PICO Question In the treatment of inpatient adults with a primary depression diagnosis, does an outcome-monitoring instrument such as a PHQ-9 monitor depressive symptoms more effectively that traditional clinical interview techniques during acute hospitalization course?
Definition of Terms
PHQ-9- Patient Health Questionnaire: The PHQ-9 is a 9-item multipurpose self-report instrument used in the screening, diagnosing, monitoring and measuring the severity of depression based on criteria presented by DSM-IV (Test Review: Patient Health Questionnaire-9, 2014). Outcome Monitoring: outcomes indicators measured repeatedly over time (Maloney, K., & Chaiken, B. P.,1999).
Introduction
Making clinical decisions in psychiatric care is difficult. This difficulty is often exacerbated by a lack of tangible objective measurability in changes of clinical condition.
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My PICO question seeks to address what best-practice might be in determining effective outcome monitoring. The most common practice is based on the tradition of careful clinical interview with …show more content…
Depression is pervasive in both mental health and medical settings. In the US, the number of discharges with major depressive disorder as first-listed diagnosis was estimated 395,000 for 2010. The CDC also cites the percentage of persons 12 years of age and older with depression in any 2-week period at an estimated 8% between 2007-2010 (CDC, 2015). The American Psychiatric Associates guidelines on treatment of Major Depressive Disorder recommend the ongoing monitoring of symptoms among patients. Specifically, the APA recommends “systemically assessing symptoms of illness and the effects of treatment”. Consideration is given to matching clinical observations with clinician and/or patient administered rating scale measurements for initial and ongoing evaluation (American Psychiatric Association,
I believe to design a study in which my pico question can be addressed is very easy to perform. I performed a data based search using the terms central line, dressing change and risk of infection. The data based showed more than hundred results of study focusing on the topic of infection control in patient with central line.
• Score: The inventory provides a Total Score and five Primary Dimensions: Negative Mood, Interpersonal Problems, Ineffectiveness, Anhedonia, and Negative Self Esteem.
M3 has a two-step scoring method that validates functional psychiatric comorbidity. It also includes a screening cut off
Discuss the strengths and weaknesses of DSM-IV TR, as well as new changes for DSM-V.
Phase V: Logs of all activity, related documents, meetings, project bids for the quantitative data analysis for its demographic approach. Furthermore, the recovery in the evaluation team, they will look into the damage peace, the internal perspective of a clinician practitioner, and a psychological expert. (HHS, 2014)
I would use the Beck Depression Inventory – II (BDI-II) to measure for symptoms of depression of an affective, cognitive, behavioral, or psychological nature
Approximately 151 million people are currently combating major depressive disorder (MDD) worldwide (Haddad & Gunn, 2011). Major depressive disorder (MDD) affects around one in six men, and one in four women during any given moment of their lives, and in any twelve-month period, nearly five percent of individuals in their surrounding communities are depressed (Haddad & Gunn, 2011). Depressive episodes may appear at any age; however, MDD is most prevalent in adults who are eighteen-years-old to sixty-four-years-old, with a median age of onset being the twenties (Hillhouse & Porter, 2015). The treatment of MDD often consists of evidence-based treatments (EBTs) that include selective serotonin reuptake inhibitors (SSRIs), and cognitive-behavioral
This instrument was developed by Aaron T. Beck who is a pioneer cognitive therapist. This instrument is commonly called the BDI and was developed in 1961. It was adapted in 1969 and a copyright was obtained in 1979. In developing the instrument Beck used a series of questions which enabled him to adequately measure the strength severity and complexity of depression. There are two versions of BDI, a long version which has 21 questions mostly used to measure specific symptom common with all patient suffering from depression. The shorter version which is composed of seven questions is meant to be used in a primary healthcare setting, with main purpose to evaluate, and monitor changes in of depression.
In 1978 the fırst multi-site mental health epidemiologic study in the U.S. reported that more than 50% of community respondents with depressive disorders were treated exclusively within the primary care system. As a result, primary care was labeled the “de facto mental health system” for Americans with the more prevalent but less severe mental health disorders. Subsequent re- search over the next decade found that only 25% to 50% of patients with depressive disorders were accurately diagnosed by primary care physicians. Moreover, among those accurately diagnosed only 50% received minimally adequate pharmacologic treatment, and less than 10% received a minimally adequate number of psychotherapy visits.
Persons who are depressed have feelings of sadness, loneliness, irritability, worthlessness, hopelessness, agitation, and guilt that may be accompanied by an array of physical symptoms. A diagnosis of major depression requires that symptoms be present for two weeks or longer…Targeted screening in high-risk patients such as those with chronic diseases, pain, unexplained symptoms, stressful home environments, or social isolation, and those who are postnatal or elderly may provide an alternative approach to identifying patients with depression”
The Beck Depression Inventory is a testing tool which is used to evaluate the continuation and severity of the symptoms of depression, as recorded in the DSM-IV-TR (American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 2000). The test includes questions which asses the symptoms of serious depression, which may possibly call for hospitalization. The latest revised edition replaces the BDI and the BDI-1A, which includes items intending to indicate symptoms of severe depression, which may require hospitalization. Items include been distorted to specify increases or decreases in sleep and appetite. The most important purpose of the new version of the BDI was
Anxiety and depression checklist (K10): the aim for K10 is to identify whether a person may have been influenced by depression or anxiety at the past four weeks period of the times. The higher score, the more likely person is to be experiencing
The Beck Depression Inventory is a self-administered test, administered in a group setting or individually, that measures the severity of depression symptoms and attitudes of depression (pg 1 of manual). The revised Beck Depression Inventory was specifically designed to assess the severity of depression in clinically diagnosed patients. However, the revised Beck Depression Inventory was not specifically developed to be used as a screening instrument in normal populations or to reflect any specific theory of depression. Although the BDI is oftentimes used for screening in normal populations, it should be used with caution because high BDI scores do not necessarily indicated depression. This provides an indication of the level of intensity a patient’s depression is for the past week including the day of administration for clinicians.
Instrument One: Zung, WW (1965). Zung Self-Rating Depression Scale. RCMAR Measurment Tools. Retrieved February 12, 2012 from HYPERLINK "http://healthnet.umassmed.edu/mhealth/ZungSelfRatedDepressionScale.pdf"http://healthnet.umassmed.edu/mhealth/ZungSelfRatedDepressionScale.pdf
Notwithstanding that, other appraisal tool can be utilized to assess the care of K and it recuperation handle. For instance, the Beck depression inventory (BDI,) (Beck et al, 1961) is as often as possible utilized for measuring depression however as indicated by NICE Guidance (2005) it is not proper for young people as the reading level and reaction configuration may not be appropriate for them. NICE prescribe The Mood and Feelings Questionnaire (MFQ) (Angold et al, 1995) which has great demonstrative and predictive validity for young people. The Reynolds Adolescent Depression Scale (RADS) planned by Reynolds (1987), has been recorded reliability and validity. These evaluations must be repeated at consistent interims of one to four weeks for the data to be precise, (NICE, 2005).