Mental and Social Health Commons^™

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

Health, Human Performance and Recreation Undergraduate Honors Theses

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

Female Genital Mutilation In The United States: Estimating The Number Of Girls At Risk, Phyllis Chesler

Dignity: A Journal of Analysis of Exploitation and Violence

Female genital mutilation (FGM) destroys the capacity of women to experience sexual pleasure. It causes serious medical complications such as bleeding, painful urination, cysts, dangerous and recurrent bladder and urinary tract infections, the growth of scar tissue that make marital intercourse a nightmare and that turns childbirth into an experience of danger and torture. Due to immigration, FGM now poses a potential health crisis in the West, both in Europe and in the United States. To estimate how many girls who live in the West are at risk, one can measure the prevalence of FGM in the non-Western countries where …

Poster: The Opioid Epidemic: Assessment Of Primary Prevention Interventions In Muskingum County Public Schools, Terra Armstead

Doctor of Nursing Practice Scholarly Projects

Understanding that the Opioid epidemic is much greater than an epidemic of mortality is critically important. This epidemic is also an epidemic of dependence, addiction, disability, and other severe adverse events affecting millions of people in the U.S. (Franklin, Sabel, Jones, Mai, & Baumgarter, 2015). The opiod epidemic is complex and can be considered a man made epidemic.

The Opioid Epidemic: Assessment Of Primary Prevention Interventions In Muskingum County Public Schools, Terra Armstead

Doctor of Nursing Practice Scholarly Projects

Understanding that the Opioid epidemic is much greater than an epidemic of mortality is critically important. This epidemic is also an epidemic of dependence, addiction, disability, and other severe adverse events affecting millions of people in the U.S. (Franklin, Sabel, Jones, Mai, & Baumgarter, 2015). The opiod epidemic is complex and can be considered a man made epidemic.

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

Evidence-Based Practice Project Reports

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

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

Evidence-Based Practice Project Reports

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

Meditation As An Intervention To Help College Students Cope With Stress, Marissa Bottos

Evidence-Based Practice Project Reports

According to the American College Health Association (ACHA) (2017), in a survey of 31,463 students, 31.7% stated that stress negatively impacts their academic performance (lower grades, dropped course, etc.). Additionally, 45.1% of the students stated they have more than average stress levels. The purpose of this evidence-based practice (EBP) project was to determine if mindfulness meditation was effective in helping college students cope with stress. Based on current evidence, Jon Kabat-Zinn’s online application for mindfulness meditation is supported as an effective way to help college students cope with stress (Regehr et al. 2013; Yusufov et al. 2018; Cavanagh et al. …

A Multi-Component Education, Skill, And Resource Evidence-Based Practice Intervention For The Alzheimer’S Caregiver, Cheryl Garmon

DNP Final Reports

Abstract

Dementia caregiving is expensive, stressful, and consumes all facets of the caregiver’s (CGs) life. The purpose of this project is to introduce the evidence-based practice (EBP) interventions most helpful in decreasing stress and burden in those who are in-home caregivers for Alzheimer’s disease and related dementias (ADRD) individuals.

The three primary intervention domains of the EBP studies that results in a positive impact are; providing education about the terminal course of the disease, introducing communication and caregiving skills, and furnishing resource and social network information.

The methodology included a convenient and voluntary population of CGs who sought service at …

Contraception Utilization Among Women, Ages 18-45, Receiving Medication Assisted Therapy For Opioid Use Disorder In Middle Tennessee, Kerry J. Ternes

DNP Projects

The prevalence of unintended pregnancy among women receiving medication assisted treatment (MAT) for opioid use disorder (OUD) exceeds 80%. While much of the existing literature has focused on the consequences of substance use in pregnancy, few have focused on the prevention of unintended pregnancy. This study explored barriers and facilitating factors impacting contraception use among women, ages 18-45, receiving MAT for OUD in Middle Tennessee. A cross-sectional survey design was used to describe the women’s sociodemographic and health characteristics; report their knowledge, attitudes, and behaviors; and to assess if these variables are associated with current use of contraception. Among survey …

Responding To Opioid Use Disorder: Identifying The Therapeutic Commitment Of Maine Nurse Practitioners, Jordan S. Porter

DNP Projects

Background: Buprenorphine, an underutilized pharmacotherapy, can play a key role in closing the substantial opioid use disorder (OUD) treatment gap in the United States. Although 2016 US legislation authorized trained nurse practitioners (NPs) to obtain the Drug Enforcement Agency waiver to prescribe buprenorphine for OUD, many NPs do not have the waiver, and a large proportion of waivered NPs do not prescribe to capacity. Purpose: To identify the therapeutic commitment of Maine NPs to OUD as well as understand why Maine NPs do not adopt and utilize buprenorphine for the treatment of OUD. Review of Evidence: Commitment …

