Nursing Commons^™

Regionality In Heart Failure Self-Care Behaviors Using The Medical Expenditure Panel Survey, Gretchen K. Wendt

Nursing Dissertations - Archive

Heart failure (HF) risks increase as patients age, with most of the HF patients having at least one chronic condition and 40% having two or more. Further confounding the HF morbidity and chronic medical conditions are psychiatric conditions like depression and anxiety. For most Americans with HF, managing the diagnosis and chronic conditions can be overwhelming. To formalize the definitions of HF disease management, the concepts of self-care from the situation-specific theory of HF self-care (SST-HFSC) were applied.

The medical complexity of HF self-care during the pandemic was shown to vary based on the US region where the individual resided. …

Psychosocial Factors Affecting Quality Of Life In Kidney Transplant Recipients, Lawrence Panlilio

Nursing | Senior Theses

Background: Kidney transplantation is the best solution to save lives for those that have end-stage renal disease. However, psychosocial issues play a huge role in their quality of life after the procedure which can affect these individuals negatively. These issues recipients face include depression and anxiety, a lack of social support, and self management difficulties. Objective: This research consists of investigating psychosocial factors that affect kidney transplant recipients’ quality of life. Evidenced by research, focused assistance with ongoing support in patients is essential after receiving surgery and recovery. A literature review was conducted that consists of research on studies with …

The Impact Of A Educational Program On Depression And Anxiety For Low Socioeconomic Latina Postpartum Mothers, Lizbeth Valdez Duran

Nursing | Senior Theses

Postpartum depression (PPD) and anxiety are significant mental health challenges that affect many mothers, especially Latina women with low socioeconomic backgrounds. These mothers often face barriers to care, health literacy, and access to healthcare resources. The problem is compounded by a lack of culturally competent care, which can contribute to mistrust of healthcare providers and discourage Latina mothers from seeking help. The literature review articles highlight that health literacy plays a crucial role in managing mental health, with effective education potentially reducing negative outcomes by improving coping strategies and bringing awareness to symptoms that are associated with postpartum. This research …

Effective Measurement-Based Care For Depression Within Va Health Systems: A Quality Improvement Initiative, Amie L. Doyle

DNP Scholarly Projects

Background: Depression is highly common among U.S. veterans, surpassing civilian rates. Measurement-Based Care (MBC), including the Patient Health Questionnaire-9 (PHQ-9), facilitates systematic symptom monitoring and treatment enhancement. At Manchester VA Medical Center (VAMC), PHQ-9 completion in primary care was low (18.93% in May 2025) due to workflow inefficiencies, provider workload, and dependence on Mental Health Service Line (MHSL) referrals.

Local Problem: Underutilization of the PHQ-9 in primary care hampers early detection and effective treatment of depression among veterans.

Methods: Four primary care teams received training on using the Behavioral Health Laboratory (BHL) software, which facilitates pre-visit electronic completion of the …

Maternal-Infant Attachment, Depression, Anxiety, And Breastfeeding Self-Efficacy Among Marginalized Populations, Leslie B. Lantz, Merilyn Arikkat, Amy Salisbury, Sara Moyer, Sally Russell, Leroy Thacker, Candice Gault, Josselyn Valenzuela, Kimberly Cruz-Lopez, S Bodnar-Deren, Patricia Kinser

School of Nursing Publications

No abstract provided.

A Comprehensive Exploration Of Stress And Depressive Symptoms In Farm Populations, Julie C. Derringer

Theses and Dissertations--Nursing

High rates of depression and suicide continue to be a concern, despite four decades of growing research into the mental health of farmers. Most farmers have an awareness of a need for improved mental health, but a lack of knowledge persists. As agricultural production demands increase and the number of family farms decreases, the stress placed upon farmers to support the food chain is higher than ever. Understanding the association between farm demands and resources among farmers is key for the development and implementation of programs to decrease occupational stress and depressive symptoms to improve mental health outcomes across farming …

Self-Determined Strategies For Physical Activity Motivation Among Women With Polycystic Ovary Syndrome, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Cynthia Corbett Phd, Rn, Faan, Bernardine M. Pinto Phd, Fapa, Fsbm, Fabmr, Michael D. Wirth Msph, Phd, Face, Robin M. Dawson Phd, Rn, Cpnp-Pc

