Contributing influences of work environment on sleep quantity and quality of nursing assistants in long-term care facilities: A cross-sectional study.

The effect of shift work on nurses' sleep is well-studied, but there are other challenging aspects of health care work that might also affect the sleep of direct caregivers. This study examined the influence of the long-term care work environment on sleep quantity and quality of nursing assistants. A cross-sectional survey collected data from 650 nursing assistants in 15 long-term care facilities; 46% reported short sleep duration and 23% reported poor sleep quality. A simple additive index of the number of beneficial work features (up to 7) was constructed for analysis with Poisson regression. With each unit increase of beneficial work features, nursing assistants were 7% less likely to report short sleep duration and 17% less likely to report poor sleep quality. These results suggest that effective workplace interventions should address a variety of work stressors, not only work schedule arrangements, in order to improve nursing assistants' sleep health.

Stigma, American military personnel and mental health care: challenges from Iraq and Afghanistan.

BACKGROUND: Since 2001, more than 2.5 million United States military personnel have been deployed for combat. Over one million have served multiple deployments. Combat generally involved repeated exposure to highly traumatic events. Personnel were also victims of military sexual trauma (MST), a major risk factor for psychiatric illness. Most survivors do not seek or receive mental health care. Stigma is one of the main barriers to that care. AIMS: To explore the impact of stigma on personnel with psychiatric illness, and suggest some innovative ways to potentially reduce stigma and improve care. METHODS: Cinahl and PubMed databases were searched from 2001 to 2014. RESULTS: Anonymity, the use of non-stigmatizing language, peer-to-peer, and stigma-reduction programs help military personnel receive mental health care. Technology offers the opportunity for effective and appropriate education and treatment. CONCLUSIONS: Although stigma is formidable, several innovative services are available or being developed for military victims of trauma. Commitment of resources for program development and further research to explore which interventions offer the best clinical outcomes are needed to increase efforts to combat stigma and ensure quality care.

Approaches to reduce physical comorbidity in individuals diagnosed with mental illness.

It is essential to recognize the relationship between mind and body when providing holistic, client-centered care. The need for an improved care delivery system is highlighted by the health inequity experienced by those with severe mental illness (SMI). Clinical guidelines on physical health monitoring for those with SMI are condition-specific and do not focus on prevention. Health status data on clients with SMI suggest that barriers exist to the delivery of holistic care. Clients with SMI may benefit from a collaborative care model, holistic approaches, and preventive health monitoring. The mental health advanced practice nurse is pivotal in providing quality care to limit the burden of disease and promote health. The following literature review describes models of care aimed at reducing the comorbidity of physical and mental illness in outpatient care settings.