Psychiatry and Psychology Commons^™

A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula

Nursing Masters Papers

Abstract

Delirium is a complex syndrome resulting from compounding effects of acute illness, comorbidities, and the environment. It results in adverse outcomes: elevated mortality rates, length of stay, readmissions, institutionalization, long-term cognitive changes, and diminished quality of life. The rate of iatrogenic delirium is astounding, ranging from 10%-89%. There are no curative treatments; thus, primary prevention is the key. The purpose of this literature review is to identify and critique the research for the accuracy of risk stratification and feasibility in practice. Support for interventions that prevent delirium is mounting; however, interventions are resource-intensive and often not implemented. Researchers have …

Combined Effects Of Gender Affirmation And Economic Hardship On Vulnerability To Hiv: A Qualitative Analysis Among U.S. Adult Transgender Women., Larissa Jennings Mayo-Wilson, Eric G. Benotsch, Sheila R. Grigsby, Sarah Wagner, Fatmata Timbo, Tonia Poteat, Lauretta Cathers, Ashlee N. Sawyer, Shelby A. Smout, Rick S. Zimmerman

School of Nursing Faculty Publications

Background: Transgender women ("trans women"), particularly African-American and Latina trans women, have disproportionately high prevalence of HIV in the United States (U.S.). In order to decrease gender dysphoria and overcome discrimination, trans women affirm their gender through social and medical transition, often in contexts of economic hardship and sexual risk. This study qualitatively examined how gender-affirming behaviors enhance or diminish vulnerability to HIV in light of structural and economic barriers to gender transition.Methods: We conducted individual interviews with 19 adult trans women in two U.S. cities (Richmond, VA and St. Louis, MO) who reported one or more sexual risk behaviors …

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 …

The Effects Of Motivational Interviewing For Those Afflicted With Opioid Addiction, Kathy Roberts

Evidence-Based Practice Project Reports

Substance use disorders are a worldwide problem, according to the Center for Disease Control (CDC) there were 70,237 drug overdose deaths that occurred in the United States in 2017, of which 47,600 were opioid related. Illinois had a 14.3% increase of opioid deaths from 2016-2017 (CDC, 2017). Numerous interventions exist to address this health concern, yet evidence shows that Motivational Interviewing (MI) was the most efficient and effective way to promote behavioral change. The purpose of this EBP project was to provide evidence that MI increased referrals and promoted compliance with appointments to treatment programs. The sample for this project …

Impulsivity As A Trait Predictor In Baccalaureate Nursing Students, Jennifer Bertucci

Dissertations

Impulsive personality traits have been linked to pathological decision making in individuals who possess the trait. Impulsive pathological decision making may include acts of aggression, divergence, risky behavior, lack of self-care, etc. The purpose of this study was to examine impulsive personality traits among nursing students. Traditional students are defined by the following characteristics: earns a high school diploma, enrolls full time immediately after finishing high school, are financially dependent on parents, and either do not work during the school year or works part-time (the exception to the rule) (Choy, 2002). A non-traditional nursing student is defined as students who …

You're Not Forgotten: Effects Of Screening For Postpartum Depression Within A Pediatric Setting, Marrisa S. Culver

Evidence-Based Practice Project Reports

Postpartum depression (PPD) is depression that occurs in women following childbirth occurring during the postpartum period and affects 1 in 7 women (The United States Preventive Services Task Force, 2019). The American Academy of Pediatrics [AAP] (2019), recommends that pediatric healthcare providers utilize their position to screen for PPD. The purpose of this evidence-based practice (EBP) project was to implement a PPD screening intervention within a pediatric healthcare setting using the Edinburgh Postnatal Depression Scale (EPDS). The Academic Center for Evidence-Based (ACE) Practice Star Model guided this EBP project with evidence-based interventions developed after a comprehensive literature search. Implementation of …

The Effect Of Dance Movement Therapy On The Mood Of Hospitalized Psychiatric Adolescents, Amy Chiu

Nursing | Senior Theses

Mental illness in children has increased over all aspects throughout the years to right now (CDC, 2019). Many of these children do get treatment for these disorders but there are still a percent that do not receive any treatment or find effective ways to maintain non-pharmaceutical alternatives for mood stabilization. The alternative therapies that are introduced in hospital settings plays a role in allowing for alternative therapies to be apart of the treatment plan for patients. Dance Movement therapy (DMT) is an alternative therapy that uses movement to conduct change in patient’s emotions based on their own choices of movement …

