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Articles 1 - 30 of 41
Full-Text Articles in Medicine and Health Sciences
Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard
Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard
Doctoral Dissertations
Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.
Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …
Fostering Interprofessional Collaboration In Community College Mental Health Centers: A Quality Improvement Project, Sara Jane Hamilton
Fostering Interprofessional Collaboration In Community College Mental Health Centers: A Quality Improvement Project, Sara Jane Hamilton
Doctor of Nursing Practice (DNP) Projects
Background The worsening mental health rates among college students in the United States highlight the critical need for campuses to have high-quality comprehensive mental health centers (MHC). This necessity is particularly urgent in community college MHCs, which often lack these attributes. Local Problem An MHC within a large California community college recently introduced telepsychiatry services and is considering integrating a Psychiatric Mental Health Nurse Practitioner (PMHNP) into their team. However, knowledge gaps and limited interprofessional education (IPE) may hinder effective collaboration within the team. Methods A comprehensive literature review was conducted to assess current research on IPE, community college mental …
A Quality Improvement Project On Anxiety Management Before Ketamine-Assisted Psychotherapy, Kiera Paulo
A Quality Improvement Project On Anxiety Management Before Ketamine-Assisted Psychotherapy, Kiera Paulo
Doctor of Nursing Practice (DNP) Projects
Background: This Quality Improvement project sought to determine if a brief progressive muscle relaxation (PMR) session could decrease patient anxiety before receiving intramuscular (IM) injections for ketamine-assisted therapy. Problem: The Kerstin Helgason, NP clinic does ketamine-assisted therapy, and many patients express anxiety beforehand, either due to a fear of needles or nerves surrounding the medication treatment. Intervention: This project implemented a brief progressive muscle relaxation therapy for patients with anxiety before receiving their IM injection. Measures: The patient’s anxiety levels were measured before and after the PMR therapy using a five-point Likert scale ranging from none to very severe. Results: …
Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus
Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus
Doctoral Dissertations
This dissertation explored the potential effects of intersections of oppression (i.e., anti-Black racism, diabetes discrimination, and sexism) on mental health and pregnancy experiences among Black women and birthing people with Type 1 diabetes (T1D). Previous studies about pregnancy and T1D have included mainly white, cisgender women. Three participants qualified for inclusion in the present study and participated in semi-structured interviews, which the researcher analyzed using an interpretative phenomenological analysis (IPA) framework. Participants described feeling uncertain about whether aspects of their pregnancy experiences were related to obstetric and/or medical racism. Similarly, participants sometimes seemed uncertain about how racism may affect their …
Improving Minors' Access To Treatment For Opioid Use Disorder: A Policy Analysis, Sara Jane Hamilton
Improving Minors' Access To Treatment For Opioid Use Disorder: A Policy Analysis, Sara Jane Hamilton
Master's Projects and Capstones
As the opioid epidemic continues to have devastating effects on our communities, medications to treat opioid use disorder (MOUDs) are severely underutilized especially for adolescents. Unlike adults, minors need parental approval before obtaining MOUDs presenting a key barrier to timely treatment. Being able to treat adolescents as soon as they are ready is critically important for people with OUD, and while cost and other barriers have been addressed in the literature, there is a paucity on how parental consent affects the accessibility of treatment. This paper aims to explore a potential policy in California that addresses the lack of access …
Meet Me In The Middle: A Scoping Review On Understanding Adolescent Needs In Climate Communication, Gwendolyn Monica Hoff Anderson
Meet Me In The Middle: A Scoping Review On Understanding Adolescent Needs In Climate Communication, Gwendolyn Monica Hoff Anderson
Master's Projects and Capstones
The greatest effects of climate change are likely to be felt by youth. Young people are disproportionately affected by climate change due to their critical developmental stage and lack of power, and they experience both higher severity and prevalence of mental health issues related to climate change. Strong emotions have long been recognized as potential catalysts for action, or they may lead to paralyzing feelings of being overwhelmed. Climate communication is a critical tool to spark climate concern and encourage action. Activism, in turn, may help youth manage their anxiety about climate change. This scoping review examines emerging evidence on …
Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb
Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb
Master's Projects and Capstones
