Medicine and Health Sciences Commons^™

Fostering Resilience In Children Of United States Navy Seals Using A Social Media Platform, Riley Walker

Doctor of Nursing Practice Final Manuscripts

Background: Having resilience helps children overcome, cope, and manage stressors that they encounter throughout life and provides intrinsically protective factors to help a child thrive in the face of adversity.

Local problem: Children of United States Navy Sea, Air, and Land Operators (SEALs) face consistent stress as their parent is away from home more than 240 days per year doing high-risk training exercises.

Methods: Resilience education to mothers of children whose fathers are United States Navy SEALs delivered virtually on a social media platform. Pre- and post- intervention surveys using the Likert scale were conducted to measure the mothers’ understanding …

Be Kind To Your Mind: The Use Of Mobile Based Applications To Reduce Stress And Improve Health Outcomes, Akira Hanson Finn

Doctor of Nursing Practice Final Manuscripts

Now more than ever mental health is in the spotlight on a global scale. Professionals from a variety of different disciplines are being encouraged to evaluate several different coping techniques in order combat the magnitude of societal crisis being discovered post-pandemic. At the top the list is Mindfulness-based interventions. The concept of mindfulness practices is nothing new. Evidence suggests it has existed for thousands of years; however, it is getting more notoriety in the past decade due to increasing expansion of mobile-based applications. These types of technology driven applications offer an easily accessible, convenient, and trackable way for individuals to …

Implementation Of A Shared-Decision Making (Sdm) Approach In A Community Based Outpatient Mental Health Clinic, Alexa Vuylsteke

Doctor of Nursing Practice Final Manuscripts

Purposes/Aims: The purpose of this Doctor of Nursing Practice (DNP) project is to implement an evidence-based SDM approach in a culturally diverse community mental health clinic in order to increase patient-provider collaboration and improve patient autonomy and engagement in decision making processes of care in a mental health setting.

Rationale/Background: According to the Substance Abuse and Mental Health Services Administration (SAMHSA), shared decision-making (SDM) is a collaborative communication approach between patient and provider that aims to help people in treatment work together to have informed, meaningful discussions about their health care decisions. SDM is an evidence-based approach to encourage and …

Exercise As A Prescription For Patients With Depressive Disorders: A Quality Improvement Project, Sydney Roscoe, Rachelle Pace

Doctor of Nursing Practice Final Manuscripts

Purpose: The aim of this Doctor of Nursing Practice project was to increase exercise counseling rates in the treatment of depression by (1) implementing a focused educational training program and (2) understanding factors that impacted utilization of the practice change.

Background: Approximately 280 million individuals suffer globally from depressive disorders. Depression remains the fourth leading cause of disabilities, significantly contributing toward the global burden of disease by increasing morbidity and mortality risk. Psychopharmacology and psychotherapy are current gold standards of treatment; however, providers often overlook the significant role exercise serves in reducing depressive symptoms and severity, as it remains underutilized. …

Smiling Mind: A Mobile Based Application To Reduce Stress, Agnes Rodrigues

Doctor of Nursing Practice Final Manuscripts

It has been recognized healthcare professionals experience high levels of stress at work with many working in environments characterized by high productivity targets, overtime, customer aggression, continuous organizational changes, and employee shortages. Mindfulness-based interventions such as mobile based meditation applications have gained popularity in the workplace given their potential benefits in decreasing workplace related stress, their ease of use, and cost-effectiveness. The purpose of this evidence based project (EBP) project was to reduce perceived workplace stress and to increase mindfulness using a mobile meditation application. Employees of an outpatient psychiatric clinic used the mobile meditation application Smiling Mind to meditate …

Identifying Adverse Childhood Experiences (Aces) In A Federally Qualified Health Center Using The Pediatric Aces And Related Life Events Screener, Melody Albarran-Slovin, Bsn, Rn

Doctor of Nursing Practice Final Manuscripts

Background: Evidence links adverse childhood experiences (ACEs) to health issues later in life. Most research has been conducted in adults but there is a lack of recent research on the impact of ACEs in the pediatric population particularly in relation to mental health conditions. Utilizing the Pediatric ACEs Screener (PEARLS) health care providers can screen for ACEs at earlier ages.

