Depression (Major Depressive Disorder)

Provide ongoing discussion and drafts of work For examples of projects broken down by chapter, see Project Examples at https://repository.usfca.edu/dnp/; notice that all projects do not use the same format for headings or organizing the contents of the chapters. You will need to apply these examples to the format and structure required. Your chapters will continue to develop throughout your project however at this stage the majority of the work should be in Chapter 2 of the literature review. This week provide the latest work you have done to develop all three chapters with a focus on Depression (Major Depressive Disorder)

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Conceptual Framework for Chapter 2.

What theoretical models/perspectives inform your project?  This is an opportunity to justify the theoretical model you have chosen for your project.  Describe how the theoretical foundation applies to the problem under study.  This section supports the constructs (conceptual framework) related to the project.  This section addresses the importance of the topical area or field of study.  This section may further discuss the history of the topic and its theoretical underpinnings according to the literature.  Additionally, this section may address the methodology employed in the study.  Some suggested areas for discussion follow here.  Each area addresses what the literature revealed concerning the particular area.

Scope and Importance of [Topical Area or Field of Study]

Theoretical Frameworks of [Topical Area or Field of Study]

History of [Topical Area or Field of Study]

[Name} Theory

Abstract

In 2010, depressive disorders were ranked as the second main causes of disabilities around the entire world. Depression is considered to be the third highest disease burden globally in relation to the associated strokes and suicidal deaths. In comparison to men, epidemiological data reports incidence of depression in females was 1.7 times higher, (Van Grieken et al. 2018). Finding ways to improve patient functioning and, reduce healthcare cost for patients with depression can be achieved with the appropriate self-management tools and strategies.

Impaired social functioning is a characteristics of depression, (Ladegaard et al., 2016). Individuals with depression often reports having difficult relationships, and less satisfying social lives, (Ladegaard et al., 2016). Encouraging the use of self-help tools at the onset of psychological distress in depressed women and even after remission may improve social cognition and functioning. Together with pharmacological treatment and psychotherapy, self-help tools could be an important part to addressing this health problem.

(An additional paragraph was added this week to explain reasons for embedding self-help tools in treatment plans for depressed women. This will be discussed further in the study and will make the case for self-help tools to be a standard of care).

Introduction

Depression is considered to be the third highest disease burden globally in relation to the associated strokes and suicidal deaths. In comparison to men, epidemiological data reports incidence of depression in females was 1.7 times higher, (Van Grieken et al. 2018). Biological, psychological, and environmental factors are associated with an increased risk of depression, (IOM, 1997). For women, abuse, heredity, and socioeconomic burdens are known to cause mentally disturbing consequences which could result in depression.

This project gives participants, depressed women strategies that encourage self-management during acute and past the point of symptom remission. Interactions and assessments conducted by providers with participants will provide opportunities to identify, develop and promote treatment plans with self-help techniques that can be utilized throughout the intervention. This will allow patients to recognize how cognitive and emotional functioning affects their behavior. A skills-oriented approach may be relevant in treating depressed patients, (Ladegaard et al., 2016). (A paragraph emphasizing the reason for the research and goals were added).

Background

There is a high prevalence of major depression among women which is connected to biological and socioeconomic factors. Abuse of women along with violence and sexual abuse, poverty, low education and illiteracy and insufficient income to sustain households, increased sensitivity to interpersonal relationships makes women vulnerable to depression. Furthermore, certain cases of depression are linked to ovarian hormonal changes which cause anxiety, postmenopausal depression, postpartum depression, and premenstrual dysphoric disorder (Sadeghi et al. 2019). Domestic violence is associated with physical, sexual, or emotional harassment and harm by persons within the domestic circle of the victim.Depression (Major Depressive Disorder)

Problem Statement

Negative thoughts could lead to depression. When this occurs, there is often an increase in stress, lack of sleep, poor diet, non-compliance with medication regimen or if drugs or alcohol is involved. In many cases, medication alone is not enough to help patients recover and remain compliant with their treatment plan. It is evident that major depression disproportionately affects more women than men thereby creating a need for an intervention approach targeted at women. Consequently, Depression and depressive symptoms are also associated with physical complaints that will often lead to the access of health care services.

Evidence-Based Practice Model

The management of major depression in women can be done using both pharmacological and psychotherapeutic approaches. The goal would be to boost existing interventions through the use of a self-monitoring/self-help tools. Tracking habits, offering wellness goals, engaging in workouts, finding ways to improve sleep, nutrition suggestions and fluid monitoring could help patients achieve their goals, (Biesheuvel-Leliefeld et al., 2017).

