11Conclusion 5.0. Essay Example

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Table of Contents

1Introduction 1.0.

2Background Information 2.0.

4Significance and Aetiology of Depression 3.0.

4Early Life Trauma 3.1.

6Genetic Factors 3.2.

7Biochemical Factors 3.3.

8The Ageing Brain 3.4.

8The Role of Nurses in Prevention and Risk Management of Depression 4.0.

11Conclusion 5.0.

  1. Introduction

The debate on global effects of depression has become contentious. Particularly, its effects in Australia call for succinct statistical analyses that connect evidence-based researches and nursing practices. Currently, depression is regarded as the third most common reason for primary care consultation around the world, including Australia (Hegney et al., 2014). Statistics that have been provided by the National Survey of Mental Health and Wellbeing noted that about 13 percent of Australians have been experiencing depressive episodes at a given point in their life (ABS, 2013). This finding agrees with previous statistics that the prevalence of depression in across the world is about 7-9 percent of global population (Morgan et al., 2013). Noting that Morgan et al. found that at least 10,000 Australian live with depression in any year, there is need for an understanding on how nurses are supposed to use evidence-based researches in the prevention and treatment of depression. To concepualise this position, this report critically assesses ways in which depression have affected globally and people of Australia in particular. Taking case studies and statistical data globally and Australia in particular, the report provides an approach that nurses can adopt looking after patients, prevention and treatment of depression. Grounded on a multiple systematic reviews, theoretical models and meta-analysis from Australia and other parts the world, the report will be structured as follows. The first part introduces the thesis statement elaborating approach and scope of the report. The second part provides background information where the report identifies history and nature of a well-defined approach of the depression with reference to existing literature. Thus the report uses background information to provide root of the problem with regard to depression. Background information will be followed by the discussion of the report. Finally, the report presents conclusion that summarises depression as global health issue, statistical data, theories, concepts and ideas relating to depression, its effects and models needed to prevention and treatment.

  1. Background Information

For many years depression has become a major concern not only in Australia but for international community. This concern has caused worries to nurses, regardless of specialty. While studies have noted that physicians are now focused on medical treatment and aetiology, concerns are now shifting to ways in which nurses attend to incidences of depression and how people express and deal with their crippling illness. Studies have provided knowledge regarding depression that can be regarded as clinical care on both the community and knowledge. Specifically, studies such as Jarzyna et al. (2011) have noted the need to shed light on debilitating chronic disorder thus providing an understanding on ways nurses can manage, treat and prevent depression.

Studies agree that depression affects an estimated 13 to 18 percent of population across the world (Jarzyna et al., 2011; Chiang and Chang, 2012). In detail, studies on multiple systematic reviews and meta-analyses have noted that in Australia, close to 14 percent of people between 15 and 75 years old deal with depression in a given year (Fuller et al., 2015). Based on this data, the processes of preventing and treating depression need to incorporate risk factors specifically to the old owing to the fact that some of the effects of depression that have been recoginsed globally include cognitive or physical functional decline, experiencing a number of losses and social isolation.

Depression is considered globally as the most frequent mental disorder among different ages. To be precise, the rate of depression among nursing home patients has become three to form times higher than among community based, and a large overlap of instances such as anxiety is found. The concern among medical practitioners is to find a balance where strategies that succinctly identify, prevent and treat depression are adopted. Australian Institute of Health and Welfare (2012) and the Department of Health and Ageing (2013) have constantly reviewed prevalence and effects of depression in Australia. The two research bodies have been concerned with the levels of stress and depression of Australian population and ways nurses have been taking initiatives to prevent and treat the health issue. From the one hand, Australian Institute for Suicide Research and Prevention (2014) found that on the epidemiology of depression, 2-4 percent of Australians, representing about 700, 000 have been having serve depression between 2001 and 2010. Still in Australia, the National Mental Health Report in collaboration Department of Health and Ageing (2013) reported that about 7 percent of Australian population suffers from moderate disorders annually. These reports and records on the status of depression in Australia call for the need to find approaches for looking after patients with depression.

While there is consensus among different studies that depression affects people globally and Australian population, such effects have been documented in a multifaceted clinical demographics. To provide an understanding on specific effects and models nursing should take in dealing with and looking after patients with depression, previous researches have dwelt on importance of good mental health. Specifically, Australian Government including all territory governments have incorporated different approaches in ensuring that effects of depression is documented in addition to developing evidence-based practices that necessitate prevention and taking care of patients’ depression. In particular, such initiatives have included the establishment of the National Mental Health Commission that has worked with other organization across the world in documenting and ascertaining the effects of depression (Bruce et al., 2015). Regardless of these initiatives, the rate and statistics on the effects of depression remains scanty. Additionally, there is need for evidence-based research that combines theoretical models and practices to conceptualise ways in which nurses can prevent and look after patients with depression.

  1. Significance and Aetiology of Depression

Depression remains global health issue since it continues to be debilitating illness contributing to significant disability and distress. Valenstein et al. (2015) noted that the best approach in understanding its effects and approaches nurses need to take in the prevention and caring for patients is to conceptualuse its significance, aetiology and cause. Regardless of the prevalence and the costly effects of depression, there is paucity of data presenting validated and diagnostically information on the aetiology of depression. Of considerable concern is the recent understanding, stemming from large-scale treatment studies that noted the effectiveness of documenting the aetiology of depression. Taking case studies on different countries including Australia, the research categorized the cause of depression as follows:

    1. Early Life Trauma

Traumatic experiences of childhood lives accounts for almost 35 percent of total cases of depression reported in patients’ future lives (Stafford et al., 2015). Unfortunately, prevalence in the current society and worldwide instances continue to increase according to recent data released by Valenstein et al. (2015). The statistics on the global increase of early childhood traumas have been supported by Valente and Saunders (2016) who found that there are about 4 million cases of child maltreatment annually. Among these cases, 60 percent are categorized as parental neglect, 15 percent are physical abuse and 25 percent are sexual abuse. Figure 1 below presents statistical findings from Australian National Wellbeing and Mental Health Survey on the prevalence of early life trauma (Slade et al. 2009).

11Conclusion 5.0.

From the figure above the three main causes of trauma in Australia include threat, violence and rape. The study further finds that within one year at least 12 percent of male and 5.4 of female suffer trauma as a result of violence. It therefore means that within one year at least there are 30 percent cases of depression reported among male who suffered trauma in early life.

The data as presented in figure 1 above shows a reflection of the link between early life trauma and incidences of depression as reported in the other parts of the world. Australian National Wellbeing and Mental Health Survey also reflected in a different study where young adulthood early life trauma was assessed and future instances of depression recorded. Child Trends Databank as cited in Shaw et al. (2016) took a survey across 33 different countries to find whether early life trauma had an effect of on incidences of depression as reported in different health facilities. Their findings indicated that the incidences of depression were on increase among victims who experienced early life instances of trauma. Basing on figure 2 below Child Trends Databank further noted that children and young adults who reported one or two symptoms of depression suffered some cases of trauma during early life.

11Conclusion 5.0. 1

A number of researches conducted after the Child Trends Databank (2015) findings support figure 2 above in that onset of mood disorders such as depression is without doubt affected by stressful events that one experienced in childhood (Shaw et al., 2016).

    1. Genetic Factors

A number of studies agree that causes of depression can be attributed to genetic factors. There is strong evidence from studies such as Craigie et al. (2016) that genetic factors contribute significantly towards a person’s predisposition towards developing symptoms related to depression. Craigie et al. attempted to answer this question by developing a model that was to provide a link between depression and genetic factor; specifically a genetic factor responsible for melancholic depression. Their theory focused on effects of emotional arousal and levels of genetic factors. While assessing instances of depression among men and women aged between 15 and 75 Craigie et al. noted that gene plays critical role in the development of depression noting that bipolar depression, psychotic depression and melancholic depression are characterized by different genes. However, the study noted that there seems to be no single gene responsible for depression, but rather combinations of different genes are likely to trigger depression. Conclusively, this report further borrows from Yazdani et al. (2011) which found that predisposition for someone to develop depression is likely to be inherited. As such, the genetic risk of one developing clinical depression is put at about 40 percent when biological parent was diagnosed with depression, with the remaining 60 percent coming as a result of factors inherent in one’s own environment. While depression may not occur without stressors, the risk of developing depression due to a stressor is genetically determined.

