Digital Commons Network^™

The Relationship Between Self-Reported Depressive Symptoms At 3 Timepoints And Infant Sleep Practices At 6-Month Follow-Up In A Population Of Mothers In Santo Domingo, Ecuador, Kassidy Lane

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Background

Previous studies have linked maternal depression with poor infant sleep (e.g., waking up at night and infants having trouble settling to sleep). This study examined the relationship between maternal depressive symptoms at three time points and safe infant sleep at 6-month follow-up.

Methods

Data was collected from a randomized clinical trial including 100 women recruited from a health center in Santo Domingo, Ecuador during their third trimester of pregnancy. Log-binomial regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of safe infant sleeping at 6 months among mothers who reported depressive symptoms at 3 …

Depression Management Among Primary Care Providers: Evaluation Of An Educational Intervention, Whitney Hunt

DNP Projects

Background: Nearly one-third of patients diagnosed with depression and prescribed an antidepressant medication will stop taking their medication within the first month. Timely follow-up care can improve medication adherence and symptoms for depressed patients on antidepressants however, most patients do not receive timely follow-up. Common system and provider-based barriers to timely follow-up include limited provider time, lack of training, and mental health stigma.

Objective: The purpose of this project was to assess provider attitudes, knowledge level, perceived barriers, and current depression management strategies in a primary care setting.

Methods: In this quasi-experimental one group pre/post-test study a survey was used …

Mental Health In The Courtroom: How Victim Mental Illness Impacts Juror Decision-Making In A Rape Case, Mary M. Levi

Theses and Dissertations--Psychology

The influence of mental illness on jury decision-making has rarely been investigated, and even fewer studies have examined how jurors perceive a victim with mental illness. The present study investigated the effect of victim mental illness on jury decision-making in a rape trial using a 3 (victim mental health status: schizophrenia, depression, no illness) x 2 (participant gender: female, male) between-subjects design. I hypothesized that mock jurors would render fewer guilty verdicts in the schizophrenia condition compared to the depression condition, and render fewer guilty verdicts in the schizophrenia and depression conditions compared to the control. I also hypothesized that …

Decreasing Anxiety, Depression, And Suicidal Ideation Through The Implementation Of Education And Screening At Chandler Medical Center, Ashley Gillstrap

DNP Projects

PURPOSE: To provide education on high suicide rates within the healthcare community, screen providers for suicide risk factors, and disseminate mental health resources at the University of Kentucky Chandler Medical Center (UKCMC). The goal of this intervention is to increase awareness and provide resources to providers to essentially decrease these suicide rates.

METHODS: A randomized controlled trial was used with a non-equivalent group pretest-posttest survey design to examine the effect of an education module about suicide risk factors. Along with a rating of how COVID-19 affected mental health, a Patient Health Questionnaire 9 (PHQ-9) was implemented, and mental health resources …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

Promotion Of Early Recognition Of Depression To Improve Health Related Quality Of Life In Pediatric Oncology Patients, Jennifer Blankenship

DNP Projects

Background: Depression and anxiety are serious complications of cancer and deemed a challenging diagnosis due to the symptoms of depression mimicking common side effects of chemotherapy and radiation. Signs/symptoms frequently are underrecognized thus appropriate treatment is delayed, compromising the health-related quality of life (HRQOL) for pediatric oncology patients.

Purpose: Analyze existing physician and Advanced Practice Provider (APP) clinical practice regarding depression, via a pre- and post-survey and educational PowerPoint on the use of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to promote early recognition of depression.

