A modern history of psychiatric-mental health nursing.

This paper discusses the progression of developments in psychiatric-mental health nursing from the 1960s to the present. The 1960s were a time of shortage of psychiatric APRNs, with legislation expanding the availability of mental health services. We find ourselves in a similar time with 7 million new health insurance enrollees, because of the Affordable Care Act (ACA). The expansion of health insurance coverage comes at a time when some colleges of nursing are closing master's programs in psychiatric-mental health, in lieu of the DNP mandate from the American Association of Colleges of Nursing. Is history repeating itself?

Identification, prevention, and treatment of children with decreased bone mineral density.

Osteoporosis in children is the presence of decreased bone mineral density in association with a significant fracture history. The amount of bone accretion in childhood and early adulthood is predictive of the risk of osteoporosis and fracture in later adulthood. A myriad of disorders and medications are associated with decreased bone mineral density in childhood. In addition, lifestyle factors including poor dietary habits and minimal physical activity are associated with low bone mass. Because of the limited attention given to childhood osteoporosis, this review was undertaken to examine the diagnostic criteria, etiologies, prevention of and treatment strategies for osteoporosis in children and adolescents.

Who cares if it is a hate crime? Lesbian, gay, bisexual, and transgender hate crimes--mental health implications and interventions.

PURPOSE: The purpose of this paper was to discuss lesbian, gay, bisexual, or transgender-targeted hate crimes and their mental health consequences for the victim and community. CONCLUSIONS: Hate crimes are typically more violent than nonhate-motivated crimes and have more deleterious mental health consequences. PRACTICE IMPLICATIONS: Thorough assessment coupled with an understanding of the social milieu and the meaning of the experience to the survivor can help the psychiatric nurse partner with the client to select the most appropriate treatment.

Can anesthesia trigger delayed-onset posttraumatic stress disorder in veterans?

PURPOSE: The clinical presentation of a 60-year-old Vietnam veteran who developed delayed-onset posttraumatic stress disorder (PTSD) after surgery is presented along with mechanisms for storing traumatic memory and a discussion of the potential contributions of anesthesia and aging to his clinical presentation. CONCLUSION: Although additional research is needed to clarify the contributions of memory processes, anesthesia, and aging in delayed-onset PTSD, prudent clinicians will be cognizant of a potential correlation and screen patients appropriately. PRACTICE IMPLICATIONS: A thorough surgical and anesthetic exposure history should be explored in presentations of delayed-onset posttraumatic disorder symptomatology. Additionally, clinicians working with trauma patients who anticipate surgery are uniquely positioned to serve as a liaison between the patient, surgeon, and anesthetist, thereby decreasing the potential for delayed-onset PTSD.

Connectedness in community-dwelling older adults.

The purpose of this study was to examine the processes involved with connectedness in community-dwelling older adults, which the authors contend is quality of life from a generative perspective. Using a grounded theory approach, 12 older adults were interviewed using a semistructured interview guide. The tape-recorded interviews were transcribed verbatim, categories were created to code the data, and themes were extracted. Four processes involved with connectedness in older adults were identified: (a) having something to do, (b) having relationships, (c) having a stake in the future, and (d) having a sense of continuity. Various aspects of spirituality were also apparent in each of the four processes. This study suggests that connectedness provides older adults with a mechanism to engage life in meaningful, positive, and purposeful ways.

Using focus groups to understand mother-child communication about sex.

The purpose of this descriptive focus group study was to examine communication themes regarding sex and sexual risk behavior in low-income mothers of adolescent children. Focus group questions were guided by Jaccard's communication constructs. Data analysis provided three overriding themes in all five construct areas: mothers are often uncomfortable discussing sex with their male children, mothers feel strongly that their own values and beliefs must guide discussion, and mothers believe their children need developmentally appropriate information. This information may be useful in assisting pediatric nurses in discussing adolescent sex and sexual risk behavior with families.

A comparison of two types of social support for mothers of mentally ill children.

PROBLEM: The purpose of this analysis was to compare social support offered by two telehealth nursing interventions for mothers of children with serious mental illnesses. METHODS: A randomized, controlled, quantitative investigation is underway to test two support interventions, using the telephone (TSS) or Internet (WEB). Qualitative description was used to analyze data generated during telehealth interventions. FINDINGS: The behaviors and attitudes of children were challenging for the mothers to manage. Mothers' emotional reactions included fear, frustration, concern, and guilt. They sought to be advocates for their children. The nurses provided emotional, informational, and appraisal support. TSS mothers were passive recipients, while WEB mothers had to choose to participate. CONCLUSIONS: Mothers in both interventions shared similar concerns and sought support related to their child's problems.