Purpose: The aim of this evidence-based project is to determine if there is an increase of newly diagnosed mental health related disorders when using PEARLS compared to not using PEARLS in the previous months before implementation.

Methods: ACEs were identified …

Balancing Provider Stress And Resilience In The Time Of Covid, Zachary Love

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice project is to improve secondary traumatic stress (STS), compassion satisfaction, and burnout amongst providers—physicians, residents, and nurse practitioners—within the acute psychiatry units of the La Jolla Veterans Health Administration (VHA) through a one-time educational training session.

Background: Mental health providers at the VHA acute psychiatry units experience one of the highest risks for the development of STS, CF, and burnout amongst all professions due to a number of individual and institutional factors. STS is characterized by secondhand traumatization with symptoms similar to that of Post-Traumatic Stress Disorder—difficulty sleeping, mood changes, upsetting images appearing …

Making The Case For Psychedelics: Comparing Alternative Treatment Options For Depression, Nicole Amavisca

Undergraduate Honors Theses

Given the number of people who are treated for depression each year and the knowledge that treatments work differently for everyone, there is a pressing need to provide a variety of treatment options. Although psychedelic research had been halted for a few decades due to recreational abuse, there has been revived interest due to its therapeutic potential in the treatment of mood disorders and addiction. As an example, the hallucinogen ketamine has recently been approved as a treatment for depression, which has opened the door for broadening the discussion on psychedelic research. Although the research is limited, psilocybin mimics ketamine …

Screening For Resilience In Pediatric Primary Care, Kaitlin Phelan, Martha Grant Fuller

Doctor of Nursing Practice Final Manuscripts

Introduction: Adversity in childhood increases risk for physical and mental health problems. Children who undergo adverse events can still flourish, due to the concept of resilience. Literature shows that resilience influences health more than adversity, and screening for resilience may improve practice.

Method: A valid screening tool for resilience, The CD-RISC, was given to children twelve and above during their well visit during February 2021 at a clinic in Oceanside, CA. Scores were categorized into four quartiles. Children responding in the lowest two quartiles received provider follow up.

Results: 97 surveys were scored: 39 scoring in the lowest quartile, 19 …

Using Short Message Services (Sms) To Reduce No-Show Rates An Evidence-Based Practice Project, Matthew Rocklage

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: No-shows (NS) are correlated with reduced treatment efficacy, increased financial burden on medical institutions, and early treatment termination for therapy. NS occur for a variety of reasons and appointment compliance within outpatient mental health clinics has a wide variance with clinics reporting no-shows ranging from 15% to 50%. This section of the project is a continuation started by an earlier USD DNP student Fernando Serrano, in which the projects aims were expanded beyond the participation of nurse practitioners only to now include marriage family therapists (MFT), psychologists and medical residents, and to address the NS rates clinic-wide. One …

Metabolic Syndrome Screening Among Inpatient Psychiatric Patients, Susan Magorno

Doctor of Nursing Practice Final Manuscripts

Background: More than 50% of patients with severe mental illness carry undiagnosed Metabolic Syndrome (MetS) comorbidities of hypertension, hyperlipidemia, or diabetes. These patients are three times more likely to die of cardiovascular-related causes; however, this population is not routinely assessed for MetS and frequently lack appropriate treatment.

Objective: The objective is to implement a screening tool designed to identify risk for MetS and trigger appropriate treatment.

Design: The screening tool triggers the provider to address positive criteria through interventions such as further evaluation, medical and/or diabetes educator consultation.

Results: Although overall rates of screening improved significantly, follow-up interventions were …

The Health Of Human Trafficking Victims In San Diego, California: A Retrospective Study, Noelle Lipkin Leveque

Dissertations

Background/Purposes/ Aims: Human trafficking (HT) is a threat to human rights globally. Studies indicate between 28% and 87% of HT victims encountered a health care professional during their trafficking period. Nonetheless, little is known about the health care needs of victims of HT. The purpose of this study was to examine the health care needs of a self-identified group of trafficked women in San Diego County, California.

