Dissertation
Integration of mental health services by an advanced practice psychiatric nurse in a primary care setting
Doctor of Nursing Practice (D.N.P.), Drexel University
13 May 2016
DOI:
https://doi.org/10.17918/etd-6823
Abstract
Background and Purpose: The burden of depression, from an economic and individual perspective, has significant implications for our society. Currently two-thirds of those diagnosed with depression receive treatment in primary care settings. Previous treatment models for depression have considered onsite mental health clinicians; however, numerous studies demonstrate the role of an advanced practice psychiatric nurse (APPN) in primary care settings. The purpose of this project was to examine and compare differences in patient satisfaction and level of depression in patients with major depression managed by primary care clinicians with those managed by an advanced practice nurse in the primary care setting. Methods: This study is a prospective cohort design that took place at El Pueblo Health Services, a Federally Qualified Health Center Look-Alike in Bernalillo, New Mexico. Twenty-four adults who self-reported with symptoms of major depressive disorder participated in an intervention that consisted of a psychosocial intake followed by a psychiatric evaluation and administration of the Beck Depression Inventory-II (BDI-II) and Client Satisfaction Questionnaire-8 (CSQ-8). The intervention included pharmacologic and nonpharmacologic treatment over a 3-month period for a minimum of four, or twice monthly, sessions for up to 3 months. A comparison group of 14 adults with major depression participated in care as usual with their primary care providers. Patients in both groups were administered the BDI-II and CSQ-8 at baseline and 3 months. Evaluation: Differences in the mean scores on the BDI-II and CSQ-8 between pre- and post-test in the intervention group were statistically significant compared with the comparison group that only demonstrated statistical significance on the CSQ-8 scores. In addition, preintervention and postintervention change scores on the BDI-II were statistically significant. However, there was a lack of statistical significance in the change scores on the CSQ-8. Clinical Implications and Recommendations: Results from this project highlight the effectiveness of an intervention consisting of pharmacologic and nonpharmacologic services provided by a psychiatric nurse practitioner in a sample of adults with major depression in a primary care setting.
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Details
- Title
- Integration of mental health services by an advanced practice psychiatric nurse in a primary care setting
- Creators
- Rachel Rodriguez-Marzec - DU
- Contributors
- William J. Lorman (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Nursing Practice (D.N.P.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Doctoral Nursing; Nursing (Graduate); College of Nursing and Health Professions; Drexel University
- Other Identifier
- 6823; 991014632829004721