Psychiatric and Mental Health Commons^™

Comparison Of Cognitive Behavioral Therapy And Pharmacologic Intervention In Alcohol Use Disorder Treatment, Analily Wong, Collin Owen, Meghan Vatave

Symposium of Student Scholars

Background: Alcohol use disorder (AUD) is a condition that can result in chronic health conditions that negatively impact a person’s life. Methods to treat AUD involve cognitive behavioral therapy (CBT) and pharmacologic intervention, including disulfiram (DIS), naltrexone (NTX), and acamprosate (ACA).

Objectives: The purpose of this review is to determine the efficacy of CBT compared to pharmacologic intervention within one year of treatment in adult patients who have been diagnosed with AUD.

Methods: A reference search was conducted using various databases to locate literature. Combined keywords and Boolean operators were utilized to reveal desired articles. A total of 10 …

Reducing Suicide Reattempts With A Telephone Follow Up Program, Bailey Breaux

MSN Capstone Projects

Suicide is one of the leading causes of death in the United States. Most people can say they know at least one person who has committed suicide or has considered suicide. The number of deaths continues to rise, and they aren’t stopping anytime soon. Many of these patients visit emergency rooms around the country seeking help for their depression and suicidal ideation. Some are brought into the emergency department following a suicide attempt and their visit only predicts another one happening in the near future. Some hospitals around the globe has tried to stop this recurrence of suicide reattempts by …

Implementing Evidence-Based Adult Psychiatric Inpatient Depression Assessment, Treatment, And Post-Hospitalization Referral, Lucy Flores

Doctor of Nursing Practice

Purpose: This project was designed to strengthen the quality of depression assessment with evidence-based depression assessment tools in inpatient psychiatric units.

Background: Missed diagnosis and treatment of depressive disorders contribute to the most severe outcome of depression: suicide. A crisis stabilization facility with inpatient psychiatric units had significant opportunities to improve clinical outcomes by screening for depression in adults and to monitor symptoms with evidence-based tools.

Methods: The 12-week quality improvement project included implementation of staff education sessions of evidence-based tools to screen, monitor, interpret scores, and detect risk modifiers. The design and build with Information …

Implementing The Depression Screening Tool Phq-9 In The Annual Wellness Exam Of Concierge Family Medicine, Eric Iglesias

Doctor of Nursing Practice

Abstract

Background: Depression has been one of the most common mental health disorders that our population fact but is underdiagnosed and undertreated. Primary care providers are often the first line of defense in detecting depression. Because of this, implementing a depression screening tool in a primary care setting will improve holistic management of care and improve quality of life.

Project Aim: The aim of this project was to increase the number of clients who are evaluated for depression by using the PHQ-9 screening tool during their annual wellness exam and initiate treatment according to the Veteran’s Affairs/Department of Defense Depression …

Tiny Tusks Breastfeeding And Infant Support: Breastfeeding's Effects On Maternal Mental Health, Anna Jacobs

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Breastfeeding has proven to be beneficial for infant health and maternal physical health, but there are variable outcomes for maternal mental health. This literature review explores the relationship between breastfeeding and maternal mental health, a topic that is often disregarded when discussing breastfeeding with mothers. After an internship with Tiny Tusks Breastfeeding and Infant Support, a program to make breastfeeding more accessible at Razorback Athletics events, maternal mental health related to breastfeeding was shown to be a topic in need of more current research. This objective of this literature review was to determine how breastfeeding can impact maternal mental health …

Reducing Physical Restraints And Emergency Psychiatric Medications On An Inpatient Psychiatric Unit With The Broset Violence Checklist, Victoria Hernandez

Doctor of Nursing Practice

Background: Physical restraint and psychiatric emergency medication use, especially psychotropic medications, is problematic, negatively impacting patient safety on psychiatric units (Ambwani et al., 2021; Iuppa et al., 2013; Rahman, 2021). The Bröset Violence Checklist (Woods & Almvik, 2002), a short-term violence-predicting tool, has been used in the inpatient setting to predict violent outbursts and determine when high-level violence interventions are needed.

