Medicine and Health Sciences Commons^™

Implementing Routine Depression Screening In An Urgent Care Setting: An Implementation Science Project, Lori Conyers

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Identifying patients with depression is essential, and early detection of depression leads to early intervention. Routine screening of patients for depression is the responsibility of the primary care provider, but many patients have not had a primary care visit in the recent past. Those patients without a primary care provider are likely not being screened for depression. Urgent care (UC) may be the best opportunity to screen patients who do not have a medical home. However, the dynamic nature of the urgent care setting may dissuade staff from engaging in routine screening. As a quality improvement (QI) effort, regular PHQ …

After Being Ignored, Autistic Adults Find Their Place On The Spectrum, Leonardo A. Lopez Carreno

Capstones

Autistic adults have been historically ignored by researchers and clinical psychologists when discussing autism spectrum disorder. But the broadening of the diagnosis requirements for the disorder, as well as the perspectives from autistic adults that have been shared on social media, have made it so that autistic adults are being discussed more now than ever before, both in the autism community and among professionals in the field. This project puts together interviews with autistic people who have found communities online and in person, as well as the perspectives of researchers who have published studies about autism.

https://medium.com/@leonardolpezcarreo/after-being-ignored-autistic-adults-find-their-place-on-the-spectrum-6e131fc00796

Assessing The Methodology, Prevalence, And Associated Factors For Adverse Childhood Experiences (Aces) Among Children And Adolescents In The United States, Kiara L. Lyons

Theses & Dissertations

To comprehensively capture the risk and protective factors of ACE exposure and ACE-related outcomes, we propose to consider a social-ecological model framework. The concept of the Social-Ecological Model was originally introduced in the 1970s by psychologist Urie Bronfenbrenner and designed to theoretically capture the multifaceted influence different personal, social, and environmental factors have on health behaviors and outcomes. Additionally, this would help to determine what prevention and intervention methods would be more appropriate to implement. This conceptual framework had five system levels: microsystem (individual), mesosystem (interpersonal), exosystem (community context), macrosystem (societal and cultural influences), and chronosystem (internal and external elements …

The Usability And Feasibility Of A Nursing Evidence-Based Comorbidity Educational Website For An Urban Mental Health Assertive Community Treatment (Act) Program, Andrea Brudigan, Laurie Sewell-Muller, Kokuvi Sena Tsogbevi

Doctor of Nursing Practice Projects: College of Nursing

Objective: Serious mental illness (SMI) causes an increased risk for comorbidities like heart disease, obesity, metabolic syndrome, and diabetes. Many times, these comorbidities are due to side effects of antipsychotics and poor self-management from low insight and other symptoms of mental illness. This project aims to enhance client care enrolled in an Assertive Community Treatment (ACT) program by providing evidence-based resources tailored to clients with SMI, providing ACT team members with support to promote healthy behaviors in clients.

Methods: A website was developed that provides printable, easy-to-read, evidence-based resources that address physical comorbidities. The ACT team integrated these resources into …

The Art Of Surviving: Alchemy Of Healing Trauma In Relation To Identity: A Self Study., Rebecca Morgan

Electronic Theses and Dissertations

The following thesis explores trauma’s physical and psychological aspects concerning identity as an artistic practice. Through exploring materials, subject matter, and media, my approach to trauma is based on personal and socially engaged experiences and my attempt to re-conceptualize that experience through the language of contemporary art. Extensively this work is governed by childhood memories and the critical aspect of being raised as a female in a patriarchal society. Being raised female comes with a certain number of expectations and requirements. This work creates a physical and spiritual connection between trauma and the identity of what is female. Discussing these …

Music Therapy For Men With Co-Occurring Disorders, Yolana Kaml

Dissertations, Theses, and Projects

This project explores both quantitative and qualitive research that discusses the effectiveness of music therapy, its use in group settings, and its use in treatment of many different mental health states. This project also explores what the treatment process of music therapy looks like. Music therapy was found to be effective in lowering pain levels, anxiety, and promote better sleep in a research study done on cancer patients (Tang et al. 2021). The research done also showed that music therapies effectiveness extends to people with a variety of mental health histories and of different ages. This includes parent/child dyads (Teggelove …