Conceptual Basis: The Model of Human Trafficking and Health by Zimmerman et al. (2011) was used to identify multiple determinates of health following the trafficking period including demographic factors (age at assessment, age …

Campus Mental Health Practices And The Stigma Of Mental Illness: A Quantitative Analysis Of Student Affairs Professionals, Megan Krone

Dissertations

Around half of undergraduate college students will experience mental illness to some extent during their academic careers, yet a low percentage of students experiencing signs and symptoms of mental illness will seek help despite the availability of proven, effective treatments. The field of higher education has demonstrated a genuine concern for individuals with mental illnesses and mental health care on campuses, yet implementation of practices that connect students to treatment is inconsistent and effectiveness is uncertain.

This study searched for associations between campus practices and campus culture regarding mental illness. While institutions of higher education are using both traditional and …

Is Combat Exposure Predictive Of Higher Preoperative Stress In Military Members?, Eric J. Bopp Phd

Dissertations

Since September 11, 2001, the United States has been engaged in large-scale combat operations exposing numerous military service members to stressful, traumatic, and threatening environments. As a result, many of these individuals have experienced significant psychological problems, such as anxiety, depression, and posttraumatic stress disorder (PTSD), as well as physiological alterations, such as cardiovascular changes and neuroendocrine disturbances. The preoperative experience may be perceived as stressful, often increasing in magnitude as the patient progresses through the preoperative period. Military anesthesia providers frequently provide anesthetic care to military members with a history of combat exposure. Anecdotally, it is not uncommon for …

Efficacy Of Mantram Repetition Program On Sleep In Veterans With Posttraumatic Stress Disorder, Lindsay Cosco Holt Phd

Dissertations

Posttraumatic Stress Disorder (PTSD) affects over seven million (3.5%) of the US adult population. In 2011, 476,515 veterans were currently seeking treatment for PTSD. Statistics show that 87% of veterans with PTSD report sleep disturbances and 52% experience frequent nightmares, making sleep the second most common reason why veterans seek mental health care upon return from deployment (Germain et al., 2006). Studies have sought to find a link between PTSD and sleep, and the importance of sleep in the recovery process, but there is a gap in the research on sleep disturbances and interventions for improvement in veterans with PTSD. …

Quality Of Life Among Southwest American Indians And Alaska Natives Living With The Hepatitis C Virus, Rydell Todicheeney-Mannes Phd, Rn, Acns-Bc

Dissertations

Background: Hepatitis C Virus is considered to be a global public health threat because seventy-five percent of infected persons have no symptoms and are unaware of their infection. It is significant to note that AI/ANs commonly contend with issues that prevent them from receiving or seeking medical care. Objectives: The purpose of this study was to: (a) Characterize the level of depression, alcohol consumption, stigma, and quality of life; (b) Examine the relationship among the variables of age, gender, residing on an AI/AN reservation, current partner status, depression, alcohol consumption, and stigma with quality of life in a sample of …

Acupuncture For Sleep Disturbances In Veterans With Post Traumatic Stress Disorder, Heather C. King Phd

Dissertations

Post Traumatic Stress Disorder (PTSD) has emerged as a significant problem among Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans. Disturbed sleep is one of the most frequently reported symptoms among OEF/OIF veterans with PTSD. PTSD itself is impairing, but the burden of this disorder is likely heightened when accompanied by sleep disturbances. Sleep disturbances have been associated with a 75-90% increased risk of co-morbid conditions, increased levels of depression and anxiety, daytime sleepiness and fatigue, reduced psychomotor performance, diminished work productivity, and decreased quality of life. These consequences of disturbed sleep emphasize the critical need for additional evidence based therapies …

The Impact Of Guided Imagery On Sleep Quality In Mothers Of Preterm Infants, Linda M. Schaffer Phd, Mn, Rn

Dissertations

Background: Mothers who have given birth to preterm infants are at an increased risk for impaired sleep. Evidence based interventions are needed to assist mothers in improving their sleep quality as few are available. Purpose: Guided by the transactional framework of Lazarus and Folkman (1984), the purpose of this study was to: describe maternal and infant factors which influence sleep quality, examine the relationships between depression, anxiety, stress, social support, to sleep quality, and describe the influence of a R-GI intervention on sleep quality among a sample of mothers whose preterm babies were admitted to NICU. Methods: This prospective, descriptive, …

