Effectiveness of School-based Health Center Delivery of a Cognitive Skills Building Intervention in Young, Rural Adolescents: Potential Applications for Addiction and Mood.

PURPOSE: Uniquely positioned, school nurses address two of the most critical adolescent health issues - addiction and mood. Cognitive behavioral therapy, the mainstay in management of adolescent mood disorders, demonstrates promise in the treatment and prevention of addictive behaviors. Quality decision-making may protect adolescents from substance abuse. Executive function, a neurocognitive aspect of decision-making, involves impulse control, future thinking, and behavioral regulation. Further, the continuum of addition implicates executive function, which makes executive function a viable target for prevention and treatment of substance use. This pilot study examined the effectiveness of a nurse-led cognitive skills training intervention, Creating Opportunities for Personal Empowerment, on executive function and mood in a novel population and setting. DESIGN AND METHODS: The study sample included adolescents ranging in age from 12 to 15 years and enrolled in a rural school-based health center. Fifteen (n = 15) adolescents completed the seven-week cognitive skills building intervention led by a nurse practitioner. Researchers measured executive function, anxiety, and depression at: baseline, after the intervention series, and three-months later. RESULTS: One domain of executive function - behavioral regulation - improved, as did anxiety. Depression showed short-term improvement. Metacognition did not change over time. CONCLUSIONS: Preliminary results indicate that cognitive skills building delivered by school nurses may enhance aspects of executive function linked with addiction and coping, such as behavioral regulation. Further, this intervention may also improve mood in this population. PRACTICE IMPLICATIONS: Delivery of cognitive skills training by school nurses could be an accessible, effective piece in addressing addiction and mood in young, rural adolescents.

Family caregiver burden in mental illnesses: The case of affective disorders and schizophrenia - a qualitative exploratory study.

BACKGROUND: Caregivers of people with mental illnesses often experience a wide range of burdens. Although many studies have confirmed burdens among family caregivers of mentally ill relatives in general, specific knowledge regarding the concrete everyday hassle and existential sorrows from the caregivers subjective reasoning perspective is lacking. Furthermore, there is little evidence on the possible different effects of affective disorders and schizophrenia on the quality of burden; this is also true with regard to the role of cultural traditions and lay beliefs. AIMS: The aim of this study was to explore the specific burdens experienced by caregivers of patients with schizophrenia and affective disorders. METHODS: A qualitative study was conducted by semi-structured interviews with 45 caregivers of patients with schizophrenia and affective disorders. Data were analysed by qualitative content analysis. RESULTS: Eleven encumbering themes resulted from the interviews including incertitude, unawareness, emotional burden, stigma and blame, financial burden, physical burden, restriction in routine, disruption in routine, dissatisfaction with family, relatives, and acquaintances, troubles with patients' adherence to medication, and problems with health services and governmental support. CONCLUSIONS: Caring for a person with mental illness affects caregivers emotionally, financially, physically, and it elicits some restrictions in their routine (daily hassles). Finally, it causes conflicts in family relationships. Despite some differences regarding perceived burden among caregivers of schizophrenia and affective disorders, a common pattern of burden could be identified. Thus, authorities should provide adequate financial, educational, and psychosocial supports for caregivers of mental illnesses.

[The use of expressive writing in the course of care for cancer patients to reduce emotional distress: analysis of the literature]. / L'uso della scrittura espressiva nei percorsi di cura dei pazienti oncologici per la riduzione del distress emozionale: analisi della letteratura.

AIM: The emotional distress represents one of the symptoms most frequently reported in the cancer patient in therapy, increasing the risk of developing a disease depressive. Through the analysis of the literature we want to assess whether the use of expressive writing on cancer patients in their care pathway compared to the use of writing neutral reduces emotional distress. METHOD: The bibliographic search was conducted using the databases CINAHL, PubMed, Cochrane Library and PsycInfo. RESULTS: The results of research conducted on 7 randomized controlled trials, including 3 pilot studies have shown after expressive writing sessions (experimental group) versus neutral writing (control group) a significant reduction in distress in the experimental group early stages of cancer (p = 0,0183); in patients with a diagnosis of metastatic assigned to the group expressive writing there was a statistically significant relevance in the reduction of mood disorders (p = 0,03).Were determined statistically significant group differences also with respect to some measure on the quality of sleep (p = 0,04). The expressive writing did not produce significant reductions in psychological distress and improvements in physical health (p > 0,20) in patients diagnosed with metastatic disease of long duration and, in the palliative care there have been results of feasibility for poor adherence at follow-up. CONCLUSION: From the results it is evident that the strategies of expressive writing improves the management of the disease, reduce the physical and psychological symptoms related to the tumor while reducing the emotional distress in patients at an early stage of the disease.