Genetic And Transcriptomic Aspects Of Major Depressive Disorder: In Vivo Functional Assays Of Risk-Associated Variation, Candidate Disease Cell Types, And Their Pharmacologic And Sex Interactions, Bernard Mulvey

Arts & Sciences Electronic Theses and Dissertations

Major depressive disorder (MDD) is a debilitating illness that affects hundreds of millions globally, with substantial personal, medical, economic, and societal consequences. While depression occurs more commonly in females, the biology of the brain and sex underlying this skewed prevalence remains unclarified. This body of work explores two aspects of how biological sex may influence the brain at the level of gene expression: through intrinsic sex differences and through sex-mediated effects of depression risk genetics.

The monoamine hypothesis of depression suggests that modulatory neurotransmitters including serotonin and norepinephrine constitute a key axis in development of MDD. Large-scale studies of MDD …

An Updated Look At Mental Health Services In American Public And Private Prisons, Lieren E. Tyira

Student Theses

People residing in American prisons have the legal right to mental health care while incarcerated (Justia, 2021). This is important, as the prevalence of mental disorders is high in this population (Prins, 2014), and incarceration is a psychologically damaging experience, which hinders a person’s success at rehabilitation. Numerous of issues related to the mental health services (MHSs) in both public and private prison facilities have been reported in recent years, which warrants systematic exploration. The little existing research comparing the presence of MHSs in these facilities has produced mixed results, it uses out-of-date datasets, and none has explored MHSs in …

The Effect Of Childhood Maltreatment On Psychotherapy Effectiveness In Adulthood: Implications For Counselors, Michael Hillerman

Theses and Dissertations

Recent gains in understanding the effects of childhood maltreatment on the development of the brain and nervous system, combined with the revelation that nearly all psychiatric neuroimaging studies have had an unrecognized confound in childhood maltreatment, imply the possibility that psychotherapy treatment effectiveness studies have been similarly confounded by childhood maltreatment. This study examines whether treatment-seeking adults exposed to childhood maltreatment respond differently to psychotherapy than do individuals who report no history of childhood maltreatment. Response to therapy is conceptualized in this study as reduction in symptom measures pre- and post- treatment, as well as client dropout. It is hypothesized …

Does The Use Of Mental Health Screenings And Targeted Stress Interventions Improve Mental Health Outcomes In Outpatient Clinic Staff?, Mary Benson

Doctoral Projects

The Perceived Stress Scale (PSS) has been used as a classic stress assessment instrument to evaluate perceived stress across many settings. As stress is the primary phenomenon in this review due to varying stressors, including infectious diseases among healthcare workers, the PSS is the most appropriate scale for evaluating the degree to which a health worker feels stressed. In addition, the PSS is valuable as it encompasses ten items that researchers use to explore how respondents react to stress due to unpredictable events. Thus, this DNP project is based on the postulation that screening with the PSS and applying stress …

Data-Driven Neuroanatomical Subtypes In Various Stages Of Schizophrenia: Linking Cortical Thickness, Glutamate, And Language Functioning, Liangbing Liang

Electronic Thesis and Dissertation Repository

The considerable variation in the spatial distribution of cortical thickness changes has been used to parse heterogeneity in schizophrenia. We aimed to recover a ‘cortical impoverishment’ subgroup with widespread cortical thinning. We applied hierarchical cluster analysis to cortical thickness data of three datasets in different stages of psychosis and studied the cognitive, functional, neurochemical, language and symptom profiles of the observed subgroups. Our consensus-based clustering procedure consistently produced a subgroup characterized by significantly lower cortical thickness. This ‘cortical impoverishment’ subgroup was associated with a higher symptom burden in a clinically stable sample and higher glutamate levels with language impairments in …

Reducing Physical Restraints And Emergency Psychiatric Medications On An Inpatient Psychiatric Unit With The Broset Violence Checklist, Victoria Hernandez

Doctor of Nursing Practice

Background: Physical restraint and psychiatric emergency medication use, especially psychotropic medications, is problematic, negatively impacting patient safety on psychiatric units (Ambwani et al., 2021; Iuppa et al., 2013; Rahman, 2021). The Bröset Violence Checklist (Woods & Almvik, 2002), a short-term violence-predicting tool, has been used in the inpatient setting to predict violent outbursts and determine when high-level violence interventions are needed.

