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This version was published on October 1, 2008
Western Journal of Nursing Research, Vol. 30, No. 6, 653-672 (2008)
DOI: 10.1177/0193945907310643

Certified Nursing Assistants' Explanatory Models of Nursing Home Resident Depression

Mary Lynn Piven

University of North Carolina-Chapel Hill School of Nursing, piven{at}email.unc.edu

Ruth A. Anderson

Duke University School of Nursing

Cathleen S. Colón-Emeric

Duke University Medical Center

Margarete Sandelowski

University of North Carolina-Chapel Hill School of Nursing

In this study, the authors describe certified nursing assistants' (CNA) Explanatory Models (EMs) of depression and aspects of their EMs that may contribute to the underdetection of depression in nursing homes. Interviews with 18 CNAs working in two nursing homes are guided by Kleinman's Explanatory Models of Illness framework. Interview data are content analyzed and CNAs' descriptions of depression are compared to the MDS 2.0 Mood Screening criteria and to the DSM-IV-TR diagnostic criteria for depression. The result is that the CNAs are unsure about the duration and normalcy of depression in residents. Although they have no formal training, CNAs feel responsible for observing for signs of depression and describe verbal and nonverbal ways of interacting when providing emotional care to residents. CNAs hold potential to improve the detection of depression and contribute to the emotional care of residents. Attention to staff knowledge deficits and facility barriers may enhance this potential.

Key Words: psychiatric illness • clinical focus • depression • health behavior and symptom focus • nursing home • location of care • qualitative methods • gerontology • population focus


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