Name
Chamberlain University
NR-715: Scientific Underpinnings
Prof. Name
Date
Doctor of Nursing Practice (DNP)-prepared nurses are uniquely equipped to address the global demand for advancing nursing practice and improving public health outcomes. Their doctoral training positions them as leaders who not only implement but also evaluate evidence-based practices. In this context, the doctoral student accessed the Chamberlain University Library to select a population health topic and analyze peer-reviewed studies for evidence-based interventions.
The process began with abstract screening, followed by detailed reviews of relevant studies. The purpose was to extract and synthesize major findings from both quantitative and qualitative research. Through this synthesis, recurring themes and patterns were identified, compared, and contrasted to evaluate their implications for clinical practice and health policy.
For this assignment, three peer-reviewed studies were examined:
Cheruvu & Chiyaka (2019): Relationship between healthcare costs and delayed treatment for depression among older adults.
Griffiths et al. (2021): Patient experiences with ketamine infusion therapy for treatment-resistant depression.
Pokhrel, Khadayat, & Tulachan (2020): Prevalence of depression, anxiety, and burnout among medical students in Nepal.
Together, these studies highlight that depression transcends demographic, social, and geographic boundaries. They emphasize the urgent need for affordable, accessible, and innovative interventions to reduce the burden of mental illness worldwide.
Cheruvu and Chiyaka (2019) identified depression in older adults as a significant and growing public health issue. Their quantitative, cross-sectional study, published in BMC Geriatrics, analyzed Behavioral Risk Factor Surveillance System (BRFSS) data from 24,810 individuals aged 65 and older.
The findings revealed a clear association between delayed depression treatment and financial barriers, particularly out-of-pocket medical costs. This indicates that economic challenges remain a critical obstacle to accessing mental health care. Although the study relied on self-reported data—which may introduce recall or reporting bias—the evidence remains compelling.
The authors recommended that policymakers and healthcare leaders implement strategies to minimize cost-related obstacles. By addressing financial barriers, especially among vulnerable populations with chronic conditions, mental health access can be significantly improved.
Griffiths et al. (2021) conducted a qualitative study to explore the lived experiences of patients receiving ketamine infusion therapy for treatment-resistant depression. The study, published in the Journal of Affective Disorders Reports, included semi-structured interviews with 13 participants who had completed at least three ketamine sessions.
Patients described severe depressive symptoms before treatment, including hopelessness, suicidal ideation, cognitive impairments, and persistent anxiety. For many, ketamine infusion was considered a last resort after traditional therapies failed.
Findings revealed that ketamine infusion resulted in noticeable improvements: reduced suicidal thoughts, improved mood, and in some cases, restored ability to work or engage in daily life. Although the small sample size limits generalizability, the study emphasized the value of integrating patient experiences into treatment planning. This highlights ketamine’s potential as a promising, cost-effective therapeutic alternative for severe depression.
Pokhrel, Khadayat, and Tulachan (2020) investigated the prevalence of psychological distress among medical students in Nepal. Their cross-sectional survey of 651 participants, published in BMC Psychiatry, demonstrated high levels of depression, anxiety, and burnout.
Students attributed stress to demanding coursework, long academic timelines, financial strain, and patient-care responsibilities. Many reported feelings of emotional exhaustion and disconnection, raising concerns about their mental well-being and long-term career sustainability.
The authors acknowledged the limitation of not including formal diagnostic tools, but their findings still provide essential insight into the mental health struggles of future healthcare providers. They stressed the importance of early interventions, wellness programs, and institution-driven mental health initiatives to mitigate burnout and improve student resilience.
The three studies (Cheruvu & Chiyaka, 2019; Griffiths et al., 2021; Pokhrel et al., 2020) collectively emphasize depression as a pervasive public health challenge.
All highlighted barriers to mental health care or the negative outcomes of untreated depression.
Each emphasized the urgent need for interventions tailored to specific populations—older adults, treatment-resistant patients, and medical students.
Findings reinforced the universal nature of depression, illustrating its widespread impact regardless of age, geography, or profession.
Cheruvu & Chiyaka (2019): Focused on economic barriers to treatment for older adults.
Griffiths et al. (2021): Highlighted patient experiences with an innovative therapeutic option (ketamine).
Pokhrel et al. (2020): Identified academic and professional burnout as precursors to depression among medical students.
| Study | Design/Method | Population | Key Findings | Limitations | Implications |
|---|---|---|---|---|---|
| Cheruvu & Chiyaka (2019) | Quantitative, cross-sectional (BRFSS survey) | 24,810 older adults (65+) | Financial barriers delayed or prevented depression treatment | Reliance on self-reported data | Highlights policy needs to reduce cost barriers and expand access |
| Griffiths et al. (2021) | Qualitative, semi-structured interviews | 13 adults with treatment-resistant depression | Ketamine infusion improved mood, reduced suicidal thoughts, and enhanced daily functioning | Small sample size | Suggests ketamine as a viable and affordable treatment option |
| Pokhrel et al. (2020) | Quantitative, cross-sectional survey | 651 medical students in Nepal | High prevalence of depression, anxiety, and burnout | Lack of formal diagnostic assessments | Calls for institutional reforms, early interventions, and student wellness programs |
The synthesis of these three studies illustrates the multifaceted challenges of addressing depression across diverse populations. Financial barriers, treatment resistance, and academic pressures are significant contributors to mental health disparities.
These findings underscore the necessity of multi-level strategies:
Policy advocacy to reduce financial obstacles.
Innovative treatments such as ketamine infusion for severe depression.
Institutional reforms to support medical students’ mental health.
Ultimately, this synthesis demonstrates that depression is not confined to one group—it is a universal public health issue requiring comprehensive, culturally sensitive, and accessible solutions.
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
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
