{"title":"“It’s My Secret”: Shame as a Barrier to Care in Individuals With Opioid Use Disorder","authors":"Monika S. Schuler, Valerie Seney","doi":"10.1177/10783903241242748","DOIUrl":"https://doi.org/10.1177/10783903241242748","url":null,"abstract":"BACKGROUND:Substance use disorder (SUD) is a chronic illness impacting more than 59 million Americans last year. Opioid use disorder (OUD) is a subset of SUD. The literature supports that healthcare providers frequently stigmatize patients with OUD. Individuals with OUD often feel shame associated with their disorder. Shame has been associated with maladaptive and avoidant behaviors.AIM:The aim of this qualitative descriptive study was to examine and describe the experiences of shame and health-seeking behaviors in individuals with OUD.METHODS:A qualitative exploratory design using focus groups with individuals in treatment for OUD was used to identify the issue of shame and its relationship to health-seeking behaviors.RESULTS:A systematic content analysis of discussions with 11 participants in four focus groups revealed four major themes and associated subthemes: Avoidance of Preventive Care (belief providers are judgmental); the Hidden Disorder (keeping secrets); Constraints of Shame (justification for the continuation of drug usage); and Trust in MOUD (Medication for Opioid Use Disorder) Providers. The feeling of shame leads to a reluctance to engage in health-promoting actions, such as scheduling appointments with primary care providers and dentists.CONCLUSION:Healthcare practitioners must prioritize providing a safe, nonstigmatizing environment for patients with SUD/OUD. This includes establishing trust and rapport, providing education, collaboration with psychiatric mental health specialists and other healthcare providers, and the offering support and resources to help patients manage their condition to achieve optimal health outcomes.","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":"15 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140587537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nurse Practitioner Certification Examination Development: From Reflecting Clinical Practice to Ensuring Lifelong Learning","authors":"Tara Myers, Kathy Chappell, Cherith Godwin, Jeanna Krissel, Jeffery Ramirez, Justin Smith","doi":"10.1177/10783903241240075","DOIUrl":"https://doi.org/10.1177/10783903241240075","url":null,"abstract":"OBJECTIVE:Certifications in psychiatric-mental health nursing promote safe practice by psychiatric-mental health nurse practitioners (PMHNPs) and nurses (PMHNs) and help protect the public from harm. This protection begins with the development of an examination that meets rigorous national education, practice, and accreditation standards and reflects PMHNPs’ or PMHNs’ clinical practice. Achievement and maintenance of a certification is a journey that involves a commitment to lifelong learning and the improvement of the field of psychiatric-mental health nursing through involvement in the examination process.METHODS:This discussion paper outlines the role nurses can play in the development of certification examinations. It describes the process of developing an effective certification examination, including the role of standards, accrediting bodies, and content experts; determining necessary tasks, knowledge, and skills; surveying practitioners to validate information; writing test questions; and ongoing analysis of examination content. The Psychiatric-Mental Health Nurse Practitioner (across the lifespan) Certification (PMHNP-BC) is presented as an example of the process.RESULTS:This discussion paper raises awareness of how certification exams are developed, PMHNPs participate in certification development, and volunteering promotes career development.CONCLUSION:The PMHNP-BC examination is based on education, practice, and certification accreditation standards and reflects current clinical practice. PMHNPs can (a) point to the rigor of certification as an indication of the quality of care they deliver, (b) volunteer to participate in the examination process to ensure examination rigor, and (c) advance their careers through the development and application of a valuable skill set.","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":"97 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140587478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Belle Zaccari, Athena D F Sherman, Melinda Higgins, Ursula Ann Kelly
{"title":"Trauma Center Trauma-Sensitive Yoga Versus Cognitive Processing Therapy for Women Veterans With PTSD Who Experienced Military Sexual Trauma: A Feasibility Study.","authors":"Belle Zaccari, Athena D F Sherman, Melinda Higgins, Ursula Ann Kelly","doi":"10.1177/10783903221108765","DOIUrl":"10.1177/10783903221108765","url":null,"abstract":"<p><strong>Background: </strong>Posttraumatic stress disorder (PTSD) is a common sequela to military sexual trauma (MST) among women veterans. Yoga has shown promise in research examining its benefit for symptoms and sequela of PTSD.</p><p><strong>Aims: </strong>The objective of this study was to evaluate the feasibility of a randomized controlled trial (RCT) of Trauma Center Trauma-Sensitive Yoga (TCTSY) for women veterans with PTSD related to MST.