A qualitative study of nurses' clinical experience in recognising low mood and depression in older patients with multiple long-term conditions.

Abstract

To explore how nurses' recognise depression in older patients with multiple long-term conditions and the strategies they use to support the patient. Depression decreases an older person's quality of life and sense of wellness, and increases functional impairment. The positive role of nurses working with patients with long-term conditions is now being recognised internationally; however, there is a gap in the research about how nurses recognise depression in older patients and how this impacts on their practice. This is a qualitative study informed by a constructivist grounded theory approach. In-depth telephone interviews were conducted with 40 nurses working in geographically diverse areas in New Zealand. Having the conversation with older patients about their low moods, or specifically about depression was not something that all the nurses had, or felt they could have. While some nurses knew they could provide specific advice to patients, others believed this was not their responsibility, or within the scope of their role. Faced with an increasing number of older people with long-term conditions, one of which maybe depression itself or as a result of living with other long-term conditions, ongoing monitoring and support pathways are necessary to prevent further decline in the older person's quality of life and well-being. Nurses in primary health care can build on current knowledge and skills to increase their capability to promote 'ageing well' with older people who have long-term conditions and depression.