Nurses Work with Depressed Patients Almost Daily - Research Paper Example

? Depressed Patients Depressed patients Depression is a heterogenic psychological condition associated with low mood and aversion which have an adverse effect on the behavior, thoughts, sense of well being and feelings of an individual. Approximately two thirds of the population has been found to suffer from depression and by 2020 this has been predicted to be leading medical condition in terms of pharmaceutical expenditure. Depressive patients have been found to present with numerous somatic complaints such as headache, fatigue, malaise, sleep disorders and abdominal distress. Depression has been broadly classified into the following groups; depression with catatonic and melancholic features, psychotic features, atypical depression, bipolar depression, dysthymia, recurrent and single episode and seasonal affective disorder. When patients present to the department and depression is suspected, a differential diagnosis should be made from neurological disorders, other psychiatric disturbances, endocrine pathologies, substance abuse related pathologies and inflammatory and infectious diseases. Depression is a key psychological condition that often accompanies the majority of all illnesses. A study that was carried out by Katon et al., discovered that depression was one of the most prevalent disorders in primary care with a prevalence of approximately 10% (Katon et al., 2010). However, some patients were found to be more susceptible to depression. These include patients suffering from chronic illnesses as they often lack optimism in the improvement of their health. In addition, they also neglect the treatment regimes that have been prescribed for them by the doctors. Due to these factors, depression has been found to have an adverse effect on the current condition of the patient and his or her prognosis. This disease is also widely under diagnosed in patients and it has also been found to be inadequately treated. Precisely, research found that only 50% of patients suffering from depression in primary care are correctly diagnosed (Thoits, 2013). In addition, from these patients only 40% were properly treated and were able to fully recover within a 6 month period. In summation, patients suffering from depression possess a low mood which often leads to negligence and poor adherence to the prescribed treatment regime. Chronic illnesses are often incurable and therapeutic intervention is mainly to alleviate symptoms and improve the patient’s quality of life. Therefore, patients suffering from chronic diseases often possess the misconception that their condition is incurable therefore, they are already approaching death and treatment is not going to largely benefit them or prolong their lifespan. Environmental factors such as family relationships also play a role in the development of depression in primary care patients. New York is one of the most diversely populated cities and has individuals from different parts of the world. It was determined by the New York City Department of Health and Mental Hygiene that approximately 430 000 individuals living in New York suffer from depression (Brown et al., 2013). Similar to the study mentioned above, only 50% of all individuals suffering from depression in New York are correctly diagnosed and three out of five of these individuals are not given the right treatment (Brown et al., 2013). Numerous medical practitioners have recommended that all patients should be screened for depression as this is pertinent illness that has a cure. The New York City Health and Nutrition Examination Survey has discovered that depression in New York has a larger effect on a certain demography. For example, in New York, women were found to have a greater predisposition to depression than men. They were found to be twice as much likely to suffer from the condition. In addition, age was also a determining factor in the rates of depression as the condition was more dominant among the younger population between the ages of 20 and 30 years old. The ratio between individuals above 60 and the previously mentioned age group suffering from depression is approximately 1:2 (Brown et al., 2013). Divorce has also been found to be increasing in New York and victims of divorce, both parents and children, have been found to have higher rates of depression. Among the above mentioned groups, immigrants have been found to have a very low rate of depression. This data has been thought to be vastly inaccurate as it does not take several factors into consideration. There are several barriers faced by immigrants which limit their number of hospital visits and therefore puts them at a higher risk of under diagnosis. Immigrants have been found to be one of the most under diagnosed demographic group with approximately 60% of their cases of depression being more likely to be misdiagnosed than native citizens (Brown et al., 2013). This has also been attributed to the cultural differences that exist between these immigrants and American born patients. Depression is also very prominent among individuals suffering