Publications

BACKGROUND: According to clinical practice guidelines for polycystic ovary syndrome, first-line treatment includes performing 150 min of moderate-to-vigorous physical activity on most days of the week plus at least 2 days of resistance training. However, < 40% of women with polycystic ovary syndrome engage in regular physical activity, and about 60% are sedentary. Research evidence supports theory-informed physical activity interventions to improve motivation for physical activity. This study examined the fit of a behavioral change theory for women with polycystic ovary syndrome. OBJECTIVES: The purposes of this qualitative study were to analyze physical activity barriers through the lens of self-determination theory and identify motivational strategies that may promote initiation and maintenance of physical activity among women with polycystic ovary syndrome. DESIGN: The study involved a qualitative, descriptive design using theory-driven thematic analysis. METHODS: After emailing a demographic questionnaire and Personal Health Questionnaire-8 to screen for depressive symptoms, participants (n = 7) met three times via Zoom during the summer of 2021. Meetings were audio-recorded, transcribed, and analyzed. RESULTS: Participants were aged 33.9 (±8.1) years, premenopausal, mostly White (71%), educated (100% with at least some college), employed full-time (86%), and married (86%) with a mean depressive symptoms score of 6.4 (±3.4) indicating mild depression. Strategies such as a buddy system, physician support, technology, and behavioral change techniques are necessary to meet the psychological needs of autonomy, competence, and relatedness among women with polycystic ovary syndrome to help increase exercise motivation. CONCLUSION: Findings supported the use of self-determination theory by emphasizing that the social context of polycystic ovary syndrome can undermine physical activity behavior. Thus, physical activity interventions should consider the social context, peer support system, and mental health status of women with polycystic ovary syndrome, and include tailored programs and motivational strategies to help meet the psychological needs of autonomy, competence, and relatedness.

Evaluating Knowledge, Skills, Attitudes, And Suicide Hotline Referrals In Aprns Screening Children For Depression And Suicide In Primary Care, Brooklyn D. Higginbotham

DNP Projects

Background: Suicide is the 2nd leading cause of death in adolescents across the United States (US). Primary care providers (PCPs) are often the first people an adolescent sees for depression or suicide symptoms; however, evidence shows PCPs may not be comprehensively screening for suicide in the primary care setting by using the Patient Health Questionnaire (PHQ) alone. Screening tool usage for depression and suicide among PCPs is currently at rates as low as 26% due to lack of knowledge and insufficient resources. Evidence-based education on American Academy of Pediatrics (AAP) recommendations can improve PCPs’ knowledge, skills, and attitudes when assessing …

Nurse-Led Cbt For Depression In Heart Transplant Patients: A Feasibility Study, Matthew R. Wallace

DNP Projects

Background: Heart transplant recipients are at an elevated risk of experiencing depressive symptoms compared to the general population. Those with depression post-transplant face increased complications, e.g., infection, organ rejection, prolonged hospitalization, and higher mortality rates. However, specific psychotherapeutic interventions tailored for heart transplant recipients remain limited. Nevertheless, there is substantial evidence supporting the effectiveness of various interventions for adults with heart failure, a condition frequently diagnosed in these patients. This suggests that successful strategies for managing depressive symptoms in heart failure patients could be adapted for heart transplant recipients.

Purpose: The purpose of this project was to evaluate …

Cognitive Impairment And Depression In Hispanic And Non-Hispanic White Low-Income Older Adults A Cross-Sectional Study, Cecil Latta

Honors Undergraduate Theses

Hispanic older adults represent a growing population in the United States and may be disproportionately affected by cognitive impairment and depression. We theorize that cognitive impairment would be more prevalent in the older Hispanic community and would affect the levels of depression in both Hispanic and non-Hispanic Whites older adults. This cross-sectional study examined the association between cognitive impairment and depression in 157 older adults, including Hispanic (n = 91, 57.96%, age: M = 76.4, SD = 6.8) and non-Hispanic White (n = 66, 42.04%, age: M = 76.2, SD = 6.5). We used the Memory Impairment Screen to assess …

The Association Between Sleep Quality, Depression, Anxiety, And Job-Related Stress Among Nurses In Saudi Arabia, Romeo Jr Patague Mostoles

Makara Journal of Health Research

Background: This study examined the mediating role of sleep quality in the relationship between depression, anxiety, and job-related stress among nurses in Saudi Arabia.

