ABSTRACT
In the United States, 9.3% of the population, or 29.1 million people have diabetes, and depression affects 20% to 40% of these individuals. Diabetic foot ulcers are a common and serious complication of diabetes and one of the most costly. It is estimated that 2% to 3% of persons with diabetes will develop diabetic foot ulcers each year. There is an association between depression and the development of diabetic foot ulcers. The estimated costs associated with managing diabetes, depression, and diabetic foot ulcers place a substantial burden on the U.S. healthcare system and society. Patients should be screened and evaluated by professionals qualified in the diagnosis and management of depression and diabetic foot ulcers. To be effective, an interprofessional approach that includes the patient and significant others should be used.
Subject(s)
Depression/epidemiology , Depression/prevention & control , Diabetic Foot/epidemiology , Diabetic Foot/psychology , Cost of Illness , Humans , Patient Care Team , Physical Examination , Quality of Life , United StatesABSTRACT
Depression and cardiovascular disease are leading causes of morbidity and mortality in the United States and globally. Depression significantly increases the risk of fatal and nonfatal cardiovascular disease and increases the risk of mortality in patients with cardiovascular disease. Patients receiving home healthcare are disproportionally affected by depression. Comorbid depression can occur in two time frames: precardiac and postcardiac. It is imperative that home care patients be adequately screened and monitored for depressive symptoms. Home care patients with cardiac disease who are under treatment for depression should be carefully monitored for adherence to their medical care, drug efficacy, and safety with respect to their cardiovascular as well as mental health.
Subject(s)
Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/psychology , Depression/epidemiology , Home Care Services/organization & administration , Sickness Impact Profile , Aged , Aged, 80 and over , Cardiovascular Diseases/diagnosis , Comorbidity , Depression/diagnosis , Depression/therapy , Early Diagnosis , Female , Home Health Nursing , Humans , Incidence , Male , Middle Aged , Nurse's Role , Prognosis , Psychotherapy/methodsABSTRACT
Depression is significantly higher among elderly adults receiving home healthcare, particularly among adults with Type 2 diabetes. Depression leads to greater medical illness, functional impairment, and chronic pain. Opportunities are often missed to improve mental health and general medical outcomes when mental illness is underrecognized and undertreated. This article discusses the mandate by the Centers for Medicare & Medicaid Services (CMS), Outcome and Assessment Information Set-C (OASIS-C) (2009) for the use of the Patient Health Questionnaire (PHQ-2) to screen for depression in home care patients, with special emphasis on the patient with diabetes.
Subject(s)
Centers for Medicare and Medicaid Services, U.S./standards , Depression/diagnosis , Depression/therapy , Diabetes Mellitus, Type 2/therapy , Home Care Services/standards , Outcome and Process Assessment, Health Care/standards , Aged , Aged, 80 and over , Diabetes Mellitus, Type 2/psychology , Female , Geriatric Assessment/methods , Humans , Male , Practice Guidelines as Topic , Practice Patterns, Physicians'/standards , United StatesABSTRACT
Diabetes with comorbid depression increases healthcare use, expenditures, and risk for complications. This study investigated current practice patterns for diabetic management as measured by HbA1C (A1C). Results indicated significant increases in Patient Health Questionnaire (PHQ)-9 and HbA1C scores among patients with diabetes who take antidepressant drugs.
Subject(s)
Antidepressive Agents/therapeutic use , Depression/drug therapy , Diabetes Mellitus, Type 2/psychology , Disease Management , Adult , Aged , Aged, 80 and over , Comorbidity , Depression/epidemiology , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/ethnology , Female , Glycated Hemoglobin/analysis , Health Surveys , Hispanic or Latino , Humans , Male , Middle Aged , New York City/epidemiology , Retrospective Studies , Treatment OutcomeABSTRACT
Type 2 diabetes has been associated with an increased risk of dementia compared to non-diabetes. Vascular dementia is increased two-to-three fold in persons with type 2 diabetes. Proper management of risk factors can reduce the risk of developing cognitive impairment for persons with diabetes.
Subject(s)
Dementia, Vascular/etiology , Dementia, Vascular/therapy , Diabetes Mellitus, Type 2/complications , Cognition Disorders/diagnosis , Dementia, Vascular/epidemiology , Dementia, Vascular/nursing , Humans , Incidence , Nursing Audit , Time FactorsABSTRACT
Herbal medicines were the "sole" source of medicine for thousands of years, in every culture since the advent of human civilization. Today, patients are increasing the use of these botanicals for numerous conditions, such as mood and cognition. This article will explore commonly used herbal remedies for mood and cognition functioning. It is imperative that nurses and nurse practitioners obtain expertise with these botanicals with regard to efficacy, adverse effects and contraindications, possible drug interactions, and safety considerations.
Subject(s)
Cognition Disorders/drug therapy , Herbal Medicine , Mood Disorders/drug therapy , Phytotherapy , Plant Extracts/therapeutic use , Affect , Clinical Competence , Cognition , Herb-Drug Interactions , Humans , NursingABSTRACT
The purpose of this article is to describe the creation of a transdisciplinary group, consisting of nurse educators, a medical librarian, lab technologists, and a technology expert. to lead the integration of electronic health technology, including high-fidelity simulation, handheld technology, and electronic health records, within a school of nursing. The use of innovative educational tools by nursing faculty can be daunting because of the steep learning curve. The model described here is effective in developing faculty to use simulation and other technologies as teaching-learning strategies.
Subject(s)
Computer User Training/methods , Education, Nursing, Baccalaureate/organization & administration , Educational Technology , Faculty, Nursing/organization & administration , Medical Laboratory Personnel/organization & administration , Medical Record Administrators/organization & administration , Computers, Handheld , Cooperative Behavior , Curriculum , Educational Technology/education , Educational Technology/organization & administration , Electronic Health Records/organization & administration , Humans , Interprofessional Relations , Models, Educational , Models, Nursing , New York City , Nursing Education Research , Professional Role , Program Development , Program Evaluation , Staff Development/organization & administrationABSTRACT
Evidence indicates rates of depressive disorders are higher among adults with diabetes than in the general population. The instrument most frequently utilized in primary care to screen for major depression is The Patient Health Questionnaire (PHQ-9). Its use can have a dramatic impact on the initial diagnosis and ongoing treatment of patients with diabetes and depression.
