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Increasing Adherence To Measurement-Based Depression Management In Primary Care, Renad Saadat

Doctor of Nursing Practice

Background and Review of Literature. Approximately 11 million Americans 18 years or older experienced a severe symptom of depression leading to impairment in 2017. The severity of depressive symptoms is often miscalculated in primary care as measurement-based tools for the diagnosis and ongoing reassessment varies. Purpose. The purpose of the project was to increase provider adherence in using the patient health questionnaire-9 (PHQ-9) for ongoing evaluation of the severity of depressive symptoms in patients with depression at a primary care clinic in San Antonio, Texas. Objectives. The main objective of this Doctor of Nursing Practice project is …

Effect Of A Self-Care And Self-Awareness Education Program On Resilience To Burnout And Depression In Clinically Experienced Nursing Students, Andrew Taylor

Undergraduate Honors Theses

The purpose was to examine the effect of a self-care educational intervention on nursing student resilience and thus the potential for compassion fatigue, depersonalization, burnout, depression, and inadequate self-care. A one-group pretest-posttest research design was applied to a convenience sample of 104 nursing students near the end of their last semester in a baccalaureate nursing program. The measurements were demographics, a psychometric resilience scale, program evaluation, and reflection question. The intervention was a standardized, intensive 30 min training program on the high degree of stress and burnout nurses face and the core self-care methods that can promote resilience to these …

Perceptions Of Executive Functions And Self-Care Actions In Major Depressive Disorder., Melanie G. Walters

Electronic Theses and Dissertations

This dissertation encompasses a study of the effect of impaired executive functions on decision-making and self-care of depressive illness. The first chapter provides an introduction and summarizes the body of literature on the executive functions and its association with depressive symptoms. The second chapter contains the second of two systematic reviews which examines conceptualizations of executive functions, classical and current measures used to assess the executive functions, and challenges and limitations related to current methods of assessment. The third chapter describes the development of a vignette technique and its use in a study to examine the association of depressive symptoms …

Bipolar Disorder, Heather Guthrie

Nursing Student Class Projects (Formerly MSN)

Bipolar disorder is a mental disorder that causes severe swings in mood, energy, activity, concentration, and activities of daily living. These mood swings range from extremely euphoric, irritable, or animated behavior (manic) to despondent, apathetic, or dejected periods (depressive). This phenomenon was why this disorder was known as manic-depressive or manic depression. The need to understand the multiple factors regarding the disease process of this disorder, and the importance of treatment is vital for the safety and health of people across the world inflicted by bipolar disorder. Education is the key to how this disorder affects the entire trajectory of …

The Long-Term Multidimensional Impact Of Persistent Multisite Pain On Physical And Psychological Disability, And Mortality In Community-Dwelling Older Adults, Saurja Thapa

Graduate Doctoral Dissertations

Persistent multisite pain is highly prevalent, affecting 25-43% of community-dwelling older adults. Although existing evidence suggests that persistent multisite pain is associated with physical and psychological disability, studies use a cross-sectional assessment approach that overlooks pain duration or persistence. This study aimed to estimate the persistence of multisite pain and the proportion of incident multisite pain and examine the association between persistent multisite pain and physical (ADL and IADL) and psychological disability (depression and anxiety) at 18 months and six years. Also, the association between baseline persistent multisite pain and mortality was assessed.

Secondary data analysis of the MOBILIZE Boston …

Depression: The Cause, The Signs, The Stigma, Elisabeth Sanderson

Nursing Student Class Projects (Formerly MSN)

Depression is a common phenomenon. According to World Health Organization (2020) there are over 264 million people suffering from depression globally. Takahashi (2019) states that major depressive disorder is the most common mood disorder and additionally notes that it is the leading cause of disability not just in the United States but in the world. From a pathophysiological perspective depression has multiple possible causes. This paper seeks to look at depression as a relevant health care concern and to describe accepted theories on the pathophysiology of depression as well as discussing key signs and symptoms of the disorder. It seeks …

Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Mental Health Screening For Low-Income Adolescents

BACKGROUND: Nearly 80% of adolescents in the United States will suffer from a mental illness and not receive evaluation or services. Children from low socio-economic backgrounds have an increased risk of mental health disorders which permeate into adulthood, leading to additional negative sequel and lower quality of life. Among adolescent mental health conditions, depression and anxiety are the most common. Literature has suggested provider intuition alone has low sensitivity and specificity for detecting mental illness and that screening tools are indicated.