Religious Coping And Christ-Centered Recovery For Women With Substance Use Disorders, Mary Beth Bever

DNP Projects

Women have unique risk factors for the development of substance use disorder (SUD), barriers to SUD treatment, and risk factors for SUD relapse that require holistic care models and provide trauma-informed care approaches that address effective coping strategies. The use of religion and spirituality has been commonplace in many SUD programs to inspire the use of positive religious coping; however, negative religious coping may also be drawn on which poses a potential harm for women with SUD. The aim of this project was to assess for a correlation in positive and negative religious coping scores and program completion rates in …

Effects Of Adverse Childhood Experiences On Pain Interference And Anxiety In An Integrative Chronic Pain Clinic, Kerrin Doran Kunze

DNP Projects

One in four children in the United States will experience abuse or neglect before the age of 18-years-old. Adverse childhood experiences increase the risk for chronic pain disorders and maladaptive coping strategies that can intensify patients’ experience of pain and disrupt or prolong treatment. Current research encourages a biopsychosocial approach to understanding and treating chronic pain, one that acknowledges the influence of childhood trauma and works to restore health by treating pain of the body, mind, and spirit. This retrospective study examined self-reported measures in a convenience sample of 162 individuals seeking treatment for chronic pain at an integrative care …

Self-Care And Burnout Among Nurses In A Hospital Setting, Hannah Stirnaman

DNP Projects

Rates of burnout among healthcare professionals are well documented. The burnout of professional nurses is associated with a number of poor outcomes with costly consequences to both the healthcare system and public health. The American Nurses Association (ANA) has pushed for an initiative entitled Healthy Nurse Healthy Nation that encourages nurses to prioritize their health first and lists compelling statistics of nurse stress, mental health concerns, and workplace injuries. Burnout, a combination of emotional exhaustion, depersonalization, and decreased productivity, is one consequence of workplace stress and the demands placed on nurses; however, there is a lack of research on individualized …

Neonatal Abstinence Syndrome, Marissa Thompson, Barbara Mcclaskey

Posters

Neonatal abstinence syndrome (NAS) is becoming more and more prevalent today. The number of women who are using narcotics while they are pregnant continues to rise. Neonatal abstinence syndrome may occur when a pregnant woman takes narcotics that cross the placenta to the fetus. The fetus then becomes dependent on the drug. When the infant is born, they are no longer receiving the drug. A large percent of these infants will go on to develop withdrawal signs and symptoms after birth. Since there has been no consistency in providing specific standardized care for treating infants with NAS, the purpose of …

Implementation Of An Evidence Based Screening Protocol To Improve The Diagnosis Of Dementia In A Home-Based Primary Care Setting, Lauren Liesbeth Sutton

Doctoral Projects

Dementia is a major public health concern that is both debilitating and deleterious to those afflicted with its various forms. The number of those living with dementia is increasing exponentially as the population continues to rise, with 46.8 million people worldwide currently afflicted with dementia (Chow et al., 2018). Dementia causes cognitive impairment that is severe enough to affect everyday function (Chow et al., 2018). The impairment and disability resulting from dementia indicates a significant health problem in primary care. Findings from research studies indicate that prophylactic and periodic screening for dementia can heighten provider suspicion and translate into earlier …

Availability And Nursing Implementation Of Measurement Tools In The Co-Occurrence Of Depression And Chronic Pain: An Integrative Literature Review, Ashley Thomas

Grace Peterson Nursing Research Colloquium

Availability and Nursing Implementation of Measurement Tools in the Co-Occurrence of Depression and Chronic Pain: An Integrative Literature Review

Ashley Thomas

Faculty Sponsor: Barbara Harris

Background: There is high correlation between chronic pain and depression. They are seen throughout the literature to interact and feedback symptoms upon each other. However, there is not a comprehensive screening tool that assess both symptoms and not a clear indication of nursing responsibility in assessment of the co-occurrence.

Objectives: The purpose of this literature review is to create a comprehensive review of current research concerning the availability of screening tools that measure the co-occurrence …

Adolescent Substance Abuse Patients Within The Therapeutic Alliance: An Integrative Literature Review, Emily Decker

Grace Peterson Nursing Research Colloquium

Background: Adolescent patients with substance use disorders (SUD) struggle with seeking treatment, staying motivated during treatment, and are at a higher risk of relapse following treatment compared with other SUD patients. A positive therapeutic alliance between provider and patient has been shown to positively affect treatment outcomes. Therefore, describing interpersonal patient traits which influence this alliance is integral to keeping patients in treatment and preventing relapse post-treatment.