Mental health care professionals' experiences with the discharge planning process and transitioning patients attending outpatient clinics into community care.

BACKGROUND: Health care reform promotes delivery of mental health care in the community. Outpatient mental healthcare professionals (HCPs) are pressured to discharge patients. This study's purpose: to understand the experience and perceptions of mental HCPs with discharge planning and transitioning patients into community care. METHODS: Twelve HCPs participated in semi-structured qualitative interviews. FINDINGS: Three main categories: engaging in the discharge planning process, making the transition smooth, and guiding values emerged. A conceptual framework was created to explain the phenomenon. CONCLUSION: HCPs valued strengthening partnerships and building relationships to ensure smooth transition. Sufficient resources and trust imperative for safe patient discharge.

Frequency of involuntary admissions and its associations with demographic and clinical characteristics in China.

Involuntary admissions (IA) continue to be a controversial topic in psychiatry. There have been very few studies investigating the pattern of IA and contributing factors in Chinese psychiatric patients. This study examined the prevalence of IA and its relationships with demographic and clinical characteristics in a large psychiatric institution in Hunan province, China. A consecutively collected sample of 161 psychiatric inpatients was collected. The patients' basic socio-demographic and clinical data including admission types were collected. The frequency of IA was 53.1% in the whole sample. In multiple logistic regression analysis, IA was independently associated with female sex, more recent aggression prior to admission and poorer social function and insight into illness. IA was common in clinical practice in China, and its demographic and clinical correlates are similar to the findings reported from western settings.

Psychological and organizational impact of bullying over and above negative affectivity: a survey of two nursing contexts.

Limited research exists on the impact of bullying across psychological and/or organizationally orientated outcomes for nurses working within different nursing contexts. Research that has explored these outcomes has not considered the potential confounding effects of negative affectivity (NA). This study's aim was to examine the extent hospital and aged care nurses are impacted by bullying on these outcomes, while considering NA. A total of 267 hospital nurses/midwives and 168 aged care nurses from an Australian healthcare organization responded to a survey. The results revealed hospital nurses/midwives who experienced bullying reported higher levels of psychological distress, as well as lower commitment and job satisfaction levels. Aged care nurses who experienced bullying reported lower levels of well-being and commitment. NA was a significant covariate for most analyses. Thus, nurses across these contexts are affected by bullying in relation to psychological and organizational-orientated outcomes over and above the effects of NA, particularly for commitment.

Developing a manual for strengthening mental health nurses' clinical supervision.

In this article, we report findings from a study aimed at developing the content and implementation of a manual for a research-based intervention on clinical supervision of mental health nursing staff. The intervention was designed to strengthen already existing supervision practices through educational preparation for supervision and systematic reflection on supervision. The intervention consists of three sessions and was implemented on two groups of mental health hospital staff. We present an outline of the manual and explain how the trial sessions made us adjust the preliminary manual. The effects of implementing the manual will subsequently be analysed in an independent randomised controlled trial.

Therapies for obesity and medication-associated weight gain.

Compared to the general population, individuals with psychiatric illness, especially serious and chronic mood and psychotic disorders, are more likely to be overweight or obese, have higher rates of weight-related medical conditions, and have greater non-suicide mortality rates. Lorcaserin (Belviq(®)), phentermine/topiramate combination (Qsymia(®)), and bupropion/naltrexone combination have been demonstrated to be effective for the treatment of obesity, as an adjunct to a reduced-calorie diet and physical activity, although their absolute safety has yet to be established with more widespread use or longer use. Bariatric surgery is an effective approach for morbid obesity, but careful psychiatric assessment before and follow up after surgery is necessary. Behavioral lifestyle interventions to promote weight loss are effective and should be implemented along with or instead of drug therapies or surgery.

[The illustrated depression scale, an innovative tool]. / L'echelle de depression illustrée, outil innovant au quotidien.

