The comparison of effectiveness of two modalities of mental health nurse follow-up programmes for female outpatients with depression in Taipei, Taiwan.

ABSTRACT

AIMS AND OBJECTIVES: This study compares the effectiveness of two modalities of mental health nurse three-month follow-up programmes telephone counselling programme and group therapy programme for female outpatients with depression. BACKGROUND: The lifetime prevalence of major depression is 15% and is about twice as common in women as in men. Outpatients with depression often discontinue their treatment after the initial visits to their physicians. METHODS: This study used a quasi-experimental, pre-post-test comparison group design. Twenty-six female outpatients with depression were assigned to one of follow-up programmes telephone counselling programme or group therapy programme. To qualify for group therapy programme, potential participants were required to come to group sessions weekly. To be accepted into telephone counselling programme, potential participants had to be able to be contacted by phone regularly. Mental health nurse three-month follow-up programmes included care management and structured psychotherapy. Patients in telephone counselling programme received 10 regular telephone calls of 30-60 minutes each. Patients in group therapy programme received 12 sessions of weekly group meetings of 90-120 minutes each. RESULTS: Wilcoxon signed ranks tests provided evidence that the group therapy programme (S = -52.5, p < 0.001; S = 31.5, p = 0.046) and telephone counselling programme (S = -36, p = 0.002; S = 25, p = 0.050) follow-up programmes were effective in terms of relieving depressed symptoms and improving quality of life. According to Quade's analysis of covariance, telephone counselling programme and group therapy programme appeared to have similar effects of relieving depressed symptoms (F(1,24) = 0.06, p = 0.813) and increasing quality of life (F(1,24) = 0.07, p = 0.792). While there was no significant difference in using emergency services ( chi(2)(1)= 0.89, p = 0.539) between telephone counselling programme and group therapy programme, the rate of adherence to scheduled outpatient appointments with psychiatrists was higher among patients in group therapy programme than patients in telephone counselling programme (chi(2)(3) = 8.67, p = 0.034). CONCLUSIONS: Establishing two modalities of mental health nurse follow-up programmes in Taiwan could benefit patients with different needs. RELEVANCE TO CLINICAL PRACTICE Mental health nurses specialized in management of depression could provide not only care management but also structured psychotherapy.