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- All Subjects: Mindfulness
- All Subjects: College students
- Creators: Kinnier, Richard
- Status: Published
There were three main purposes of this study: 1) to construct a quantitative measure of parental pressure, 2) to evaluate whether self-esteem was a potential buffer of the negative impacts of parental pressure and academic stress, and 3) to understand better the factors impacting suicidality among adolescents in India by testing a path model of possible predictors suggested by the literature. Prevalence data of suicidal ideation and attempt history were also collected. Reporting on their experience over the past six months, 14.5% (n = 82) of the participants endorsed suicidal ideation and 12.3% (n = 69) of the participants admitted to having deliberately attempted to hurt or kill themselves.
Five constructs were explored in this study: parental pressure, academic stress, depression, suicidality, and self-esteem. The Parental Pressure for Success Scale, designed for this study, was used to measure parental pressure. The Educational Stress Scale-Adolescents was used to measure academic stress. The Center for Epidemiological Studies-Depression scale was used to measure depressive symptomology. Two items from the Youth Self-Report Checklist were used as a measure of suicidality in the past six months. The Rosenberg Self-esteem Scale was used to measure global self-esteem.
Preliminary support for the reliability and validity of the Parental Pressure for Success Scale was found. While self-esteem was not a significant moderator in this study, it was a predictor of both stress and depression. Results of the path analysis indicated that parental pressure predicted academic stress, stress predicted depression, and depression predicted suicidality. Parental pressure indirectly predicted suicidality through academic stress and depression. Results were discussed in the context of cultural influences on study findings such as the central role of parents in the family unit, the impact of cultural valuing of education, collectivistic society, and the Hindu concept of dharma, or duty.
Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?
The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.
Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.