1. By: Brittany Klug Ferris State University NURS 441 DEPRESSION

2. INTRODUCTION More than 1 out of 20 Americans 12 years of age and older reported current depression in 2005–2006 (Pratt, 2008). Depression is a mental Illness characterized by: Depressed or sad mood Diminished interest in activities (that were formerly pleasurable) Weight gain or loss Fatigue Difficulty concentrating Inappropriate guilt Recurrent thoughts of death

3. PURPOSE STATEMENT “Based upon the research literature nurse led depression management provides effective treatment across a range of long term health conditions” (Ekers, murphy, Archer, Ebenezer, Kemp & Gilbody, 2013).

4. EVIDENCE FOR CARE Nursing Care Problem: Collaborative care provided by nurses Nursing Theory: Health Promotion Model by Nola J.

5. EVIDENCE FOR CARE CONTINUED Basis for care Collaborative Care: Health providers working together. Weekly contact with specialists

6. EVALUATION OF THE EVIDENCE Methods: 14 studies Including 4440 participants Using data conducted over the past decade Systematic review and meta analysis Results: Improved severity of depression symptoms in patients

7. EVALUATION OF THE EVIDENCE CONTINUED Credibility & Implications Training nurses 1 to 7 days Different training Limitations of the study: 12 of the 14 studies were conducted in the United States, limiting the implications to American health care services. Only 1 study provided information on cost effectiveness of nurse collaborative care over usual care.

8. PATIENT CARE DESIGN Collaborate & Manage Care Nurse’s play a large role in advocating for their patients Nurses using collaborative care work with patients doing a number of care they have been specially trained The nurse works hand in hand with the patients primary care provided and psychologist/psychiatrist.

9. PATIENT CARE DESIGN CONTINUED Incorporating, as appropriate, the findings from the research. Nurses were commonly supported by general practitioners and psychiatrists or psychologists in the studies Nurses trained in collaborative care are better equipped to help patients in primary care settings.

10. PATIENT CARE DESIGN CONTINUED… NANDA Nursing Diagnosis: hopelessness r/t feeling of abandonment, long-term stress Interventions: Determine appropriate approach based on underlining condition Facilitate access to resources to support spiritual well-being Spend one-on-one time with the client Involve family in plan of care

11. PATIENT CARE DESIGN CONTINUED… Patient Goals: Patient will make positive statements Patient will sleep for appropriate length of time for age and physical health Patient will verbalize feelings and participate in care Rationale: The patient population of the study had depression and an additional long-term health care condition.

12. ADVOCATE ROLE Empathy: the feeling that you understand and share another person's experiences and emotions : the ability to share someone else's feelings Providing empathetic, equitable care: Therapeutic communication Non-judgmental nursing care Many depressed patients feel alone and isolated They have difficulty coping

13. ADVOCATE ROLE Role of Nurse Advocate Nurse/patient bond with therapeutic communication Helping patients cope Lobbying for patients best interest

14. ADVOCATE ROLE Significance of this research to nursing practice: Nurses using collaborative care is more beneficial than care as usual for patients with depression Nurse’s Advocating for patients through case management Collaborative care proven beneficial in primary care settings

15. REFERENCES Center for Disease Control and Prevention (2013). Mental Health Basics / Mental Illness / Depression. Retrieved from http://www.cdc.gov/mentalhealth/basics/mental-illness/depression.htm Ekers, D., Murphy, R., Archer, J., Ebenezer, C., Kemp, D., Gilbody, S. (2013). Nurse-delivered collaborative care for depression and long-term physical conditions: A systematic review and meta analysis. Journal of Affective Disorders, 149 (14-22). Ladwig, G., & Ackley, B. (2014). Mosby's guide to nursing diagnosis (4 th ed.). Saint. Louis, MO: Mosby-Elsevier. Pratt LA, Brody DJ. Depression in the United States household population, 2005–2006. NCHS Data Brief. 2008(7):1– 8. Taylor, C., Lillis, C., Lemone, P., Lynn, P. (2011). Fundamentals of Nursing the art and science of nursing care (7 th ed.). Philadelphia, PA: Lippincott Williams & Wilkins