from chronic illnesses. This is a common trend throughout the country. Chronic illnesses that are often accompanied by depression include HIV/AIDS, asthma, diabetes and heart disease (Thoits, 2013). Pregnant women have also been found to have high rates of depression, especially if they are f\single parents. In summation, depression among the diverse New York population follows similar trends to that across the nation. However, there is a large number of immigrants living in New York and these have a high rate of under diagnosis (Brown et al., 2013). Caring for depressive patients has to be done both systematically and thoroughly as this condition has an impact on the current condition and prognosis of the patient. There has been constant research on caring for depressive patients and how to best improve their condition (Brown et al., 2013). Certain trends have been found when caring for such individuals. The most important trait that exists among depressed patients is under diagnosis which has often been accompanied by the reluctancy of patients to seek treatment. There have also been several barriers that have been noticed in treating depressed patients which include the in ability to monitor outcomes and side effects of treatment, irregular visits to the primary healthcare provider which are insufficient for appropriate treatment, there has also been very little collaboration between metal illness specialists and primary care providers and poor insurance policies among patients which are insufficient to cover healthcare costs (Brown et al., 2013). In summation, under diagnosis is the major problem that needs to be addressed among depressed patients. Patients with depression have also been found to have exaggerated symptoms hence these have to be managed appropriately. It has also been found that the appropriate follow up measures improve treatment. There are certain implementations that have been applied in order to improve care for depressed patients. The first measure that has to be taken is rectifying the initial treatment system by injection of funding for the development of better organizational structures. An example is the Depression Breakthrough Series that was described by Katzelnick, which was comprised of 23 geographically and ethnically diverse healthcare organizations (Johnson et al., 2013). Principles that were implemented by these institutes include better activation and patient education and utilizing more nursing staff members to monitor outcomes of the depression symptoms aster treatment. The intervention was carried out on 2000 patients and 58% of them showed improved symptoms. (Johnson et al., 2013). The next intervention includes Model Collaborative care which includes treating patients with antidepressants. Studies have shown that approximately 70% of patients with mild depression recover within the next 4 months. Wayne Katon, a psychiatrist at the University of Washington, illustrated programs that involved the implementation of mental health practitioners into primary care (Katon et al., 2010). Two trials were carried out with the first involving prescription of anti depressants to patients along with three sessions of psychotherapy. The second trial involved an increment in the number of psychotherapy sessions to 6. (Katon et al., 2010). Both trials showed that there was an improvement in the rate of recovery with an increase in therapy sessions (Katon et al., 2010). The third and final intervention involves the utilization of a Care Extender Model (Johnson et al., 2013). This approach was suggested by Dr. Oxman from Dartmouth Medical School in New Hampshire which involved the creation of an online depression toolkit. This project also utilized this toolkit to improve the follow up on patients and track the outcome of treatment. In addition, it was also utilized for patient education (Johnson et al., 2013). Therefore, these three measures may help in improving care for depressed patients and hence improve his or her quality of life. Different medical branches such as primary care and metal help should collaborate in order to issue that the prognosis is favorable. Patients should also be well educated on the subject of depression. References Brown, P. J., Liu, X., Sneed, J. R., Pimontel, M. A., Devanand, D. P., & Roose, S. P. (2013). Speed of Processing and Depression Affect Function in Older Adults With Mild Cognitive Impairment. The American Journal of Geriatric Psychiatry. Johnson, J. A., Sayah, F. A., Rees, S., Qiu, W., Chik, C., Chue, P., ... & Majumdar, S. R. (2013). Screening and Follow Up as Effective as Collaborative Primary Care Models for Patients with Depression and Diabetes: Results of a Controlled Trial. Canadian journal of diabetes, 37, S41-S41. Katon, W. J., Lin, E. H., Von Korff, M., Ciechanowski, P., Ludman, E. J., Young, B., ... & McCulloch, D. (2010). Collaborative care for patients with depression and chronic illnesses. New England Journal of Medicine, 363(27), 2611-2620. Thoits, P. A. (2013). Self, identity, stress, and mental health. In Handbook of the sociology of mental health (pp. 357-377). Springer Netherlands. Read More