PURPOSE: The aim of this project is to implement standardized routine …

Utilizing Telehealth Technology To Reduce Social Isolation And Depression In Seniors, Bohan Farrell

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Social isolation in the elderly has been identified as a risk factor for poor mental and physical health, as well as higher rates of mortality, depression, and cognitive decline. Loneliness is the unpleasant experience that occurs when a person’s network of social relationships is deficient in some important way, either quantitatively or qualitatively. Depression is a mental condition characterized by feelings of severe despondency and dejection, typically with feelings of inadequacy and guilt, and accompanied by lack of energy and disturbance of appetite and sleep. Physically, lonely people have more disorders, such as sleeping problems, stomach pain, and …

A Dnp-Led Educational In-Service To Increase Depression Screening In Primary Care, Shaylyn White

Doctor of Nursing Practice Final Manuscripts

Background: Depressive disorders are a major contributor to disability in the United States and worldwide. They are associated with multiple comorbid conditions including cardiovascular disease, obesity, stroke, and premature mortality. In the US, only 4.2% of primary care patients are being screened for depression and approximately 50% of cases of major depression are being missed.

Purpose: Implementation of a nurse practitioner-led educational intervention, discussing when, why, and how to screen utilizing the PHQ-2 and PHQ-9 screening tools, with the medical assistant staff in order to increase compliance with annual screening.

EBP Model/Frameworks: The Iowa model was used to guide implementation …

A Multicomponent Tailored Intervention Program Protocol For Weight Loss In An Underserved Adult Patient Population With Obesity, Rita R. Arnold

Evidence-Based Practice Project Reports

Obesity is a multifactorial, individualized, chronic disease that increases known risk factors for significant comorbidities and mortality. The primary purpose of this Evidence-Based practice project was to improve indicators of obesity (weight, BMI) among patients served by a free medical clinic, using a tailored multicomponent intervention. The secondary purpose was to determine if the weight loss intervention was associated with a decrease in blood pressure and depression symptoms. The intervention was guided by the Health Promotion Model by Nola Pender. The Johns Hopkins Nursing Evidence Based Practice Model (JHNEBP) guided implementation of the project. A comprehensive literature review was completed …

Creating Opportunities For Personal Empowerment: A Project Evaluation, Ann L. Cudney

Doctoral Projects

Introduction: 66% of individuals in the United States who experienced a major depressive episode in the last year saw a general practitioner or family doctor and not a psychiatrist or psychotherapist (Center for Behavioral Health Statistics and Quality, 2018). Many primary care providers treat with medication, however, a combination of medication and psychotherapy is associated with better results (Anxiety and Depression Association of America, n.d.). A Midwestern faith-based healthcare organization implemented a pilot cognitive behavioral therapy program at a family medicine residency clinic to improve mental health care.

Objectives: The purpose of this project was to evaluate if the implementation …

The Effect Of The Screening, Brief Intervention, Referral To Treatment (Sbirt) Model On Adult Depression In An Outpatient Setting, Genevieve E. Sweeney

Doctoral Projects

Depression is one of the most common chronic conditions in the world. Despite this, depression continues to be under-screened, inaccurately assessed and diagnosed, and poorly treated in outpatient settings. Many providers solely rely on clinical judgement instead of a screening tool or evidence-based toolkit when a patient presents with depression symptoms, resulting in underdiagnosis and inappropriate treatment. Utilization of resources can help a provider appropriately screen, diagnose and treat an individual with depression. Screening, Brief Intervention, Referral to Treatment (SBIRT) is an evidence-based model intended to improve these measures. Studies from the literature support the efficacy of the SBIRT model …

Pediatric Providers' Perceptions Of Their Role In Early Detection Of Postpartum Depression, Laura Aime De La Pena

Dissertations

The birth of a child is usually a happy occasion in a woman's life. It is also often a time of overwhelming anxiety, stress and hormonal changes. Postpartum depression (PPD) could occur during the first year of childbirth in approximately 10-20% of mothers (Waldrop, Ledford, Perry, & Beeber, 2017). PPD is the most common maternal health problem within the first year after childbirth (the American College of Obstetricians and Gynecologists, 2018). Recognition of mothers who are at risk for PPD allows health professionals to initiate care that can prevent further problems for the mother, infant, and the rest of their …

