The Activities on these Portfolio Pages correspond with the learning objectives of the Guided Learning unit published in Nursing Times 106: 31 (10 August, 2010) and 106: 32 (17 August, 2010). The full reference list for this unit follows Activity 4.

Before starting to work through these Activities, save this document onto your computer, then print the completed work for your professional portfolio. Alternatively, simply print the pages if you prefer to work on paper, using extra sheets as necessary.

Recording your continuing professional education
To make your work count as part of your five days’ CPD for each registration period, make a note in the box below of the date and the total number of hours you spent on reading the unit and any other relevant material, and working through the Activities.

| | |
|Hours: |Date: |

|ACTIVITY 1 |

Learning objective: Know the procedures involved in the screening and assessment of depression and understand nurses’ role in this process.

Activity: Describe how you would assess for depression in your clinical area.

• What would your initial screening questions be? • If one or both of the screening questions are positive, what is the procedure for further assessment in your practice area? If a more detailed assessment beyond the remit of your service is required, identify how you would access the appropriate resources. • How might a person’s cultural background influence the assessment and identification of depression? • If a person described chronic sleep disturbance with early morning wakening and loss of energy, consider how these symptoms might impact on their activities of daily living. What questions might you ask to assess the extent of any disruption? How might you be able to monitor this on an ongoing basis?

|RESPONSE |

Begin your response here.

|ACTIVITY 2 |

Learning objective: Identify the initial interventions recommended for persistent subthreshold depressive symptoms and mild to moderate depression.

Activity: Consider the following vignette:

Mr C is 35 and has recently presented with symptoms consistent with mild depression. At a review meeting a fortnight after his initial presentation, his symptoms have persisted and he has asked for help in treating this depressive episode. He had a moderate depressive episode five years ago.

• What psychosocial interventions would be indicated for Mr C in this instance? • What might your role be in terms of improving compliance and helping to deliver an appropriate intervention? • Should an antidepressant be considered for this current episode? Under which circumstances (if any) should an antidepressant be considered for persistent subthreshold or mild depression?

|rESPONSE |

Begin your response here.

|ACTIVITY 3 |

Learning objective: Be familiar with the treatments available for moderate to severe depression.

Activity: Miss D is 25 and has been diagnosed with a moderate depressive episode. She is considering taking an SSRI antidepressant and has approached you to discuss this.

• What points should you raise with Miss D before starting antidepressant treatment? What is the potential benefit of raising these points? • Three weeks into treatment Miss D reports no improvement in her depressive symptoms. How would you respond and why? • If Miss D decides not to take an antidepressant, what alternative treatments could she consider?

|RESPONSE