Spirit of Inquiry

Current treatments are known to improve self-care, and these treatments support patients with developing essential life skills to avoid worsening depression and hospitalization. However, non-compliance, inappropriate prescribing, lack of education, not recognizing suicide risk will likely lead to ineffective care, functional impairment, and an increase in hospitalizations and suicide by depressed patients has been seen.

 Identified Issue

A diverse mix of biological, psychosocial, and environmental factors are associated with increased risk for depression (IOM, 1997). Medications are not enough to reduce depression in some cases. More needs to be done to reduce relapse and recurrence. Social cognitive impairments can be improved with psychotherapeutic interventions and with other measures like self-regulation, self-efficacy and, social support.

Specifics of the Clinical Problem

The concern is that major depression disproportionately affects more women than men thereby creating a need for an intervention approach targeted at women. A review of this problem reveals that women are vulnerable because of the social disadvantages they face to include sexual abuse and domestic violence (Sadeghi et al. 2019). Abuse, biological factors, and socioeconomic factors are known to cause mentally disturbing consequences for women which could result in depression.

Clinical Question

There is an abundance of information available that shows self-help tools are useful in a patient’s ultimate remission and, recovery. In order to understand the underlying factors that are associated with social cognition and symptomatic depressed patients, this PICOT question was asked. In women with Major Depression (P), how does a daily self-help tool (I) compared to medication management (C) alone affect the patient’s recovery (O)? (Additional sentences to were included this week to underscore the connection of the PICO Question with the Social Cognitive Theory).

Significance of Problem

When negative thoughts occur, there can be an increase in stress levels, lack of sleep, poor diet, non-compliance with medication regimen or if drugs or alcohol is involved. Finding solutions to maintain both physical and mental wellbeing is aimed at improving self-care, learning essential life skills that replace negative thoughts that often leads to depression.

Purpose Statement

The purpose of this quantitative, cross-sectional, descriptive project study is to discover the efficacy of self-help tools to maintain both physical and mental wellbeing of depressed patients. If self-help tools become standardized, people at greater risks of experiencing depression or those with past depression episodes to avoid occurrence, recurrence, or regression of major depression. This research project seeks to boost the use of existing interventions by increasing the use a self-monitoring/self-management tools.

Proposed DNP Essentials

Scientific Underpinnings for Practice

Major depression issues can be solved when the members interact with the surrounding while using the best integration methods that includes psychological and biophysical science. Through the application of science-based concepts will enable women to overcome some of the drawbacks that affect their moods in comparison to medication.

Organizational and Systems Leadership for Quality Improvement

Women suffering from depression are physically and emotionally affected. This calls for researchers to do develop clinical practices and guidelines that are placed to design evidence-based practices that will determine patient’s outcome by lowering the level of stigmatization. Healthcare leaders in various clinical settings will be expected to support providers and patients by ensuring consistent use of self-management strategies and incorporating self-help tools for self-help in treatment plans for depressed patients to improve care self-care and develop life skills which could reduce negative thoughts and prevent relapse. Having a self-help-tool included in the care of depressed women would be similar to the depression screening that is now a standard part of our mental health assessment.Depression (Major Depressive Disorder)

Clinical Scholarship and Analytical Methods for Evidence-Based Practice

The applicability will be to women with depression using well-thought ideas with the enhancement of modern health care plans. The medical staff can offer quality healthcare as well as maintaining ethical dilemmas. For instance, a depressed patient, in this case, need to be approached with care to avoid the notion that use of antidepressant is irrelevant. Therefore, the patient needs to be educated within the recommended measures. Addressing the underlying causes of the illness and finding ways to reduce the chance of relapse by promoting the use of a daily self-care tool.

Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care

Health field activities are now linked to current technologies. Researchers can now apply technological advancement to help minimize altered their moods. Using daily self-help tools allows patients with major depressive disorder patient to invest in themselves.  Patients will be encouraged to use the latest technology to track their moods, log their moods, sleep, and activities each day to determine their mental and emotional health before their symptoms become unmanageable. Promoting the use of a daily self-care tools through the use of apps, social media videos and websites could help to permanently modify habits and change the entire lifestyle of an individual thus providing a permanent solution to major depression in women. (More was added to this section to highlight the use of technology and social media to support behavioral change.)

