Practicing nurses are responsible for a myriad of duties in clinical settings. Practicing nurses often take on patients that require regular maintenance and monitoring, so that physicians can focus on more immediate and urgent medical needs. Practicing nurses also conduct evaluations and make recommendations as needed. But can they adequately and effectively provide ongoing support for individuals with chronic depression? That was the questions asked by Madeleine Bennett of the Research Department of Primary Care & Population Health at the University College London.
Bennett extended existing findings from a study on Pro-active Care and its Evaluation for Enduring Depression (ProCEED). The original exploration into the use of this nurse-based ongoing treatment protocol for chronically depressed individuals detailed the clinical outcomes. Bennett, however, chose to focus on how the program was received by both clients and nurses. Bennett interviewed 15 nurses and 26 clients involved in the program and found that the clients and nurses were both comfortable with the treatment. Clients felt that the nurses were able to adequately address their illness and manage their care. Further, most of the nurses felt that they were capable of managing care for those with depression.
One of the main findings was related to therapeutic alliance, which is the foundation on which positive outcomes are built. Clients who felt the nurses were detached from them reported low levels of therapeutic alliance and less satisfaction with ProCEED than those who felt a strong therapeutic bond to the nurses. Similarly, nurses who did not have the experience or desire to empathize and engage with clients reported lower levels of overall satisfaction with ProCEED than those nurses who were highly involved with clients. One of the concerns raised by developers of ProCEED was that clients would prefer to discuss their depression with their doctors rather than with nurses.
But Bennett’s results show just the opposite. She said, “Most patients reported uneasiness in reviewing their mental health problems with their GP and a willingness to be more open with the practice nurse by comparison.” Overall, this study provides positive support for ProCEED, but emphasizes the need for nurses to be fully capable of delivering empathy, understanding and education to clients.
Bennett, M., Walters, K., Drennan, V., Buszewicz, M. (2013). Structured pro-active care for chronic depression by practice nurses in primary care: A qualitative evaluation. PLoS ONE 8(9): e75810. doi:10.1371/journal.pone.0075810
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