Mental and Social Health Commons^™

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 …

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 …

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 …

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 …

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 …

Maternal Psychological Distress And Cortsiol, Jenna Schroeder

Grace Peterson Nursing Research Colloquium

Abstract

Background: Previous studies have reported associations between prenatal maternal distress and negative health outcomes for the unborn. There are gaps within this body of knowledge and inconsistencies in the research which make the relevant relationships unclear. If changes in maternal cortisol cause alterations in fetal development, it is important to gain an adequate understanding of how, and if, maternal psychological distress predicts maternal cortisol levels. This study is an integrative literature review that looks at the research investigating a connection between maternal psychological distress and maternal cortisol levels during pregnancy. Lazarus and Folkman’s (1984) Transactional Model of Stress and …

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 …

Conversion Disorder, Ann Summar

Nursing Posters

Conversion Disorder:

• Neurologic symptoms that are inconsistent with a neurologic disease
• Symptoms cause distress and/or impairment
• No radiological or laboratory findings for symptoms
• May have poor outcomes without proper treatment

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 …

Association Of Youth Characteristics And Recent Utilization Of Dental Services In The United States, Ilana R. A. Chertok, Nathaniel Chertok, Zelalem T. Haile, Bhakti Chavan

Faculty & Staff Scholarship

Background: Oral health is important for overall health of youth, although dental service utilization is lower than national goals. The purpose of the study was to identify sociodemographic and health behavioral characteristics of youth in the United States who reported having at least one dental visit in the past 12 months.

Methods: Secondary data analysis was conducted using the 2015 Youth Risk Behavior Survey (YRBS) to examine factors associated with dental care utilization using Andersen’s theory-based Behavioral Model of Health Care Utilization.

Results: Among 5,814 youth, nearly 78 percent reported visiting a dentist in the past 12 months. After adjusting …

Discerning Suicide In Drug Intoxication Deaths: Paucity And Primacy Of Suicide Notes And Psychiatric History, Ian Rh Rockett, Eric D. Caine, Hilary S. Connery, Gail D'Onofrio, David J. Gunnell, Ted R. Miller, Kurt B. Nolte, Mark S. Kaplan, Nestor D. Kapusta, Christa L. Lilly, Lewis S. Nelson, Sandra L. Putnam, Steven Stack, Peeter Varnik, Lynne R. Webster, Haomiao Jia

Faculty & Staff Scholarship

Objective

A paucity of corroborative psychological and psychiatric evidence may be inhibiting detec- tion of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation—the other two major, but overtly violent methods.

Methods

This observational multilevel (individual/county), multivariable study employed a general- ized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System …

Mental Health Interventions For Adolescent Cancer Patients, Kelsey A. Faherty

Honors Undergraduate Theses

Background: According to the National Cancer Institute (2017) approximately 15,270 individuals’ ages 0 to 19 years would be diagnosed with cancer in 2017. Although pediatric cancer survival rates continue to rise, there are high rates of anxiety, fear, and depression amongst this population. The purpose of this literature review was to explore mental health interventions for adolescent cancer patients.

Methodology: A total of 165 articles were found in a literature search. Databases used include: CINAHL Plus with Full Text, Cochrane Center Register of Controlled Trials, Cochrane Clinical Answers, MEDLINE, and PsycINFO. As results were further narrowed based on relevance and …

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 …

Healthcare Providers’ Perceptions Of Pregnant Women, Allison Goderwis

Theses and Dissertations--Family Sciences

Health care providers’ (N = 421) implicit perceptions of pregnant women based on age, race or ethnicity, marital status, and socioeconomic status are assessed through a true-experiment design. Ordinal and binary regression analyses revealed that respondents felt more pity for an unmarried than married pregnant woman and more anger toward an unemployed pregnant woman without health insurance compared to a pregnant woman who was employed with health insurance. Male, Asian, and Hispanic respondents were less likely to help the pregnant woman, Black and protestant respondents were more likely to express some degree of anger toward the pregnant woman, and …

Scope Of Advance Practice Providers' Role In Transition To Adulthood Care, Cathy Cartwright, Teresa Hickam

Posters

Advance Practice Providers adopting formal transition planning provided a wider scope of responsibilities supporting transition to adult care than those who did not.

The Effect Of Breastfeeding And Rooming-In Care On Neonatal Abstinence Syndrome, Rachel Boyer, Lindsay Gal, Mahaylie Cline

Williams Honors College, Honors Research Projects

Concurrent with a rise in opioid abuse during pregnancy is an increase in the number of babies born with Neonatal Abstinence Syndrome (NAS). Despite this crisis, no single treatment has been identified for NAS. This paper sought to analyze and synthesize research evaluating the effectiveness of breastfeeding and rooming-in care on the need and length of pharmacologic treatment and length of hospital stay for neonates with NAS. Twenty-six peer reviewed research articles published between 2006 and 2017 were selected from PubMed and CINAHL for analysis. The studies focused on neonates with NAS born to mothers addicted to opioids or undergoing …

The Impact Of Schizophrenia On Copd Readmission Rate Among Hospitalized South Carolinians, Emilienne Y. Watonsi

DNP Research Projects

Due to elevated readmission costs, the Affordable Care Act established the Hospital Readmission Reduction Program in 2012 to curb the 30-day readmission rates. COPD and schizophrenia are two very expensive diseases, COPD national medical costs is projected to be $49.0 billion in 2020; the cost of schizophrenia was 155.7 billion in 2013. The main objective of this study was to determine if schizophrenia is a significant predictor of 30-day readmission following hospitalization for acute exacerbation of COPD after adjusting for age, gender, anxiety, smoking status, T2DM, chronic ischemic heart disease, and GERD. Methods: A retrospective cohort design was used to …

