Pamela Nassisi

Publications (5)7.47 Total impact

• Article: A randomized trial of depression assessment intervention in home health care.

  Martha L Bruce, Ellen L Brown, Patrick J Raue, Amy E Mlodzianowski, Barnett S Meyers, Andrew C Leon, Moonseong Heo, Amy L Byers, Rebecca L Greenberg, Susan Rinder, Wendy Katt, Pamela Nassisi
  [show abstract] [hide abstract]
  ABSTRACT: To determine whether an educational intervention would improve depression assessment and appropriate referral. Secondary analyses tested whether referral led to depression improvement. Training in the Assessment of Depression (TRIAD) was a three-group, nurse-randomized trial. Researchers interviewed randomly selected patients at baseline and 8 weeks. Three certified home healthcare agencies in Westchester County, New York. Fifty-three medical/surgical nurses were randomized within agency to three intervention groups: full, minimal, or control. Research contact with nurses' patients (aged >65; N=477) yielded 256 (53.7%) enrolled subjects, 84 (17.6%) ineligibles, and 120 (25.2%) refusals; 233 of the 256 (87.1%) enrolled patients completed follow-up interviews. Nurse training in clinically meaningful use of depression sections of Medicare's mandatory Outcome and Assessment Information Set (OASIS). Nurse-assessed mood or anhedonia (OASIS) versus research assessments using the Structured Clinical Interview for Axis I Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Disorders (SCID); referrals for mental health evaluation (agency records), and depression severity (24-item Hamilton Depression Rating Scale; HDRS). Referral rates for patients with (SCID) depressed mood or anhedonia (n=75) varied according to nurse group: 50.0% full intervention, 18.5% minimal, 21.4% control (P=.047). Rates for nondepressed patients (n=180) did not differ (4.9%, 2.0%, 5.8%, respectively; P=.60). In patients with major or minor depression (n=37), referral was associated with symptom improvement. Change in HDRS was 5 points greater in referred patients than others (P=.04). Concordance between OASIS and SCID did not differ between intervention groups. TRIAD showed that training nurses to assess for depression using an approach developed in partnership with home healthcare agencies led to appropriate referral and care for depressed patients.
  Journal of the American Geriatrics Society 11/2007; 55(11):1793-800. · 3.74 Impact Factor
• Article: An agency-university research partnership: focus on late-life depression.

  Ellen L Brown, Martha L Bruce, Pamela Nassisi, Wendy Katt, Susan Rinder
  [show abstract] [hide abstract]
  ABSTRACT: Does anyone working in home care have the time to do one more thing? We would think most clinicians, administrators, educators, and quality improvement coordinators would answer "NO." This article provides a current example of what happened when three Medicare-certified home health agencies answered "YES" to a research partnership dedicated to addressing the unique challenges of enhancing late-life depression treatment and outcomes in the home care setting. The development of an ongoing home care agency-university partnership is described to stimulate other agencies to consider this type of research collaboration.
  Home Healthcare Nurse 10/2004; 22(9):597-600.
• Article: How Well Do Clinicians Recognize Depression in Home Care Patients?

  ELLEN L. BROWN, MARTHA L. BRUCE, PATRICK J. RAUE, PAMELA NASSISI
  [show abstract] [hide abstract]
  ABSTRACT: This article summarizes a study published in the Journal of the American Geriatric Society (2004) that evaluated the accuracy of home care nurses' ratings of two OASIS items: depressed mood (MO590-1) and diminished interest in most activities (MO600-2, optional OASIS item as of December 2002). In comparison to research diagnostic interviews, nurses underidentified OASIS depression items. The clinical implications for these findings are discussed.
  Home Healthcare Nurse. 07/2004; 22(8):569-571.
• Article: Recognition of late-life depression in home care: accuracy of the outcome and assessment information set.

  Ellen L Brown, Martha L Bruce, Gail J McAvay, Patrick J Raue, Mark S Lachs, Pamela Nassisi
  [show abstract] [hide abstract]
  ABSTRACT: This study evaluated the accuracy of home care nurses' ratings of the Outcome and Assessment Information Set (OASIS) depression items. The accuracy of home care nurses' depression assessments was studied by comparing nurse ratings of OASIS depression items with a research diagnostic assessment based on the Structured Clinical Interview for Axis I Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). The setting for this study was a nonprofit, Medicare-certified, voluntary home healthcare agency. Sixty-four home care nurses assessed 220 patients aged 65 and older with the OASIS upon admission. Of the 220 patients, using standard SCID criteria, 35 cases of major or minor depression were identified. The home care nurses accurately documented the presence of depression in 13 of 35 cases (sensitivity=37.1%; positive predictive value=0.56). Of the 220 patients, 185 had no SCID-identified major or minor depression. The nurses agreed on the absence of depression in 175 of 185 cases (specificity=94.6%; negative predictive value=88.8%). This study indicates that home care nurses often do not accurately rate OASIS depression items for older adult patients.
  Journal of the American Geriatrics Society 07/2004; 52(6):995-9. · 3.74 Impact Factor
• Article: Increasing Recognition and Referral of the Depressed Elderly

  Ellen L. Brown, Patrick J. Raue, Pamela Nassisi, Martha L. Bruce
  [show abstract] [hide abstract]
  ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
  Home Healthcare Nurse 08/2001; 19(9):558-564.