Mental and Social Health Commons^™

Critical Illness Survivors’ Perceptions Of Their Recovery: An Interpretive Phenomenological Inquiry, Kelly Calkins

Theses and Dissertations

Surviving critical illness with its physical, cognitive, and psychosocial morbidities is a growing clinical and research challenge and an important public health concern. Currently, there are few interventions for survivors of critical illness after hospital discharge. Potential interventions include rehabilitation services, Intensive Care Unit (ICU) diaries and ICU follow-up clinics, however, most survivors do not have access to these post-hospital interventions.

The purpose of this study is to gain a better understanding of how critical illness survivors experience their recovery, interventions they use, and what they perceive as facilitators and barriers to their recovery. A better understanding of these factors, …

Depression Screening At A Mental Health Outpatient Clinic: A Quality Improvement Project, Renee Licorish

Doctor of Nursing Practice

Project Background: Depression is one of the most common mental health problems in the United States. Many individuals may seek treatment but go undiagnosed due to the lack of recognition by clinicians. Clinical guidelines recommend the use of a standardized depression screening tool within a clinician’s evaluation process. The Patient Health Questionnaire 9 (PHQ-9) is such a tool and recommended for use in the outpatient care setting. Aims of the Project: To increase depression screening of clients at a hospital-based outpatient behavioral health clinic. Purpose and Objectives: Implementation of the PHQ-9 into the clinic’s mental health assessment process to increase …

Searching For Wisdom: A Phenomenological Investigation Of Women's Perspectives Following Participation In An Ovarian Cancer Supportive Care Group, Helen Butlin

Electronic Thesis and Dissertation Repository

This study used a novel methodology of hermeneutic-poetic-phenomenology to explore perspectives of women living with ovarian cancer. Each had participated in a supportive care group process Soul-Medicine prior to volunteering. Three women, Beth, Carrie, and Denise contributed to this study. The methodology was grounded in Gaston Bachelard’s philosophy of poetic-phenomenology. Data was analyzed with attention to image-centred knowledge; material imagination; reverie; and horizons of hope to elucidate their implicated aspects of wisdom and the ways participant’s formed their personal wisdom integrating feminist theories of embodiment and bioethics.

Findings are framed through three images of a uniquely formed inner ‘wisdom-compass’, an …

Improving A Discharge Process To Decrease Readmission Rates, Erni Ensing

Master's Projects

No abstract provided.

Nurses Role In Health Home Mixed Methods Study, Jacqueline S. Prokop

Nursing Theses and Dissertations

Managing individuals with chronic health conditions in the primary care setting continues to be a significant challenge in the U.S. health care system. This issue is further compounded for low-income individuals with both mental health and physical health chronic conditions. With the enactment of the Affordable Care Act (ACA), new chronic disease health home opportunities have emerged to address the existing structural and process gaps found in primary healthcare. The nurse’s role is integral to health homes as they empower nurses to play a greater role in improving patient experiences, population health, and lowering healthcare costs. Three research manuscripts presented …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Stop, Meditate, And Listen: A Treatment Modality For Iraqi Refugees With Depression, Katherine Goehring

Doctor of Nursing Practice Final Manuscripts

Purposes: To implement a mindfulness meditation program with Arabic speaking clients as an adjunctive treatment of depression

Background: Depression rates among Iraqi refugees are between 28.3 and 75% compared to 8.6% in the general population (Slewa-Younan, Guajardo, Heriseanu, & Hasan, 2015). Treatment options are limited at Neighborhood Healthcare in El Cajon due to budget limitations, cultural beliefs and language barriers, among other reasons. Individual therapy is intended to be a brief intervention due to limited staffing. Many middle eastern refugees decline group therapy due to stigma surrounding mental health treatment and concerns about privacy. Even though traditional treatment …

The Effect Of Mantram Repetition On Qol In Low-Income, Urban Dwelling Older Adults, Marissa Katerina Mackiewicz

Dissertations

Background: Quality of life is an important concept of increasing significance for the healthcare in the United States, especially when taken in perspective of the aging population. Low-income, urban dwelling older adults are challenged in a number of ways that may negatively impact their QOL. This unique group is prone to report lower QOL, therefore, interventions targeted to improve QOL are timely. The purpose of this study was to describe the effect of mantram repetition (MR) on QOL in a sample of low-income, urban dwelling older adults.