Health Care Policy for Advocacy in Health Care

The researcher and medical staff will campaign fully for safeguarding healthcare policies put in place in the healthcare delivery system while advocating for social justices for depressed patients and for the profession with the installation of self-help tools that act as complementary in the treatment of mood issues among women. Standardization of daily self-care tool will permanently modify habits and change the entire lifestyle of individuals thus providing a permanent solution to major depression in women.

Inter-Professional Collaboration for Improving Patient and Population Health Outcomes

Patient and population health outcome is boosted by formulating a well-structured team that is equipped with are requirements that ensure wellbeing for the patients. Patients should be approached with adequate communication strategies that will enable staff to explain all treatment possibilities to ensure the patient chooses the best treatment therapies such as self-monitoring plans as well as changing their lifestyles.

Clinical Prevention and Population Health for Improving the Nation’s Health

This element allows practitioners to offer services to patients while interpreting occupational, epidemiological, environmental biostatistical information to patients as well as the community at large. This also enables doctors to synthesize the psychosocial dimension and cultural impacts that put patient health at stake. The goal will be to have more clinicians offer or recommend the appropriate self-help tools for their patients in combination with medication management to their patients. Having this intervention become standardized like the depression screen, Woooely-2 and PHQ9 as part of every depressed patients’ treatment plan is expected to allow patients to have a longer-term recovery.Depression (Major Depressive Disorder)

Advanced Nursing Practice

Nurses and doctors attending to depressed women in the community will engage in engage critical thinking and offer evidence-based care services since every patient case is different from the other. The DNP project, and the study of women with depression in the community will consider all cultural beliefs and personal beliefs to avoid resistance from the drugs.

Chapter Two

The common definition of depression is that it is the result of dynamic interactions of

environmental and biological risk factors. However, the contemporary conceptualization of depression has been distorted by the media to convince individuals that it is merely a “chemical imbalance” that needs to be addressed by taking drugs in order to “restore the imbalance” (Duggal, 2019). This has resulted in a misconception that antidepressant medications are the only form of treatment for major depression. The fact, however, is that the response rate for antidepressants is estimated to be fifty-four percent and that for placebo is around thirty-seven percent (Duggal, 2019). The relapse rate, often known to be the target for antidepressants, also poses a startling image, with just thirty-seven percent of individuals with major depression remitting after the first antidepressant trial and corresponding remission rates are much lower,

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 with subsequent treatment approaches.

This does not mean that antidepressant medication is not an efficient approach for managing depression and that patients should stop taking medication or stop seeking medical help. However, it demonstrates that medications alone can never treat depression. Therefore, a daily self-help tool is needed to complement medication management to manage depression by bolstering the patient’s mood. The most significant components of a daily self-help tool include information (educating oneself and family about depression), symptom management (self-monitoring of symptoms), and lifestyle (exercise and leisure activities), and communication (communication strategies and assertiveness), (Duggal, 2019).

Literature Review

A literature review was conducted primarily through the Aspen University library for background, theoretical foundations, and key themes on Cochrane and, ProQuest databases. These key words were utilized in the search: effectiveness of self-help tools for depression, self-management strategies to improve mood, daily self-help tools. women and depression.

Interventional Strategies. In a randomized control trial (RCT), Sadeghi et al., (2019) the conceptual framework known as the theory of emotion to implement mindfulness-based emotional self-help as an intervention for women since they are more are vulnerable and experience psychological problems caused by social disadvantages, sexual abuse, and domestic violence. A significant decrease in anxiety, depression and stress was seen participants in the mindfulness experimental group, (Sadeghi et al., 2019).

Effective Self-Management Strategies. In a Retrospective study, van Grieken et al, (2018) explored self-management strategies to help patients participate in their care and recovery. from depression. Participants in this study who used a daily self-help tool group performed better than those in the medication management group. The data clearly shows self-help tools have been proven to maintain both physical and mental well-being.

Self-Help Tools for Longer Term Solutions. In a randomized controlled trial in primary the results indicated that although medication is effective, the daily self-help tool is more effective since it addresses the root cause of the depression and presents a longer-term solution with fewer concerns.  Self-help tools are known to improve self-care, and they are able to help depressed patients develop essential life skills to avoid worsening depression and hospitalization.Depression (Major Depressive Disorder)

Conceptual Framework

Theoretical Framework

The Social cognitive theory (SCT) that was developed by Albert Bandura provides a good framework to guide this research. This theory helps to inspire change by improving an individual’s self-efficacy in combination with individual and environmental-level characteristics (Schunk & DiBenedetto, 2020). Bandura suggested that interactions between behaviors, thoughts, and the environment shape people. Therefore, human behavior is largely an outcome of learning which can occur through direct experiences and observations.

