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Knowledge, skills, and attitude of hemodialysis nurses in recognizing depression among hemodialysis patients in Northern Philippines: a mixed methods study.
Corresponding Author(s) : Ashley A. Bangcola
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 12 No. 2 (2024): 2024 Volume -12 - Issue 2
Abstract
Background: Depression in hemodialysis patients is a significant concern, and hemodialysis nurses play a crucial role in its identification and management.
Objective: This study aimed to explore the knowledge, skills, and attitudes of hemodialysis nurses in Iligan City towards recognizing depression in hemodialysis patients.
Methods: A mixed-methods approach was employed, combining quantitative and qualitative phases. Purposive sampling selected 35 participants for the quantitative phase, and twelve of these were chosen for the qualitative phase based on extreme responses in the questionnaire. Descriptive analysis, Spearman Rank Point-Biserial Correlation, and Z-Score analysis were used in the quantitative phase, while content and thematic analyses were applied in the qualitative phase.
Results: The findings reveal that the general knowledge level was average (M=0.55), and skills in identifying depression were moderate (M=3.18). Attitudes were generally neutral regarding professional confidence (M=3.22) and therapeutic optimism (M=3.25), but positive from a generalist perspective (M=3.87). In the qualitative phase, professional development, self-efficacy, and self-awareness emerged as crucial factors influencing knowledge, skills, and attitudes.
Conclusion: The study provided a comprehensive understanding of the factors affecting hemodialysis nurses' knowledge, skills, and attitudes towards recognizing depression. Triangulation and validation of results highlighted the importance of professional development, self-efficacy, and self-awareness in enhancing nurses' abilities to manage depression in hemodialysis patients.
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- Caldeira Skrebsky Menegazzo, N., Kitzberger, I., de Miranda Gauza, M., Sombrio Fronza, C., Soares, A., & do Nascimento Lima, H. (2023). Work Activity Challenges among Hemodialysis Patients and Their Impact on Quality of Life. O Mundo da Saúde, 43. https://doi.org/10.15343/0104-7809.202347e14092022i
- Mazharulhaq, Rafique, K., Ahmad, Z., Khan, A. U., Arshad, A., & Ilyas, K. (2023). Prevalence of depression in patients on hemodialysis. International Journal of Health Sciences, 7(S1), 41–48. https://doi.org/10.53730/ijhs.v7nS1.14149
- Callahan, M., & Malhotra, S. (2020). Mental health: Assessment, treatment, and outcomes. In Handbook of Healthcare in the 21st Century (pp. 153-171). Springer. https://doi.org/10.1007/978-3-319-59014-1_8
- Mohamed, R., El-Okely, A., Abdel Hamid, A., & Alaa, Z. (2023). Correlation between Depression and End-Stage Renal Disease (ESRD): Review Article. The Egyptian Journal of Hospital Medicine, 91(1), 4832-4836. doi: 10.21608/ejhm.2023.300797
- Almutary, H. (2023). Psychosocial Aspects in Hemodialysis. Updates on Hemodialysis. IntechOpen. Available at: http://dx.doi.org/10.5772/intechopen.109592.
- Hsu, S.-Y., & Huang, H.-S. (2019). Improving depression, hope, and quality of life in dialysis patients using health promotion education groups. The Journal of Nursing (China), 66(4), 29-39. https://doi.org/10.6224/JN.201908_66(4).05
- Forwaty, E., Usraleli, U., & Khusniyati, N. (2022). Improving the knowledge and skills of hemodialysis nurses about intradialytic exercise at Arifin Achmad Hospital, Riau. Community Empowerment, 7(2). https://doi.org/10.31603/ce.6152
- Gurung, S., Shah, S., & Lamichhane, K. (2019). Knowledge among nurses regarding post-partum depression in a tertiary hospital setting of Nepal. Journal of Psychiatrists' Association of Nepal, 8(1), 61-65. https://doi.org/10.3126/jpan.v8i1.26339
- Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches. Sage Publications.
- Toledo-Bruno, A., Bruno, E., & Paquit, J. (2022). Spatial information on the Central Mindanao University’s academic services in the Northern Mindanao geographically isolated and disadvantaged areas. CMU Journal of Science, 26(2). https://doi.org/10.52751/dlqf8496
- Griffiths, K. M., Christensen, H., & Jorm, A. F. (2008). Predictors of depression stigma. BMC Psychiatry, 8(25). https://doi.org/10.1186/1471-244X-8-25
- Haddad, M., Menchetti, M., McKeown, E., & et al. (2015). The development and psychometric properties of a measure of clinicians’ attitudes to depression: The revised Depression Attitude Questionnaire (R-DAQ). BMC Psychiatry, 15, 7. https://doi.org/10.1186/s12888-014-0381-x
- Aggarwal, C. C. (2017). Outlier analysis (2nd ed.). Springer.
