Psychiatry and Psychology Commons^™

Ontrack: A Program Evaluation, Justin Mynatt

Doctoral Projects

OnTrack is a program that provides coordinated specialty care (CSC) services for patients who have experienced their first episode of psychosis (FEP). Appropriately identifying and aggressively treating this vulnerable population, while providing support to both them and their families is critical for improved outcomes. Appropriate treatment of FEP patients can improve their quality of life, preserve brain matter, improve overall functioning, and lessen the burden of the clients’ family who may be involved in their care, such as caregiver strain or financial hardship. The purpose of this project is to evaluate the success of OnTrack, a FEP program, at improving …

Hierarchy Of Evidence [Eps File], Judy Schmitt

Library Faculty Works

Hierarchy of Evidence showing primary and secondary sources

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Increasing Rates Of Larc Uptake And Continuation Through Contraceptive Counseling: An Effective Approach For Women With Underutilization, Malia Johnson

DNP Qualifying Manuscripts

Unintended pregnancies in women with a substance use disorder are estimated to be nearly double that of the general population, of which negative health consequences are increased for both mother and neonate. Unintended pregnancies are preventable through the use of highly effective contraception that is less susceptible to the effects of typical versus perfect use. Long-acting reversible contraception (LARC) is ideal for this patient population. Therefore, a thorough literature review was performed to evaluate the role of contraceptive counseling on LARC uptake and continuation among women. The results indicated that contraceptive counseling does influence LARC uptake and continuation and it …

Nursing Campus Therapy Dog, Deborah A. Hall

Nursing Theses and Dissertations

An acknowledged bond has existed between humans and animals throughout history. Therapeutic physical and psycho-social effects of these bonding relationships have been noted in health care settings. Professional nursing education is known to be one of the most demanding and stressful fields of study. Students begin to experience extreme stress early in their nursing education. An animal-assisted intervention with a therapy dog is an innovative and inexpensive action that can help decrease the stress, anxiety, and depression students experience in higher education.

The focus of this dissertation portfolio was an animal-assisted intervention with a nursing campus therapy dog. The initial …

Tell Me A Story As A Bibliotherapy Intervention To Promote Resiliency In Military Children, Katherinemarie Conover

2019 Sigma Region 15 Nursing Research Symposium

Project studied effect on resiliency of Tell Me A Story™ intervention with children of active duty military members. Outcomes included improvement in resiliency and ego-resiliency after attending intervention; boys benefited in reduction of internalizing problem behaviors more than girls.

Implementing Screening To Assess Readiness To Change In Overweight And Obese Patients At A Patient-Centered Medical Home, Jarrod Gant

Doctoral Projects

Obesity is at epidemic levels within the United States (U.S.), but the Southern U.S. has some of the most obese states. Mississippi (MS) is the most obese state in the country (Robert Wood Johnson Foundation, 2018). Factors such as diet, sedentary lifestyle, cultural influences, and socioeconomic status contribute to the state’s citizens being overweight and obese.

Contributing to the state’s obesity is the fact that MS has more people living in poverty than any other state (Center for American Progress [CAP], 2018). Lacking the ability to afford healthy foods and the ability to afford quality healthcare adds to the state’s …

Using Teamstepps® To Improve Interprofessional Collaboration In The Outpatient Psychiatric Care Setting, Amy Michele Wadsworth

Doctoral Dissertations and Projects

The AACN has identified in their QSEN competencies that collaborative teamwork and patient-centered care are two qualities that skilled nurses must exhibit to provide high-quality care. The IOM has made a call to action that healthcare professionals must exhibit patient-centered care in interdisciplinary team settings to achieve high-quality care. At a community resource program in the mid-Atlantic region, a recent qualitative job satisfaction survey revealed that employees identified issues with interprofessional collaboration and a lack of teamwork at the facility. Using the Iowa Model, this EBP project involves the use of a cohort study with a pretest-posttest design, where the …

An Animal-Assisted Intervention Study In The Nursing Home: Lessons Learned, Lonneke G. J. A. Schuurmans, Inge Noback, Jos M. G. A. Schols, Marie-Jose Enders-Slegers

People and Animals: The International Journal of Research and Practice

AAI studies in the nursing home pose a specific set of challenges. In this article the practical and ethical issues encountered during a Dutch psychogeriatric nursing home AAI study are addressed with the aim of sharing our experiences for future researchers as well as AAI practitioners in general.

