Psychiatric and Mental Health Commons^™

A Curriculum On Culturally Competent Practices To Prevent Retraumatization In Diverse Survivors, Luana Rodriguez

Walden Dissertations and Doctoral Studies

This DNP project addresses the healthcare issue of intimate partner, domestic, and sexual violence (IPDSV), its impact on survivors, and reducing the potential for retraumatization by those who care for them in the clinical, behavioral, and social settings. Trauma-informed care interventions are designed to address the sequelae of trauma, promote recovery, and support resilience. Since IPDSV is a global health issue, supporting cultural needs of all clients is an essential aspect of trauma-informed care. This project was guided by a central research question that examined if trauma-informed, culturally competent curriculum be viewed by community stakeholders as an appropriate intervention for …

The Aftermath Of Violence: The Lived Experience Phenomena Of Assault In Nursing, Kathleen Clark

Walden Dissertations and Doctoral Studies

Despite the high incidence of violence directed at registered nurses while on duty, there is limited qualitative data that explores the lived experience of returning to the workplace after an assaultive incident. This phenomenological study sought to explore and analyze the phenomena of registered nurses who are employed in high-risk settings. The research questions considered the detailed descriptions of the experiences of nurses returning to the workplace. The conceptual framework was resiliency, as these participants continued to survive and thrive after the adverse assaultive events. Data were collected using in-depth interviews from purposeful sampling. Registered nurses working in the high …

Reducing Length Of Hospital Stay For Intellectually Disabled Psychiatric Patients With Chronic Medical Problems, Joseph Wigwe

Walden Dissertations and Doctoral Studies

Length of hospital stay (LOS) is a major indicator for measuring efficient care. Intellectually disabled psychiatric patients (IDPP) with chronic medical problems have longer LOS due to challenges faced by providers in jointly managing both psychiatric and medical problems. The purposes of this study were to understand the significance of LOS for IDPP, create an intervention toolkit to reduce LOS, establish the content validity of the toolkit, and recommend its implementation. The items of the toolkit are pharmacology, somatic, rehabilitation, psychosocial, and monitoring patients' psychiatric and medical symptoms across care domains. The toolkit was created from the constructs of the …

Understanding Bipolar Disorder, Tisha Perreira

Nursing Student Class Projects (Formerly MSN)

According to McCance, Huether, and Brashers (2014), bipolar disorder is classified as bipolar I and bipolar II mood disorder. Bipolar I disorder, causes extreme mood swings of mania or hypomania (emotional highs) or emotional lows (depression). Manic disorder symptoms include: excessive risky activities, irritable mood, elevated mood, distractibility, excessive talking, inflated self-esteem, racing/crowded thoughts, decreased need for sleep, and increase in goal-directed activity. Symptoms of depression include: loss of interest/pleasure, weight gain or loss, fatigue/loss of energy, feeling of worthlessness or excessive guilt, depressed/irritable mood, recent thoughts of death/suicide, insomnia/or hypersomnia, poor concentration/indecisiveness, and psychomotor agitation. Bipolar II disorder has …

Post Traumatic Stress Disorder, Zachary Packard

Nursing Student Class Projects (Formerly MSN)

Posttraumatic stress disorder (PTSD) can occur after witnessing or experiencing a terrifying event (Mayo Clinic, 2015). PTSD can manifest in a variety of symptoms including, nightmares, flashbacks, insomnia, irritability, and anger (Mayo Clinic, 2015). The extended combat engagement in Afghanistan and Iraq have caused many casualties for American service members, both physically and mentally. The Veterans Affairs (VA) stated that 476,515 people sought treatment for PTSD in 2011 alone (Veteran Affairs, 2014). The veterans returning home from combat require adequate services to support their transition to civilian life. Barriers may exist for those members with PTSD symptoms seeking treatment. The …

Uncovering The Concealed Part Of Motherhood-Postpartum Depression In Mothers, Hunaina Hadi, Shamsa Hadi

School of Nursing & Midwifery

Introduction: Motherhood is the most pleasing experience of a woman's life. Birth of a child gives birth to new hopes and ambitions. But Post-partum Depression is a condition when this blessing turns into curse. It can affect the mother, the partner and the child and can even lead to infanticide as well as maternal death, often by suicide.

