NR601 Week 3 Psychiatric Disorders and Screening Complete Solution
Depression: Patient Health Questionnaire-9 (PHQ-9)
A common disorder that a nurse
... [Show More] practitioner will encounter in primary care is depression (Dunphy, Winland-Brown, Porter & Thomas, 2019). Depression is characterized by prevalent and sustained feelings of sadness, lack of joy in activities that use to provide pleasure, feelings of guilt, lack of motivation, being discouraged, low energy, sleep disturbance, and/ or changes in appetite (Kennedy-Malone, Martin-Plank, & Duffy, 2019). The screening tool that I have chosen to utilize in K.F. is the PHQ-9. The PHQ-9 is a tool developed for the use in primary care to evaluate and identify symptoms related to depression; it is a self-report screening tool (Manea, Gilbody, & McMillian, 2015). The PHQ-9 is a self-reporting questionnaire; it is based on symptoms that are experienced over a two-week period. This screening tool is comprised of 9 items. These 9 items are calculated to result in an overall score; the scoring ranges from 0 to 27 (Hirschtritt & Kroenke, 2017). The scoring for the PHQ-9 is as follows: 1-4 = minimal depression, 5-9 = mild depression, 10-14 = moderate depression, 15-19 = moderate/severe depression, and 20 -27 = severe depression (Manea et al., 2015). The PHQ-9 has a 61% sensitivity and 94% specificity in adults (Levis, Benedetti, & Thombs, 2019). Positives for using this specific screening tool for depression is that it is in a format that is self-reporting, quick, easy to interpret, and is available in many languages (Hirschtritt & Kroenke, 2017).
PHQ-9:
Over the last 2 weeks, how often have you been bothered by any of the following problems? (0 = not at all, 1 = several days, 2 = more than half the days, 3 = nearly every day)
1. Little interest or pleasure in doing things = 3
2. Feeling down, depressed, or hopeless = 3
3. Trouble falling or staying asleep, or sleeping too much =1
4. Feeling tired or having little energy = 3
5. Poor appetite or overeating = 3
6. Feeling bad about yourself or you are a failure or have let yourself or your family down = Not known
7. Trouble concentrating on things, such as reading the newspaper or watching television = 3
8. Moving or speaking so slowly that other people could have noticed? Or the opposite—being
so fidgety or restless that you have been moving around a lot more than usual = Not
Known
9. Thoughts that you would be better off dead or of hurting yourself in some way = Not Known
Total score = 16
A score of 15 to 19 is indicative of moderate to severe depression (Manea et al.,2015).
Anxiety- Post- Traumatic Stress Disorder: Primary Care PTSD Screen (PC-PTSD-5 )
Post-Traumatic Stress Disorder (PTSD) develops due the exposure of a person witnessing, participating in, or experiences trauma; whether threatened or actual (Dunphy et al., 2019). Symptoms of PTSD can present as nightmares, unwanted memories or flashbacks, anxiety, depression, and of reactionary awareness (Bisson, Cosgrove, Lewis, & Robert, 2015). The PC-PTSD-5 screening tool is a 5-item questionnaire that was designed to be utilized in primary care; it is self-reporting and easily used by the patient. The evaluation begins by assessing whether the patient has had any exposure to a traumatic event. In the event the patient denies any exposure to a traumatic event a score of 0 is given and the PC-PTSD-5 is complete. However, if the patient reports any exposure to any traumatic event over their lifetime, the patient will then complete the questionnaire. The PC-PTSD-5 is comprised of 5 yes or no questions; it is scored 1. Answering yes to 3 out of the 5 questions regarding how the past traumatic event has affected them over the past month is significant for the probability of PTSD (Prins et al., 2016). This screening tool was chosen based on information provided by the patient regarding reports of a history of great anxiety due to verbal and concern for physical abuse while with her first husband in France, being torn from her son at the age of 11 after the divorce when the French government gave custody of her son to her ex-husband, and the sudden death of her second husband 2 years ago. All of these situations are traumatic and can have a lasting affect on a person.
PC-PTSD-5:
Sometimes things happen to people that are unusually or especially frightening, horrible, or traumatic. For example:
• a serious accident or fire
• a physical or sexual assault or abuse
• an earthquake or flood
• a war
• seeing someone be killed or seriously injured
• having a loved one die through homicide or suicide.
Have you ever experienced this kind of event?
YES NO [Show Less]