title: A qualitative study of nurses' clinical experience in recognising low mood and depression in older patients with multiple long-term conditions.
abstract: OBJECTIVE
  To explore how nurses' recognise depression in older patients with multiple long-term conditions and the strategies they use to support the patient.
  
  
  BACKGROUND
  Depression decreases an older person's quality of life and sense of wellness, and increases functional impairment. The positive role of nurses working with patients with long-term conditions is now being recognised internationally; however, there is a gap in the research about how nurses recognise depression in older patients and how this impacts on their practice.
  
  
  METHODS
  This is a qualitative study informed by a constructivist grounded theory approach.
  
  
  METHODS
  In-depth telephone interviews were conducted with 40 nurses working in geographically diverse areas in New Zealand.
  
  
  RESULTS
  Having the conversation with older patients about their low moods, or specifically about depression was not something that all the nurses had, or felt they could have. While some nurses knew they could provide specific advice to patients, others believed this was not their responsibility, or within the scope of their role.
  
  
  CONCLUSIONS
  Faced with an increasing number of older people with long-term conditions, one of which maybe depression itself or as a result of living with other long-term conditions, ongoing monitoring and support pathways are necessary to prevent further decline in the older person's quality of life and well-being.
  
  
  CONCLUSIONS
  Nurses in primary health care can build on current knowledge and skills to increase their capability to promote 'ageing well' with older people who have long-term conditions and depression.
authors.affiliation: Faculty of Medical and Health Sciences, School of Nursing, University of Auckland, Auckland, New Zealand.
authors.forename: Susan
authors.initials: S
authors.lastname: Waterworth
authors.affiliation: School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: Bruce
authors.initials: B
authors.lastname: Arroll
authors.affiliation: School of Nursing, University of Auckland, Auckland, New Zealand.
authors.forename: Deborah
authors.initials: D
authors.lastname: Raphael
authors.affiliation: School of Nursing, University of Auckland, Auckland, New Zealand.
authors.forename: John
authors.initials: J
authors.lastname: Parsons
authors.affiliation: School of Nursing, University of Auckland, Auckland, New Zealand.
authors.forename: Merryn
authors.initials: M
authors.lastname: Gott
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000451:nursing / Q000523:psychology*; D003142:Communication; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D009723:Nurse-Patient Relations; D009733:Nursing Diagnosis
keywords: depression; long-term conditions; older people; primary health care; primary health care nursing