</p><p><strong>Method: </strong>In this feasibility study, the final sample included women veterans (<i>n</i> = 41) with PTSD related to MST accessing health care in a Veterans Affairs Health Care System in the southeast United States; the majority were African American (<i>n =</i> 33; 80.5%). Interventions used established protocols of 10 weekly sessions of group TCTSY versus 12 weekly sessions of group Cognitive Processing Therapy (CPT). PTSD was assessed via clinical interview and participant report. Additional data collection included multiple participant-reported outcomes commonly associated with PTSD and psychophysiological measures. We also collected data regarding participant satisfaction and feasibility-related feedback from participants and providers.</p><p><strong>Results: </strong>Feasibility and acceptability were evaluated via demand, practicality, fidelity, and acceptability. This was measured by expressed interest, attendance, program completion, barriers to care and satisfaction with treatment, and satisfaction with interventions and data collection.</p><p><strong>Conclusions: </strong>Results indicate the RCT design and TCTSY implementation were feasible; a full-scale RCT was subsequently conducted to determine efficacy of the experimental intervention. Recommendations for successful research strategies are provided.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"343-354"},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9433917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bassema Abufarsakh, Janet K Otachi, Tianyi Wang, Yazan Al-Mrayat, Chizimuzo T C Okoli
{"title":"The Impact of a Nurse-Led Service on Tobacco Treatment Provision Within a Psychiatric Hospital: A Time Series Study.","authors":"Bassema Abufarsakh, Janet K Otachi, Tianyi Wang, Yazan Al-Mrayat, Chizimuzo T C Okoli","doi":"10.1177/10783903221093582","DOIUrl":"10.1177/10783903221093582","url":null,"abstract":"<p><strong>Introduction: </strong>Psychiatric hospitalization is an opportunity to provide evidence-based tobacco treatment to optimize cessation efforts among people living with mental illnesses (MI). The purpose of this study was to examine the effectiveness of nurse-driven initiatives to enhance tobacco treatment within an inpatient psychiatric setting.</p><p><strong>Aims: </strong>We assessed the 4-year impact of implementing a nurse-led tobacco treatment service offered to 11,314 inpatients at admissions in a tobacco-free psychiatric facility in Kentucky.</p><p><strong>Method: </strong>Through a time-series design, we compared the differences in rates of screening for tobacco use and providing treatment from September to December 2015 (prior to implementing the nurse-led tobacco treatment services) to each subsequent year in a 4-year period (2016-2019).</p><p><strong>Results: </strong>Approximately 60.0% of inpatients were persons using tobacco during the assessment period. Although there were no changes in tobacco use prevalence over the 4-year evaluation duration, there were significant increases in the provision of practical counseling and Food and Drug Administration-approved nicotine replacement therapies for persons using tobacco.</p><p><strong>Conclusions: </strong>Our findings support the effectiveness of implementing tobacco treatment programs at the organizational level. Psychiatric hospitalizations provide an opportunity to optimize nurse-driven efforts to deliver tobacco treatment to people with MI. Similar models of nurse-led tobacco treatment services can be adopted within inpatient and other mental and behavioral health settings.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":"1 1","pages":"434-440"},"PeriodicalIF":2.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42855630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Use of Standardized Patients as an Educational Strategy in Baccalaureate Psychiatric Nursing Simulation: A Mixed Method Pilot Study.","authors":"Kimberly A Conway, Robert L Scoloveno","doi":"10.1177/10783903221101049","DOIUrl":"10.1177/10783903221101049","url":null,"abstract":"<p><strong>Objective: </strong>Prior psychiatric simulation experiences required our nursing students to role-play in an unknown area of nursing. Students confidence, clinical satisfaction, and use of clinical skills were negatively impacted leading to unmet course objectives. The aim of this pilot study was to strengthen our baccalaureate senior nursing students' simulation experience in their psychiatric nursing course with the use of standardized patients (SPs) instead of student role-play and measure the impact of this strategy on students' learning, satisfaction, and confidence in an unfamiliar area of nursing.</p><p><strong>Methods: </strong>A mixed method explanatory sequential design was used. Participants consisted of a convenience sample of senior nursing students enrolled in their psychiatric nursing course. A quantitative simulation tool and a four-item questionnaire were analyzed after completion of the simulations (<i>n</i> = 47).</p><p><strong>Results: </strong>Findings of this study identified greater than 80% of students had increased level of learning, confidence, and satisfaction with the SP simulation experience. Nurse faculty were able to overcome simulation barriers, that is, a patient hearing voices, non-verbal signs of depression, and evaluate students meeting course learning outcomes.