The Lived Experiences Of Opioid Withdrawal: A Phenomenological Study, Eliza Mall

DNP Research Projects

The United States is in the midst of an opioid overdose epidemic resulting to 40,000 accidental drug overdose deaths. In 2016, the number of deaths related to opioid overdose increased to 116 people per day resulting to $504 billion in economic costs. This research study explored the lived experiences of drug addicts having experienced opioid withdrawal symptoms. Phenomenology is useful in discovering the narrative lived experiences that cannot be obtained in quantitative approach. Six themes emerged to describe the lived experiences of opioid addicts who have undergone withdrawal: (a) Increasing desires that are hard to resist (b) Helplessness and hopelessness …

Assessment Of The Need For Provider Education On Screening For Depression In Patients With Select Dermatologic Problems, Sarah B. Zerhusen

DNP Projects

PURPOSE: The purpose of this project is to evaluate the knowledge, attitudes, perceptions, skills, and self-efficacy of dermatology providers’ assessment of depression in patients with chronic skin disease to determine the need for continuing education programs.

METHODS: This is a single practice, multi site, quantitative correlational design study to assess provider use, comfort, and proficiency of screening and discussion of depression in patients suffering from plaque psoriasis and atopic dermatitis. Data was collected through the use of a questionnaire dispensed in January of 2018. The sample consisted of 23 dermatology providers in a dermatology practice with clinics in Louisville, Lebanon, …

Diabetes-Related Distress Screening: A Survey Of Primary Care Providers' Knowledge, Attitudes, And Practices In Treating Patients With Difficulty Meeting Glycemic Goals., Michele Patrice Paxton

DNP Projects

A patient with diabetes is two to three times more likely to be depressed than the general population. Furthermore, the combination of diabetes and depression is associated with increased morbidity and mortality. However, research has shown that treatment for depression does not correlate with lower HbA1c levels or a decrease in morbidity and mortality. Recently, a body of evidence has shown that increased HbA1c levels and depression are associated with the emotional burden of managing diabetes. The emotional burden is caused by the constant behavioral and mental demands of managing the disease and the worry and fear of the impending …

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 …

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 …

Improving Adherence To Mental Health Treatment In A Low-Income Clinic, Janice G. Gandy

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The increasing prevalence of mental illness in the United States presents significant challenges for primary care providers in low-income settings. Integrated Behavioral Health (IBH) programs have resulted in improved general health for low-income participants; however, managing appointment adherence, in which the patient attends appointment as scheduled, is particularly challenging. The purpose of this pilot project was to implement bundled interventions at a low-income primary care clinic to improve patient adherence to behavioral health treatment. The bundle of interventions included: 1) educational interventions emphasizing the benefits of IBH care 2) warm patient handoffs between the primary care provider to a behavioral …

Effectiveness Of An Open Access Scheduling System In A Community Mental Health Center, Callie Crockett

Doctoral Projects

Abstract

Open Access Schedule (OAS) systems are a new way to schedule patient appointment in an outpatient medical setting. In theory these systems will provide many benefits that are not seen in a traditional scheduling model, such as decreased wait times to see a provider and more provider flexibility. However, little research has been done to examine how effective these systems are once they are put into practice, particularly in the mental health setting. The purpose of this project was to examine a recently implemented open access scheduling system in a community mental health center in rural Northeast Tennessee and …

Evaluation Of Delivery Methods Of Chemical Dependency And Wellness Education, Marissa Coggin

Doctoral Projects

Anesthesia practice is learned in a stressful environment, and these stressors may lead to the students’ development of maladaptive coping mechanisms. Despite significant improvements in our understanding of addiction and our approaches to combat this problem, the risk of substance misuse remains high in nurse anesthesia students. Education and intervention are imperative when taking preventative measures. The purpose of this Doctor of Nursing Practice (DNP) project was to determine whether delivery method of chemical dependency/wellness educational program effects the level of understanding of anesthesia providers and substance misuse and the development of healthy coping mechanisms.

In determining whether the delivery …

Prenatal Opioid Exposure And Intermittent Hypoxemia In Preterm Infants: A Retrospective Assessment, Elie G. Abu Jawdeh, Philip M. Westgate, Amrita Pant, Audra L. Stacy, Divya Mamilla, Aayush Gabrani, Abhijit R. Patwardhan, Henrietta S. Bada, Peter J. Giannone

Pediatrics Faculty Publications

Introduction: Intermittent hypoxemia (IH) is defined as episodic drops in oxygen saturation (SpO₂). Preterm infants are at increased risk for IH due to their immature respiratory control/apnea of prematurity. The clinical relevance of IH is a relatively new observation with rising evidence linking IH to neonatal morbidities and long-term impairment. Hence, assessing factors that influence IH in preterm infants is imperative. Given the epidemic of opioid misuse in the USA, there is an urgent need to understand the impact of prenatal opioid exposure on neonatal outcomes. Hence, we wanted to assess the relationship between isolated prenatal opioid exposure …

Implementing Evidence-Based Opioid Prescription Practices In A Primary Care Setting, Cyril Gaiennie

Doctor of Nursing Practice

The use and misuse of opioid pain medication has reached epidemic proportions in the United States. More than 16,000 people die each year due to the misuse or abuse of prescription opioid medications, which is more than from heroin, cocaine, and benzodiazepines combined. The purpose of this evidence-based practice project is to establish processes enabling a primary care clinic to implement and adhere to the 2016 Centers for Disease Control’s guidelines for opioid prescription practices in the primary care setting. A retrospective chart review conducted prior to implementation of the guidelines demonstrated that four of six of the CDC’s recommendations …