Methods: Sociodemographic information, Pittsburgh Sleep Quality Index, depression, anxiety, and work-related stress were evaluated in 851 nurses. Structural equation modeling was used to investigate the mediation effect of sleep quality on mental health and job stress in nurses.

Results: High rates of anxiety (65.9% severe, 34.1% moderate), depression (37.2% moderate to severe), and poor sleep (51.4%) were found. Sex, marital status, education, nationality, and smoking status significantly influenced mental health outcomes. For example, …

An Integrative Review Of Trauma Informed Care With Pediatrics To Minimize Psychological Sequelae Post Discharge, Amber Lee, Courtney Heinzelman

Master's Projects

Each year, a significant number of children sustain injuries requiring hospitalization, and while many recover physically, some face long-term psychological challenges such as post-traumatic stress, anxiety, and depression. This integrative review focuses on adolescents aged 13–18 who have experienced accidental trauma, exploring how trauma-informed care (TIC) in nursing compares to traditional approaches in reducing psychological impacts after discharge. Research suggests that many young patients report mental health symptoms for months following traumatic events. Trauma-informed care prioritizes principles such as safety, trust, peer support, and empowerment, aiming to reduce emotional distress and promote recovery. This review examines the application of these …

Educational Program On Depression And Anxiety For Low Socioeconomic Postpartum Latina Mothers, Lizbeth Valdez Duran

Nursing | Student Research Posters

Postpartum depression (PPD) and postpartum anxiety are common mental health conditions that women experience after childbirth. PPD involves intense feelings of extreme sadness, and diminished interests in activities that once brought them happiness. Postpartum anxiety involves constant worry and fear, often centered on the well-being of the baby. Symptoms may include restlessness or irritability, panic attacks, and trouble concentrating or sleeping. Barriers to treating depression and anxiety among Latinas include a lack of awareness or understanding of mental health issues. (Lopez et al., 2018).

Health Literacy refers to the individual's ability to understand and process health-related information. By assessing a …

Domestic Violence And Mental Health In Pregnant Women, Arabella M. Co

Nursing | Student Research Posters

Background: Domestic violence can include verbal, emotional, and physical abuse, which can lead to long-term mental health disorders such as stress, anxiety, or post-traumatic stress disorder. Purpose: This research includes a literature review, as well as a proposed research design to examine the significance of intimate partner violence in relation to mental health by implementing screening methods and interventions. Method: Participants will be recruited from prenatal clinics around the Bay Area. A quantitative, randomized, controlled-trial cohort study will investigate the effectiveness of the Pregnancy Risk Assessment Monitoring Systems (PRAMS). A screening tool used in determining intimate partner violence within the …

Identifying Adolescent Depression In The Public School System, Laura Lee Griffith

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Twenty percent of United States adolescents experience major depression at some point. Elevated school dropout rates, substance abuse, chronic disease, mortality and morbidity rates, and impaired growth remain because 60 % of adolescents with unidentified depression do not receive treatment. Purpose: This evidence-based project identified adolescents aged 16-19 in a South Carolina high school who had symptoms of depression. Counseling and resource information were provided for students with scores of 10 or greater, or thoughts of self-harm on the PHQ-9. Method: Students were screened using the PHQ-9. Data was organized in Excel and analyzed using the T-tests and …

Depression In Individuals With Chronic Liver Disease: Improving Screening In The Outpatient Setting, Kayla Corine Wright

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Individuals with chronic conditions such as chronic liver disease experience higher rates of depression, often underdiagnosed and placing high risk demographics in jeopardy of adverse outcomes, including worsening prognosis, decreased quality of life, and increased symptomatology.

Purpose: Evidence advocates for routine depression screening within high-risk patient populations. This paper outlines the implementation of a quality improvement initiative aimed at enhancing depression screening at a selected outpatient liver clinic within an extensive hospital system by implementing the PHQ-9 questionnaire during patient clinic visits, where no standardized screening protocol was previously in place.

Methods: The Plan-Do-Study-Act cycle guided the implementation …

Screening For Depression Post Acute Coronary Syndrome, Alyssa Graham

Dissertations

Background: Acute coronary syndrome (ACS) and depression have profound impacts on patient outcomes. Patients who experience ACS are at increased risk of developing depression, which is associated with an increased risk of death and recurrent cardiac events. The evidence following ACS events promotes routine depression screening. The purpose of this project was to identify early depression in patients 65-99 years of age who had a recent diagnosis of ACS during their hospitalization.