Public Stigma And Self-Stigma Of Depression In College Students, Peyton Lee

DNP Projects

A large body of literature portrays the long-term, increased presence of mental illness stigma in college students, a vulnerable population at high risk of victimization. However, literature lacks sufficient research differentiating between the separate forms of mental illness stigma as well as consistent research examining stigma specific to the mental illness of depression in college students. A cross-sectional, web-based survey design was utilized to collect quantitative data from 432 students at a private, four-year university in the southeastern United States. The primary investigator both described the presence of and relationship between levels of perceived public stigma, personal public stigma, and …

Reproductive Health Needs Among Women In Treatment For Substance Use Disorder, Jaanki Bhakta, Elizabeth Morse, David Phillippi

DNP Projects

Integrated care models for substance use disorder (SUD) and reproductive health care have been proposed as a strategy to increase access to reproductive health care for women in treatment for SUD. This cross-sectional, survey-based study measured how women of childbearing age in residential treatment report their demand for and access to reproductive health care, their pregnancy intention, contraceptive utilization and preference for integrating reproductive health care with their current SUD treatment milieu. Eighty-five percent of the women interviewed (N=108) expressed a desire to prevent pregnancy in the next year, although only one-third (33.6%) were using a form of contraception at …

(Des)Cuidando A Quienes Nos Crían: Una Exploración Cualitativa Del Abordaje Para El Diagnóstico, La Prevención Y El Tratamiento De La Depresión Posparto En La Ciudad Autónoma De Buenos Aires (2020) / (In)Adequate Care For Those Who Raise Us: A Qualitative Exploration Of The Approach To Diagnosis, Prevention And Treatment Of Postpartum Depression In The City Of Buenos Aires (2020), April Hopcroft

Independent Study Project (ISP) Collection

Aunque el embarazo y la maternidad están representadas como periodos de alegría, la llegada de un bebé es una transición significativa en la vida que también puede provocar sentimientos de ansiedad y depresión. La depresión posparto (DPP) es un trastorno de estado de ánimo que plantea consecuencias graves para ambas madre y bebé. Dada la vacancia de investigación en la Argentina, este trabajo pretende analizar el abordaje actual de intervención de la DPP en la Ciudad Autónoma de Buenos Aires. Los objetivos específicos son: 1) identificar y describir el proceso de diagnóstico, prevención y tratamiento, y 2) indagar las percepciones …

Dementia: Types, What They Are And How They Differ, Jessica N. Schnetzer

Honors Thesis

Dementia: types, what they are and how they differ centers on the known and unknown complexities of dementia. Dementia is a very complex cognitive disease that consumes the brain, an organ of which we know very little about. Even so, this common disorder is actively being researched and is the topic of special interest of this thesis research. Described are Alzheimer’s disease, Creutzfeldt-Jakob disease, Frontotemporal dementia, Huntington’s disease, Korsakoff’s syndrome, Lewy body dementia, Parkinson’s dementia, and Vascular dementia, focusing on what they are, their specific risks, diagnosis, treatment, and their differing progressions. Guidance of this study provided by thesis director …

Non-Pharmacological Interventions For Alcohol, Marijuana, And Opioid Use During Pregnancy: A Systematic Review, Hannah Safranek, Madeline Frausto, Amy King, Stoneking Madison

Williams Honors College, Honors Research Projects

The purpose of this review is to analyze evidence on prevalence of opioid, alcohol and marijuana use during pregnancy and answer the PICOT question: In pregnant women addicted to or using marijuana, opioids, and alcohol, how do non-pharmacological interventions, compared to standard care of pharmacological interventions alone, affect health outcomes in mothers and neonates between birth to hospital discharge? Diagnosis of substance use disorder is increasing and with it comes increased risk of complications to mother and neonate including neonatal abstinence syndrome (NAS), fetal alcohol syndrome (FAS) and other negative neonatal and maternal outcomes. Evidence was identified on the online …

Ontrack: A Program Evaluation, Justin Mynatt

Doctoral Projects

OnTrack is a program that provides coordinated specialty care (CSC) services for patients who have experienced their first episode of psychosis (FEP). Appropriately identifying and aggressively treating this vulnerable population, while providing support to both them and their families is critical for improved outcomes. Appropriate treatment of FEP patients can improve their quality of life, preserve brain matter, improve overall functioning, and lessen the burden of the clients’ family who may be involved in their care, such as caregiver strain or financial hardship. The purpose of this project is to evaluate the success of OnTrack, a FEP program, at improving …

