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, 21 15-16: 2228-2234. doi:10.1111/j.1365-2702.2011.03934.x

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Author Ski, Chantal F.
Page, Karen
Thompson, David R.
Cummins, Robert A.
Salzberg, Mike
Worrall-Carter, Linda
Title Clinical outcomes associated with screening and referral for depression in an acute cardiac ward
Journal name Journal of Clinical Nursing   Check publisher's open access policy
ISSN 0962-1067
Publication date 2012-08
Sub-type Article (original research)
DOI 10.1111/j.1365-2702.2011.03934.x
Volume 21
Issue 15-16
Start page 2228
End page 2234
Total pages 7
Place of publication Oxford, U.K.
Publisher Wiley-Blackwell Publishing
Collection year 2013
Language eng
Formatted abstract
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.
Keyword Acute cardiac ward
Heart disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Nursing, Midwifery and Social Work Publications
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Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 14 Feb 2012, 13:30:39 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work