Psychiatry and Psychology Commons^™

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 …

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 …

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. …

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 …

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 …

The Effects Of School-Based Art Therapy On Depressed Adolescents, Jasmine Nicolas

Nursing | Senior Theses

Depression in adolescents is associated with deficient behavioral and health outcomes (Fletcher, 2019). Art therapy has been shown to be effective in treating mental health condition such as depression. A student’s academic success heavily depends on treating their depression. Community health nurses can play a vital role in advocating for adequate mental health support to improve a student’s overall well-being and academic success. The literature review contains six articles on the prevalence and impact of depression among adolescents, art therapy as an intervention for improving psychological outcomes and resilience among adolescents, and experiences of adolescent clients in art therapy within …

Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon

Doctor of Nursing Practice Projects

African Americans (AA) have the highest prevalence of stroke and death compared to other racial groups in the United States. Post-stroke depression (PSD) affects approximately 1/3 of all stroke patients and is underdiagnosed in the African American community.

Aim: By using a mHealth mobile app and a Psychiatry provider list at discharge, PSD can be identified, and interventions initiated, thus decreasing the sequela of PSD in AA.

Methods: Nurses were provided education on PSD, expressions of depression in African-Americans, cultural humility, implicit bias, and the importance of the nurse's role in developing a therapeutic relationship.

Results: Quantitative analysis revealed the …

Improving Patient Outcomes In Substance Use Disorder Through Behavioral Therapy In Depression Development And Impacts Of Social Determinants Of Health During And After Substance Use Treatment, Jerry Ryan Armstrong, Chyanne Napp

Doctoral Projects

Substance Use Disorder (SUD) is a growing problem in the United States (U.S.) and worldwide and relapse is a common occurrence among those facing SUD. Limited scholarly research has been published addressing evidence-based treatment improvement strategies. This study focused on improving SUD treatment through the incorporation of depression tracking from admission to and discharge from inpatient treatment, as well as the incorporation of social determinants of health education during treatment, with an evaluation of relapse rates 30-days after inpatient treatment discharge. Results indicated a significant improvement in depression scores from admission to discharge. Results also revealed improved knowledge regarding social …

Evaluating Patient Health Questionnaire-9 (Phq-9) Use In Burn Survivors, Chelsey Friend

Dissertations

Problem: A burn injury affects both psychological and physical health, resulting in a greater than 50% major depressive disorder morbidity. The purpose of this quality improvement (QI) project is to evaluate the use of the Patient Health Questionnaire-9 (PHQ-9) in adult burn survivors, with an aim to increase the use of the screening tool.

Methods: A mixed-methods pre/post-survey design with an educational component was utilized to assess nurse knowledge, confidence, willingness, and barriers to completion of the PHQ-9. Aggregate data were collected to determine PHQ-9 completion rates for patients admitted to and discharged from the unit during the two months …

Implementation Of Routine Screening With Patient Health Questionnaire 9 (Phq-9) Of Adults With Crohn’S Disease, Jo A. Muller-Krause

Doctor of Nursing Practice Projects

Introduction: Mild levels of depression have been measured with screening tools at rates of 15-24% in adults with Crohn’s disease (CD). The spectrum of the impact of depressive symptoms is measurable and documented for those with CD. Patient perspectives support the integration of psychological care, and the Patient Health Questionnaire 9 (PHQ-9) is a well validated tool for the measurement of depressive symptoms.

Purpose: Increase depression screening of adult CD patients in the outpatient gastroenterology clinic and evaluate the provider perspectives regarding PHQ-9, depression, and CD.

Conceptual Framework: The Johns Hopkins Nursing Evidence Based Practice (JHNEBP) Model was selected as …

Nutrition On The Prevention And Treatment Of Depression, Gracie Polen

Nursing | Senior Theses

Today, the general population consumes a diet high in sugars, saturated fats, incomplete protein sources, and the tendency to exceed the bodies caloric requirements. The trend of obesity due to poor dietary habits is alarming. Mental illness has increasingly risen over the past decade. Specifically, the incidence of depression has reached a startling rate. The relationship between poor dietary intake and depression have grown together and it is imperative that methods are introduced to aid in resolving this issue. The prevention and treatment of depression needs to be explored through alternative methods. Healthier dietary choices have been shown to have …