Methods: This quality improvement (QI) project was a prospective descriptive observational design implementing a depression screening protocol to evaluate post-ACS referrals within 7-14 days of screening from February …

Depressive Symptoms And Sleep Quality Mediate The Relationship Between Race And Quality Of Life Among Patients With Heart Failure: A Serial Multiple Mediator Model, Jia-Rong Wu, Debra K. Moser, Chin-Yen Lin, Ambrose A. Chiang, Barbara Riegel

UK CARES Faculty Publications

Background: Black patients with heart failure (HF) report worse quality of life (QoL) than White patients. Few investigators have examined mediators of the association between race and QoL, but depressive symptoms and sleep quality are associated with QoL.

Objective: The aim of this study was to determine whether depressive symptoms and sleep quality are mediators of the relationship between race and QoL among patients with HF.

Methods: This was a cross-sectional study. We included 271 outpatients with HF. Self-reported race (White/Black), depressive symptoms (Patient Health Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), and QoL (Kansas City Cardiomyopathy Questionnaire) were collected …

Companion Dogs And Depression, Anxiety, And Posttraumatic Stress Disorder In Adult Icu Survivors: A Scoping Review, Lindsey Nelson, Sue Lasiter, Amanda Emerson

People and Animals: The International Journal of Research and Practice

Intensive care unit (ICU) survivors are at risk for developing persistent psychological sequelae that have been linked to decreased quality of life and increased mortality after hospital discharge. Standardized evidence-based treatments are lacking, mainly focus on physical rather than psychological recovery, and often occur in formal settings. Benefits of human– companion dog relationships have not been explored in the ICU survivor population before. Thus, the purposes of our review were to summarize the literature focused on the influence of companion dogs on depression, anxiety, and posttraumatic stress disorder (PTSD); identify what is known about the potential role companion dogs play …

A Quality Improvement Project On The Evaluation Of A Community Gastroenterology Advanced Practice Providers’ Update On The Utilization Of The American College Of Gastroenterology (Acg) Recommendation For Annual Depression Screening In Patients With Inflammatory Bowel Disease, Yolanda Levy Dnp, Fnp-Bc

All Dissertations

Inflammatory bowel disease (IBD) is an autoimmune disease that can result in chronic inflammation in the gastrointestinal tract (Farbod et al., 2021). The two most common types of IBD are called Crohn’s disease and Ulcerative Colitis. There have been several studies that have shown how the psychological disorders, including depression, can be associated with flares of IBD (Farraye et al., 2017). The American College of Gastroenterology (ACG) published clinical practice guidelines in 2017, which recommended gastroenterology (GI) healthcare providers screen for depression in all patients with IBD at least once annually (Farraye et al., 2017). This quality improvement did show …

Provider Implementation Of Probiotics As An Adjuvant Treatment Modality For Patients With Anxiety And Or Depression In A Primary Care Setting, Sarah Dedmon

Doctoral Dissertations and Projects

The prevalence of anxiety and depression among Americans is growing rapidly. Patients are seeking out traditional treatments as offered by their primary care providers, but also frequently look toward integrative or complementary methods of managing their symptoms. The use of dietary supplements is at an all-time high, yet the U.S. Food and Drug Administration does not regulate these substances for potency and purity or evaluate them using quality standards as it does pharmaceuticals. Most providers lack education regarding the physiological interaction their patients may experience when using these substances and are naïve to their place in primary care medicine. The …

Improving Mental Health Outcomes For Amputees, Zachary Elmore

Dissertations

Problem: depression, anxiety, and other mental health disorders are more commonly diagnosed in the amputee population related to changes in mobility, activities of daily living, and quality of life (Turner et al., 2020.) As the amputation population is projected to reach over 3 million Americans in the next 25 years, additional screening is imperative to identify patients at high-risk for mental health deterioration (Ziegler-Graham et al., 2018).

