Web-Based Interventions to Support People Globally who are Diagnosed with Major Depression

Wednesday, 15 July 2009: 10:45 AM

Jan Belcher, RN, PhD, PMHCNS, NEA-BC
College of Nursing and Health, Wright State University, Dayton, OH

Learning Objective 1: examine the usability of web sites by patients diagnosed with depression for global nursing practice

Learning Objective 2: describe depression trends worldwide with implications for web-based interventions

Purpose: Depression is a leader in worldwide disability. Although the prevalence of other public health issues is decreasing due to technology, the prevalence of depression is increasing globally. Nurses use web-based technology to successfully support people worldwide. The purpose of this descriptive study was to explore the usability of three web page designs for hospitalized patients who are diagnosed with depression (Major Depressive Disorder 296) and are within three days to home discharge.

Methods: Usability is human interaction with computers examining effectiveness and user satisfaction with the interaction.  This study examined the human-computer interface and judged the quality of the interaction. Usability was operationalized by 1) patient responses to interview exploratory usability questions 2) researcher’s observation of the patient during interaction with the web page 3) patient’s verbalization of the computer interaction process (think aloud method) and  4) patient responses on the  Web Depression Tool.
       Three informational web pages were designed in a simple format, medium complex format and complex format. Complexity characteristics included font size, density of writing, links, and graphics.  The setting was a 848 bed general USA hospital with a 32 bed acute psychiatric unit. A convenience sample (n=15) was composed of 40% (6/15) patients of primarily Medicaid and indigent patients.

Results:  There were two distinct groupings of patients evaluating three web sites which have global implications.  Computer literate patients (80%, 12/15), who used the Internet at least 1-2 times a week and had Internet access at home or work preferred a more complex web site.  Patients (3/15) who had no computer experience preferred a simple format.

Conclusion: On all web pages, patients performed tasks involving e-mail, chat rooms, and hyperlinks regardless of  previous computer experience. Most patients (14/15) were positive about using the web sites at home for support of their depression.