- Braun, V., & Clarke, V. (2016). Thematic analysis in psychology. In D. Fonow & A. R. Cook (Eds.), Handbook of case study research in psychology (pp. 51-68). Routledge.
- O’Sullivan, T., & Khan, Y. (2020). Addressing complexity through mixed methods. In WHO guidance on research methods for health emergency and disaster risk management (Chapter 4.13). World Health Organization.
- Barba, K., Ram, R., Gautam, & Paula, Knotts. (2022). Late Life Depression Education: Impact on Acute Care Nurses' Knowledge, Attitude, and Screening Practices. Journal of Gerontological Nursing, 48(12), 43-51. https://doi.org/10.3928/00989134-20221108-01
- Sumari, E., Jia, L., Furia, F. F., & Mkoka, D. (2023). Knowledge and Its Associated Factors among Nurses Caring Patients with Chronic Kidney Disease (CKD) in Referral Hospital: A Descriptive Cross-Sectional Study. International Clinical and Medical Case Reports, 2(1). https://doi.org/10.59657/2837-5998.brs.23.012
- Cukor, D., Cohen, S. D., Peterson, R. A., & Kimmel, P. L. (2007). Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. Journal of the American Society of Nephrology: JASN, 18(12), 3042–3055. https://doi.org/10.1681/ASN.2007030345
- Hurley, J., Foster, K., Campbell, K. L., Edan, V., Hazelton, M., Kennedy, H., Roper, C., & Lakeman, R. (2022). Mental health nursing capability development: Perspectives of consumers and supporters. International Journal of Mental Health Nursing, 32(1), 172-185. https://doi.org/10.1111/inm.13074
- Micallef, C., Sammut, A., & Grech, P. (2022). Knowledge, Attitude, Preparedness and Behavior of Nurses Towards Intimate Partner Violence in Mental Health Settings. Humanities and Social Science Research, 5(2), 47. https://doi.org/10.30560/hssr.v5n2p47
- Sreeram, A., Cross, W., & Townsin, L. (2023). Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice in acute inpatient psychiatric units: A non-participant observation study. International Journal of Mental Health Nursing, 32(4) 1112-1128. https://doi.org/10.1111/inm.13152
- Kigozi-Male, N. G., Heunis, J. C., & Engelbrecht, M. C. (2023). Primary health care nurses’ mental health knowledge and attitudes towards patients and mental health care in a South African metropolitan municipality. BMC Nursing, 22(25). https://doi.org/10.1186/s12912-023-01188-x
- 22.Kolb, K., Liu, J., & Jackman, K. B. (2022). Stigma towards patients with mental illness: An online survey of United States nurses. International Journal of Mental Health Nursing, 32(1), 323-336. https://doi.org/10.1111/inm.13084.
