NSG 4055 Illness and Management of a Disease across Lifespan
NSG 4055 Illness and Management of a Disease across Lifespan
The promotion of health and wellbeing of diverse populations is important in nursing and healthcare. Nurses and other healthcare providers work in collaboration to ensure that high quality care that meets the care needs of their patients is offered. The HealthyPeople 2030 provides guidelines about the prioritized health problems that should be addressed for the promotion of the health and wellbeing of the diverse global populations. One of the critical health problems addressed in the HealthyPeople 2030 is depression in adults. Accordingly, it is identified that depression in adults is a critical public health concern in the US that affects the quality of life of the patients as well as their significant others. Therefore, the purpose of this paper is to explore the issue of depression in adults, its morbidity and comorbidity and impacts on the population.
Identified Chronic Illness
The identified health problem is depression in adults. According to HealthyPeople 2030, depression is a common problem that is affecting adults in the USA. The existing statistics shows that about 17.3 million adults in the US have experienced at least a major depressive episode. The population of adults with history of a major depressive episodes constitutes 7% of the adults in the US. The rate of depression is reported to be higher females (8.7%) when compared to the males (5.3%). The prevalence is also higher in adult individuals aged between 18 and 25 years (13.1%) when compared to any other age groups of the adults (NIMH, n.d.).
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Depression among adults was chosen because of its severe health impacts to the population. Depression is associated with severe impairment in adults. Accordingly, it is estimated that 11 million adults with age above 18 and above experienced episodes of major impairment that were associated with severe impairment (NIMH, n.d.). Depression is also associated with decline in the quality of life of patients. The evidence shows that depression increases the costs of care incurred by patients and their significant others in seeking the care that they need. It also lowers the productivity of the affected populations (CDC, 2019). Nurses have a critical role to play in ensuring that the health needs of the adults affected by depression are met (Weinberger et al., 2018). Therefore, a critical analysis of its morbidity, comorbidity and impacts should be explored to increase the need for interventions to promote their health-related needs.
Over the last 2 weeks, how often have you experienced the following problems? (Tick to indicate the answer that aligns the most with your experiences)
|Not at all (0)||Several days (1)||More than half the days (2)||Nearly every day (3)|
|I have little or lack interest in doing things|
|I feel down, depressed, and hopeless|
|I sleep too much or have difficulties in sleeping or maintaining sleep|
|I feel tired and lack energy|
|I have poor appetite or over eat|
|I feel bad about myself or feel a failure or have let yourself and others down|
|I have difficulties in concentrating|
|I am slow in talking or doing things and people have noticed it|
|Feeling that you would have hurt yourself or kill yourself|
The guideline for diagnosis is that the healthcare provider should ask the above questions and mark accordingly based on the responses by the patient. A patient is diagnosed with a depressive disorder if there are at least four ticks in the statements rated two or three. A patient is diagnosed with major depression if there at least four ticks in the sections rated two or three. A patient is diagnosed with other depressive disorder if there are at least 2-4 ticks in the regions rated 1.
Morbidity and Comorbidity
Major depression in adults is reported to be a critical public health concern in not only the US but also other global states too. The global risk of developing major depression is reported to be between 15 and 18%. Major depression is associated with adverse effects that include the lowering of the psychosocial functioning as well as quality of life of the affected populations. The existing evidence shows an increased interconnectedness of depression with other health problems. Accordingly, the risk of patients experiencing other health problems that include anxiety and substance abuse disorders is high in those diagnosed with depression. Patients diagnosed with depression have about 50-60% risk of developing at least one anxiety disorder. There is also the high risk that 14% of the adults with major depression are likely to be diagnosed with alcohol use disorder while 4.6% of them have drug use disorder. The lifetime prevalence of alcohol abuse disorder is reported to be 40% and 17% for drug use disorder (Steffen et al., 2020). There is also the evidence that depression is an independent risk factor as well as negative prognostic factor for somatic disorders that include cardiovascular disease, diabetes, chronic respiratory disorders, hypertension and arthritis (Gutiérrez-Rojas et al., 2020). Due to the above comorbidities, diabetes is linked to poor quality of life, higher functional impairment as well as disability, higher medical costs, increased utilization of care services, worse course of disability, and enhanced risk for mortality.
According to Baldessarini et al. (2017), morbidity in depressive disorders is significantly high. The high rate morbidity can be seen from the fact that up to 50% of the patients with major depressive disorders experience illnesses even after their discharge from the hospital. The high rate of morbidity is attributed to a number of risk factors. They include recurring manic depressive states and predominance of depression that cause inferior response to treatment and outcomes. In addition, patients may present with depression with mixed features, which has been associated with poor response to recommended treatments such as the use of antidepressants. Treatment interventions such as rapid cycling may also increase the risk of morbidity due to reduced efficacy of medications in stabilizing mood and un-sustained therapeutic effectiveness of antidepressants (Baldessarini et al., 2017). Therefore, psychiatric mental health nurse practitioners should be aware of the risk factors for morbidity for them to adopt favorable interventions that will optimize the care outcomes of the patients.
