Function of a Psychological Nursing Intervention on Depression, Anxiety, and Quality of Life in Older Adult Patients With Osteoporotic Fracture.

BACKGROUND: Osteoporotic fracture is a serious complication of osteoporosis. The long-term therapy process and the heavy restriction to physical activities give rise to a psychological burden on osteoporotic fracture patients, especially older adult patients. Psychological nursing interventions significantly alleviate negative emotional reactions in cancer patients. This research aimed to investigate the function of psychological nursing interventions in the reduction of depression and anxiety and the improvement of quality of life in older adult patients with osteoporotic fracture. METHODS: Osteoporotic fracture patients (n = 106) were divided into control group (n = 53) or intervention group (n = 53). In the control group, the participants were given conventional nursing care. In the intervention group, the participants were given psychological nursing interventions. Anxiety, depression, and quality of life were evaluated and compared between the two groups. RESULTS: After 5 weeks of psychological nursing intervention, the anxiety and depression scores significantly decreased in the intervention group. The Mental Function in Quality of Life Questionnaire of the European Foundation for Osteoporosis score also decreased in the intervention group. LINKING EVIDENCE TO ACTION: Psychological nursing interventions alleviate anxiety and depression in older adult osteoporotic fracture patients and enhance their mental function.

The Effect of FAmily-CEntered (FACE®) Pediatric Advanced Care Planning Intervention on Family Anxiety: A Randomized Controlled Clinical Trial for Adolescents With HIV and Their Families.

Clinicians fear pediatric advance care planning (pACP) for adolescents is too distressing for families. Multisite longitudinal randomized controlled trial of adolescents with HIV tested the effect of FAmily-CEntered (FACE®) pACP intervention on families' anxiety and depression. One hundred five adolescent/family dyads were randomized to FACE® (n = 54 dyads) or control (n = 51 dyads). Families were 90% African American, 37% HIV-positive, and 22% less than high school educated. Families reported lower anxiety 3 months post-FACE® intervention than control (ß = -4.71, 95% confidence interval [CI] = [-8.20, -1.23], p = .008). Male family members were less anxious than female family members (ß = -4.55, 95% CI = [-6.96, -2.138], p ≤ .001). Family members living with HIV reported greater depressive symptoms than HIV-uninfected families (ß = 3.32, 95% CI = [0.254, 6.38], p = .034). Clinicians can be assured this structured, facilitated FACE® pACP model minimized family anxiety without increasing depressive symptoms. Adolescent/family dyads should be invited to have access to, and provision of, evidence-based pACP as part of patient-centered/family-supported care in the HIV continuum of care.

Excessive daytime sleepiness in general hospital nurses: prevalence, correlates, and its association with adverse events.

OBJECTIVE: To investigate the prevalence and correlates of excessive daytime sleepiness (EDS) in a population of hospital nurses in South China as well as the influence of EDS on the occurrence of adverse events. METHODS: A total of 1102 nurses working in a large medical center were invited to participate in this cross-sectional study (96.9% females, mean age 29.6 years). They all completed a self-reported questionnaire consisting of items on demographic variables, lifestyle factors, insomnia, anxiety, depression, and both work-related and sleep-related characteristics. RESULTS: A total of 1048 nurses gave a valid response (response rate 95.1%). Among them, 169 (16.1%) reported EDS as defined as an Epworth Sleepiness Scale ≥ 14. Depression (adjusted odds ratio = 2.24, 95% confidence interval 1.51-3.31), anxiety (1.65; 1.02-2.67), insomnia (2.29; 1.56-3.36), rotating shift work (1.98; 1.03-3.83), and low interest in work (1.74; 1.01-2.99) were all independent risk factors of the occurrence of EDS. EDS is associated with the occurrence of adverse events after controlling for confounding factors (adjusted OR 1.83, CI 1.26 to 2.67). CONCLUSIONS: EDS was common among this relatively young and healthy nurse population in south China. There were clear associations between EDS and depression, anxiety, insomnia, rotating shift work, and low work-related interest. Furthermore, EDS was an independent risk factor in the occurrence of adverse events (AEs) in our subjects.

Prostate cancer-specific anxiety and the resulting health-related quality of life in couples.

