Recognition of late-life depression in home care: accuracy of the outcome and assessment information set.
This study evaluated the accuracy of home care nurses' ratings of the Outcome and Assessment Information Set (OASIS) depression items. The accuracy of home care nurses' depression assessments was studied by comparing nurse ratings of OASIS depression items with a research diagnostic assessment based on the Structured Clinical Interview for Axis I Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). The setting for this study was a nonprofit, Medicare-certified, voluntary home healthcare agency. Sixty-four home care nurses assessed 220 patients aged 65 and older with the OASIS upon admission. Of the 220 patients, using standard SCID criteria, 35 cases of major or minor depression were identified. The home care nurses accurately documented the presence of depression in 13 of 35 cases (sensitivity=37.1%; positive predictive value=0.56). Of the 220 patients, 185 had no SCID-identified major or minor depression. The nurses agreed on the absence of depression in 175 of 185 cases (specificity=94.6%; negative predictive value=88.8%). This study indicates that home care nurses often do not accurately rate OASIS depression items for older adult patients.
Brown
Ellen L
EL
Weill Medical College of Cornell University, White Plains, New York 10605, USA. ebrown@med.cornell.edu
Bruce
Martha L
ML
McAvay
Gail J
GJ
Raue
Patrick J
PJ
Lachs
Mark S
MS
Nassisi
Pamela
P
D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment; D006699:Home Care Services; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009730:Nursing Assessment; D010043:Outcome and Process Assessment, Health Care; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires