Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-10-2024

Graduate Advisor

Dr. Joshua Minks Ph.D., FNP-C

Committee

Dr. Brittania Phillips DNP, APRN, PMHNP-BC

Brooke-Marie Strout MSN, RN

Abstract

Problem: depression, anxiety, and other mental health disorders are more commonly diagnosed in the amputee population related to changes in mobility, activities of daily living, and quality of life (Turner et al., 2020.) As the amputation population is projected to reach over 3 million Americans in the next 25 years, additional screening is imperative to identify patients at high-risk for mental health deterioration (Ziegler-Graham et al., 2018).

Methods: this was a project that included screening all patients with the Personal Health Questionnaire for Depression (PHQ-8) meeting the inclusion criteria of being admitted to 7500 Vascular Surgery at Barnes-Jewish Hospital with an amputation within 24 hours of their procedure. Patients were identified according to their results as mild, moderate, high, or severe, and referred to appropriate treatment, as applicable.

Results: a total of 31 patients (N = 31) were included in this project, 16 male and 15 female. On the PHQ-8, a total of 21 patients scored mild, eight scored moderate, and two scored severe. The average PHQ-8 score amongst the sample was 4.10 (SD = 2.92). The referral to treatment rate was 6.4% (n = 2) and included advanced practice provider assessment and social work referral. The independent variables of age, race, gender, and previous mental health history were not predictors of PHQ-8 risk. The type of procedure completed correlated with PHQ-8 risk score, but the results are subject to statistical error related to sample size.

Implications for practice: findings support all patients where amputation is a consideration need structured, comprehensive, and targeted depression risk screening throughout their evaluation and recovery to identify potential mental health decline.

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