家庭健康护士综合抑郁护理管理但有限的利益

Medicare家庭医疗保健护士有效地将抑郁护理管理计划纳入常规实践，但根据在线发表的一份报告，该报告称，效益仅限于中度至严重抑郁症的患者贾马内科。

临床显着的抑郁症会影响超过25％的老年患者家庭医疗保健服务。根据研究中的背景信息，高患病率与表征这些患者的残疾，疾病和心理社会压力源是一致的。

The Depression Care for Patients at Home (Depression CAREPATH) trial by Martha L. Bruce, Ph.D., M.P.H., of the Weill Cornell Medical College (Department of Psychiatry), White Plains, N.Y., and colleagues used specially trained home health care nurses to manage depression at routine home visits. The trial randomly assigned 178 nurses from six home health agencies to 12 Depression CAREPATH intervention teams or nine enhanced usual care teams. The study enrolled 306 Medicare Home Health patients 65 years and older who screened positive for depression and were followed up at three, six and 12 months. About 70 percent of patients were female with an average age of 76.5 years. Depression severity was assessed using a scale score.

根据研究结果，干预在患者的完整样本中没有影响。干预患者在患者的子样本中也没有影响轻度萧条（抑郁症得分低于10），因为抑郁分数在任何后续点都没有不同。然而，抑郁症治疗方法在208例抑郁症患者中有效，抑郁症评分为10或更大，持续三个月（14.1与16.1），六个月（12与14.7），12个月（11.8 vs.15.7）。

“Medicare推荐抑郁症筛选和干预，但家庭医疗保健患者的临床需求，心理健康专家的稀缺和家庭医疗保健的结构和实践对此目标挑战。这种有效性试验表明家庭医疗护士可以有效地整合DCM [沮丧护理管理]进入常规实践，临床效益中度较为严重抑郁症患者超越家庭医疗服务期间，“研究结束。

---

---