Methods: A prospective, single-arm, study was completed in the Kentucky Children’s …

An Examination Of Communication Sequencing In Enacted Support Interactions For People With Major Depressive Disorder, Madison Adams

Theses and Dissertations--Communication

Social support is integral to helping one manage Major Depressive Disorder [MDD], but enacted social support, or the supportive behavior itself, is not always beneficial. Using a normative theoretical perspective on social support and theory related to sequencing as guiding frameworks, in this thesis I examined common sequential patterns of enacted support between support providers and individuals with MDD. Moreover, I investigated how individuals with MDD evaluated the helpfulness of each of the different sequential patterns. To examine the sequential patterns and how individuals with MDD evaluated their helpfulness, I interviewed 20 participants who had been diagnosed with MDD. The …

The Outcomes Of Cope, A Cognitive Behavioral Therapy Program, In Patients Awaiting Lvad Implantation, Aaron G. Harris

DNP Projects

PURPOSE: The purpose of the Doctor of Nursing Practice (DNP) project was to pilot Creating Opportunities for Personal Empowerment (COPE), an evidence based cognitive behavioral therapy (CBT) intervention, with patients diagnosed with advanced heart failure who are awaiting Left Ventricular Assist Device (LVAD) implantation or those who have had one recently implanted before they are discharged home. METHODS: A cross-sectional study design was used for this Pilot project. Patients were identified for potential participation by LVAD coordinators and represent a convenience sample. The patients were screened for anxiety and depression using the GAD-7 and PHQ-9 screening tools. If patients scored …

Adhd-Internalizing Disorder Co-Occurrence In Childhood And Adolescence: Comparing Network And Latent Variable Conceptualizations, Patrick Kenneth Goh

Theses and Dissertations--Psychology

Co-occurrence of attention-deficit/hyperactivity disorder (ADHD) with depression or anxiety (i.e., internalizing disorders) is a major route to poor outcomes, with temperament traits presenting as potential shared risk markers that underlie these disorders’ development and characterization. Prior work investigating the nature of ADHD-internalizing disorder co-occurrence using structural equation modeling has provided support for both temperament-based common cause (i.e., effortful control and negative affect as liabilities for multiple disorders) and direct causation (i.e., ADHD directly contributing to risk for internalizing disorders) effects separately. Using a network approach, the current study represented the first attempt to integrate these effects into one model while …

Diabetes Locus Of Control And Depression In Older Adults With Type 1 And Type 2 Diabetes: The Study Of Longevity In Diabetes, Jahvona Pretty

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract:

Objective: To determine if diabetes locus of control (dLOC) is associated with depression in older adults with type 1 and type 2 diabetes and whether this association differs by diabetes type.

Methods: Data for the current study were obtained from The Study of Longevity in Diabetes (SOLID), a prospective cohort study of aging, and diabetes. SOLID participants aged 60 and older with type 1 diabetes (T1D), type 2 diabetes (T2D), and without diabetes were recruited from members of Kaiser Permanente Northern California (KPNC). For the current study, we excluded all of the participants without diabetes since the primary exposure, …

Race-Based Discrimination, Occupational Stress, And Depression In Black Registered Nurses, Arica A. Brandford

Theses and Dissertations--Nursing

The purpose of this dissertation was to examine depression, experiences of work-related racism, and occupational stress among black nurses. Nursing is a highly stressful and demanding profession that can negatively affect health. Underscoring this is the high rate of depression experienced by nurses. In fact, nurses experience depression at a rate twice that of individuals in other occupations. Examining depression in nurses can provide insights that can inform measures addressing the psychological health of this group. This may be particularly important in black nurses who, in addition to the already high occupational stress associated with nursing, may experience additional stress …

Evaluating Depression Management In Primary Care, Danica Amos

DNP Projects

Background: Within primary care patients identified with depression often do not receive appropriate care (43%). Guidelines recommend combining pharmacotherapy and psychotherapy when possible and establishing follow up with patients to improve their response to treatment According to the APA, only 10% of patients receive combination therapy.

Purpose: The purpose of this study was to evaluate depression management practices in a primary care clinic, describe providers’ attitudes and skills related to depression treatment, and work with the healthcare team to identify strategies to improve depression management within the clinic.

