Date of Award

Spring 5-26-2018

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Michael Terry, DNP, APRN

Abstract

Purposes: To implement a mindfulness meditation program with Arabic speaking clients as an adjunctive treatment of depression

Background: Depression rates among Iraqi refugees are between 28.3 and 75% compared to 8.6% in the general population (Slewa-Younan, Guajardo, Heriseanu, & Hasan, 2015). Treatment options are limited at Neighborhood Healthcare in El Cajon due to budget limitations, cultural beliefs and language barriers, among other reasons. Individual therapy is intended to be a brief intervention due to limited staffing. Many middle eastern refugees decline group therapy due to stigma surrounding mental health treatment and concerns about privacy. Even though traditional treatment options are effective in many cases, there is also a gap in care. Numerous patients continue to exhibit significant depression with the current interventions in place. Mindfulness interventions are shown to have a medium to large effect size for the treatment of depression. In addition, mindfulness interventions are easy to teach and can be practiced by the patient independently.

Methods:The nurse practitioner met with six clients for individual sessions in order to teach clients how to meditate. Inclusion criteria are a Patient Health Questionnaire 9 (PHQ-9) score greater than 10 and primary language of Arabic. The nurse practitioner instructed clients regarding guided meditation and mindfulness. The patients had access to meditation tracks and were calls by clinic staff to encourage practice at home during the initiation of treatment. Quality of Life Scores (QoL) were measured at the first and last session. PHQ-9 scores were measured at all sessions.

Outcomes Achieved: Three of six patients completed the program with partial adherence to treatment. Patients experiences a 9% to 58% increase in QoL. One patient experienced an improvement in PHQ-9. Patients reports positive outcomes subjectively and planned to continue meditating.

Conclusions: Meditation is a treatment option already widely used in western cultures. Although meditative practices are used in some religious practices, most Middle Eastern patient have little exposure to meditation. Recently, resources for meditation in Arabic were developed in Australia and have already shown to be effective in the treatment of depression for people from the Middle (East South Eastern Sydney Local Health District, 2017).

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