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Remote Presence in Nature through Virtual Reality: A Pilot Study on the Mental Well-Being of Older Adults

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By 2030, the number of people above the age of 65 is projected to outnumber those under the age of 18 for the first time in United States history. With a growing older population, it is predicted that the amount

By 2030, the number of people above the age of 65 is projected to outnumber those under the age of 18 for the first time in United States history. With a growing older population, it is predicted that the amount of people moving into nursing homes and care facilities will also increase. However, a pressing problem is the high prevalence of depression and anxiety among elderly people residing in institutionalized living arrangements. With drugs and antidepressants less effective at treating patients with both dementia and depression, there is a need for more non-pharmacological interventions geared toward improving older adults’ mental well-being. In response, the potential therapeutic effect of exploring virtual nature through EcoRift—which provides dynamic and realistic 360-degree audio and visual environments—on older adults’ mental well-being was examined in this study. Ten individuals (3 men and 7 women) aged 50 and above were recruited and each participant experienced the virtual nature sojourns for 15 minutes once a week, for a total of three weeks. Pre- and post- virtual reality (VR) survey questionnaires were implemented to gauge the participants’ emotional response, including overall well-being and level of relaxation. Physiological measures such as heart rate and blood pressure were also taken before and after the VR experience. Findings show that immersion in nature through virtual reality improves older adults’ mental well-being by eliciting a transient sense of relaxation, peacefulness, and happiness. Further studies need to be performed in order to validate EcoRift’s effect on physiology; however, preliminary data suggests that immersive virtual nature also acts to decrease blood pressure. Overall, EcoRift shows to be a promising tool for bridging access to remote natural environments and may be a mentally beneficial activity for patients isolated in hospitals, hospices, and nursing homes.

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2019-05

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A Cross-cultural Analysis of the Emotional Effects of Climate Change

Description

Climate change presents a significant threat to human health, both mental and physical; as a result, it has become one of the most commonly discussed phenomena of the 21st century. As many people are aware, a wide range of social

Climate change presents a significant threat to human health, both mental and physical; as a result, it has become one of the most commonly discussed phenomena of the 21st century. As many people are aware, a wide range of social and physical factors affects mental health. However, many people fail to realize that these increases global temperatures also have a significant impact on mental health as a result of increased vulnerability that is often manifested through one's emotions. By analyzing perceptions of people across the globe, in the United Kingdom, New Zealand, and Fiji, we were able to pinpoint these emotions and trace them individual's feelings of worry, distress, and hope that resulted from their perceived impacts on climate change. Overall, we found that people tend to have overall more negative emotional reaction when it comes to the perceived effects of climate change. Of the respondents, more men than women expressed concern regarding the various negative implications. Finally, those in the United Kingdom exhibited a stronger emotional response, followed by those in New Zealand and Fiji, respectively.

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2017-05

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An Ethical Evaluation of the Boarding of Psychiatric Patients in the Emergency Department

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My thesis project, "An Ethical Evaluation of the Practice of Psychiatric Patient Boarding in the Emergency Department" sets out to address a relatively nameless problem in the healthcare system in the United States. This problem is the boarding of psychiatric