Methods: A quasi-experimental pre-posttest study was conducted using a sample population of low-income …

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 …

Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller

Master's Theses

This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …

The Effect Of A Mindfulness Intervention On The Depression Symptoms Of Mothers In Treatment For An Opioid Use Disorder, Karen Alexander

Electronic Theses and Dissertations

BACKGROUND: Mothers in treatment for an opioid use disorder experience a high prevalence of depression which may influence their relationship with their child. In the general population, mindfulness-based parenting intervention has been seen in the literature to have a clear positive effect on maternal depression. No research has been published regarding the effect of mindfulness intervention on maternal depression of women in treatment for an opioid use disorder.

OBJECTIVES: To describe the characteristics of mothers in treatment for opioid use disorder, including depression and adverse childhood experiences, and to evaluate the characteristics associated with participation in a mindfulness intervention. Lastly, …

Interlace: Designing An Inclusionary Architecture For Alzheimer's Sufferers, Alexander Fashinasi

Bachelor of Architecture Theses - 5th Year

This thesis intends to address the increasing challenges the Alzheimer’s disease poses for our growing American population. The research begins by looking at the brain as a combination of components which make up the individual. Following this, the research compiles information on the Alzheimer’s disease and its symptoms, followed by an analysis of the built environments effects on the condition.

Through analysis of precedent cases and the combined Alzheimer’s research, I chose to propose an experimental community in which those with Alzheimer’s can live a life with greater autonomy while simultaneously slowing the progression of the disease. I place this …

Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott

DNP Scholarly Projects

The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …

Measuring Physiological Responses To Sensation In Typical Adults, Sarah Button, Kristen Christensen, Emily Minor

Dissertations, Masters Theses, Capstones, and Culminating Projects

Objective: Sensory processing issues can have a large negative impact on the ability to participate in daily occupations such as ADLs, access to work, school and leisure environments, and social interactions (Dunn, 2001). The evidence documenting sensory processing issues in adults is sparse. Physiological information can be used as objective evidence to support the claim that those with over-responsivity to sensations are experiencing their environment differently than the typical population. Understanding more about sensory processing in adults may lead to increased recognition of the problem and more opportunities for intervention to increase occupational participation. The purpose of this quantitative study …

Watson’S Theory Of Human Caring: Effect On Nurse Perception Of Care Environment, Shannon Jones

Nursing Theses and Capstone Projects

Psychiatric and mental health nurses face unique problems related to the specifics of the role including low morale and burnout. These problems stem from many factors including insufficient staffing, lack of support from management, and patient behaviors such as aggression or noncompliance which lead to poor patient outcomes. The purpose of this study was to determine what effect adoption of Dr. Jean Watson’s Theory of Human Caring has on nurse perception of the care environment on an inpatient psychiatric unit in a rural community hospital as measured by a modified version of the Combined Assessment of Psychiatric Environments (CAPE) instrument. …

An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup

Electronic Theses and Dissertations

ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …

A Multi-Faceted Intervention To Improve Naloxone Co-Prescription Rates Among Primary Care Providers, Jolane S. Conklin

Evidence-Based Practice Project Reports

It is estimated that 91 Americans die every day due to opioid overdoses, with at least half of those overdoses involving an opioid prescription (CDC, 2016d). To address this issue, the U.S. Department of Health and Human Services (USDHHS) has initiated an opioid initiative, and the Centers for Disease Control and Prevention (CDC) has released a clinical guideline, both of which include a focus on increasing use of naloxone. Despite these recommendations, providers often fail to co-prescribe naloxone to patients at increased risk of opioid overdose. The purpose of this evidence-based practice (EBP) project was to evaluate the effect of …

Pilot Study Of Anxiety, Depression, And Quality Of Life In Patients With The Diagnosis Of Metastatic Uveal Melanoma, Regine Nshimiyimana, Dnp, Bpharm, Fnp-Bc, Agacnp-Bc, Ocn, Aocnp

Doctor of Nursing Practice Projects

Background: Awareness of a patient’s anxiety, depression, and quality of life (QOL) in those with metastatic uveal melanoma (MUM) can influence care that meets patients’ bio-psychosocial-spiritual needs.

Objectives: To measure the level of anxiety, depression, and QOL in patients with MUM and explore differences by gender, age range, time to metastatic disease, and duration of illness since metastasis.