Behavioral Symptoms, Inflammation And Cortisol: Relationship To Cardiac Health And Quality Of Life In Cardiac Rehabilitation Patients, Deborah Anne Sindewald

Dissertations

Background: The experience of a cardiac event is associated with psychological stress, which is often accompanied by depressive mood, fatigue and sleep disturbance (i.e., psycho-behavioral symptoms). To assist in recovery, cardiac patients can participate in a structured rehabilitation program, which provides monitored exercise and health education. There is limited knowledge, however, as to the extent to which cardiac rehabilitation reduces psycho-behavioral symptoms; nor is there knowledge of the association of these symptoms with stress-related biological mediators. Cortisol and inflammatory mediators (e.g., interleukin 6; IL-6) contribute to cardiovascular disease, and are also associated with greater stress perception, depressive mood, fatigue, and …

Educating Nurses About Poststroke Depression And Using The Phq-2/9, Mary Mcmullen

Walden Dissertations and Doctoral Studies

Stroke has affected more than 7 million people and up to 33% of those patients reporting depression. The lack of screening for depression for patients post stroke can delay treatment for depression and hinder or lengthen recovery. The purpose of this project was to develop a nursing staff education program on using the Patient Health Questionnaire (PHQ) tools (PHQ-2 and PHQ-9) at the bedside to detect signs and symptoms of depression and identify nurse-driven interventions. Using the Johns Hopkins nursing evidence-based practice model and Orem's self-care model for guidance, an interdisciplinary team was assembled to collaborate on the development. A …

Staff Instruction On Patient Health Questionnaire And Collaborative Care Model In Primary Care, Jennifer Carton

Walden Dissertations and Doctoral Studies

The DNP project examined the effectiveness of the Patient Health Questionnaire-9 (PHQ-9) and the Collaborative Care Model (CCM) as a practice protocol for patients suffering from depression in primary care to address the problem of a shortage in mental health specialists. Research reveals an increase in Americans suffering from depression. Many primary care clinics do not have a practice protocol in place to screen and manage depression. The project's purpose was to develop a lesson plan to instruct staff on the PHQ-9 and CCM to implement into their practice. The project questions were if the lesson plan developed by the …

Promoting The Recognition Of Depression In The Geriatric Population, Rose L. Hodge

Walden Dissertations and Doctoral Studies

Depression is a chronic condition that has both physical and mental consequences, complicating the elderly’s health status and interfering with daily functioning. Depression is not a normal part of aging and the elderly frequently seek mental health care in outpatient clinical settings where there is need for effective screening and prompt recognition leading to decreased morbidity and mortality. It is critical for psychiatric care settings to provide the most effective screening tools for recognizing depression as quickly as possible. This Doctoral Nursing Project quality improvement (QI) evaluation project resulted from observation of lack of a tool for recognizing depression in …

Postpartum Depression In Military Mothers:Active Duty And Partners Of Active Duty Service Members, Amanda Willis

Master of Science in Nursing Theses and Projects

Postpartum depression (PPD) is the most common complication of pregnancy. Active duty mothers and mothers with active duty spouses have a unique risk factor, deployment. Military mothers may receive PPD education prenatally and during postpartum visits if necessary. This project created a postpartum depression video that was mandatory for mothers to watch before they were discharged from the postpartum unit after the delivery of their baby. Early education and treatment are the key to managing PPD in all mothers. The mothers were surveyed at their postpartum office visits to evaluate effectiveness of video.

Benefits Of Exercise On Mental Health: Literature Review, Angela Ristau

All Graduate Theses, Dissertations, and Other Capstone Projects

Providers diligently educate patients on exercise to reduce the risk of cardiovascular disease, hypertension, diabetes, and stroke. However, in recent years, providers judiciously educate patients on exercise and its correlation to improving or impacting mental health disorders. Physical activity has been steadily shown to relate to improved physical health, life satisfaction, cognitive functioning, and psychological well-being. A large body of literature examines the impact of physical activity and exercise on mental health. There is a growing interest in the use of exercise in the treatment of depression and anxiety, as a primary option or as an adjunct to pharmacological treatment. …