The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell

Undergraduate Honors Theses

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression …

Family-Centered Psychosocial Care For Pediatric Oncology Patients, Jessica W. Casey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Psychosocial conditions are prevalent in pediatric oncology patients (Kahalley et al., 2013). Family and social support are essential aspects of a patient's health care outcomes (Merck & McElfresh, 2019). Anxiety and depression are common in pediatric oncology patients due to trauma during treatment (Pao & Kazak, 2015). These patients also can have preexisting developmental or behavioral conditions before starting treatment. Treatment side effects can also cause cognitive and behavioral changes (Nixon, 2014b). Nurses should be knowledgeable and confident in their ability to care for patients' psychosocial health and development. The purpose of this Doctor of Nursing Practice (DNP) project is …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

The Effect Of Implementing A Generalized Anxiety Disorder Protocol For Anxiety And Depression Symptoms In The Primary Care Setting, Bailey J. Hinman

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is very prevalent in the United States with 5.7% of citizens affected (National Institute of Mental Health [NIMH], 2017). This number is expected to be even higher because individuals avoid care due to stigma of mental illness (Andrews et al., 2018). GAD can have significant implications such as decreased ability to function, decreased quality of life and increased risk of suicide (Fong, 2018; Lizarondo, 2018). The purpose of this project was to improve outcomes for adult patients with GAD in the primary care setting by improving treatment to follow best practice recommendations. The Johns Hopkins Evidence …

Using A Psychopharmacology Education Program To Increase Primary Care Provider Comfort With Treating Basic Psychiatric Disorders, Latesha Reed

DNP Scholarly Projects

BACKGROUND: Almost 1 in 5 people have been diagnosed with a mental health illness but the supply of psychiatric providers does not meet patient’s needs. Multiple reasons contribute to this shortage and nurse practitioners are part of the solution. Even with nurse practitioners specializing in psychiatric mental health there is still a shortage. Primary care is where most patients first present their mental health issues.

METHODS: Literature review informed the development of the educational intervention presented to the primary care providers using a digital, asynchronous learning format. A gap analysis of organizational needs and weaknesses was used to determine the …

Differences In Smoking Behaviors And Readiness To Change For Patients With Copd And Differing Categories Of Depression, Jessica M. Floyd

Graduate Theses, Dissertations, and Problem Reports

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world. Depression is a common comorbidity of COPD and affects patient outcomes and smoking cessation. The purpose of this study was to explore and describe factors influencing smoking behaviors and readiness to change in patients with comorbid COPD and depression.

Aims: The research question that guided this study was, “What are the relationships among smoking, COPD, and depression?” The following aims stemmed from the research question: to describe the characteristics of a convenience sample of people living with COPD and differing categories of depression who …

Stressful Life Events And Postpartum Depression, Madison E. Laurent

Honors Theses and Capstones

No abstract provided.

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 …

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 …

Analysis Of A Universal Depression Screening Workflow At An Integrated Healthcare Center, Arthur Roehr

Doctor of Nursing Practice Final Manuscripts

Purpose: Evaluation of an evidence-based protocol that measures the effectiveness of universal depression screening at an integrated healthcare center. At risk patients are those who complete a patient health questionnaire (phq-9) and score ≥ 10 when presenting for a primary care visit. A score of ≥ 10 prompts further evaluation by the primary care provider (PCP) prior to behavioral health care management (BHCM) referral.

Background: In 2016, 16.2 million adults aged 18 or older in the U.S. experienced a major depressive episode (MDE). 65.3% of those received some form of treatment from a healthcare professional (therapy and/or medication). Early identification …

Anxiety Is Something To Worry About: The Effects Of A Cognitive Behavioral Therapy And Selective Serotonin Reuptake Inhibitor Intervention Protocol On Generalized Anxiety Disorder, Alesha E. Mcclanahan

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is highly prevalent in the United States with at least 12% of the population affected (Edmund & Sheppard, 2018). GAD can pose significant distress and debilitation throughout the lifespan (Bystritsky, Khalsa, Cameron, & Schiffman, 2013; Edmund & Sheppard, 2018). Barriers to treatment include adverse effects, inaccessibility, and expense. The purpose of this project was to implement an evidence-based protocol involving combination therapy with self-administered cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication in order to improve patient outcomes through more accessible, affordable, and standardized treatment of GAD. The Neuman Systems Model and Stetler …

Effects Of Therapeutic Music On Improving Depressive Symptoms Among Long-Term Care Facility Residents, Yi Jin

