Theses and Dissertations at Montana State University (MSU)
Permanent URI for this communityhttps://scholarworks.montana.edu/handle/1/732
Browse
4 results
Search Results
Item Improving detection and treatment of anxiety and depression in a southwest Montana women's clinic: a quality improvement project(Montana State University - Bozeman, College of Nursing, 2023) Waldeisen, Hillary Joi; Chairperson, Graduate Committee: Alice RunningBackground: Depression and anxiety are the most prevalent mental health disorders affecting women. Primary care providers predominantly screen for and manage depression and anxiety, improving detection and treatment when adequate systems are in place. As many as 30% of women utilize an OBGYN provider for primary care yet are not typically screened for either diagnosis. Local problem: Rates of anxiety and depression in Montana are higher than the national average. Women utilizing the clinic's OBGYN providers for primary care were not being screened for these disorders. Methods: Over five weeks, Plan-Do-Study-Act cycles were completed weekly. Participants included women utilizing the clinic for annual wellness exams. Data gathered during the project included documented PHQ-9 and GAD-7 scores, and management metrics including behavioral health or psychiatry referrals, prescribed medications, immediate evaluations, and monitored patients. Interventions: Staff education occurred before the implementation date. PHQ-9 and GAD-7 scores were entered into the EHR during wellness exams. Staff surveys were emailed weekly to elicit feedback. PDSA cycles were performed utilizing data from chart audits and survey results. Results: The implementation was well received by both staff and patients. In the first five weeks following the implementation, chart audits demonstrated an average of 86 % of PHQ-9 and 81% of GAD-7 scores entered into the EHR. In addition, management metrics showed improvement in the last week of data collection. Conclusions: Implementation of screening for anxiety and depression during annual wellness exams allowed for early identification and treatment after shared decision-making. Screening was considered a valuable addition to the care provided by the clinic.Item Prevention of postpartum depression at an OB/GYN clinic: a translational research project using group interpersonal psychotherapy(Montana State University - Bozeman, College of Nursing, 2018) Donofry, Susana Joy; Chairperson, Graduate Committee: Sandra KuntzBetween one in eight to ten mothers in the United States experience frequent postpartum depressive symptoms. Postpartum depression has a wide range of negative effects on a woman's psychological and social functioning, as well as her family's. Sufficient evidence indicates that an interpersonal psychotherapy group therapy intervention may help prevent postpartum depression in childbearing women. Unfortunately, many obstetrician and gynecologist clinics are not utilizing collaborative-care models that address such mental health needs. The purpose of this project was to (a) translate current best evidence into practice, (b) design and implement an interpersonal psychotherapy group intervention at one Colorado obstetrician and gynecologist clinic, and (c) evaluate the impact of the intervention based on the Edinburgh Postnatal Depression Scale scores at the beginning of the project and at six weeks postpartum. An evidence table was created to evaluate the current best evidence for preventing postpartum depression. A Colorado clinic was selected for its convenient location and sufficient patient population. An intervention was created based on the description of interventions utilized in the randomized-controlled trials that were included in the evidence table. Four women were recruited for the group intervention and only one woman completed the intervention and post-assessment tools. This woman had a clinically significant improvement in her depression scale from pre-intervention to post-intervention. An unanticipated difficulty was the low attendance rate or follow through with the intervention. This project highlights the need for more comprehensive services to prevent and treat postpartum depression. Psychiatric nurse practitioners are optimally placed to coordinate and/or deliver the services in coordination with obstetrician and gynecologist clinics.Item Perceptions of rural women's experiences with infertility services in Montana(Montana State University - Bozeman, College of Nursing, 2002) Timmer, Kelly Angelos; Chairperson, Graduate Committee: Therese SullivanItem Community assessment of cancer screening services for women in Cascade County and perceptions of American Indian women regarding those services(Montana State University - Bozeman, College of Nursing, 2001) Rowell, Nancy Jo; Chairperson, Graduate Committee: Therese Sullivan