Nurses Able to Support Those with Chronic Depression

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.

Reference:
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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  • JoeG

    JoeG

    October 7th, 2013 at 10:29 AM

    In many ways I think that it could be the personality and the whole bedside/ patient manner that make the biggest difference. You know that your doctor is smart enough and qualified enough to talk to you about any health problem that comes up, but sometimes it just seems so much more comfortable to talk to the nurse about it. They just seem more human, you know, more relatable to what you are going through, and honestly, it’s like they know how to better communicate with you in real terms that I understand and not just in medical jargon. I think that most patients really apprecaite that.

  • Sela

    Sela

    October 8th, 2013 at 3:59 AM

    Please don’t confuse providing support with providing treatment. Nurses are great to talk to and to be there for patients when they may not feel what they are getting what they need from a physician on a personal level, but the treatment has to be left to the doctor in charge. They are the ones who have been educated and trained to give you that.

  • hans j

    hans j

    October 8th, 2013 at 10:35 AM

    Aren’t we always talking about how overworked and under valued nurses are already? Do we really need to add anything more to their plate?

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