Evidence-Based Practice Project Reports

Depression is a common mental disorder that can contribute to both physical and psychological suffering (Skinner, 2014). The prevalence rate of depression is especially high among long-term care facility residents (CounsultGeri, 2018; Lolk & Andersen, 2015). The purpose of this EBP project was to establish a protocol incorporating therapeutic music as an adjunct therapy for managing depressive symptoms among residents of a long-term care facility in the Midwest. Roy adaptation model (Roy, 2009) was utilized as the theoretical framework, and the model for evidence-based practice change (Rosswurm & Larrabee, 2009) guided the project implementation. A total of 13 subjects were …

Increasing Utilization Of Cognitive Behavioral Therapy To Reduce Morbid Obesity In A Primary Care Setting, Erin J. Mccue

Doctoral Projects

Background: Obesity among adults is characterized by a body mass index (BMI) of 30 or higher. The impairment and disability resulting from obesity indicates a significant health problem that is often seen in primary care settings. Research indicates that cognitive behavioral therapy (CBT) is an underutilized, but extremely beneficial intervention that may support individuals in achieving weight loss. Adults suffering from obesity with or without comorbid conditions such as psychiatric disorders (e.g. anxiety and depression) have benefitted from CBT.

Purpose: To implement the increased utilization of CBT in the adult population with obesity and depression or anxiety in a primary …

Improving Depression Screening And Follow-Up In Primary Care Through Implementation Of An Evidence-Based Protocol, Cheryl Fowler

Doctoral Projects

Depression is a leading cause of disability in adults and is a major contributor to burden of disease (World Health Organization [WHO], 2018). The United States Preventative Services Task Force (USPSTF) provides evidence-based recommendations to promote disease prevention. Among these, is the recommendation that all adults, regardless of risk factors, should be screened for depression in the primary care setting with adequate systems in place to allow for appropriate diagnosis and management (USPSTF, 2016). The purpose of this Doctor of Nursing Practice (DNP) student project was to develop and implement an evidence-based protocol in the primary care setting with aims …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …

Prevention Of Post Intensive Care Syndrome-Family With Sensation Awareness Focused Training Intervention: A Randomized Controlled Trial Pilot Study, Paula L. Cairns

USF Tampa Graduate Theses and Dissertations

Post Intensive Care Syndrome-Family (PICS-F) refers to acute and chronic psychological effects of critical illness on family members of patients in intensive care units (ICU). Evidence about the increase and persistence of PICS-F warrants the need for prevention interventions. This study evaluated the feasibility of providing Sensation Awareness Focused Training (SĀF-T) during the ICU stay for spouses of mechanically ventilated patients. Methods: A randomized controlled trial of SĀF-T versus a control group was conducted (n=10) to assess safety, acceptability, feasibility, and effect size of the intervention on PICS-F symptoms. Symptoms assessed as outcome measures included stress, anxiety, depression, posttraumatic stress …

The Effect Of Routine Adult Phq-2 Depression Screen And Scheduled Follow-Up Protocol In The Primary Care Setting, Alex F. Bikowski

Evidence-Based Practice Project Reports

Healthy People has projected depression to be the primary cause of disability by 2020; therefore routine depression screening has been prioritized as a national healthcare initiative. The purpose of this Evidence-Based Practice (EBP) project is to demonstrate that routine implementation of the 2-item Patient Health Questionnaire (PHQ-2) depression screener, along with a scheduled follow-up protocol for adults in the primary care setting, can improve current mental health practices regarding the identification of depression by clinicians. The evidence supports use of the PHQ-2 for routine adult depression screening, as long as a scheduled follow-up protocol is available for positive screens. This …

Examining The Associations Between Depressive Symptoms, Body Mass Index, And Physical Activity Self-Efficacy In African American Mother-Child Dyads, Y'Esha Vonyae Williams

Theses and Dissertations (ETD)

In recent decades the prevalence of childhood and adult depression and obesity has increased worldwide. Multiple factors influence the onset of both depression and obesity. Individual manifestations of depressive symptomatology and health-related problems associated with obesity vary; however, genetics and environmental and psychological factors have been implicated as correlates. Consequently, both disorders can ultimately interfere with individuals’ activities of daily living and decrease their quality of life. African American women are known to have a higher prevalence of obesity and more severe depressive symptoms in comparison to Caucasian women. Likewise, African American children are more obese and experience many factors …