My thesis project, "An Ethical Evaluation of the Practice of Psychiatric Patient Boarding in the Emergency Department" sets out to address a relatively nameless problem in the healthcare system in the United States. This problem is the boarding of psychiatric patients in emergency departments nationwide. What is psychiatric patient boarding? This term refers to the increasingly common practice of care provided to psychiatric patients upon arrival at an emergency department. When inpatient psychiatric beds or services are not available, "boarding" is performed by simply storing mentally ill patients in hallways or other emergency room areas while they wait for the availability of psychiatric treatment, which may take hours, or in more extreme cases has been cited to last for days at a time (Alakeson et. al, 2010). While any individual can expect to wait a prolonged period of time for medical care in the increasingly overcrowded emergency departments, the psychiatric patient experience is astonishingly unique. A psychiatric patient presenting, or arriving, at the ED in crisis can often times find him or herself not only waiting hours to be admitted and assessed as a medical patient would, but with a limited and ever attenuating supply of psychiatric treatment rooms and services, these patients will often times be harbored in an ED room designed for short-term medical treatment without care until psychiatric services become available. Patients can be left waiting for days for an in-patient vacancy; all the while not receiving true psychiatric treatment and in some cases being held against their will in a chaotic environment far from conducive for treatment of a mental health ailment. In this analysis, I will discuss and review aspects of psychiatric patient boarding from various literature, such as why boarding occurs from a hospital and historical standpoint, negative implications of boarding for psychiatric and medical patients, and the burden placed on the hospital when practicing psychiatric boarding. To learn further on the topic, I will share the results from 14 semi-structured, qualitative interviews performed with ED healthcare professionals, being physicians, charge nurses, nursing staff, and certified nursing assistants or patient safety advocates. This portion of my investigation is designed to offer a perspective that the literature cannot, being a first hand outlook on psychiatric boarding from those working on the front line, focusing on topics of all aspects, such as causation, consequences for all involved parties, and proposed solutions.

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2017-05

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An Anxious Person's Guide to Getting Better

Description

More than 260 million people suffer from an anxiety disorder worldwide, with 40 million in the U.S. alone—18% of the American population. And that label includes everything from Social Anxiety and Posttraumatic Stress Disorder to phobias and Obsessive Compulsive Disorder.

More than 260 million people suffer from an anxiety disorder worldwide, with 40 million in the U.S. alone—18% of the American population. And that label includes everything from Social Anxiety and Posttraumatic Stress Disorder to phobias and Obsessive Compulsive Disorder. Thus, people with anxiety may not have a singular cause for their worry, but a myriad number of them that influence every aspect of their lives. And, that doesn’t include people who’ve never been formally diagnosed and don’t receive proper medication or therapy.

Unfortunately, medication has many possible side effects, and both medication and therapy are often expensive. However, there are alternatives for someone dealing with anxiety. This book proposal offers a range of solutions for anxiety management, from do it yourself techniques like guided imagery and yoga, to biofeedback devices like HeartMath, to research trials on Eye Movement Desensitization and Reprocessing, as well as Repetitive Transcranial Magnetic Stimulation. The idea was not to outline every potential solution for anxiety, but to educate people on available opportunities and empower them to take control.

Though anxiety can be managed and reduced, there is no cure. That’s because anxiety is a normal part of life, and in most cases a helpful evolutionary tool to keep people on track. But, when this anxiety becomes a burden on someone’s life, there is a plethora of alternative solutions available. Understanding anxiety and learning to manage it is not an impossible task. This thesis provides an introduction to the idea and then allows the reader to move forward on their own path as they choose.

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Date Created
2018-05

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Health Disparities Among LGB Women From Experiences With Their Healthcare Providers

Description

This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball

This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball sampling. Interviews were conducted inquiring about their health history and their experiences within the healthcare system in the context of their sexual orientation. The data collected from these interviews was used to create an analysis of the healthcare experiences of those who identify as queer. Although the original intention of the project was to chronicle the experiences of LGB women specifically, there were four non-binary gender respondents who contributed interviews. In an effort to not privilege any orientation over another, the respondents were collectively referred to as queer, given the inclusive and an encompassing nature of the term. The general conclusion of this study is that respondents most often experienced heterosexism rather than outright homophobia when accessing healthcare. If heterosexism was present within the healthcare setting, it made respondents feel uncomfortable with their providers and less likely to inform them of their sexuality even if it was medically relevant to their health outcomes. Gender, race, and,socioeconomic differences also had an effect on the patient-provider relationship. Non-binary respondents acknowledged the need for inclusion of more gender options outside of male or female on the reporting forms often seen in medical offices. By doing so, medical professionals are acknowledging their awareness and knowledge of people outside of the binary gender system, thus improving the experience of these patients. While race and socioeconomic status were less relevant to the context of this study, it was found that these factors have an affect on the patient-provider relationship. There are many suggestions for providers to improve the experiences of queer patients within the healthcare setting. This includes nonverbal indications of acknowledgement and acceptance, such as signs in the office that indicate it to be a queer friendly space. This will help in eliminating the fear and miscommunication that can often happen when a queer patient sees a practitioner for the first time. In addition, better education on medically relevant topics to queer patients, is necessary in order to eliminate disparities in health outcomes. This is particularly evident in trans health, where specialized education is necessary in order to decrease poor health outcomes in trans patients. Future directions of this study necessitate a closer look on how race and socioeconomic status have an effect on a queer patient's relationship with their provider.

