NR 715 Week 5 Evidence Synthesis

NR 715 Week 5 Evidence Synthesis

Student Name

Chamberlain University

NR 715 Week 1 The Theory- Practice Gap and Nursing Research

Prof. Name:

Date

Evidence Synthesis

Doctor of Nursing Practice (DNP)-prepared nurses hold a vital role in addressing global health challenges by advancing nursing practice and promoting population well-being. As part of this academic preparation, the doctoral student accessed the Chamberlain University Library to identify a relevant health issue and review peer-reviewed articles that provide evidence for potential interventions.

The evidence synthesis process began with a thorough review of article abstracts, which was followed by the selection of the most relevant studies for in-depth analysis. The primary goal was to extract major themes and findings from both quantitative and qualitative research and then evaluate how these results can be applied to improve clinical outcomes for a pressing public health problem.

For this project, three research articles were selected:

• Cheruvu & Chiyaka (2019) investigated how medical costs impact access to depression treatment among older adults.

• Griffiths et al. (2021) explored patient perspectives on ketamine infusion therapy for treatment-resistant depression.

• Pokhrel, Khadayat, & Tulachan (2020) studied the prevalence of depression, anxiety, and burnout in medical students in Nepal.

The collective evidence from these studies demonstrates that depression is a global concern, cutting across age groups, professions, and geographical boundaries. Findings emphasize the urgent need for affordable, innovative, and accessible strategies to address the burden of depression and associated mental health conditions.

Article One: Evidence Synthesis

Cheruvu and Chiyaka (2019) examined the public health burden of depression among older adults, predicting it will remain one of the leading causes of disability worldwide. Their cross-sectional quantitative study used data from the Behavioral Risk Factor Surveillance System (BRFSS), analyzing responses from 24,810 adults aged 65 years and older.

Results revealed that many older adults delayed or avoided depression treatment due to the high cost of care. Financial constraints emerged as a significant barrier, particularly for those managing chronic illnesses alongside depression.

Although the study relied on self-reported survey data—a noted limitation—the findings highlight the importance of reducing out-of-pocket healthcare costs. The authors called for stronger policy reforms and interventions to ensure older adults have equitable access to mental health care.

Article Two: Evidence Synthesis

Griffiths et al. (2021) conducted a qualitative study that investigated patient experiences with ketamine infusion therapy for treatment-resistant depression. Using semi-structured interviews with 13 adults, the researchers explored participants’ challenges prior to treatment and their responses after at least three ketamine sessions.

Before ketamine therapy, participants described intense symptoms including suicidal ideation, anxiety, hopelessness, and impaired memory. Many had tried multiple treatments without success. Following ketamine infusion, participants reported meaningful improvements such as enhanced mood, decreased suicidal thoughts, and, in some cases, restored ability to work and engage in daily life.

The small sample size limited generalizability, yet the findings show that ketamine may serve as a promising alternative for individuals unresponsive to conventional treatments. Importantly, the study emphasized incorporating patient perspectives to guide mental health interventions.

Article Three: Evidence Synthesis

Pokhrel, Khadayat, and Tulachan (2020) assessed the prevalence of depression, anxiety, and burnout among medical students in Nepal. Their cross-sectional survey included 651 participants, revealing high levels of psychological distress among future healthcare professionals.

Students reported multiple sources of stress, including academic demands, personal challenges, and clinical responsibilities. Burnout was linked to the rigorous and extended nature of medical education, as well as financial and emotional pressures.

While the authors acknowledged the need for further diagnostic confirmation, their findings highlight the urgent necessity of early intervention, academic support systems, and access to counseling services for medical students.

Compare and Contrast the Main Points

The reviewed studies (Cheruvu & Chiyaka, 2019; Griffiths et al., 2021; Pokhrel et al., 2020) all examined the pervasive impact of depression but from different perspectives.

Key Similarities

• All studies highlighted barriers to effective depression management or the consequences of untreated mental illness.

• Each emphasized the importance of accessible, tailored interventions for distinct populations (older adults, patients resistant to standard therapies, and medical students).

• Collectively, they reinforce that depression is a universal concern with significant public health consequences.

Key Differences

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

• Griffiths et al. (2021): Highlighted novel treatment experiences with ketamine infusion.

• Pokhrel et al. (2020): Explored academic stress and burnout as precursors to depression in medical students.

NR 715 Week 5 Evidence Synthesis

Comparison Table

Study	Design/Method	Population	Key Findings	Limitations	Implications
Cheruvu & Chiyaka (2019)	Quantitative, cross-sectional (BRFSS)	24,810 older adults (65+)	Financial barriers delayed or prevented depression treatment	Reliance on self-reported survey data	Need for policy reforms to reduce healthcare costs and improve access
Griffiths et al. (2021)	Qualitative, semi-structured interviews	13 adults with treatment-resistant depression	Ketamine infusion improved mood, reduced suicidal thoughts, restored functioning	Small sample size	Suggests ketamine as an alternative and cost-effective therapy option
Pokhrel et al. (2020)	Quantitative, cross-sectional survey	651 medical students in Nepal	High prevalence of depression, anxiety, and burnout due to academic stress	Requires further diagnostic confirmation	Calls for supportive academic structures and mental health interventions

Conclusion

This synthesis illustrates the multifaceted impact of depression across diverse populations, revealing financial, therapeutic, and academic barriers that perpetuate the crisis. The studies collectively call for policy advocacy, innovative therapies, and robust institutional support to reduce the burden of mental illness.

By reviewing evidence from older adults, treatment-resistant patients, and medical students, it becomes clear that depression transcends age, location, and socioeconomic boundaries. Effective solutions will require a comprehensive, multi-level approach that includes affordable care, innovative treatment, and proactive institutional support.

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