Training primary care nurses in late-life depression: knowledge, attitude and practice changes.

Aim.  This paper reports on the uptake of a two-day late-life depression training programme with primary care nurses and its impact on knowledge, attitudes and the use of a brief screening protocol following training. Background.  Late-life depression is a common condition associated with medical illnesses, impaired psychosocial functioning and risk for suicide. Although treatable, it is under recognized in primary care. Nurses have an important contribution to make to its detection, yet few studies have focused on training primary care nurses for this role. Design.  An uncontrolled pre- and post-test design was used. Data were collected using the Late-Life Depression Quiz, the Depression Attitude Questionnaire (DAQ) and an Impact on Clinical Practice Questionnaire at 1 and 3 months. Seventy-three nurses commenced training and 66 completed the programme out of a total of 253 invited to participate. Results.  Statistically significant differences were found between pre- and post-training for knowledge about late-life depression (P < 0.0005). No significant association was found between age, length of experience, level of contact and pre-training knowledge scores. Attitudes towards depression were more optimistic following training which were significant for nine of the DAQ statements (P < 0.05). However, when the overall level of significance was adjusted for multiple testing of 20 DAQ items, two remained statistically significant (P < 0.0025). Finally, a 77% response rate to the 1-month practice questionnaire and a 52% at 3 months showed that nurses were using the screening measure (mean 5.0, SD 7.71; mean 5.6, SD 7.71 respectively). Conclusion.  A short training programme on late-life depression was effective in producing both knowledge and attitude change in primary care nurses. The use of a short two-item depression screening measure prompted nurses to complete more in-depth assessment for depression. Relevance to clinical practice.  Training primary care nurses to identify and manage older persons with depression is essential to improve quality of life.