In our study we compared three groups of clients with dementia who participated in group sessions of either visiting dog teams, visiting FurReal Friend robot animals, or visiting students (control group) and monitored the effect on social interaction and neuropsychiatric symptoms through video analysis and questionnaires. We encountered the following four categories …

Motivation Of Use Of Electronic Cigarettes Among Youth Aged 13-18, Leah Severson

Grace Peterson Nursing Research Colloquium

Abstract

Background: For individuals aged 13-18, electronic cigarettes are the most commonly used tobacco product. These devices are highly addictive and negatively affect health. To reduce early nicotine use, it is important to understand the reasoning behind why youth choose to use electronic cigarettes.

Purpose of Study: The purpose of this integrative literature review was to review existing studies on why youth aged 13-18 use electronic cigarettes. In evaluating multiple up to date research studies the goal was to find trending results.

Method: An integrative literature review was utilized to evaluate peer-reviewed articles published from 2013-2018. Search terms included: Electronic …

The Effects Of Rape Trauma And Ptsd On The Childbirth Process, Helena Kevorkian

Grace Peterson Nursing Research Colloquium

Abstract

Background: Sexual trauma, including rape and childhood sexual abuse, takes a toll on the survivor emotionally and physically. With the invasive procedures, physical exposure and feelings of loss of control related to childbirth, the survivor may become triggered and become retraumatized. Through an integrative literature review, the effects of rape trauma and PTSD on the childbirth process were identified.

Objective: The purpose of this integrative literature review was to determine the effects of rape trauma and PTSD on the childbirth process. Through determining the effects, a greater understanding will be gained on how to best approach a situation with …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Understanding The Impact Of A Perinatal Mood And Anxiety Disorders Phone Support Line, Diana Nguyen, Semira Semino-Asaro

Doctor of Nursing Practice Final Manuscripts

Postpartum depression affects one in every seven women and anxiety is estimated to range from 13-21% in new mothers. Risk factors include prior diagnosis of depression, family history of depression, having medical complications during childbirth including a premature baby and a lack of social, emotional support. The purpose of this evidence-based practice project was to increase the amount of data gathered by a local perinatal support organization by analyzing the callers’ demographics through phoneline surveys and use the information to expand resources and access to care for mothers with perinatal mood and anxiety disorders (PMADs). The project was guided by …

Do Not Miss Your Shot: Improving Follow-Up In Patients Receiving Long-Acting Injectable Medications, Mary O'Hara

Doctor of Nursing Practice Final Manuscripts

Background: Serious mental illness including schizophrenia and bipolar disorder affects 1 in 24 adults in California. These chronic disorders are difficult to treat and often sabotaged by medication nonadherence. Long-acting injectable (LAI) medications are one strategy to combat medication nonadherence. Effectively providing treatment with LAI medications can be challenging at the clinic level.

Objectives: Reduce the number of days without medication by reducing the number of days between injection due date and injection administration for patients receiving LAI medications.

Design: Establish appointments for all injection visits. Standardize visit protocol for injection encounters to optimize provider time. Arrange immediate follow-up and …

Analysis Of A Universal Depression Screening Workflow At An Integrated Healthcare Center, Arthur Roehr

Doctor of Nursing Practice Final Manuscripts

Purpose: Evaluation of an evidence-based protocol that measures the effectiveness of universal depression screening at an integrated healthcare center. At risk patients are those who complete a patient health questionnaire (phq-9) and score ≥ 10 when presenting for a primary care visit. A score of ≥ 10 prompts further evaluation by the primary care provider (PCP) prior to behavioral health care management (BHCM) referral.

Background: In 2016, 16.2 million adults aged 18 or older in the U.S. experienced a major depressive episode (MDE). 65.3% of those received some form of treatment from a healthcare professional (therapy and/or medication). Early identification …

School-Based Mental Health Screening: Improving Outcomes Through Interprofessional Communication And Collaboration, Tiffany Gishizky

Doctor of Nursing Practice (DNP) Projects

For the adolescent population, the immediate impact a mental health disorder has on academics,relationships, and even suicide risk cannot be understated. Access to mental health care in low socioeconomic communities for adolescents is fraught with barriers. These include lack of transportation, lack of insurance coverage, fear of stigma, and a fundamental lack of knowledge regarding available resources. It is therefore a two-fold problem that exists for those in the care and observation of these adolescents; underutilization of appropriate routine screening and navigation to access care. This project aimed to remediate both of these issues at a high school located in …

Associations Of First Trimester Co-Use Of Tobacco And Cannabis With Prenatal Immune Response And Psychosocial Well-Being, Kristin Ashford, Amanda Fallin-Bennett, Andrea Mccubbin, Amanda T. Wiggins, Sheila Barnhart, Joshua A. Lile

Perinatal Research and Wellness Center Faculty Publications

PURPOSE: This study aims to describe the association of first trimester co-use of tobacco and cannabis with maternal immune response and psychosocial well-being, relative to tobacco use only.

