College of Nursing and Health Sciences, Florida International University, Miami, FL 33199, USA.
J Am Geriatr Soc. 2010 Jan;58(1):122-8. doi: 10.1111/j.1532-5415.2009.02626.x. Epub 2009 Dec 9.
To describe the implementation and acceptability of the TRaining In the Assessment of Depression (TRIAD) intervention, which has been tested in a randomized trial. The primary aim of TRIAD is to improve the ability of homecare nurses to detect depression in medically ill, older adult homecare patients.
Description of the important components of TRIAD, its implementation, and evaluation results from nurse surveys.
Three certified home healthcare agencies in Westchester County, New York.
Thirty-six homecare nurses.
Participants randomly assigned to TRIAD (n=17) were provided with the opportunity to observe and practice patient interviewing. The approach focused on clinically meaningful identification of the two "gateway" symptoms of depression and is consistent with the newly revised Medicare mandatory Outcome and Assessment Information Set (OASIS-C). Control group participants (n=19) received no training beyond that which agencies may have provided routinely.
Baseline and 1-year nurse confidence in depression detection, and postintervention acceptability ratings of the TRIAD intervention.
Participants randomized to the TRIAD intervention reported a statistically significant increase in confidence in assessing for depression mood (P<.001), whereas the usual care group's confidence remained unchanged (P=.34) 1 year later.
An educational program designed to improve depression detection by giving nurses the skills and confidence to integrate depression assessment into the context of routine care can be successfully implemented with homecare agency support. The authors discuss the intervention in terms of OASIS-C and the "real world" realities of intervention implementation.
描述 TRaining In the Assessment of Depression（TRIAD）干预措施的实施情况和可接受性，该干预措施已在一项随机试验中进行了测试。TRIAD 的主要目的是提高家庭护理护士识别患有医学疾病的老年家庭护理患者中抑郁症的能力。
描述 TRIAD 的重要组成部分、实施情况及其从护士调查中获得的评估结果。
纽约州威彻斯特县的三个认证家庭保健机构。
36 名家庭护理护士。
随机分配到 TRIAD 的参与者（n=17）有机会观察和练习患者访谈。该方法侧重于对抑郁的两个“门户”症状进行有临床意义的识别，并且与新修订的 Medicare 强制性结果和评估信息集（OASIS-C）一致。对照组参与者（n=19）除机构可能提供的常规培训外，没有接受任何培训。
基线和 1 年时护士对抑郁检测的信心，以及对 TRIAD 干预措施的接受度评分。
随机分配到 TRIAD 干预组的参与者报告在评估抑郁情绪方面的信心有统计学显著增加（P<.001），而常规护理组的信心在 1 年后保持不变（P=.34）。
一项旨在通过赋予护士将抑郁评估纳入常规护理背景的技能和信心来提高抑郁检测能力的教育计划，可以在家庭护理机构的支持下成功实施。作者根据 OASIS-C 以及干预实施的“现实世界”现实讨论了干预措施。