As an aid to daily practice in mental health, the Fribourg Mental Health Network in Switzerland has developed an innovative tool to measure the symptoms of depression, the Illustrated Depression Scale. It provides a simple and quick assessment of the symptoms of depression and their evolution during hospitalisation.This article gives an overview of the development of this scale, its psychometric qualities and its use in practice.

Relationship of nursing education and care management inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: the SCIRehab project.

OBJECTIVE: To investigate associations of nursing bedside education and care management activities during inpatient rehabilitation with functional, participation, and quality-of-life outcomes for patients with traumatic spinal cord injury (SCI). METHODS: In a prospective observational study, data were obtained by means of systematic recording of nursing activities by registered nurses (RNs), chart review and patient interview. RESULTS: Greater patient participation in nursing activities is associated with better outcomes. More time spent by RNs in coordination with other members of the care team, consultants and specialists, along with participation in physician rounds (team process) is associated with patient report of higher life satisfaction and higher CHART mobility at the one-year injury anniversary; more time providing psychosocial support is associated with higher CHART mobility and occupation scores and with greater likelihood of working or being in school at the anniversary. More time spent providing education about specific care needs is associated with several outcomes but not as consistently as might be expected. CONCLUSION(S): Higher levels of patient participation in nursing care activities is associated with multiple better outcomes, and hence, nurses should promote active patient participation during all aspects of care and interactions between themselves and patients with SCI. Time spent providing psychosocial support of patients and their families should be evaluated to ensure that other necessary education or care management interventions are not minimized. Note: This is the seventh of nine articles in the SCIRehab series.

Health education needs of family caregivers supporting an adolescent relative with schizophrenia or a mood disorder in taiwan.

This study, which is part of a larger research program, examined the health education needs of family caregivers providing care and support for an adolescent relative with schizophrenia or mood disorder in Taiwan. Family caregivers reported significant unmet information needs, and those with higher incomes or educational levels were more likely to report unmet educational needs. Caregivers using information resources consistently had high unmet educational needs. Results revealed the importance of assessing specific educational needs of families, as educational needs of caregivers differed according to diagnostic group, especially with regard to etiology, symptoms, and coping strategies.

[Psychiatric disorders and somatic pathologies]. / Les troubles psychiatriques et les pathologies somatiques.

Over recent decades significant advances have been made in the treatment of patients with serious psychiatric illnesses such as schizophrenia or mood disorders. These advances result from the use of new molecules and especially biopsychosocial treatments drawing on multidisciplinarity and networking. Supporting the somatic treatment of patients is one of the major challenges for improving psychiatric care.

[Caring for children in the face of social mutations]. / L'accueil de l'enfant face aux mutations sociales.

In 50 years, as a result of works on hospitalism, attachment and intelligence of babies, the latter have gradually gone from being considered as vegetative beings to being seen as a person. A new model of socialisation has appeared which sees a wide variety of players confronted with contemporary social mutations and which is changing professional and parenting practices.

Correlates of mood disturbance in women with breast cancer: patterns over time.

AIM: This study examined factors associated with mood disturbance prior to, during and after adjuvant therapy. BACKGROUND: Breast cancer is the most common cancer in women worldwide. Mood disturbance affects between 20% and 30% of women with breast cancer and is associated with other debilitating symptoms. However, factors associated with mood disturbance across the breast cancer diagnosis-treatment trajectory are not clearly understood. METHOD: A stress-coping framework guided this longitudinal study. A convenience sample of 49 American women with newly diagnosed breast cancer aged 37-77 years completed questionnaires assessing age, optimism, disease stage, type of adjuvant therapy, lymph node status, emotional support, aid (tangible) support, perceived stress and mood disturbance. Data were collected over an 18-month period in 2002-2003 at three time points: prior to, during and after adjuvant therapy. Descriptive statistics, Pearson's correlation and multiple regression were used. FINDINGS: At all three time points, higher stress was significantly related to greater mood disturbance. Perceived stress mediated the relationship between (1) emotional support and mood disturbance prior to and after adjuvant therapy and between (2) aid support and mood disturbance during adjuvant therapy. In addition, the type of support that was most important to mood disturbance varied over time. Emotional support was related to reduced mood disturbance prior to and after adjuvant therapy, whereas aid support was most important during adjuvant therapy. CONCLUSIONS: Nurses may use this information to develop interventions that bolster appropriate types of support to reduce stress and ultimately lower mood disturbance. Further research across cultures is needed.