Matching Items (79)

126890-Thumbnail Image.png

Implementation of Adolescent Depression Care Guidelines into the Electronic Health Record at a Rural Pediatric Primary Care Clinic

Description

Background: Healthcare providers are encouraged to prepare their practice to effectively manage the care of mild to moderate adolescent depression. Cost-effective screening, diagnostic, and newly developed pediatric primary care depression

Background: Healthcare providers are encouraged to prepare their practice to effectively manage the care of mild to moderate adolescent depression. Cost-effective screening, diagnostic, and newly developed pediatric primary care depression management guidelines have been established. To integrate guidelines into practice, primary care providers (PCPs) must document effectively to ensure a complete treatment plan is in place in the patient’s electronic health record (EHR).

Intervention: Elements from a flowsheet were implemented into the EHR to promote thorough assessment and documentation of care delivered to adolescents with depression.

Methods: An initial chart review was completed on patients diagnosed with depression. An updated depression template was implemented within the EHR for six weeks. A follow-up chart review was completed post-intervention to determine if documentation of elements from the adolescent depression guidelines improved after the EHR update. Pre-intervention and post- intervention surveys were delivered to PCP’s to understand their perspective on adolescent depression management.

Outcomes: The chart review revealed that baseline PHQ-9 screenings were documented in 91% (n=43) of the charts reviewed in the pre-intervention timeframe. Only 78% (n=7) of the charts reviewed during post-intervention included PHQ-9 screenings. Early intervention treatment options documented in the pre-intervention timeframe included education 100% (n=47), medication prescriptions 53% (n=25), and psychotherapy referrals 18% (n=18). During post- intervention, education 100% (n=9), medication prescriptions 78% (7), and psychotherapy referrals 22% (n=7) were documented by the PCPs.

Recommendation: The quality improvement project focused heavily on documentation completed over a one year pre-intervention timeframe compared to a six-week post-intervention timeframe. Further evaluation and chart review over the next year will provide a more adequate comparison of documentation within primary care practice.

Contributors

Agent

Created

Date Created
  • 2020-05-01

141148-Thumbnail Image.png

Does Online "Working Out Work" as a Treatment and Prevention for Depression in Older Adults?

Description

RESEARCH QUESTION: Does Online "Working Out Work" as a Treatment and Prevention for Depression in Older Adults? An Analysis of a Prescribed and Monitored Exercise Program Administered via the Internet

RESEARCH QUESTION: Does Online "Working Out Work" as a Treatment and Prevention for Depression in Older Adults? An Analysis of a Prescribed and Monitored Exercise Program Administered via the Internet for Senior Adults with Depression.
OBJECTIVE: The purpose of this study is to investigate and access the effectiveness of an online prescribed and monitored exercise program for the treatment of depression in Older Adults. The Dependent Variable for the study is Depression. The Independent Variable for the study is the Effects of Exercise administered via the Internet and the population is geriatric adults defined as senior adults aged 50 and older. Depression is defined by Princeton University Scholars (Wordnet, 2006) as a mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity.
METHODS: The presence and severity of depression will be assessed by using The Merck Manual of Geriatrics (GDS-15) Geriatric Depression Scale. Assessments will be performed at baseline, before and after the treatment is concluded. The subjects will complete the Physical Activity Readiness Questionnaire (PAR-Q) prior to participating in an exercise program three times per week.
LIMITATIONS OF RESEARCH: The limitations of this study are: 1) There is a small sample size limited to Senior Adults aged 50 - 80, and 2) there is no control group with structured activity or placebo, therefore researcher is unable to evaluate if the marked improvement was due to a non-specific therapeutic effect associated with taking part in a social activity (group online exercise program). Further research could compare and analyze the positive effects of a muscular strength training exercise program verses a cardiovascular training exercise program.

Contributors

Created

Date Created
  • 2011-05-02

126911-Thumbnail Image.png

Access to Healthcare Among Those Experiencing Homelessness: A Depression Screening Project

Description

Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health.

Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health. Depression is a prevalent mental health disorder in the US linked to increased risk of mortality. Literature suggests depression screening can identify high-risk individuals with using the patient health questionnaire (PHQ-9).

The objective of this project is to determine if screening identifies depression in the homeless and how it impacts healthcare access. Setting is a local organization in Phoenix offering shelter to homeless individuals. An evidence-based project was implemented over two months in 2019 using convenience sampling. Intervention included depression screening using the PHQ-9, referring to primary care and tracking appointment times. IRB approval obtained from Arizona State University, privacy discussed, and consent obtained prior to data collection. Participants were assigned a random number to protect privacy.

A chart audit tool was used to obtain sociodemographics and insurance status. Descriptive statistics used and analyzed using Intellectus. Sample size was (n = 18), age (M = 35) most were White-non-Hispanic, 44% had a high school diploma and 78% were insured. Mean score was 7.72, three were previously diagnosed and not referred. Three were referred with a turnaround appointment time of one, two and seven days respectively. No significant correlation found between age and depression severity. A significant correlation found between previous diagnosis and depression severity. Attention to PHQ-9 varied among providers and not always addressed. Future projects should focus on improving collaboration between this facility and providers, increasing screening and ensuring adequate follow up and treatment.

Contributors

Agent

Created

Date Created
  • 2020-05-04

126916-Thumbnail Image.png

Obesity in Adults on Antidepressant Therapy

Description

In the United States obesity continues to be a growing issue in the adult population, which is compounded by the fact that many people have had antidepressant therapy at some

In the United States obesity continues to be a growing issue in the adult population, which is compounded by the fact that many people have had antidepressant therapy at some point in their lives. Health problems such as metabolic syndrome, diabetes, skeleton/joint issues and more can stem from obesity. These comorbid health care problems can increase the costs at the state and federal levels. This paper will examine obesity and its relation to antidepressant therapy in depressed adults that are obese or endeavoring to avoid further weight gain. Research indicates that antidepressant therapies have shown a greater propensity towards weight gain, though few research studies show weight loss.

Intervention: 10 minutes of nutritional counseling during office visits. Setting: Family psychiatric clinic in the southwest of the United States.

Methods: Data collection process: Depressed adults on antidepressant therapies were randomly selected.

Instrumentation: Weight scale, National Literacy Scale, pamphlet (for teaching) and height scale. Data collected was at baseline, 4 weeks and 8 weeks.

Outcomes: 14 Participants agreed to the project, 10 completed to the 4-week mark and 4 finished the project to the 8-week mark. 10 female participants and 4 male participants. The remaining 4 participants showed 1.6% reduction in body mass index, which correlated with an increase in nutritional learning from baseline to 8-weeks.

Recommendations: Nutritional counseling is a non-pharmacological intervention for achieving and a desired weight, which has shown positive results in varying populations and clinical situations.

Contributors

Agent

Created

Date Created
  • 2020-05-07

134139-Thumbnail Image.png

Impact of Family Support on Early Childhood Dysregulation in the Context of Maternal Depression

Description

The ability to regulate emotions, attention, and behavior develops early in life and impacts future academic success, social competency, behavioral problems, and psychopathology. An impairment in regulation is known as

The ability to regulate emotions, attention, and behavior develops early in life and impacts future academic success, social competency, behavioral problems, and psychopathology. An impairment in regulation is known as dysregulation. Past research shows that children of mothers with postpartum depression are more likely to show impairment in regulatory abilities. There is an established link in the literature between family support and maternal depression, which in turn can impact child behavior. However, further research is needed to explore the impact of family support on early childhood dysregulation in the context of maternal depression. Using a sample of 322 Mexican-American, mother-child dyads, two models were examined. Model one hypothesized family support would buffer the effects of maternal depression on child dysregulation at 24 months. Model 2 hypothesized that family support is related to child dysregulation through its effect on maternal depression. Results showed that increased family support was related to more child dysregulation when there were high levels of maternal depression. There was no evidence to support the hypothesis that maternal depression mediated the relationship between family support and child dysregulation.

