in ' The experimental group participating in the reality treatment program will have a lower level of

advance ( K-MMSE) Through the Subjects who do not have problems with cognitive function and depression than the control group. ' The hypothesis is · The post-depression score changes in the

judgment One's own Obtain consent to participate freely and obtain a written consent to participate experimental group - 2.77±2.89 Dot, control 0.00±2.33 It was a point, and it was supported due to

in the research. received. In addition, after the study is over to provide equity for treatment Depressed statistically significant differences ( t=3.61, p=. 001).

even the control group Mental health promotion program to alleviate It was carried out. The

collected data It was used for research purposes only. Argument

This study developed a reality treatment program for the elderly who are diagnosed and

treated for depression living in the community and verified its effectiveness.
 Effects of Reality Therapy Program for the Depressed Elderly 101

Table 3. Homogeneity of General Characteristics between Two Groups (N=48)

Experimental group
Control group (n=22)
Characteristic Category (n=26) χ2 p

n (%) n (%)

Gender Male 4 (15.4) 3 (13.6) 0.03 1.000*

Female 22 (84.6) 19 (86.4)

Age 61-70 5 (19.2) 3 (13.6) 2.66* . 301

71-80 16 (61.6) 10 (45.5)

81-90 5 (19.2) 9 (40.9)

Education No education 5 (19.2) 5 (22.7) 0.96* . 875

Elementary school 11 (42.3) 7 (31.8)

Middle school 6 (23.1) 7 (31.8)

High school 4 (15.4) 3 (13.7)

Marriage Married 8 (30.8) 10 (45.5) 1.10 . 375

Divorce/ Bereavement 18 (69.2) 12 (54.5)

Living status Living alone 17 (65.4) 13 (59.1) 0.20 . 768

Living with spouse or family 9 (34.6) 9 (40.9)

Religion Have 23 (88.5) 19 (86.4) 4.91* . 184

Haven't 3 (11.5) 3 (13.6)

Medical security Medical care 17 (65.4) 18 (81.8) 1.63 . 329

Health insurance 9 (34.6) 4 (18.2)

Perceived health Healthy 1 (3.8) 1 (4.5) 3.00* . 198

Moderate healthy 6 (23.1) 10 (45.5)

Weak 19 (73.1) 11 (50.0)

Complain problem Economic problem 4 (15.4) 8 (36.4) 3.23 . 220

Health problem 15 (57.7) 8 (36.4)

Conflict, loneliness problem 7 (26.9) 6 (27.2)

* Fisher's exact test

Table 4. Homogeneity of Self-esteem, Internal Control, and Depression between Two This resulted in an opportunity to freely announce each. This is the result of a study that
Groups (N=48)
self-esteem was improved when the need for love and belonging, and the need for power and
Experimental Control
achievement were met through actual treatment[ 27] And also matches. Second, as a result of
Variable (n=26) (n=22) t p

Mean±SD Mean±SD understanding the effect of the reality treatment program on the internal control, the score of the

Self-esteem 28.62±4.92 30.32±5.80 - 1.10 . 277 internal control of the experimental group was improved than the control group, but the difference

Internal control 8.31±2.45 7.32±3.05 1.06 . 293

was not statistically significant. This is a prior study that applied real-world treatment to adults or
Depression 10.19±2.25 10.91±2.45 - 1.06 . 296
adolescents[ 8,28] The results were not consistent. In this study, the causes of the reality

Willing Was tried first, Research results Reality treatment The program diagnoses and treats treatment program that was not effective for the subject's internal control were as follows. First of

depression Receiving Elderly It was found to be effective in increasing self-esteem. To the all, it can be said that internal control is not a characteristic that can be changed in a short period

program Before participating, the self-esteem score 28.62± of time [ 29]. Intrinsic control means an attitude that believes that the degree to which one is

responsible for a given result is more determined by internal factors. I think it was because it was

4.92 It was a point, After participating in the program 35.12±5.23 In dots 6.50±4.27 difficult to change for a while. The second reason is that the internal control tendency was not

point Increased. This is a prior study that applied reality treatment to the elderly. high in the subject's prior investigation. Control material is a vulnerable variable of depression[ 6] Participants

[14] I Adults or Other preliminary studies that applied real-world treatment to adolescents[ 8,9,12,14] in the study who were diagnosed with depression and who were on medication were generally not

Wow similar Is the result. The program shows the person's self-esteem What improved, Make at a high level of internal control, indicating that they had some degree of external control. The

specific plans that can be implemented in the program successfully Due to the fact that they third reason is the reliability of the internal control measure used in the study. Cronbach's α= .60 to

practiced to feel fulfilled I think. Also Through a group counseling program, the target audience Considering

and practicing the techniques learned through assignments Check, Program Feeling joy as you

progress, your life

102 Journal of East-West Nursing 22(2), 2016 Jinju Kim and Myeongseon Hyun

Table 5. Effects of Reality Therapy Program on Self-esteem, Internal Control, and Depression (N=48)

Pre test Post test Post-Pre

Variable Group t p
Mean±SD Mean±SD Mean±SD

Self-esteem Experimental (n=26) 28.62±4.92 35.12±5.23 6.50±4.27 - 4.87 <.001

Control (n=22) 30.32±5.80 29.68±4.19 - 0.64±5.87
Internal control Experimental (n=26) 8.31±2.45 8.42±2.73 0.11±2.38 - 0.66 . 510

Control (n=22) 7.32±3.05 6.95±2.85 - 0.36±2.17

Depression Experimental (n=26) 10.19±2.25 7.42±3.11 - 2.77±2.89 3.61 . 001

Control (n=22) 10.91±2.45 10.91±2.76 0.00±2.33

low The point can be mentioned. So later In reality treatment, depression is diagnosed For elderly It seems to be. Based on the research results, I would like to suggest the following. First, the

people being treated When you want to measure internal control, Suggest to try the tool. third, Reality number of samples was small. Therefore, further research is needed to verify the effectiveness of

treatment The program diagnoses depression and treats depression in the elderly Level It was this reality treatment program by applying it to more subjects. Second, since the continuity of the

confirmed that it was effective in reducing. this is Reality treatment group Program Depressed depressedeffectiveness of the reality treatment program conducted in the study was not evaluated, it is

That was effective in lowering the level Yang Etc[ 14] Results of research Department of Normal necessary to verify it later as a parallax study to verify the long-term effects. Third, the target

Elderly Prior studies that applied reality therapy to adolescents It is also consistent with the selection process included subjects who were taking antidepressants, but did not control the

research results[ 11,13]. This is the current program Now Focus on it, knowing that depression was effects of antidepressant types or doses. Therefore, future research suggests controlling such

eventually your choice Realistic How to meet your needs and help your needs Act Acquire skills that exogenous variables. Fourth, the reliability of the internal control tool used in the study was low.

can be self-assessed, and take responsibility for selected actions What was emphasized was that Therefore, it is suggested to develop more reliable tools for the elderly. Lastly, the reality

it contributed to the reduction of the depressed level of the subjects. I think [ 7]. Also Emphasizing treatment program proved through this study needs to be researched to identify the effects by

the strengths and current importance of the participants and making choices Respected, to applying it to the elderly who have various psychological problems in addition to the elderly who

increase the bond between participants and relieve tension happy In addition, rhythm and are diagnosed and treated for depression.

subject-specific work activities were also used to reduce depression scores. Contributing It is fed.

Therefore, depression is diagnosed and treated there is Elderly As a way to relieve depression,

psychiatric medications, psychotherapy, etc. can also have good effects. Improvement effect can

be obtained. Through this study, Melancholy In the nursing of health problems by combining real

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