Bruce Martha L
J Psychosoc Nurs Ment Health Serv. 2015 Nov;53(11):25-30. doi: 10.3928/02793695-20151021-01.
Depression is common in older home health patients and increases their risk of adverse outcomes. Depression screening is required by Medicare's Outcome and Assessment Information Set. The Depression Care for Patients at Home (CAREPATH) was developed as a feasible strategy for home health nurses to manage depression in their patients. The protocol builds on nurses' existing clinical skills and is designed to fit within routine home visits. Major components include ongoing clinical assessment, care coordination, medication management, education, and goal setting. In a randomized trial, Depression CAREPATH patients had greater improvement in depressive symptoms compared to usual care. The difference between groups was significant at 3 months, growing larger and more clinically meaningful over 1 year. The intervention had no impact on patient length of stay, number of home visits, or duration of visits. Thus, nurses can play a pivotal role in the long-term course and outcomes of patients with depression.
抑郁症在老年家庭健康患者中很常见，并增加了他们出现不良后果的风险。医疗保险的结果与评估信息集要求进行抑郁症筛查。“居家患者抑郁症护理（CAREPATH）”被开发为一种可行的策略，供家庭健康护士管理其患者的抑郁症。该方案基于护士现有的临床技能，旨在适应常规家访。主要组成部分包括持续的临床评估、护理协调、药物管理、教育和目标设定。在一项随机试验中，与常规护理相比，接受抑郁症CAREPATH干预的患者抑郁症状有更大改善。两组之间的差异在3个月时显著，在1年中变得更大且更具临床意义。该干预对患者住院时间、家访次数或访视时长没有影响。因此，护士在抑郁症患者的长期病程和结局中可发挥关键作用。
