Nurse Practitioners' Attitudes Toward Nonpharmacological Interventions for Individuals Diagnosed with Clinical Depression

Nurse Practitioners’ Attitudes Toward Nonpharmacological Interventions for Individuals Diagnosed with Clinical Depression by Joseph Ocran MSN, Lehman College, 2006 BSN, Lehman College, 1998 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University December 2015 Abstract Depression negatively impacts the American economy, and there is a shortage of physicians to provide treatment. Nurse practitioners are viable alternatives to provide high-quality treatment of depression. The project’s purpose was to describe nurse practitioners’ attitudes toward nonpharmacological interventions to treat clinical depression. Attitude theory provided the theoretical framework. The American Psychiatric Association’s guidelines for treating major depression provided the conceptual framework. The project used a quantitative nonexperimental descriptiveDepression negatively impacts the American economy, and there is a shortage of physicians to provide treatment. Nurse practitioners are viable alternatives to provide high-quality treatment of depression. The project’s purpose was to describe nurse practitioners’ attitudes toward nonpharmacological interventions to treat clinical depression. Attitude theory provided the theoretical framework. The American Psychiatric Association’s guidelines for treating major depression provided the conceptual framework. The project used a quantitative nonexperimental descriptive survey research design. A purposeful sample of 63 nurse practitioners was obtained from members of the American Association of Nurse Practitioners. Data were collected through an online survey that included questions about participant demographics, attitudes about depression treatment modalities, and experience with individual and group psychotherapy in the treatment of depression. Frequencies and percentages were calculated for demographic information and information related to the use of individual and group therapy. Means and standard deviations were calculated for each of the Likert scale items. The findings showed that participants had more knowledge about medications used to treat depression and individual therapy than they did about group therapy. Findings showed that the participants believed that medication combined with individual therapy was the most effective treatment for individuals diagnosed with depression. Barriers to using group therapy were identified. These findings provided information to nurse practitioners about preferred treatment modalities for depression and the barriers to using group therapy to treat depression. Nurse Practitioners’ Attitudes Toward Nonpharmacological Interventions for Individuals Diagnosed with Clinical Depression by Joseph Ocran MSN, Lehman College, 2006 BSN, Lehman College, 1998 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University December 2015 Dedication I am dedicating this project to my father and mother who have long passed on to the spirit world. My father; John Aidoo (alias Papa), a sweet, humble, God-fearing and loving father, who together with my mother, made it possible for my existence in the world. May his soul rest in everlasting peace. My mother; Lucy Essel (alias Mame), a strict disciplinarian was a kind and God-fearing individual, always making sure that all her children were fed. She called me often and said "Kojo," my native name, “always work hard, for had work does not kill, rather it makes you a better person.” May her soul rest in the bosom of the Almighty father in eternity. Amen. Acknowledgments Late one evening after I completed the proposal for this project, I received the devastating news that my older brother—the very reason for my education and prosperity—went home to join our parents in heaven. In silent reverie, I still lie awake in my room and return to that solemn night before my journey to America 28 years ago. My brother burned his last instruction in my memory forever. He said, “Kojo, do not come back to Ghana without attaining your doctorate degree.” His name is Joseph Afreh. And I thank him for giving the intellectual spirit to me so freely. His eccentricities rival any self-made man; everything he did—from his deep love of Jim Reeves records to his self-prescribed ritual of alcohol, women, and cigarettes—imprinted the idea upon me that if I fought for intellectual riches, I too will never be poor: neither in spirit, nor in other matters. Certainly, this project would remain a dream unrealized without him. I thank my dear wife Freda Ocran, the woman who continues to see potential in me as a man, a father, a provider, and a nurse. Our journey together, through marriage, through college, and through parenthood has yielded an invaluable support. Freda’s expertise as a psychiatric nurse has been the perfect sounding board for my thoughts on depression and her unwavering godliness continues to shelter me from the inevitable yet necessary storms of life. I will always love her: eternally, deeply, madly. This project—inspired by my brother’s spirit, shouldered by my wife’s love— could not reach its conclusion without the tireless efforts and insights of my son, Nana Kwame. Nana possesses superior intellect and his ingenuity has been my saving grace on countless occasions. He is my compass, my editor, my motivator. Time immemorial, Nana encouraged me to push past the walls of setbacks in the writing process; he found words that poignantly delivered my message. And when he was diagnosed as manicdepressive shortly after this work began, his personal struggle became the genuine counterpoint to my academic struggle. As he coped, recovered, and evolved, I too crawled, walked, and ran with the idea of transforming the way we deal with depression as a society. My hope is that his help and his example never cease to inspire change in our perception and treatment of depression in health care. It would be remiss of me not to thank my second son, Papa Kwame Ocran, who, I am sure, will be extremely happy to know that I have finally obtained my Doctorate of Nursing Practice. And I thank my daughter, Maame Tiwaa Ocran, for being the jewel of my eye and my source of happiness during this endeavor. There are a number of wonderful individuals who have been vital to this journey. A special thanks to: Dr. Allison Terry, my chairperson, who provided excellent guidance and support; Dr. Sherry Holly, committee member, who supported my project; and Dr. Nancy Moss, director of the DNP program, who also provided support and guidance; Dr. Shirley Walker (for her evenhanded approach to academic writing and her hopeful disposition), my classmates and my mentors at Walden University; you have made this final step in my educational journey easier. I must thank my brother, Mr. James Atuah; my nephew Mr. Emmanuel OforiYeboah; my dearest loving friend Flore Jean Claude, my sisters and brothers; my colleagues from my early days at Bronx Lebanon Hospital; my team at Harlem Hospital,; colleagues from Bellevue and Montifiore Hospitals in New York City; and particularly Dr. Witter, Dr. Joseph, Miss Revulos, Adjoa Donkoh, Mr. Jones Abankwah. Miss Pauline Anderson, Emily Benjamin. Mr. Gannet, Peter Osei, Alma Wislon, Moose Huggette, Mr. Kofi Dankwa, Freda’s mother Oye Agatha Mensah, my oldest friend—who lives in my hometown in Ghana—Mr. Kwaku Moosi. Lastly, I thank God, my church community at Word Enlightenment Church in the Bronx and its general overseer, Dr. George Baah.