- Endacott, R., & Blot, S. (2022, September 28). Fundamental drivers of nurses’ experiences of ICU surging during the coronavirus disease 2019 (COVID-19) pandemic. Current Opinion in Critical Care, 28(6), 645-651. https://doi.org/10.1097/mcc.0000000000000995
- Hsiao, C.-Y., Lu, H.-L., & Tsai, Y. T. (2023). Factors associated with attitudes of mental health nurses towards the importance of families in mental health nursing care. International Journal of Mental Health Nursing, 32(5), 1429-1438. https://doi.org/10.1111/inm.13187
- Alsolais, A., Jr, B., Areola, N., Alfouzan, A., Grace, M., Nones, M., & Alharbi, T. A. (2023, January 1). Undergraduate Student Nurses’ Attitude Toward Mental Health Education: A Cross-sectional Analysis. Makara Journal of Health Research, 27(1). https://doi.org/10.7454/msk.v27i1.1410
- Tomaszewska, K., Guty, E., & Majchrowicz, B. (2023). Professional burnout syndrome in a group of nursing staff employed in a psychiatric hospital. Journal of Education, Health and Sport, 30(1), 28-37. https://doi.org/10.12775/jehs.2023.30.01.002
- McGregor, K. E., Boyd, S. E. M., Collins, E. C. M. L., Mcdonald, A. M., Pereira-Edwards, M. P. A., Scott, S. J., Neufeld, T. D., Harrigan, T., Sawatzky, B. L., Chorney, M. A., & Mitchell, K. M. (2023). The Effects of Mental Health First Aid Preparation on Nursing Student Self-Efficacy in their Response to Mental Health Issues. Quality Advancement in Nursing Education - Avancées en formation infirmière, 9(2). https://doi.org/10.17483/2368-6669.1381
- Klein, J. P., Barthel, B., Berger, T., & Moritz, S. (2020, December 1). Feasibility, effectiveness and safety of the self-management intervention deprexis in routine medical care: Results of an uncontrolled observational study. Internet Interventions, 22, 100341. https://doi.org/10.1016/j.invent.2020.100341
References
Caldeira Skrebsky Menegazzo, N., Kitzberger, I., de Miranda Gauza, M., Sombrio Fronza, C., Soares, A., & do Nascimento Lima, H. (2023). Work Activity Challenges among Hemodialysis Patients and Their Impact on Quality of Life. O Mundo da Saúde, 43. https://doi.org/10.15343/0104-7809.202347e14092022i
Mazharulhaq, Rafique, K., Ahmad, Z., Khan, A. U., Arshad, A., & Ilyas, K. (2023). Prevalence of depression in patients on hemodialysis. International Journal of Health Sciences, 7(S1), 41–48. https://doi.org/10.53730/ijhs.v7nS1.14149
Callahan, M., & Malhotra, S. (2020). Mental health: Assessment, treatment, and outcomes. In Handbook of Healthcare in the 21st Century (pp. 153-171). Springer. https://doi.org/10.1007/978-3-319-59014-1_8
Mohamed, R., El-Okely, A., Abdel Hamid, A., & Alaa, Z. (2023). Correlation between Depression and End-Stage Renal Disease (ESRD): Review Article. The Egyptian Journal of Hospital Medicine, 91(1), 4832-4836. doi: 10.21608/ejhm.2023.300797
Almutary, H. (2023). Psychosocial Aspects in Hemodialysis. Updates on Hemodialysis. IntechOpen. Available at: http://dx.doi.org/10.5772/intechopen.109592.
Hsu, S.-Y., & Huang, H.-S. (2019). Improving depression, hope, and quality of life in dialysis patients using health promotion education groups. The Journal of Nursing (China), 66(4), 29-39. https://doi.org/10.6224/JN.201908_66(4).05
Forwaty, E., Usraleli, U., & Khusniyati, N. (2022). Improving the knowledge and skills of hemodialysis nurses about intradialytic exercise at Arifin Achmad Hospital, Riau. Community Empowerment, 7(2). https://doi.org/10.31603/ce.6152
Gurung, S., Shah, S., & Lamichhane, K. (2019). Knowledge among nurses regarding post-partum depression in a tertiary hospital setting of Nepal. Journal of Psychiatrists' Association of Nepal, 8(1), 61-65. https://doi.org/10.3126/jpan.v8i1.26339
Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches. Sage Publications.
Toledo-Bruno, A., Bruno, E., & Paquit, J. (2022). Spatial information on the Central Mindanao University’s academic services in the Northern Mindanao geographically isolated and disadvantaged areas. CMU Journal of Science, 26(2). https://doi.org/10.52751/dlqf8496
Griffiths, K. M., Christensen, H., & Jorm, A. F. (2008). Predictors of depression stigma. BMC Psychiatry, 8(25). https://doi.org/10.1186/1471-244X-8-25
Haddad, M., Menchetti, M., McKeown, E., & et al. (2015). The development and psychometric properties of a measure of clinicians’ attitudes to depression: The revised Depression Attitude Questionnaire (R-DAQ). BMC Psychiatry, 15, 7. https://doi.org/10.1186/s12888-014-0381-x
Aggarwal, C. C. (2017). Outlier analysis (2nd ed.). Springer.
Braun, V., & Clarke, V. (2016). Thematic analysis in psychology. In D. Fonow & A. R. Cook (Eds.), Handbook of case study research in psychology (pp. 51-68). Routledge.
O’Sullivan, T., & Khan, Y. (2020). Addressing complexity through mixed methods. In WHO guidance on research methods for health emergency and disaster risk management (Chapter 4.13). World Health Organization.
