View
2
Download
0
Category
Preview:
Citation preview
Workplace : Depression Center, Prasrimahabhodi Psychiatric Hospital, Ubon
Ratchathani, Thailand
Background : Globally, depression is a leading cause of disability across
all age groups, currently ranked the fourth in terms of burden of disease and will
be ranked the second highest in 2020. Appropriate treatment and therapies are
more important for reducing depressive symptoms. Therefore, clinical practice
guideline of psychosocial intervention in depressive disorders should be
developed for psychiatric nurses in tertiary care centers.
Objective : To develop clinical practice guideline of psychosocial intervention
/therapy in depressive disorder for psychiatric nurses in tertiary care centers.
Material and method : Clinical practice guideline has been developed
through five main processes: 1. initial draft prepared by CPG meeting group
following careful review of existing practice and available published evidence
on topic. International evidence-based practice and consensus statements
considered and included as appropriate. All guidelines adapted to local
conditions. 2. Consultation with another group member and with an appropriate
external specialists where appropriate. 3. Test and evaluation with appropriate
sample. 4. Draft for implementation and evaluation after implementation.
5. Continues development after implementation.
Results : There are four processes of this clinical practice guideline
which are as follows: 1. Severity evaluation of depressive disorder. 2. Problem
evaluation related to depressive disorder. 3. Psychosocial therapy with severity;
mild to moderate disorder managed with exercise or problem-solving, moderate
to severe disorder managed with Cognitive-Behavior Therapy or Interpersonal
Therapy 4. Outcome evaluation was done by testing 22 depressive disorder
patients after therapy. There were 18 patients who received full course therapy
with psychosocial intervention. It is found that severity of depressive symptom
was reduced by 100 percent and satisfaction level of patients was found to be
100 percent.
Clinical practice guideline of psychosocial intervention in depressive disorders
for psychiatric nurses in tertiary care centersAuthors : Assoc.Prof.Dr.Somporn Rungreangkulkij, Dr.Thoranin Kongsuk, Mrs.Supattra Sukhawaha, Mrs.Jintana Leejongpermpoon, Miss.Supranee Phimtra, Miss.Kedsaraporn Kenbubpha,
Presenter : Kedsaraporn Kenbubpha, kkenbubpha@yahoo.com
Algorithm Psychosocial Intervention for MDD in Tertiary Care Settings
Patients come to health services
MILD(9Q=7-12)
Step I
Assessment
Step II
Planning
Step III
Intervention
Step IV
Evaluation
Non history diseases to
prohibit exercise and/or non
specific social problem
Present distorted of negative
thoughts and/or non specific
relationship problem
Present specific social problem and/or have diseases to
prohibit exercise
Present specific
relationship problem
Interpersonal Psychotherapy
(IPT)
Problem solving
therapy (PST)
Cognitive Behavioral
Therapy (CBT)
Exercise Therapy
(ET)
NO
YES
Case conference with Multidisciplinary health professionals for finding others
methods
Moderate(9Q= 13-18)
Severe(9Q≥19)
Psychiatrists diagnose to be major depressive disorder
Outcome assessment of therapy with 9Q at least 6 months continuous
Stop treatment
Assessment severity of depressive symptoms by using 9 - questions (9Q)
Assessment specific problem of depressive symptoms for choosing suitable therapy to depressed patients
9Q scores <7 or not?
to to
References
1. Mello M.F. et al. (2005). A systematic review of research findings on the efficacy of interpersonal therapy for depressive disorder.Eur Arch Psychiatry Clin Neurosci.Vol 255;75-82 2. Luty S.E. et al. (2007); New Zealand. Randomized controlled trial of interpersonal psychotherapy and cognitive behavioral therapy for depression. British Journal of Psychiatry Vol.190; 496-502. 3. Bell A C, D’Zurilla T J (2009). Problem-solving therapy for depression: A metaanalysis. Clinical Psychology Review . Vol. 29; 348–353 4. Cape J (2010). Brief psychological therapies for anxiety and depression in primary care: metaanalysis and meta-regression. BMC Medicine. ; 8:38 5. Gellis Z.D.& Kenaley B. (2008). Problem-Solving Therapy for Depression in Adults: A Systematic Review. Social Work Practice. March Vol. 18 ( 2); 117-131 6. Peraton LG, Kumar S, And Machotka Z. (2010).Exercise parameters in the treatment of clinical depression: a systematic review of randomized controlled trials. Journal of Evaluation in Clinical. Vol.16 ; 597-624.
Conclusion and suggestion : This cl inical practice guideline
for psychiatric nurses was proved to be very effective in the reduction of
depressive symptoms, with 100 percent patient satisfaction. Therefore, this
guideline should be practiced in all secondary care centers and the nurses
in secondary care centers should be trained for correct and effective
implementation of this guideline.
Keywords : clinical practice guideline, psychosocial therapy, depressive
disorders, psychiatric nurses, tertiary care centers
Recommended