Contributors

Agent

Created

Date Created
  • 2017-12

134931-Thumbnail Image.png

The Effects of Interaction with Children in Symptoms of Depression in the Elderly

Description

The purpose of the study was to determine the impact of social interaction with children on the symptoms of depression in elderly participants at the John C. Lincoln Adult Day

The purpose of the study was to determine the impact of social interaction with children on the symptoms of depression in elderly participants at the John C. Lincoln Adult Day Healthcare center when compared to depressive symptoms in the elderly who do not regularly interact with children. This organization provides care to elderly members of the community in a dignified and stimulating manner. It allows caregivers of participants to take a break from day to day responsibilities while providing the participants with a safe and active environment. It shares premises with the Lincoln Learning Center, which is a care/educational facility for children ages 6 weeks to 12 years of age. The children and the elderly interact one day a week for half an hour in a planned activity in the Adult Day Healthcare Center. The Geriatric Depression Scale- Short Form was used to assess for presence of depressive symptoms in both the control group (those who did not regularly interact with children) and the experimental group (those who did regularly interact with the children). The scale consisted of 15 yes-or-no questions regarding the average emotions the participants experienced in a week. A total of 15 people participated in the study, eight in the control group and seven in the experimental group. Eight of the participants were male, seven were female and they ranged in age from 58 to 96 years old. An independent sample t-test was performed to assess the data for statistical significance.

Contributors

Agent

Created

Date Created
  • 2016-12

135033-Thumbnail Image.png

Limited ""down time"" with parents: Associations with maladjustment among affluent youth

Description

Affluent children have been previously understudied and considerably neglected in developmental research due to the notion that they are "low risk." There is limited empirical research exploring the effects of

Affluent children have been previously understudied and considerably neglected in developmental research due to the notion that they are "low risk." There is limited empirical research exploring the effects of parent involvement in affluent youth: specifically, the importance of the adolescent's perception that their mother/father do not spend as much time with them as they would like. The goals of the study were to explore the role of this dimension of perceived parental involvement in anxious-depressed symptoms, somatic symptoms, rule breaking behaviors and substance use with upper-class suburban youth. The sample was taken from the New England Study of Suburban Youth Cohort (NESSY) (Luthar & Latendresse, 2005b) consisting of 252 high school students in the 12th grade located in an affluent community in the Northeast. Results showed that the participants who indicated their fathers could have dinner with them more often if they tried presented significant group differences in anxious-depressed symptoms, somatic symptoms, and rule breaking behaviors while substance use trended towards significant. Thus, these data demonstrate that parent-child relationships are not only important for infant and child development, but are also an integral part of development of adaptive behaviors during adolescence. In addition, the data suggest the benefits from having strong, supportive, and stable relationships with not only mothers but with fathers as well. Results from post hoc analyses revealed perceived absence of fathers at dinnertime affects the adolescent more than the perceived absence of mothers at dinnertime. Finally, teens who indicated a need to spend more dinnertimes with their father may be suffering from a lack of open communication and opportunities to discuss social and emotional issues that are conducive to adolescent development and adjustment.

Contributors

Agent

Created

Date Created
  • 2016-12

135051-Thumbnail Image.png

Views of Maternal Depression In Rural Kenya

Description

Investment and interest in mental health on a global scale is increasing. This interest creates a need to gain an in depth understanding about how mental illness is conceptualized and

