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The Development Of The DNP Practicum Project Discussion

The Development Of The DNP Practicum Project Discussion

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Brief tools are required for effective screening and diagnosis of patients for patients in primary care settings. A screening tool, if utilized properly might assist health care providers in accurately detecting patients with major depressive disorder and commence appropriate management.  Numerous instruments are available for screening and diagnosing depression; nevertheless, not all the tools are appropriate for utilization in primary care settings.   My proposed PICOT question is: In adults aged 20-65, does the use of Patient Health Questionnaire-9 during regular family practice visits, compared to no use of Patient Health Questionnaire-9, significantly improve the detection and prompt treatment of major depressive disorder in 8 weeks?  Several studies have been conducted to assess the usefulness of PHQ-6 in screening for depression in primary care patients. These studies have demonstrated that the PHQ-9 is a reliable and valid tool for detecting depression in primary care settings The Development Of The DNP Practicum Project Discussion.

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The study by Rancans et al. (2018) was conducted to assess the validity of PHQ-2  and PHQ-9 in screening for depression in primary care settings and determine a cut-off score to detect depression. The study included patients from twenty-four primary care facilities visiting their general practitioner due to health concerns.   A total of 1585 aged 18 years or older completed the PHQ-9. In the study, the point prevalence of depression was approximated to be 10.2 percent.   The study revealed that the Russian and Latvian versions of the PHQ-2 and PHQ-9 have moderated psychometric properties for major depression screening in primary care, with a recommended cut-off score of two or greater for the PHQ-2 or eight or greater for PHQ-9 The Development Of The DNP Practicum Project Discussion.

The purpose of the study by Molebatsi et al. (2020) was to determine the reliability and validity of  aPHQ-9 for depression screening in primary care patients in Botswana.  The PHQ-9 was administered by an interviewer with the MINI major depressive episode being utilized as a reference standard.  The study was carried out in two primary care facilities in Gaborome. Convenience sampling was utilized in selecting potential study subjects. 257 patients who were 18 years or older were included in the study.   The English version of the PHQ-9 was used in screening for depression.  The study findings were that 105 participants met the DSM-IV criteria for major depressive disorder, utilizing the MINI depression module equivalent to a prevalence of 40.9 percent.  The PHQ-9 mean depression scores were considerably higher among patients with depression compared to patients without depression. Participants who had had positive screening results or those found to be suicidal were referred to a mental health nurse situated at the facility for further evaluation and management.  The study shows that PH-9 is a valid and reliable screening tool for depression in primary care facilities at a cut-off score of 9 or more The Development Of The DNP Practicum Project Discussion.

Examine how your PICOT question addresses the identified practice problem

The PICOT question addresses the identified practice problem in that it seeks to establish if the use of the PHQ-9 depression screening tool to screen patients during primary care visits can help in the detection and treatment of depression. Low rates of depression screening are in part due to low rates of identification. Samples et al. 2020) indicate that a meta-analysis investigating unaided depression diagnosis by general providers revealed that less than fifty percent of primary care patients are appropriately recognized. Nevertheless, patients who fail to meet diagnostic criteria for depression are at times misdiagnosed with depression and are treated, which mirrors the misrecognition of subclinical symptoms or barriers to the appropriate diagnosis. Evidence has demonstrated that primary care providers record diagnoses for somatic complaints (for example, headache, insomnia, or fatigue)The Development Of The DNP Practicum Project Discussion instead of depression mainly since they are uncertain about the diagnosis.  Depression screeners were developed with the aim of reducing diagnostic ambiguity.

Evaluate how the outcome identified in your PICOT question aligns with the evidence-based intervention

The outcome (improved depression detection and timely treatment) aligns with depression screening using the PHQ-9 as the evidence-based intervention for the identification, diagnosis, and treatment of depression. According to Rahman et al. (2022), .individuals with depression are frequently misdiagnosed or/ and underdiagnosed, which impedes effective treatment.  to overcome these barriers, a rapid, valid, and reliable screening instrument for depression is needed. The  Patient Health Questionnaire 9 was designed to screen for and assess how severe depressive symptoms are in clinical as well as research contexts.   PHQ-9 has been demonstrated to be a valid and reliable depression screening tool and there has been the evaluation of the psychometric properties of PHQ-9 in different patient samples, including certain groups of medical patients, psychiatric patients, and primary care patients as well as in multicultural populations The Development Of The DNP Practicum Project Discussion.

References

Molebatsi, K., Motlhatlhedi, K., & Wambua, G. N. (2020). The validity and reliability of the Patient Health Questionnaire-9 for screening depression in primary health care patients in Botswana. BMC Psychiatry, 20, 195. https://doi.org/10.1186/s12888-020-02719-5

Rahman,  M. A., Dhira,  T. A., Sarker, A. R., & Mehareen,  J.  (2022) Validity and reliability of the Patient Health Questionnaire scale (PHQ-9) among university students of Bangladesh. PLoS ONE 17(6): e0269634. https://doi.org/10.1371/journal.pone.0269634

Rancans, E., Trapencieris, M., Ivanovs, R., & Vrublevsak, J. (2018). Validity of the PHQ-9 and PHQ-2 to screen for depression in nationwide primary care population in Latvia. Annals, of General Psychiatry, 17, 33. https://doi.org/10.1186/s12991-018-0203-5

Samples, H., Sturat, E. A., Saloner, B., Barry, C. L., & Mojtabai, M. (2020). . The Role of Screening in Depression Diagnosis and Treatment in a Representative Sample of US Primary Care Visits.  Journal of General Internal Medicine, 35(1), 12-20. doi: 10.1007/s11606-019-05192-3

Hello, For this essay
Example of PICOT question: The PICOT question, in this case, will be: In adults aged 20-65, does use of Patient Health Questionnaire-9 during regular family practice visits, compared to no use of Patient Health Questionnaire-9, significantly improve the detection and prompt treatment of major depressive disorder. Time of 8 weeks The Development Of The DNP Practicum Project Discussion.

I will be looking at number of patients screened.

Discussion

Purpose

The purpose of this assignment is to examine a PICOT question, which will serve as the mechanism for the development of the DNP practicum project.

Instructions

Reflect on your readings this week and respond to the following:

  1. State your proposed DNP practicum project PICOT
  2. Examine how your PICOT question
  3. addresses the identified practice problem.
  4. Evaluate how the outcome identified in your PICOT question aligns with the evidence-based intervention.

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Example of PICOT question: The PICOT question, in this case, will be: In adults aged 20-65, does use of Patient Health Questionnaire-9 during regular family practice visits, compared to no use of Patient Health Questionnaire-9, significantly improve the detection and prompt treatment of major depressive disorder. Time of 8 weeks.

I will be looking at number of patients screened. The Development Of The DNP Practicum Project Discussion

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