Practices of Depression Care in Home Health Care: Home Health Clinician Perspectives

• Published in: Psychiatric services (Washington, D.C.) Vol. 66; no. 12; pp. 1365 - 1368
• Main Authors: Bao, Yuhua, Eggman, Ashley A, Richardson, Joshua E, Sheeran, Thomas F, Bruce, Martha L
• Format: Journal Article
• Language: English
• Published: United States American Psychiatric Association 01.12.2015; American Psychiatric Publishing, Inc
• Subjects: Antidepressants; Attitude of Health Personnel; Depressive Disorder - nursing; Depressive Disorder - psychology; Home Care Agencies; Home Care Services - statistics & numerical data; Home health care; Humans; Interviews as Topic; Mental depression; Nurses, Community Health - psychology; Nurses, Community Health - statistics & numerical data; Primary care; Qualitative research; Quality of care
• ISSN: 1075-2730; 1557-9700
• DOI: 10.1176/appi.ps.201400481

Objective:The study assessed gaps between published best practices and real-world practices of treating depression in home health care (HHC) and barriers to closing gaps.Methods:The qualitative study used semistructured interviews with nurses and administrators (N=20) from five HHC agencies in five states. Audio-recorded interviews were transcribed and analyzed by a multidisciplinary team using grounded theory method to identify themes.Results:Routine HHC nursing overlapped with all functional areas of depression care. However, gaps were noted between best and real-world practices. Gaps were associated with perceived scope of practice by HHC nurses, knowledge gaps and low self-efficacy in depression treatment, stigma attached to depression, poor quality of antidepressant management in primary care, and poor communication between HHC and primary care clinicians.Conclusions:Strategies to close gaps between typical and best practices include enhancing HHC clinicians’ knowledge and self-efficacy with depression treatment and improving the quality of antidepressant management and communication with primary care.