A controlled comparison of the ability of practice nurses to detect psychological distress in patients who attend their clinics.
This study aimed to compare the ability of practice nurses in two groups of general practices to detect psychological distress in patients attending their clinics. Practice nurses in Britain are employed directly by general practitioners (GPs) and carry out their duties mainly in treatment rooms in GP's practices. The number of practice nurses has increased rapidly since the mid-1970s; recent estimates put the total between about 15000 and 18000. Most psychiatric disorders that come to medical attention do so initially within a primary care setting. In Britain, 98% of the population is registered with a GP and 70% of these people will consult their doctor in a given year. In the early 1990s the WHO found a 24% prevalence of current mental disorder in users of general health care. A further 9% of patients had significant and/or disabling symptoms but did not reach the threshold criteria for a confirmed diagnosis of mental disorder. Although published reports of surveys of practice nurses have shown varying degrees of involvement in mental health care, it is thought to be important that they become agents of detection of mental health problems because these nurses are in contact with a wide range of vulnerable people. Armstrong (1994) found that informants in a survey thought that practice nurses needed additional training in three main areas of mental health care: recognition followed by appropriate referral and on-going care of people with depression and anxiety; primary prevention of depression; and care in the community for people with serious long-term mental illness. The study briefly reported here measured practice nurses' detection of mental health problems. Results showed that practice nurses detect about 23% of those identified as cases using the General Health Questionnaire (GHQ). Testing of agreement between nurses and patients using Cohen's (1960) kappa showed a low level of agreement between nurses and patients concerning psychological distress.
Plummer
S E
SE
Christ Church College, Canterbury, UK.
Ritter
S A
SA
Leach
R E
RE
Mann
A H
AH
Gournay
K J
KJ
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003155:Community Mental Health Centers; D006801:Humans; D009722:Nurse Practitioners / Q000592:standards*; D009730:Nursing Assessment / Q000592:standards*; D015403:Nursing Evaluation Research; D013315:Stress, Psychological / Q000451:nursing*