Medicine and Health Sciences Commons^™

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …

Improving Early Identification And Management Of Depression Symptomology Through Implementation Of Universal Depression Screening In A University Student Health Center, Jessica M. Monjaras

Evidence-Based Practice Project Reports

Depression is the leading cause of disability in the United States for individuals aged 15 to 44 (Anxiety and Depression Association of America, 2023). The purpose of this evidence-based practice (EBP) project was to increase early identification of depression through implementation of universal depression screening, and to implement management strategies to decrease symptoms of depression. A two-tiered approach to universal depression screening was utilized through use of the PHQ-2 and PHQ-9 screening tools. Ten young adult patients, between the ages of 18 to 25, from a university student health center clinic in Northwest Indiana participated in this project. Participants underwent …

Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor

Doctor of Nursing Practice Projects

Depression remains an increasingly prevalent and underdiagnosed disorder affecting approximately 21 million adults in the United States with only 66% seeking treatment (NIMH, 2022). Untreated depression can lead to worsening mental and physical health which negatively impacts a person’s quality of life. The implementation of routine depression screening in primary care is recommended by the US Preventive Services Task Force (USPSTF) to improve early detection leading to improved outcomes (USPSTF, 2023). Despite increased depression prevalence and USPSTF recommendation, there remained an absence of routine depression screening in a primary care practice in Midwest Illinois which led to the development of …

Utilizing A Structured Music Therapy Program For Adolescents With Anxiety And Depression, Amy Haagen

West Chester University Doctoral Projects

Anxiety and depression are two of the most common mental health issues that affect children and adolescents. It has been noted that twenty percent of adolescents will have a depressive episode or be affected by anxiety by the time they are 18 years old. Mental health issues affecting children and adolescents majorly impact all aspects of their lives, most notably academic success, behavior, growth, and development (Porter et al., 2017). Current treatments for mental disorders, including depression and anxiety, include pharmacological and psychotherapeutic treatments. In the adolescent population, there are conflicting opinions on the use of antidepressants due to risks …

Integrating Behavioral Health Into Family Medicine: Improving Access To Specialty Care Using A Collaborative Care Model, Christina Stephens

DNP Scholarly Projects

Primary care, an extensive of family medicine remains a key access point for patients entering the healthcare system. Accessing medical care and specialty psychiatric services is limited in rural communities. Patients often find exhaustive wait times, untimely referrals, and reliance on emergency services for crisis management. The primary care provider is able to help their community improve access to behavioral health care by using a collaborative approach. This quality improvement initiative used the framework produced by the AIMS Center at the University of Washington and adopted for use creating an 8-week intensive program in a family medical practice located in …

Nurse Suicide: Examining Depression And Anxiety In Critical Care Settings, Arianna Bernardine Barata

Nursing | Senior Theses

Nurses play a critical role in healthcare, yet the demanding work environment often exposes them to stressors, leading to the development of depression and anxiety. According to the National Library of Medicine (NLM) (2021), 50.8% of nurses have stress, 74% have anxiety, 70.8% have depression, and 79.1% have at least one of them. Burnout, understaffing, COVID fatigue, alarm fatigue, patient ratios, and disrupted sleep patterns are some of the stressors nurses contend with in every shift. While some nurses may cope and overcome these challenges, many face more severe issues, such as suicide. Nurse suicide is an issue that has …

Increased Concern Of Suicide Behaviors In The Adolescent Population, Jaime Shareen-Porter Earle

Doctor of Nursing Practice Projects

This quality improvement project focused on addressing the concern for the increase of depression, anxiety, and self-harm behaviors among adolescents, which can lead to suicidal ideation and attempts. Suicide behaviors have increased among adolescents, and research revealed that suicide is the second leading cause of death in this population. An educational PowerPoint was presented to members of the community on suicide behaviors, how to identify the behaviors, and where to get support and resources in the community. Pre- and post-surveys were used to assess the participants' knowledge and confidence levels before and after project implementation. The surveys contained the same …

Introducing Mental Health Resources To Nurse Practitioner Residents, Tiffanie Bailey

Doctor of Nursing Practice Projects

This DNP Project identified the increased need for mental health resources after the COVID-19 pandemic. Studies showed the rate of anxiety, depression, and substance use has also been on the rise since the beginning of the pandemic. As the impact of the COVID-19 pandemic began to devastate the country mentally and physically, it became quickly apparent that additional resources to provide support for those suffering from mental illness were essential. This project aimed to introduce a Mental Health First Aid course within the Residency Program at the Center for Family Guidance. Participants were asked to complete a pre-test indicating their …

Community Educational Session On Identifying The Signs Of Depression And Resources Available, Desiree Young

Doctor of Nursing Practice Projects

The DNP Project was designed to educate the community on identifying the signs of depression and the community resources available to them. The intent of the project was to improve the community’s knowledge of depression symptoms and the community resources available that offer assistance to those dealing with these symptoms. There is a great need for education on depression signs, as many in various communities suffer from untreated depression, which often leads to negative outcomes. The impact of the project implementation was measured by using pre- and post-survey data evaluating the participants' overall knowledge of the signs of depression, stigma …

Depression Screening Tool For Hysterectomy Patients, Dede C. Mihedji

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The prevalence of hysterectomies in the United States ranges from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing

depression preoperatively could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy.