Methods: We used a descriptive-comparative survey design. Over three months, a convenience sample of 70 patients with MUM aged ≥ 18 years, treated at a Mid-Atlantic hospital were invited to complete a combined survey of the Hospital Anxiety and Depression Scale and …

Shelburne And Clark’S Harbour Quit Smoking: A Community-Based Smoking Cessation Initiative Process Evaluation, Georgeann Lois Macdonald Mn: Dnp, Anp, Rn, Accn, Np

Doctor of Nursing Practice Projects

Background: The prevalence of Canadian smokers is 14.6%. Clark’s Harbour and Shelburne’s rate of smoking increased from 15.6% in 2012 to 19.4% in 2015 (Propel Centre for Population Health Impact, 2015). It was imperative that innovative ways be found to reduce the smoking prevalence.

Objectives: 1) Identify a difference in the participants’ Stages of Change before and after completing the smoking cessation program. 2) Determine whether the participants quit smoking 3) Assess whether there was satisfaction with the program.

Methods: In this one group pre and post-test design, the participants completed a series of pre and post program questionnaires. The …

Effects Of A Phase Ii Cardiac Rehabilitation Program On Patient Depression, Michael R. Legal, Dnp, Msn-Ed, Rn, Ccrn-K

Doctor of Nursing Practice Projects

Background: Screening for depression upon intake and completion of a Phase II cardiac rehabilitation (CR) program may influence the type of interventions implemented by CR staff and reduce depression.

Objectives: We examined patients before and after a Phase II CR program who self-reported as depressed using the CES-D score and also assessed scores by procedure, gender and age. We further identified the types of interventions used for those who were depressed.

Methods: We conducted a pre-post intervention study. Using a convenience sample, data were collected on CES-D scores before and after the program and by type of procedure, gender, and …

The Effects Of A Structured Teaching Session On Perceived Self-Efficacy Among Mental Health Nursing Supervisors, Pamela Fess, Dnp, Msn

Doctor of Nursing Practice Projects

Background: Specific factors that contribute to nursing supervisors perceived self-efficacy remains unclear. Although several studies have examined the relationship between self-efficacy and mental health nursing supervision most have focused on the impact of client care. To date, there is a dearth of studies to assess the impact of a leadership focused teaching session on the perceived self-efficacy of mental health nursing supervisors. Equipping nurses who are responsible for the supervision of others with the skills needed to fulfill their role responsibilities has the potential to improve their job performance, the work satisfaction, and well-being of staff nurses they supervise as …

Assessing Employee Needs To Enhance A Workplace Wellness Program, Paige Herschend, Dnp, Msn, Bsn, Ba

Doctor of Nursing Practice Projects

Background: Workplace wellness programs are increasingly prevalent, but their designs vary dramatically. While successful programs differ, those that are coordinated, comprehensive, and planned intentionally to address specific workplace needs have been found most beneficial.

Objective: This project assessed the perceived health status and wellness needs of employees at one company to determine whether its workplace wellness program could be enhanced.

Methods: This project focused on one site of a large, multi-state company. A retrospective review of data from an employees’ health and wellness survey was performed. Univariate and bivariate statistics were used to analyze the relationships among …

A Retrospective Study: Diagnosis And Treatment Of Depression In Breast Cancer Patients, Cheryl Ann Thaxton, Dnp

Doctor of Nursing Practice Projects

Background: One issue related to breast cancer diagnosis and treatment is the risk of depression.

Objectives: The purpose of this study is to examine ethnic differences and commonalties in the method of diagnosis and treatment of depression for female breast cancer patients.

Specific Aims: The study aims to examine the method of diagnosis and treatment of depression in Caucasian, Latino, and African American breast cancer patients.

Questions/Hypothesis: 1. Does the method of diagnosis and treatment of depression differ based on ethnicity? Hypothesis: Method of diagnosis and treatment will differ for Minorities as compared to Caucasians; 2. What percentage of patients …

Improving Primary Care Utilization For Transgender Patients At An Fqhc, Timothie J. Rochon, Dnp, Rn, Cnm

Doctor of Nursing Practice Projects

Background: Transgender and Gender-Nonconforming (TGNC) populations comprise approximately 6% of the U.S. population. Socially and within the medical treatment system TGNC individuals face widespread stigmatization and discrimination which negatively impacts their mental, physical, and emotional health and contributes to health disparities. Real and perceived barriers to safe and effective healthcare are worsened by the scarcity of primary care providers knowledgeable in caring for these populations.