Feasibility Study Among Military Personnel With Traumatic Amputation During Military Combat Or Training, Michele (Shelly) R. Burdette-Taylor Phd, Msn, Rn-Bc, Cwcn, Cfcn

Dissertations

Military operations have resulted in a significant number of mangled extremities leading to traumatic amputations. Extremity injuries predominate, representing 50% to 70% of all injuries treated (Melcer, 2010). The majority of injuries sustained in Operation Endearing Freedom/Operation Iraqi Freedom (OEF/OIF) are combined penetrating, burn and blast injuries, traumatic amputation, and infections from the multi-drug resistant organism, Acinetobacter (Melcer, 2010). The purpose of this study was to measure the quality of well-being and impact of events in a group of adults who served in the U.S. armed forces and sustained the loss of one or more limbs during any combat or …

Violence, Depression, Parental Stress, And Child Neglect Among High Risk Postpartum Women, Kristen D. Lambert Phd, Msn, Rn

Dissertations

The purpose of this study was to characterize a vulnerable population of postpartum women at risk for family violence and maladaptive outcomes and to determine the degree the identified attributes increase the risk of child neglect and psychological aggression. Lazarus' Appraisal Theory and Scaer's Traumatic Spectrum framework provided a conceptual basis to examine the interrelationships between intimate partner violence (IPV), depression, previous traumatic history, and child neglect. A descriptive correlation design using secondary analysis of longitudinal data collected for the Healthy Families San Diego Clinical Trial was used. Standardized measures including the CTS, CTS2, CTSPC, CES-D and PSI were administered …

An Examination Of Alcohol Use In The Gastric Bypass Patient, Kathleen Winston Phd, Msn, Rn

Dissertations

Introduction: Obesity and morbid obesity, along with their co-morbidities, are impacting the national and international healthcare delivery systems and policy agendas. Bariatric surgery is a dynamic and fast-changing medical and surgical practice designed to mitigate the consequences of 60 million obese adults in the United States alone. Alcohol consumption after gastric bypass surgery presents potential physiological and psychological problems. Purpose: Examine the prevalence and incidence of increased alcohol consumption among a group of post-gastric bypass patients; identify the relationship of the alcohol use with time since surgery, psychosocial issues (depressive symptomatology, anxiety, coping) and demographic variables. Theoretical Framework: Coping serves …

Sense Of Humor, Stress And Coping, And Outcomes In Children's Lives, Lambertha Okhuizen-Stier Phd, Mph, Rn

Dissertations

Children are confronted with many stressors in their environment which may bring about symptoms such as anxiety, sadness, worry, aggressiveness, hyperactivity, restlessness, or low self esteem (Sharrer & Ryan-Wenger, 2002). To prevent the short and long term effects of stress, children may use coping strategies to manage or alter stressful life events (Lazarus & Folkman, 1984). This study explores the relationships between stress and sense of humor among school-age children. A sample of 106 students (and parents/guardians) in the San Diego Unified School District (SDUSD) returned self-report instruments packets containing the Multidimensional Sense of Humor Scale for Children, and the …

Beholding The Beauty Of Self: The Psychological Integration Of The Afrocentric-Self Among African-American Females Socialized In A Eurocentric Aesthetic, Donna Lynn Cook Phd

Dissertations

Self-esteem and body image disturbances prominently figure into many physical and psychological health disorders such as depression, eating disorders, anxiety disorders, and chemical dependency. In Euro-American culture, media images of femininity and physical attractiveness reinforce generally held perceptions of the idealized female beauty as tall, white, slender, and often blond and blue eyed. The physical morphology of African-American women does not genetically "fit" this westernized standard of beauty with implications for their mental health. The socialization of African-American women in a culture that embraces a different ethnic standard of beauty influences their perceptions of how physically attractive they see themselves. …

The Relationship Between Coping, Anxiety, And Quality Of Life For Taiwanese Post-Coronary Artery Bypass Graft Surgery Patients, Heng-Hsin Tung Phd

