Charting Cognitive Growth of Nursing Students Using Linguistic Software.

BACKGROUND: Students' word choice when writing in a reflective journal may reveal their emotional development, sense of belonging, cognitive processing, and ability to appraise their own growth and understanding. New linguistic analysis software can scan and categorize these journals for the use of pronouns, positive and negative emotions, and cognitive keywords. METHODS: A retrospective study design evaluated student journaling from a psychiatric clinical course. Journal entries from weeks 1 and 12 were compared by z-score analysis. FINDINGS: Significant increases were found in the use of "we" (P = .001), positive emotions (P < .001), inclusion words (P < .001), and insight words (P = .004), whereas the use of cause and self-discrepancy words were not significantly different. CONCLUSION: Identification of learning as expressed in words could have an impact on how student assignments are designed by including the use of the Linguistic Inquiry and Word Count software to assess changes in student cognition.

Adolescent Stress Treatment Study: A Cluster Randomized Trial.

High school students experience a variety of stressors. Mental health issues are critical to their health. The "Adolescent Stress Treatment (AST) Study: A Cluster Randomized Trial" compared the efficacy of two stress reduction devices, the EnergyPod™ and the SleepWing™. The EnergyPod™ is a device that provides a semiprivate acoustical and visual environment for rest, stress reduction, and sleep. The SleepWing™ is a smaller device offering similar benefits. High school students were offered the opportunity to participate in the AST study when they exhibited signs of agitation. The students completed the Profile of Mood States-Short Form (POMS-SF) pre- and postintervention. Total Mood Disturbance (TMD) was measured from the POMS-SF and significant improvement postintervention (p < .001), regardless of intervention used. POMS-SF subscales were all significantly improved no matter which device was used. All participants in the study dramatically improved their mood after being in either therapeutic device.

Motivational Interviewing to Treat Adolescents With Obesity: A Meta-analysis.

CONTEXT: Successful treatment approaches are needed for obesity in adolescents. Motivational interviewing (MI), a counseling approach designed to enhance behavior change, shows promise in promoting healthy lifestyle changes. OBJECTIVE: Conduct a systematic review of MI for treating overweight and obesity in adolescents and meta-analysis of its effects on anthropometric and cardiometabolic outcomes. DATA SOURCES: We searched Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, Web of Science, Cochrane Library, and Google Scholar from January 1997 to April 2018. STUDY SELECTION: Four authors reviewed titles, abstracts, and full-text articles. DATA EXTRACTION: Two authors abstracted data and assessed risk of bias and quality of evidence. RESULTS: Seventeen studies met inclusion criteria; 11 were included in the meta-analysis. There were nonsignificant effects on reducing BMI (mean difference [MD] -0.27; 95% confidence interval -0.98 to 0.44) and BMI percentile (MD -1.07; confidence interval -3.63 to 1.48) and no discernable effects on BMI z score, waist circumference, glucose, triglycerides, cholesterol, or fasting insulin. Optimal information size necessary for detecting statistically significant MDs was not met for any outcome. Qualitative synthesis suggests MI may improve health-related behaviors, especially when added to complementary interventions. LIMITATIONS: Small sample sizes, overall moderate risk of bias, and short follow-up periods. CONCLUSIONS: MI alone does not seem effective for treating overweight and obesity in adolescents, but sample size and study dose, delivery, and duration issues complicate interpretation of the results. Larger, longer duration studies may be needed to properly assess MI for weight management in adolescents.

Training Primary Care Providers in the Use of Motivational Interviewing for Youth Behavior Change.

BACKGROUND AND PURPOSE: Adolescent obesity is a global epidemic. Motivational interviewing (MI) is a promising strategy to address adolescent obesity risk behaviors. However, primary care providers (PCPs) tend to express discomfort with learning and adopting MI practices and with addressing patient weight issues. PCP proficiency in using MI to discuss body mass index, health screening results, and nutrition and physical activity behaviors after receiving training and coaching from an MI expert and practicing the technique was evaluated. We hypothesized that comfort with MI would increase consistently over time. METHODS: Self-assessment surveys in MI proficiency were administered to PCPs after every youth participant MI session. MI comfort as determined by proficiency was categorized into low, medium, and high comfort according to survey Likert scale responses. Data were analyzed using analysis of variance (ANOVA) and Fisher's exact tests. RESULTS: Two hundred twenty-seven youth were seen for MI-based discussions by 4 PCPs. Two hundred twenty-six surveys had complete data for analysis. As anticipated, overall PCPs reported significantly more comfort with MI from the first to the final MI session over a 2- to 3-month period (p< .001). Comfort scores did not increase linearly over time for all PCPs. Despite standard training practices, overall MI proficiency as measured by comfort scores varied by PCP (p< .01). IMPLICATIONS FOR PRACTICE: This type of MI training program should be considered for clinical nurses and nurse practitioners during their nursing education training to facilitate their ability to consistently and effectively support youth behavior change for conditions such as obesity (ClinicalTrials.gov Number NCT02502383).

