Treatment of Depression in Homecare Patients

这项关于医生决定的拟议研究：抑郁症家庭护理患者的治疗申请1年的资金，以进行一项试点调查，调查初级保健医生对接受家庭护理护理的老年患者的抗抑郁治疗的观点，以解决内科或外科问题。抑郁症在家庭护理患者中非常普遍，但通常没有被发现，也很少得到治疗。这项试点将加强纽约康奈尔访问护士服务(VNSNY)抑郁症治疗研究，研究护士发起和管理的抗抑郁药物治疗老年抑郁症的有效性。这项研究的主要目的是(1)描述医生对老年家庭护理患者抗抑郁治疗的知识和态度；(2)确定医生特定的和患者特定的因素，与医生在老年家庭健康患者中开始抗抑郁治疗的意愿相关；以及(3)描述高级实践精神科护士和治疗医生在启动和管理老年人抑郁方面的互动。这项拟议的研究将联系并试图采访80名初级保健医生，他们的患者参加了康奈尔-VNSNY抑郁症治疗研究。这些数据以及这项研究的高级实践精神科护士收集的关于她与每位初级保健医生互动的信息、患者病历和患者访谈将被用来解决研究目标。正在要求资金收集更多的数据，以加强和扩大正在进行的研究，总体目标是改善老年保健患者对晚年抑郁症的认识和治疗。

This proposed study of A Physician's Decision: Treatment of Depression Homecare Patients requests 1 year of funding to conduct a pilot investigation into the primary care physicians' perspectives on anti- depressant treatment for t6heir older patient receiving homecare nursing for medical or surgical problems. Depression is highly prevalent in home care patients but usually unrecognized and rarely treated. This pilot will augment the Cornell-Visiting Nurse Services of New York (VNSNY) Depression Treatment Study of the effectiveness of nurse initiated and managed antidepressant treatment for geriatric depression. The primary aims of this study are to (1) describe the knowledge and attitudes of physicians toward antidepressant treatment for older homecare patients, (2) identify both physician-specific and patient-specific factors associated with the physician's willingness to initiate antidepressant treatment in the older depressed home health patient, and (3) describe the interaction between the Advanced Practice Psychiatric Nurse and the treating physician in initiating and managing depression in older adults. The proposed study will contact and attempt to interview the 80 primary care physicians whose patients were enrolled in the Cornell-VNSNY Depression Treatment Study. These data as well as information collected by the study's Advanced Practice Psychiatric Nurse about her interaction with each primary care physician, the patient medical record and the patient interview will be used to address the study aims. Funds are being requested to collect additional data to build on and extend ongoing research with the overall goal of improving recognition and treatment of late-life depression in older health care patients.