Psychiatric and Mental Health Nursing Commons^™

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 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 …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

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 …

Examining The Relationship Between Medical Concerns And Overall Mental Health Rating, Sarah M. Wilson

Masters Theses & Specialist Projects

It is widely supported that there are significant, positive relationships between the occurrence of some mental health symptoms and physical illnesses. Research indicates that the burden experienced by those with a physical and mental illness are magnified compared to individuals who do not experience an illness. More specifically, one of the burdens experienced by individuals is the monetary burden of affording the necessary health services to properly manage their illness.

This study attempts to reveal a difference between mental health symptom count for individuals who do and do not experience difficulty affording health care for their physical problems. The first …

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

Treatment Recidivism In Adolescents With Mental Illness: A Focused Applied Medical Ethnography, Chukwudi C. Ekwemalor

Dissertations and Theses (Open Access)

Background

Treatment recidivism, described as frequent unplanned relapse readmissions, is a national problem predominant in adolescents with mental illness with significant socioeconomic consequences. Adolescents living with mental illness are a sub-culture of adolescence, the critical growth period of developmental and social transition from childhood to adulthood. The main triggers of treatment recidivism in this population are not fully understood from previous studies.

Purpose

The study purpose was to explore treatment recidivism with the following aims:

1. To illuminate treatment recidivism from the perspectives of recidivist adolescents with mental illness.

2. To describe the main factors that contribute to treatment recidivism …

Predicting Burnout Among Psychiatric Technicians, Sarah E. Hernandez

Electronic Theses, Projects, and Dissertations

This thesis attempted to examine stressors associated with the psychiatric technician profession and levels of burnout amongst them. This was accomplished through the use of a survey which included demographic data, the Maslach Burnout Inventory Human Services Survey (MBI‑HSS), an adaptation of the Nursing Stress Scale (NSS) and a self‑care assessment tool. A total of three research questions were examined statistically including levels of burnout on subcategories (personal accomplishment, emotional exhaustion and depersonalization), most common stressors identified by psychiatric technicians and percentage of participants who utilized therapy to cope with work related stress. The survey was made available via survey …

The Secret Ingredient For Improving Infant/Child Mental Health: Teaching Parents To Play, Geraldine Healy Marini

Occupational Therapy Doctorate Capstone Projects

Disorders in mental health are the highest of all disorders and results in the most common form of disability. Since 2011, mental health disorders have increased at alarming rates. It is estimated that 9.5 to 14.2% of children between the ages of 0 to 5 years have and emotional or behavioral problem. The mental health of parents or caregivers can affect and impact the development of young children (Nelson & Mann, 2011, Zero to Three, 2004).

The over arching goal of this research is to explore issues of mental health within parent-child interactions. Coaching parents during the co-occupation of play …

Intensive Care In Oncology: Admission And Outcomes In Adult Patients With Cancer, Surya John

Honors Undergraduate Theses

Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care.

Methods: A total of 768 articles were found in a literature search including all literature from 2005 to …

Psychological Distress And Cardiac Disease, Tracey Vitori

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate the association of psychological distress with cardiac disease, events, and mortality. Specific aims were to: 1) to evaluate the association between hostility level and recurrence of acute coronary syndrome (ACS) and all-cause mortality in patients with coronary heart disease (CHD); 2) to evaluate the psychometric properties of the Brief Symptom Inventory (BSI) hostility and anxiety subscales in a group of incarcerated participants at high risk of cardiovascular disease; and 3) to evaluate the association of patient and caregiver psychological state with quality of life in both patient and caregiver, and postoperative complications …

Relationship Among Motivation, Emotion Regulation, And Psychological Well-Being Of Sophomore And Senior Level Nursing Students, Aryene Delgado, Douglas Garner, Nicole Langhals

Williams Honors College, Honors Research Projects

Nursing education and professional work involve stressful circumstances that may lead to attrition, which can further contribute to the projected nursing shortage. This study examines the relationships between motivation, emotional regulation, psychological well-being and academic performance in baccalaureate sophomore and senior level nursing students at a Midwest urban university in the United States. The non-experimental, correlational study is guided by Deci and Ryan’s self-determination theory and uses an online survey data collection and convenience sampling. Measures include: motivation, emotional regulation, psychological well-being (burnout; inauthenticity), and academic performance (GPA), and will be measured using Deci and Ryan’s scale, the Emotion Regulation …

Self-Efficacy And Coping In Transition Of Care After Remission Of Cancer In Adolescents, Leah M. Mcdonnell