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Date Created
2016-05

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Mental Health Training: Pathway to Early Mental Health Intervention

Description

There is an increase in the prevalence of mental health problems in the United States. Healthy People 2020’s leading mental health indicator is to increase the delivery of care to those with mental health issues and lower the number of

There is an increase in the prevalence of mental health problems in the United States. Healthy People 2020’s leading mental health indicator is to increase the delivery of care to those with mental health issues and lower the number of youth who experience a major depressive disorder. Teachers and non-teaching staff are well placed in the community to identify youth undergoing emotional distress and facilitate early interventions, yet do not receive adequate training in mental health.

A project was undertaken to determine if a mental health training intervention affected the community youth mentors knowledge, attitude and self-efficacy towards helping youth with mental health issues. Three instruments with good validity and reliability namely Mental Health Literacy Scale (MHLS), Attitudes to Severe Mental Illness (ASMI) scale, and Gatekeeper Behavior Scale were used in pre intervention, immediately post intervention and two weeks post intervention questionnaires. The Wilcoxon Signed Ranks test indicated changes in the pre and post intervention scores as significant in knowledge, and attitude between pre intervention and immediately post intervention time periods. Cohen’s effect size value suggested large, medium, small, and minimum clinical significance in the variables over period of time.

Mental health literacy narrows the gap between symptom onset and intervention. Numerous mental health trainings are currently available worldwide. Schools and after school clubs in collaboration with hospital mental health and other community agencies are better equipped to bridge the gap. School staff report better confidence in addressing mental health and behavioral health issues among youth when equipped with additional resources within the school in the form of psychologists, social workers, and counselors.

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Date Created
2020-05-03

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Screening for Posttraumatic Stress Disorder in Behavioral Health

Description

Background: Non-Veteran Affair (VA) mental health care facilities are admitting increased numbers of military affiliated members due to recent changes, allowing veterans to outsource healthcare at civilian treatment centers. The VA reports less than 9 million veterans enrolled in VA

Background: Non-Veteran Affair (VA) mental health care facilities are admitting increased numbers of military affiliated members due to recent changes, allowing veterans to outsource healthcare at civilian treatment centers. The VA reports less than 9 million veterans enrolled in VA services, leaving over 50% seeking treatment from civilian providers. Given the high prevalence of Posttraumatic Stress Disorder (PTSD) in the military population, it is imperative to implement a valid and reliable screening tool at primary care facilities to ensure timely and accurate diagnosis and treatment.

Method: This project aimed to provide an evidence-based education for intake nurses to understand prevalence of PTSD and to use a screening tool Primary Care PTSD for DSM-5 (PC-PTSD-5) in a non-VA behavioral health facility.

Setting: The project site was a civilian behavioral health facility located in West Phoenix Metropolitan area. The behavioral health facility serves mental health and substance abuse needs. Project implementation focused on the intake department.

Measures: Sociodemographic data, PTSD diagnosis criteria, prevalence and PC-PTDSD-5 screening tool knowledge collected from pre and posttest evaluation. Patients’ charts for those admitted 6-week before and 6-week after the education to calculate numbers of screening tools completed by nurses at intake assessment.

Data analysis: Descriptive statistics was used to describe the sample and key measures; the Wilcoxon Signed Rank Test was used to examine differences between pre-test and post-test scores. Cohen’s effect size was used to estimate clinical significance.

Results: A total of 23 intake nurses (87.0% female, 65.2% 20-39 years old, 52.2% Caucasian, 95.6% reported having 0-10 years of experience, 56.5% completed Associate’s degree) received the education. For PTSD-related knowledge, the pre-test score (Mdn = 6.00) was significantly lower than the post-test score (Mdn = 10.00; Z= -4.23, p < .001), suggesting an increase of PTSD knowledge among nurses after the education. Regarding the diagnosis, the percentage of patients who were diagnosed with PTSD increased from (0.02% to 20% after the education).