Method: A qualitative systematic review was conducted through electronic medium to explore the relevant literature. Various databases i.e. Pubmed, Google search engines, Science Direct, JPMA, the Cumulative Index to Nursing and Allied Health Literature CINHAL and SAGA were used. Manual search was …

The Association Between Self-Rated Mental Health Status And Total Health Care Expenditure: A Cross-Sectional Analysis Of A Nationally Representative Sample, Muoi T. Nguyen, Winnie Y. Chan, Courtney Keeler

Nursing and Health Professions Faculty Research and Publications

Both clinical diagnoses and self-rated measures of mental illness are associated with a variety of outcomes, including physical well-being, health utilization, and expenditure. However, much of current literature primarily utilizes clinically diagnosed data.

This cross-sectional study explores the impact of mental illness and health care expenditure using 2 self-rated measures: self-rated measured of perceived mental health status (SRMH) and Kessler Screening Scale for Psychological Distress (K6).

Data from the 2011 Medical Expenditure Panel Survey Household Component, a nationally representative sample of noninstitutionalized individuals (n = 18,295), were analyzed using bivariate χ² tests and a 2-part model (logistics regression and …

Factors Influencing Depression In Men: A Qualitative Investigation, Lori A. Mutiso

Theses and Dissertations--Nursing

The purpose of this qualitative descriptive study is to describe men’s experiences of depression in order to provide direction for future research of the screening, diagnosing, and treatment of men's depression. Previous research indicates that men experience different depressive symptoms than women, and there is a possibility that men's depression is not being adequately captured by current screening standards, which would theoretically lead to a large number of men with unrecognized, undiagnosed, and untreated depression. If this is the case, this may explain the disproportionately low number of men diagnosed with depression compared to women, in contrast to the disproportionately …

Sleep, Depressive Symptoms And Cognition In Older Adults And Caregivers Of Persons With Dementia, Glenna Shemida Brewster

USF Tampa Graduate Theses and Dissertations

Caregivers of persons with dementia, who are often older adults, report sleep disturbance, high rates of depressive symptoms and may be at risk for impaired cognition. This dissertation examined sleep, depressive symptoms, and cognition in older adults and caregivers of persons with dementia. The aims of the review of literature were to understand, in community dwelling adults 60 years and older, the relationships among sleep parameters (sleep onset latency, wake after sleep onset, sleep efficiency, total sleep time, and general sleep complaints), and the domains of cognition (Executive Function, Attention, Episodic Memory, Working Memory, Processing Speed), and global cognition. Based …

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Impact And Prevention Of Psychiatric Polypharmacy In The Elderly, Rose Cordelia E Onyekwe

Walden Dissertations and Doctoral Studies

Adequate medication management is a focus of effective care that is often overlooked in caring for adults with comorbid psychiatric and physical conditions, especially in patients who are treated by multiple care providers and have a variety of health issues at the same time. The purpose of this project was to develop evidence-based policies and practice guidelines to reduce polypharmacy in elderly patients in a rural outpatient psychiatric clinic. Bandura's self-efficacy theory was used to inform the project for its value in assessing motivation, capacity for self-regulation, and perceptions of individual ability. An interdisciplinary team of stakeholders explored best practices …

Building Resilience And Coping Effectiveness (Brace): A Program For Military Families, Linda Pauline Zarrett

Walden Dissertations and Doctoral Studies

Building Resiliency and Coping Effectiveness (BRACE): A Program for Military Families

by

Linda Zarrett

MSN, University of Cincinnati, 2012

BSN, Minnesota State University, Moorhead, 1985

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

Veterans returning from combat report significant family strain and Post Traumatic Stress Symptoms (PTSS) yet have limited access to care resources. Family members, including children, report very similar symptoms to those of veterans and have yet fewer health care resources. The purpose of this project was to apply principles from existing research on post-traumatic stress …

Planning A Smoking Cessation Program In A Mental Health Hospital, Victoria Omuson