Dissertations

Coronary artery bypass grafting surgery (CABG) is a stressful event and requires coping strategies to achieve adaptation. In Taiwan, despite the fact that the incidence of CABG is increasing in both men and women, research on post-CABG adaptation is very limited and no research focuses on outcomes for women. This can lead to problems for health care providers who lack effective interventions to help these patients. The purpose of the study was to examine the relationship between coping, anxiety, and quality of life in Taiwanese post-CABG patients. A cross-sectional correlational design was used; the sample consisted of 50 female and …

Psychosocial Responses By Adolescent Male Victims To Peer Bullying, Karin Eve Reuter-Rice Phd

Dissertations

Bullying remains a pervasive problem in most schools throughout the nation. Peer-bullied victims report higher levels of depression, suicidal ideation, anxiety, and concerns regarding their safety in school. Reactions of victims to peer bullying have been extreme, as in the cases of the rampage school shooters. Primarily, current research has not focused on the high school adolescent, although most school shooters arise from that age group. The overall purpose of this study was to examine the psychosocial responses by adolescent male victims to peer bullying. Research questions addressed the frequency and severity of peer-victimization, distress, anxiety, and their perception of …

Exercise Level And Age As Related To Self-Perceived Physical Health, Mental Health, And Social Health In Older Adults, Barbara Jean Leach Phd, Msn, Rn

Dissertations

The purpose of this study was to examine the relationship between the level of exercise and age and self-perception of physical, mental and social health in older adults. Voluntary quota sampling was used to recruit 224 older adults aged 55 and up. The Physical Activity Questionnaire for the Elderly (Voorrips, Ravelli, Dongelmans, Deurenberg, & Van Staveren, 1990) was used to determine the current level of exercise of the older adult. Age was measured using the Demographic Questionnaire by Leach (1999) and self-perception of physical health and mental health was measured using the SF-36 Health Survey by Ware (1993). The Texas …

Effect Of Relaxation On Neuro-Immune Responses Of Persons Undergoing Chemotherapy, Patricia K. Taylor Pothier Phd, Ms, Rn

Dissertations

Chemotherapy can be considered both a physiologic and a psychological stressor. Anxiety, nausea, emesis, and immunosuppression are commonly associated with chemotherapy, and may adversely affect the outcome or the process of treatment. Chemotherapy-related anxiety can exacerbate negative side-effects. Some psychological stressors, such as anxiety, can result in down-regulation of certain immune functions. Studies have demonstrated that behavioral interventions, such as specific relaxation strategies, can modify stress-related immune modulation. These behavioral interventions have also been shown to decrease the degree of nausea and vomiting associated with chemotherapy. The purpose of this study was to examine whether a relaxation intervention would result …

Relationships Between Posttraumatic Stress, Acculturation, And Maternal Sensitivity In Vietnamese And Hmong Mothers, Gwendolyn F. Foss Dnsc

Dissertations

The purposes of this study were to determine if posttraumatic stress (PTS), depression, and anxiety occurred in a community sample of Vietnamese and Hmong mothers and to describe relationships between PTS, depression, anxiety, acculturation and maternal sensitivity. Transition theory (Bridges, 1980), and a conceptual model of parenting in immigrant populations building on Belsky's (1984) work, provided the theoretical framework (Foss, 1996). The sample was divided evenly between Vietnamese and Hmong participants. Ages ranged from 17–43 years, time lived in the United States ranged from 3–21 years, and education ranged from no formal education to completion of college. Maternal sensitivity was …

Elders Caring For Elders: Risk Of Abuse And Neglect?, Marjorie F. Bendik Dnsc, Msn, Rn

Dissertations

This study was designed to examine the phenomena of mood disturbance and associated potential to abuse in an elderly caregiver population. The data from which the results were obtained came from structured interviews, using quantitative measures, with 110 men and women caregivers aged 55 and over, living at home and caring for another physically or mentally ill elder (usually a spouse or other relative) who was living with them. A causal model was developed to examine the effects of locus of control, social support, physical health, stress perception, and coping efficacy on total mood disturbance and potential to abuse. Standardized …