Purpose: The purpose of this project was to recognize signs and symptoms of aggression and agitation early and intervene to reduce the use of physical restraints and emergency restraint medications on an inpatient psychiatric unit, thereby improving patient safety. …

Psychiatric Medications: Does Education Affect Medication Prescriptions?, Surina M. Narine, Mary D. Ramos, Sarah Chu

Symposium of Student Scholars

Background: There is a lack of research on racial challenges among underrepresented adolescents regarding prescription drug use for mental illnesses. Purpose: This study addressed the following question: In adolescent minorities, how does education about racial disparity and culture affect the stigma and number of prescriptions written for psychiatric medications? This evidence-based practice project aimed to identify if racial awareness directly impacts the amount of psychiatric medication prescribed for adolescent minorities. Methods: Literature reviews analyzed qualitative and quantitative data to provide correlating information on racial disparities and psychotropic medications. This study examined the following possible factors for decreased prescribed drugs within …

Resilience And Prenatal Mental Health In Pakistan: A Qualitative Inquiry, Shireen Shehzad, David Arthur, An-Sofie Van Parys, Nicole Letourneau, Gail Wagnild, Shahirose Sadrudin Premji, Nargis Asad, Olivier Degomme

School of Nursing & Midwifery

Background: Women in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention.
Methods: The exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A …

Depression Awareness Programs For Adolescents: A Scoping Review, Kincharska N. Freeman Msn, Aprn, Fnp-C, Cnor, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

The purpose of this DNP project is to determine if receiving school-based depression awareness education affects the depression scores of adolescents between 10 and 19 years of age.

Utilization Of A Multimodal De-Escalation Class To Improve Staff Confidence When Caring For Behaviorally Escalating Patients, Tara B. Neuner

Graduate Theses, Dissertations, and Capstones

Workplace violence is a common challenge seen in the healthcare settings across the world. This problem is steadily increasing in all types of hospitals, including a level one trauma center located in an urban area. There has been a steady rise in the number of assaults and workplace violence reported from bedside staff at this hospital. The leadership of the organization formed a work group to help combat the workplace violence and staff assaults that were occurring. In this process, a behavior response team was created to help nursing staff with escalating behavior in patients, and to help de-escalate the …

Insights From Nursing Students About Factors Affecting And Strategies Supporting Their Mental Health, Saima Hirani, Ambreen Tharani, Zohra Jetha, Shehla Khan

Journal of Wellness

Introduction: Nursing students experience high stress and mental health issues. It is essential to pay adequate attention to students’ mental health so they are trained to deliver quality patient care in complex settings. In order to provide a healthy environment to student nurses, it is essential that nursing students’ voices are heard. This study aims to explore nursing students’ perceptions about factors that influence their mental health and understand strategies that support mental health during nursing education.

Methods: The study used an exploratory descriptive qualitative design to achieve the objective. Purposive sampling was used to recruit nursing students from a …

Parent And Child Anxiety Evaluated During An Early Period Of The Covid-19 Pandemic: A Mixed-Methods Study, Karla M. Abela, Darlene Acorda, Stanley Cron, Geri Lobiondo-Wood

Journal of Patient-Centered Research and Reviews

Purpose: The objective of this study was to explore parent and child anxiety during the pandemic. Unlike previous pandemics, measures implemented to prevent the transmission of the SARS-CoV-2 virus have been much more limiting.

Methods: An explanatory convergent mixed-methods design was used to describe anxiety of children 9–17 years of age and their parents during August–October 2020. Adult and child versions of State-Trait Anxiety Inventory (STAI) were used to examine levels as measured on STAI’s state-anxiety subscale. Web-based interviews with a subset of patients were conducted qualitatively to analyze anxiety-related themes.

Results: A total of 188 parents …

Implementation Of Nurse Navigators For Behavioral Health, Theresa Papagna

Seton Hall University Dissertations and Theses (ETDs)

Mental health patients have been notoriously non-adherent with diligent medication conformity, office visit fidelity, candor about side effects, use of illegal substances for self-medication, and truthfulness about co-occurring conditions. This non-adherence makes treatment difficult for psychiatric providers, and all those who participate in the care of patients with mental illness. Patient non-adherence can cause frustration and can lead to provider burnout, which affects patients as well as providers. Also, there are concerning financial implications of excessive time and resources needed to adequately monitor mental health patients. Implications regarding 30- day re-admissions are tantamount to consideration of financial strains put on …

Connecting And Communicating To Support Youth Mental Health, Michele Davide

Seton Hall University Dissertations and Theses (ETDs)

The nation is experiencing a pediatric mental health crisis amid a shortage of pediatric mental health care providers. The Connecting and Communicating project explores a strategy pediatric primary care practitioners can employ to bridge this gap and maximize their impact on supporting youth mental health in a community.

For this project, a pediatric primary care nurse practitioner created a pilot educational video with the dual purpose of educating parents and school staff on the importance of connecting with adolescents using the proven evidence supported communication technique of validating strong emotions without judgement, and partnering with pediatric health stakeholders by requesting …

Wellness Review 2022, Part 1, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: This article represents the first of a two-part assessment of 2022 literature addressing wellness in healthcare professionals published from January 1, 2022 to June 30, 2022.