Bandura also highlighted in the SCT theory that, the self-concepts of individuals with depression differ totally with those of individuals without depression. Depressed people take responsibility for bad occurrences and are full of blame in their lives. In comparison, successes are only considered as being caused by external factors beyond an individual’s control (Schunk & DiBenedetto, 2020). Moreover, depressed people strongly believe that they cannot influence their situations through self-efficacy. Due to flawed judgmental processes; they set high personal goals and then fail to attain them. Repeated failure will likely decrease their self-esteem and self-belief to change anything which often results in depression.

Scope and Application

A significant   psychological concept that is directly associated with self-efficacy in Bandura’s idea is the locus of control such that, when an individual strongly believes that he/she can change and affect his/her situation, he/she is termed to have an internal locus of control, and a high-self efficacy. On the contrary, when an individual feels that he/she is completely at the mercy of the environment and cannot alter their situation, they possess an external locus of control which is characterized by a low self-efficacy sense.

The social cognitive theory has predicted that, the uptake of new resources/tools by patients and healthcare providers can promote early recovery in Major Depressive Disorder (MDD). Therefore, these self-help tools should primarily focus on, increasing knowledge and awareness by utilizing knowledge on an individual’s behavior, environmental interaction, and personal factors (Moeini et al., 2019). Besides, adopting a theoretical framework to promote change in behavior during the designation, implementation, and evaluation of self-help tools can help to define, promote, and explain change. According to Tak et al., (2017), this can be attained through the SCT constructs of self-efficacy, social support, outcome expectations, and goal setting.

According to SCT, the most immediate antecedents to MDD are behavioral performance and intentions to perform a behavior such as using a self-help tool. These tools also promote significant change in a person’s health seeking behavior, decrease the barriers to accessing mental healthcare services, an increase the presumed value in mental health care. In primary care settings, users experience a decrease in comorbid symptoms of anxiety and are less likely to meet the criteria for MDD with continued use.Depression (Major Depressive Disorder)

Summary

(In the practice setting this week, nine charts of three providers were reviewed. It was discovered that the providers suggested the use of self-help tools to most of their clients at least one time. Only one provider out of three suggested the use of a self-help tool two times. The only patient that was not told about a self-help tool, did not return for any of her other scheduled appointments after three visits. This demonstrates the need for new protocols. The self-help tool is evidence -based. It will help to promote better practice protocols and be educational for patients. This section makes the case for implementing the behavioral intervention using the Social Cognitive theoretical framework).

The Social Cognitive Behavioral theory is commonly used to develop behavioral intervention strategies. Utilizing this theoretical approach will help to identify causative factors and connections to casual factors and this will provide the framework for this researcher. Personal factors, environmental factors and an individual’s behavior are associated with specific behaviors. The Social Cognitive Behavioral theory can be paired with behavioral interventions strategies that promote Self-regulation, Self-Efficacy and Social Support. The proposed research study will translate the constructs of the Social Cognitive Behavioral theory into practice. Customizing self-help tools for will require interventions strategies to have providers include it in their treatment plan and promote its use consistently.

According to Ladegaard et al., (2016) most studies examine lower order social cognition in the acutely depressed individuals but there are limited studies on the trajectory of intermediate and higher-order social cognition in patients moving from the acute state to full symptomatic remission. Social Cognition will be the framework that will be used to identify self-help tools that will provide mental activities for learning and problem solving. Social cognitive abilities are in a spectrum that ranges from lower order to intermediate to higher order activities. the point of remission and social cognition

In conclusion, the eight of the AACN \’s- Essentials of Doctoral Education can be synthesized into the DNP Project primarily to safeguard patient’s health. More so, the element offers guidelines that enforce quality healthcare to the patients as provided by health care providers.

 Chapter 3:  Methodology

Major depression disproportionately affects more women than men thereby creating a need for an intervention approach targeted at women. Depression is different from other chronic illnesses due to the stigmatization assorted with it and the impact on identity and self-esteem. The key symptoms entail the loss of motivation, decreased interest, and reduced level of energy, and are much more severe than those of other health problems. Hence, it is disputable whether general self-help tools like those used in the Chronic Disease Self-Management Program (CDSMP) are pertinent to depression (Houle et al., 2013). Research also suggests that, provided the alternative of psychotherapy and medication, individuals with major depression will choose psychotherapy as they believe that it offers them a potential for personal interaction and to address the issue behind depression. Self-help also shows significance in the context of recovery. The idea of mental health recovery has broadened from the classical meaning of clinical symptoms absence to mood changes that includes feeling empowered, feeling connected to others, taking accountability for one’s life, development of personal significant objectives, the reestablishment of a positive identity, and hope for the future (Jorge-Monteiro & Ornelas, 2016).  Medication management of depression can enable a patient to reach the therapeutic cut-off for depression remission on rating scales but improving mood always will always be a patient-centered model. This is where a daily self-help tool assists in complementing the conventional treatment approach for depression.