Impact of the Chronic Illness
Depression in adults is associated with a number of adverse health impacts. Depression is estimated to affect one in every five people in the world, making it among the conditions with high prevalence and incidence rate. The prevalence of depression among adults in not only the USA but also globally makes it the leading cause of disability across the world (Filatova et al., 2021). The impacts of major depression on the population is reported to be higher than that seen in conditions that include rheumatoid arthritis, coronary heart disease, and diabetes mellitus (Gutiérrez-Rojas et al., 2020). Major depression is also associated with significant impairment in psychosocial functioning in the affected populations and their significant others. The impairment in psychosocial functioning is seen in the inability of the patients to engage in their daily social and occupational roles. There is also the fact that patients’ experience diminishes in the quality of life due to the effects of depression. The decline in the quality of life is attributed to the loss of productivity and independence in the society (Malhi & Mann, 2018). Patients and their significant others also suffer from the economic burden of depression management. The economic burden of depression is largely attributed to the increased need for hospital visits and hospitalization for the management of depression symptoms (Malhi & Mann, 2018). Greenberg et al., (2021) showed in their study that the economic burden of adults suffering from major depression rose by 37.9% ($US 236.6 billion) in 2010 to 326.2 billion in 2020. The increase could be seen in different variables of depression management that included direct costs, workplace costs, and suicide-related costs (Greenberg et al., 2021). According to Armbrecht et al. (2021), adults with major depression in the US suffer from adverse health effects of the disease that include increased per patient inpatient visits on an annual basis, office visits, annual drug costs, total medical costs, and emergency department visits. When combined, the above effects have a significant psychosocial toll on the patients, hence, adverse health outcomes.
Depression among adults is one of the public health concerns being experienced in the USA. Depression is associated with poor health outcomes in the affected populations. It predisposes patients to poor quality of life, disability, and premature mortality. Evidence based interventions can be used to lessen the impacts of major depression on the population. Therefore, it is critical that interventions that minimize the impacts and severity of major depression in the population be embraced.
Armbrecht, E., Shah, R., Poorman, G. W., Luo, L., Stephens, J. M., Li, B., Pappadopulos, E., Haider, S., & McIntyre, R. S. (2021). <p>Economic and Humanistic Burden Associated with Depression and Anxiety Among Adults with Non-Communicable Chronic Diseases (NCCDs) in the United States</p>. Journal of Multidisciplinary Healthcare, 14, 887–896. https://doi.org/10.2147/JMDH.S280200
Baldessarini, R. J., Forte, A., Selle, V., Sim, K., Tondo, L., Undurraga, J., & Vázquez, G. H. (2017). Morbidity in Depressive Disorders. Psychotherapy and Psychosomatics, 86(2), 65–72. https://doi.org/10.1159/000448661
CDC. (2019, June 7). Products—Data Briefs—Number 303—February 2018. https://www.cdc.gov/nchs/products/databriefs/db303.htm
Filatova, E. V., Shadrina, M. I., & Slominsky, P. A. (2021). Major depression: One brain, one disease, one set of intertwined processes. Cells, 10(6), 1283.
Greenberg, P. E., Fournier, A.-A., Sisitsky, T., Simes, M., Berman, R., Koenigsberg, S. H., & Kessler, R. C. (2021). The economic burden of adults with major depressive disorder in the United States (2010 and 2018). PharmacoEconomics, 39(6), 653–665. https://doi.org/10.1007/s40273-021-01019-4
Gutiérrez-Rojas, L., Porras-Segovia, A., Dunne, H., Andrade-González, N., & Cervilla, J. A. (2020). Prevalence and correlates of major depressive disorder: A systematic review. Brazilian Journal of Psychiatry, 42(6), 657–672. https://doi.org/10.1590/1516-4446-2020-0650
Malhi, G. S., & Mann, J. J. (2018). Depression. The Lancet, 392(10161), 2299–2312. https://doi.org/10.1016/S0140-6736(18)31948-2
NIMH. (n.d.). NIMH » Major Depression. https://www.nimh.nih.gov/health/statistics/major-depression
Steffen, A., Nübel, J., Jacobi, F., Bätzing, J., & Holstiege, J. (2020). Mental and somatic comorbidity of depression: A comprehensive cross-sectional analysis of 202 diagnosis groups using German nationwide ambulatory claims data. BMC Psychiatry, 20(1), 142. https://doi.org/10.1186/s12888-020-02546-8
Weinberger, A. H., Gbedemah, M., Martinez, A. M., Nash, D., Galea, S., & Goodwin, R. D. (2018). Trends in depression prevalence in the USA from 2005 to 2015: Widening disparities in vulnerable groups. Psychological Medicine, 48(8), 1308–1315. https://doi.org/10.1017/S0033291717002781