Methods: Three editors conducted a similar keyword search in Pubmed, also adding manually curated articles. Focusing chiefly on clinical trials and other prospective research, we settled on a final 25 significant papers focusing on wellness in medical professionals to include in this review.

Literature Review: Recent literature into HCW wellness continues to describe burnout factors and COVID-19 impact, but includes more resilience-targeting interventions and systematic reviews of trials seeking bolstering of well-being. Subsections …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Improving Trauma-Informed Education And Parenting For Resource Parents At A Foster Care Agency., Courtney Albers

Doctor of Nursing Practice Papers

675,000 children nationwide were involved with the foster care system in 2019, and nearly all children within the foster care system are actively suffering from the effects of trauma. Resource parent trauma-informed trainings, such as Resource Parenting Curriculum (RPC) developed by The National Child Traumatic Stress Network, are associated with improved parental perceptions towards trauma-informed care, improved child outcomes, and placement stability. Foster care agencies have trauma-informed state-based curriculum, but it does not meet the needs of resource parents, specifically those caring for children with developmental delays or disorders. The project was implemented at a therapeutic foster care agency for …

Associations Between Postpartum Depression And Child Overweight And Obesity: Mediating Effect Of Maternal Feeding Behaviors And Beliefs, Michelle Harrison

Theses and Dissertations (ETD)

Purpose. Postpartum depression (PPD) is a mental condition that significantly affects 10% to 25% of women within the first year after the birth of their child. The mother-infant relationship is key to child growth. Previous studies have shown that PPD has a detrimental effect on children’s physical and psychological well-being as it affects the child through the mother’s parenting behavior. Depressed mothers show a lack of engagement with their children, which could extend to feeding practices influencing weight gain. The prevalence and severity of childhood overweight and obesity is a global public health problem. An increase in weight gain in …

Evaluating Burnout, Secondary Traumatic Stress, And Sleep Disturbances In Healthcare Professionals During A Global Pandemic, Laura K. Miller, Sarah Pehlke

Journal of Wellness

Introduction: For healthcare workers, the COVID-19 pandemic resulted in increased workload, work related stress and patient acuity potentially leading to burnout, secondary traumatic stress (STS), and sleep disruptions. This study aims to assess the prevalence of burnout and STS symptoms, as well as sleep disturbances among healthcare personnel working in the United States during the pandemic.

Methods: Healthcare workers from all disciplines and settings in the United States completed a cross-sectional survey about work and personal characteristics from January 20-March 1, 2021. Participants reported on symptoms of burnout, STS, and sleep disruptions.

Results: A total of 360 participants in the …

The Effect Of Transfer Of Care Protocol On The Rehospitalization Rates In Psychiatric Patients, Fernando Guillen Msn, Cnp, Pmhnp-Bc

Student Scholarly Projects

Practice Problem: The problem involved the transition of psychiatric care from long psychiatric hospitalizations to community-based psychiatric treatment which has developed into shorter inpatient psychiatric hospitalizations, which in turn has developed into a significantly higher number of individuals being readmitted within one year of inpatient discharge.

PICOT: In adult patients undergoing inpatient acute psychiatric care (P), how does the use of a transfer of care protocol (I), compared to current transfer of care practice (C), affect the rate of readmission within 30 days for inpatient acute psychiatric care (O), in 10 weeks?

Evidence: The evidence from an extensive literature review …

Visualizing Depressive Symptom Improvement: Implementing The 17-Item Hamilton Depression Rating Scale, Briana Raterman

Dissertations

Visualizing Depressive Symptom Improvement: Implementing the 17-Item Hamilton Depression Rating Scale

Abstract

Problem

Depression, a mental health diagnosis, has affected about 18.5% of adults (Villarroel & Terlizzi, 2020). Ketamine, a medication initially used as an anesthetic, has improved depressive symptoms in individuals struggling with treatment-resistant depression.

Method

This quality improvement (QI) project used the 17-item Hamilton Depression Rating Scale questionnaire to assess depressive symptom changes in patients receiving intramuscular ketamine for treatment-resistant depression. The questionnaire was administered to patients pre-and post-intramuscular ketamine administration. The data was collected on injections one, three, and six on each participant’s set schedule of injections …

An Evaluation Of Mindstrong™ Implementation With Graduate Nursing Students, Angela B. Sabblut

Dissertations

Problem: Nursing graduate students are at increased risk of greater stress, anxiety, and depression (Hoying, 2020; Melnyk et al., 2020). Cognitive Behavioral Therapy is the gold standard in the treatment of anxiety and depression (Hoying et al., 2020; Melnyk et al., 2015; Melnyk et al., 2020). MINDSTRONG™, a CBT-based training program, has been proven in many studies to be effective in helping individuals prevent or cope with these issues (The Ohio State University College of Nursing, 2020).

