Depression recognition and capacity for self-report among ethnically diverse nursing homes residents: Evidence of disparities in screening.
Audrey Chun, Joann P Reinhardt, Mildred Ramirez and 6 others
PMID 28722775WHAT IT FOUND
Nursing home staff's routine depression screening ratings did not agree well with trained researchers' ratings.
Trained researchers identified more moderate depression and suicidal thoughts, especially in Spanish-speaking residents. Routine screening may miss depression.
Key findings
01Among 155 analysed residents, researchers classified 13% as having at least moderate depression, compared with 7% classified by MDS clinician raters.
02Only two cases (1%) were identified by MDS as having suicidal ideation, compared with 15 cases (10%) identified by the research PHQ-9.
03For Spanish speakers, the research protocol identified 16% with PHQ-9 scores of 10 or greater and 14% with thoughts of self-harm, compared with 6% and 0% by MDS clinician raters.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used residents from a single urban long-term care facility, so findings may not generalise. The sample was small, and residents unable to consent were excluded from direct comparison. The MDS and research assessments were separated by time, and mood can fluctuate. Routine MDS used clinician judgement and interpreters, while research used trained assessors and standardised Spanish translations, so context may explain part of the discordance. The qualitative interviews involved clinician raters, not residents.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not read the lower MDS rates as evidence that residents have less depression. The research protocol found more moderate depression and suicidal thoughts, especially among Spanish speakers. Routine MDS assessment appears to under-recognise them.