Medicine and Health Sciences Commons^™

A Multimodal Approach: Implementing Omm For Spinal Surgery Patients' Pain And Anxiety, Summer Barnes

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.

Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and …

Incorporation Of Mindfulness Application Use In Doctoral Nurse Anesthesia Curricula For Mitigation Of Stress And Anxiety In Student Registered Nurse Anesthetists, Kerrie Rodgers

Doctor of Nursing Practice Scholarly Projects

The nurse anesthesia specialty is highly stressful, with educational training being no exception. High didactic demands and intensive clinical experiences are placed on student registered nurse anesthetists (SRNAs), increasing stress and anxiety in their personal and professional lives. High levels of psychological distress can lead to inadvertent consequences in students’ mental, emotional, and physical health and can contribute to illness, burnout, substance use, and compromise in patient safety. Some degree of stress is necessary for motivation to succeed and perform at high levels, and encountering stress while enrolled in a doctoral nurse anesthesia program is expected and unavoidable. A search …

Comparisons Of Using Alcohol, Coping Strategies, Anxiety, And Depression Between Usa And Taiwanese College Students, Pi-Ming Yeh Associate Professor, Cheng-Huei Chiao Professor, Jennchang Liou Professor

Epsilon Sigma at-Large Research Conference

Purpose: In this study, we compared United States (US) and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression.

Research Questions:

1. What were the differences in demographic characteristics, using alcohol, coping strategies, anxiety, and depression between US and Taiwanese college students?

2. What were the relationships between US and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression?

3. How much of US and Taiwanese college students’ anxiety and depression were predicted by their use of alcohol, coping strategies?

Methods: Four hundred and one US and 180 Taiwanese college students were recruited in this study. This was …

Implementation Of Vinyasa Yoga For Adults Experiencing Anxiety, Megan K. Malyuk

Theses and Graduate Projects

Anxiety disorders are the most prevalent mental illness in the United States (US) and holistic treatment approaches, such as vinyasa yoga, are often practiced to alleviate the severity of symptoms (The Anxiety and Depression Association of America, 2020). A comprehensive literature review including evidence-based research, Metis-based knowledge, and personal accounts are used to support this scholarly project. Jean Watson’s Theory of Human Caring is explicated and synthesized as a theoretical framework. Methodology and evaluation of the scholarly project are described, analyzed, and reflected that vinyasa yoga has a positive impact on individuals who experience anxiety. This scholarly project was implemented …

Implementing Distress Screening And Hospital Management Of Oncology Patients With Distress, Rhezarie Mae Agtarap

Doctor of Nursing Practice Projects

Of the nearly 2 million new cancer cases projected to occur in the United States in 2022, up to 65% of patients may be hospitalized in the first year of their diagnosis. Hospitalized oncology patients have been documented to experience psychological distress during their hospitalization related to physical and emotional challenges related to their disease. In ***, a tertiary hospital located in ***, Oregon, hospitalized cancer patients with hematologic malignancies and aggressive or advanced solid cancers have verbalized distress, including depression, anxiety, feelings of isolation, and fatigue during prolonged hospital stays. According to the National Comprehensive Cancer Network (NCCN), distress …

The Prevalence Of Stress And Stressors Among Pediatric Oncology Nurses Working In Pediatric Oncology Units In Pakistan - An Analytical Cross-Sectional Study, Shenila Anwarali

Theses & Dissertations

Introduction: Pediatric oncology nurses in Pakistan are at the forefront of caring for young cancer patients. In Pakistan, thousands of children are diagnosed with cancer every year, however the country's healthcare system lacks a comprehensive National cancer registry. Pediatric oncology nurses face high stress levels due to the demanding nature of their work, lack of specialized training, and communication challenges with patients and families. This study aims to explore the prevalence of stress and its predictors among these nurses in Pakistan, addressing a significant research gap.
Purpose: The purpose for the study was to measure stress and identify its predictors …

The Impact Of Brief Electronic Guided Mindfulness Meditation On Anxiety Scores, Sierra King