Hierarchy Of Evidence [Eps File], Judy Schmitt

Library Faculty Works

Hierarchy of Evidence showing primary and secondary sources

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Increasing Rates Of Larc Uptake And Continuation Through Contraceptive Counseling: An Effective Approach For Women With Underutilization, Malia Johnson

DNP Qualifying Manuscripts

Unintended pregnancies in women with a substance use disorder are estimated to be nearly double that of the general population, of which negative health consequences are increased for both mother and neonate. Unintended pregnancies are preventable through the use of highly effective contraception that is less susceptible to the effects of typical versus perfect use. Long-acting reversible contraception (LARC) is ideal for this patient population. Therefore, a thorough literature review was performed to evaluate the role of contraceptive counseling on LARC uptake and continuation among women. The results indicated that contraceptive counseling does influence LARC uptake and continuation and it …

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 …

Tell Me A Story As A Bibliotherapy Intervention To Promote Resiliency In Military Children, Katherinemarie Conover

2019 Sigma Region 15 Nursing Research Symposium

Project studied effect on resiliency of Tell Me A Story™ intervention with children of active duty military members. Outcomes included improvement in resiliency and ego-resiliency after attending intervention; boys benefited in reduction of internalizing problem behaviors more than girls.

Implementing Screening To Assess Readiness To Change In Overweight And Obese Patients At A Patient-Centered Medical Home, Jarrod Gant

Doctoral Projects

Obesity is at epidemic levels within the United States (U.S.), but the Southern U.S. has some of the most obese states. Mississippi (MS) is the most obese state in the country (Robert Wood Johnson Foundation, 2018). Factors such as diet, sedentary lifestyle, cultural influences, and socioeconomic status contribute to the state’s citizens being overweight and obese.

Contributing to the state’s obesity is the fact that MS has more people living in poverty than any other state (Center for American Progress [CAP], 2018). Lacking the ability to afford healthy foods and the ability to afford quality healthcare adds to the state’s …

Using Teamstepps® To Improve Interprofessional Collaboration In The Outpatient Psychiatric Care Setting, Amy Michele Wadsworth

Doctoral Dissertations and Projects

The AACN has identified in their QSEN competencies that collaborative teamwork and patient-centered care are two qualities that skilled nurses must exhibit to provide high-quality care. The IOM has made a call to action that healthcare professionals must exhibit patient-centered care in interdisciplinary team settings to achieve high-quality care. At a community resource program in the mid-Atlantic region, a recent qualitative job satisfaction survey revealed that employees identified issues with interprofessional collaboration and a lack of teamwork at the facility. Using the Iowa Model, this EBP project involves the use of a cohort study with a pretest-posttest design, where the …

An Animal-Assisted Intervention Study In The Nursing Home: Lessons Learned, Lonneke G. J. A. Schuurmans, Inge Noback, Jos M. G. A. Schols, Marie-Jose Enders-Slegers

People and Animals: The International Journal of Research and Practice

AAI studies in the nursing home pose a specific set of challenges. In this article the practical and ethical issues encountered during a Dutch psychogeriatric nursing home AAI study are addressed with the aim of sharing our experiences for future researchers as well as AAI practitioners in general.

In our study we compared three groups of clients with dementia who participated in group sessions of either visiting dog teams, visiting FurReal Friend robot animals, or visiting students (control group) and monitored the effect on social interaction and neuropsychiatric symptoms through video analysis and questionnaires. We encountered the following four categories …

A Polygenic Resilience Score Moderates The Genetic Risk For Schizophrenia, Jonathan L. Hess, Et Al, Schizophrenia Working Group Of The Psychiatric Genomics Consortium, Nancy G. Buccola

School of Nursing Faculty Publications

Based on the discovery by the Resilience Project (Chen R. et al. Nat Biotechnol 34:531–538, 2016) of rare variants that confer resistance to Mendelian disease, and protective alleles for some complex diseases, we posited the existence of genetic variants that promote resilience to highly heritable polygenic disorders1,0 such as schizophrenia. Resilience has been traditionally viewed as a psychological construct, although our use of the term resilience refers to a different construct that directly relates to the Resilience Project, namely: heritable variation that promotes resistance to disease by reducing the penetrance of risk loci, wherein resilience and risk loci operate orthogonal …

Motivation Of Use Of Electronic Cigarettes Among Youth Aged 13-18, Leah Severson

Grace Peterson Nursing Research Colloquium

Abstract

Background: For individuals aged 13-18, electronic cigarettes are the most commonly used tobacco product. These devices are highly addictive and negatively affect health. To reduce early nicotine use, it is important to understand the reasoning behind why youth choose to use electronic cigarettes.

