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Improving Depression Assessment & Management in Heart Failure Patients at the Pali Momi Medical Center

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Item Summary

dc.contributor.advisor Mobley, Joseph Jang, Hee Yun 2019-07-02T18:00:27Z 2019-07-02T18:00:27Z 2019
dc.subject Nursing
dc.subject Psychology
dc.subject Medicine
dc.subject depression
dc.subject depression assessment and management
dc.subject evidence-based project
dc.subject heart failure
dc.subject Patient Health Questionnaire Version 9
dc.subject PHQ-9
dc.title Improving Depression Assessment & Management in Heart Failure Patients at the Pali Momi Medical Center
dc.type Thesis
dc.contributor.department Nursing Practice D.N.P.
dcterms.abstract Background/Purpose: Heart failure (HF) is an increasingly prevalent disease and a major cause of morbidity and mortality around the world. Depression is more common in people with HF than in the general population however, it is under-diagnosed and under-treated. The purpose of this project was to implement a depression assessment program to improve staff knowledge about evidence-based depression screening and management guidelines, as well as increase the number of patients screened for depression in an outpatient cardiology setting. Method and Results: Providers and staff participated in an educational presentation that covered various topics including depression incidence in HF patients, evaluating depression in the primary care setting, interpretation of the PHQ-9 score, and depression screening guidelines & recommendations. A pre- and post-test was used to measure if there was an improvement in staff knowledge after the educational intervention. The total staff knowledge rating of the pre-test showed a mean score of 5.9 and post-test score of 8.1. Changes from pre-test to post-test were assessed using a paired samples t-test which showed the results to be significant: t(9) = -2.39, p<.01. The t-value was then converted to a correlation to assess strength of effect. Results indicated a large effect size (i.e., >.50) with an r = .62. During the PHQ-9 pilot period, the depression assessment was administered to HF patients. The patient’s PHQ-9 score was shared with the cardiologist for further evaluation and management. The number of completed PHQ-9 surveys were tracked at weekly intervals. Of the 87 patients who completed the PHQ-9 survey, the average score was 2.94. 61.7% of patients scored 0 to 4 (no depression), 9.3% scored 5 to 9 (mild depression), 9.3% scored between 10 to 14 (moderate depression), less than 1% scored between 15 to 19 (moderate-severe depression), and 0% of patients scored greater than 20 (severe depression). 2 patients were referred to the psychologist for further evaluation. Discussion: Depression is under-recognized and under-treated in the HF population due to a lack of systematic assessment. Administering depression screenings in a cardiology outpatient setting affords a rich opportunity for identifying and managing patients at risk for psychosocial issues. Although our findings suggest a low prevalence of depression in the HF population, this project supports the continued use of the PHQ-9 survey as a cost-saving measure to enhance patient care. Additional implications included raising awareness on depression and the benefits of an EBP project.
dcterms.description D.N.P. Thesis. Ph.D. Thesis. University of Hawaiʻi at Mānoa 2019
dcterms.extent 37 pages
dcterms.language eng
dcterms.publisher University of Hawai'i at Manoa
dcterms.rights All UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.
dcterms.type Text
Appears in Collections: D.N.P. - Nursing Practice

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