Mental and Social Health Commons^™

The Development Of A Wayfinding Smart Phone Application As A Large Healthcare Facility Investment Opportunity, Jessie Fortson Marshall

Doctoral Projects

Health care is a continually growing field. New hospitals are constantly being built, while older facilities are experiencing renovation and expansion. With this growth comes a set of difficulties for patients as they try to navigate through large, multi-building facilities. Most large facilities have multiple parking garages, numerous buildings, and medical towers with an unending number of floors. Patients are forced to rely on directional signage to find their destination that is often insufficient. Attempting to navigate through large facilities is often overwhelming for visitors leading to frustration and stress.

New technology has allowed a convenient solution to this problem …

To Heal, Escape: Using Theatre Arts To Promote Holistic Health In The Clinical Setting, John Filegar

Senior Honors Theses

The purpose of this thesis is to provide an argument for the implementation of theatre arts therapy in the clinical setting. The effects of traditional art therapies involving visual arts, expressive arts, and music on the holistic health of the patient in the clinical setting have been thoroughly researched and understood. However, the extent of the influence of theatre arts therapy on the holistic health of individuals in the clinical setting lacks sufficient evidence and therefore cannot be compared to the influence of traditional art therapies on the holistic health of individuals in the same setting. Following an overview on …

Grace Peterson Research Colloquium, Emma Pfeiffer

Grace Peterson Nursing Research Colloquium

Mental illness is commonly under-diagnosed, misdiagnosed, or untreated, particularly in the elderly population. An expected population increase for those 65 years and older, increased in health care expenses coupled with the moral and ethical obligation of health care providers to promote quality of life at all ages makes investigation to alternative treatments in this population is worth investigating. The purpose of this literature review is to synthesize existing studies to clarify the following questions: What are the effects of pet therapy on those experiencing signs and symptoms of depression and anxiety? Why is pet therapy still lagging in validated studies, …

College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane

The Qualitative Report

Besides many benefits of the cell phone technology, numerous arguments are raised on the different and important negative effects of such a technology. This qualitative content analysis study explored the common usages of smart phone technology, its challenges, and benefits among Iranian college students. Participants were 32 bachelor degree students who were recruited using purposive sampling method with maximum variation. Data were collected through 11 individual semi-structured interviews and 3 focus group discussions (5-8 students in each group). Data analysis was done based on a conventional content analysis approach. Data analysis resulted in 3 main themes and 12 sub-themes. The …

Plasma Brain-Derived Neurotrophic Factor Levels In Newborn Infants With Neonatal Abstinence Syndrome, Lochan Subedi, Hong Huang, Amrita Pant, Philip M. Westgate, Henrietta S. Bada, John A. Bauer, Peter J. Giannone, Thitinart Sithisarn

Pediatrics Faculty Publications

Background: Brain-derived neurotrophic factor (BDNF) is a type of growth factor that promotes growth and survival of neurons. Fetal exposure to opiates can lead to postnatal withdrawal syndrome, which is referred as neonatal abstinence syndrome (NAS). Preclinical and clinical studies have shown an association between opiates exposure and alteration in BDNF expression in the brain and serum levels in adult. However, to date, there are no data available on the effects of opiate exposure on BDNF levels in infant who are exposed to opiates in utero and whether BDNF level may correlate with the severity of NAS.

Objective: To compare …

Tailoring A Nicu-Based Tobacco Treatment Program For Mothers Who Are Dependent On Opioids, Amanda Fallin-Bennett, Kristin Ashford

Nursing Faculty Publications

Objective—To collect formative information to design a tailored tobacco treatment intervention for women with newborns treated or evaluated for neonatal abstinence syndrome and to explore current tobacco use behaviors and facilitators and barriers to smoking cessation.

Design—Qualitative descriptive study.

Setting—An academic medical center in the southern United States.

Participants—Mothers of newborns who were treated or evaluated for neonatal abstinence syndrome at birth within the preceding three months. Women were recruited who were older than 18 and reported opioid dependence and smoking during pregnancy.

Methods—Participants took part in semi-structured individual interviews that lasted approximately one hour. …

Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons, Amanda Fallin-Bennett, Nadra E. Lisha, Pamela M. Ling

Nursing Faculty Publications

Introduction—Lesbian, gay, and bisexual (LGB) individuals smoke at rates 1.5–2 times higher than the general population, but less is known about LGB consumption of other tobacco products (OTPs) and gender differences. OTP use among young adult LGB bar patrons and the relationship among past quit attempts, intention to quit, and binge drinking with OTP use was examined.