Local Problem: Currently, there is no standard of practice to routinely screen for depression in preoperative patients scheduled for hysterectomy surgeries. However, as with any surgical intervention, there are risks of long-term complications. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). …

A Quality Improvement Project To Screen For Food Insecurity In Adults With Anxiety Or Depression, Kelsie Evelyn Kroll

Doctor of Nursing Practice

Background Food insecurity is the limited availability and inconsistent accessibility of healthy foods (Coleman-Jensen et al., 2022a). Food insecurity contributes to mental health problems. Individuals with food insecurity have greater odds of screening positive for depression and anxiety (Wolfson et al., 2021). The Hunger Vital Sign™ screening tool is a 2-questions evidence-based tool used to identify food insecurity (Hager et al., 2010). Purpose. Implement the Hunger Vital Sign™ tool at a non-profit behavior health clinic to identify food insecurity in adults who screened positive for anxiety or depression, offer resources for them to obtain nutritious food, and provide additional information …

Targeting Loneliness In Older Adults With Weekly Socialization, Tanja Johnson

Dissertations

Problem: Loneliness related to social isolation among the older adult population has become an increasing health concern with few interventions available for the general population. Loneliness has been directly associated with depression, poorer physical health outcomes, and overall quality of life.

Methods: The purpose of this study is to evaluate loneliness in the older adult population residing in a senior living community in an urban area in Missouri. Weekly one-on-one socialization, ranging from 45-60 minutes, will be implemented over 6 weeks, with pre and post-intervention screening for loneliness with the 28-item Visit-A-Bit (VAB) screening tool. Approval was received by both …

Psychological Distress, Resilience, And The Impact On Quality Of Life In Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy, Lauren Schwab

USF Tampa Graduate Theses and Dissertations

The purpose of this dissertation study was to longitudinally examine psychological distress (depressive symptoms and anxiety symptoms), resilience, and the impact on quality of life (QOL) in breast cancer survivors (BCS) with taxane-induced peripheral neuropathy (TIPN). The specific aims were 1) to describe psychological distress (depressive and anxiety symptoms) in BCS with TIPN and the impact on QOL using a scoping review; 2) to determine the relationship between psychological distress, QOL, and resilience in BCS with TIPN over time in a 16-week randomized controlled trial (RCT); and 3) to determine if resilience moderates psychological distress and QOL in BCS with …

Prevalence Of Depression In Patients With Cardiovascular Diseases, Faryal Ghafoor

Theses & Dissertations

Background: Approximately 17.3 million individuals across the globe lose their lives to cardiovascular diseases (CVD), with a majority of these cases occurring in low-to-middle-income countries. The incidence of cardiovascular disease in Pakistan is 918 cases per 100,000 individuals. Depression frequently impacts the health, expenses, and prognosis of patients with cardiovascular disease.
Purpose: This study aimed to determine the prevalence of depression among CVD patients at Aga Khan University Hospital, Karachi, and explore the influence of co-morbidities, marital status, age, and educational background on one's status, regarding depression.
Method: A quantitative descriptive cross-sectional study was conducted at the Aga Khan University …

Psychological Distress, Resilience, And The Impact On Quality Of Life In Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy, Lauren Schwab

USF Tampa Graduate Theses and Dissertations

The purpose of this dissertation study was to longitudinally examine psychological distress (depressive symptoms and anxiety symptoms), resilience, and the impact on quality of life (QOL) in breast cancer survivors (BCS) with taxane-induced peripheral neuropathy (TIPN). The specific aims were 1) to describe psychological distress (depressive and anxiety symptoms) in BCS with TIPN and the impact on QOL using a scoping review; 2) to determine the relationship between psychological distress, QOL, and resilience in BCS with TIPN over time in a 16-week randomized controlled trial (RCT); and 3) to determine if resilience moderates psychological distress and QOL in BCS with …

Improving Health Outcomes Among Patients With Chf Through Implementation Of Telehealth Depression Screening And Chf Symptom Management, Akudo Udodiri Unanwa

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Comorbid congestive heart failure (CHF) and depressive disorder is a leading cause of mortality globally. Despite effective detection and therapeutic options, 30-day hospital readmission rates for CHF patients remain high, with patients experiencing adverse clinical outcomes and poorer quality of life. Depression is identified as a common comorbidity among CHF patients that may negatively impact patient self-care and adherence to a CHF treatment plan.