Project Design

The purpose of this quantitative, cross-sectional, descriptive project study is to discover the efficacy of self-help tools to maintain both physical and mental wellbeing of depressed patients. A cross-sectional design will be a population-based survey that will be used needed as an observational study of women who are using a self-help tool to manage their depression. Assessing exposure and outcomes are strategies that are used in this type of research study to determine relationships and be able to design a cohort study, (Setia, 2016). This study design has been used for public health planning, monitoring and for evaluations, (Setia, 2016). Compared to cohort studies, it can be quicker and less expensive to conduct. Including quantitative research will ensure a systematic strategy to gather evidence and test the support for the framework. Since the study will be non-experimental is will also be considered to be descriptive. A descriptive design will be a way to record information by using a survey without manipulating variables in this self-selecting sampling design.Depression (Major Depressive Disorder)

Sample and Setting

The quantitative, descriptive, relational design will be non-experimental, cross-sectional that will attempt to determine the associative relationships between project variables and to explain cause and effect. A quantitative strategy will provide measurements using a descriptive survey. It will measure the strength and direction of association. Likert-Style descriptive survey question will be used to collect data for measurement.  Inclusion criteria for the study will be:

• Adult females eighteen years old and over
• Diagnosis of major depression for at least one year
• Self-management tool was used for more than ninety days.
• Current or former medication orders for depression
• Recovered with no medication and recurring exacerbations.

Exclusion Criteria would be:

• Diagnosis besides depression and anxiety
• Acute or chronic medical conditions that would limit participation.
• Refusal to give consent.

The setting will be a mental health clinic. Voluntary female patient participants will be recruited. Describe the setting where the study will take place.  If your study setting is a facility or organization, written permission must be obtained and attached as an appendix.  The adequacy of the location should be described included the support, services, costs, and other resources needed.  Sufficient detail regarding the setting should be provided for replication of your study or generalizations/inferences to target populations in similar settings.

Instrumentation

A questionnaire will be used for this quantitative research study. The presence or absence of positive mood changes with use of self-management strategies will be quantified and objectively measured.

Data Collection

Day-to-day data collection of depressed females’ responses to the use of a self- help tool or self-management strategies will be done after the questionnaire is uploaded to the EHR at the psychiatric clinic. The clinical preceptor has agreed to include the questionnaire in the EHR and a letter of approval will be requested.

Data Analysis Methods

A summary of the collected information will be interpreted and presented after testing the hypothesis. A numeric description of the data will be generated, (Simpson, 2015). A pie graph or bar graph, figures and descriptive statistics will be used.

Data Management Methods

An appropriate database management system and software tools that are secure will be selected. Proper planning and analysis of the of the data management tools and systems will be conducted before allowing patients to self-volunteer.

Ethical Considerations

The Belmont guidelines will be used to guide this quantitative descriptive cross-sectional project. The procedures for the protection of human participants should be stated.

Internal and External Validity

The instrument will be designed to measure improved mood changes from self-management. How well the instrument measures mood changes should have a context-validity index range from 0-1. Recovery of those using self-management strategies will be compared to those who do not. The valid instrument is expected to show patients who include a self-help tool as part of their daily routine will have better outcomes than those who take medication only. This instrument will also have sensitivity, specificity, and predictive values.Depression (Major Depressive Disorder)

Conclusion

Medication management of depression can enable a patient to reach the therapeutic cut-off for depression remission on rating scales but improving mood will always be a patient-centered model. This is where a daily self-help tool assists in complementing the conventional treatment approach for depression. In addition, self-help tools may be utilized as a prophylactic technique for people at greater risks of experiencing depression or those with past depression episodes to avoid occurrence, recurrence, or regression of major depression. Medication management of depression can enable a patient to reach the therapeutic cut-off for depression remission on rating scales but improving mood will always be a patient-centered model. This is where a daily self-help tool assists in complementing the conventional treatment approach for depression. In addition, self-help tools may be utilized as a prophylactic technique for people at greater risks of experiencing depression or those with past depression episodes to avoid occurrence, recurrence, or regression of major depression.

