Nursing Commons^™

The Green Rx: An Intervention In Nurse Anxiety And Depression, Melissa Dawley

DNP Research Projects

No abstract provided.

Perceptions Of Self-Efficacy And Experiences Of Mindfulness On Pain And Anxiety In Patients Undergoing A Colorectal Surgery: A Prospective Mixed Methods Study, Rebecca Brown, Julie Fitzgibbons, Rachel Farrington

Costas T. Lambrew Research Retreat 2021

Introduction

• Pain and anxiety have a physiological response on the body.

• Increased heart rate, respiratory rate and blood pressure can lead to complications, and thus longer hospitalization along with decreased patient satisfaction.

The Outcomes Of Cope, A Cognitive Behavioral Therapy Program, In Patients Awaiting Lvad Implantation, Aaron G. Harris

DNP Projects

PURPOSE: The purpose of the Doctor of Nursing Practice (DNP) project was to pilot Creating Opportunities for Personal Empowerment (COPE), an evidence based cognitive behavioral therapy (CBT) intervention, with patients diagnosed with advanced heart failure who are awaiting Left Ventricular Assist Device (LVAD) implantation or those who have had one recently implanted before they are discharged home. METHODS: A cross-sectional study design was used for this Pilot project. Patients were identified for potential participation by LVAD coordinators and represent a convenience sample. The patients were screened for anxiety and depression using the GAD-7 and PHQ-9 screening tools. If patients scored …

Preoperative Education In Lumbar Fusion Patients: Impact On Postoperative Disability Perception, Megan Curtis

Doctor of Nursing Practice Scholarly Projects

Background/Review of Literature: A lumbar fusion is a complex surgical intervention with many postoperative guidelines and restrictions. Preparing patients with surgery specific education has shown to decrease their sense of disability and postoperative pain in other surgical specialties, but a disparity exists in spinal surgery.
Purpose: To examine the effect of a preoperative education class for lumbar fusion patients on their perceived level of disability, the number of patient phone calls made to the neurosurgery office, the number of postoperative emergency room (ER) visits, and the number of hospital readmissions after surgery.
Methods: A quality improvement project utilizing a quantitative …

Social Media And Mental Health In Adolescents And Young Adults: A Systematic Review, Dawn Ritter, Kimberly Ray, Celia Keefe

Williams Honors College, Honors Research Projects

The goal of our project is to increase understanding of the link between social media use and mental illness in teens and young adults. Our objective is to write a systematic review of the literature to answer the PICOT questions: (1) In teens and adults, younger than 25 years, what is the relationship between social media use and mental illness? (2) In teens and adults, younger than 25 years, what is the effect of interventions, such as social media as a resource, on mental health promotion and well-being? The motivation for our project comes from the increased use of social …

Anxiety Screening In Children & Adolescents With Type 1 Diabetes Using The Gad-7 Tool, Allison B. Reynolds

DNP Projects

BACKGROUND: Children and adolescents with type 1 diabetes (T1DM) can encounter a variety of factors that affect proper management of their diabetes, including mental health. Youth with diabetes have significantly higher rates of depression, anxiety, and mental health problems compared to the general population. Anxiety is especially prevalent. PURPOSE: The objective of this project was to evaluate anxiety screening of children and adolescents with T1DM during their routine diabetes visits. Specifically, to assess for any trends in anxiety levels and patient characteristics including demographics, insulin regimen and A1C levels. METHODS: A cross- sectional, retrospective review of ambulatory electronic health records …

A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas

Walden Dissertations and Doctoral Studies

High utilization of the emergency department (ED) by patients with anxiety symptoms has brought attention to mental health access disparities among low-income racially/ethnically diverse populations. The health system in this study attempted to increase access to mental health care with integrative group medical visits (IGMVs), a nonpharmacological intervention with biomedical care consultation, health education, and peer support. The purpose of this retrospective comparative analysis, guided by integrative health equity in primary care framework, was to determine whether patients with diagnoses of anxiety who attended four or more IGMVs had reduced nonemergent ED utilization, reduced prescribed doses of benzodiazepine (BZD), and …

Prospective Evaluation Of Association Between Negative Emotions And Heart Failure Symptom Severity, Kyoung Suk Lee, Terry A. Lennie, Debra K. Moser

Nursing Faculty Publications

Background: Prior studies of symptoms in heart failure (HF) were largely cross-sectional and symptoms were measured using retrospective recall. Because negative emotions influence information processing, retrospective symptom reports by patients with depressive symptoms and anxiety may be biased. The purpose of this study was to determine whether there are differences in patterns of symptom changes, measured prospectively, over 15 days by levels of depressive symptoms and anxiety.