    1. Biochemical Factors

Within the context of nursing approaches towards understanding of biochemical factors responsible for depression, our knowledge remains fairly limited. However, some cases of clinical depression involve disturbance of neurotransmitter functions. While there are different neurotransmitters serving different functions in human bodies, studies have been interested in three essential ones that affect people’s moods or ones which cause depression; noradrenaline, serotonin and dopamine (Yazdani et al., 2011). When brains are functioning normally, neurotransmitters are able to interact with a number of nerve cells, with one’s signal being as strong as the second as well as subsequent cells as it was the case with the first cell. Conversely, with individuals who are under depression, neurotransmitters regulating moods fail to function as expected to an extent that the signal is either disrupted or depleted before passing to the next nerve cell.

    1. The Ageing Brain

The TruBlue randomised control trail, the Australia’s main study of practice nurse management of depression noted that age is factor that contributes towards depression (Lohman et al., 2016). TruBlue randomised control trail examined clinical outcomes of age and prevalence of depression among 3,200 cases. As with the TruBlue, global prevalence of depression has often been associated with age. Lohman et al. (2016) found that our brains can be compromised as we advance in age. This process affects the neurotransmitter pathways that affect the state of our moods. According to the research, there are three distinct changes that are related with depression and age;

  • Late onset depression: the research noted that elderly people developing dementia are likely to develop moderate to severe depression for the first time in their lives. This type of depression has been found to be commonly melancholic or psychotic thus reflecting the disruption of different circuits linking frontal regions of the brain and basal ganglia.

  • The brain changes are likely to reflect the process of ageing, more so in individuals vulnerable to ‘tear and wear.’

  • The third change may be a situation of mini-strokes or high blood pressure.

  1. The Role of Nurses in Prevention and Risk Management of Depression

Depression was estimated to be responsible for 14 percent of the total burden of disease in Australia in 2013, placing it third as a broad group after cardiovascular disease and cancers (Lohman et al., 2016)). Basing on this point, studies have examined the effects of depression to the generation population. Key findings from Australian Bureau of Statistics (2011) that took national survey concerning the effects of depression noted that Australians with affective mood experience severe levels interference with their lives, including work, home responsibility and social life. This finding is in agreement with global survey on the effect of depression which noted that people living with depression often report high levels of psychological distress (Shaw et al., 2016). High or very high psychological depression or distress was reported by 56 percent of people with generalized depression in 2014 global survey of adult population (Shaw et al., 2016). Based on these effects, the role of nurses in prevention and risk management of depression remain significant. To begin with, prevention and looking after patients with depression requires that nurses focus basically on recognition and early management of different risk factors that increase patients’ vulnerability to depression. This position has been supported by evidence-based researches from studies such as Chiang and Chang (2012) that noted that preventative and treatment procedures nurses should take should include recognition as well as response to the presence of risk factors. In managing depression, nurses will be expected to practice ongoing treatment and follow-up.

One of the effects of depression that nurses have been grappling with is the incidences of suicide. Almost one-quarter (12 percent) of global population having psychotic depression participating in the psychosis study noted that at least 30 percent of the sample group attempted suicide (Lohman et al., 2016). In addition, the 2012 survey of the Australian adult population indicate that suicidality (suicidal ideation or suicide attempts and plans) in the previous 10 months before 2012 was three and a half times as high for citizens with depression as for the general public. The figure below indicates incidences of suicide among Australians (Australian Institute for Suicide Research and Prevention, 2014). Between 2004 and 2013, incidences of suicides related with depression increased steadily between 2004 and 2013 (Australian Bureau of Statistics 2013).