In a world that demands the constant requirement of adaptability and technology, the need for ‘hands on the ground’ continues to persist, and perhaps even grow. This research project explores burnout in the healthcare and nonprofit settings, as a pre-existing and ongoing issue, that was brought to centre-stage during the Covid-19 pandemic. The researcher explores the intersections of burnout with workplace culture, person-centered care (PCC), sweat equity and duty-of-care, through expert interviews and literature reviews. Data collected provides an immediate understanding of current workplace cultures and environments for human service providers, in both healthcare and nonprofit sectors. While the data …
Therapeutic Gardening For Mental Health In Substance Use Recovery, Stephanie E. Schafer
Therapeutic Gardening For Mental Health In Substance Use Recovery, Stephanie E. Schafer
Master's Projects and Capstones
Abstract
As the clinical nurse leader (CNL) in this project, I used the “[CNL]
Essential 1: Background for Practice from Sciences and Humanities” (Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice, 2013) and its competencies to focus on designing nursing care for a clinical or community-focused population based on biopsychosocial, public health, nursing, and organizational sciences and to synthesize evidence for practice to determine appropriate application of interventions across diverse populations. With the help of the CNL competencies and collaboration with the healthcare team, we created and implemented a therapeutic garden for residents in a substance use …
Mental Health Navigators Bridging The Gap Of Care, Valentina Loreto-Ashley
Mental Health Navigators Bridging The Gap Of Care, Valentina Loreto-Ashley
DNP Qualifying Manuscripts
Individuals with schizophrenia are most vulnerable at time of discharge due to risk factors that lead to relapse, re-admission, suicide and/or danger to others. A successful discharge process can decrease overall care costs, promotes team collaboration, supports the therapeutic relationship between client and care provider, and helps the client to reach autonomy and self-efficacy. This DNP is a quality improvement project that aims at educating Mental Health Navigators about symptoms of schizophrenia, medications management, and community resources. Effectiveness of the educational intervention will be assessed as the differences between the pre- and post-test assessment score on insight or lack of …
Surviving The Stigma: Incorporating Mental Health Literacy To Increase Help-Seeking In California First Responders, Yvonne C. Newson
Surviving The Stigma: Incorporating Mental Health Literacy To Increase Help-Seeking In California First Responders, Yvonne C. Newson
Master's Projects and Capstones
First responders are at risk of developing mental health problems due to repeated exposure to traumatic incidents, increasing their chance of developing Post Traumatic Stress Disorder, substance abuse, suicidal ideation, and suicide. Unfortunately, first responders do not recognize that they may have a mental illness and are reluctant to seek help. This paper will discuss the prevalence of mental health problems among first responders and the barriers to their help-seeking. These barriers include the stigma around mental illness within the culture, the assessability of professional help, and the lack of mental health literacy regarding their well-being. Further discussion will focus …
Decreasing Restraint Use By Utilization Of Agitation Assessment And Verbal De-Escalation Strategies In An Inpatient Non-Psychiatric Hospital, Kiera Paulo
DNP Qualifying Manuscripts
Background: This paper reviews the literature on ways to decrease the use of restraints in hospitals – specifically the use of agitation assessments and verbal de-escalation to be implemented in healthcare facilities to decrease the number of restraints being used to manage undesirable patient behavior and workplace violence incidents. Problem: Restraints have been shown to impede the nurse-patient relationship and cause emotional and physical trauma to staff and patients. They are no longer considered preferred management and in some circumstances can be considered abuse. Intervention: Agitation assessments and verbal de-escalation have been shown to produce less aggressive behavior and decrease …
Standardizing Perinatal Mental Health Interventions: A Guide For The U.S., Maile Lauren Robles
Standardizing Perinatal Mental Health Interventions: A Guide For The U.S., Maile Lauren Robles
Master's Projects and Capstones
The term perinatal individual refers to women and other individuals who are pregnant or who have been pregnant within the last 12 months. Every year, in the United States there are 700 pregnancy-related deaths and 10% are due to mental health causes including death by suicide. Mental health conditions including but not limited to anxiety, depression, substance use disorders, and post-traumatic stress disorder affect one in five perinatal individuals throughout the United States. This increases perinatal morbidity, hospitalization costs, and economic burden nationwide.
After 43 days postpartum, mental health conditions are the second leading cause of death. The United States …
The Child Care Crisis: Through The Social Ecological Lens, Jocelyne Saldana
The Child Care Crisis: Through The Social Ecological Lens, Jocelyne Saldana
Master's Projects and Capstones
Abstract
Objective - Working mothers face mental strain when returning to work due to the challenges of the current child care system. It is unclear how the instability of the child care sector impacts the mental health of working mothers.
Methods - The systematic review of literature was conducted to identify existing evidence to determine the influence access to quality, dependable, and affordable child care has on maternal mental health outcomes in working mothers. Multiple databases were used including PubMed and Scopus.