Methods—A cross-sectional survey of young adults (aged 18–26) in bars/nightclubs in seven U.S. cities between 2012 and 2014 (N=8,010; 1,101 LGB participants) was analyzed in 2016. Logistic regressions examined current use of five OTPs (cigarillos, electronic cigarettes, hookah, chewing tobacco, and …

The Effects Of Perinatal Oxycodone Exposure On Behavioral Outcome In A Rodent Model, Thitinart Sithisarn, Sandra J. Legan, Philip M. Westgate, Melinda E. Wilson, Kristen Wellmann, Henrietta S. Bada, Susan Barron

Pediatrics Faculty Publications

Opiate addiction is now a major public health problem. Perinatal insults and exposure to opiates such as morphine in utero are well known to affect development of the hypothalamic–pituitary–adrenal axis of the offspring adversely and are associated with a higher risk of developing neurobehavioral problems. Oxycodone is now one of the most frequently abused pain killers during pregnancy; however, limited data are available regarding whether and how perinatal oxycodone exposure (POE) alters neurobehavioral outcomes of the offspring. We demonstrated that exposure to 0.5 mg/kg/day oxycodone in utero was associated with hyperactivity in adult rats in an open field. No significant …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Clinicians’ Perspectives And Utilization Regarding Harm Reduction In Nursing Practice In Care Of Persons With Addiction: A Literature Review, Audrey Killarney

Grace Peterson Nursing Research Colloquium

Clinicians’ perspectives and utilization regarding harm reduction in nursing practice in care of persons with addiction: A literature review

Audrey Killarney, BS

Prof. Michelle Neuman, MSN, APN, RN

NSG 598: Graduate Research Synthesis

18 August 2017

Introduction

Background & Significance

Harm reduction is a concept best described as the recognition that individuals will engage in unhealthy behaviors, and the goal is to minimize the associated potential harm. (Stockwell, Reist, Macdonald, Benoit, & Jansson, 2010). Classically, it was used an alternative model of care for treating smokers and controlling the spread of HIV and hepatitis B (Henwood, Padgett, & Tiderington, 2014). …

The Benefits Of And Barriers To Psychiatric Advance Directive Implementation, Lauren Haindfield

Grace Peterson Nursing Research Colloquium

The Benefits of and Barriers to Psychiatric Advance Directive Implementation

Lauren Haindfield

Faculty Sponsor: Dr. Barbara Harris

Background: Psychiatric advance directives can be beneficial for patients with mental disorders, but their implementation is limited in large part due to a knowledge gap.

Objectives: The purpose of this integrative literature review was to identify both the benefits of and barriers to psychiatric advance directives.

Methods: This integrative literature review used the databases of CINAHL, PubMEd, and PsychInfo. Search terms included pad implementation, barriers to pad implementation, psychiatric advanced directives, benefits of psychiatric advanced directives, and current pad practices.

Results: PAD implementation …

Effective Methods For Domestic Violence Screening In The Emergency Department, Megan Bryan

Grace Peterson Nursing Research Colloquium

Abstract

Background: The CDC reports that one in four women and one in ten men will experience some form of domestic violence in their lifetime that will have either a short-term or long-term impact on their well-being. Often the first place these victims are seen where they can receive help is the emergency department. Objectives: The goal of this systematic integrative literature review was to explore existing literature on domestic violence screening methods used in the emergency department and determine which methods prove most effective. Concurrently, this review examined the barriers to effective domestic violence screening and how nursing education …

Barriers To Medication-Assisted Opioid Recovery: An Integrative Review Of Literature, Emily Miller

Grace Peterson Nursing Research Colloquium

Abstract

Background: Opioid addiction has become one of the fastest growing epidemics sweeping the world, but despite the use of opioid agonist medication-assisted treatment (MAT) with methadone or buprenorphine having been found to be one of the most effective methods for treatment of this epidemic, there is still a significant gap between the number of people that need MAT and the number of people that actually receive MAT.

Objective: The purpose of this integrative literature review is to explore the barriers that prevent many addicts from receiving MAT and to identify strategies that may assist in eliminating these barriers in …

A Demonstration Project To Address Juvenile Drug Addiction, Mary Ellen Broaddus

Graduate Theses, Dissertations, and Capstones

The rise in adolescent drug use and addiction is becoming a worldwide phenomenon. An eleven year study of youth in European countries found drug use widespread and increasing (Molinaro, Sicilian, & Curzio, 2011). In 2013 there were over 2.8 million new users of illicit drugs, over half of whom were under 18 years of age (‘Drug Facts’, 2015).