Objectives: The aim of this quality improvement project was to examine the impact of inclusive gender-affirming integration on the utilization of preventive and primary care services.

Methods: A one group pre- and post-intervention design was …

Prevention Of Post Intensive Care Syndrome-Family With Sensation Awareness Focused Training Intervention: A Randomized Controlled Trial Pilot Study, Paula L. Cairns

USF Tampa Graduate Theses and Dissertations

Post Intensive Care Syndrome-Family (PICS-F) refers to acute and chronic psychological effects of critical illness on family members of patients in intensive care units (ICU). Evidence about the increase and persistence of PICS-F warrants the need for prevention interventions. This study evaluated the feasibility of providing Sensation Awareness Focused Training (SĀF-T) during the ICU stay for spouses of mechanically ventilated patients. Methods: A randomized controlled trial of SĀF-T versus a control group was conducted (n=10) to assess safety, acceptability, feasibility, and effect size of the intervention on PICS-F symptoms. Symptoms assessed as outcome measures included stress, anxiety, depression, posttraumatic stress …

A Study Of Registered Nursing Students’ Perceptions Of Confidence In Providing Quality Nursing Care To Patients With Alzheimer’S Disease Or Other Dementia, Louanne E. Harto

Doctor of Education (Ed.D)

There are currently millions of persons living with Alzheimer’s disease or other dementia; a number that will rise as the older adult population increases. Patients with Alzheimer’s disease or other dementia who are admitted to the acute care hospital for a physical problem may not receive the same standard of care as those persons without a cognitive impairment. The purpose of this study was to explore the perceptions of students in a prelicensure registered nursing program regarding their confidence to provide patient-centered nursing care to patients with cognitive impairment, specifically Alzheimer’s disease or other dementia. This quantitative study used a …

Best Practices For Screening, Identification, And Referral Of Female Collegiate Athletes With Disordered Eating, Brenda Caudill

Doctor of Nursing Practice Projects

Eating disorders have the highest mortality rate of any mental illness, including depression. Female collegiate athletes are at greater risk compared to the non-athlete population. Athletic personnel should be prepared to screen, identify, and refer female athletes for eating disorders. However, most staff are not familiar with common signs and symptoms of disordered eating, which could delay recognition of unhealthy behavior and ultimately long-term health risks. Appropriate screening protocols can assist with early identification. The purpose of this DNP project was improve the knowledge of the athletic staff regarding eating disorder recognition, awareness of university policy for identification and referral …

Case For House Resolution 107, Kaitlyn Coleman

Honors Projects

No abstract provided.

Relationship Of Physical Health Risk Screenings In Seriously Mentally Ill With Self-Efficacy For Health, Perception Of Health Risk, And Intention To Follow-Up With Medical Care., Dawn (Vanruler) Bos

Electronic Theses and Dissertations

Morbidity and mortality occur at higher rates in those with serious mental illness (SMI) than those without SMI. These higher rates are worsening in degree, despite known preventative strategies, such as physical health risk screening (HRS). This study evaluates the relationship of physical HRS with self-efficacy for health prevention behaviors, perception of level of risk of health consequences, and intention to follow up with medical care for identified health risks. The study considers Protection Motivation Theory (PMT) factors related to HRS in individuals with SMI. A HRS tool was administered to 54 adult ambulatory clients from the Midwestern United States …

Stress, Anxiety, And Depression: Role Of Campus Connectedness, Social Support, And Coping Among Nepalese Nursing Students, Priscilla Samson

Walden Dissertations and Doctoral Studies

High levels of stress, anxiety, and depression (SAD) can adversely influence physical health, psychological well-being, and academic and clinical performance of nursing students. Numerous studies have identified the factors associated with SAD; however, a paucity of empirical research addresses the relationship of SAD with campus connectedness (CC), perceived social support (PSS), and coping. The purpose of this quantitative cross-sectional study, guided by Lazarus and Folkman's theory of stress, coping, and adaptation, was to determine the prevalence of SAD and examine its relationship with CC, PSS, and coping among undergraduate nursing students of Nepal. Survey research was conducted using depression anxiety …