Training nursing staff to recognize depression in home healthcare. 2010

Ellen L Brown, and Patrick J Raue, and Bernard A Roos, and Thomas Sheeran, and Martha L Bruce
College of Nursing and Health Sciences, Florida International University, Miami, FL 33199, USA. ebrown@fiu.edu

OBJECTIVE To describe the implementation and acceptability of the TRaining In the Assessment of Depression (TRIAD) intervention, which has been tested in a randomized trial. The primary aim of TRIAD is to improve the ability of homecare nurses to detect depression in medically ill, older adult homecare patients. METHODS Description of the important components of TRIAD, its implementation, and evaluation results from nurse surveys. METHODS Three certified home healthcare agencies in Westchester County, New York. METHODS Thirty-six homecare nurses. METHODS Participants randomly assigned to TRIAD (n=17) were provided with the opportunity to observe and practice patient interviewing. The approach focused on clinically meaningful identification of the two "gateway" symptoms of depression and is consistent with the newly revised Medicare mandatory Outcome and Assessment Information Set (OASIS-C). Control group participants (n=19) received no training beyond that which agencies may have provided routinely. METHODS Baseline and 1-year nurse confidence in depression detection, and postintervention acceptability ratings of the TRIAD intervention. RESULTS Participants randomized to the TRIAD intervention reported a statistically significant increase in confidence in assessing for depression mood (P<.001), whereas the usual care group's confidence remained unchanged (P=.34) 1 year later. CONCLUSIONS An educational program designed to improve depression detection by giving nurses the skills and confidence to integrate depression assessment into the context of routine care can be successfully implemented with homecare agency support. The authors discuss the intervention in terms of OASIS-C and the "real world" realities of intervention implementation.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009733 Nursing Diagnosis Conclusions derived from the nursing assessment that establish a health status profile for the patient and from which nursing interventions may be ordered. Diagnosis, Nursing,Diagnoses, Nursing,Nursing Diagnoses
D009740 Nursing Staff Personnel who provide nursing service to patients in an organized facility, institution, or agency. Nursing Staffs,Staff, Nursing,Staffs, Nursing
D003863 Depression Depressive states usually of moderate intensity in contrast with MAJOR DEPRESSIVE DISORDER present in neurotic and psychotic disorders. Depressive Symptoms,Emotional Depression,Depression, Emotional,Depressive Symptom,Symptom, Depressive
D005260 Female Females
D005851 Geriatric Nursing Nursing care of the aged patient given in the home, the hospital, or special institutions such as nursing homes, psychiatric institutions, etc. Nursing, Geriatric,Geriatric Nursings,Nursings, Geriatric
D006699 Home Care Services Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals. Domiciliary Care,Home Health Care,Care Services, Home,Home Care,Services, Home Care,Care, Domiciliary,Care, Home,Home Care Service,Service, Home Care
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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