A cognitive model for assessing depression and providing nursing interventions in cardiac intensive care

Depression is an emotion experienced by each individual as some point in his or her lifetime. For some, the feelings are temporary, such as when one feels momentarily let down. For others, the feelings are deeper and may last for longer periods of time. Deeper and longer lasting depression may occur when individuals are confronted by certain unfavourable types of life situations such as a major physiological loss. For a once healthy individual, the depression associated with a physiological loss has penetrated through the individual's prior coping process and defences. Depression is a particularly common problem in individuals with a medical illness (Cavanaugh 1983). Heart disease is often experienced as a major loss for patients. Reports of depression in patients with coronary artery disease have ranged from 18% to 60% (Clark 1990). A broad range of physical disorders are commonly associated with depression. Among the most prominent disorders is congestive heart failure (Buckwater & Babich 1990). For depressed congestive heart failure (CHF) patients, a critical care nurse needs to assess the factors contributing to depression and recognise behaviours reflective of depression to be able to make appropriate nursing diagnoses and devise a plan to manage the patient's depression. To help critical care nurses accomplish this goal, this article contains an examination of depression as it applies to CHF patients according to Beck's cognitive triad (Ulerman et al 1984).