AIMS: To explore health-related quality of life (HRQOL) and its individual or mutual influences in people with prostate cancer and their spouses. BACKGROUND: Few studies have explored the influence of prostate cancer-specific anxiety of these people and their spouses on their individual or mutual HRQOL. DESIGN: Repeated-measures design. METHODS: Data on 48 dyadic of people and their spouses were collected from August 2015 - December 2016. Before the people' treatment for prostate cancer, the first data collection occurred for the people and their spouses. The second to fifth data collections were conducted 6, 10, 18, and 24 weeks after the initial measurement. The variables concerned health status, marital satisfaction, positive affect, negative affect, prostate cancer-specific anxiety, and HRQOL. The Actor-Partner-Interdependence Model was adopted for data analysis. RESULTS: The people who had better physical HRQOL were those with good self-reported health status, higher positive affect and lower prostate cancer-specific anxiety. Better physical HRQOL was observed in the spouses who had good self-reported health status and had lower prostate cancer-specific anxiety. The people with localized cancer stages and lower negative affect had a better mental HRQOL. Better mental HRQOL was detected in spouses who had higher marital satisfaction, higher positive affect and lower negative affect. CONCLUSION: Nurses can improve the HRQOL of people and their spouses by implementing activities that promote health and energy and reduce stress and by administering a mindfulness intervention.

Prevalence and correlates of depression, anxiety and symptoms of stress in vocational college nursing students from Sichuan, China: a cross-sectional study.

Nursing students from vocational college programs contribute to over 60% of the nursing student population in China. However, there remains a lack of systematic, quantitative studies examining the prevalence of mental health problems in this population. The purpose of this study was to explore the prevalence of depression, anxiety and stress symptoms and associated factors in vocational college nursing students in Sichuan, China. A total of 554 nursing students from vocational colleges participated in this cross-sectional study. Outcomes were measured with the Depression, Anxiety and Stress Scale 21 (DASS 21). Logistic regressions analysis was performed to examine correlates of mental health problems. The prevalence rates of depression, anxiety and stress symptoms among vocational college nursing students in China were 28.7% (95% CI 24.9%-32.5%), 41.7% (95% CI 37.6%-45.9%) and 20.2% (95% CI 16.8%-23.6%). Mental health problems were elevated as compared to a reference population of Chinese college students of all majors. However, only two percent indicated to seek treatment. The most consistent correlates of mental health problems were reduced engagement in physical and other leisure activities, poor sleep quality, experience of negative life events and poor self-perceived mental health.

Prevalence of Chronic Health Conditions in Australian Adults with Depression and/or Anxiety.

The association between psychotic illness and poor physical health is now clearly articulated in the literature. By contrast the impact of depression and/or anxiety on physical health is considerably less understood, despite depression being the leading cause of disability worldwide and is associated with significantly higher prevalence of physical comorbidities than found in the general population. An Australia national cross-sectional population-based survey was conducted to ascertain the prevalence of chronic physical health conditions in persons with, and without depression and/or anxiety, allowing for demographic characteristics and lifestyle factors. The telephone-based survey was conducted using trained interviewers. Survey questions included those eliciting information about demographics, health status, and health behaviours. Independent t-tests and chi square tests showed demographic, health behaviours, and physical illness differed between those with and without depression and/or anxiety. Heart disease, high blood pressure, stroke, cancer, arthritis, chronic neck and/or back pain, and asthma were significantly higher in participants diagnosed with depression and/or anxiety. Binary logistic regression showed the strongest predictor of chronic illness was having a diagnosis of depression and/or anxiety. Depression and anxiety present major health problems impacting a considerable proportion of the population. A greater understanding of the associated physical health issues should provide impetus to broaden the physical health and mental illness research agenda to include these diagnoses.

Death anxiety interventions in patients with advanced cancer: A systematic review.

BACKGROUND: Death anxiety is a common issue in adult patients with advanced cancer and can have a large impact on quality of life and end-of-life care. Interventions are available to assist but are scarcely used in everyday practice. AIM: To assess quantitative studies on interventions for adult patients with advanced cancer suffering from death anxiety. DATA SOURCES: MEDLINE, PsycINFO, Embase and CINAHL were searched to identify quantitative or mixed studies on death anxiety or relatable existential intervention studies in advanced cancer patients published from 1990 to December 2016. Two reviewers independently screened titles and abstracts and assessed relevant studies for eligibility. Data were then extracted from included studies for analysis. RESULTS: Nine unique quantitative studies were identified, including five randomised controlled trials, involving a total overall of 1179 advanced cancer patients. All studies were psychotherapeutic in nature and centred on existential themes such as meaning, dignity, relationships and spiritual well-being. The therapies investigated shared overlapping themes but varied in duration, therapist experience, training required and burden on patient. Heterogeneity of studies and measures prevented determination of an overall effect size. CONCLUSION: Interventions were identified for this clinical scenario of death anxiety in patients with advanced cancer. Therapies of short duration incorporating spiritual well-being and those evoking a sense of meaning were claimed to be the most beneficial, despite lacking rigorous statistical analysis. More high-quality studies with tailored outcome measures are required to fully evaluate the most effective interventions for death anxiety in patients with advanced cancer.

