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Monday, November 2, 2009: 2:00 PM
Learning Objective 1: Describe the strategies and their effectiveness in clients with depression who are treated by Advanced Practice Psychiatric Nurses(APPN).
Learning Objective 2: Evaluate the effectiveness and satisfaction of the care provided by the APPN in improving clinical outcomes of the depressed client.
A review of the literature revealed that there is limited research based evidence that identifies which psychiatric nursing strategies are associated with successful outcomes. The major issue for APPNs is the lack of documentation of clinical outcomes that indicate the most effective psychiatric nursing strategies for treating depression. A qualitative descriptive study describing the strategies used by APPNs to treat clients with depression was conducted. The effectiveness of the strategies were also explored.
A longitudinal study using repeated measures was conducted to evaluate the clinical outcomes of depressed clients treated by APPNs. Data were collected at baseline and at 1 and 3 months post initiation of treatment. Data were collected on depressive symptoms, clinical outcomes, health-related quality of life, satisfaction with care, treatment strategies, and office milieu as well as personal/socio-demographic characteristics. The volunteer sample consisted of 20 individuals 18 years of age and older who were seeking treatment from an APPN for major depression.The Hamilton Rating Scale for Depression and the Patient Health Questionnaire–9 (PHQ9) were used to verify diagnosis of major depression. The Beck Depression Inventory (BDI), PHQ9, SF- 36 Health Status, Self-Evaluation Scale of Well Being, and Outcomes Questionnaire-45 (OQ-45) were administered at baseline and at one month and three months post enrollment to measure the effectiveness of the treatment in reducing depression. The Patient Satisfaction Questionnaire was administered at three months. Data also were collected on intervention strategies used by the APPN and office milieu. Descriptive analyses, including means and standard deviations or frequency distributions, were used to summarize the data and to check for out-of-range values. Repeated measures analysis of variance (ANOVA) was used to determine changes over time in the outcome measures. Post-hoc pair-wise comparisons for significant ANOVA models were conducted using Fisher’s least significant difference procedure.
A longitudinal study using repeated measures was conducted to evaluate the clinical outcomes of depressed clients treated by APPNs. Data were collected at baseline and at 1 and 3 months post initiation of treatment. Data were collected on depressive symptoms, clinical outcomes, health-related quality of life, satisfaction with care, treatment strategies, and office milieu as well as personal/socio-demographic characteristics. The volunteer sample consisted of 20 individuals 18 years of age and older who were seeking treatment from an APPN for major depression.The Hamilton Rating Scale for Depression and the Patient Health Questionnaire–9 (PHQ9) were used to verify diagnosis of major depression. The Beck Depression Inventory (BDI), PHQ9, SF- 36 Health Status, Self-Evaluation Scale of Well Being, and Outcomes Questionnaire-45 (OQ-45) were administered at baseline and at one month and three months post enrollment to measure the effectiveness of the treatment in reducing depression. The Patient Satisfaction Questionnaire was administered at three months. Data also were collected on intervention strategies used by the APPN and office milieu. Descriptive analyses, including means and standard deviations or frequency distributions, were used to summarize the data and to check for out-of-range values. Repeated measures analysis of variance (ANOVA) was used to determine changes over time in the outcome measures. Post-hoc pair-wise comparisons for significant ANOVA models were conducted using Fisher’s least significant difference procedure.
Results APPNs were effective in treating clients with depression. They provided a holistic approach to the care of the depressed client and valued the client as a partner in their treatment. APPNs evaluated their practice based on verbal feedback from the client. The clients were highly satisfied with the care they received from APPNs.