The study will be implemented in a nursing home situated in Virginia. The nursing home is a place for caring for the needs of the older adults. The setting is one where depression is very common among the individuals who have been separated from their families. However, depression has been very difficult to diagnose due to the lack of an effective procedure for the diagnosis. Hence, it is critical to adopt a more effective diagnostic procedure, including the use of an evidence-based questionnaire certified for accurate diagnosis of depression. There is a need to promote and educate the health care providers in the nursing home about the proper use of the questionnaire.
While mental health care is critical for individuals residing within the nursing home, it is not adequately provided because of the lack of the effective diagnosis mechanism, which leads to inadequate management. The introduction of Patient Health Questionnaire -9 (PHQ-9) will play a critical role in the diagnosis and management of depression in the settings. The questionnaire as a screening tool for depression will allow the providers to optimize the use of mental health care for positive outcomes for older adults with depression. The outcome in management will be achieved because of the high chances of timely diagnosis. The tool will be newly introduced in the setting.
- What benefits will be achieved with the introduction of Patient Health Questionnaire-9 (PHQ-9) in a nursing home for effective diagnosis of depression among the residents?
- What is the timeline for the effective adoption of the screening tool in the setting?
- What factors are likely to impact on the implementation of the screening tool in the nursing home?
- What measures will be necessary to ensure that the health care providers within the nursing home fully accept the adoption of the screening tool?
Context for the Doctoral Project
Research has indicated the negative impact of failure to achieve timely diagnosis and treatment of individuals suffering from depression based on the high risk involved due to their mental status (Allgaier et al., 2013). Despite the knowledge of the challenges involved in depression, there is still inadequate use of effective screening tools, especially in nursing homes (Meeks et al., 2014). According to Moriarty et al. (2015), there is a need for a proper tool such as the Patient Health Questionnaire -9 (PHQ-9). The tool is effective in recognizing depression among the at-risk individuals. Given the reality that Patient Health Questionnaire -9 (PHQ-9) is useful in the diagnosis of depression among adults; the approach can be effectively used in the nursing home settings. Hence, with minor modifications to match the needs of the population and adequate time, the tool can be effectively implemented in the nursing home setting (Iden et al. 2014). With training and awareness creation, it is expected that the health care providers within the setting will accept and adapt to its use.
Possible Sources of Evidence
The project is evidence-based, which means that there will be need for proper evidence to back up the project’s outcome. Both primary and secondary sources of evidence will be used. The primary sources will include reports, journals, and online articles. Some of the secondary sources used will include books and review of primary studies. The sources will provide critical information on the implementation of the project, including the measures of validity and reliability of the Patient Health Questionnaire -9 (PHQ-9) (Zimmerman et al., 2013). They will also indicate the evidence from what has been done using the tool and the success achieved to-date.
Allgaier, A. K., Kramer, D., Saravo, B., Mergl, R., Fejtkova, S., & Hegerl, U. (2013). Beside the Geriatric Depression Scale: the WHO‐Five Well‐being Index as a valid screening tool for depression in nursing homes. International journal of geriatric psychiatry, 28(11), 1197-1204.
Iden, K. R., Engedal, K., Hjorleifsson, S., & Ruths, S. (2014). Prevalence of depression among recently admitted long-term care patients in Norwegian nursing homes: associations with diagnostic workup and use of antidepressants. Dementia and geriatric cognitive disorders, 37(3-4), 154-162.
Meeks, S., Van Haitsma, K., Schoenbachler, B., & Looney, S. W. (2014). BE-ACTIV for depression in nursing homes: primary outcomes of a randomized clinical trial. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70(1), 13-23.
Moriarty, A. S., Gilbody, S., McMillan, D., & Manea, L. (2015). Screening and case finding for major depressive disorder using the Patient Health Questionnaire (PHQ-9): A meta-analysis. General Hospital Psychiatry, 37(6), 567-576.
Zimmerman, M., Martinez, J. H., Attiullah, N., Friedman, M., Toba, C., Boerescu, D. A., & Ragheb, M. (2013). A new type of scale for determining remission from depression: the remission from depression questionnaire. Journal of psychiatric research, 47(1), 78-82.