A randomized controlled trial of a nursing psychotherapeutic intervention for anxiety in adult psychiatric outpatients.

AIM: To evaluate the short-term efficacy of a psychotherapeutic intervention in nursing on Portuguese adult psychiatric outpatients with the nursing diagnosis "anxiety." BACKGROUND: Several efficacious forms of treatment for anxiety are available, including different forms of psychotherapy and pharmacotherapy. However, literature tends to favour findings from studies on the efficacy of psychotherapies and therapies provided by nurses to the detriment of those arising from studies on the efficacy of nursing psychotherapeutic interventions (interventions which are classified, for instance, on Nursing Interventions Classification). DESIGN: Randomized controlled trial. METHODS: The study was performed, between November 2016 - April 2017, at a psychiatry outpatient ward. Participants were randomly allocated to an intervention group (N = 29) or a treatment-as-usual control group (N = 31). Patients in the intervention group received psychopharmacotherapy with interventions integrated in the Nursing Interventions Classification for the nursing diagnosis "anxiety." A treatment-as-usual control group received only psychopharmacotherapy (if applicable). Anxiety level and anxiety self-control were the primary outcomes. RESULTS: Patients from both groups had reduced anxiety levels, between the pre-test and the posttest assessment; however, according to analysis of means, patients in the intervention group displayed significantly better results than those of the control group. Furthermore, only patients in the intervention group presented significant improvements in anxiety self-control. CONCLUSION: This study demonstrated the short-term efficacy of this psychotherapeutic intervention model in nursing in the decrease of anxiety level and improvement of anxiety self-control in a group of psychiatric outpatients with pathological anxiety. TRIAL REGISTRATION NUMBER: NCT02930473.

Nursing diagnoses related to psychiatric adult inpatient care.

AIMS AND OBJECTIVES: To detect the prevalence of NANDA-I diagnoses and possible relationships between those and patient characteristics such as gender, age, medical diagnoses and psychiatric specialty/setting. BACKGROUND: There is a lack on studies about psychiatric inpatient characteristics and possible relationships among these characteristics with nursing diagnoses. DESIGN: A quantitative-descriptive, cross-sectional, completed data sampling study was performed. METHODS: The data were collected from the electronic patient record system. Frequencies for the social-demographic data, the prevalence of the NANDA-I diagnoses and the explanatory variables were calculated. RESULTS: In total, 410 nursing phenomena were found representing 85 different NANDA-I diagnoses in 312 patients. The NANDA-I diagnosis "Ineffective Coping" was the most frequently stated diagnosis followed by "Ineffective Health Maintenance," "Hopelessness" and "Risk for Other-Directed Violence". Men were more frequently affected by the diagnoses "Ineffective Coping," "Hopelessness," "Risk for Self-Directed Violence," "Defensive Coping" and "Risk for Suicide," whereas the diagnoses "Insomnia," "Chronic Confusion," "Chronic Low Self-Esteem" and "Anxiety" were more common in women. Patients under the age of 45 years were more frequently affected by "Chronic Low Self-Esteem" and "Anxiety" than older patients. "Ineffective Coping" was the most prevalent diagnosis by patients with mental disorders due to psychoactive substance use. Patients with schizophrenia were primarily affected by the diagnoses "Ineffective Coping," "Impaired Social Interaction" and "Chronic Low Self-Esteem." CONCLUSIONS: This study demonstrates the complexity and diversity of nursing care in inpatient psychiatric settings. Patients' gender, age and psychiatric diagnoses and settings are a key factor for specific nursing diagnosis. RELEVANCE TO CLINICAL PRACTICE: There are tendencies for relationships between certain nursing diagnosis and patient characteristics in psychiatric adult inpatients. This enhances the specific, extended knowledge for nursing care and its demands in this setting and therefore supports the daily nursing psychiatric care and its needs.

Assessing anxiety and depression in cancer patients.

