A Brief Discussion and Evaluation, Article Critique Example

Abstract

The paper provides a brief discussion and evaluation of an evidence-based nursing research article. The summary of the article is provided. The paper discusses the conceptual framework, preliminary findings, methodology, and research results. The discussion and evaluation of the research limitations is performed. The paper provides recommendations for the future research.

Introduction

That screening for depression in geriatric patients predetermines the quality of life in older adults cannot be denied. The current state of literature provides compelling evidence, to support the need for depression screening in older adults. Unfortunately, screening for depression in older adults with dementia and other mental impairments is increasingly problematic: despite the availability of numerous screening instruments and forms, clinicians are concerned about the validity of these instruments in such patients (Lach, Chang & Edwards, 2010). Given the importance of the topic, Lach, Chang and Edwards (2010) developed a new research design, to test the relevance and validity of depression screening instruments in older adults with dementia.

In their article, Lach, Chang and Edwards (2010) provide a brief review of literature relevant to the topic of depression screening in older adults. Lach, Chang and Edwards (2010) claim that the Geriatric Depression Scale (GDS) was developed specifically to screen older adults and has been tested extensively in numerous settings. Screening older adults is crucial, because geriatric patients with dementia have higher risks of depression compared with patients without similar cognitive impairments (Lach, Chang & Edwards, 2010). However, clinicians and researchers believe that patients with dementia cannot use self-reported screening forms and lack the insight needed to answer such questions (Lach, Chang & Edwards, 2010). That is why, the purpose of the study was “to compare the different versions of the GDS with the ‘gold standard’: concurrent diagnosis of depression by a clinician” (Lach, Chang & Edwards, 2010, p.31). The researchers obtained the data through a retrospective review of patients who had attended a geriatric assessment program for at least 15 months prior to the study; and each patient was mailed a GDS form along with other standard assessment forms (Lach, Chang & Edwards, 2010). Also, all participants were interviewed by an advanced practice nurse, a physician, or a social worker, to confirm the depression diagnosis. The Clinical Dementia Rating Scale was used to evaluate the presence and severity of dementia for each patient (Lach, Chang & Edwards, 2010). The final sample included 160 patients, only 9 of whom had severe dementia (Lach, Chang & Edwards, 2010). DSM-IV-TR was used as the basic criterion for the gold standard for diagnosis of depression in research participants (Lach, Chang & Edwards, 2010). The 30-item long form of GDS was used to assess the state of depression in patients (Lach, Chang & Edwards, 2010). Descriptive statistics were used to evaluate each variable. The results show that all versions of GDS are excellent instruments of screening for major depression across all patient groups, and shorter forms of GDS can be used to screen patients with cognitive impairments, to save clinical time (Lach, Chang & Edwards, 2010).

Given the impact of depression on the efficiency and quality of life in geriatric patients, screening for depression in older adults is of critical importance for their health and well-being. The study by Lach, Chang and Edwards (2010) adds to the current state of nursing evidence and provides nursing professionals with the new ways of screening older adults with cognitive impairments. That GDS scores were compared with the clinical diagnosis against DSM-IV-TR criteria makes the study results even more relevant, reliable, and justified. Yet, the study design was not without its problems. The most serious issue was in that the clinicians and nursing professionals making the diagnosis were not fully blinded to the GDS scores in patients (Lach, Chang & Edwards, 2010). Furthermore, the GDS forms were completed at home, and it is impossible to define how often family members and other informants interfered with the process of completing the forms by the research participants (Lach, Chang & Edwards, 2010). The results of the discussed research lay the foundation for the development of more effective and unbiased research frameworks: the evidence provided by Lach, Chang and Edwards (2010) suggests but does not confirm that patients with dementia may have insight needed to use self-reported forms in depression screening. The researchers will need to ensure that clinicians do not have access to the GDS scores and forms filled out by the patients. Also, future research participants will need to complete the forms in clinical environments, where clinicians and nurses can monitor the process. In this way, researchers will be able to prove the relevance and provide more reliable evidence, to support and encourage the use of self-reported screening forms in older adults with cognitive impairments.

References

Lach, H.W., Chang, Y.P. & Edwards, D. (2010). Can older adults with dementia accurately report depression using brief forms? Journal of Gerontological Nursing, 36, 5, 30-38.