Problem: Telehealth applications are an increasingly utilized approach to healthcare delivery that enhances timely access to healthcare services by reducing physical proximity and transportation barriers to care. Currently, telehealth screening for CHF in the …

Implementation Of A Postpartum Depression Screening Protocol, Samantha Abercrombie

Doctor of Nursing Practice Projects

Background: Postpartum depression (PPD) is a major depressive disorder that can occur after having a baby and anytime during the first year postpartum (Centers for Disease Control and Prevention [CDC], 2021). Symptoms of PPD may include anger, crying more than usual, withdrawing from family, inability to bond with the baby, feelings of anxiousness, or thoughts of the mother harming herself or the baby. PPD can yield many challenges and hinder daily living activities. Recent research by the CDC (2021) estimates that 1 in 8 women experience manifestations of PPD. Findings also suggest that 1 in 5 women were not …

Incorporating A Depression Screening Tool With A Music Strategy For Depression In Adults Aged 50 And Older In An Ltc Facility, Margaret L. Hill

Doctor of Nursing Practice Projects

Background: Depression is not a normal part of life or the aging process. Unfortunately, older adults are at an increased risk of experiencing depressive symptoms. The global prevalence of major depression in older adults at 13.3%, and adults (70 and above) have a higher risk of depression compared to other age groups.

Purpose: The purpose of the DNP project was to improve patient outcomes through the implementation of depression screening and an adjunctive music strategy in older adults with depressive symptoms.

Methods: A pre, mid, and post-intervention was conducted in a long-term care facility. This author conducted a …

Implementation Of A Progressive Muscle Relaxation Intervention To Decrease Cancer Patients' Distress: A Quality Improvement Project., Theresa Thomas

Doctor of Nursing Practice Papers

Background: People affected by cancer often experience psychological distress that ultimately decreases their health, adherence to treatment, overall well-being, and quality of life. Research has shown that MBIs can reduce psychological distress, depression, and anxiety and increase quality of life. A needs assessment conducted within a local cancer support organization, Gilda’s Club Kentuckiana, has expressed the need for providing a more comprehensive range of accessible MBIs in their programming to meet their psychosocial goals by reducing psychological distress in their members. PMR is an MBI not currently used by GCK that has been proven effective at reducing anxiety, depression, and …

Nurse-Led Post Stroke Depression Screening (Psd) For Patients With Acute Stroke Using Patient Health Questionnaire-9 (Phq9), Stefan Panov

Doctor of Nursing Practice Final Manuscripts

Introduction: This Evidence-Based Practice Doctor of Nursing Practice project aimed to implement a nurse-led post-stroke depression (PSD) screening using Patient Health Queastionnaire-9 (PHQ-9) in a 12-bed progressive care neuro-stroke unit at a tertiary care hospital. The first goal of this project was to detect stroke patients at risk for depression who met specific inclusion criteria. The second goal was to provide depression education, initiate social work and medical referrals, and start pharmacological treatment to reduce the medical and socioeconomic burden associated with untreated PSD before discharge from the hospital.

Background: Globally, stroke is a prominent cause of death and disability. …

Mental Health Wellness In The Latino Population: Improving Phq-9 Scores In Depressed Patients With Comorbid Type Ii Diabetes, Amanda Cuellar

Doctor of Nursing Practice Final Manuscripts

Major depressive disorder is one of the most common mental health conditions. In the United States, 8.1% of the population have symptoms of depression. Patients with diabetes are 2–3 times more likely to experience symptoms of depression compared to the general population. Having these chronic conditions simultaneously can cause complications in both. The purpose of this study was to improve depression scores for patients who have comorbid type II diabetes. This project took place in a rural community with the Latino population. The nurse practitioner led an evidence-based practice project implementing treatment of depression with medication management, individual psychotherapy, and …

Exercise As A Prescription For Patients With Depressive Disorders: A Quality Improvement Project, Sydney Roscoe, Rachelle Pace

Doctor of Nursing Practice Final Manuscripts

Purpose: The aim of this Doctor of Nursing Practice project was to increase exercise counseling rates in the treatment of depression by (1) implementing a focused educational training program and (2) understanding factors that impacted utilization of the practice change.