Methods: A single site, descriptive study utilized a retrospective chart review of …

An Evaluation Of Depression In Adolescents With Type 1 Diabetes Mellitus, Elleanor Gray

DNP Projects

Depression can significantly affect how adolescents with T1DM self-manage their disease. The combination of depression and diabetes is closely linked to reduction in self-care behaviors, poor treatment adherence, and sub-optimal metabolic control.

PURPOSE: The purpose of this study was to evaluate current screening for depression in adolescents with T1DM and determine the need for additional support or services to improve the quality of routine, follow-up diabetes care.

METHODS: A cross-sectional, retrospective review of electronic medical records was used to evaluate current practice of depression screening for adolescents with T1DM (11-21years) bring followed at a local pediatric diabetes center between April …

Evaluation Of Depression Screening By Providers For Adult Patients With Type 2 Diabetes In Primary Care, Kristy M. Bryant

DNP Projects

BACKGROUND: Depression in adults with type 2 diabetes can lead to non-adherence to self-management behaviors and treatment recommendations, and ultimately worse health outcomes. Currently, only 50% of adult patients with type 2 diabetes treated in the primary care setting are screened for depression. Without screening for depression, a diagnosis of depression and subsequent treatment is likely to be missed and the patient is more likely to experience worse health outcomes and worse quality of life.

PURPOSE: The purpose of this study was to evaluate impact of provider education on improving screening rates for depression in adult patients with type 2 …

Evidence-Based Music Therapy Treatment To Elevate Mood During Acute Stroke Care, Jessica L. Rushing

Theses and Dissertations--Rehabilitation Sciences

Stroke is the fifth leading cause of death in the U.S. with approximately 795,000 Americans experiencing a stroke each year. In addition to common difficulties with communication and physical impairments following stroke, psychosocial impacts warrant assessment and treatment. Experiencing a stroke can lead to depression, mood disorders, and difficulties with emotion regulation. It is well documented that post-stroke depression (PSD) affects a third of stroke survivors. Higher levels of depression and depressive symptoms are associated with a less efficient use of rehabilitation services, poor functional outcomes, greater odds of hospital readmission, negative impacts on social participation, and increased mortality. The …

Transactions Between Thinness Expectancies And Depression In The Prediction Of Adolescent Weight Restricting Behaviors, Anna Marie L. Ortiz

Theses and Dissertations--Psychology

Both the transdiagnostic risk associated with depression and the eating disorder-specific risk associated with expectancies for reinforcement from thinness have been identified as risk factors for the development of weight restricting behaviors. The purpose of this study was to examine if these risk factors transact to further predict risk in youth. Depression, thinness expectancies, and weight restriction were assessed in 1,907 adolescents three times during the transitional period between middle school and high school. We compared three different possible transactional processes. Mediation tests demonstrated that depression in 8th grade predicted an increase in the number of weight restricting behaviors endorsed …

Evaluating The Relationship Between Phq9 And Global Pain Scale (Gps) Scores In Opioid Dependent Adults: A Retrospective Correlational Study, Lori Nolan

DNP Projects

Background: Depression, chronic pain and opioid dependence are conditions commonly encountered in primary care settings. These comorbidities create treatment challenges while negatively influencing outcomes of care. The Patient Health Questionnaire (PHQ9) and Global Pain Scale (GPS) are valid screening tools used to score depression and pain symptoms. The purpose of this study was to determine the relationship between the PHQ9 and Global Pain Scale (GPS) scores in opioid dependent adults with chronic pain to determine whether both tools are necessary.

Methods: This was a descriptive study using a retrospective correlational research design. Data was obtained from the electronic medical records …

Appraisal Of Depression Among Individuals With T2dm Not On Insulin Therapy, Beverly Woods

DNP Projects

Abstract

BACKGROUND: Type 2 diabetes (T2DM) is a complicated disease process that affects more than 15 percent of adults in the state of Kentucky, with a national average of 9.4%. Individuals with diabetes are at increased risk for micro and macro neurovascular complications. Depression is a common co-morbidity and potentially affects their ability to manager this complex disease.

