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Implementing PEARLS with Older Adults in the Nursing Home to Improve Depression Screening and Care
Massena, Kayla
Massena, Kayla
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Abstract
Purpose. Depression is common among nursing home residents and is often under-recognized due to inconsistent screening and limited use of evidence-based, non-pharmacologic interventions. The Program to Encourage Active, Rewarding Lives (PEARLS) is an evidence-based depression care model. This Doctor of Nursing Practice quality improvement project evaluated the feasibility and acceptability of implementing PEARLS and its impact on depression screening and depressive symptoms among cognitively intact residents.
Methods. This project was conducted over 18 weeks in a Vermont nursing home using a structured PEARLS implementation protocol. Eligible residents were identified through chart audit and screened using the Patient Health Questionnaire-9 (PHQ-9) and Brief-6 cognition screen. Participants completed six group-based PEARLS sessions. Outcomes included depression screening rates, enrollment and retention, PHQ-9 score changes, and participant satisfaction. Data were analyzed descriptively using within-participant comparisons.
Results. Depression screening rates increased from 52.4% to 85.7%, a 33.3% improvement. The mean absolute reduction in PHQ-9 score from baseline to post-intervention was 7.25 points, representing a 64.4% reduction in mean PHQ-9 scores. Retention was 100%. All participants (100%) demonstrated clinically meaningful improvement in depressive symptoms, defined as a reduction of five or more points on the PHQ-9.
Conclusions. PEARLS was feasible and acceptable in a nursing home setting and was associated with improved depression screening and reduced depressive symptoms. These findings support integrating structured, non-pharmacologic depression interventions into long-term care practice.
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2026-05-03
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Massena_DNP Project Manuscript_4.2.26.pdf
Adobe PDF, 1.04 MB
- Embargoed until 2027-05-01