Background: Approximately 280 million individuals suffer globally from depressive disorders. Depression remains the fourth leading cause of disabilities, significantly contributing toward the global burden of disease by increasing morbidity and mortality risk. Psychopharmacology and psychotherapy are current gold standards of treatment; however, providers often overlook the significant role exercise serves in reducing depressive symptoms and severity, as it remains underutilized. …

Cbt Technology Implementation With Pediatric And Adolescent Populations, Tracey W. Kreipe, Heath Gage, Sandra Obiebi

Doctor of Nursing Practice Projects

Abstract

Digital therapy is a growing healthcare intervention improving limited access to specialty care for specific populations and geographic areas. Cognitive Behavioral Therapy (CBT) applications focus on treating anxiety and depression and assist pediatric and adolescent patients in learning behavioral techniques as they wait for 3-6 months or longer to see a mental health provider. Such delays are attributed to the national shortage of mental health practitioners and the further scarcity of fewer psychiatric providers in rural areas, causing the potential for adverse patient outcomes. The setting for this 8-week quality improvement project was a pediatric care clinic that sees …

Improving Depression Remission Screening Compliance, Crystal Wingerter

Doctor of Nursing Practice Projects

Depressive disorders are widespread in the United States and are diagnosed and treated in the primary care setting. In 2019, there were an estimated 19.4 million adults that had at least one major depressive episode. The purpose of this project was to improve follow up and depression remission assessment for patients with a diagnosis of depression at a metropolitan family care practice clinic. The Patient Health Questionnaire (PHQ–9) was utilized for remission assessment. Front desk staff and providers were trained and granted access to the quality information system (QIS) in the electronic medical records (EMR) system which allowed easy identification …

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

Personal Health Questionnaire-9 And Interventions In Adults, Grace Alford

Masters Theses/Capstone Projects

This is an evaluation of the PHQ-9 depression screening and interventions in adults within an urban setting.

Mental Health Burden And Attitudes And Intention To Seek Mental Health Services In Saudi Women Living In The United States, Wjdan A. Almutairi

Doctoral Dissertations

Background: The number of Saudi nationals immigrating to the U.S. continues to increase. Saudi women immigrants may be at increased risk for mental health disorders, including depression and anxiety, due to immigration-related stressors such as language difficulties, family separation, and cultural adjustment. Purpose: The purpose of this study was to measure anxiety and depression levels in Saudi women living in the U.S. and to assess factors affecting their intention to seek mental health services in the U.S. Methods: A descriptive cross-sectional design was employed, using online self-reported surveys. The study included a convenience sample of 160 Saudi women living in …

Implementation Of Collaborative Care Intervention Within A Fqhc To Achieve Uniform Data System (Uds) Measure Of Depression Remission, Rasha A. Kafi Msn, Rn, Fnp-C

Doctor of Nursing Practice Projects

Background: Depression is one of the most common and treatable mental health conditions. Untreated depression causes emotional suffering, reduced productivity, lost wages, increased comorbidity risks, and increased healthcare costs.

Purpose: The purpose of this project was to implement Collaborative Care Interventions (CCI) to achieve the Uniform Data System (UDS) Measure of Depression Remission.

Aims: The AIMS of this project were: (a) Increases the percentage of nursing staff compliance and completion of the educational training; (b) increases nursing staff knowledge of recognition of depression signs and symptoms, early identification of depression, and administration to all adult patients; (c) Increase the percentage …

Faith-Based Collaboration To Improve Depression & Self-Compassion In The Elderly: A Dnp Project, Julita Cinguina

Doctor of Nursing Practice Projects

Abstract

Faith-based organizations are in a position to improve mental health outcomes for the elderly. With the help of the Community Wellness Center at Our Lady of Fatima (OLF) Catholic Church in Wilton, Connecticut, a new action plan was implemented to accomplish this goal. The proposed DNP Project was an evidence-based, multi-factorial intervention to improve self-compassion and reduce risk for depression for the elderly in the community. It consisted of four structured group sessions over a 6-week period with each session lasting 45 minutes. The group meetings offered evidence-based strategies to improve mental health including: (1) purposeful spiritual counseling utilizing …

Nursing Interventions To Decrease Depressive And Anxious Symptoms In Hispanic-American Youth, Vanessa C. Hernandez

Honors Undergraduate Theses

Introduction: Hispanic-American youth are less likely to receive mental health services despite being at increased risk for depression and anxiety. Having depression and anxiety at a young age can have detrimental long-term effects such as sexual risk behavior, delinquency, and suicide. Various kinds of nurses interact with this age group which can be a missed opportunity to intervene for the welfare of these youth. Interventions exist for depression and anxiety; however, they are not specific to nurses who care for young Hispanic-American patients. Methods: An integrative literature review was performed to identify nursing interventions for Hispanic American youth with depression …