BACKGROUND: empirical evidence suggests that anxiety and depression in cancer patients is underdiagnosed and subsequently this patient population receives little or no support or intervention to address their psychosocial needs. It is often difficult to distinguish between normal emotional distress experienced following a cancer diagnosis and anxiety and depression, which can have a significant impact on coping mechanisms and subsequent outcomes. AIM: a qualitative study using the Hospital Anxiety and Depression Scale (HADS) was undertaken in the National Centre for Cancer Care and Research in Qatar. The driver for change was to provide evidence of the need for an assessment to be incorporated into the nursing admission process as a means of early detection and onward referral for more formal interventions if required. The sample size was 57. FINDINGS: the evidence from the outcome data supported the hypothesis that anxiety and depression were present in a significant number of the sample group. This would support the proposal of early screening and onward referral. A number of patients surveyed expressed moderate to severe depression, which may impact negatively on outcomes. CONCLUSION: screening for anxiety and depression in adult cancer patients should form part of an early nursing assessment to identify those who may benefit from more structured interventions. HADS is a useful screening tool; however, further research is required on validating tools used to screen for anxiety and depression in cancer and chronic disease in different cultures to ensure validity and reliability of outcome data.

Conflicting Cultural Values, Gender Role Attitudes, and Acculturation: Exploring the Context of Reproductive and Mental Health of Asian-Indian Immigrant Women in the US.

Asian-Indians, one of the fastest growing US immigrant groups, experience depression and anxiety, particularly among women. In this mixed-methods study, quantitative (n = 217) and qualitative (n = 36) data explored egalitarian vs. traditional views regarding women's roles and rights. Bicultural integration, family planning decision-making ability, and anxiety were associated with more egalitarian views, while Punjabi language preference, depression, and more births were associated with traditional views. Health care professionals serving this population need to be aware of the potential cultural values conflicts and gender role expectations that influence decisions around reproductive health and mental health care for Asian-Indian immigrant women.

Living with the Choice: A Grounded Theory of Iraqi Refugee Resettlement to the U.S.

Though the United States has become a place of increasing resettlement for refugees, particularly Iraqi refugees who have been forced to flee their homeland due to violence, persecution and civil unrest, little is known about Iraqi refugee resettlement in the United States, or the way in which resettlement impacts health and adjustment. A grounded theory study was conducted to develop a substantive theory of Iraqi refugee resettlement. Participants in the qualitative study included 29 Iraqi refugees and 2 community partners who participated in face-to face interviews. Data analysis and interpretation revealed fundamental concepts related to Iraqi refugee resettlement. Results of analysis showed that for Iraqis choosing to resettle here, the outcome is dichotomous: satisfaction or regret. The outcome is influenced by contextual factors as well as facilitating and hindering intervening conditions during the basic social process of resettlement transition. Each refugee's story is unique, yet all share common threads. This study allowed Iraqi refugees the opportunity to voice their personal experiences of resettling in America, and revealed life stories that inspire and illuminate a process that can guide health care delivery as they cope with the stresses of their journey. As a result, an in-depth storyline was established to explain the process of resettlement for Iraqi refugees. The development of this resettlement theory, grounded in Iraqi refugee experience, has the potential to guide nursing education, enhance the efficacy of practice, inform policy development and form the basis for research.

Anxiety Disorders among US Immigrants: The Role of Immigrant Background and Social-Psychological Factors.

This study used the National Epidemiological Survey on Alcohol and Related Conditions, a longitudinal adult sample, to estimate the rates of prevalent, acquired, and persisting anxiety disorders by nativity and racial-ethnic origin while adjusting for acculturation, stress, social ties, and sociodemographics. Prevalent and acquired anxiety disorders were less likely among foreign-born than US-born, except Puerto-Rican- and Mexican-born who had higher risks. Persisting cases were similar between foreign-born and US-born, except Asian/Pacific Islanders who had lower risk. Stress and preference for socializing outside one's racial-ethnic group were associated with higher while close ties were associated with lower rates of acquired/persisting anxiety disorders.

Methodological Challenges in Conducting Research with Refugee Women.

The purpose of this pilot study was to evaluate the acceptability and feasibility of a 10-week community-based, culturally tailored mental health intervention, called Healthy Sudanese Families, with 12 South Sudanese refugee women living in a metropolitan area of the Midwestern United States. This mixed-methods study used the Dinka and Arabic versions of the Hopkins Symptoms Checklist-25 to measure indicators of anxiety and depression and a final focus group to evaluate the women's responses to the intervention. The women found the mental health intervention acceptable and relevant. Methodological challenges encountered in cross-cultural research with refugees are discussed.

Improving Quality Outcomes in Veteran-Centric Care.

