The effect of nurse-led group discussions by race on depressive symptoms in patients with heart failure.
Ubolrat Piamjariyakul, Noreen C Thompson, Christy Russell and 1 others
PMID 29606370WHAT IT FOUND
Depressive symptoms improved at six months in heart failure patients, regardless of race.
African American patients in the nurse-led discussion groups had a greater average reduction of 4.19 points than Caucasian patients.
Key findings
01Depressive symptom scores improved at six months among all patients, regardless of race.
02African American patients in the intervention discussion groups had a significantly greater average reduction of 4.19 points in depressive symptom scores compared with Caucasian patients.
03Of the 11 checklist items, four showed differences between African Americans and Caucasians: more African Americans reported physician discussion about seeing a dietitian and help writing questions, while fewer reported discussion of worsening heart failure symptoms and next appointment date.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis, and the original trial's primary outcome was heart failure rehospitalization, which is not reported here. The paper reports a race comparison for depressive symptoms, not a reported comparison of intervention versus standard care for depressive symptoms. The patients received several things together, including standard heart failure care, group discussions, DVDs, worksheets, mood elevating activities, and appointment preparation, so the contribution of any single component cannot be separated. African American patients were significantly younger by 10 years on average and had lower education levels than Caucasian patients, so the race comparison was not between groups matched on age and education. The appointment checklist had a Kuder-Richardson 20 reliability score of 0.64 and recorded only whether a topic was discussed, not who raised it. Only African American and Caucasian patients were analyzed, and 14 Hispanic or Latino patients were excluded from this secondary analysis.
Declared interests
The article is listed as receiving NIH extramural research support. The authors declared no relationships with industry or financial associations that might pose a conflict of interest.
The easy way to misread this
Do not conclude that nurse-led group discussions caused a greater reduction in depressive symptoms for African American heart failure patients. This was a secondary analysis of a randomized trial, the trial's primary outcome was heart failure rehospitalization and is not reported here, and patients received standard heart failure care plus group discussions with a heart failure nurse practitioner, psychiatric mental health clinical nurse specialist, social worker, and dietician, DVDs, worksheets, mood elevating activities, and appointment preparation, so the effect of any single component cannot be separated.