Results - Subsidized programs help reduce the cost of child care, however, income eligibility criteria makes it difficult …
Ask Your Doctor About: Prescribing Activism For Eco-Anxiety In Adolescents, Lexi Nutkiewicz
Ask Your Doctor About: Prescribing Activism For Eco-Anxiety In Adolescents, Lexi Nutkiewicz
Master's Projects and Capstones
Climate change is an ongoing public health crisis. Efforts to protect future generations' physical and mental health are more urgent than ever. Youth, in particular, are experiencing eco-anxiety, a specific form of anxiety relating to stress or distress caused by environmental changes and one’s knowledge of them due to the climate crisis. This scoping review provides a better understanding of the value of youth climate change activism as a strategy to mitigate eco-anxiety. This review evaluates the current definitions of eco-anxiety, the risk factors for eco-anxiety among adolescents, and considers the benefits and drawbacks of youth activism. To identify relevant …
Using Machine Learning To Analyze Children’S Drawings As Indicators Of Mental Well-Being, Nicholas R. Lawrie
Using Machine Learning To Analyze Children’S Drawings As Indicators Of Mental Well-Being, Nicholas R. Lawrie
Master's Theses
Human figure drawings are a well-studied diagnostic tool for emotional distress in children. Cleft lip/palate is one of the most common birth defects in the world, and has been shown to negatively impact emotional well-being in childhood which can have negative economic consequences in adulthood. Utilizing a dataset of human figure drawings from children in India and survey data on mental health, this paper will assess the impact of corrective surgery on mental health outcomes, as well as assess the validity of the drawing emotional indicators themselves. The results indicate that while the emotional indicators may not be valid in …
A New Narrative: Freeing Pediatricians From A Single Story, Tanya Scott, Tanya Scott
A New Narrative: Freeing Pediatricians From A Single Story, Tanya Scott, Tanya Scott
DNP Qualifying Manuscripts
An adolescent pediatric patient who presents with psychiatric and medical conditions is subject to a pediatrician's diagnostic acuity, experience with pediatric psych patients, and existing constraints on providing an appropriate course of care. Too often, the psychiatric DRG becomes the pediatrician's single story of the patient, accompanied by subtexts of aggressive behavior, and the pediatrician's own biases about psychiatric patients. The novelist Chimamanda Adichie warns of the dangers of a single story. As a child in Nigeria, Adiche devoured stories. The children were fair-skinned and blue-eyed in the books available to her. As Adiche began to write her own stories, …
Implementation Of A Mental Health Environmental Risk Assessment Tool, Alan Le
Implementation Of A Mental Health Environmental Risk Assessment Tool, Alan Le
Doctor of Nursing Practice (DNP) Projects
Background: Patient suicide is a serious safety issue, especially in mental health settings since suicides disproportionately affect psychiatric patients. Environmental hazards are a primary contributing factor in patient suicide cases.
Problem: Mental health staff may lack tools and training to perform proper environmental risk assessments, which is the case at a psychiatric crisis residential center in northern California that utilized no environmental risk assessment tool.
Methods: An environmental risk assessment tool was implemented at the site for four months to increase staff confidence, ability to identify hazards and decrease risk of patient suicides.
Interventions: The Suicide and …
Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa
Doctor of Nursing Practice (DNP) Projects
Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.
Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.
Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.
Intervention: A de-escalation …
Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen
Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …
Community Based Participatory Research Informed Manualization And Piloting Of E-Training Of A Modified Dialectical Behavior Therapy Intervention, Annika M. Miyamoto
Community Based Participatory Research Informed Manualization And Piloting Of E-Training Of A Modified Dialectical Behavior Therapy Intervention, Annika M. Miyamoto
Doctoral Dissertations
This study explores the efficacy of delivering modified dialectical behavior therapy (m-DBT) to direct support staff who work with seriously mentally ill patients with neurocognitive deficits using remote web-based technology. The partnering facility for this study is a residential skilled-nursing facility that provides 24-hour care to individuals under conservatorship. Using a previously piloted m-DBT protocol, qualitative feedback was gathered from four participants with background training in psychology and varying experiences with DBT. All participants had direct knowledge of the treatment environment and experience working with the patient population. Gathered feedback was used to revise the m-DBT protocol to be used …
Identification And Mitigation Of Environmental Hazards In Psychiatric Patient Suicide Prevention: A Review, Alan Le
DNP Qualifying Manuscripts
Background: Environmental hazards are a factor in the bulk of inpatient suicide cases, which disproportionately impact psychiatric patients. Current measures to minimize suicide risk include process-oriented solutions and environmental safeguards such as breakaway structures.
Aims: To perform a review of the literature that identifies environmental suicide hazards and interventions implemented to abate hazards and reduce suicide risk.