Methods: HF patients (N=52) rated daily symptom severity for shortness of breath (SOB), fatigue, sleep disturbance, and edema over 15 days on a 10-point visual analogue scale. Patients were grouped into higher vs …

The Long-Term Multidimensional Impact Of Persistent Multisite Pain On Physical And Psychological Disability, And Mortality In Community-Dwelling Older Adults, Saurja Thapa

Graduate Doctoral Dissertations

Persistent multisite pain is highly prevalent, affecting 25-43% of community-dwelling older adults. Although existing evidence suggests that persistent multisite pain is associated with physical and psychological disability, studies use a cross-sectional assessment approach that overlooks pain duration or persistence. This study aimed to estimate the persistence of multisite pain and the proportion of incident multisite pain and examine the association between persistent multisite pain and physical (ADL and IADL) and psychological disability (depression and anxiety) at 18 months and six years. Also, the association between baseline persistent multisite pain and mortality was assessed.

Secondary data analysis of the MOBILIZE Boston …

Improvement In Patients’ Ability To Care For Anxiety And Impaired Body Image: A Case Report Of Acceptance And Commitment Therapy And Family Psychoeducation, Rasmawati Rasmawati, Budi Anna Keliat, Herni Susanti

Jurnal Keperawatan Indonesia

Heart failure and hypertension are non-communicable diseases that are responsible for 70% of deaths world wide and cause anxiety and impaired body image. Nursing interventions(therapy in general) and acceptance and commitment therapy increase patients’ acceptance of the disease and commitment to alleviate anxiety and improve impaired body image. Meanwhile, family psychoeducation improves the family’s ability to care for the patient. This case report presents two patients with heart failure and hypertension. The two patients experienced a decrease in symptoms on the cognitive aspects(difficulty concentrating, focusing on self, and decline body changes), affective aspects (worry, shame, and despair), physiological aspects(sleep disorders …

Utilizing Mindfulness-Based Exercises To Reduce Anxiety Severity Scores According To The Gad-7, Kelly Calhoun

Dissertations

Abstract

Problem: Generalized anxiety disorder (GAD) affects thousands of Americans every year. Mindfulness, a practice of bringing oneself into the present moment, has been shown to impact anxiety symptoms positively.

Objective: This prospective observational correlational study utilized mindfulness-based exercises to help decrease anxiety severity according to the generalized anxiety disorder-7 (GAD-7) in an outpatient psychiatric practice.

Methods: Participants practiced mindfulness exercises for two months. The GAD-7 was completed three times to monitor symptom severity. Two participant satisfaction surveys were completed to determine whether participants felt the exercises were beneficial for decreasing their anxiety.

Results: A repeated measures ANOVA was used …

Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Mental Health Screening For Low-Income Adolescents

BACKGROUND: Nearly 80% of adolescents in the United States will suffer from a mental illness and not receive evaluation or services. Children from low socio-economic backgrounds have an increased risk of mental health disorders which permeate into adulthood, leading to additional negative sequel and lower quality of life. Among adolescent mental health conditions, depression and anxiety are the most common. Literature has suggested provider intuition alone has low sensitivity and specificity for detecting mental illness and that screening tools are indicated.