Objectives: The purpose of this integrative review was to identify interpersonal characteristics of adolescent patients with a substance use disorder which can significantly influence their therapeutic alliance with the provider, ultimately leading to …

Built Food Environment And Perinatal Depression: An Integrative Literature Review, Rachel N. Mileski

Grace Peterson Nursing Research Colloquium

Background: Built food environment contributes to food access and insecurity, which impactsmaternal health due to increased rates of perinatal depression.

Objectives: The purpose of this integrative literature review will be to (1) identify contributing factors of built food environments in communities that increase the rate of perinatal depression and (2) evaluate the current intervention programs and methods addressing these factors in order to provide recommendations for further research.

Method: An integrative literature review will be used, in accordance with the Ecological Model, to evaluate contributing factors and suggestions.

Results: Findings from this integrative literature review revealed a link that connects …

Non-Psychiatric Nurse Self-Efficacy With Suicidality After An Educational Intervention, Nadin E. Knippschild

Nursing Theses and Capstone Projects

Lack of acute-care hospital non-psychiatric nurses’ confidence and competence with suicidality has been reported in the literature. Evidence supports multi-modal education to increase recall and improve outcomes. The theory of self-efficacy included concepts of confidence as well as competence and served as the project’s theoretical underpinning. A descriptive design was utilized to examine the effects of an education intervention using various methodologies addressing suicide risk factors, prevention, management, and safe care on nurses’ perceived level of self-efficacy. Methods included a pre-test survey, an education module intervention, and a non-matched post-test survey. The survey used consisted of 11 of the original …

Mental Health Concerns In African American Churches: Pastoral Preparedness In Counseling, Melody Samuel

Nursing Theses and Capstone Projects

African Americans rely heavily upon their pastors for more than spiritual guidance. Pastors are known as gatekeepers in the African American community serving as a resource to address a multitude of issues for their congregant from personal issues such as finances and marital issues, grief and bereavement, to physical and mental health issues. The aim of this study was to examine pastoral preparedness for counseling of mental health concerns in the African American church. To better understand the demand of mental health counseling for their congregants and assess the pastor’s perception of educational and training needs, 35 pastors and/or associate …

Gender Differences In Harmful Use Of Alcohol Among Korean Adults, Eunok Park, Yeon Sook Kim

Nursing Faculty Publications

Objectives: Harmful alcohol consumption is associated with considerable social and economic damage to individuals and society. Because gender and ethnic background influence alcohol intake differently, examining gender specific factors influencing harmful drinking is necessary. This study investigated gender differences in alcohol consumption, harmful drinking, and the associated factors among Korean adults. Methods: We analyzed the data from the 2012–2015 Korean National Health and Nutrition Examination Survey. Data from survey participants aged 20–64 years (N = 18,581) were included. The Alcohol Use Disorders Identification Test was used for alcohol dependence, and pooled weights were used. Chisquared tests and multiple logistic regression …

Evaluating An Evidence-Based Suicide Risk Assessment Intervention For An Inpatient Mental Health Hospital Unit, Tyler D. Green

Doctor of Nursing Practice Program Projects

Suicide is a worldwide problem that claims over 800,000 lives annually (NIMH, 2017; WHO, 2017). Almost one third of mental health professionals feel they have received inadequate training on suicide prevention (Jahn, Quinnett, & Ries, 2016). Asking mental health clients to agree to a no-suicide contract is a widely-used practice in the inpatient mental health care setting but lacks efficacy and can have ethical implications (Bryan et al., 2017). The NGASR was selected from a variety of suicide risk assessment tools for incorporation into a public inpatient mental health hospital unit in the Midwestern U.S.A. The NGASR is unique in …

The Efficacy Of Meditation-Based Treatments In Relapse Prevention For Persons With Substance Use Disorders, Florence C. Bates

Honors Undergraduate Theses

Substance abuse is a global problem that has contributed to a variety of societal, financial, health, and familial strains. An increasing prevalence of illicit drug, prescription opioids, and alcohol abuse has created a need for re-evaluation of recovery and relapse treatments. This literature review examines the efficacy of meditation-based treatments for relapse prevention in persons recovering from Substance Use Disorders (SUDs). A comparative analysis of Mindfulness Based Relapse Programs (MBRP), an adapted MBRP-W program, and a Transcendental Meditation (TM) intervention was used to examine the success of meditation-based interventions. Research supports improvements associated with the meditation-based interventions including significant reductions …

Barriers And Facilitators To Accessing And Utilizing Mental Health Services For Homeless Youth: A Systematic Review, Abbygail P. Lapinski