Methods: This Quality Improvement (QI) project was a descriptive-observational, pre-post design. Sample and setting were nursing graduate students from a Midwestern, middle-sized urban, …

Nursing Anxiety Self-Evaluation And Resiliency Methods, Dianne Deck

Dissertations

Abstract

Introduction: Nurses are stressed due to the demands of their job. This study aims to determine whether MICU nurses at a large Midwestern hospital would have reduced stress and anxiety after a 30-day meditation and exercise intervention.

Design and Methods: A quasi-experimental pre-post pilot study design was adopted. The convenience sample consisted of eight Medicine Intensive Care Unit (MICU) nurses in a large Midwestern urban tertiary medical center. Data collected included demographics, pre- post-Beck Anxiety Inventory Scale (BAIS), pre- and post-Single Item Stress Scale (SISS), and weekly diaries on exercise and meditation.

Results: The pre- post-SISS showed statistical significance …

Implementing Adverse Childhood Experience Screening In An Intensive Outpatient Mental Health Program, Bryan Amaro

Doctor of Nursing Practice Final Manuscripts

Adverse Childhood Experiences (ACES) are linked to damaging events which happen to people when we are young (0-18). ACEs are connected to a phenomenon known as the toxic stress response which can later become the root etiology for many mental health, substance abuse and chronic medical health complications our society faces. ACEs affect all populations and do not discriminate across socioeconomic, racial, ethnic, gender, or geographic lines. Roughly two thirds of Americans have experienced at least one ACE. This project seeks to perform ACE screening at an Intensive Outpatient behavioral health center by screening for ACEs upon all admissions into …

Implementing Universal Depression Screening In A College Health Clinic, Marilyn J. Grabau

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: College students are at high risk for depression, and this carries a considerable burden. The American College Health Association supports depression screening on college campuses recognizing that early identification leads to better outcomes.

LOCAL PROBLEM: The project site is a public university located in New England. The college campus health center incorporates medical and counseling services. From August 2019 to December of 2019, 67% of students seen in the counseling center described depressed mood as the presenting concern. Currently there is no routine depression screening in place.

METHODS: This QI project implemented universal depression screening at the student health …

The School Nurse's Experience Of Secondary Exposure To Trauma, Catherine A. Grano

Seton Hall University Dissertations and Theses (ETDs)

The school nurse (SN) is often the sole health care expert in the school setting, providing for the physical and socio-emotional needs of others. SN may be exposed to reports of trauma, a widespread and costly public health issue. This study sought to explore the experience of the SN when exposed to reports of trauma from those in their care. Seven N.J. certified school nurses participated in two online interviews via Microsoft Teams, spaced one to two weeks apart between June 2021 and September 2021. Interviews were recorded & transcribed verbatim and thematic analysis applied. This study found that SN …

Integrating Mental Health Into Primary Care, Lori Hopwood, April Schmidt

Doctor of Nursing Practice Projects

BACKGROUND: The purpose of this project was to examine the effects of a newly integrated collaborative mental health care model. The primary goal of the integrated behavioral health program was designed to increase the ability of primary care providers to provide mental health services with the support and expertise of a consulting psychiatrist and behavioral health specialist. Additional goals were to improve access to care and improve mental health outcomes.

AIMS: The aim of this project was to evaluate a new way of integrating mental health services in a rural health, primary care practice in central Illinois.

METHODS: Measures …

Improving Depression Surveillance At The We Care Clinic, Kaitlin Springer, Emma Hanney

Doctor of Nursing Practice Projects

Depression is one of the most underdiagnosed and untreated disorders affecting more than 16 million people in the United States each year (Henry et al., 2020). Unmanaged depression can lead to emotional suffering, decreased productivity, reduced income, impaired relationships, and an increased risk for comorbidities (Sinisalchi et al., 2020). It can affect anyone, however, individuals who are non-white, female, undereducated, disabled, pregnant or postpartum, have low socioeconomic status, or lack social support are at an increased risk (United States Preventative Services Task Force, 2019). The Southern Illinois University Edwardsville We Care Clinic provides primary care to minority patient populations who …

The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell

Undergraduate Honors Theses

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …