Educating Nurses About Poststroke Depression and Using the PHQ-2/9

Mary McMullen, Walden University

Abstract

Stroke has affected more than 7 million people and up to 33% of those patients reporting depression. The lack of screening for depression for patients post stroke can delay treatment for depression and hinder or lengthen recovery. The purpose of this project was to develop a nursing staff education program on using the Patient Health Questionnaire (PHQ) tools (PHQ-2 and PHQ-9) at the bedside to detect signs and symptoms of depression and identify nurse-driven interventions. Using the Johns Hopkins nursing evidence-based practice model and Orem's self-care model for guidance, an interdisciplinary team was assembled to collaborate on the development. A pre post design was used to assess whether the program would increase knowledge on PHQ tool use and comfort level in recognizing signs and symptoms of depression following program implementation. A total of 53 registered nurses participated in the educational sessions. Nursing knowledge on PHQ tool use increased from a mean of 2.89 to 4.92 on the pretest and posttest, respectively. The comfort level of the nurse participants to recognize the signs and symptoms of depression increased from a mean score of 4.13 to 4.81. Recommendations include educating all bedside nurses within the hospital beginning at orientation and providing annual refresher education on the signs and symptoms of depression, conducting effective screening using the PHQ tools, and adding tools to the electronic health record. The social and psychological impact of post stroke depression affects not only the patient, but their family, friends, and the community. Providing nurses post stroke depression education and a validated tool for assessments will allow them to advocate for patients to receive prompt treatment for depression and to foster a healthy recovery following a stroke.