Walden Dissertations and Doctoral Studies

The incidence of smoking among mentally ill people is very high. Smokers have a 50%, rate of mental illness diagnosis compared with 23% rate for general population. To address this problem, the purpose of this project was to plan a smoking cessation program for patients in a mental health facility. The theoretical foundation for this project was based on the theory of planned behavior, which identifies the predictive nature of smoking and the benefits that can be derived from implementing a systematic approach for change. The project question examined the effectiveness of smoking cessation program using educational support, pharmacological strategies, …

Psychiatric Mental Health Nurse Practitioner Workforce Development In Behavioral Healthcare Settings In Rural Mississippi, Arlen Davis Cooper

Doctoral Projects

Description and Significance of the Problem: The United States is facing a significant rural mental healthcare workforce shortage and an uneven distribution of mental healthcare professionals. The psychiatric mental health nurse practitioner (PMHNP) may increase access to mental healthcare in rural underserved regions (NRHA, 2012). However, little is known regarding their distribution. The lack of uniform and consistent data collection methods regarding the number and the geographic distribution of PMHNPs in rural areas, specifically in rural Mississippi, exists. The importance of better data collection and improving infrastructure through collaboration with state licensing boards and state nursing workforce centers is …

Disseminating An Evidence-Based Course To Teach Self-Management Of Auditory Hallucinations, M Buffum, Robin Buccheri, L Trygstad, G Dowling

Nursing and Health Professions Faculty Research and Publications

This multi-site project extended course dissemination of the 10-session Behavioral Management of Auditory Hallucinations Course to U.S. Department of Veterans Affairs (VA) mental health outpatient settings. The VA Quality Enhancement Research Initiative (QUERI) model and Rogers' theory of diffusion of innovations served as the theoretical framework. The course was taught to mental health professionals using teleconferencing, electronic media, and monthly conference calls across 24 VA mental health outpatient sites. Twenty course leaders provided feedback. One hundred percent reported being better able to communicate with patients about their voices and 96% reported improved understanding of the voice-hearing experience. Thirty-three course participants …

Implementation Of A Depression Screening Protocol Specific To Implantable Cardioverter Defibrillator Patients; A Quality Improvement Project, Kendra M. Kratzwald

DNP Projects

Background: Depression in patients with implantable cardioverter defibrillators (ICD) is a problem that has not been well addressed by providers. In 2012 the American Heart Association (AHA) released a scientific statement that recommended structured and routine depression screening of these patients. The AHA statement also recommended further research on depression screening instruments and their use with this population. Aims: 1.) To develop and implement an evidenced based depression screening protocol appropriate for patients with an ICD seen in an outpatient setting. 2.) Evaluate provider knowledge about depression screening (? Is this what you mean) and depression screening practices before and …

Advanced Nurses' Perspectives On The Drug Addiction Treatment Act, 13 Years Later, Dorothy L. Were

Walden Dissertations and Doctoral Studies

The United States experiences opioid addiction at epidemic levels. In 2012, the National Institute of Drug Abuse reported that 23.1 million Americans were in need of addiction treatment services, although only 2.5 million were enrolled in treatment. Following an amendment to the Drug Addiction Treatment Act of 2000 (Public Law 106-310), advanced practice nurses were qualified as providers who could bridge the healthcare gap in treatment access. The purpose of this project was to determine the interest of advanced practice nurses in (a) prescribing buprenorphine and (b) establishing guidelines that would allow them to do so. This quantitative project used …

Relationship Between Psychotropic Drugs And Falls In The Geriatric Population, Lauren E. Fletcher Crotts

Nursing Theses and Capstone Projects

Falls in the geriatric population are extremely common and the risk for falls continues to increase with age. Falls are a leading cause of mortality in the geriatric population, and it is the number one reason for institutionalization in the United States. The purpose of this study was to explore the relationship of the prescribing effects of psychotropic medications such as antidepressants, benzodiazepines, and antipsychotics on falls in the geriatric population who live in a long term care community with a diagnosis of depression, dementia, anxiety, delirium, and Alzheimer's disease. The literature provided mixed conclusions on the effects of psychotropic …

Self-Management Of Unpleasant Auditory Hallucinations: A Tested Practice Model, Robin Buccheri, L Trygstad, M Buffum, P Birmingham, G Dowling

