Depression

Depression experienced post-operatively can be due to stress, hopelessness, helplessness, lack of support systems, chronic illness, chronic pain, palliative care diagnosis, extensive surgery,inadequate coping skills, separation from family, role changes or identity crisis.

To help alleviate depression seen in patients, the nurse can:

• Assess for feelings of hopelessness, isolation, anger, hostility, helplessness, and guilt/shame.

• Determine how the patient has previously coped with depression.

• Work with positive goals to affect change in attitude.

• Be non-judgmental and empathetic.

• Encourage interactions with others.

• Encourage appropriate expression of anger and hostility.

• Facilitate examination of stresses, present/past coping mechanisms — assist in planning alternatives.

• Involve patient in planning treatment goals and evaluating progress.

• Provide teaching that will prepare patient to deal with life stresses (relaxation, problem-solving skills, how to express feelings constructively).

• Recognize increase in risk (i.e. change in behaviour, verbal, nonverbal communication, withdrawal, signs of depression, decrease in sleep or appetite, hopelessness, helplessness, increase self-destructive thoughts of behaviours.

• Consult with Psychiatry, Social Work, CNS, Enterostomal Therapy nurses for additional support.

• If anti-depressant medication is prescribed, reassure patient it may take three to six weeks before differences in mood are noted.

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