METHODS: A preliminary midpoint analysis included 138 pregnant women with biologically verified tobacco use, 38 of whom (28%) also tested positive for recent cannabis use. Maternal perceived stress (Perceived Stress Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and serum immune markers (IL-1β, IL-2, IL-6, IL-8, IL-10, TNFα, CRP, MMP8), were collected, although cytokine data were only available for 122 women.

RESULTS: Participant average age was 29.1 years, approximately half had a high …

The Effects Of A Dementia Simulation Experience On Attitudes Towards People With Dementia, Micah Huckabee

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: The neurodegenerative effects of dementia resulting in cognitive and behavioral impairments is plausibly one of the reasons for a societal stigma towards individuals with dementia. Societal stigmas are associated with decreased life satisfaction, depressive symptoms, and decreased psychological well-being for stigmatized individuals. In an effort to improve attitudes towards individuals with dementia, this study utilized a dementia simulation to measure attitudinal changes after a dementia simulation. Methods: There were 33 participants in this study (13 male and 20 female) between the ages of 18 and 25. Participants completed a Dementia Attitudes Scale (DAS) survey, and then they dressed in …

Toward Expert Consensus On Guidelines For The Use Of Yoga In The Treatment Of Anxiety In Children And Adolescents., Laura J. Abels

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Despite clinical evidence to support the use of yoga as a treatment option for children and adolescents with anxiety, clinical practice guidelines do not exist. Purpose: This project used the modified Delphi technique to determine if consensus exists on the need for clinical practice guidelines among experts in the fields of child and adolescent psychiatry, psychology, and yoga. Additionally, this project aimed to determine if consensus exists on what should be included in clinical practice guidelines for the use of yoga as a therapeutic intervention for anxiety in children and adolescents. Methods: Three rounds of questionnaires were used …

Effects Of Therapeutic Music On Improving Depressive Symptoms Among Long-Term Care Facility Residents, Yi Jin

Evidence-Based Practice Project Reports

Depression is a common mental disorder that can contribute to both physical and psychological suffering (Skinner, 2014). The prevalence rate of depression is especially high among long-term care facility residents (CounsultGeri, 2018; Lolk & Andersen, 2015). The purpose of this EBP project was to establish a protocol incorporating therapeutic music as an adjunct therapy for managing depressive symptoms among residents of a long-term care facility in the Midwest. Roy adaptation model (Roy, 2009) was utilized as the theoretical framework, and the model for evidence-based practice change (Rosswurm & Larrabee, 2009) guided the project implementation. A total of 13 subjects were …

Anxiety Is Something To Worry About: The Effects Of A Cognitive Behavioral Therapy And Selective Serotonin Reuptake Inhibitor Intervention Protocol On Generalized Anxiety Disorder, Alesha E. Mcclanahan

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is highly prevalent in the United States with at least 12% of the population affected (Edmund & Sheppard, 2018). GAD can pose significant distress and debilitation throughout the lifespan (Bystritsky, Khalsa, Cameron, & Schiffman, 2013; Edmund & Sheppard, 2018). Barriers to treatment include adverse effects, inaccessibility, and expense. The purpose of this project was to implement an evidence-based protocol involving combination therapy with self-administered cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication in order to improve patient outcomes through more accessible, affordable, and standardized treatment of GAD. The Neuman Systems Model and Stetler …

Changing Healthcare Provider And Parent Behaviors In The Pediatric Post‐Anesthesia‐Care‐Unit To Reduce Child Pain: Nurse And Parent Training In Postoperative Stress (Np‐Tips), Brooke N. Jenkins, Michelle Fortier, Robert S. Stevenson, Mai Makhlouf, Paulina Lim, Remy Converse, Zeev N. Kain

Psychology Faculty Articles and Research

Background

Children who undergo surgery experience significant pain in the post anesthesia care unit. Nurse and parent behaviors in the post anesthesia care unit directly impact child postoperative pain. Therefore, we have developed and evaluated (Phase 1) and then tested (Phase 2) the feasibility of a new intervention (Nurse and Parent Training in Postoperative Stress) to alter parent and nurse behaviors in a way consistent with reducing child postoperative pain.