PURPOSE: The aim of this project is to implement standardized routine …

What's All The Buzzy About? Using Cryotherapy And Vibration For Pain During Vaccinations In Children, Marta L. Byma

Evidence-Based Practice Project Reports

Vaccinations are the most common painful needle procedure, with an estimated 12 billion injections given per year (CDC, 2019). The usual method for administration of vaccinations is through needle puncture, which is often painful. Children often report receiving a shot as one of the most feared and painful experiences (McMurtry et al., 2015). The purpose of this evidence-based practice (EBP) project was to improve patient experiences by decreasing the pain that is associated with vaccinations through the use of a nonpharmacological method for comfort via the Buzzy® device. After thorough analysis and synthesis of the literature, the Buzzy® device that …

Management Of Atrial Fibrillation With Smartphone Technology, Teresa Praus

UNLV Theses, Dissertations, Professional Papers, and Capstones

Atrial fibrillation is the most common arrhythmia affecting over six million people; it is predicted to increase two-fold by the year 2050. This arrhythmia results in a lack of

atrial/ventricular communication, accompanied by ineffective atrial contraction, suboptimal ventricular filling, and thrombus formation. This may lead to stroke, and ultimately heart failure. The current economic burden related to the complications of atrial fibrillation is estimated to be greater than $6 billion annually with potentially catastrophic events, further increasing expenditure.

When patients experience symptoms related to atrial fibrillation, it is common for them to present to a hospital emergency department. These visits, …

The Influence Of End Of Life Education On Stress, Anxiety, And Attitude Of The Healthcare Profession Student, Chiquesha Davis

DNP Final Reports

Providing comfort and support to the dying patient is a significant part of the dying process. When soothing a patient, who is dying, the goal is to prevent or relieve suffering as much as possible. Respecting the patient's health and quality of life goals and decisions is essential. Healthcare profession students can experience multiple levels of anxiety, stress, and a negative attitude while taking care of the dying patient. The implementation of a successful intervention is at the cornerstone of helping reduce stress, anxiety, and attitude change in healthcare profession students. The application can also have a positive impact on …

Creating Opportunities For Personal Empowerment: A Project Evaluation, Ann L. Cudney

Doctoral Projects

Introduction: 66% of individuals in the United States who experienced a major depressive episode in the last year saw a general practitioner or family doctor and not a psychiatrist or psychotherapist (Center for Behavioral Health Statistics and Quality, 2018). Many primary care providers treat with medication, however, a combination of medication and psychotherapy is associated with better results (Anxiety and Depression Association of America, n.d.). A Midwestern faith-based healthcare organization implemented a pilot cognitive behavioral therapy program at a family medicine residency clinic to improve mental health care.

Objectives: The purpose of this project was to evaluate if the implementation …

A Feasibility Study Of Lavender Aromatherapy In An Awake Craniotomy Environment, Kailah Cathey, Nichole Gunyon, Nancy Chung, Nancy Conway, Diane Ames, Maharaj Singh, Amin B. Kassam, Richard A. Rovin

Journal of Patient-Centered Research and Reviews

Purpose: Integrative medicine interventions are needed for awake craniotomies, as many patients experience anxiety. Lavender aromatherapy significantly reduces anxiety or pain in a variety of surgical procedures. This feasibility study used lavender aromatherapy during awake craniotomies to determine the number of patients who would consent and complete the study, the technicality of lavender aromatherapy use, and acceptance by operating room (OR) staff.

Methods: We approached 40 consecutive patients (≥18 years old). Exclusion criteria were pulmonary issues or sensitivity to lavender. Outcome measures in consented patients were enrollment and completion rates, anxiety and pain as measured by the Visual Analog Scale …

Implementation Of An Anxiety Screening And Treatment Protocol In Primary Care, Danielle E. Garcia

Student Theses, Dissertations and Capstones

Background: Anxiety is a prevalent problem frequently presenting in the primary care setting in the United States. The lack of routine anxiety screening and evidence-based treatment protocols in the adult primary care setting causes physical, social, and economic consequences.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) evidence-based practice (EBP) quality improvement project was to implement an EBP anxiety screening and treatment protocol for adults in a primary care clinic to increase early identification and improve management of generalized anxiety disorder (GAD).

