NR 715 Week 5 Evidence Synthesis

Evidence Synthesis

Doctor of Nursing Practice (DNP)-prepared nurses hold a crucial role in addressing the global need for advancing nursing practice and improving public health outcomes. Their advanced education enables them to lead, implement, and evaluate evidence-based practices effectively. In this synthesis, the doctoral student utilized the Chamberlain University Library to select a population health topic and analyze peer-reviewed studies related to evidence-based interventions.

The process began with screening abstracts, followed by detailed reviews of relevant studies. The main goal was to extract and synthesize major findings from both quantitative and qualitative research. This approach allowed identification of recurring themes, comparison of data, and evaluation of implications for clinical practice and health policy.

Three peer-reviewed studies were included in this evidence synthesis:

1. Cheruvu & Chiyaka (2019): Relationship between healthcare costs and delayed treatment for depression among older adults.

2. Griffiths et al. (2021): Patient experiences with ketamine infusion therapy for treatment-resistant depression.

3. Pokhrel, Khadayat, & Tulachan (2020): Prevalence of depression, anxiety, and burnout among medical students in Nepal.

Together, these studies demonstrate that depression is a global issue transcending demographic, social, and geographic boundaries. They collectively highlight the need for accessible, affordable, and innovative interventions to reduce the burden of mental illness worldwide.

Article One: Evidence Synthesis

Cheruvu and Chiyaka (2019) examined depression in older adults, identifying it as a significant public health concern. Their quantitative, cross-sectional study utilized Behavioral Risk Factor Surveillance System (BRFSS) data from 24,810 individuals aged 65 and older.

The study revealed a clear association between delayed depression treatment and financial barriers, particularly out-of-pocket costs. This indicates that economic challenges remain a major obstacle to mental healthcare access. Although self-reported data may introduce bias, the findings remain compelling and relevant to healthcare policy.

The authors recommended that policymakers and healthcare leaders implement strategies to reduce cost-related barriers. Addressing these financial challenges, especially among vulnerable older adults, can greatly improve access to timely mental health care.

Article Two: Evidence Synthesis

Griffiths et al. (2021) conducted a qualitative study exploring the experiences of patients undergoing ketamine infusion therapy for treatment-resistant depression. Published in the Journal of Affective Disorders Reports, the study included 13 participants who had received at least three ketamine sessions.

Participants described experiencing severe depressive symptoms such as hopelessness, suicidal ideation, and anxiety prior to treatment. Many viewed ketamine therapy as a last resort after other treatments failed.

Findings indicated significant improvements following treatment, including reduced suicidal thoughts, improved mood, and restored daily functioning. While the small sample size limits generalizability, the study emphasizes the importance of integrating patient experiences into treatment planning. The research suggests that ketamine infusion could serve as a promising, cost-effective treatment option for individuals with severe depression.

Article Three: Evidence Synthesis

Pokhrel, Khadayat, and Tulachan (2020) conducted a cross-sectional survey involving 651 medical students in Nepal, published in BMC Psychiatry. Their study revealed a high prevalence of depression, anxiety, and burnout among students.

Contributors to stress included demanding coursework, financial pressure, and patient-care responsibilities. Many participants reported emotional exhaustion and feelings of disconnection, raising serious concerns about their mental well-being and professional sustainability.

Although the study did not employ formal diagnostic tools, it provides valuable insights into the psychological struggles of medical students. The authors emphasized the need for early interventions, institutional wellness programs, and mental health initiatives to promote resilience and reduce burnout among future healthcare professionals.

Compare and Contrast the Main Points

The three studies—Cheruvu & Chiyaka (2019), Griffiths et al. (2021), and Pokhrel et al. (2020)—collectively emphasize that depression remains a global and multifaceted public health challenge.

Key Similarities

• All studies highlighted barriers to mental healthcare or the negative consequences of untreated depression.

• Each emphasized the need for targeted interventions specific to population needs—older adults, patients with treatment-resistant depression, and medical students.

• Findings reinforced that depression affects individuals across diverse age groups, professions, and cultural contexts.

Key Differences

• Cheruvu & Chiyaka (2019): Focused on economic barriers affecting older adults.

• Griffiths et al. (2021): Centered on the therapeutic potential of ketamine infusion.

• Pokhrel et al. (2020): Explored academic and professional burnout as contributors to depression among medical students.

NR 715 Week 5 Evidence Synthesis Comparison Table

Conclusion

This synthesis underscores that depression is a complex, multifactorial issue affecting diverse populations globally. Financial constraints, treatment resistance, and academic stressors contribute significantly to mental health disparities.

The evidence supports the need for multi-level strategies, including:

• Policy advocacy to eliminate financial obstacles.

• Innovative treatments such as ketamine infusion for treatment-resistant depression.

• Institutional reforms to support mental wellness among healthcare students and professionals.

Ultimately, the findings affirm that depression is a universal public health concern requiring comprehensive, culturally sensitive, and accessible approaches.

References

Cheruvu, V. K., & Chiyaka, E. T. (2019). Prevalence of depressive symptoms among older adults who reported medical cost as a barrier to seeking health care: Findings from a nationally representative sample. BMC Geriatrics, 19(1), 192. https://doi.org/10.1186/s12877-019-1203-2

Griffiths, C., Walker, K., Reid, I., Maravic da Silva, K., & O’Neill-Kerr, A. (2021). A qualitative study of patients’ experience of ketamine treatment for depression: The ‘Ketamine and me’ project. Journal of Affective Disorders Reports, 4, 100079. https://doi.org/10.1016/j.jadr.2021.100079

NR 715 Week 5 Evidence Synthesis

Pokhrel, N. B., Khadayat, R., & Tulachan, P. (2020). Depression, anxiety, and burnout among medical students and residents of a medical school in Nepal: A cross-sectional study. BMC Psychiatry, 20(1), 298. https://doi.org/10.1186/s12888-020-02645-6