Development of a Web-based program to improve communication about sex.

Adolescent sexual risk behavior is a serious and prevalent problem among American youth. Mothers may play a key role in discussing sex and sexual risk behavior with their adolescent children. However, mothers may lack the knowledge and skills to successfully communicate. The purpose of this study was to develop a Web site to teach mothers how to communicate with their children about sex and to demonstrate the efficacy of this Web-based program. This pilot study included 35 rural, low-income mothers of middle-school adolescents. Mothers were randomly assigned to either the Web-based experimental group or written information-only control group. Mothers in the experimental group received computers and Internet access to the Web-based program, peer support, and expert advice from a pediatric nurse practitioner. Major findings of the study were that the Web-based intervention was equally effective at improving mothers' knowledge, communication skills, and self-efficacy as the written material control and that low-income rural women who have had little to no prior experience with computers can effectively learn Web-based health-related information. Future implications for nursing are discussed.

Creativity enhancement: possibilities for successful aging.

Successful aging is of growing importance in the U.S. Many researchers have explored the phenomenon using various approaches, yet we are still lacking practical guidelines on how to promote successful aging in older adults. The Roy Adaptation Model supports the promotion of adaptation to chronic health problems at a time when one's overall health may be declining and is a useful guide for understanding successful aging. Current literature also suggests that functional performance and creativity are important in order to age successfully. This study examined the relationships between functional performance, creativity, and successful aging within the context of the Roy Adaptation Model. Although creativity was not significantly predictive of successful aging, functional performance was a statistically significant predictor of a successful aging indicator, purpose in life. The study was a pretest-posttest experimental design investigating the effects of a creativity enhancement intervention in older adults. Although the intervention did not appear to increase creativity or successful aging, there were some statistically significant results and valuable findings about the possibilities for creativity enhancement.

An Internet discussion board for parents of mentally ill young children.

PURPOSE: This paper reports parents' use of electronic bulletin board for social support during a pilot study of an Internet intervention. METHODS: Parents participated for a mean of 13.83 weeks. The convenience sample consisted of six parents. Data were from site access information and parents' postings. FINDINGS: Excluding one mother who checked frequently for messages, mothers have an average of 5.2 postings. Excluding this one mother, the postings/ accesses ratio was greater than 60%. Parents made postings in four categories of "child's illness" having 37 comments and 36 comments for "group maintenance". CONCLUSIONS: While the study findings cannot be generalized, these results suggest that parents will use electronic discussion boards.

Internet social support for parents: the state of science.

TOPIC: Parents of emotionally disturbed young children have expressed the need for more social support but societal constraints limit their ability to obtain adequate social support. PURPOSE: This paper discusses what is currently known about coping, social support and Internet social support. It proposes the use of electronic social support to meet the needs of parents of emotionally disturbed children. SOURCE: Review of literature. CONCLUSIONS: Electronic forms of social support have the potential to meet the identified needs of parents for more social support.

Emotion processing in borderline personality disorders.

This study examined relationships between the ability to recognize facial affect and affective intensity in women with Borderline Personality Disorder. Women hospitalized with borderline personality disorder and community women without psychiatric disorder (n s = 35/group) were recruited via convenience sampling. The Pictures of Facial Affect and the Affect Intensity Measure were administered to consenting women. Hypotheses related to differences in recognizing facial affect were supported, but further exploration indicated that selected negative emotions accounted for the statistical significance. Implications for practice and research are explored.

Child psychiatric hospitalization: the last resort.

The purpose of this study was to describe how parents manage the experience of hospitalizing their school-aged child in a psychiatric unit. Grounded theory methodology was used. Thirty-eight parents participated. Data were collected by interviews. Analysis was done using the constant comparative method. The basic social problem identified was the escalating behavior of the child. The child's behavior included self-injurious behavior or violence toward others. The core concept was "hospitalization, the last resort." Parents' management of the experience varied based on many factors including whether this was the child's first psychiatric hospitalization, the distance from the hospital to their home, their trust of staff members, sources of support, and their definition of the situation.

What parents of mentally ill children need and want from mental health professionals.

Child psychiatric hospitalization is a time of crisis for the parents of a child with a mental disorder. Prior to hospitalization, the child's problematic behavior has escalated. Parents have various types of contact with mental health professionals prior to, during, and after the hospitalization, which influence their ability to care for their child. This paper reports a qualitative descriptive study of what parents need and want from mental health professionals during this time frame. During the study, parents spontaneously talked about what they needed and wanted from mental health professionals, including nursing personnel. The perspectives of 38 parents of 29 hospitalized children were obtained through interviews. Parents identified needing informational, emotional, and instrumental support most often in the interviews. Specific examples from the data are included in this report.