New Study Finds Mutual Benefits Of Improved Care By Nurses Treating Depression

Editor's Choice
Main Category: Depression
Also Included In: Nursing / Midwifery
Article Date: 31 Aug 2011 - 9:00 PDT


Today new discoveries released by Mind in association with the Royal College of Nursing, reveal that the recovery in individuals suffering with chronic and recurrent depression can be helped by organized contact with practice nurses. Financed by Big Lottery Fund, the three-year ProCEED intervention study led on behalf of the mental health charity by University College London, discovered proof that improved care by nurses can have considerable benefits for both nurses and patients. The study coincides with the introduction of a new training pack on depression directed at nurses.

Despite depression being one of the most common illnesses in the UK, and accounting for a quarter of GP visits with one in six individuals being effected by it at some period in their lives, nurses receive little or no training at all and several feel ill-prepared to discuss depression. For physical chronic conditions, such as asthma or diabetes, proactive care is routinely provided by practice nurses, however, it is not always offered for depression and nurses often feel anxious about bringing up the subject with patients.

From 42 general practices across the UK, 558 nurses were recruited to participate in the ProCEED intervention study. Participants were split into two groups, with the intervention group containing 282 nurses and the control group consisting of 276. During the study all nurses received training to offer proactive, enhanced levels of care to patients experiencing severe and recurrent depression.

Patients received ten appointments over a 2 year period in which satisfaction with current treatments together with social factors, such as isolation, housing and employment were addressed during the sessions.

Key discoveries of the investigation included:

• Improved confidence and skills in nurses managing patients with depression.
• After receiving frequent sessions with nurses, patients experienced considerable improvements in social functioning and reported a rise in confidence and self esteem.
• Small improvements were indicated in the severity of depression experienced by patients when compared to a control group.
• Symptoms and social functioning were improved when patients went to all ten sessions.
• Several patients believed that ongoing proactive care should be provided by a nurse instead of a GP.
• Proactive care by nurses was revealed to be a cost effective way in achieving positive changes in severity of depression in patients and improving their ability to play a fuller role in society.

Mind's Chief Executive Paul Farmer explained:

"There is clearly an unmet need in offering people with depression ongoing holistic consultation in primary care. Practice nurses are on the front line so are well placed to provide this kind of advice and support. Nurses are already offering enhanced care packages to patients for physical conditions and with the right training and support could be equipped to do the same for depression. There must be a parity of esteem in how mental and physical health problems are addressed in primary care settings.

One of the most encouraging findings of this study was the positive impact the experience had on the lives of participants. It's time for more collaborative working on mental health. It's been shown to be cost effective and has achieved great results for all involved. The Mind and Royal College of Nursing new training pack is a great starting point and will hopefully become essential reading for practice nurses."

Royal College of Nursing Chief Executive & General Secretary Dr Peter Carter said:

"General practice nurses play a huge role in managing the care of patients with long term physical conditions. However their potential for improving the quality of life for patients with depression has never been realized across the board. We are delighted to support this new initiative and hope that nurses will be encouraged to use this excellent training pack to enhance their skills, knowledge and confidence in the management of depression.

Depression is a co-existing factor in many long term conditions and this new approach will see a more holistic approach to treatment for the benefit for patients and clients."

Research nurse Kate O'Brien who participated in the study stated:

"Caring for patients with depression is challenging and, consequently, extremely rewarding. I found that I needed to develop new skills to enable me to feel that I could be of benefit to my patients. The most important thing was listening, really listening to pick up what patients were trying to tell you. This often meant identifying what they weren't saying and finding a way of allowing them to talk comfortably.

If I am checking notes for any reason and the person is someone I have worked with on ProCEED it is such a positive feeling to see that they have not needed to restart their antidepressants or that they have only had a couple of GP consultations in the last year. It reinforces the impression of making a difference."

A patient who took part in the study commented:

"I have huge faith in my doctor if I go with a medical problem that's fine but I think depression isn't an acute medical problem. I think it's more something that you need to have time with somebody. And the time to me is more important that the prescription. That time to me (with the nurse) was worth 100 prescriptions."

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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