Depression in primary care: Attitudes of novice advanced practice nurses

Abstract

The burden of depression across the globe is estimated to be a leading cause of disability. In the U.S., a considerable portion of mental healthcare is delivered in the primary care setting. Barriers to achieve best practices are often magnified during the transition for nurses entering advanced practice. Rosswurm and Larrabee’s evidence based practice change model was utilized to develop a project aimed to improve novice APN’s attitudes about depression screening and management for adult patients in the primary care setting. The project used a purposive sample of 100 novice APNs from across the nation utilizing a quasi-experimental, one group, pre-test/post-test design to measure attitudes, professional confidence and perspectives of novice providers caring for patients experiencing depression before and after an online educational offering. The Revised Depression Attitude Questionnaire (R-DAQ) was the validated instrument used in the study. Statistical significance was achieved across all three domains of the R-DAQ. Twenty-six of the 100 participants agreed to take the R-DAQ a third time in order to synthesize the content from the educational module in practice. Mean scores returned almost to pre-test levels in all domains (p > 0.05). The diagnosis and treatment of depression in a primary care setting demands an awareness of the significance of the problem, an understanding of the tools available for use in screening and a reasonable systematic approach to ensure that a patient-centered evidence-based treatment plan is followed. Future implications for practice will need to address educational efforts that promote sustainability in the practice setting.