Date of Award

2013

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

College of Nursing

First Advisor

Gail Stuart

Second Advisor

Bonnie P. Dumas

Third Advisor

Marilyn A. Laken

Fourth Advisor

Kathleen R. Delaney

Abstract

While healthcare providers have increased depression screening of adolescents during preventive care, an enormous number of adolescents do not have regular contact with healthcare providers and, therefore, do not get screened. Nationwide screenings by school nurses would be an ideal way to capture students not seen by healthcare providers; however, this screening is not required and therefore does not occur. The purpose of this dissertation is to describe the three-step process by which the feasibility of using school nurses to identify and screen for adolescent depression (AD) was explored. In a pre-dissertation study, school nurses reported they lacked knowledge, time, and effective instruments to 'screen adolescents for depression. To begin addressing these barriers, an integrative review of the literature (Manuscript I) was conducted to identify screening instruments that could be used with adolescents in the school environment. A second integrative review (Manuscript II) was then completed to identify universal depression prevention programs that school nurses might use in primary prevention of adolescent depression. The review revealed that even if programs and instruments were identified, school nurses still face barriers in implementing programs, including lack of competence in the subject matter of adolescent depression, lack of school administrative support, and lack of time needed to provide prevention programs. Nurses also are burdened by an overload of duties and students. Therefore, research was needed to develop a school nurse friendly program that would increase the school nurses ' knowledge of the signs and symptoms of adolescent depression, train nurses to use the QIDS-C free screening instrument, and identify resources clarifying when and where to refer individuals identified as needing follow-up. To address this need, a quasi-experimental study (Manuscript III) using an online program for school nurses was developed to increase the school nurse 's ability to identify, screen and refer adolescents with depression. Findings from this dissertation are significant for school nurses and school nurse educators. The information gained through this feasibility study seeks to enhance and further develop online courses for the dissemination of adolescent depression education and training for school nurses.

Rights

All rights reserved. Copyright is held by the author.

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