The effect of nurse-led group discussions by race on depressive symptoms in patients with heart failure.

BACKGROUND: African Americans with heart failure (HF) have the highest rates of depression among all ethnicities in the USA. OBJECTIVES: To compare the effects by race on depressive symptoms and topics discussed in the first clinic appointment after HF hospitalization. METHODS: This study is a secondary analysis of data from a randomized clinical trial testing a patient group discussion of HF self-management with 93 Caucasians and 77 African Americans. RESULTS: Reduction in depressive symptoms was significantly greater among African American patients within the intervention group (F = 3.99, p = .047) than controls. There were significant differences by race in four topics (dietitian referral, appointment date, help preparing discussion questions, and advice on worsening HF symptoms) concerning patient-physician discussions. CONCLUSION: The intervention showed greater effect in reducing depressive symptoms among African Americans than Caucasians. Preparing patients for discussions at physician appointments on diet, depressive symptoms, and HF symptoms is recommended.

Comparing patient and nurse specialist reports of causative factors of depression related to heart failure.

PURPOSE: The purpose of this study was to compare participants' and a psychiatric nurse specialist's reports on factors precipitating depression and to validate a depression screening instrument. DESIGN AND METHODS: Participants were screened for and asked to self-report causative factors of their depression. Participants with moderately severe and severe depressive symptoms received a psychiatric nurse specialist assessment. FINDINGS: Participants self-reported several causative factors of depression. The psychiatric nurse specialist discovered these plus additional factors. The screening instrument was found to be reliable and valid for the measurement of depressive symptoms. PRACTICE IMPLICATIONS: Participant self-report identifies many causative factors of depression. The psychiatric nurse specialist identifies additional factors, allowing individualized diagnoses and treatments.

The experience of living with chronic mental illness: a photovoice study.

PURPOSE: This study aims to explore if photovoice methodology can be used to enhance the level of empathy professionals feel when meeting a patient who carries a psychiatric diagnosis in any setting. DESIGN AND METHODS: This study used a qualitative descriptive design. Seven adult patients were interviewed for 1 hr regarding photos that were taken to represent what it has been like to live with their chronic illness. FINDINGS: Four major themes emerged: (a) feeling misunderstood and invisible in the world; (b) attempting to gain control and be safe through various actions and activities; (c) making an ongoing effort to repair injured self-esteem; and (d) using various coping skills. PRACTICE IMPLICATIONS: Patients in this study enjoyed the process of taking photos to help tell their story, and they were able to capture meaningful images that communicated their lived experience of dealing with a mental illness.

Nonepileptic seizures: reframing the diagnosis.

PROBLEM: Protocols for disclosing the diagnosis of psychological pseudoseizures have been developed. However, outcomes have not been carefully studied. METHOD: Using a retrospective design, the investigators evaluated the outcomes by interviewing patients 2 years after diagnosis who received the diagnosis using a specific protocol. FINDINGS: There was a reduction in symptoms demonstrated by reports of lessened intensity of events or actual reduction in the number of events in 86% of those interviewed. CONCLUSION: This protocol proved helpful in the acceptance of the diagnosis and improved adherence to the treatment recommendations after disclosure of the diagnosis.