Discussion: An evidence-based education aimed at enhancing intake nurses’ knowledge, confidence and skills implementing a brief and no-cost PTSD screening tool showed positive results, including an increase of PTSD diagnosis. The implementation of this screening tool in a civilian primary mental health care facility was feasible and helped patients connect to PTSD treatment in a timely fashion. Continued use of paper version of screening tool will be maintained at facility as an intermediary solution until final approval through parent company is received to implement into electronic medical records.

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Date Created
2020-05-06

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Mental Health Application in Anxiety

Description

Background: The shortage of providers, therapists, and long waiting times for appointments in the United States is growing. Mental health technology applications (apps) expand the strategies available to people with mental health conditions to achieve their goals for well being

Background: The shortage of providers, therapists, and long waiting times for appointments in the United States is growing. Mental health technology applications (apps) expand the strategies available to people with mental health conditions to achieve their goals for well being through self-management of symptoms.

Methods: A project was undertaken at an outpatient behavioral setting in urban Arizona to determine the use and effectiveness of a mental health app called insight timer to reduce anxiety symptoms. Adult clients with anxiety symptoms were provided with the insight timer app to use over a period of eight weeks. Anxiety was evaluated with the GAD-7 scale initially and after the eight weeks of app use. Usability and the quality of the app were assessed with an app rating scale at the end of the eight weeks.

Results: Findings of the Wilcoxon Signed Ranks test indicated changes in pre and posttest assessment scores as significant (p = .028), which is a significant reduction in anxiety among seven clients who completed the 8-week intervention. the mean TI score was 15.57 (SD = 4.9), and the mean T2 score was 7.71 (SD = 5.7). Besides, Cohen's effect size value (d = 1.465) suggested large clinical significance for GAD7 in pre and posttest.

Discussion: Evidence suggests that the use of an evidence-based app can effectively reduce anxiety symptoms and improve the quality of life. The use of mental health apps like insight timer could reduce health care costs associated with unnecessary hospital admissions as well as re-hospitalizations. The routine use of apps such as the insight timer may also be beneficial to all the clients who have anxiety symptoms in outpatient as well as inpatient settings.

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Date Created
2020-05-06

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Mental Health of Sikh American Adolescents: A Thematic Literature Review

Description

The purpose of the current research is to synthesize and analyze the available literature on the mental health of Sikh American adolescents, addressing gaps and proposing areas of further research. It assesses and compares perceptions of mental health in both

The purpose of the current research is to synthesize and analyze the available literature on the mental health of Sikh American adolescents, addressing gaps and proposing areas of further research. It assesses and compares perceptions of mental health in both Asian Indian and Sikh demographics, as the majority of Sikhs are ethnically Asian Indian. The research is also intended to supplement the current understanding of mental health in the Sikh community with a discussion on the culturally-based risk and protective factors for mental health and Western mental health care access.

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Date Created
2021-05

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Association of Mental Health Stigma with Marital Quality in Police Wives

Description

Previous research on law enforcement officers has not included studies of marital relationships from the spouse perspective, and tend to focus on workplace-based manifestations of stress and other health issues. This study fills a gap in current research by surveying

Previous research on law enforcement officers has not included studies of marital relationships from the spouse perspective, and tend to focus on workplace-based manifestations of stress and other health issues. This study fills a gap in current research by surveying police wives about their personal experiences of marriage to law enforcement officers, and mental health as it relates to themselves and their husbands. We examined the association of mental health stigma with marital quality in a sample of 969 police wives. We found a significant negative association between wives’ perceptions of police officers’ mental health stigma and marital quality, and additionally that wife characteristics of positive emotion and reappraisal are positively associated with marital quality, but do not act as moderators. We also discussed methods of reducing negative impacts of mental health stigma on marital quality, specifically mandatory police officer counseling and marital quality interventions.

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Date Created
2021-05