Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 3, 2016
   Pages 335 — 344

Abstract — Implementation of a brief anxiety assessment and evaluation in a Department of Veterans Affairs geriatric primary care clinic

Christine E. Gould, PhD;1–2* Sherry A. Beaudreau, PhD, ABPP;2–3 Gail Gullickson, MD;1,4 J. Lisa Tenover, MD, PhD;1,4 Elizabeth A. Bauer, RN, MS, AGCNS-BC;1 J. W. Terri Huh, PhD, ABPP1–2

1Geriatric Research, Education and Clinical Center, Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA; 2Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA; 3Sierra Pacific Mental Illness Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA; and School of Psychology, University of Queensland, Brisbane, Australia; 4Department of Medicine, Stanford University School of Medicine, Stanford, CA

Abstract — Anxiety disorders are common and debilitating in older individuals, yet anxiety is often not formally assessed in primary care. We conducted a quality improvement project to examine the feasibility of implementing a brief anxiety assessment, the Geriatric Anxiety Inventory (GAI), in a Department of Veterans Affairs geriatric primary care clinic. We compared the GAI with a depression assessment, the 15-item Geriatric Depression Scale (GDS-15). Fifty older Veterans (mean age = 78.5 +/– 7.4 yr) completed the GAI and GDS-15. Mean completion time and feedback to patients was brief (6.20 min; n = 10). Good internal consistency (alpha = 0.82) was found for GAI scores. Patients with psychiatric diagnoses obtained significantly higher GAI scores (mean = 4.73 +/– 1.15) compared with patients without psychiatric diagnoses (mean = 1.15 +/– 1.86, t(11.46) = –3.10, p = 0.01). Findings suggest that the GAI is acceptable to patients but may not be suitable for differentiating anxiety symptoms or disorders from depression. Interdisciplinary team members continued to implement the GAI after project completion to screen for and track anxiety symptoms in our geriatric primary care patients. Detecting anxiety with the GAI had the benefit of allowing providers to initiate conversations about available treatments and track symptoms as part of noting treatment progress.

Key words: anxiety disorder, anxious, depression, mental health, older adults, program evaluation, psychiatric, quality improvement, screening, Veteran.


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This article and any supplementary material should be cited as follows:
Gould CE, Beaudreau SA, Gullickson G, Tenover JL, Bauer EA, Huh JW. Implementation of a brief anxiety assessment and evaluation in a Department of Veterans Affairs geriatric primary care clinic. J Rehabil Res Dev. 2016;53(3):335–44.
http://dx.doi.org/10.1682/JRRD.2014.10.0258
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