Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-16-2025

Graduate Advisor

Elizabeth Segura, DNP, APRN, FNP-C

Co-Advisor

Kimberly Werner, Ph.D.

Committee

Devika Kapuria, MD, MBBS

Abstract

Problem: There is a lack of mental health screenings for depression taking place in outpatient gastrointestinal (GI) clinics. Outpatient gastrointestinal (GI) offices are not consistently screening patients for depression despite a rise in depression rates and the known adverse impact depression can have on the GI tract.

Methods: This Quality Improvement (QI) study used a descriptive research design guided by the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model. Its purpose was to implement a 10-week PHQ-2/PHQ-8 depression screening protocol at a large midwestern health center's gastroenterology outpatient clinic. The study used purposive sampling, including all GI outpatients aged 18+ with any GI condition and no history of depression, as it aimed to identify new cases of depression.

Results: Out of 127 documented visits during the study period, 89 patients (70.08%) were screened for depression using the PHQ-2. Of these, 19 (21.35%) screened positive and underwent further screening with the PHQ-8. Ultimately, 4 patients (n = 4, 100%) were referred to either a primary care (n = 3, 75%) or a psychiatric (n = 1, 25%) provider for further follow-up.

Implications for Practice: The findings suggest that utilizing the PHQ-2/PHQ-8 depression screening protocol can help identify undiagnosed depression in patients with GI issues. This proactive screening approach should be continued as it may help prevent the development of chronic GI symptoms that can be associated with untreated depression.

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