PURPOSE: The purpose of this study was to examine the prevalence of depression in a group of patients with T2DM, not on insulin therapy. Further, relationships between depression and blood glucose monitoring, Hgb A1c, other co-morbidities, number of medications taken, and demographics …

Diabetes-Related Distress Screening: A Survey Of Primary Care Providers' Knowledge, Attitudes, And Practices In Treating Patients With Difficulty Meeting Glycemic Goals., Michele Patrice Paxton

DNP Projects

A patient with diabetes is two to three times more likely to be depressed than the general population. Furthermore, the combination of diabetes and depression is associated with increased morbidity and mortality. However, research has shown that treatment for depression does not correlate with lower HbA1c levels or a decrease in morbidity and mortality. Recently, a body of evidence has shown that increased HbA1c levels and depression are associated with the emotional burden of managing diabetes. The emotional burden is caused by the constant behavioral and mental demands of managing the disease and the worry and fear of the impending …

Influence Of Depression On Treatment And Survival: A Population-Based Study In Patients With Breast Cancer In Kentucky, Feitong Lei

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This capstone project describes the results of a consultative experience in biostatistics.

Reducing Depression And Suicide Ideation Among College Students, Andrew Ritzel

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Suicide rates have been on the rise for the past 30 years; 42,773 Americans dying every year by suicide. Suicide is the tenth leading cause of death among all ages, but the second leading cause of death among Americans ages 15-24. College students traditionally fall within this age group, and are especially at risk for suicide due to stressful life conditions. The University of Kentucky, located centrally within Kentucky in the city of Lexington, is an ideal location for a suicide prevention intervention. Students demonstrated an increased rate of depression compared to the national population (15.13% of students surveyed reported …

Evaluation Of Depression Screening Implementation In The Adult Inpatient Heart Failure Population: A Process Outcomes Evaluation, Jennifer Sustek

DNP Projects

BACKGROUND: Extensive study has found depression in heart failure (HF) patients to be a significant risk factor which has been associated with poor outcomes and increased medical cost for this population. It is highly recommended to screen HF patients for depression to identify this important risk factor. The PHQ-9 depression screening instrument (sensitivity 70% specificity 92%) has been identified as a valid measure to detect depression in the HF population. Implementing a depression screening protocol in an inpatient environment requires education of providers to establish awareness of best practice and foster confidence in their application of the screening instrument. OBJECTIVE: …

Internalizing And Externalizing Dysfunction: An Integrative Model Of Adolescent Drinking, Leila Guller

Theses and Dissertations--Psychology

Separate externalizing and internalizing pathways to problem drinking have been described. However, internalizing and externalizing are substantially correlated, thus, there is good reason to believe that these two forms of dysfunction behaviors do not operate independently.

We tested an integrative developmental model of transactions among internalizing symptomatology, externalizing personality, and psychosocial learning in the prediction of both drinking problems and future internalizing symptoms. To do so, we studied a large sample (n = 1910, 49.9% female) of children over a critical developmental period, from the spring of 5th (last year elementary school) grade through the spring of 9th grade (first …

Evaluation Of Depression Screening Practices In Comorbid Patients In The Primary Care Setting, Kristyn L. Clark

DNP Projects

SPECIFIC AIMS: To evaluate the current rates of depression screening using the PHQ-2/9 in patients with comorbid conditions at a single, urban primary care office; to explore barriers to depression screening among providers.

METHODS: A retrospective chart review was completed on a sample of 188 patients seen between January and June 2017. Patients were equally divided among four comorbid diagnoses- COPD, obesity, hypertension, and type 2 diabetes. A provider interview was conducted to identify depression screening barriers and typical treatments regimens.

