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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Kay Foland


heart failure, depression, screening, referral, PHQ-9


Heart failure (HF) continues to increase annually in the United States. HF and depression share many of the same symptoms. When HF and depression occur concomitantly they are associated with a decreased quality of life (QOL) and an increase in health care spending. However, many providers are not screening for depression in HF patients despite evidence-based guidelines and recommendations. The purpose of this pilot study was to determine the effectiveness of screening adult HF patients using the Patient Health Questionnaire-9 (PHQ-9). An urban Midwestern Cardiovascular (CV) clinic with Electrophysiology specialization incorporated depression screening and referral in HF patients utilizing the PHQ-9. The PHQ-9 screening form, a referral form and educational handout were integrated into the routine HF recheck appointment. At the end of the pilot study phase, the incidence of positive depression screens was 38.1% and of those, 67.5% elected to be referred. The participants were surveyed regarding usefulness, comfort level, and knowledge. Ninety-fiver percent believe the screen and referral were useful, 95% were comfortable completing the screen, and 73% indicated they had increased their level of depression. The providers and nurses also felt the screening and referral was useful (83.3%). They also indicated their desire to continue the screening and referral process and expand it to other CV populations seen in the clinic. Implementation of routine depression screening and referral into the standard of care may positively affect HF patients QOL and health care spending.

Library of Congress Subject Headings

Heart failure -- Psychological aspects
Heart failure -- Patients
Depression, Mental -- Diagnosis


Includes bibliographical references (pages 46-50)



Number of Pages



South Dakota State University


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