title: Practices of Depression Care in Home Health Care: Home Health Clinician Perspectives.
abstract: OBJECTIVE
  The study assessed gaps between published best practices and real-world practices of treating depression in home health care (HHC) and barriers to closing gaps.
  
  
  METHODS
  The qualitative study used semistructured interviews with nurses and administrators (N=20) from five HHC agencies in five states. Audio-recorded interviews were transcribed and analyzed by a multidisciplinary team using grounded theory method to identify themes.
  
  
  RESULTS
  Routine HHC nursing overlapped with all functional areas of depression care. However, gaps were noted between best and real-world practices. Gaps were associated with perceived scope of practice by HHC nurses, knowledge gaps and low self-efficacy in depression treatment, stigma attached to depression, poor quality of antidepressant management in primary care, and poor communication between HHC and primary care clinicians.
  
  
  CONCLUSIONS
  Strategies to close gaps between typical and best practices include enhancing HHC clinicians' knowledge and self-efficacy with depression treatment and improving the quality of antidepressant management and communication with primary care.
authors.affiliation: Dr. Bao, Ms. Eggman, and Dr. Richardson are with the Department of Healthcare Policy and Research, and Dr. Bao and Dr. Bruce are with the Department of Psychiatry, all at Weill Cornell Medical College, New York City and White Plains, New York (e-mail: yub2003@med.cornell.edu ). Dr. Sheeran is with the Department of Psychiatry and Human Behavior, Rhode Island Hospital and Warren Alpert Medical School, Brown University, Providence, Rhode Island.
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Dr. Bao, Ms. Eggman, and Dr. Richardson are with the Department of Healthcare Policy and Research, and Dr. Bao and Dr. Bruce are with the Department of Psychiatry, all at Weill Cornell Medical College, New York City and White Plains, New York (e-mail: yub2003@med.cornell.edu ). Dr. Sheeran is with the Department of Psychiatry and Human Behavior, Rhode Island Hospital and Warren Alpert Medical School, Brown University, Providence, Rhode Island.
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Eggman
authors.affiliation: Dr. Bao, Ms. Eggman, and Dr. Richardson are with the Department of Healthcare Policy and Research, and Dr. Bao and Dr. Bruce are with the Department of Psychiatry, all at Weill Cornell Medical College, New York City and White Plains, New York (e-mail: yub2003@med.cornell.edu ). Dr. Sheeran is with the Department of Psychiatry and Human Behavior, Rhode Island Hospital and Warren Alpert Medical School, Brown University, Providence, Rhode Island.
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Richardson
authors.affiliation: Dr. Bao, Ms. Eggman, and Dr. Richardson are with the Department of Healthcare Policy and Research, and Dr. Bao and Dr. Bruce are with the Department of Psychiatry, all at Weill Cornell Medical College, New York City and White Plains, New York (e-mail: yub2003@med.cornell.edu ). Dr. Sheeran is with the Department of Psychiatry and Human Behavior, Rhode Island Hospital and Warren Alpert Medical School, Brown University, Providence, Rhode Island.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Sheeran
authors.affiliation: Dr. Bao, Ms. Eggman, and Dr. Richardson are with the Department of Healthcare Policy and Research, and Dr. Bao and Dr. Bruce are with the Department of Psychiatry, all at Weill Cornell Medical College, New York City and White Plains, New York (e-mail: yub2003@med.cornell.edu ). Dr. Sheeran is with the Department of Psychiatry and Human Behavior, Rhode Island Hospital and Warren Alpert Medical School, Brown University, Providence, Rhode Island.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Bruce
mesh_terms: D001291:Attitude of Health Personnel; D003866:Depressive Disorder / Q000451:nursing* / Q000523:psychology; D018574:Home Care Agencies; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D064691:Nurses, Community Health / Q000523:psychology / Q000706:statistics & numerical data*