Purpose: The purpose of this project was to recognize signs and symptoms of aggression and agitation early and intervene to reduce the use of physical restraints and emergency restraint medications on an inpatient psychiatric unit, thereby improving patient safety. …

A Program Evaluation Of Bhc Alhambra Hospital Outpatient Services, Emily Rose House

Loma Linda University Electronic Theses, Dissertations & Projects

A program evaluation of the Behavioral Health Care (BHC) Alhambra Hospital's Outpatient Service program was conducted. The purpose was to evaluate the program implementation, assess the program results, and highlight methods of program improvement. The evaluator conducted focus groups with administrative and clinical program staff and evaluated data utilizing thematic analysis. Three themes, education, programmatic operations, and team highlighted areas of program effectiveness and areas of program improvement. Administrative staff and clinical staff highlighted the importance of training and improved communication between program staff and board and care staff. Recommendations include the administrative staff creating a plan to account for …

Implementing Evidence-Based Adult Psychiatric Inpatient Depression Assessment, Treatment, And Post-Hospitalization Referral, Lucy Flores

Doctor of Nursing Practice

Purpose: This project was designed to strengthen the quality of depression assessment with evidence-based depression assessment tools in inpatient psychiatric units.

Background: Missed diagnosis and treatment of depressive disorders contribute to the most severe outcome of depression: suicide. A crisis stabilization facility with inpatient psychiatric units had significant opportunities to improve clinical outcomes by screening for depression in adults and to monitor symptoms with evidence-based tools.

Methods: The 12-week quality improvement project included implementation of staff education sessions of evidence-based tools to screen, monitor, interpret scores, and detect risk modifiers. The design and build with Information …

Therapists’ Demonstrated Multicultural Competence In Treating Latinx Immigrants, Dulce Diaz Benitez

Graduate Theses and Dissertations

Studies suggest that health disparities occur when people from marginalized communities receive care that is inadequate based on their cultural needs (USDHHS, 2011). Multicultural competence (MCC) models have been proposed to provide a framework of the competencies that therapists should develop to work with multicultural populations (Sue et al., 1992). Researchers have questioned the validity of measures, which are mostly based on therapist self-report (Cartwright, 2008). The multicultural case conceptualization ability task has been used in previous studies as a measure of demonstrated cultural competence using a vignette to assess case conceptualization abilities (Ladany et al., 1997). However, it has …

A Structural Examination Of The Connection Between The Amygdala And Nucleus Accumbens In Adolescents With Clinical Anxiety, Alyssa Griffith

Biological Sciences Undergraduate Honors Theses

The prominence of anxiety disorders in today’s general population is a major public health concern. Advancing research of the underlying pathophysiology of anxiety disorders can lead to the discovery of effective treatment interventions to treat the mental and physical symptoms of anxiety, and thus improve quality of life. This study aimed to examine two brain areas in the limbic and reward systems, the amygdala and Nucleus Accumbens (NAcc), and the structural white matter connection between them. This neural circuit assigns affective valence to environmental stimuli and motivates behavior to avoid potential harm. This study utilized diffusion Magnetic Resonance Imaging (dMRI) …

Substance Use Among Nurses As A Result Of Covid-19, And The Impact Of Rehabilitative Programs On Nurses, Gerome Macaspac

Nursing | Senior Theses

Background: The incidence of substance use among nurses has been a persistent issue for decades. The effects associated with substance misuse depend on what is used, the amount, how often, and how they are taken. Regardless of the substance used, any nurse who enters the workplace using substances puts the lives of others at risk. Due to the widespread effects of the COVID-19 pandemic, there is a risk that the number of nurses resorting to the use of substances may have increased. Therefore, an investigation into drug use among nurses during the pandemic is particularly important.

Objective: To explore the …

How Has The Pandemic Exacerbated Nurse Burnout, And What Can Be Done To Improve Their Psychological And Emotional Well-Being?, Lisette Diaz

Nursing | Senior Theses

Background: The COVID-19 pandemic has affected millions of people, both emotionally and physically. Nurses are among the people who are most affected. The nurses' quality of life and the way they provide care has been changed by the pandemic. Nurses are so focused on providing the best possible care for their patients that they neglect to look after themselves.

