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- Creators: Guthrey, Ann
- Creators: McIntosh, Wayne
- Member of: Doctor of Nursing Practice (DNP) Final Projects
- Status: Published
Description
Healthcare workers may have poor attitudes, bias or feel unprepared when caring for patients with mental illness in the pediatric intensive care unit (PICU) setting. The aim of this project was to resolve these biases using education to increase quality of care for pediatric mental health patients using Rossworm and Larabee’s change model. The Questionnaire on Stigmatizing Attitudes Towards Children with Emotional and Behavioral Disorders (EBD) was completed by voluntary participants at pretest, posttest and at a one month follow up. Between pretest and posttest, participants engaged in three educational modules regarding mental health. Participants were voluntary, anonymous staff members at a pediatric hospital currently employed in the PICU. Results of the questionnaires pre M= 23 post M=11 and follow up M=9.5 indicates education improves attitudes, and decreases bias in PICU staff. Recommendation to obtain larger population of study with trial implementation. Recommend adding educational modules to annual education or to new hire orientation.
ContributorsMoore, W. Alexandra (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
Description
Burnout has become an increasingly popular topic among registered nurses, but unfortunately burnout among psychiatric nursing is less understood than other nursing specialties such as the Intensive Care Unit, Emergency Room, or Oncology. Psychiatry is unique and psychiatric nurses, in particular, are often subjected to physical and verbal violence as well as exposure to patient’s trauma. The aim of this project was to decrease burnout among psychiatric nurses in a private practice out-patient family psychiatric facility using Rossworm and Larabee’s change model (Appendix D). The MBI-HSS was completed by 1 participant (n=1) at pre-intervention and post-intervention. Between the pre/post MBI-HSS questionnaire the participant was asked to partake in a mindfulness-based intervention utilizing the smartphone application Headspace to complete a 10-session meditation course over one week. The results conclude the participant’s burnout decreased overall from pre-intervention to post-intervention. Internal Review Board (IRB) was granted in September 2021, and the project was completed in November 2021. The impact of the project was projected to have a more thorough statistical influence, but due to the participant size, there is minimal impact of system or polices in the psychiatric facility.
ContributorsSteward, M. Shannon (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-30
Description
Purpose: The COVID-19 pandemic has increased depression among the population. Exercise is a useful coping mechanism for depression and high intensity interval training (HIIT) can be utilized.
Background: A community exercise facility provides HIIT exercises for gym members. The gym owner believed their HIIT program is a great tool for coping with depression.
Methods: The gym offered a 21-day free HIIT program. Those who signed up for the program, 18 years of age or older, and were able to exercise under the Physical Activity Readiness Questionnaire were offered to participate in the study. Participants were given a pre-survey before they started exercises. This survey utilized the Patient Health Questionnaire-9 (PHQ-9), a standard depression rating tool that determines depression symptom prevalence. After the 21-day program, participants were given a post-survey involving the same PHQ-9. The survey scores were compared pre- to post-program. The surveys were coded to exclude any identifying information.
Results: Mean PHQ-9 pre-test was 7.67, mean score post-test was 3. A paired t-Test resulted in a p=0.60, showed that it was not statistically significant.
Discussion: The goal of this study was to determine if HIIT training was an effective coping mechanism for depression. The data shows that participants had decreased PHQ-9 scores from the pre- and post-program surveys showing a clinical significance. This data can be used to provide those suffering from depression a coping mechanism.
ContributorsSmith, Kolter (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
Although estimated to be 50-60% more than in heteronormative populations, intimate partner violence (IPV) in LGBTQ+ populations is often unrecognized. This project aims to increase nurse practitioner (NP) IPV screening to facilitate early intervention and decrease LGBTQ+ IPV rates.
The researcher gathered information from 1:1 interview with LGBTQ+ IPV survivors (n=3) and produced a dramatization narrating experiences. Subjects were required to preregister and consent. Nurse practitioners (n=6) participated in a 1.5hr online educational intervention, viewing the video and a 45-min webinar.
The Physician Readiness to Manage Intimate Partner Violence Scale (PREMIS) and the LGBT Development of Clinical Skills Scale (LGBT-DOCCS) were administered as test-retest. The PREMIS measures (? =.963) readiness to screen for IPV, the LGBT-DOCCS measures attitude (?=.80), clinical preparedness (?=.88) and knowledge (?=.83). All participants in both groups were voluntary and recruited from e-lists and special interest groups. Cox’s Theory of Interaction and the Minority Stress Theory were the dual framework along with the ACE model of transformational knowledge to support methodology and outcomes.