DNP Scholarly Projects

In the United States, anxiety rates are on the rise for the general population (Goodwin et al., 2020a). Prolonged and frequent anxiety can become unprompted and problematic (American Psychiatric Association, 2021). Management of anxiety is crucial for overall wellbeing. Access to treatment and resources for anxiety may be limited in rural geographical locations (Morales et al., n.d.). This DNP project sought to determine whether a brief intervention of electronic guided mindfulness meditation (MM) by Insight Timer is effective in decreasing anxiety in a rural populous. Convenience sampling recruited a final total of 11 rural participants who participated in seven sessions …

Distraction Interventions And Play Therapy: Decreasing Fear And Anxiety In Hospitalized Patients Less Than 12 Years, Terence J. Olds, Jordan Conroy, Rebecca Rider, Julia Good, Hannah Peacock

Non-Thesis Student Work

Hospitalization can be a frightening experience for pediatric patients. Addressing these negative emotions greatly impacts their experience, wellbeing, and recovery process. It is crucial to understand and implement strategies that alleviate these negative emotions and promote healing during hospitalization. The authors will review two safe, effective, and reliable methods of alleviating fear and anxiety in hospitalized children under 12 years old; distraction techniques and play therapy. A literature search was conducted on CINAHL and PubMed using the following search criteria: child, youth, kid, play therapy, therapeutic play, anxiety disorders, generalized anxiety, hospital, acute setting, inpatient, and distraction. A total of …

Integrating Behavioral Health Into Family Medicine: Improving Access To Specialty Care Using A Collaborative Care Model, Christina Stephens

DNP Scholarly Projects

Primary care, an extensive of family medicine remains a key access point for patients entering the healthcare system. Accessing medical care and specialty psychiatric services is limited in rural communities. Patients often find exhaustive wait times, untimely referrals, and reliance on emergency services for crisis management. The primary care provider is able to help their community improve access to behavioral health care by using a collaborative approach. This quality improvement initiative used the framework produced by the AIMS Center at the University of Washington and adopted for use creating an 8-week intensive program in a family medical practice located in …

The Effects Of Yoga On Anxiety And Sleep Quality Levels Among College Students, Larisa Lucas Mullins

DNP Projects

Background: College students have poor sleep quality due to a newfound sense of freedom, exposure to new influences, or poor sleep hygiene (Dinis & Barganca, 2018). Specifically, evidence supports a correlation between sleep latency in onset or lack of nighttime sleep and increased anxiety (Dinis & Barganca, 2018). Yoga has been shown to decrease anxiety, stress symptoms, and depression (Mullen et al., 2021). Teaching yoga techniques and encouraging routine yoga practice to college students may improve sleep quality and decrease anxiety.

Purpose: This project's purpose was to evaluate the effect of yoga education and videos on sleep quality and …

Utilizing A Structured Music Therapy Program For Adolescents With Anxiety And Depression, Amy Haagen

West Chester University Doctoral Projects

Anxiety and depression are two of the most common mental health issues that affect children and adolescents. It has been noted that twenty percent of adolescents will have a depressive episode or be affected by anxiety by the time they are 18 years old. Mental health issues affecting children and adolescents majorly impact all aspects of their lives, most notably academic success, behavior, growth, and development (Porter et al., 2017). Current treatments for mental disorders, including depression and anxiety, include pharmacological and psychotherapeutic treatments. In the adolescent population, there are conflicting opinions on the use of antidepressants due to risks …

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: …

Identifying Risk And Improving Outcomes: Application Of The Gad-7 Screening Tool Used Among Patients With Chronic Pain In An Outpatient Setting, Connor J. Cochran

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: It is estimated that chronic pain affects one in every five adults and that one in every three adults will be diagnosed with an anxiety disorder within their lifetime, indicating an overlap in both chronic pain and anxiety. Early identification of anxiety in the outpatient setting has the potential to increase identification and referral rates to specialized care.

Local Problem: An outpatient primary care facility that treats patients with chronic pain located in Philadelphia, Pennsylvania was the project setting. Prior to implementation, there was no standard process for identifying anxiety in patients.