Objective: The purpose of this literature review is to identify and evaluate how the COVID-19 pandemic has affected nurses and their well-being. The significance of this research was to establish how the ongoing pandemic has impacted nurses’ performance and …

The Uncertainty And Psychological Health Of Family Caregivers Of Patients With Delirium In Intensive Care Units, Amal Shokri Haji Assa

Theses and Dissertations (ETD)

Each year, more than 5 million patients are admitted to an intensive care unit (ICU) in the United States, and up to 80 % of these patients develop delirium. Delirium is a common indicator of acute brain dysfunction in the ICU and a predictor of mortality, longer ICU/hospital stay, and long-term cognitive impairment. Family caregivers are a valuable resource in preventing, detecting, and managing delirium in the ICU. However, witnessing delirium episodes can generate adverse psychological symptoms in family caregivers that may compromise their health and well-being. Research in this area has demonstrated a gap in the literature regarding how …

Implementing The Depression Screening Tool Phq-9 In The Annual Wellness Exam Of Concierge Family Medicine, Eric Iglesias

Doctor of Nursing Practice

Abstract

Background: Depression has been one of the most common mental health disorders that our population fact but is underdiagnosed and undertreated. Primary care providers are often the first line of defense in detecting depression. Because of this, implementing a depression screening tool in a primary care setting will improve holistic management of care and improve quality of life.

Project Aim: The aim of this project was to increase the number of clients who are evaluated for depression by using the PHQ-9 screening tool during their annual wellness exam and initiate treatment according to the Veteran’s Affairs/Department of Defense Depression …

Evaluating How Physical Activity Affects The Perception Of Resilience In Box Butte County, Nebraska, Eric Pulver

Capstone Experience

Physical activity is one of the modern hallmarks for good health in individuals and the public, in general. Resiliency is a growing concentration in all levels of disaster preparedness where the focus is on how to deal with the growing number of disasters stemming from global climate change. This research project’s aim is to look at the possible relationships between physical activity and resiliency in a rural Nebraska population. This was done with the use of a cross-sectional study utilizing a fifteen-question survey to gather demographics, assess the amount of physical activity, and then apply a perception of resilience tool …

Alcohol Use Disorder And Major Depressive Episodes: Findings From The National Survey On Drug Use And Health, Samantha Madler

Theses and Graduate Projects

Alcohol use disorder (AUD) is one of the leading causes of death and disability among individuals in the United States (Bergmann et al., 2013; Jung, 2019; Sliedrecht et al., 2019; Witkiewitz, 2019). A number of individuals reporting an AUD diagnosis also report difficulties related to numerous physical, social, and mental health consequences, most notably, major depression. Major depressive disorder (MDD) and AUD co-occur at high rates, and researchers have been investigating the negative consequences and outcomes related to these co-occurring illnesses (McHugh & Weiss, 2019; Tolliver & Anton, 2022). Using a large nationally representative sample of 18–36-year-olds, treatment completion within …

Clinician’S Recommendations In Treating Victims And Survivors Of Narcissistic Abuse, Sadaf Shalchian

Loma Linda University Electronic Theses, Dissertations & Projects

Although marriage and family therapists are one of the main providers in treating mental and relational health issues, there is not a significant emphasis on the identification, assessment, and treatment of victims and survivors of narcissistic abuse in COAMFTE-accredited Masters level Marriage and Family Therapy programs (COAMFTE, 2017). This needs assessment aimed to identify the knowledge and clinical skills recommended by clinicians who treat victims and survivors of narcissistic abuse to identify some needs, assessments, and treatment practices that can guide LMFTs in treating this population. This needs assessment explored current literature, research, and academic and clinical resources focused on …

An Assessment Of The Sexual And Mental Health Needs Of Transition Age Foster Youth In New York City, Elizabeth Claessens

Health Advocacy Theses

Young adults age 18 to 21 who are transitioning out or “aging out” of foster care are an extremely vulnerable group who lack typical family support and preparation for independent adulthood. All transition age foster youth have been exposed to trauma and likely have had multiple adverse childhood experiences. This population is understood to have significant mental and sexual health risks. Foster care service agencies in New York City provide mental and sexual (reproductive) health care to foster youth as mandated by the state of New York. This needs assessment seeks to better understand whether those services meet the mental …

