Effectiveness of Nurse-Based Program

Effectiveness of a Nurse-Based Outreach Program for

Identifying and Treating Psychiatric Illness in the Elderly

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Effectiveness of a Nurse-Based Outreach Program for

Identifying and Treating Psychiatric Illness in the Elderly

The research to be discussed in this paper is a study conducted to examine the effectiveness of the Psychogeriatric Assessment and Treatment in City Housing (PATCH) program. This study was conducted in six public housing developments for the elderly in Baltimore, Maryland, where there was no on-site psychiatric care provided. A total of 945 of the 1195 residents (83%) in all 6 sites were screened for psychiatric illness. Among those screened, 342 came out positive for having psychiatric illness and 603 came out negative. From those who screened positive for psychiatric illness, all who aged 60 years and older were chosen for psychiatric interviews; so were a 10% random sample from those who screened negative (p. 2803-2804).

The psychogeriatric assessment used in this the PATCH program consisted of three intervention elements: 1) the training of indigenous building workers to identify those at risk for psychiatric disorder; 2) the identification and subsequent referral of potential cases by these workers to a psychiatric nurse; and 3) psychiatric evaluation and treatment in the residents’ homes. In the PATCH program, nurses are the primary service providers, while the psychiatrists serve as only supervisors or consultants (p. 2803).

There were three main outcome measures used in this study: the Brief Psychiatric Rating Scale (BPRS) to measure psychiatric symptoms and behavioral disorders; the Montgomery-Asberg Depression Rating Scale (MADRS) to detect change in mood and to measure depressive symptoms; and the third outcome measure used was entitled “undesirable moves” (p.2805). Based on the data and after 26 months of follow-up, it was found to be that the psychiatric cases at the intervention sites had significantly lower MADRS scores and significantly lower BPRS scores than those who did not receive any treatment. There was also no significant difference between the groups in undesirable moves. Main conclusion of this study is that the PATCH intervention was more effective than the usual care given, in reducing psychiatric symptoms in persons with psychiatric disorders and those with elevated level of psychiatric symptoms (p. 2802).

Work Cited

Rabins, P.V., Black, B.S., Roca, R., German, P., McGuire, M., Robbins, B. (2000). Effectiveness of a Nurse-Based Outreach Program for Identifying and Treating Psychiatric Illness in the Elderly. Journal of the American Medical Association, 2000;283(21):2802-2809.

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