Methods: Electronic databases were searched using relevant keywords. Inclusion criteria consisted of articles published 2009-2020 that identified environmental suicide hazards or examined efficacy of interventions implemented to abate hazards. The Johns Hopkins Research and Non-Research Evidence Appraisal Tools were used for critical appraisal. …
The Importance Of Nutrition Education As A Recovery Component For Individuals With Severe Mental Illnesses, Emily Martinez
The Importance Of Nutrition Education As A Recovery Component For Individuals With Severe Mental Illnesses, Emily Martinez
Master's Projects and Capstones
In efforts to challenge the Western medicine’s determination of nutrition as a holistic approach, this paper represents the intent for mental health facilities in California to improve or implement nutrition education curriculum by enhancing interprofessional teams with dietitians as an important component of recovery for severe mental illness patients. There is concrete evidence proving that individuals who are in facilities recovering from mental illnesses have benefited from optimal nutrition consumption. Nutrition education has become a component among the toolbox of recovery options, but unfortunately it is not encouraged enough. Pharmaceutical companies advertise drug therapy as the most effective way to …
Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario
Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario
Doctor of Nursing Practice (DNP) Projects
Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change.
Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression …
Three Good Things To Extinguish Caregiver Burnout, Justin Haley
Three Good Things To Extinguish Caregiver Burnout, Justin Haley
Master's Projects and Capstones
Caregiver burnout is a widespread issue in healthcare and institutions should be increasingly concerned about burnout because of the significant impact on quality of patient care, employee health, and financial stability. Many interventions and studies regarding burnout are focused on improving systems issues or removing negative stressors on caregivers. Although such interventions may be necessary to attempt, comprehensive systems-wide changes can be cumbersome and expensive, while removing negative stressors may be an unrealistic goal in a fast-paced, demanding healthcare environment. The Three Good Things method is an evidence-based, effective, simple, low-cost intervention to improve feelings of caregiver burnout in which …
Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek
Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek
DNP Qualifying Manuscripts
Abstract
The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.
Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …
Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg
Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg
Doctoral Dissertations
For psychotherapists, encountering clients who have experienced sexual trauma or abuse is inevitable, whether or not the abuse is disclosed to the therapist; however, mental health professionals receive extremely limited (if any) training on how to identify or effectively support adult clients who are survivors of childhood sexual abuse (CSA). Many people who experienced CSA, especially those who identify as male, remain isolated and invisible in their suffering as adults even within therapeutic spaces, facing what feel like insurmountable barriers – both internal and external – to getting help. When sexual abuse is intrafamilial, these barriers are both amplified and …
Grounding Frequent Flyers: Understanding High Er Utilization And Developing Primary Care Solutions, Jillian Millares
Grounding Frequent Flyers: Understanding High Er Utilization And Developing Primary Care Solutions, Jillian Millares
Master's Projects and Capstones
Background: Regular access to primary care can positively impact long-term, chronic conditions. However, medically underserved individuals, particularly individuals with Severe Mental Illnesses(SMI), typically underutilize primary care. Root causes include client level factors such as socioeconomic barriers, provider level issues such as lack of training or general knowledge of SMI issues, and system level factors such as a lack of coordinated services. Methods: The present study conducted a needs assessment to identify the most influential of these factors on clients at an Acute Residential Treatment Center in San Francisco, California. The needs assessment consisted of semi-structured client and staff interviews. Results: …
Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller
Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller
Master's Theses
This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …
A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez
A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez
Doctoral Dissertations
The current study is a program evaluation at John Muir Behavioral Health, Center for Recovery. The research determined the effectiveness of the program at Center for Recovery that is offered to patients that struggle with substance use disorder and their families. The purpose of this study is to assess patients’ behavioral, cognitive and social/environmental factors as it relates to their commitment to sobriety and examine how the involvement of family members influences the patient’s recovery process. I utilized a mixed methodology of quantitative and qualitative interviews of patients and family members. The findings suggest depressive symptoms were negatively correlated with …
On-The-Spot Mindfulness Based Practices For Addressing Behavior Challenges Among 3rd Graders, Christina Francis
On-The-Spot Mindfulness Based Practices For Addressing Behavior Challenges Among 3rd Graders, Christina Francis
Master's Projects and Capstones
Purpose: The purpose of this project was to introduce and implement a mindfulness based tool that will empower students to manage their stress which contributes to their classroom behavior and allow teachers to minimize the amount of classroom time spent addressing behavior challenges.
Methods: Observations of third grade classrooms, key informant interviews with third grade teachers and community observations were conducted at the Achieve Academy School while throughout the school day.
Results: Findings showed that students would benefit from the implementation of On-The-Spot Mindfulness Based Techniques and Practices by minimizing stress, increasing academic success and improving the overall behavior, …