Ski Chantal F, Munian Sam, Rolley John X, Thompson David R
Centre for the Heart and Mind, Australian Catholic University, Melbourne, Vic., Australia.
J Clin Nurs. 2015 Jan;24(1-2):235-43. doi: 10.1111/jocn.12703. Epub 2014 Sep 26.
The aim of this study was to evaluate nurses' perceptions of an education programme and screening and referral tool designed for cardiac nurses to facilitate depression screening and referral procedures for patients with coronary heart disease.
There is a high prevalence of depression in patients with coronary heart disease that is often undetected. It is important therefore that nurses working with cardiac patients are equipped with the knowledge and skills to recognise the signs and symptoms of depression and refer appropriately.
A qualitative approach with purposive sampling and semi-structural interviews was implemented within the Donabedian 'Structure-Process-Outcome' evaluation framework.
Semi-structured interviews were conducted with 14 cardiac nurses working in a major metropolitan hospital six weeks post-attending an education programme on depression and coronary heart disease. Thematic data analysis was implemented, specifically adhering to Halcomb and Davidson's (2006) pragmatic data analysis, to examine nurse knowledge and experience of depression assessment and referral in an acute cardiac ward.
The key findings of this study were that the education programme: (1) increased the knowledge base of nurses working with cardiac patients on comorbid depression and coronary heart disease, and (2) assisted in the identification of depression and the referral of 'at risk' patients.
Emphasis was placed on the translational significance of educating cardiac nurses about depression via the introduction of a depression screening and referral instrument designed specifically for use in the cardiac ward. As a result, participants found they were better equipped to identify depressive symptoms and, guided by the screening instrument, to confidently instigate referral procedures.
Much complexity lies in caring for cardiac patients with depression, including issues such as misdiagnosis. Targeted education, including use of appropriate instruments, has the potential to facilitate early recognition of the signs and symptoms of depression in the acute cardiac setting.
本研究旨在评估护士对一项为心脏科护士设计的教育项目以及筛查和转诊工具的看法，该工具旨在促进冠心病患者的抑郁症筛查和转诊程序。
冠心病患者中抑郁症的患病率很高，且常常未被发现。因此，为心脏病患者提供护理的护士具备识别抑郁症的体征和症状并进行适当转诊的知识和技能非常重要。
在唐纳贝迪安“结构 - 过程 - 结果”评估框架内采用了目的抽样和半结构化访谈的定性方法。
对在一家大型都市医院工作的14名心脏科护士进行了半结构化访谈，这些护士在参加关于抑郁症和冠心病的教育项目六周后接受访谈。实施了主题数据分析，特别遵循哈尔科姆和戴维森（2006年）的实用数据分析方法，以研究急性心脏病房中护士对抑郁症评估和转诊的知识及经验。
本研究的主要发现是该教育项目：（1）增加了护理心脏病患者的护士对合并抑郁症和冠心病的知识储备，（2）有助于识别抑郁症并转诊“有风险”的患者。
通过引入专门用于心脏病房的抑郁症筛查和转诊工具，强调了对心脏科护士进行抑郁症教育的转化意义。结果，参与者发现他们更有能力识别抑郁症状，并在筛查工具的指导下自信地启动转诊程序。
护理患有抑郁症的心脏病患者存在诸多复杂性，包括误诊等问题。有针对性的教育，包括使用适当的工具，有可能促进在急性心脏环境中早期识别抑郁症的体征和症状。
