Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2018


Doctor of Nursing Practice (DNP)

Primary Advisor

Cathie E. Guzzetta PhD., RN, FAAN; Kenneth J. Oja PhD, RN


Background: Screening for depression upon intake and completion of a Phase II cardiac rehabilitation (CR) program may influence the type of interventions implemented by CR staff and reduce depression.

Objectives: We examined patients before and after a Phase II CR program who self-reported as depressed using the CES-D score and also assessed scores by procedure, gender and age. We further identified the types of interventions used for those who were depressed.

Methods: We conducted a pre-post intervention study. Using a convenience sample, data were collected on CES-D scores before and after the program and by type of procedure, gender, and age from May 1, 2013 to April 30, 2017. We conducted independent and paired t-test and ANOVA analyses.

Results: Among 132 patients, 25 (19%) self-reported as depressed and most who were depressed patients had at least one intervention (n=22, 88%). For the total group, patients had significantly lower mean CES-D scores at the end of the CR program (6.87 ± 6.64) compared to scores before they started (8.79 ± 8.09, t=0.53; p=0.003). For only depressed patients, CES-D scores were also lower at the end versus the start of the program (p<.001). No differences were found in level of depression based on type of procedure, gender or age.

Conclusion: Interventions used by CR staff were effective in decreasing depression scores from intake to completion of a Phase II program. Our results and recommendations were reviewed and discussed with the stakeholders to improve and standardize depression interventions.

Open Access




To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.