Adolescents are at unique risk because biochemical distinctions in their brains, when compared with adults, prompt more risk-taking behaviors (Gallager, 2014). Health risks are considerable and include hypertension, stroke, convulsions and seizures, and liver disease such as cirrhosis and hepatitis. In 2013 …

Comparing Total Expenditures By Source Of Long-Term Services And Supports., Maresa R. Corder

Electronic Theses and Dissertations

This study compares total expenditures between beneficiaries enrolled in traditional Long-Term Care (LTC) and beneficiaries enrolled in Home and Community Based Services (HCBS) in a Quasi-Experimental Simple Ex Post Facto study utilizing multiple linear regression with inverted propensity score weighting. The results demonstrated, during the two years of the study period, that total expenditures were on average $14,565.03 (with a p-value oflessfor the total two years of the study, for HCBS beneficiaries when compared to their LTC counterparts. There remains today a belief that expenditures of elderly, dual beneficiaries electing to age-in-place for supported self-care expend less than that of …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

A Healthcare Provider Needs Assessment Regarding Transgender Patient Health For A Student Health Services Center, Dorothy J. Cochran

Dissertations

Objective: This study sought to identify education and training needs of university health service providers regarding transgender patient care. Transgender patients are a vulnerable population who tend to have negative health outcomes. Limited information exists regarding transgender patients and their providers at student university health services nationally.

Methods: The researcher conducted a one hour semi-structured focus group with the professional staff at a Midwestern state university health service. The focus group conversation was guided by a list of prepared questions but other issues were allowed to arise. Two readers qualitatively analyzed the focus group transcripts for predominant themes.

Participants: The …

Alternative Interventions For Children Coping With Chronic Conditions: A Critical Review Of The Literature, Nina M. Pelsi, Kim S. Amer

DePaul Discoveries

Reduction of stressors and anxiety levels in adolescents with chronic illnesses is a critical concept in pediatric health care in America today. The many stressors associated with chronic illness include displaying physical and mental differences, social stigma, financial difficulty, and family stress. These stressors may affect the adolescent’s ability to learn and cope in everyday life. The current research was a critical review of the literature examining studies done with adolescents coping with chronic diseases and illnesses. The aim was to analyze the most efficacious non-pharmacological methods for reducing stressors in adolescents with chronic illness. A critical review of the …

Mental Illness Stigma, Socially Acceptable Treatment, And Barriers To Health, Frances Renee Gellert

Independent Study Project (ISP) Collection

This paper discusses the topic of mental illness stigma and treatment in Uganda as explored through internship in the Social Work Department at Butabika National Referral Mental Hospital. The objectives of this project were to complete a meaningful internship while exploring causes of mental illness in Uganda, contradictions between traditional and modern approaches to treatment, and the affect of stigma on mental well-being. The internship included a total of 120 hours at Butabika Hospital. Individual research using documentary and literature review methods accompanied the internship. Butabika Hospital did not consent to the completion of formal research at, so any conclusions …

The Public Health Harms Of Pornography: The Brain, Erectile Dysfunction, And Sexual Violence, John D. Foubert

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Gadgets And Grieving: A Chronological Analysis On The Ways In Which Advancements In Medical Technologies Have Altered The Grieving Process, Grace Mcnair

Dialogue & Nexus

Since the 1940s, both end-of-life care and advancements in medical technologies have expanded exponentially. This article explores the advancements in medical technologies and how these have altered the way that Western society grieves death. With the capabilities to prolong life, the family, the patient, and the medical team, all grieve the end of life in different ways. This article provides a chronological analysis of palliative care, hospice care, and various medical advancements. These changes in medicine are then paralleled with alterations in the bereavement process. This article explores historical narratives of Western society’s transformation of grief through the lens of …

Education Program Using Non-Pharmacologic Support During Benzodiazepine Reduction In Patients With Anxiety Disorders, Kelly D. Kearney Dnp, Rn, Pmhnp-Bc, Diane Wardell Phd, Whnp-Bc

Journal of Nursing & Interprofessional Leadership in Quality & Safety

A private mental health clinic developed an initiative to aid patients with anxiety disorders to taper their use of benzodiazepines. Based on best practices, a treatment protocol was developed in which patients attended 4 sessions (1 per month) in which they combined instruction in non-pharmaceutical anti-anxiety techniques (guided imagery, mindfulness meditation, deep breathing, progressive muscle relaxation, exercise, emotional freedom) with cognitive behavioral therapy and use of selective serotonin re uptake inhibitors. Participants experienced a reduction in benzodiazepine use. This small scale initiative showed that the holistic approach to anxiety management was an effective plan to decrease the use of benzodiazepines …

