Increasing Pediatric Primary Care Providers Knowledge and Confidence Level of Screening for Depression in Caregivers of Chronically Ill Pediatric Patients

Abstract

Purpose: The purpose of this DNP Quality Improvement (QI) project is to provide education on increasing providers’ knowledge and confidence level of screening for depression in caregivers of chronically ill pediatric patients. Background: Chronic diseases in children are defined as health conditions that persist for more than three months or have a high probability of recurring at least three times in the recent year. Having a child diagnosed with a chronic disease is associated with losing the healthy child that caregivers thought they had. Providing care for a child with a chronic health problem can cause depressive symptoms in caregivers. Increased caregiving demands may cause chronic stress and emotional as well as physical fatigue, which can lead to caregiver depression. A reliable, validated tool that can be used to screen for depression in caregivers is the Patient Health Questionnaire (PHQ-9). Utilizing this screening tool as a future implementation in clinic can aid in identifying depression in the caregiver population of chronically ill pediatric patients. Methods: A pretest-posttest survey was used to assess provider knowledge and confidence level of screening to change practice. The pretest-posttest questionnaires were delivered using Qualtrics to generate, collect, and analyze data. The project was implemented over a 2-week period at a federally qualified health center (FQHC), El Rio Community Health Center Pediatric Department in Tucson, Arizona. The participants were given 1 week to complete the pretest-posttest questionnaire. Results: A total of 15 pediatric primary care providers participated in the educational intervention PowerPoint and completed the pretest and posttest. Ten of those 15 completed the evaluation Likert-based questions. A 50% response rate was achieved as the original email was sent to 30 pediatric providers. After participating in the educational intervention, more than half of the participants acknowledged that their confidence level was above an 8/10, where 10 were “very comfortable,” and 80% of the 10 evaluation question participants answered the intend to apply this knowledge in clinical practice. Conclusions: Providing an educational intervention regarding evidence-based information on the importance of screening for depression and mental health concerns in Arizona was an effective way to increase pediatric providers’ knowledge and confidence level in screening for depression in caregivers of chronically ill children by utilizing the PHQ-9 tool. Future recommendations include implementing the screening of these caregivers in clinical practice by pediatric primary care providers, with regard and intent of referring to the embedded behavioral health program at El Rio.