Honors Undergraduate Theses

The improvement in cancer remission rates in children and adolescents due to advances in cancer treatment and therapy has led to the development of guidelines that address long-term follow up for survivors of childhood cancers. Adolescents often experience negative emotions related to the fear of uncertainty about long-term survival after cancer remission, yet often report feelings of hope and optimism for the future more than adult cancer survivors. The purpose of this study was to understand the role of self-efficacy and coping in adolescents after remission of cancer. A secondary purpose was to analyze which coping strategies supported long-term survival …

Practice Matters: Screening And Referring Congregants With Major Depression, Kim Link, Dawn M. Garrett Wright, Mary Branstetter Dnp

International Journal of Faith Community Nursing

The purpose of this article is to provide Faith Community Nurses with current recommendations regarding screening and caring for individuals with major depression. Epidemiological data on major depression will be presented, along with recommended screening tools to assist in detecting major depression. Recommendations for the management of major depression will be presented, including the role that the Faith Community Nurse can play when providing care and education to individuals with major depression.

Health-Related Beliefs, Practices, And Experiences Of Migrant Dominicans In The Northeastern United States, Constance Sobon Sensor

Seton Hall University Dissertations and Theses (ETDs)

Purpose: This study aimed to discover and describe migrant Dominican cultural beliefs and practices related to health, the ways that migrant Dominicans take care of their health in their new environment, and their experience with professional health care in the Northeastern United States.

Design: This descriptive qualitative study was guided by Leininger’s Theory of Culture Care Diversity and Universality and four-phase analysis method. The health-related beliefs, practices and experiences of a convenience sample of 15 self-identified adult Dominicans living in the United States for six months or more were explored in three focus groups, assisted by trained culturally appropriate interpreters. …

Diabetes Self-Management Education For Adolescent Patients: The Importance Of A Developmentally Sensitive Approach, Laura Mumme

Senior Honors Theses

The attention of healthcare providers to the developmental level of adolescent patients with type one diabetes (T1D) maximizes effective patient education and glycemic control. Due to the dynamic changes that occur in the mind and body during adolescence, self-care for adolescent T1D patients is overwhelming as it envelopes activities of everyday life. The disease process and the unique aspects of adolescence in relation to T1D are important for caregivers to consider. Developmentally appropriate teaching during the initial onset of the disease must inform the patient and the patient’s family of the basics of the disease process and the daily care …

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 …

Delirium Screening Instrument Knowledge And Perception Among Cardiovascular Intensive Care Nurses, Brittany Lynn Dahl

DNP Projects

Background: Delirium is a serious condition that affects critically ill adult patients in the intensive care unit. Bedside nursing delirium measurements are considered a dependable source of information that can be used for clinical decision-making. Nurse education and assessment of perceptions is important when building a framework for successful delirium assessment. However, few data exist about nursing perceptions and practices associated with delirium screening instruments. The overall purpose of this project is to examine nurse perceptions and knowledge about delirium and delirium screening instruments at the University of Kentucky (UK) Hospital’s Cardiovascular Intensive Care Unit (CVICU).

Objectives: The aims of …

The Effect Of Patient Education On Anxiety Levels In Patients Receiving Chemotherapy For The First Time, Sarah Garcia

Evidence-Based Practice Project Reports

Cancer affects approximately 1.5 million people every year throughout the United States.Comprehensive care that includes psychosocial aspects is important to help patients effectively adapt to their diagnosis and treatment plan. Improper prevention and management of anxiety can lead to poor psychosocial outcomes, dissatisfaction with care, and decreased adherence to treatment. Current evidence suggests that education is effective at helping reduce anxiety in patients receiving chemotherapy for the first time. The purpose of this evidenced based practice project was to determine if nurse-led patient education regarding chemotherapy side effects, side-effect management, and orientation to the infusion center was effective at decreasing …

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 …

Understanding Autism, Kaileigh J. Sweeney

Senior Honors Projects

Understanding Autism

Kaileigh Sweeney

Faculty Sponsor: Carolyn Hames

Autism spectrum disorders are greatly misunderstood in today’s society.  In the United States, it is estimated that 1 in 110 children are diagnosed with an autism spectrum disorder.  Despite this high prevalence, a great deal of the population is under the impression that a diagnosis of autism is straight forward and indicative of one set of devastating signs and symptoms.  However, the severity of this disorder can range from mild to severe. According to the National Institute of Health, an autism spectrum disorder (ASD) is a range of complex neurodevelopment disorders characterized …

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 …

A Pilot Study Of Bibliotherapy To Reduce Alcohol Problems Among Patients In A Hospital Trauma Center, Paul Amrhein, Timothy Apodaca, William R. Miller, Carol R. Schermer