Nursing and Health Professions Faculty Research and Publications

Individuals who experience auditory hallucinations (AH) frequently report hearing unpleasant voices saying disturbing things to them, making derogatory remarks about them, or commanding them to do something, including harming themselves or someone else. The Self-Management of Unpleasant Auditory Hallucinations Practice Model was developed to help psychiatric-mental health nurses in both inpatient and outpatient settings implement evidence-based nursing care for voice hearers who are distressed by unpleasant voices. The model's utility extends to nursing education, administration, and research. The model is comprised of three parts: (a) Assessment of Voice Hearer's Experience, (b) Nursing Interventions, and (c) Voice Hearer's Expected Positive Outcomes. …

Constructivism Applied To Psychiatric–Mental Health Nursing: An Alternative To Supplement Traditional Clinical Education, Michelle Hampton

Faculty Publications

With the popularity of accelerated pre‐licensure nursing programmes and the growth in nursing student enrolments, traditional clinical education continues to be a challenge to deliver. Nursing faculty members are required to develop and implement educational innovations that achieve effective learning outcomes, while using fewer resources. The purpose of this qualitative study was to explore the effectiveness of a constructivism‐based learning project to achieve specific learning outcomes and to supplement approximately 30 clinical hours in a psychiatric–mental health nursing course. Students participated in a 10‐week, multistage project that examined life histories, treatment resources, and evidence‐based practice, as applied to a single …

Hospital Loneliness And The Patient-Physician Relationship: A Preliminary Analysis Of Associations With Recovery In Bone Marrow Transplant Patients, Lindsay E. Balfour

UNF Graduate Theses and Dissertations

The purpose of the present study was to examine general loneliness, hospital loneliness, and the patient-physician relationship in regards to their associations with Bone Marrow Transplant (BMT) recovery outcome variables (days until engraftment and quality of life). Fifteen (66.7% female, 33.3% male; 93.3% white, 6.7% Black/African American; average age 61.73) individuals who had an allogeneic or autologous BMT at The Mayo Clinic of Jacksonville completed the FACT-BMT, UCLA-Loneliness Scale Version 3, the CARE Measure, and provided disease and treatment information at the 6 month posttransplant date (+/- 30 days). Patients recovering from BMT indicated significantly higher scores of hospital loneliness …

A Study Of Expressed Emotion In Psychiatric Nurses And Its Relation To The General Role And Effects Of Emotions In Nursing, Lauren A. Buck

Senior Honors Theses

Nurses play a vital role in the health and care of a patient. Through that care, the nurse has the ability to improve the patient’s experience or ruin it. A vital component influencing the care provided are the emotions the nurse displays toward her coworkers, patients, and patients’ family members. The emotions of a nurse may positively or negatively impact a patient. The studies that examine the impact of the nurse’s emotions on patient’s outcomes are varied and few. The communication and emotion of nurses are likely to impact their care and, from that, the patient’s outcome; however, there is …

Differences In Substance-Related Risk Behavior Between Dual And Triple Diagnosed Severely Mentally Ill Adults, Michelle Hampton, Linda Chafetz, Carmen Portillo

Faculty Publications

The purpose of this study was to determine whether differences exist between adults with dual and triple diagnoses with regard to substance-related risk behaviors. This secondary analysis was a cross-sectional study. There were 252 subjects with dual and triple diagnoses recruited from residential crisis programs in San Francisco. Using descriptive and logistic regression analyses, subjects in the two groups were compared with regard to demographic data, types of substances, and routes of administration used in the previous 30 days to determine risk for exposure and/or transmission of human immunodeficiency virus/hepatitis C virus. When compared to the dual diagnosis group, subjects …

Relationship Between Cancer-Related Fatigue And Depression: A Pilot Study, Gloria Michelle Guess

USF Tampa Graduate Theses and Dissertations

Fatigue is one of the most bothersome symptoms reported by patients diagnosed with cancer, and research indicates that the majority of patients receiving chemotherapy report symptoms of fatigue. Fatigue can have an effect on quality of life; therefore, it is essential that healthcare providers gain a better understanding and recognition of fatigue.