Results
Statistically significant (p<0.05) improvements in readiness to screen for IPV, knowledge, and attitudes as measured by PREMIS domains (p= .006; p=.012) and LGBT-DOCSS (p = .028). Clinically significant improvement in mean scores for likelihood to screen for SOGI.
Supported by the theoretical framework and implementation model, increased readiness to screen, improved knowledge and improved attitude, will lead to better NP-patient interactions, decreased minority stress, increased NP screening and intervention, and decreased rates of IPV in LGBTQ+ populations.
ContributorsPhelps-Byam, Wendy (Author) / McIntosh, Wayne (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Sleep deprivation is linked to poor mental and physical health outcomes for professional firefighters. The importance of sleep hygiene practices and health promotional activities may increase the amount of quality sleep firefighters get on their days off. As the adverse outcomes of circadian misalignment due to sleep deprivation becomes more apparent in firefighter wellbeing, the need for a sleep health program becomes more evident. The purpose of this paper is to examine and assess the effects of a sleep health program for firefighter wellness. Research emphasizing the relevance of poor health outcomes related to sleep disturbances is prevalent in the literature. The findings have prompted the development of an evidence-based sleep coaching program for firefighters in a local fire department guided by The Cognitive Behavioral Therapy Model (Brewin, C.R., 1996). and a knowledge-to-Action process framework for evidence-based-practice (Graham et al., 2006).
ContributorsAnon, Melanie (Author) / McIntosh, Wayne (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
Description
Attention Deficit Hyperactivity Disorder (ADHD) impacts as many as 1 in 10 children. ADHD can affect academic performance, social interactions, relationships, and self-esteem. Pharmacological interventions with the use of stimulant medication is the first line of treatment. Children who do not respond to medication trials and suffer adverse side effects need alternative treatment options to manage symptoms. New and immerging treatment options being studied to determine efficacy for symptom management is cognitive behavior therapy, social skills training, exercise and neuro feedback. They represent alternative options for non-pharmacological treatment. Evidence supports the use of these treatment options alone, or in conjunction with medication management. The evidence has led to an evidence base practice project conducted in a psychiatric outpatient clinic using Play Attention technology and quantitative behavior testing to determine the effectiveness of neurofeedback in treating children and adolescents with ADHD.
ContributorsCarter, Adam (Author) / McIntosh, Wayne (Thesis advisor)
Created2018-04-18
Description
Background and Purpose:
Depression in older adults is a significant problem that often goes undetected and untreated in primary care. The U.S. Preventive Services Task Force recommends screening adults for depression in primary care to increase detection, so it can be adequately managed. Despite this recommendation, screening rates in primary care are low. The purpose of this project was to implement a screening intervention and examine the effect of screening on the treatment of depression in older adults.
Methods:
The screening intervention was implemented as an evidence-based project in a small primary care practice. Consenting adults ≥ 65 years of age were screened with the Patient Health Questionnaire-9 (PHQ-9). Research indicates the PHQ-9 is valid and reliable for older adults. A post-screening chart audit was conducted to collect data and analyze the outcome of screening related to treatment.
Conclusions:
A total of 38 participants were screened. Five (13.2%) participants had a positive screening, two received treatment during the follow up period. The number of participants who were treated after a positive screening was significant (p= .040).
Implications for Practice:
Screening can increase detection and treatment of depression and reduce the associated illness burden in the older adult population.
ContributorsRiutta, Troy (Author) / Guthrey, Ann (Thesis advisor)
Created2018-04-21
Description
Background and Aims: The aim of this research was to assess whether clients receiving treatment for substance abuse in a residential treatment facility will achieve lower rates of relapse with treatment in combination with active sponsorship. Prior studies suggest sponsorship may equally be impactful as attending 12-step meetings.
Design: The primary hypothesis was that active participation as defined by contact with a sponsor of an hour or more per week, as measured by the impact on affective characteristics correlated with increased levels of sobriety, when measured by the AWARE questionnaire (Advance Warning of Relapse) within 7 days of entry and prior to discharge (within 30 days). Setting: The project took place in a residential treatment facility in Phoenix, Arizona.
