The use of reflective practice in new graduate registered nurses residency program.

New graduate nurses encounter emotional distress related to complex patient care situations and overwhelming workloads. Unequipped with coping mechanisms, new nurses verbalize difficulty feeling accepted in their assigned units. Self-perceptions of inadequacy and lack of independence contribute to anxiety. Consequently, hospitals are at risk for losing newly graduated nurses within the first year. The cost of losing new nurses is overwhelming to hospital institutions and further contributes to the looming nursing shortage. This article describes the use of a reflective practice exercise in a new registered nurse residency program in a magnet hospital to facilitate reflection and problem solving in the patient care unit. More research is needed to investigate the effectiveness of reflective practice in developing coping skills and retention rate in new graduate nurses.

Predictors of mental health, subjective burden, and rewards in family caregivers of patients with chronic liver disease.

Patients with chronic liver disease (CLD) often experience severe symptoms that cause functional impairment and necessitate assistance from a family caregiver. Few studies investigate family caregivers of patients with CLD. This descriptive correlation study described demographic characteristics, depressive and anxiety symptom levels, and prevalence of hazardous drinking, rewards, and subjective burden and explicated predictors of subjective burden and mental health status for a convenience sample of 73 family caregivers of persons with CLD. Interventions are needed to offset decreased income reported by caregivers and to treat depressive symptoms; clinically significant levels were present, and clinical referrals were warranted in this study sample.

Pilot study of INSIGHT therapy in African American women.

The purpose of this pilot study was to determine if treatment with INSIGHT therapy, designed specifically for women, could reduce depressive and anxiety symptoms, hopelessness, and loneliness in African American women. Prevalence of mental illness differs in African Americans and Caucasians. The nonexperimental one-group pretest posttest design study examined the effectiveness of a 12-week INSIGHT group intervention. Due to the stigma of mental illness, groups met at an African American church. Reliability and validity of instruments were effectively demonstrated. Statistically significant difference was found in the level of depression but the study was underpowered to detect statistically significant differences in anxiety, hopelessness, and loneliness. Clinically significant improvement occurred for some participants in anxiety, hopelessness, and loneliness.

The clinical utility of the Stress Process Model in family caregivers of liver transplant candidates.

This article describes the important relationship between theory and practice and demonstrates the application of Pearlin and colleagues' Stress Process Model to family caregivers of liver transplant candidates. Theory enhances the use of specific nursing interventions. This connection of theory to practice is especially important in the current health care environment, where the nursing shortage demands efficient and effective patient care. The Stress Process Model is a specific and concrete middle-range theory, which makes it simple to apply in clinical practice and research. This model is particularly useful for nurses who support the family caregivers of clients on the liver transplant list. The model identifies characteristics that predispose caregivers to stress that can interfere with completion of caregiving roles and tasks before and after patients' liver transplantation.

INSIGHT potentially prevents and treats depressive and anxiety symptoms in black women caring for chronic hemodialysis recipients.

End stage renal disease (ESRD) unduly affects black families in the U.S., including black women who are the family caregivers of affected patients. Nephrology nurses who support chronic hemodialysis recipients may be the first to recognize depressive and anxiety symptoms in this understudied caregiver population. This article describes the risk factors for depression in black women who care for persons receiving chronic hemodialysis therapy and INSIGHT therapy as a potential intervention to reduce depressive symptoms.

Length of stay, admission types, psychiatric diagnoses, and the implications of stigma in African Americans in the nationwide inpatient sample.

African Americans purportedly have a higher prevalence of mental illnesses but are often misdiagnosed and less likely to seek treatment. Delayed treatment has been associated with the stigma related to these disorders. The demographic characteristics, length of stay, most prevalent psychiatric diagnoses, and hospital admissions of African Americans were compared to other U.S. populations using a nationwide sample (N = 4,474,732). African American participants were younger, had significantly longer lengths of stay, and were admitted more often through the emergency room than the other groups in this sample. Psychosis, alcohol/drug dependence, and depressive neurosis were the most prevalent psychiatric diagnoses reported for African American participants. Research is needed to explain these results so that strategies can be instituted to improve the poor mental health outcomes often observed in African American populations.