Clinical outcomes associated with screening and referral for depression in an acute cardiac ward

Ski, Chantal F., Page, Karen, Thompson, David R., Cummins, Robert A., Salzberg, Mike and Worrall-Carter, Linda 2012, Clinical outcomes associated with screening and referral for depression in an acute cardiac ward, Journal of clinical nursing, vol. 21, no. 15-16, pp. 2228-2234, doi: 10.1111/j.1365-2702.2011.03934.x.

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Title Clinical outcomes associated with screening and referral for depression in an acute cardiac ward
Author(s) Ski, Chantal F.
Page, Karen
Thompson, David R.
Cummins, Robert A.ORCID iD for Cummins, Robert A.
Salzberg, Mike
Worrall-Carter, Linda
Journal name Journal of clinical nursing
Volume number 21
Issue number 15-16
Start page 2228
End page 2234
Total pages 7
Publisher Wiley - Blackwell Publishing
Place of publication Oxford, England
Publication date 2012-08
ISSN 0962-1067
Keyword(s) acute cardiac ward
heart disease
Summary Aim.  The aim of this paper is to describe the implementation of a depression screening and referral tool in two cardiac wards of a major metropolitan public hospital. The tool consisted of two sections: (1) screening for depression risk (Cardiac Depression Scale-5) and (2) consequential referral actions.

Background.  Prior research has shown that depression in patients with heart disease is associated with significantly impaired quality of life, decreased medication adherence, increased morbidity and increased use of healthcare services.

Design.  A prospective in-patient study design.

Method.  A consecutive sample of 202 patients admitted to either the cardiac medical (n = 145) or surgical (n = 57) wards of a major Melbourne metropolitan hospital were recruited into the study over an 18-week period.

Results.  Just over half (54%) of the patients were identified as ‘at risk’ of depression. Of these, 19% were assessed as moderate risk and 35% high risk. Of those patients, 91% had the risk score documented in their medical history, 90% had engaged in discussions with clinicians regarding their risk score, 85% had their risk score communicated formally to the medical team and 25% were formally referred for appropriate follow-up – significantly more than prior to implementation of the screening and referral tool.

Conclusions.  By providing a formalised mechanism for detecting depression, documented screening and referral rates improved for those with comorbid depression and heart disease affording an opportunity for early intervention. These findings support a move towards integrated approaches to screening of depression to become standard practice in the acute cardiac setting.

Relevance to clinical practice.  Such mechanisms also have the potential to initiate the development of new models of care that acknowledge the complexity of comorbid depression and heart disease and provide pathways from speciality to primary care which integrate the physical and psychosocial domains inclusive of screening, referral, systematic monitoring and streamlined behavioural and physical care.
Language eng
DOI 10.1111/j.1365-2702.2011.03934.x
Field of Research 170199 Psychology not elsewhere classified
Socio Economic Objective 970117 Expanding Knowledge in Psychology and Cognitive Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2012, Blackwell Publishing Ltd
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Document type: Journal Article
Collections: Faculty of Health
School of Psychology
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Created: Thu, 23 Aug 2012, 13:22:50 EST by Jane Moschetti

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