The topic we learned this week is “Ability of nurses to identify depression in primary care, secondary care and nursing homes—A meta-analysis of routine clinical accuracy.” This study To clarify the ability of nurses and nursing assistants working in primary care, secondary care and nursing homes to identify depressed individuals using their clinical skills using meta-analysis of published studies.
The methods this study used is literature search, appraisal and meta-analysis.We located 22 studies reporting on the detection of depression, 4 involving primary care or community nurses; 7 involving hospital nurses and 11 from nursing homes.17 of 22 studies had specificity data.
From this study we know that nurses have considerable difficulty accurately identifying depression but are probably at least as accurate as medical staff.
This is the first data synthesis to summarize the clinical ability of nursing staff to identify depression across healthcare settings. In a previous meta-analysis Mitchell found that amount of time spent with patients positively influenced detection of mental health problems, However as this comparison is pooled independently, it would be useful to briefly review the studies that have compared doctors and nurses abilities directly in the same setting.
This study has several limitations. First, detection in these primary studies is mostly based on single-assessments which may not reflect clinical practice. Second, where case-ascertainment was interview based, healthcare professionals were usually aware of the purpose of the study and may have made special efforts to diagnose accurately.Thirdly, where case-ascertainment was based on medical records true opinions of the staff were likely to be underestimated favouring specificity over sensitivity. Fourthly, there was inadequate data to look at several important aspects.