Bridging distance and culture with a cyberspace method of qualitative analysis.

This article describes a qualitative research method that weds the cyberspace technology of e-mail with a phenomenological research approach. Examples are provided from 2 separate data sets. One data set explored the meaning of health for Japanese elders; the second explored Chinese nurses' experience of taking care of patients with severe acute respiratory syndrome. Lessons learned while using the cyberspace method are discussed, including guidance for organizing a long-distance research team, the central place of trust, and the time when e-mail communication demands to be supplemented with face-to-face interaction. The potential for bridging distance and culture with this cyberspace method is introduced for consideration and critique.

School-based health center viability: application of the COPC model.

Providing effective primary and preventive health care to adolescents is challenging. Traditional medical and nursing models have had little success in guiding health care for the individual adolescent. A community-based model would aim programs and intervention at high-risk adolescents identified as needing treatment. Community-Oriented Primary Care (COPC) bridges the gap between primary care and public health to evaluate and improve the delivery of health care to identified populations. The COPC model was used to develop and implement an adolescent school-based health center in a southwestern border community. The four process steps based on the COPC model include: identifying the community of interest, identifying the health problem, developing and implementing intervention(s), and conducting ongoing evaluation. Key stakeholders from the medical, educational, and consumer groups were invited to participate in the first and second steps. Representatives of various school adolescent subcultures formed a group of promotores (health promoters) to monitor, advise, and contribute to the process. The Dartmouth COOP survey was selected to identify health concerns and risks of the targeted high school. The promotores prepared and administered the survey to 1,116 students. Results were used to design the initial health center program components using an interdisciplinary team to implement interventions aimed at the major health concerns and risks identified by the COOP. A short feedback loop contributed to program refinements, and ongoing evaluation continues to shape the practice of health care providers in the school-based health care center.

Mutual timing: an essential component of provider/patient communication.

PURPOSE: To present a concept clarification in an effort to give a name to a commonly experienced but poorly understood communication process: mutual timing. DATA SOURCES: Extensive literature review of scientific and nursing literature; relevant theories; standardized process for concept clarification as delineated in the literature. CONCLUSIONS: Good communication involves many familiar concepts, including good eye contact, attentive listening and the use of silence and touch. Mutual timing is the difference-making moment, creating common ground in the midst of engagement. Concept clarification is a critical step to understanding important practice concepts. Wedding the concept to everyday practice provides the beginning for development of guidelines, which can be used by nurse practitioners (NPs) for making decisions while caring for patients. IMPLICATIONS FOR PRACTICE: Nursing has claimed to be privy to a special relationship with patients that differs from other health care professions. When asked to differentiate their care from that of physicians, NPs are often quoted as valuing the psychosocial aspect of care and stressing the importance of their relationship with patients. Many NPs define themselves in terms of relationship, emphasizing strong moral obligations and mutual commitments with their patients. One of the core processes of the effective patient/provider relationship is good communication.

Psychiatric-mental health clinical nurse specialist practice in a public school setting.

The public school setting is increasingly becoming an entry point of contact for an array of healthcare services because it is most likely the best positioned institution to improve a community's overall healthcare. By linking behavioral healthcare services with primary healthcare services in the school setting, the psychiatric-mental health clinical nurse specialist is well suited to provide comprehensive behavioral health services.

Connecting with others in the midst of stressful upheaval on September 11, 2001.

This study was originally planned from September tenth through twelfth to assess concurrent use of three real-time data sources during a usual day. When the World Trade Center towers collapsed, the plan expanded to describe 24-hour blood pressure and heart rate, natural environment word use, television viewing/radio listening, and self-reported diary feelings for six undergraduate students in the midst of stressful upheaval. Heart rate, "we" word-use and television viewing/radio listening increased over time. Higher negative and lower positive feelings/emotions occurred during morning hours on September 11. Students connected with others and shared good thoughts. Measurement with real-time data sources was informative.