11Conclusion 5.0. 2

The figure 3 above indicates the number of suicide related deaths as a result of depression recorded by Australian Bureau of Statistics. Based on the figure above, suicide claimed at least 200 depression related deaths per year in different States within Australia. In management and taking care of depression leading to suicide, nurses are supposed to note that suicide have rarely been a spur-of-the moment decision. Weeks or hours before suicide, depressed patients present some signs to nurses. It therefore means that taking care of depressed patients would entail nursing assessment of suicidal ideation when their histories reveals aspects such as chronic pain, previous attempted suicide or recent divorce or separation. Researches such as Bruce et al. (2015) have noted that nursing prevention of depression related deaths among patients should entail references to mental health counseling if there is evidence of suicidal ideation of intent. In particular, nursing should monitor evidences such as obtaining weapon, giving away priced possessions or preparation of a suicide note.

Previous review of journal articles and experimental studies focusing on the effects of depression have noted that the effects of diagnosed depression on the functioning memory continue to affect population globally (Valentea and Saunders, 2016; Bruce et al. 2015). Valentea and Saunders (2016) took a lumping study on all depressed individuals into a single group thus courting greater variability with regard to performance scores as a result of the general variance in in-depressive core symptomatology. The conclusion of the study was that depression affects mental functioning specifically on hopelessness, reduced appetite, and exhibition of sleep abnormalities, psychomotor retardation, helplessness or depressed mood. Differently, Bruce et al. (2015) noted that effects of depression include mortality, functional impairment, morbidity, and decreased quality of life. While nursing intervention need to take care of these effects, it has to be noted that clinical features of depression are mainly uncharacteristic of mood changes, including somatic symptoms, aggression and cognitive impairment. An approach nurses should use in prevention and looking after patients with depression should entail adoption of reminiscence particularly in taking care and prevention of depression among patients who have mental dysfunction. According to Bruce et al. (2015), reminiscence is a structured individual or group work approach that aims at stimulating and talking about personal memories of the depressed. Nurses will have to adopt reminiscence therapy by using the memory in the protection of mental health thus improving the quality of depressed life. Specifically, the model will entail a reflection on re-evaluation, resolution of past conflicts and assessment of former adaptive coping responses.

  1. Conclusion

The aim of this report was to critically evaluate how depression affect globally and Australian population taking case studies on ways in which nurses can prevent and take care of the depressed. It has been observed that depression is reversible with detection and necessary treatment such as medication, counseling and patient-centred care initiated by nurses. For instance, the report noted that suicide related deaths in Australia continue to grow thus calling for nurses to adopt recreational therapy that encourages patients to participate in expressive and challenging activities that consequently promote life satisfaction, increasing affiliation with others or verbal interaction. The report further discussed aetiology and management of depressive disorders. As a result, the report concludes that there is paucity of data and research providing link between violence and mental illness. However, this is concentrated in a given sub-groups, for instance—patients are not receiving treatment who have reported a history of violence or drug addicts.


ABS (2013). Disability, ageing and carers, Australia: summary of findings, 2009. ABS cat. no. 4430.0. Canberra: ABS. AIHW (Australian Institute of Health and Welfare) 2012. Comorbidity of mental disorders and physical conditions 2007. Cat. no. PHW 155. Canberra: AIHW.

AIHW (Australian Institute of Health and Welfare) (2012). Comorbidity of mental disorders and physical conditions 2007. Cat. no. PHW 155. Canberra: AIHW.

Australian Bureau of Statistics (2011). Causes of Death Australia, 2011 Catalogue No. 3303.0. ABS: Canberra.

Australian Bureau of Statistics. (2007). National Survey of Mental Health and Well-being: Summary of results. Catalogue No. 4326.0. Canberra, ACT: Australian Bureau of Statistics.

Australian Institute for Suicide Research and Prevention (AISRAP) (2014)– a World Health Organization Collaborating Centre for Research and Training in Suicide Prevention.

Bruce, M. L., Raue, P. J., Reilly, C. F., Greenberg, R. L., Meyers, B. S., Banerjee, S., … & Rosas, V. H. (2015). Clinical effectiveness of integrating depression care management into Medicare home health: the depression CAREPATH randomized trial. JAMA internal medicine, 175(1), 55-64.