Barba, K., Ram, R., Gautam, & Paula, Knotts. (2022). Late Life Depression Education: Impact on Acute Care Nurses' Knowledge, Attitude, and Screening Practices. Journal of Gerontological Nursing, 48(12), 43-51. https://doi.org/10.3928/00989134-20221108-01
Sumari, E., Jia, L., Furia, F. F., & Mkoka, D. (2023). Knowledge and Its Associated Factors among Nurses Caring Patients with Chronic Kidney Disease (CKD) in Referral Hospital: A Descriptive Cross-Sectional Study. International Clinical and Medical Case Reports, 2(1). https://doi.org/10.59657/2837-5998.brs.23.012
Cukor, D., Cohen, S. D., Peterson, R. A., & Kimmel, P. L. (2007). Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. Journal of the American Society of Nephrology: JASN, 18(12), 3042–3055. https://doi.org/10.1681/ASN.2007030345
Hurley, J., Foster, K., Campbell, K. L., Edan, V., Hazelton, M., Kennedy, H., Roper, C., & Lakeman, R. (2022). Mental health nursing capability development: Perspectives of consumers and supporters. International Journal of Mental Health Nursing, 32(1), 172-185. https://doi.org/10.1111/inm.13074
Micallef, C., Sammut, A., & Grech, P. (2022). Knowledge, Attitude, Preparedness and Behavior of Nurses Towards Intimate Partner Violence in Mental Health Settings. Humanities and Social Science Research, 5(2), 47. https://doi.org/10.30560/hssr.v5n2p47
Sreeram, A., Cross, W., & Townsin, L. (2023). Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice in acute inpatient psychiatric units: A non-participant observation study. International Journal of Mental Health Nursing, 32(4) 1112-1128. https://doi.org/10.1111/inm.13152
Kigozi-Male, N. G., Heunis, J. C., & Engelbrecht, M. C. (2023). Primary health care nurses’ mental health knowledge and attitudes towards patients and mental health care in a South African metropolitan municipality. BMC Nursing, 22(25). https://doi.org/10.1186/s12912-023-01188-x
22.Kolb, K., Liu, J., & Jackman, K. B. (2022). Stigma towards patients with mental illness: An online survey of United States nurses. International Journal of Mental Health Nursing, 32(1), 323-336. https://doi.org/10.1111/inm.13084.
Endacott, R., & Blot, S. (2022, September 28). Fundamental drivers of nurses’ experiences of ICU surging during the coronavirus disease 2019 (COVID-19) pandemic. Current Opinion in Critical Care, 28(6), 645-651. https://doi.org/10.1097/mcc.0000000000000995
Hsiao, C.-Y., Lu, H.-L., & Tsai, Y. T. (2023). Factors associated with attitudes of mental health nurses towards the importance of families in mental health nursing care. International Journal of Mental Health Nursing, 32(5), 1429-1438. https://doi.org/10.1111/inm.13187
Alsolais, A., Jr, B., Areola, N., Alfouzan, A., Grace, M., Nones, M., & Alharbi, T. A. (2023, January 1). Undergraduate Student Nurses’ Attitude Toward Mental Health Education: A Cross-sectional Analysis. Makara Journal of Health Research, 27(1). https://doi.org/10.7454/msk.v27i1.1410
Tomaszewska, K., Guty, E., & Majchrowicz, B. (2023). Professional burnout syndrome in a group of nursing staff employed in a psychiatric hospital. Journal of Education, Health and Sport, 30(1), 28-37. https://doi.org/10.12775/jehs.2023.30.01.002
McGregor, K. E., Boyd, S. E. M., Collins, E. C. M. L., Mcdonald, A. M., Pereira-Edwards, M. P. A., Scott, S. J., Neufeld, T. D., Harrigan, T., Sawatzky, B. L., Chorney, M. A., & Mitchell, K. M. (2023). The Effects of Mental Health First Aid Preparation on Nursing Student Self-Efficacy in their Response to Mental Health Issues. Quality Advancement in Nursing Education - Avancées en formation infirmière, 9(2). https://doi.org/10.17483/2368-6669.1381
Klein, J. P., Barthel, B., Berger, T., & Moritz, S. (2020, December 1). Feasibility, effectiveness and safety of the self-management intervention deprexis in routine medical care: Results of an uncontrolled observational study. Internet Interventions, 22, 100341. https://doi.org/10.1016/j.invent.2020.100341