RESULTS: A total of 70.2% of patients had a documented depression screening. Of 67 patients diagnosed with depression, 11.9% …

Extended Family Relationships: How They Impact The Mental Health Of Young Adults, Kayla Jansen

Theses and Dissertations--Family Sciences

This study bridges the gap in literature about the impact of extended family relationships on young adult depression and self-esteem. A sample of 304 undergraduate students between the ages of 18 and 21 at the University of Kentucky was recruited to complete an online survey about their immediate and extended family relationships and their mental health. The largest predictor of self-esteem and depression in early young adults is perceived social support from the family of origin, which is also moderately correlated with perceived support from extended family members. This indicates that extended family support collaborates with family of origin support …

Assessment Of Depression Screening In Women’S Primary Care Clinic, Susanna Gorton

DNP Projects

Purpose: The purpose of this practice inquiry project was to evaluate provider adherence to depression screening documentation in the ambulatory electronic health record (AEHR) before and after changing locations of the depression screening questions within the AEHR. Provider knowledge about depression screening and barriers related to depression screening were also examined.

Methods: A retrospective chart review was completed for patients seen for an annual exam by a physician provider in a women’s primary care clinic. Data collected included demographic data, co-morbid conditions, depression screen documentation (PHQ-2 & PHQ-9), and interventions documented. A questionnaire was sent to providers in the primary …

Biobehavioral Influences Of Anxiety, Depression, And Hostility Symptoms On Health-Related Outcomes In Patients With Heart Failure, Lynn P. Roser

Theses and Dissertations--Nursing

The incidence of heart failure (HF) has increased each year as more people are living longer with heart disease and other chronic conditions. Recently, there has been much interest in the psychological dimensions of HF and the influence psychological symptoms have on the health outcomes (e.g., self-care, rehospitalization, mortality and quality of life) of patients living with HF. Patients with HF frequently experience symptoms of anxiety, depression, and hostility that may be associated with poor health outcomes. The purpose of this dissertation was to examine how psychological variables influence health outcomes of patients with HF, how psychological variables change over …

Identifying Predictors Of Functional Limitations Associated With Depression, Anxiety, And Emotional Problems In Us Adults, Jillian Richardson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Depressive disorders are characterized as sharing affected mood, and somatic (e.g. sleep pattern, appetite, and unintentional changes in weight) and cognitive alterations from previous normal daily functioning that are clinically significant. Anxiety disorders are characterized by excessive fear, general or specific anxiety, and related behavioral disturbances that are also clinically significant. This project attempts to identify risk factors that may predict what groups are most likely to be affected by depression and/or anxiety.

Sponsored by the CDC, the National Health Interview Survey collects general health information for non-institutionalized individuals living in the US. Variables for use in logistic regression model …

Postpartum Depression: The Effects Of A Video Intervention On Knowledge And Stigma, Lekie Dwanyen

Theses and Dissertations--Family Sciences

Postpartum Depression (PPD) has gained well-deserved traction in healthcare policy discourse as a public health concern. Although one in seven American women are believed to experience PPD, mental illness stigma induces feelings of shame and guilt, reduces treatment-seeking behaviors, and ultimately contributes to a low PPD diagnosis rate. Risk of experiencing PPD is associated with various contextual factors, yet little is known about the association between stigma and PPD risk factors. A multiple-segment factorial vignette was used with 1,871 respondents to examine the impact of maternal age, depression history, infant temperament, and diagnosis on attitudes toward PPD. In addition, the …

Hiv Risks, Intimate Partner Violence (Ipv), And Depression Among A Sample Of Women Who Have Sex With Men And Women (Wsmw), Krystal S. Frieson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: The purpose of this study is to examine the associations between interpersonal partner violence (IPV), HIV risks, and depression among a sample of adolescent females who have sex with men and women.

Methods: A cross-sectional study was conducted using data from the Youth Risk Behavior Surveillance System (YRBSS). YRBSS data was obtained from representative samples of students in grades 9-12. The study sample was comprised of adolescent and young women who self-identified as having sex with men and women (WSMW)(N=526). The primary exposure was sexual behavior (having sexual intercourse with both male and female partners). The primary outcomes were …