From the diary it obvious that Molly is looking at life from a negative aspect. This prompts the nurse to look in depth at her emotional feelings.
One of the following tools used is the pHQ-9, click here for more information.
Consider asking the following 2 questions to start an assessment of depression
- During the last month, have you often been bothered by feeling down, depressed or hopeless?
- During the last month have you often been bothered by having little interest or pleasure in doing things?
If Molly answers yes to EITHER identification questions, ask the following 3 questions
- During the last month have you often been bothered by feelings of worthlessness?
- During the last month have you often been bothered by poor concentration?
- During the last month have you often been bothered by thoughts of death?
Consider using a validated measure for further evaluation, PHQ-9
If Molly is assessed to be at risk of suicide or deliberate self-harm:
- take into account toxicity in overdose if an antidepressant is prescribed or if necessary, limit the amount of drug(s) available
- consider increasing the level of support, such as more frequent direct or telephone contacts
- consider referral to specialist mental health services
Life situations/relationships and practical problems
recently diagnosed with HF and ongoing physical problems
Altered thinking
‘My life is over’
Altered emotions
Depressed … low mood
Altered behaviour
withdrawn … not attending exercise classes
Altered physical symptoms
tired/lethargic
Page last reviewed: 28 Jul 2020
