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Satisfaction and Outcomes of Depressed Older Adults With Psychiatric Clinical Nurse Specialists in Primary Care

Department of Psychiatry and Behavioral Sciences, Department of Medicine, Duke University Medical Center, Durham, NC, Saur0001{at}mc.duke.edu

David C. Steffens

Department of Psychiatry and Behavioral Sciences, Department of Medicine, Duke University Medical Center, Durham, NC

Linda H. Harpole

Global Health Outcomes, GlaxoSmithKline, Research Triangle Park, NC

Ming-Yu Fan

Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, WA

Eugene Z. Oddone

Department of Medicine, Duke University Medical Center, Durham, NC

Jürgen Unützer

Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, WA

BACKGROUND: Recent models integrating depression care management into primary care have demonstrated improved clinical outcomes and patient satisfaction. To date, none have examined psychiatric—mental health clinical nurse specialists (PCNSs) as providers in primary care. OBJECTIVES: To describe patient perception of and satisfaction with care provided by PCNSs, to compare patients with high versus lower levels of satisfaction and clinical outcomes, and to explore patient preference for future depression treatment and willingness to copay for PCNS services. STUDY DESIGN: A postintervention survey after a 12-month late-life depression care program delivered by a PCNS in primary care. Participants were 105 adults age 60 or older with major depression and/or dysthymia. RESULTS: A majority of patients perceived PCNS care as excellent, were highly satisfied with the relationship with the PCNS, would seek future treatment with the PCNS, preferred the primary care physician's office for mental health care, and reported improved clinical and functional outcomes. CONCLUSIONS: PCNS services are well received by patients in the primary care setting. PCNSs are uniquely qualified to help patients achieve significant clinical improvement in collaboration with their primary care providers. J Am Psychiatr Nurses Assoc, 2007;13(1), 62-70.

Key Words: depressed older adults • patient satisfaction • clinical outcomes • psychiatric—mental health clinical nurse specialists

Journal of the American Psychiatric Nurses Association, Vol. 13, No. 1, 62-70 (2007)
DOI: 10.1177/1078390307301938


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