Addressing Mental Health Issues Through A Screening Tool, Simran Sandhu

Capstone Projects and Master's Theses

This capstone project was implemented at Rancho San Juan High School which is located on the far north side of Salinas, CA. RSJHS is a newly constructed public high school. The capstone project's goal was to assist RSJHS Wellness Center by determining what services are needed by removing obstacles to accessing services. Intervention services can benefit students greatly. Services focus on mental, emotional, and socioeconomic needs. The project was specifically focused on creating a screening tool for the intervention specialist. A standard screening tool form was developed. The form is a well-organized easy to understand form that contains some personal …

The Impact Of Covid-19 On Recreational Therapists Working In Inpatient Mental Health Settings, Summer Matics

All Dissertations

Since 2020, the novel coronavirus (COVID-19) has impacted the lives of the general public, but healthcare workers including those that work in inpatient mental health settings have seen long-lasting impacts in their workplace. Recreational therapists (CTRSs) are among the mental healthcare workers that have been impacted by the pandemic but there is no existing research that specifically studies their lived experiences. This study used the theoretical foundations and methods of hermeneutic phenomenology in order to describe how COVID-19 has impacted CTRSs’ workplace from a safety perspective, their stress and coping, and also their supervisory duties. Seventeen participants were recruited and …

Tiny Tusks Breastfeeding And Infant Support: Breastfeeding's Effects On Maternal Mental Health, Anna Jacobs

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Breastfeeding has proven to be beneficial for infant health and maternal physical health, but there are variable outcomes for maternal mental health. This literature review explores the relationship between breastfeeding and maternal mental health, a topic that is often disregarded when discussing breastfeeding with mothers. After an internship with Tiny Tusks Breastfeeding and Infant Support, a program to make breastfeeding more accessible at Razorback Athletics events, maternal mental health related to breastfeeding was shown to be a topic in need of more current research. This objective of this literature review was to determine how breastfeeding can impact maternal mental health …

Anxiety, Depression, And Suicidal Ideation Among Transgender Individuals With Gender Receiving Gender-Affirming Hormone Therapy, Rosa E. Diaz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Gender may align with one’s sex but doesn’t always and sometimes leads to Gender Dysphoria (GD). Gender-affirming hormone therapy (GAHT) is often one of the first medical treatments used for GD yet few studies have examined the effects of GAHT on mental health (depression, anxiety, and suicidal ideation).Methods: Participants were 18 years or older and self-reported as being diagnosed with GD and recruited across the United States using snowball and convenience sampling. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depression scores, General Anxiety Disorder-7 (GAD-7) was used to measure anxiety scores, and Suicidal Behaviors Questionnaire-Revised (SBQ-R) was …

Individual Differences In Lpp Amplitude And Theta Power Predict Cue-Induced Eating During A Cued Food Delivery Task, Kyla Gibney

Dissertations & Theses (Open Access)

Due to individual differences in the brain’s reward system, some individuals are more vulnerable than others to maladaptive, reward-seeking behaviors, such as substance use or compulsive eating. A body of research has demonstrated that individuals who attribute higher levels of incentive salience to reward-associated cues than to pleasant images (termed “C>P group” throughout) are more vulnerable to compulsive eating than those who attribute higher incentive salience to pleasant images than reward- associated cues (P>C group). Meanwhile, a separate body of research has demonstrated that cognitive control also regulates eating by enabling top-down attentional control. This dissertation aims to …

Health Care Transition Experiences Of Youth With Intellectual Disabilities In A Post-Secondary Inclusive Program, Faith Duensing

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Between the ages of 18-21 years old, youth and young adults make the transition from pediatric to adult health care. While it may be an easy and seamless transition for some, that is not always the case, especially for youth and young adults with disabilities. Youth with disabilities experience several distinct health disparities compared to their peers without disabilities and these can be carried over to impact their health care transition (HCT) process. The purpose of this study was to learn more about the HCT experiences of young adults with disabilities and their families to learn and develop ways that …