Theoretical Framework: W. Edwards Deming’s Plan-Do-Study-Act (PDSA) cycle framework was utilized for this project. The PDSA …

Reducing Nurses' Communication Anxiety During End Of Life Care, Susan Dunbar Wolfrom

Master of Science in Nursing Theses and Projects

End of life (EOL) conversations are meaningful discussions pertaining to the patient’s disease trajectory, symptom management, and the patient’s goals at end of life. End of life care discussions have been associated with many benefits for the patient including: decreased healthcare costs, less aggressive treatments at EOL, and a good death. These sensitive discussions must occur over the course of several interactions or spontaneously in the moment in order to support the patient during delicate moments. This makes the nurse the prime candidate to help facilitate and harbor these discussions. However, barriers to communication exist, leading to the omission of …

Benefits Of Exercise On Mental Health: Literature Review, Angela Ristau

All Graduate Theses, Dissertations, and Other Capstone Projects

Providers diligently educate patients on exercise to reduce the risk of cardiovascular disease, hypertension, diabetes, and stroke. However, in recent years, providers judiciously educate patients on exercise and its correlation to improving or impacting mental health disorders. Physical activity has been steadily shown to relate to improved physical health, life satisfaction, cognitive functioning, and psychological well-being. A large body of literature examines the impact of physical activity and exercise on mental health. There is a growing interest in the use of exercise in the treatment of depression and anxiety, as a primary option or as an adjunct to pharmacological treatment. …

Impact Of Mentoring On First Year Nursing Student Anxiety, Heather Ann Clesi

Walden Dissertations and Doctoral Studies

First-year nursing students (FYNS) experience anxiety that can decrease academic achievement and result in attrition from the nursing program (NP). Research has not evaluated the impact of faculty mentoring (FM) offered by the NP on FYNS anxiety level and academic achievement in didactic courses. This study, guided by Neuman’s system model, used a descriptive cross-sectional design. An online survey link was distributed to FYNS in a southwestern state via NP directors and social media. FYNS were asked if their NP offered FM and were sorted into groups based on their response. Responses were received from 321 participants with 75 meeting …

Childhood Anxiety, Cognitive Behavioral Therapy And/Or Pharmacological Treatment, Jennifer S. Mccarthy

All Graduate Theses, Dissertations, and Other Capstone Projects

Objective: Evaluate best practice in managing anxiety in the pediatric population, including both school age children and adolescents. This literature review compared pharmacological treatment and cognitive behavioral therapy (CBT)’s effectiveness on the management of anxiety within the pediatric population.

Background: Up to 25% of children in the United States are affected by a mental health disorder, anxiety being the most prevalent. Childhood anxiety can have a distressing impact on social, family, and academic functioning. If persisting into adulthood it increases the risk of developing other co-occurring mental health conditions, substance abuse issues, and contributes to impaired employment retention and socioeconomic …

Benson’S Relaxation Response: Psychological And Physiological Responses Among Patients With Copd, Crista Reaves

UNLV Theses, Dissertations, Professional Papers, and Capstones

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. In patients with COPD, distress is significantly prevalent and can have adverse psychological and physiological effects. Considering the increased rate of COPD, a mind-body intervention focusing on the reduction of both psychological and physiological responses such as anxiety, elevated blood pressure (BP), heart rate (HR), dyspnea, and respiratory rate must be integrated into the patient’s plan of care. The relaxation response (RR) is a term coined by Dr. Herbert Benson in the 1970s describing the body’s ability to counter the fight-or-flight response to decrease …

Peer Mentorship: Reported Outcomes Among Student Registered Nurse Anesthetists, Aja Rivera, Champagna Conner

College of Science and Health Theses and Dissertations

Background: Student Registered Nurse Anesthetist (SRNAs) experience high levels of stress and anxiety while enrolled a demanding nurse anesthesia program; a peer mentorship program fosters an encouraging support system for SRNAs. Purpose: The purpose of this project was to evaluate if a peer mentorship program was effective at diminishing stress & anxiety, social isolation, enhancing preparedness amongst the first and second-year SRNAs, and to evaluate the perceived effectiveness of mentorship amongst students enrolled in the NorthShore University HealthSystem School of Nurse Anesthesia (NSUHS SONA). Methods: This quantitative, descriptive, cross-sectional study design involved three cohorts of SRNAs. Participants communicated through personal …

Nursing Campus Therapy Dog, Deborah A. Hall

Nursing Theses and Dissertations

An acknowledged bond has existed between humans and animals throughout history. Therapeutic physical and psycho-social effects of these bonding relationships have been noted in health care settings. Professional nursing education is known to be one of the most demanding and stressful fields of study. Students begin to experience extreme stress early in their nursing education. An animal-assisted intervention with a therapy dog is an innovative and inexpensive action that can help decrease the stress, anxiety, and depression students experience in higher education.