The University of Alabama at Birmingham (UAB) School of Nursing and the Birmingham Veterans Affairs Medical Center (BVAMC) created a Psychiatric-Mental Health Nurse Practitioner (PMHNP) Residency Continuity Clinic tasked with providing Veteran-centric mental health outpatient treatment informed by measurement-based care (MBC) to provide quality outcomes. Approved by the BVAMC, the UAB Institutional Review Board also approved and exempted the project as quality improvement. PMHNP residents administered the Patient Stress Questionnaire (PSQ)-an MBC tool that incorporates validated tools for assessing depression, anxiety, posttraumatic stress, alcohol use, and pain-to each Veteran from March to August 2016. Patient outcomes focused on depression and anxiety. PSQ scores were reviewed retrospectively via descriptive statistics, paired t tests, and Wilcoxon signed ranks tests. Analysis showed improvement in depression and anxiety that approached significance, and in several national Veterans Affairs mental health performance measures, reinforcing the importance of using MBC in psychiatric assessment. [Journal of Psychosocial Nursing and Mental Health Services, 55(1), 37-44.].

COPD: a proposed multidisciplinary approach to psychological issues.

Patients with chronic obstructive pulmonary disease (COPD) form a sizeable part of the ill-health demographic, both internationally and nationally, impacting markedly on hospital admissions. While prevalence rates of psychological comorbidity vary, there appears to be a consistent presence of depression and anxiety, and additional COPD symptom-related psychological distress. The research evidence base is limited, with seemingly little potential for expansion. Based on the available evidence, this study proposes a multidisciplinary team working model to support the integration of psychological input into the care of inpatients with COPD.

The effect of a researcher designated music intervention on hospitalised psychiatric patients with different levels of anxiety.

AIMS AND OBJECTIVES: The purpose of this study was to investigate the effects of a music intervention on hospitalised psychiatric patients with different levels of anxiety. BACKGROUND: In clinical practice, psychiatric inpatients and nurses routinely suffer from anxiety. A music intervention may possibly be useful, but knowledge as to how useful and how effective it is in patients with different levels of anxiety is limited. DESIGN: The study design was a three-group, repeated-measures experimental study. METHODS: Subjects were 22 psychiatric patients who were divided into three groups based on their level of anxiety. They listened to 20 minutes of music each day for 10 days and were assessed using the Beck Anxiety Inventory before and after the music intervention and at a one-week follow-up; an electroencephalogram and finger temperature were monitored before and during the music intervention. RESULTS: Anxiety levels of all three groups showed a significant difference (p = 0·0339) after the intervention. The difference alpha and beta electroencephalogram percentages for all three groups showed a significant difference (p = 0·04; p = 0·01). The finger temperature showed a non-significant difference (p = 0·41). CONCLUSIONS: A music intervention can effectively alleviate the anxiety of hospitalised psychiatric patients who suffer from all levels of anxiety. RELEVANCE TO CLINICAL PRACTICE: The study recommends a practice in alleviating anxiety. Effective lower-cost interventions to reduce anxiety in psychiatric inpatient settings would be of interest to nurses and benefit patients.

Assessment of anxiety in advanced cancer patients: a mixed methods study.

BACKGROUND: Anxiety is a risk for reduced quality of life in advanced cancer patients. However, it is an overlooked symptom without routine use of instruments to assess anxiety. AIM: To gain insight into the use of instruments by nurses to assess anxiety in advanced cancer patients and the rationale behind it. METHODS: Data with regard to nurses' use of instruments were collected from medical records of 154 patients in three settings. Additionally, 12 nurses were interviewed. FINDINGS: Four instruments were used to assess anxiety. The frequency of assessed anxiety differed among settings. The application of instruments guided patient care and improved communication. Lack of knowledge was the main reason not to use instruments. CONCLUSIONS: Application was influenced by patient and environmental factors, knowledge, attitudes and beliefs of nurses. Multifaceted strategies, leadership and education of nurses in the assessment and analysis of anxiety are needed to improve symptom management in advanced cancer patients.

Using health psychology to help patients: common mental health disorders and psychological distress.

This article provides an overview of how health psychology can be used by nurses to help patients experiencing common mental health problems and psychological distress. Mental health problems are common and are associated with poor outcomes, especially for patients with comorbid physical health conditions. Mental health problems are associated with unhealthy behaviours such as smoking, physical inactivity, overeating and excessive alcohol use, which will result in poorer outcomes for patients. Consideration of a patient's psychological health is therefore important for all nurses providing holistic care. Awareness of the symptoms of psychological distress, good communication skills and simple screening instruments can be used by nurses to assess patients' mental health. The cognitive and behavioural risk factors associated with depression and anxiety are also explored, as an understanding of these can help nurses to provide appropriate care.

[Discussion around the use of yoga in psychiatry]. / Réflexion sur l'usage du yoga en psychiatrie.

Many mind-body practices have recently been introduced into psychiatric care including yoga. An experiment in the field addresses the issue of the organisation and applications of this discipline, and envisages the possibility of extending the scope of indications.