Date of Award

Winter 12-16-2022

Document Type

DNP Project

Project Team Faculty Member

April Schmidt

Keywords

African American, depression, implicit bias, holistic nursing, stroke disparities, nurses, nursing influence, post stroke depression, PHQ2, racism

Abstract

African Americans (AA) have the highest prevalence of stroke and death compared to other racial groups in the United States. Post-stroke depression (PSD) affects approximately 1/3 of all stroke patients and is underdiagnosed in the African American community.

Aim: By using a mHealth mobile app and a Psychiatry provider list at discharge, PSD can be identified, and interventions initiated, thus decreasing the sequela of PSD in AA.

Methods: Nurses were provided education on PSD, expressions of depression in African-Americans, cultural humility, implicit bias, and the importance of the nurse's role in developing a therapeutic relationship.

Results: Quantitative analysis revealed the mean score of the pre-education test was 56% and the post-education test was 95%. There was a 59% increase in recipient knowledge after education was provided compared to pre-education. Stroke nurse navigators provided quantitative data to measure PHQ2 at seven and 30-day follow-ups and whether the provider list and mHealth app were utilized. 100% of the post-implementation surveys demonstrated the use of the knowledge gained during the implementation and an increase in comfortability discussing PSD.

Limitations: Stroke unpredictability, therapy needs, hospital discharge timing, small sample size, time limit of implementation, and no 30-day post-stroke follow-up data. Of the 31 patients discharged that received a seven-day follow-up call, only three were AA.

Conclusion: With education nurses are empowered to recognize PSD and initiate intervention, reducing the sequela of PSD in the AA community.

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