Methods: The Iowa model of Evidence-Based Practice …

Anxiety Screening At A Psychiatric Inpatient Facility: A Quality Improvement Project, Irene Akwitti

Doctor of Nursing Practice

Background. Generalized anxiety disorder is characterized by persistent anxiety and uncontrollable worry occurring more days than not for a minimum of 6 months (Patriquin & Mathew, 2017). Presently, anxiety screening and evidence-based practice treatment for adults are suboptimal. It is impossible to overemphasize the importance of early diagnosis and prompt treatment of generalized anxiety disorder in patients. Purpose. The purpose of this quality improvement project was to implement the Generalized Anxiety Disorder-7 (GAD-7) screening tool, a validated, evidence-based instrument, in a psychiatric inpatient facility to improve early detection and treatment of anxiety disorders in patients. Methods. Staff members were educated …

A Quality Improvement Project To Screen For Food Insecurity In Adults With Anxiety Or Depression, Kelsie Evelyn Kroll

Doctor of Nursing Practice

Background Food insecurity is the limited availability and inconsistent accessibility of healthy foods (Coleman-Jensen et al., 2022a). Food insecurity contributes to mental health problems. Individuals with food insecurity have greater odds of screening positive for depression and anxiety (Wolfson et al., 2021). The Hunger Vital Sign™ screening tool is a 2-questions evidence-based tool used to identify food insecurity (Hager et al., 2010). Purpose. Implement the Hunger Vital Sign™ tool at a non-profit behavior health clinic to identify food insecurity in adults who screened positive for anxiety or depression, offer resources for them to obtain nutritious food, and provide additional information …

Prevalence Of Type A And Type B Personality Among Undergraduate Nursing Students At Private School Of Nursing Karachi Pakistan: A Cross-Sectional Analytical Study, Farhana Shaheen

Theses & Dissertations

Background: Academic institutions strive for exceptional graduates. However, personality and learning psychology affect student performance. Type A personality students may develop heart palpitations due to impatience and stress. They are less sociable than Type B personalities but more idealistic, competitive, and deadline oriented. These disparities among personalities may impair their academic and job success, especially in healthcare, where interpersonal skills are vital.
Aims: The primary aim of the study was to find out the prevalence of Type A and Type B personality among undergraduate nursing students and to find the association between personality Types and academic years.
Methodology: In this …

Coping Strategies To Promote Mental Wellness, Luma Aziz, Domonique Jackson, Jessica Herzog, Molly Mcdonough, Ashley Kim, Arianne Faye Villaflor

Nursing Leadership in Community Engagement Projects

Coping Strategies to Promote Mental Wellness

Over eight weeks, our nursing school leadership team collaborated with a Seattle non- profit agency whose mission is to provide resources, planning, and housing to families with children experiencing homelessness. Our team’s overarching goal by the end of this project, based on the needs expressed by the agency, was to create a tool that provides resources and coping skills to families experiencing homelessness to improve mental health and promote wellness.

Background

The population that is served by the agency includes families with at least one child under the age of eighteen, children with medical …

Psychological Distress, Resilience, And The Impact On Quality Of Life In Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy, Lauren Schwab

USF Tampa Graduate Theses and Dissertations

The purpose of this dissertation study was to longitudinally examine psychological distress (depressive symptoms and anxiety symptoms), resilience, and the impact on quality of life (QOL) in breast cancer survivors (BCS) with taxane-induced peripheral neuropathy (TIPN). The specific aims were 1) to describe psychological distress (depressive and anxiety symptoms) in BCS with TIPN and the impact on QOL using a scoping review; 2) to determine the relationship between psychological distress, QOL, and resilience in BCS with TIPN over time in a 16-week randomized controlled trial (RCT); and 3) to determine if resilience moderates psychological distress and QOL in BCS with …

Prevalence Of Depression In Patients With Cardiovascular Diseases, Faryal Ghafoor

Theses & Dissertations

Background: Approximately 17.3 million individuals across the globe lose their lives to cardiovascular diseases (CVD), with a majority of these cases occurring in low-to-middle-income countries. The incidence of cardiovascular disease in Pakistan is 918 cases per 100,000 individuals. Depression frequently impacts the health, expenses, and prognosis of patients with cardiovascular disease.
Purpose: This study aimed to determine the prevalence of depression among CVD patients at Aga Khan University Hospital, Karachi, and explore the influence of co-morbidities, marital status, age, and educational background on one's status, regarding depression.
Method: A quantitative descriptive cross-sectional study was conducted at the Aga Khan University …