The focus of this dissertation portfolio was an animal-assisted intervention with a nursing campus therapy dog. The initial …

Development Of Mechanical Ventilator Educational Brochure For Patients/Families, Cathy Palleschi, Wendy Osgood, Mark Parker

Operations Transformation

Patients on mechanical ventilation often have no memory of events while being ventilated. In addition, families during this time, are often overwhelmed and unable to retain information provided to them by caregivers.

In attempt to address these issues, a team of care providers in an tertiary academic hospital established a goal to create a mechanical educational brochure with the goal to reduce associated anxiety and improve overall understanding of information provided.

As part of a clinical transformation project, a root cause analysis was conducted and a number of countermeasures were initiated. Some of these included a survey to capture feedback …

Perinatal Mood And Anxiety Disorders, Stigma, And Social Support Among Postpartum Women, Ellen K. Fleischman

Dissertations

Purpose/Aims: The purpose of this descriptive, correlational, cross-sectional study was to examine the relationships among perinatal mood and anxiety disorder (PMAD) symptomatology, select demographics, stigma of mental illness, and social support, among inpatient postpartum women. Rationale: PMADs affect as many as 21% of childbearing women, yet these disorders are identified and treated less than half the time. There is a gap in the literature regarding the relationships among stigma, social support, and PMADs in postpartum women.

Conceptual Basis/Background: Despite recommendations from professional organizations, screening for PMADs is not consistently completed using a valid, reliable instrument. Stigma contributes to the low …

Toward Expert Consensus On Guidelines For The Use Of Yoga In The Treatment Of Anxiety In Children And Adolescents., Laura J. Abels

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Despite clinical evidence to support the use of yoga as a treatment option for children and adolescents with anxiety, clinical practice guidelines do not exist. Purpose: This project used the modified Delphi technique to determine if consensus exists on the need for clinical practice guidelines among experts in the fields of child and adolescent psychiatry, psychology, and yoga. Additionally, this project aimed to determine if consensus exists on what should be included in clinical practice guidelines for the use of yoga as a therapeutic intervention for anxiety in children and adolescents. Methods: Three rounds of questionnaires were used …

Toward Reducing Stress And Anxiety In Nursing Students: Implementing An Evidence-Based Mindfulness Program, Susan Mckee

DNP Final Reports

Stress and anxiety are increasing in college students, especially in nursing students who complete didactic and clinical courses concurrently. Nursing students report feeling overwhelmed, with distress affecting academic performance and balance of school and personal demands. Mindfulness is an evidence-based method of reducing human suffering due to troubling conditions such as pain, chronic illness, or psychological issues including stress and anxiety. This paper addresses the state of the science of mindfulness and details the current mental health concerns of college students, specifically nursing students. The body of evidence, gathered through a systematic search, suggests that mindfulness reduces stress and anxiety …

Increasing Utilization Of Cognitive Behavioral Therapy To Reduce Morbid Obesity In A Primary Care Setting, Erin J. Mccue

Doctoral Projects

Background: Obesity among adults is characterized by a body mass index (BMI) of 30 or higher. The impairment and disability resulting from obesity indicates a significant health problem that is often seen in primary care settings. Research indicates that cognitive behavioral therapy (CBT) is an underutilized, but extremely beneficial intervention that may support individuals in achieving weight loss. Adults suffering from obesity with or without comorbid conditions such as psychiatric disorders (e.g. anxiety and depression) have benefitted from CBT.

Purpose: To implement the increased utilization of CBT in the adult population with obesity and depression or anxiety in a primary …