Methods

In Phase 1, a multidisciplinary team of experts (physicians, nurses, and psychologists) developed an empirically‐based intervention which was then evaluated by experienced nurses (N = 8) and parents …

Organizations As Evil Structures, Cary Federman, Dave Holmes

Cary Federman

Nursing practice in forensic psychiatry opens new horizons in nursing. This complex, professional, nursing practice involves the coupling of two contradictory socioprofessional mandates: to punish and to provide care. The purpose of this chapter is to present nursing practice in a disciplinary setting as a problem of governance. A Foucauldian perspective allows us to understand the way forensic psychiatric nursing is involved in the governance of mentally ill criminals through a vast array of power techniques (sovereign, disciplinary, and pastoral), which posit nurses as “subjects of power.” These nurses are also “objects of power” in that nursing practice is constrained …

Using The Rapid Assessment For Adolescent Preventive Services (Raaps) To Screen For Risk Taking Behaviors Of 13 To 18 Year-Olds In A Regional Family Practice Office, Megan E. Carpenter

Doctoral Projects

Risk-taking behaviors are a significant problem in the adolescent population and the three leading causes of mortality for adolescents are suicide, homicide, and unintentional injury (Heron, 2017). National organizations support screening for adolescent risk-taking behaviors and research demonstrates effectiveness of screening. This quality improvement (QI) project implemented the Rapid Assessment for Adolescent Preventive Services (RAAPS) screening tool at a regional family practice office as a vehicle to accomplish the objectives of increased identification of, and intervention for, risk-taking behaviors in adolescent patients. Included in the methods were baseline and implementation chart reviews that were used to assess the change in …

Increasing Utilization Of Cognitive Behavioral Therapy To Reduce Morbid Obesity In A Primary Care Setting, Erin J. Mccue

Doctoral Projects

Background: Obesity among adults is characterized by a body mass index (BMI) of 30 or higher. The impairment and disability resulting from obesity indicates a significant health problem that is often seen in primary care settings. Research indicates that cognitive behavioral therapy (CBT) is an underutilized, but extremely beneficial intervention that may support individuals in achieving weight loss. Adults suffering from obesity with or without comorbid conditions such as psychiatric disorders (e.g. anxiety and depression) have benefitted from CBT.

Purpose: To implement the increased utilization of CBT in the adult population with obesity and depression or anxiety in a primary …

Improving Depression Screening And Follow-Up In Primary Care Through Implementation Of An Evidence-Based Protocol, Cheryl Fowler

Doctoral Projects

Depression is a leading cause of disability in adults and is a major contributor to burden of disease (World Health Organization [WHO], 2018). The United States Preventative Services Task Force (USPSTF) provides evidence-based recommendations to promote disease prevention. Among these, is the recommendation that all adults, regardless of risk factors, should be screened for depression in the primary care setting with adequate systems in place to allow for appropriate diagnosis and management (USPSTF, 2016). The purpose of this Doctor of Nursing Practice (DNP) student project was to develop and implement an evidence-based protocol in the primary care setting with aims …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …

The Impact Of Ptsd And History Of Involvement In The Criminal Justice System On Medication Treatment Success In Opioid Use Disorder, Kirk Sanger

Doctoral Dissertations

This analysis examined the impact of post-traumatic stress disorder (PTSD), history of trauma, and a history of involvement in the criminal justice system (CJS) on treatment outcomes related to medication treatment for opioid use disorder. This study employed a secondary analysis of data derived from a multi-state, multi-site treatment center focused on substance abuse and more specifically opioid use disorder treatment. The total sample size was 19,970 patients. The majority of the sample received treatment in Massachusetts, was white, and non-Hispanic. Those with PTSD accounted for 9.5% of the sample, while 12% had a history of trauma. Just under 1/4 …

An Exploration Of Why Healthcare Professionals Under-Report Observed Patient Aggression, Sydney Bonta

UNO Student Research and Creative Activity Fair

An Exploration of Why Healthcare Professionals Under-Report Observed Patient Aggression

Authors: Sydney Bonta & Lisa L. Scherer, Ph.D.

Advisor: Lisa L. Scherer, Ph.D.

According to the 2011 US Bureau of Justice Statistics report, medical professionals experienced the third highest proportion of workplace violence (WPV), with violence primarily emanating from patient. In a national survey of nurses employed in hospitals, 76% stated that they had encountered some sort of violence in their workplace (Speroni, Fitch, Dawson, Dugan, Atherton, & Leesburg, 2014). Similarly, patient aggression against physicians has long been a problem (Morrison, Lantos, Levinson, 1998). Despite this widespread exposure to WPV …

The Lived Experiences Of Parenting Children With Food Allergies: A Phenomenological Study, Anne Zavell

Dissertations

This phenomenological study focuses on five mothers' experiences of the phenomenon of living with a diagnosed food allergy in the family. Attention is given to the contexts or situations that have typically influenced or affected their experiences, including the impact of the diagnoses, travel and restaurants, friendships, sibling relationships, and anxiety. There is a major emphasis on these mothers' experiences advocating for the needs of their children in schools, including their strategies, concerns, and frustrations. Policies related to food allergies are reviewed from the contemporary and historical perspectives, with recommendations for policy change. The lived experiences of food allergy mothers …