title: Treatment practices and barriers for depression and anxiety by primary care advanced practice nurses in Wyoming.
abstract: OBJECTIVE
  The aim of this study was to investigate barriers to treatment and screening related to depression and anxiety and the diagnostic and treatment practices of primary care advanced practice nurses (APNs) in the state of Wyoming.
  
  
  METHODS
  Every primary care APN in Wyoming received a mailed questionnaire asking them about treatment barriers, screening and treatment practices, and attitudes toward depression and anxiety.
  
  
  CONCLUSIONS
  Wyoming APNs in primary care routinely identify, evaluate, and treat patients with both depression and anxiety. APNs generally felt positive about treating these patients, although they reported that their patients encounter a number of financial barriers in accessing treatment. Routine screening practices for depression and anxiety were relatively low among the APNs, and they used a wide variety of interventions for these patients.
  
  
  CONCLUSIONS
  The findings identify a lack of standardized approaches to assessment, referral, and treatment, especially pharmacologic intervention, and may indicate the need for alterations in the educational preparation of primary providers in order to improve clinical outcomes of treatment for depression and anxiety.
authors.affiliation: Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY 82071, USA. mburman@uwyo.edu
authors.forename: Mary E
authors.initials: ME
authors.lastname: Burman
authors.forename: Susan
authors.initials: S
authors.lastname: McCabe
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Pepper
mesh_terms: D000328:Adult; D001007:Anxiety / Q000451:nursing*; D001291:Attitude of Health Personnel; D003863:Depression / Q000451:nursing*; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009722:Nurse Practitioners / Q000458:organization & administration* / Q000523:psychology; D024802:Nurse's Role; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D012017:Referral and Consultation; D019035:Rural Health Services / Q000458:organization & administration; D011795:Surveys and Questionnaires; D014959:Wyoming