title: Evaluation of nurses' perceptions of the impact of targeted depression education and a screening and referral tool in an acute cardiac setting.
abstract: OBJECTIVE
  The aim of this study was to evaluate nurses' perceptions of an education programme and screening and referral tool designed for cardiac nurses to facilitate depression screening and referral procedures for patients with coronary heart disease.
  
  
  BACKGROUND
  There is a high prevalence of depression in patients with coronary heart disease that is often undetected. It is important therefore that nurses working with cardiac patients are equipped with the knowledge and skills to recognise the signs and symptoms of depression and refer appropriately.
  
  
  METHODS
  A qualitative approach with purposive sampling and semi-structural interviews was implemented within the Donabedian 'Structure-Process-Outcome' evaluation framework.
  
  
  METHODS
  Semi-structured interviews were conducted with 14 cardiac nurses working in a major metropolitan hospital six weeks post-attending an education programme on depression and coronary heart disease. Thematic data analysis was implemented, specifically adhering to Halcomb and Davidson's (2006) pragmatic data analysis, to examine nurse knowledge and experience of depression assessment and referral in an acute cardiac ward.
  
  
  RESULTS
  The key findings of this study were that the education programme: (1) increased the knowledge base of nurses working with cardiac patients on comorbid depression and coronary heart disease, and (2) assisted in the identification of depression and the referral of 'at risk' patients.
  
  
  CONCLUSIONS
  Emphasis was placed on the translational significance of educating cardiac nurses about depression via the introduction of a depression screening and referral instrument designed specifically for use in the cardiac ward. As a result, participants found they were better equipped to identify depressive symptoms and, guided by the screening instrument, to confidently instigate referral procedures.
  
  
  CONCLUSIONS
  Much complexity lies in caring for cardiac patients with depression, including issues such as misdiagnosis. Targeted education, including use of appropriate instruments, has the potential to facilitate early recognition of the signs and symptoms of depression in the acute cardiac setting.
authors.affiliation: Centre for the Heart and Mind, Australian Catholic University, Melbourne, Vic., Australia.
authors.forename: Chantal F
authors.initials: CF
authors.lastname: Ski
authors.forename: Sam
authors.initials: S
authors.lastname: Munian
authors.forename: John X
authors.initials: JX
authors.lastname: Rolley
authors.forename: David R
authors.initials: DR
authors.lastname: Thompson
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D064646:Cardiovascular Nursing / Q000193:education*; D003142:Communication; D003327:Coronary Disease / Q000451:nursing / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology / Q000451:nursing; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012017:Referral and Consultation
keywords: coronary heart disease; depression; nurse education; screening and referral