Department of Psychology Faculty Scholarship and Creative Works

Because alcohol use plays a major role in many injuries that require hospital care, there is increasing interest in developing interventions to address alcohol problems among emergency department and trauma center patients. The aim of the current study was to extend past research on brief interventions by investigating the use of a self-help manual to treat problem drinkers in a hospital trauma center. Forty injured patients who were either intoxicated at the time of injury or screened positive for harmful drinking were randomly assigned to receive either a brief assessment and a self-help booklet with no more than 5 minutes …

Eligibility, Recruitment, And Retention Of African Americans With Severe Mental Illness In Community Research, Michelle Hampton, Mary White, Linda Chafetz

Faculty Publications

Data that addresses severely mentally ill (SMI) African Americans (AAs) likelihood to participate in clinical research is limited. This study’s purpose was to determine if differences exist between races regarding eligibility, recruitment, and retention in a community-based clinical trial. The sample included 293 participants. Data sources included clinical records and interviews. Logistic regression was used for analysis. AAs were as likely to participate and to complete followup interviews as Whites. In contrast to studies about non-mentally ill AAs, AAs with SMI appeared to be as willing to consent to and to remain in clinical research studies as Whites.

Bring Mental Health Services Home: Meeting The Mental Health Needs Of Adolescents And Their Families In Rural Minnesota, Laura Filzen

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this project was to develop a program that addressed housing and therapeutic support to adolescents experiencing mental health issues, allowed adolescents to remain in the community, and promoted reunification with their families. “An important indicator of success for children in out-of-home care is a timely transition to reunification” (Park and Ryan, 2009). Based on the literature and practice, it is believed that intensive family therapy is needed to promote reunification and reduce recidivism of placement.

Recognition Of Depression In Primary Care Settings: The Influence Of Patient Age And Gender On Patient Care, Kelly Marie Monette

All-Inclusive List of Electronic Theses and Dissertations

Depression is a common condition that is often poorly detected in primary care medical settings. The elderly often fail to receive appropriate attention to their mental health needs, possibly due to physician's interpretation of physical and emotional changes as part of the normal aging process. The purpose of this study was to explore physicians' identification of depression and to determine whether age-related factors and gender impact recommendations for patient care. The respondents were full-time primary care physicians (N = 46; 63% male) who were randomly selected from a national listing of family medicine practitioners and primary care physicians (family medicine, …

Evaluating The Effect Of Family Stroke Education On The Anxiety Levels Of Families Of Stroke Patients, Keri Lynne Kuniyoshi

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included]

The Effect Of Self-Help Support Groups On Self Esteem And Blood Glucose In Young Insulin-Dependent Diabetics, Linda L. Woertz

Loma Linda University Electronic Theses, Dissertations & Projects

Successful adaptation to diabetes is probably a function of many factors: the stress involved, the rewards, the motivation of the individual, and the self concept. The more optimal the self concept the more optimal the behavior may be. By helping the patient shape a positive self concept, a base can be built for blood glucose control (Bruhn, 1977, pp. 93-97). One method of improving self concept or self esteem may be through the development of self-help support groups for diabetics.

The purpose of this study was to evaluate the effect of self-help support group intervention on the levels of self …

Two Emotional Factors And Weight Loss Among Females Attending A Weight Control Class, Karen Lynn Carrigg, Eileen Rae Wangerin

Loma Linda University Electronic Theses, Dissertations & Projects

A descriptive study was conducted on twenty-four females attending a weight control class to discover the effect of weight loss upon levels of self-esteem and anxiety, as an understanding of the relation of these factors to reduction and control of weight would prove helpful to community health nurses in counseling with overweight and obese persons in the community.

The entire sample was tested for self-esteem (TSCS) and A-State and A-Trait anxiety levels at the initial class of the weight control program sponsored by the Health Education Department of Loma Linda University Medical Center, and again after seven weeks of class …

Effects Of A Series Of Nurse-Patient Interactions On Multiple Sclerosis Patients, Lynne Campbell

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of the study was to learn whether a series of nurse-patient interactions would result in changed psychophysiologic functioning in multiple sclerosis patients.

Psychophysiologic relationships were described in the theoretical framework. Literature, reviewed in the areas of disease description and psychotherapeutic approaches to treatment, indicated that there is a high incidence of multiple sclerosis in the United States; that symptoms often include psychological alterations; that there is an emotional component to the illness; that these patients have a need for a psychotherapeutic relationship; and that psychotherapeutic approaches may have beneficial psychophysiologic effects.

Two groups of multiple sclerosis subjects were …