Methods: this was a project that included screening all patients with the Personal Health Questionnaire for Depression (PHQ-8) meeting the inclusion criteria of being admitted to 7500 Vascular Surgery at Barnes-Jewish …

Implementation Of The Edinburgh Postpartum Depression Screening Tool For Postpartum Depression In A Midwest Primary Care Clinic, Makenzie Garrison

Dissertations

Problem: Postpartum depression is a prevalent health concern in postpartum women. Screening practices to identify postpartum depression are inconsistent. The purpose of this quality initiative is to determine if the implementation of the Edinburgh Postpartum Depression Screening Tool (EPDS) to screen for postpartum depression in the primary care setting increases the detection of postpartum depression in postpartum women from delivery to one year postpartum.

Methods: This quality improvement project utilizes a descriptive, observational design. A retrospective medical record review was utilized as well as a 12-week data collection period. Retrospective medical record reviews were conducted to assess the rate of …

Improving Treatment And Follow-Up Care For Patients Who Screen Positive For Depression In Family Practice: A Quality Improvement Project., Jennifer D. Hooper

Doctor of Nursing Practice Papers

Background: Depression is a prevalent condition requiring systematic approaches for effective treatment and follow-up in primary care. This quality improvement project aimed to enhance care for patients screening positive for depression at an academic family practice with a diverse patient population and a comprehensive electronic health record (EHR) system.

Purpose: The primary objective was to assess whether a provider educational session and the implementation of an optional depression treatment and follow-up algorithm could improve timely and appropriate care for patients with positive PHQ-9 screenings.

Setting: The project was conducted at an academic family practice office.

Methods/Procedures: The intervention included a …

Increasing Patient Access To Mental Health Providers: Improving Depression And Anxiety Outcomes For African American Women Aged 18 Years Old And Older, Twanna Davis-Arnold, Farnaz Trasandes

Doctor of Nursing Practice Final Manuscripts

Increasing patient access to mental health providers: Improving depression and anxiety outcomes for African American women aged 18 years old and older.

Background: Depression and anxiety are growing health problems in the United States. In 2020/2021, there was a 36.4% to 41.5% increase in reported symptoms of depression and anxiety. Evidence has shown that African American women experience disproportionate increased risks and disparities in obtaining mental health care.

Purpose of Project: To improve access to African American or culturally competent mental health providers for adult African American women. Improving access to mental health care will lead to earlier diagnosis …

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 …

Utilization Of Depression Screening In Patients With Type 2 Diabetes Mellitus, John T. Norris Bsn, Rn, Dnp-Pmhnp Student, Robin Gordon Bsn, Rn, Dnp-Pmhnp Student, Margaret Harvey Phd, Aprn-Bc, Acnp, Chfn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes is a chronic metabolic disorder affecting millions of individuals worldwide. Research has shown that individuals with diabetes are at a higher risk of developing depression in comparison to those of the general population. Depression affects the individual's emotional well-being and has a significant impact on the management and outcomes of diabetes (Mather, 2022). This research study aims to investigate the feasibility and effectiveness of implementing the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is one the most effective assessment tools available to identify symptoms of depression (Celik, 2020).

Methods

In this retrospective chart review, at least 50 …

Tailoring Treatment Approaches With Supplemental Screening: Homeostatic Model Assessment Of Insulin Resistance (Homa-Ir) In An Obese Population, Christine Ruvaclaba

Cohort XII

Background: This quality improvement project, conducted in the Texas-Mexico border region with high obesity rates, aimed to explore the utility of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) as a screening tool for insulin resistance (IR) among overweight and obese individuals. The study focused on patients with a Body Mass Index (BMI) greater than 25 who exhibited normal blood sugar levels or Hemoglobin A1c (HbA1c) levels less than 5.7%.

Aim/Methods: The aim is to identify early intervention strategies for metabolic disorders, particularly in obese populations. Obesity is often the precursor to comorbid conditions such as diabetes and cardiovascular disease. …

The Effects Of Mediterranean Diet On The Epileptic Population With Depression, Celina Navarro

Cohort XII

Background: People with epilepsy often develop depression during the course of their disease progression. This condition is multifactorial, often related to the unpredictability of their disease, the lack of control on their symptoms, and the medications they use to treat their seizures. Mental health services continue to be insufficient for our growing border region, and patients with epilepsy, often will lack the proper mental health management due to mental health provider shortage. Multiple medications can be used to successfully treat depression in the general population, however people with epilepsy often will struggle as anti-seizure drugs can interact with antidepressants. Also, …