Allen Jacqui, Annells Merilyn
School of Nursing, Deakin University, Burwood, Victoria, Australia.
J Clin Nurs. 2009 Apr;18(7):949-59. doi: 10.1111/j.1365-2702.2008.02731.x.
To explore through literature review the appropriateness of three common tools for use by community nurses to screen war veteran and war widow(er) clients for depression, anxiety and post-traumatic stress disorder.
War veterans and, to a lesser extent, war widow(er)s, are prone to mental health challenges, especially depression, anxiety and post-traumatic stress disorder. Community nurses do not accurately identify such people with depression and related disorders although they are well positioned to do so. The use of valid and reliable self-report tools is one method of improving nurses' identification of people with actual or potential mental health difficulties for referral to a general practitioner or mental health practitioner for diagnostic assessment and treatment. The Geriatric Depression Scale, Depression Anxiety Stress Scales and Post-traumatic Stress Disorder Checklist are frequently recommended for mental health screening but the appropriateness of using the tools for screening war veteran and war widow(er) community nursing clients who are often aged and have functional impairment, is unknown.
Systematic review.
Current literature informs that the Geriatric Depression Scale accurately predicts a diagnosis of depression in community nursing cohorts. The three Depression Anxiety Stress Scales subscales of depression, anxiety and stress are valid; however, no studies were identified that compared the performance of the Depression Anxiety Stress Scales in predicting diagnoses of depression or anxiety. The Post-traumatic Stress Disorder Checklist predicts post-traumatic stress disorder in community cohorts although no studies meeting the selection criteria included male participants.
This review provides recommendations for the use of the Geriatric Depression Scale, Depression Anxiety Stress Scales and The Post-traumatic Stress Disorder Checklist based on examination of the published evidence for the application of these screening tools in samples approximated to community nursing cohorts. Findings and recommendations would guide community nurses, managers and health planners in the selection of mental health screening tools to promote holistic community nursing care.
通过文献综述,探讨社区护士用于筛查退伍军人及军属客户是否患有抑郁症、焦虑症和创伤后应激障碍的三种常用工具的适用性。
退伍军人以及在较小程度上的军属,容易出现心理健康问题,尤其是抑郁症、焦虑症和创伤后应激障碍。社区护士虽处于有利位置,但并未准确识别出患有抑郁症及相关疾病的人群。使用有效且可靠的自我报告工具是提高护士识别有实际或潜在心理健康问题的人群,以便转介给全科医生或心理健康从业者进行诊断评估和治疗的一种方法。老年抑郁量表、抑郁焦虑压力量表和创伤后应激障碍检查表经常被推荐用于心理健康筛查,但对于经常年事已高且有功能障碍的退伍军人及军属社区护理客户使用这些工具进行筛查的适用性尚不清楚。
系统综述。
现有文献表明,老年抑郁量表能准确预测社区护理队列中的抑郁症诊断。抑郁焦虑压力量表的抑郁、焦虑和压力这三个分量表是有效的;然而,未发现有研究比较抑郁焦虑压力量表在预测抑郁症或焦虑症诊断方面的表现。创伤后应激障碍检查表能预测社区队列中的创伤后应激障碍,不过符合选择标准的研究中没有男性参与者。
本综述基于对这些筛查工具在近似社区护理队列样本中的应用所发表证据的审查,为老年抑郁量表、抑郁焦虑压力量表和创伤后应激障碍检查表的使用提供了建议。研究结果和建议将指导社区护士、管理人员和健康规划者选择心理健康筛查工具,以促进全面的社区护理。