Fatigue can also be a symptom of depression. Depression is another prominent symptom reported by patients diagnosed with cancer. Unfortunately, there are similarities between the symptoms of depression and fatigue making it difficult for health care providers to distinguish between the two. This study utilizes the subscale of …

Translation And Adaptation Of The Center For Epidemiologic Studies-Depression (Ces-D) Scale Into Tigrigna Language For Tigrigna Speaking Eritrean Immigrants In The United States, Mulubrhan Fisseha Mogos

USF Tampa Graduate Theses and Dissertations

Depression is one of the oldest known mental health conditions. It is acknowledged to be a global health problem that affects people from any culture or ethnic group. The prevalence of depression widely varied across countries and cultures. The cross-cultural relevance of the concept of depression, its screening or diagnosis, and cultural equivalence of items used to measure symptoms of depression has been area of research interest. Differences in prevalence rates in depression have been suggested as being due to research artifacts, such as use of instrument developed for one culture to another culture. With the current trend of globalization …

Nurses' Knowledge And Perceptions Of Rapid Response Teams In A Psychiatric Facility, Kimberly Cecil-Riddle

Walden Dissertations and Doctoral Studies

Psychiatric illnesses can sometimes lead to behavioral outbursts that need to be addressed quickly to deescalate potentially explosive situations. Nurses are in a unique position to respond to such outbursts by calling for a rapid response team. Nurses who are part of the rapid response team should be well-informed of their roles and responsibilities in managing aggressive and violent behavior. The purpose of this project was to explore RN's and LPN's knowledge and perceptions of a rapid response team in a psychiatric facility. The Iowa model of evidence-based practice provided the framework to integrate theory into practice to improve care. …

Double The Outcomes: Employing Sensory Based Approaches To Improve The Quality Of Care And Reduce The Use Of Restraints On Inpatient Behavioral Health Units, Mary Ellen O'Connell Rn, Bsn, Msn, Mba, Jennifer P. Maloney Ms, Otr/L, Stephanie Lenhart Mba, Cphq

Administration & Leadership

No abstract provided.

Immune Function And Health Outcomes In Women With Depression, Cherie Howk, Mary P. Bennett

Nursing Faculty Publications

This research reports immune function and health outcomes in women with depression, as compared with a nondepressed control group. Using Psychoneuroimmunolgy theory and a descriptive comparison design, scores on the Beck Depression Inventory (BDI) were used to divide 40 non-hospitalized Caucasian women between the ages of 18 and 65 years into either the control or depression comparison group. Women with depression were found to report significantly more incidences of illness over the previous two months and they were found to have significantly more indicators of illness at the time of the exam as compared to the controls. However, contrary to …

Comprehensive Evidence-Based Program Teaching Self-Management Of Auditory Hallucinations On Inpatient Psychiatric Units, Robin Buccheri, L Trygstad, M Buffum, K Lyttle, G Dowling

Nursing and Health Professions Faculty Research and Publications

Patients hearing command hallucinations to harm whose only self-management strategies are to obey these commands, can represent serious safety concerns on inpatient psychiatric units. A comprehensive evidence-based program teaching self-management of auditory hallucinations on inpatient psychiatric units is described that includes five components: suggestions for staff education; patient self-assessment tools; an interview guide and safety protocol; a course to teach strategies for managing distressing voices and commands to harm; suggestions to improve staff communication; and a plan to extend the program from inpatient care settings into the community by sharing materials with community case managers and caregivers when patients are …

Exploring The Impact Of Race On Mental Health Service Utilization Among African Americans And Whites With Severe Mental Illness, Michelle Hampton, Linda Chafetz, Mary White

Faculty Publications

BACKGROUND: Disparities among African Americans and Whites with severe mental illness have been identified in numerous studies. Yet it remains unknown if disparities are associated with race or other vulnerabilities common to this population. OBJECTIVES: This study used the Behavioral Model for Vulnerable Populations to examine mental health service utilization among 155 African Americans and Whites with severe mental illness for 12 months after discharge from a residential crisis program. DESIGN: This cross-sectional study was a secondary analysis of data from a randomized trial. RESULTS: Race did not emerge as a significant predictor of mental health service utilization. Factors associated …