Finding Hidden Clinical Populations: Strategies for Identifying Women with Postpartum Depression

2.50
Hdl Handle:
http://hdl.handle.net/10755/156435
Type:
Presentation
Title:
Finding Hidden Clinical Populations: Strategies for Identifying Women with Postpartum Depression
Abstract:
Finding Hidden Clinical Populations: Strategies for Identifying Women with Postpartum Depression
Conference Sponsor:Sigma Theta Tau International
Conference Year:2006
Author:Horowitz, June Andrews, APRN, PhD, FAAN
P.I. Institution Name:Boston College
Title:Professor
Co-Authors:Joyce A. Pulcini, PhD, RN, FAAN; Katherine E. Gregory, RN, PhD; Ann Cousins, APRN; Joanne D. Wojcik, MS, APRN, BC
Purpose: Covert health problems often remain undetected and unexamined by clinicians. The purpose of this presentation is to examine strategies for finding hidden clinical populations based on experience from the CARE (Communicating and Relating Effectively) Study.   Theoretical Framework: The Agency for Healthcare Research and Quality framework informs this study. The pathway begins with identifying a cohort of postpartum women with unknown mood state and moves to symptom screening, diagnostic confirmation, and study group assignment. Methods: Identifying women with PPD has involved funneling from a large population by screening and subsequent diagnostic confirmation. After giving birth, women give permission to be contacted for PPD screening. At 4-weeks postpartum, CARE nurses administer the Edinburgh Postnatal Depression Scale (EPDS) to identify depression symptoms. Eligible women have a home-visit to obtain informed consent and participate in a Structured Clinical Interview (SCID) to confirm or rule out PPD.   Results: To date, 1,004 women have agreed to be screened for PPD. Of those, 803 women have been screened by a research nurse. Eighty-four (12.4%) women have been eligible for the study based on the EPDS screening.  Of those, 27 women have enrolled in the study and are active participants. Other eligible women declined participation for reasons including: return to work, difficulty scheduling home-visits, and lack of interest.   Conclusions and Implications: Finding a hidden clinical population requires intensive effort to: access people at-risk, evaluate symptom severity, and, ideally, confirm presence of the problem. The CARE study approach involving self-report symptom screening followed by diagnostic interview for women with positive scores is an effective way to confirm PPD diagnostic status. Use of a SCID validates symptom severity, confirms diagnostic status, and rules out false positives. Strategies tested by the CARE Project can inform other studies involving identification of hidden clinical populations across a variety of locations and settings.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleFinding Hidden Clinical Populations: Strategies for Identifying Women with Postpartum Depressionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156435-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Finding Hidden Clinical Populations: Strategies for Identifying Women with Postpartum Depression</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Horowitz, June Andrews, APRN, PhD, FAAN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Boston College</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">horowitz@bc.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Joyce A. Pulcini, PhD, RN, FAAN; Katherine E. Gregory, RN, PhD; Ann Cousins, APRN; Joanne D. Wojcik, MS, APRN, BC</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Covert health problems often remain undetected and unexamined by clinicians. The purpose of this presentation is to examine strategies for finding hidden clinical populations based on experience from the CARE (Communicating and Relating Effectively) Study. &nbsp; Theoretical Framework: The Agency for Healthcare Research and Quality framework informs this study. The pathway begins with identifying a cohort of postpartum women with unknown mood state and moves to symptom screening, diagnostic confirmation, and study group assignment. Methods: Identifying women with PPD has involved funneling from a large population by screening and subsequent diagnostic confirmation. After giving birth, women give permission to be contacted for PPD screening. At 4-weeks postpartum, CARE nurses administer the Edinburgh Postnatal Depression Scale (EPDS) to identify depression symptoms. Eligible women have a home-visit to obtain informed consent and participate in a Structured Clinical Interview (SCID) to confirm or rule out PPD. &nbsp; Results: To date, 1,004 women have agreed to be screened for PPD. Of those, 803 women have been screened by a research nurse. Eighty-four (12.4%) women have been eligible for the study based on the EPDS screening.&nbsp; Of those, 27 women have enrolled in the study and are active participants. Other eligible women declined participation for reasons including: return to work, difficulty scheduling home-visits, and lack of interest. &nbsp; Conclusions and Implications: Finding a hidden clinical population requires intensive effort to: access people at-risk, evaluate symptom severity, and, ideally, confirm presence of the problem. The CARE study approach involving self-report symptom screening followed by diagnostic interview for women with positive scores is an effective way to confirm PPD diagnostic status. Use of a SCID validates symptom severity, confirms diagnostic status, and rules out false positives. Strategies tested by the CARE Project can inform other studies involving identification of hidden clinical populations across a variety of locations and settings.</td></tr></table>en_GB
dc.date.available2011-10-26T14:46:50Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T14:46:50Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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