References

Albert, P. R. (2015). Why is depression more prevalent in women? Journal of psychiatry & neuroscience: JPN, 40(4), 219.

Biesheuvel-Leliefeld, K. E., et al., (2017). Effectiveness of supported self-help in recurrent depression: a randomized controlled trial in primary care. Psychotherapy and Psychosomatics, 86(4), 220-230.

Duggal, H. S. (2019). Self-Management of Depression: Beyond the Medical Model. The Permanente Journal, 23.

Houle, J., Gascon-Depatie, M., Bélanger-Dumontier, G., & Cardinal, C. (2013). Depression self-management support: a systematic review. Patient education and counseling, 91(3), 271-279.

IOM, (1997). Improving Health in the Community: A Role for performance Monitoring. National Academies Press.

Jorge-Monteiro, M. F., & Ornelas, J. H. (2016). Recovery Assessment Scale: Testing validity with Portuguese community-based mental health organization users. Psychological assessment, 28(3), e1.

Conceptual Framework

Theoretical Framework

The Social cognitive theory (SCT) that was developed by Albert Bandura provides a good framework to guide this research. This theory   helps to inspire change by improving an individual’s self-efficacy in combination with   individual and environmental-level characteristics (Schunk & DiBenedetto, 2020). Bandura suggested that interactions between behaviors, thoughts, and the environment shape people. Therefore, human behavior is largely   an outcome of learning which can occur through direct experiences and observations.

Bandura also highlighted in the SCT theory that, the self-concepts of individuals with depression differ totally with those of individuals without depression. Depressed   people take responsibility for bad occurrences and are full of blame in their lives. In comparison, successes are only considered as being caused by external factors beyond   an individual’s control (Schunk & DiBenedetto, 2020). Besides, depressed people strongly believe that they cannot influence their situations through self-efficacy .Due to flawed judgmental processes; they set high personal goals and fail to attain them. Repeated failure decreases their self-esteem and self-belief to change anything and results in depression.

Scope and Application

A significant   psychological concept that is directly associated   with self-efficacy   in Bandura’s idea is the locus of control such that, when an individual strongly believes that he/she can change  and affect his/her  situation, he/she is  termed to  have  an internal  locus of control  and a high-self efficacy. On the contrary, when an individual feels that he/she is completely at the mercy of the environment and cannot alter their situation, they possess an external locus of control which is characterized by a low self-efficacy sense.Depression (Major Depressive Disorder)

The social cognitive theory has predicted that, the uptake of new resources/tools by patients and healthcare providers can promote early recovery in MDD. However, these self-help tools should primarily focus on early identification, diagnosis and monitoring/follow-up of patients with depression, increasing knowledge and awareness by utilizing knowledge on an individual’s behavior, environmental interaction, and personal factors (Moeini et al., 2019). Besides, adopting a theoretical framework to promote change in behavior during the designation, implementation, and evaluation of self-help tools can help to define, promote, and explain change. According to Tak et al., (2017), this can be attained through the SCT constructs of self-efficacy, social support, outcome expectations, and goal setting.

. According to SCT, the most immediate antecedents to MDD are behavioral performance and intentions to perform a behavior such as using a self-help tool. These tools also promote significant change in a person’s health seeking behavior, decrease the barriers to accessing mental healthcare services, an increase the presumed value in mental health care. In primary care settings, users   experience a decrease in comorbid symptoms of anxiety and are less likely to meet the criteria for MDD. Since emotional and mental self-help tools can play an integral role in the management and prevention MDD, the SCT

References

Moeini, B., Bashirian, S., Soltanian, A. R., Ghaleiha, A., & Taheri, M. (2019). Examining the effectiveness of a web-based intervention for depressive symptoms in female adolescents: applying social cognitive theory. Journal of research in health sciences, 19(3), e00454.

Schunk, D. H., & DiBenedetto, M. K. (2020). Motivation and social cognitive theory. Contemporary Educational Psychology, 60, 101832.

Tak, Y. R., Brunwasser, S. M., Lichtwarck-Aschoff, A., & Engels, R. C. (2017). The Prospective Associations between Self-Efficacy and Depressive Symptoms from Early to Middle Adolescence: A Cross-Lagged Model. Journal of youth and adolescence, 46(4), 744–756. https://doi.org/10.1007/s10964-016-0614-z Depression (Major Depressive Disorder)