Purpose of Study: The purpose of this integrative literature review was to review existing studies on why youth aged 13-18 use electronic cigarettes. In evaluating multiple up to date research studies the goal was to find trending results.

Method: An integrative literature review was utilized to evaluate peer-reviewed articles published from 2013-2018. Search terms included: Electronic …

The Effects Of Rape Trauma And Ptsd On The Childbirth Process, Helena Kevorkian

Grace Peterson Nursing Research Colloquium

Abstract

Background: Sexual trauma, including rape and childhood sexual abuse, takes a toll on the survivor emotionally and physically. With the invasive procedures, physical exposure and feelings of loss of control related to childbirth, the survivor may become triggered and become retraumatized. Through an integrative literature review, the effects of rape trauma and PTSD on the childbirth process were identified.

Objective: The purpose of this integrative literature review was to determine the effects of rape trauma and PTSD on the childbirth process. Through determining the effects, a greater understanding will be gained on how to best approach a situation with …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Understanding The Impact Of A Perinatal Mood And Anxiety Disorders Phone Support Line, Diana Nguyen, Semira Semino-Asaro

Doctor of Nursing Practice Final Manuscripts

Postpartum depression affects one in every seven women and anxiety is estimated to range from 13-21% in new mothers. Risk factors include prior diagnosis of depression, family history of depression, having medical complications during childbirth including a premature baby and a lack of social, emotional support. The purpose of this evidence-based practice project was to increase the amount of data gathered by a local perinatal support organization by analyzing the callers’ demographics through phoneline surveys and use the information to expand resources and access to care for mothers with perinatal mood and anxiety disorders (PMADs). The project was guided by …

Do Not Miss Your Shot: Improving Follow-Up In Patients Receiving Long-Acting Injectable Medications, Mary O'Hara

Doctor of Nursing Practice Final Manuscripts

Background: Serious mental illness including schizophrenia and bipolar disorder affects 1 in 24 adults in California. These chronic disorders are difficult to treat and often sabotaged by medication nonadherence. Long-acting injectable (LAI) medications are one strategy to combat medication nonadherence. Effectively providing treatment with LAI medications can be challenging at the clinic level.

Objectives: Reduce the number of days without medication by reducing the number of days between injection due date and injection administration for patients receiving LAI medications.

Design: Establish appointments for all injection visits. Standardize visit protocol for injection encounters to optimize provider time. Arrange immediate follow-up and …

Analysis Of A Universal Depression Screening Workflow At An Integrated Healthcare Center, Arthur Roehr

Doctor of Nursing Practice Final Manuscripts

Purpose: Evaluation of an evidence-based protocol that measures the effectiveness of universal depression screening at an integrated healthcare center. At risk patients are those who complete a patient health questionnaire (phq-9) and score ≥ 10 when presenting for a primary care visit. A score of ≥ 10 prompts further evaluation by the primary care provider (PCP) prior to behavioral health care management (BHCM) referral.

Background: In 2016, 16.2 million adults aged 18 or older in the U.S. experienced a major depressive episode (MDE). 65.3% of those received some form of treatment from a healthcare professional (therapy and/or medication). Early identification …

School-Based Mental Health Screening: Improving Outcomes Through Interprofessional Communication And Collaboration, Tiffany Gishizky

Doctor of Nursing Practice (DNP) Projects

For the adolescent population, the immediate impact a mental health disorder has on academics,relationships, and even suicide risk cannot be understated. Access to mental health care in low socioeconomic communities for adolescents is fraught with barriers. These include lack of transportation, lack of insurance coverage, fear of stigma, and a fundamental lack of knowledge regarding available resources. It is therefore a two-fold problem that exists for those in the care and observation of these adolescents; underutilization of appropriate routine screening and navigation to access care. This project aimed to remediate both of these issues at a high school located in …

The Effects Of A Dementia Simulation Experience On Attitudes Towards People With Dementia, Micah Huckabee

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: The neurodegenerative effects of dementia resulting in cognitive and behavioral impairments is plausibly one of the reasons for a societal stigma towards individuals with dementia. Societal stigmas are associated with decreased life satisfaction, depressive symptoms, and decreased psychological well-being for stigmatized individuals. In an effort to improve attitudes towards individuals with dementia, this study utilized a dementia simulation to measure attitudinal changes after a dementia simulation. Methods: There were 33 participants in this study (13 male and 20 female) between the ages of 18 and 25. Participants completed a Dementia Attitudes Scale (DAS) survey, and then they dressed in …