Social Activity Restriction And Psychological Health Among Caregivers Of Older Adults With And Without Dementia, Elliane Irani, Kylie Meyer, Scott Emory Moore, Kedong Ding

Faculty Scholarship

Objectives: We examined associations between social activity restriction and psychological distress and well-being for caregivers of older adults with and without dementia, and if the identified associations are different for the two groups. Methods: Using data from the 2017 National Study of Caregiving, we identified caregivers of older adults with (N = 541) and without (N = 1701) dementia. Linear regression models were estimated, adjusting for caregivers’ age, gender, race, education, relationship to care recipient, and self-rated health. Results: Restriction in visiting friends and family and attending religious services were associated with higher distress in dementia caregivers. Restriction in visiting …

Expanding Clinical Knowledge And Awareness To Non-Benzodiazepine Treatments By Providing An Educational Intervention: A Quantitative Study, Alexander Labrador

Doctor of Nursing Practice Scholarly Project

This study examined the effectiveness of an educational intervention for healthcare clinicians to increase knowledge and awareness of non-benzodiazepine treatments for the treatment of anxiety and panic disorders. The target population were healthcare clinicians in a metropolitan area that commonly treat anxiety and panic disorders. Clinicians from different specialties were recruited to participate and evaluated on their knowledge of benzodiazepines on a 3-question pretest survey using a Likert scale. The clinician was then given a 30-minute educational intervention that covered the risks and dangers of benzodiazepines and a review of alternative, non-benzodiazepine treatment options. The clinician then self-evaluated themselves using …

Effectiveness Of An Evidenced-Based Cognitive Behavioral Therapy Intervention For Adolescents In A School Setting, Sarah Ellen Gray, Kimberly Michaela Carter, Amanda Harper

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

The adolescent years are a formative time when rapid hormonal and physical changes stimulate the developing mind. Exposure to poverty, abuse, violence, and lack of peer and social support causes an increase in vulnerability to the development of mental health problems. The COVID-19 pandemic has also exacerbated symptoms of depression and anxiety. Regardless of the risk factors, anxiety and depression continue to be significant health problems, affecting thousands of adolescents yearly in the United States. The first-line treatment recommendation for managing anxiety and depression symptoms is cognitive behavioral therapy (CBT). However, access to a provider for CBT treatment is …

Mental Health Problems Among Elementary School Students Mandated To E-Learning: A Covid-19 Rapid Review Caveat, Renée M. D'Amore, Angelina N. Halpern, Lauren R. Reed, Kevin M. Gorey

International Journal of School Social Work

Extended lockdowns during the COVID-19 pandemic mandated millions of students worldwide to e-learning and by default made many of their parents proxy homeschool teachers. Preliminary anecdotal, journalistic and qualitative evidence suggested that elementary school children and their parents were probably most vulnerable to this stressor and most likely to experience mental health problems because of it. We responded with a rapid review of 15 online surveys to estimate the magnitude of such risks and their predictors between 2020 and 2021. The pooled relative risk of mental health problems among school children and their parents was substantial (RR = 1.97). Moreover, …

Increasing Music Therapy Referrals In A Surgical Intensive Care Unit., Brandi Cecil

Doctor of Nursing Practice Papers

Medications have been the primary intervention in intensive care unit patients due to the fact that the patients are often unconscious, critically medically ill, or unable to actively participate in nonpharmacological treatment. Researchers have found the integration of music therapy in patient care has helped ease pain, anxiety, and stress, and has been useful in vital control, such as decreasing heart rate and respiration count. A study was conducted in a surgical intensive care unit (SICU) to examine the benefits of increasing music therapy consults. Critical care nurses were educated on the advantages of utilizing interdisciplinary care by consulting music …

Implementation Of A Progressive Muscle Relaxation Intervention To Decrease Cancer Patients' Distress: A Quality Improvement Project., Theresa Thomas

