Measurement-Based Care in Psychiatry.

Measurement-based care (MBC) uses patient-reported rating scales in conjunction with evidence-based clinical practice guidelines to provide an objective assessment of patient progress over time to guide a more precise plan of care. Use of MBC is routine in medical disease management. Unfortunately, MBC is not standard practice in psychiatric care. The current nonsystematic approach to the delivery of mental health care has created considerable variability in practice and may stall recovery. Although MBC has proven benefits, there are perceived barriers to its implementation. Greater research is needed to standardize psychiatric measures and clinical practice guidelines and determine the most effective implementation strategies. A review of the literature was conducted to (a) provide an overview of MBC and relevant screening tools; (b) examine the clinical use of MBC, including its relevance to evidence-based clinical guidelines and empirical support; and (c) detail the benefits and challenges of MBC implementation. As mental health care moves in the direction of value-driven incentives, it will be important for providers and organizations to consider MBC as an evidence-based framework to reduce variability in psychiatric treatment and improve patient outcomes. [Journal of Psychosocial Nursing and Mental Health Services, 55(11), 30-35.].

Curvilinear relationships between resource allocation and life domain-specific interference.

This study investigated the inherent complexities of the work-life interface (WLI) by examining the relationship between resource allocation (i.e., time and energy dedicated to a particular domain) and perceived interference of individual life domains. Much of the research on the WLI is based on the assumption that a linear pattern best describes the relationship between resource allocation and the interference caused by various life domains; however, this study examined the possibility that curvilinear relationships may be a more appropriate representation. Results indicated that resource allocation is a meaningful predictor of interference, and for many life domains a curvilinear relationship accounts for more variance than a linear one; a breakdown of the sample also revealed this relationship varies by gender. Overall, findings suggest that the nature of the WLI is more individualized and complex than is currently conceptualized in the field.

Transforming veterans health care through academic-practice partnerships.

The Veterans Health Affairs Office of Academic Affiliations (OAA) has invested in the creation of academic-practice partnerships to transform the care of veterans and their families. This article details how a long-standing relationship between the University of Alabama at Birmingham School of Nursing and the Birmingham Veterans Affairs Medical Center grew into such a partnership. The three programs that now exist within the Birmingham Veterans Affairs Nursing Academic Partnership (VANAP) umbrella are described, including an undergraduate VA nurse scholars program that has sustained beyond OAA funding, a VANAP graduate education program for psychiatric mental health nurse practitioners (NPs), and a Mental Health NP Residency. Key features of the programs are noted as are outcomes and lessons learned for building mutual goals and a sustainable academic-practice partnership. With the recent passage of the Veterans Choice Program, the importance of educating all nurses about veterans and veterans' health is stressed.

Adverse Childhood Experiences and the Mental Health of Veterans.

Many U.S. Veterans have experienced the burdens of mental illness and suicide. The current article focuses on Veterans who served from 2001-2015. Although combat exposure and suicidal ideation are linked, approximately one half of all suicides among Active Duty service members (who have served since 2001) occurred among those who never deployed. Researchers who sought additional risks for suicide found that Veterans have greater odds of adversities in childhood than the general population. Adverse childhood experiences are stressful and traumatic experiences, including abuse and neglect, as well as witnessing household dysfunction, or growing up with individuals with mental illness or substance abuse. Further, childhood physical abuse has been shown to be a significant predictor for posttraumatic stress disorder and suicide. Adverse childhood experiences confer additional risk for the mental health of service members. Psychiatric nursing implications include the importance of assessing early childhood adversity during psychosocial assessments. Providing trauma-informed strategies for treatment is an essential element of psychiatric nursing care.

Differentiation between work and nonwork self-aspects as a predictor of presenteeism and engagement: cross-cultural differences.

Research on the work-life interface does not specifically account for how individuals cognitively conceptualize their work and nonwork lives in terms of the differentiation between work and nonwork self-aspects. In addition, no cross-cultural research examines self-concept differentiation in conjunction with employee outcomes of presenteeism and engagement, pointing to a need to study these relationships cross-culturally. Results of the current study revealed cultural differences in self-concept differentiation, engagement, mental presenteeism, and physical presenteeism. Indian participants reported lower levels of differentiation and higher levels of engagement, mental presenteeism, and physical presenteeism than American participants. Nationality interacted with self-concept differentiation to predict mental presenteeism, physical presenteeism, and engagement. Among Indian participants, self-concept differentiation did not impact scores on the other variables. However, among American participants, those lower in differentiation reported greater engagement, lower mental presenteeism, and lower physical presenteeism. These results have important implications for the study of the work-life interface, and they provide evidence that engagement and presenteeism may be culturally contingent.