Presented in part of the American Association for Geriatric Psychiatry Annual Meeting, March 2012, Washington, D.C. and of the International Congress of Geriatric Psychoneuropharmacology, October 2012, Seville, Spain.
Special Issue Paper
Racial and ethnic variation in home healthcare nurse depression assessment of older minority patients†
Article first published online: 15 NOV 2013
Copyright © 2013 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Special Issue: ICGP Award Winning Paper
Volume 29, Issue 11, pages 1140–1144, November 2014
How to Cite
2014), Racial and ethnic variation in home healthcare nurse depression assessment of older minority patients, Int J Geriatr Psychiatry, 29, pages 1140–1144, doi: 10.1002/gps.4001, , and (
- Issue published online: 13 OCT 2014
- Article first published online: 15 NOV 2013
- Manuscript Accepted: 6 JUN 2013
- Manuscript Received: 1 MAR 2013
- geriatric depression;
- mental health disparities
The objective of this study is to determine the racial/ethnic effect of depression symptom recognition by home healthcare nurses.
This is a secondary analysis of administrative data from a large urban home healthcare agency. Patients' age were 65 years and older with a valid depression screen, identified as Caucasian, African American, or Hispanic and admitted to homecare in 2010 (N = 3711). All demographic and clinical information were obtained from the electronic medical record.
Subjects were 29.34% Caucasian, 37.81% African American, and 32.85% Hispanic. About 6.52% had a formal chart diagnosis of depression, and 13.39% received antidepressant therapy. The rates of positive depression screens by nurses were higher in Caucasians than that of in African Americans or Hispanics (13.41% vs. 9.27% vs. 10.99%; χ2 = 10.70, df [degrees of freedom] = 2; p < 0.01). Depression screening rates were then stratified by the number of clinical indicators from the chart (depression diagnosis or antidepressant on medication list). The proportion of positive screen increased for minorities with an increase in the number of indicators. African Americans had significantly greater positive screens with two indicators compared with that of the Caucasians and Hispanics (50.00% vs. 23.81% vs. 35.59%; χ2 = 6.65, df = 2; p = 0.04).
These findings show a wide range of variation in screening for depression among ethnic groups. The rates increase for minorities with the presence of increased clinical indicators, suggesting that nurses may screen higher in minorities when there is higher clinical suspicion. Future research in home healthcare should be aimed at training nurses to conduct culturally tailored depression screening to improve management of depression in older minorities. Copyright © 2013 John Wiley & Sons, Ltd.