Doctor of Nursing Practice Papers

Background: People affected by cancer often experience psychological distress that ultimately decreases their health, adherence to treatment, overall well-being, and quality of life. Research has shown that MBIs can reduce psychological distress, depression, and anxiety and increase quality of life. A needs assessment conducted within a local cancer support organization, Gilda’s Club Kentuckiana, has expressed the need for providing a more comprehensive range of accessible MBIs in their programming to meet their psychosocial goals by reducing psychological distress in their members. PMR is an MBI not currently used by GCK that has been proven effective at reducing anxiety, depression, and …

Using The Buzzy Device To Decrease Pain, Fear, And Anxiety With Venipunctures And Injections, Lisa Santiago Sauls

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Anxiety, fear, and pain related to initiating peripheral venous access or injections are a high priority in the ambulatory infusion clinic setting for both children and adult populations.

Purpose: To determine if the Buzzy device will decrease anxiety, fear, and pain related to adult patients undergoing peripheral venous access or injections in ambulatory infusion clinics.

Methods: Age, sex, route of medication the patient is receiving. A post-procedure questionnaire assessed the participant's satisfaction with the Buzzy device. Pain, fear, anxiety, and patient satisfaction were all measured using a visual analog scale.

Inclusion Criteria: Patients aged eighteen and above receive …

Effectiveness Of Virtual Reality Interventions To Reduce Pre-Operative Anxiety In Adult Surgical Patients In The Pre-Operative Period: Systematic Review And Meta-Analysis, Agnes Mulundu Mbewe, Zaneta Smith

Journal of Perioperative Nursing

Aims: To synthesise and evaluate the effectiveness of virtual reality (VR) interventions compared to standard care to reduce pre-operative anxiety in adult surgical patients during the pre-operative period.

Design: Systematic review of effectiveness and meta-analysis.

Data sources: MEDLINE, EMBASE, JBI EBP, PUBMED, CINAHL, SCOPUS, PsycINFO, Cochrane Library, EMCARE, World Health Organisation, WEB OF SCIENCE, Grey Literature, National Institute of Health & Care Excellence were searched with limits between 2010 to 2022.

Review methods: The review followed the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) guidelines. …

Differences In Anxiety In New-To-Practice Traditional And Non-Traditional Registered Nurses In Clinical Practice, Sharon Mingo

DNP Scholarly Projects

New-to-practice RNs experience anxiety during licensure preparation and orientation. Such anxiety is anticipated to linger for approximately 6 months as the RN transitions to practice and adapts to professional nursing. Many new-to-practice RNs report feelings of anxiety. Their anxiety can negatively affect the quality and safety of nursing care and increase nurse turnover. Unfortunately, the literature on anxiety in traditional post-licensure in new-to-practice RNs in clinical practice lacks information on non-traditional post-licensure new-to-practice RNs' experiences when starting professional practice roles in health care settings. This descriptive comparative study compares differences in anxiety in new-to-practice RNs of traditional and non-traditional Bachelor …

Implementation Of The Generalized Anxiety Disorder 2-Item Screening Tool For Adult Patients In An Underserved Outpatient Cardiology Clinic, Leila Joint

Doctor of Nursing Practice Final Manuscripts

Background: 11.7% of adults aged 18 and over have regular feelings of worry, nervousness, or anxiety. Anxiety can often present with somatic symptoms. The rates of misdiagnoses are high with symptoms often attributed to physical etiologies. Early recognition and treatment of anxiety can improve quality of life, prevent complications and reduce health care costs.

Purpose of Project: Implementation of the Generalized Anxiety Disorder 2-item (GAD-2) screening tool in a fast-paced underserved outpatient cardiology clinic for adult patients presenting with chest pain and/or palpitations without documented history of anxiety. The purpose of this project is to improve the utilization …

A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is a debilitating psychological condition that affects 3.1% of the American population and is one of the leading causes of disability (Anxiety and Depression Association of America, 2022; Baxter, 2014). The purpose of this evidence-based practice project was to implement a multimodal intervention to decrease GAD symptoms in adults in the primary care setting. The PICOT question that guided this project was: In adults, over the age of 18, who have been diagnosed with generalized anxiety disorder (GAD), does the combination of digital cognitive behavioral therapy (CBT) through a smartphone application, lifestyle modification education, and pharmacotherapy …