Participants: There were 12 clients from a men’s house and 12 clients from a woman’s house, all of which were going through recovery. Intervention: The educational session explained what a sponsor is and the importance of finding one early as a key role in relapse prevention.
Measurements: Pre and post-test results were compared to see if there was an impact on the predictability of relapse and sponsorship. The paired t-test was performed to compare the two means of AWARE scores. A lower score on the AWARE questionnaire indicates a person is more likely to succeed in sobriety.
Findings: Based on 24 samples collected, the mean scores within the first seven days were 91.17 with a standard deviation of 18.59 and the mean score prior to discharge were 72.78 with a standard deviation (SD) of 20.02. The mean difference between the two scores was 18.39 (SD=2.84). There was a significant effect of the relapse prevention program which included sponsorship, t (22) = 4.79, p < 0.001.
Conclusion: Implications for practice include increased time with sponsors to reduce rates of relapse. Future concerns include good fit matching which may reduce rates of relapse even further.
Design: The primary hypothesis was that active participation as defined by contact with a sponsor of an hour or more per week, as measured by the impact on affective characteristics correlated with increased levels of sobriety, when measured by the AWARE questionnaire (Advance Warning of Relapse) within 7 days of entry and prior to discharge (within 30 days). Setting: The project took place in a residential treatment facility in Phoenix, Arizona.
Participants: There were 12 clients from a men’s house and 12 clients from a woman’s house, all of which were going through recovery. Intervention: The educational session explained what a sponsor is and the importance of finding one early as a key role in relapse prevention.
Measurements: Pre and post-test results were compared to see if there was an impact on the predictability of relapse and sponsorship. The paired t-test was performed to compare the two means of AWARE scores. A lower score on the AWARE questionnaire indicates a person is more likely to succeed in sobriety.
Findings: Based on 24 samples collected, the mean scores within the first seven days were 91.17 with a standard deviation of 18.59 and the mean score prior to discharge were 72.78 with a standard deviation (SD) of 20.02. The mean difference between the two scores was 18.39 (SD=2.84). There was a significant effect of the relapse prevention program which included sponsorship, t (22) = 4.79, p < 0.001.
Conclusion: Implications for practice include increased time with sponsors to reduce rates of relapse. Future concerns include good fit matching which may reduce rates of relapse even further.
ContributorsMoore, Christa (Author) / Guthrey, Ann (Thesis advisor)
Created2018-04-21
Description
Depression and anxiety are common and debilitating illnesses that negatively impact personal well-being and functioning. The effects of depression and anxiety not only affect the individual, but also peers, family, the community, economy, and even the health care system. Pharmacological therapy is a first line treatment for depression and anxiety, but the risk for relapse remains. Cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are treatments that have demonstrated effectiveness in treating depression. The evidence suggests that both therapies are successful in terms of reducing depressive symptoms, but most effective when combined. Further, evidence shows that the combination of MBCT and traditional pharmacological therapy provides relief from depressive symptoms and lengthens the amount of time between recurrent episodes and improves the quality of life. A project was implemented at an integrated health clinic to evaluate the effectiveness of a mindfulness-based intervention to reduce the symptoms of depression and anxiety. The results revealed that practicing mindfulness was statistically and clinically significant in reducing depression and anxiety. In addition, mindfulness scores increased over 30 day application of the intervention. The results demonstrated the value of utilizing mindfulness as a cost-effective therapy in addition to pharmacological treatment to decrease symptoms of depression and anxiety, as well as improve mindfulness. The ease of use demonstrated the value of mindfulness and self-directed skills aimed at improving wellness, reducing depression and anxiety which will result in the improvement of individual, economic, healthcare system, and community health.
ContributorsFong, Luis (Author) / Guthrey, Ann (Thesis advisor)
Created2018-04-28
Description
Adolescents in the U.S. are experiencing a growing epidemic of maladaptive coping. The increasing occurrence of these behaviors make it likely that school personnel will continue to see an increase in adolescents presenting with maladaptive coping patterns, such as nonsuicidal self-injury and suicide, highlighting the urgency for continued research regarding effective education. Nonsuicidal self-injury is highly correlated with suicidal behavior, and suicide is the second leading cause of death among ten to nineteen year olds in the US. Research points to the use of a specific type of Coping Skills Training known as Mental Health Literacy that reduces the chances that maladaptive coping will become the norm in adulthood.
ContributorsLandon, Rebecca J. (Author) / McIntosh, Wayne (Thesis advisor)
Created2019-04-15