Honors Undergraduate Theses

Homelessness in the youth population is associated with elevated rates of mental illness, substance abuse, and suicidality compared to the housed population in the United States (Berdahl, Hoyt, and Whitbeck, 2005; Hodgson, Shelton, Van den Bree, 2014; Hughes et al., 2010). With a survival-focused perspective, exacerbating issues, stigmatization, and transience housing; homeless youth require special consideration to meet their diverse health needs. When barriers impede homeless youth's access to necessary health resources, their health concerns are left untreated and impound until emergency services are required. This review of literature is focused on identifying and synthesizing barriers and facilitators for homeless …

Searching For A Sense Of Place: The Process Of How Adolescent Girls Overcome Suicidality, Tamara Keefner

Electronic Theses and Dissertations

Suicide and self-harming behaviors are significant public health problems among children and adolescents globally and in the United States. Despite significant advances in recent decades to understand, prevent, and treat childhood and adolescent self-harming and suicide, suicide rates remain high. Since the National Action Alliance for Suicide Prevention set a goal to reduce suicide deaths and attempts by 40% by 2020, there has been a paradigm shift in the study of suicide yielding significant advances in the understanding of suicide and other forms of self-inflicted injury. This dissertation highlights some of the new developments in the study of suicide. First, …

Prescreening Recommendations For Patients On Medical Cannabis, Wen Chieh Hu

Walden Dissertations and Doctoral Studies

Marijuana is the most frequently used illegal substance in the United States and is most widely used among young people aged 12 to 21 years. Accurate screening and monitored issuance of medical cannabis recommendations have been shown to decrease abuse rates of the substance, create fewer deaths from opiates, reduce crime rates, reduce marijuana use in youths, decrease car crash deaths, and lessen prevalence of suicide in young men. The purpose of this project was to explore whether multiple screening methods for depression and anxiety in patients who seek medical cannabis referrals for anxiety and depression would improve screening and …

Primary Care And Behavioral Health Services In A Federally Qualified Health Center, Svetoslav A. Arsov

Walden Dissertations and Doctoral Studies

Between 2013 and 2016, 8.1% of U.S. adults 20 years and older suffered from depression, but only 29% of them sought help. This project addressed the low depression screening rate in a Federally Qualified Health Center (FQHC) that supported integrated care. The purpose of the project was to evaluate the integration of behavioral health into primary care in an FQHC through the rate of depression screenings. Two theoretical frameworks, the find-organize-clarify-understand-select/plan-do-study-act model and the Centers for Disease Control and Prevention's framework for program evaluation in public health were combined into a list of questions and data validity tests that were …

Reducing Antipsychotic Medication Use In Long-Term Care Settings, Martha Ofeibea Agbeli

Walden Dissertations and Doctoral Studies

The prescription rate of antipsychotics in patients with dementia varies between 20% and 50% for the common and troubling neuropsychiatric symptoms experienced by patients with dementia. The use of these antipsychotic medications has been linked with increased risk of morbidity and mortality due to associated Parkinsonism, over sedation, gait disturbances, cognitive decline, and cardiovascular adverse events. The purpose of this project was to assess whether development of an evidence-based clinical practice guideline (CPG) for a long-term care facility would increase awareness about issues that govern the safe use of antipsychotic medications. The conceptual framework for the project was Watson's model …

A Survey Of Providers And Patients Assessing The Need For And Use Of Prevention Practitioners To Combat Obesity In The Primary Care Setting, Amanda R. Lyons

DNP Projects

Purpose: The overall aim of this project was to gather information from two groups of stakeholders, providers and patients, on the feasibility of implementing prevention practitioners in the primary care system to address overweight and obesity.

Methods: This study utilized a quantitative descriptive design through the use of electronic surveys. Provider surveys were explained and presented during a monthly provider meeting. Patient flyers were posted in exam rooms and surveys were accessible through a provided link and QR code.

Results: Providers (N=10) agreed that they saw a need for the use of a prevention practitioner (Mean=4.44, SD=.88) as well as …

A Pilot Of Emergency Department-Initiated Buprenorphine For Opioid Withdrawal And Opioid Use Disorder: A Quality Improvement Project, Jason Lucey

DNP Scholarly Projects

Background: Emergency department (ED) visits for opioid related visits have increased dramatically during the opioid epidemic. Buprenorphine is an evidence-based therapy for treating opioid use disorder (OUD) and withdrawal. Unfortunately, lack of access to pharmacotherapy for OUD, including buprenorphine, remains a challenge. Research supports ED-initiated buprenorphine as a practical, cost-effective strategy which engages patients in treatment better than non-pharmacologic alternatives.

Purpose: The aims of this improvement project were to 1) develop a pilot process in an ED for providing buprenorphine to patients in opioid withdrawal or for OUD; 2) recruit and train a cohort of ED staff on the process; …