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

A Clinical Practice Change Initiative To Incorporate Animal Assisted Therapy In Advanced Practice Registered Nurses' Clinical Practice For Children And Adolescents, Donna Rae Cowell

Doctoral Projects

Background: Children and adolescents mental healthcare needs is vital for the future of our nation’s welfare (American Psychology Association, 2014). Research has indicated AAT may be a considerable choice to help with pediatrics mental healthcare and may be utilized as an adjunct to enhance the care within the psychiatric healthcare field (Chandler, 2012). AAT has become popular within the healthcare realm (Friesen, 2009; Uyemura, 2016) and is a unique method for providing “patients” health care, which may improve patient outcomes (Chandler, 2012; Cowell, 2013; McCullough, 2016; McQuarrie & Urichuk, 2008). Research supports that “providers” in the health care field may …

Professional Bereavement Of Oncology Nurses: A Literature Review, Nicole Ho

EVMS School of Health Professions Master's Level Capstones, Projects and Papers

The amount of resources for grief management for oncology nurses who experience professional bereavement is scarce. This review of literature found just four studies based on current solutions that have been provided for oncology nurses in addressing their patient related grief. All of the studies supported that providing resources to address bereavement helped in resolving grief, reflecting, expressing feelings, and healing. This thesis explores factors that exacerbate professional bereavement such as stressors within the work environment, the lack of supportive resources, and the scarcity of research pertaining to how oncology nurses process the death of their patients. Additionally, art therapy …

Use Of Music To Reduce Anxiety In Short Wait Periods For Patients Receiving Care In An Urgent Care Clinic, Rebecca Anne Parker

Undergraduate Honors Theses

Abstract

The concept of waiting has received limited attention in the world of research. In modern society, waiting has become a commonplace event, especially in healthcare. Although the waiting experience can produce anxiety, healthcare environments can be easily manipulated in order to increase human comfort and reduce situational anxiety. One such way of accomplishing this is to introduce music to an environment. This paper will discuss the findings related to short wait periods, anxiety, and music within the literature, and the findings within this research study. This study found listener-selected music to be statistically effective in reducing anxiety for patients …

The Effect Of Mindfulness Meditation On Perceived Stress And Total Health Care Cost, Rachel Hale

DNP Projects

Background: Chronic stress can lead to hypertension, tachycardia, and increased inflammatory markers, which put individuals at risk for chronic diseases. Mindful meditation not only decreases perceived stress but also has the potential to decrease the risk of chronic diseases and health care cost. Purpose: The purpose of this mindfulness meditation project is to reaffirm that mindfulness meditation decreases perceived stress scores and to determine whether mindfulness meditation decreases health care cost. Theoretical Model: The relation of mindfulness meditation, lowered stress levels, and chronic diseases can be explained by the social cognitive theory (SCT). Applying SCT, meditation’s goal is to alter …

Mental Health Rehabilitation In Victims Of Sex Trafficking, Kayla E. Freemire

Senior Honors Theses

Human trafficking is a global epidemic that leaves victims with short- and long-term physiological, psychological, and sociological issues. The mental health needs of trafficked persons have become a topic of research in both medical and psychiatric circles. In order to comprehensively understand the mental health consequences of trafficking, the process must be defined and related to the mental health effects on its victims. The specific mental health disorders diagnosed within this population will be discussed. Treatments used currently for this population will be reviewed, along with future treatments presently being researched and evaluated regarding their potential for use in the …

The Effect Of Routine Adult Phq-2 Depression Screen And Scheduled Follow-Up Protocol In The Primary Care Setting, Alex F. Bikowski

Evidence-Based Practice Project Reports

Healthy People has projected depression to be the primary cause of disability by 2020; therefore routine depression screening has been prioritized as a national healthcare initiative. The purpose of this Evidence-Based Practice (EBP) project is to demonstrate that routine implementation of the 2-item Patient Health Questionnaire (PHQ-2) depression screener, along with a scheduled follow-up protocol for adults in the primary care setting, can improve current mental health practices regarding the identification of depression by clinicians. The evidence supports use of the PHQ-2 for routine adult depression screening, as long as a scheduled follow-up protocol is available for positive screens. This …