Chiang, Y. M., & Chang, Y. (2012). Stress, depression, and intention to leave among nurses in different medical units: Implications for healthcare management/nursing practice. Health Policy, 108(2), 149-157.

Craigie, M., Osseiran-Moisson, R., Hemsworth, D., Aoun, S., Francis, K., Brown, J., … & Rees, C. (2016). The influence of trait-negative affect and compassion satisfaction on compassion fatigue in Australian nurses. Psychological Trauma: Theory, Research, Practice, and Policy, 8(1), 88.

DoHA (Department of Health and Ageing) (2013). National Mental Health Report 2013: tracking progress of mental health reform in Australia 1993–2011. Canberra: Commonwealth of Australia.

Fuller, J., Koehne, K., Verrall, C. C., Szabo, N., Bollen, C., & Parker, S. (2015). Building chronic disease management capacity in general practice: The South Australian GP plus practice nurse initiative. Collegian, 22(2), 191-197.

Hegney, D. G., Craigie, M., Hemsworth, D., Osseiran‐Moisson, R., Aoun, S., Francis, K., & Drury, V. (2014). Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in Australia: study 1 results. Journal of nursing management, 22(4), 506-518.

Jarzyna, D., Jungquist, C. R., Pasero, C., Willens, J. S., Nisbet, A., Oakes, L., … & Polomano, R. C. (2011). American Society for Pain Management Nursing guidelines on monitoring for opioid-induced sedation and respiratory depression. Pain Management Nursing, 12(3), 118-145.

Lohman, M., Raue, P., Greenberg, R., & Bruce, M. L. (2016). Course of Suicidal Ideation among Home Health Patients in the CAREPATH Depression Care Management Trial. The American Journal of Geriatric Psychiatry, 24(3), S68-S69.

Morgan, M. A., Coates, M. J., Dunbar, J. A., Reddy, P., Schlicht, K., & Fuller, J. (2013). The TrueBlue model of collaborative care using practice nurses as case managers for depression alongside diabetes or heart disease: a randomised trial. BMJ open, 3(1), e002171.

Shaw, J. M., Price, M. A., Clayton, J. M., Grimison, P., Shaw, T., Rankin, N., & Butow, P. N. (2016). Developing a clinical pathway for the identification and management of anxiety and depression in adult cancer patients: an online Delphi consensus process. Supportive Care in Cancer, 24(1), 33-41.

Slade, T., Johnston, A., Oakley Browne, M. A., Andrews, G., & Whiteford, H. (2009). 2007 National Survey of Mental Health and Wellbeing: methods and key findings. Australian and New Zealand Journal of Psychiatry, 43(7), 594-605.

Stafford, L., Judd, F., Gibson, P., Komiti, A., Mann, G. B., & Quinn, M. (2015). Anxiety and depression symptoms in the 2 years following diagnosis of breast or gynaecologic cancer: prevalence, course and determinants of outcome. Supportive Care in Cancer, 23(8), 2215-2224.

Valenstein, M., Eisenberg, D., McCarthy, J. F., Austin, K. L., Ganoczy, D., Kim, H. M., … & Blow, F. C. (2015). Service implications of providing intensive monitoring during high-risk periods for suicide among VA patients with depression. Psychiatric Services.

Valente, S. M., & Saunders, J. (2016). Screening for Depression & Suicide: Self-Report Instruments that Work. Journal of psychosocial nursing and mental health services, 43(11), 22-31.

Wang, S. M., Lai, C. Y., Chang, Y. Y., Huang, C. Y., Zauszniewski, J. A., & Yu, C. Y. (2015). The relationships among work stress, resourcefulness, and depression level in psychiatric nurses. Archives of psychiatric nursing, 29(1), 64-70.

Yazdani, M., Rezaei, S., & Pahlavanzadeh, S. (2011). The effectiveness of stress management training program on depression, anxiety and stress of the nursing students. Iranian journal of nursing and midwifery research, 15(4).

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