Interdisciplinary Interventions: Depression - Essay Example

Interdisciplinary Interventions: Depression Introduction: A sixty-five year old Afro-American female was admitted. She was diagnosed as suffering from depressed mood and demonstrating signs of extreme loneliness, isolation and the lack of desire to engage in any activity, which had resulted from bereavement. This paper attempts to evaluate the interventions needed in the case of this patient, with particular emphasis on the nursing interventions. Case Study: The patient had been married and had five children. Her children left home at an early age to find their own careers and had settled far away from their home. The distance had gradually led to only brief and infrequent contacts being the only interaction between them and their parents. For almost thirty years her husband was her sole companion and her whole world revolved around him. The domestic chores and catering to the requirements of her husband were the activities that she engaged herself once the house had emptied of the children. She typified a woman who had remained a wife and mother, with all her activities focused on the family and husband, and once the children moved out, she had transferred all of this to her husband. A year earlier her husband had expired, creating a vacuum in her life. She mourned the loss of her husband and dearly missed the companionship her husband had provided. This had caused a loss of meaning to life, which had resulted in her total withdrawal from society and the lack of will to maintain any normal activity in life. Interdisciplinary Interventions for this Case: Intervention for depression is multi-focused as it is a progressive disease, requiring alleviation from the immediate difficulties faced and prevention of relapse of the patient, which calls for education and activation of the patient (Gilchrist & Gunn, 2007). Hence pharmacotherapy along with psychotherapy forms the basis of interventions in the treatment of patients with depression (Fogel, 2006). Models for interdisciplinary interventions start with the collaborative care provided by a psychiatrist and a physician to enhance education and activation of the patient, monitor outcomes of the intervention and any possible side effects of the pharmacological treatment provided to the patient. Expanded models of interdisciplinary interventions incorporate the use of mental health professionals in the form of mental health nursing professionals and social workers to enhance self-management and adherence to medication. Such expanded models of interdisciplinary interventions have come more into use given the lack of sufficient availability of mental health medical professionals and the better outcomes that have resulted from such a combination of interdisciplinary interventions, with particular bearing on mental health nursing professionals (Katon & Ludman, 2003). The dynamic psychological interventions of education, activation and social support becomes more relevant, when it is seen that these nonpharmacological interventions produce larger and better effects in patients with depression (Fogel, 2006). Critique of Interdisciplinary Interventions: The patient involved in the case study is an elderly woman, which finds resonance in the greater prevalence depression in women in communities and in clinical environments (Wilhelm et al, 2008). Women are more affected by men by the events that occur around them, particularly in terms of bereavement, for according to Kulkarni, 2008, p.2, “the accumulated stresses of death, losses, demoralization, helplessness and others affect women directly and through their care for children and loved ones”. Women mental health professionals are more likely to understand these accumulated stresses and with the nursing profession an area of female domination, depressed patients are more likely to feel more comfortable in the support received from mental health nursing, which is reflected from findings of studies that outcomes of women with depression is significantly better, when there is nursing support provided to the patient (Katon & Ludman, 2003). The patient is now in a hospital environment for treatment of depression and the interventions within a hospital are different from the interventions outside the environment. While the medical professionals concentrate on therapeutical aspects, it is nursing that is capable stimulating health-seeking behaviours in the patient. This is significant, because health-seeking behaviors are predictors of more successful outcomes in depression (Zauszniewski, 1995). Age by itself brings about a reduction in social contacts and interaction (Minardi & Blanchard, 2004). In the case of this patient, besides this limiting factor, there is the tremendous loss felt due to the death of her husband, compounded by the absence of any loved ones around her, which has caused her to isolate and neglect herself. Improving social contacts around her and social networking becomes a significant element of her return to normal life and preventing a relapse of her condition. The initial move in this respect is the development of a friendly relation between this patient and the nursing professionals involved with her (Hedelin & Svensson, 1999). The next step involves increasing the self acceptance and esteem in the eyes of the patient, proceeding on to getting the patient involved in the world around her and becoming active in it (Macinnes, 2006). However, one of the issues that hamper is likely to hinder this action from the nursing professionals in charge of this patient is the lack of proper training in these aspects to the nursing professionals looking after the patient (Gray, et al, 1999). Conclusion: The patient with depression is a woman and an elderly patient. Interdisciplinary interventions are essential in improving her condition. Nursing support is a key element in this, with the inclination of the patient to receive female nursing support, through which the nursing professional will be able to increase self-acceptance and self-esteem in the patient and attempt social networking. However, the nursing professional will have to be trained in this. Works Cited Fogel, J. 2006, ‘Recognizing Minor Depression’, Medscape Psychiatry & Mental Health, vol.11, no.2 [Online] Available at: http://www.medscape.com/viewarticle/528985 (Accessed June 26, 2008). Gilchrist, G. & Gunn, J. 2007, ‘Observational Studies of Depression in Primary Care: What Do We Know? BMC Family Practice, [Online] Available at: http://www.medscape.com/viewarticle/560141 (Accessed June 26, 2008). Gray, R., Parr, A., Plummer, S. & Sandford, T. ‘A national survey of practice nurse involvement in mental health interventions’. Journal of Advanced Nursing, vol.30, no.4, pp.901-906. Hedelin, B. & Svensson, P. G. 1999, ‘Psychiatric nursing for promotion of mental health and prevention of depression in the elderly: a case study’, Journal of psychiatric and mental health nursing, vol.6, pp.115-124. Katon, J. W. & Ludman, J. E. 2003, ‘IMPROVING SERVICES FOR WOMEN WITH DEPRESSION IN PRIMARY SETTINGS’, Psychology of Women Quarterly, vol.27, pp,114-120. Kulkarni, J. 2008, ‘Women’s mental health’, Australian and New Zealand Journal of Psychiatry’, vol.42, no.1, pp.1-2. Macinnes, D. L. 2006, ‘Self-esteem and self-acceptance: an examination into their relationship and their effect on psychological health’, Journal of psychiatric and mental health nursing, vol.13, pp.483-489. Minardi, A. H. & Blanchard, M. 2004, ‘Older people with depression: pilot study’. Journal of Advanced Nursing, vol.46, no.1, pp.23-32. Wilhelm, K., Parker, G., Geerligs, L., & Wedgewood, L. 2008, ‘Women and depression: a 30 year learning curve’, Australian and New Zealand Journal of Psychiatry’, vol.42, no.1, pp.3-12. Zauszniewski, A. J.1995, ‘Health-Seeking Resources in Depressed Outpatients’, Archives of Psychiatric Nursing, vol. IX, no.4, pp.179-187. Read More