Investment and interest in mental health on a global scale is increasing. This interest creates a need to gain an in depth understanding about how mental illness is conceptualized and treated in different cultures. This article aims to explore the views of maternal mental health in Kenya's sub-counties. Maternal mental health has a significant impact on child development outcomes, so the topic has cross-generational importance. Ten focus group discussions with a variety of participants were conducted to understand the health care system. The participants were from four Kenya sub-counties: Rachuonyo N., Wagwe, Okiki Amayo, Nyative and they were either members of either SCHMT (Sub-county health management team), CHEW (community health extension worker), facility/staff of the county hospital, HHCDO (Homa Hills Community Development Organization), THRIVE II staff (Catholic Relief Service's early childhood development program) or mothers and fathers with children under two years of age. The qualitative data were translated and transcribed on site and then retranslated and counterchecked. A secondary data analysis using Atlas.ti was performed to identify themes and trends in factors that contribute to maternal wellbeing. Four main categories were identified as having prevalent effects on the Kenyan mothers' mental health: cultural values, broken support system, limitations of resources, and knowledge, behavior and attitudes. The participants were broken up into administrative, clinical, social, maternal and paternal categories to determine specific influence in each of these areas. Further analysis defined participants' involvement in the categories as mediating, moderating and direct effects on maternal depression. Main contributors to depression were identified as a lack of paternal support, poor cultural values, and administrative resistance. Discussion focuses on consequences for the future.

Contributors

Agent

Created

Date Created
  • 2016-12

133817-Thumbnail Image.png

Through It All: Toilets, Wrestling, and Anxiety

Description

Anxiety is currently the most prevalent mental disorder in America with over 4 million people struggling with it every day. I am one of those millions. This book explores the

Anxiety is currently the most prevalent mental disorder in America with over 4 million people struggling with it every day. I am one of those millions. This book explores the multitude of coping mechanisms that I have learned and developed through my time with anxiety, covering everything from humor to finding the motivation to change. It is a creative non-fiction autobiography that depicts detailed moments from my own life that provide advice and tools for managing anxiety that are made accessible to people who may have completely different experiences from my own. While anxiety has always played a huge roll in my life, it wasn't until I got to college that I decided to finally begin taking the steps I needed to in order to see the changes that I wanted to see. I am a teacher, and every day I see many of my students battling with the exact pains and stresses that I always have. This book is for all of my future students as well as all the adolescents out there who feel like nobody really understands; the ones who all they need is a little direction and the confidence to know they're not alone.

Contributors

Agent

Created

Date Created
  • 2018-05

134063-Thumbnail Image.png

Benefits of high intelligence: Potential moderating effects of emotion regulation and friendship quality

Description

Depression, anxiety, and suicidal thoughts or actions are on the rise in adolescents (National Institute of Mental Health, 2015; Bridge, Asti, & Horowitz, 2015). Parents, school administrators, and therapists are

Depression, anxiety, and suicidal thoughts or actions are on the rise in adolescents (National Institute of Mental Health, 2015; Bridge, Asti, & Horowitz, 2015). Parents, school administrators, and therapists are searching for resiliency factors with in at-risk groups to aid students in need. In previous work, Luthar and Zigler (1992) reported that intelligent youth are more resilient than less intelligent youth under low stress conditions but they lose their advantage under high stress conditions. This study examined whether intelligence (reflected in grade point average; GPA) and maladaptive (internalizing and externalizing symptoms) behaviors are negatively related in adolescents, and tested whether level of stress, reflected in emotion regulation and friendship quality, moderated that association. It also probed whether the relationships differ by gender. Sixth-graders (N=506) were recruited with active parental consent from three middle schools. Adolescents completed self-report questionnaires Regarding demo graphics, maladaptive behaviors, emotion regulation, and friendship quality, and GPA data were collected from the school. Regression analyses found that GPA was negatively related to externalizing symptoms. Girls with poor friendship communication report significantly higher maladaptive behaviors. This relation was more pronounced for girls with high GPAs, as predicted. Results support the theory that intelligent female adolescents are more reactive under adverse circumstances. Future efforts should follow students through middle school into high school to evaluate whether friendships remain important to adjustment, hold for boys as well as girls, and have implications for relationship interventions.

Contributors

Agent

Created

Date Created
  • 2017-12