</p><p><strong>Conclusions: </strong>Findings from this study highlight students' positive simulation experiences. Using SPs as an educational strategy can be effective for students to reach competency, achieve higher knowledge, and improve confidence. It is believed the use of SPs as a simulation strategy in psychiatric nursing will assist students with clinical judgment and better prepare them to meet the needs of vulnerable persons with psychiatric conditions.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":"1 1","pages":"414-417"},"PeriodicalIF":2.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46793442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"<i>JAPNA</i>'s Diversity, Equity, and Inclusion Statement Is Adopted: Commitment to DEI Action <i>and</i> Measurement.","authors":"Michelle DeCoux Hampton","doi":"10.1177/10783903241230294","DOIUrl":"10.1177/10783903241230294","url":null,"abstract":"","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"197-198"},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Attitudes Toward People With Schizophrenia Among Undergraduate Nursing Students.","authors":"Yi-Han Chen, Chiu-Yueh Hsiao, Hui-Wen Chien","doi":"10.1177/10783903221096360","DOIUrl":"10.1177/10783903221096360","url":null,"abstract":"<p><strong>Background: </strong>Negative attitudes toward mental disorders are not only an interpersonal issue but also a concern of mental health care. Given that nursing students are future health care providers, it is pivotal to improve their attitudes toward individuals with mental disorders prior to their transition into clinical practice. However, research on nursing students' attitudes in relation to schizophrenia in Taiwan remains unexplored.</p><p><strong>Aim: </strong>The aim of this article is to examine the correlates of attitudes toward individuals with schizophrenia among Taiwanese undergraduate nursing students.</p><p><strong>Method: </strong>A descriptive, correlational, and cross-sectional study was adopted. Self-reported questionnaires were conducted with a convenience sample of 306 Taiwanese undergraduate nursing students. Descriptive statistics, independent <i>t</i> tests, one-way analysis of variance, Pearson's correlations, and a stepwise regression analysis were performed.</p><p><strong>Results: </strong>Nursing students expressed negative attitudes toward individuals with schizophrenia. Nursing students, who were female, had contact with individuals with mental disorders, and expressed greater empathy and personality traits held more favorable attitudes toward individuals with schizophrenia. The study found that empathy, personality traits, and academic year were the most crucial attributes contributing to attitudes of nursing students toward individuals with schizophrenia.</p><p><strong>Conclusion: </strong>Findings suggest that nursing education programs with empathy- and personality-tailored modules in mental health are pivotal to provide humanistic approaches with supportive attitudes regarding schizophrenia.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":"1 1","pages":"313-321"},"PeriodicalIF":2.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48426810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Teresa J Ng, Jiying Ling, Lorraine B Robbins, Tsui-Sui A Kao
{"title":"Stress Management Interventions Among U.S. High School Adolescents: A Meta-Analysis.","authors":"Teresa J Ng, Jiying Ling, Lorraine B Robbins, Tsui-Sui A Kao","doi":"10.1177/10783903231161608","DOIUrl":"10.1177/10783903231161608","url":null,"abstract":"<p><strong>Background: </strong>Adolescent ineffective stress management has been associated with negative health outcomes, such as anxiety and depression. Comprehensively evaluating the effects of stress management interventions is needed.</p><p><strong>Aims: </strong>The aim of this study was to quantitatively evaluate the effects of stress management interventions on mental health outcomes (stress, anxiety, depression, and positive and negative affect) and perform moderation analysis to identify moderators of intervention effects on stress, anxiety, and depression among U.S. high school adolescents.</p><p><strong>Methods: </strong>Four databases (CINAHL, ERIC, PubMed, and PsycINFO) were searched. After literature screening, 24 articles describing 25 studies were retained. Hedge's <i>g</i> was calculated using random-effects models. Exploratory moderation analyses were performed to identify moderators.</p><p><strong>Results: </strong>The pooled effects on reducing stress were -0.36. The interventions had small effects on decreasing anxiety (<i>g</i> = -0.31) and depression (<i>g</i> = -0.23). Long-term follow-up effects were -0.77 on perceived stress, -0.08 on anxiety, and -0.19 on depression. Mind-body and cognitive-behavioral interventions had moderate effects on reducing anxiety (<i>g</i> = -0.51). Interventions with longer duration (>8 weeks) were more effective in reducing anxiety (-0.39 vs. -0.26) and depression (-0.36 vs. -0.17).</p><p><strong>Conclusions: </strong>These findings support the short-term effectiveness of stress management interventions in improving mental health among high school adolescents in the United States. Subsequent research efforts should focus on sustaining long-term effects.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"252-278"},"PeriodicalIF":2.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9170251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alec M Bernstein, Seth B Clark, Amy E Pattishall, Claudia R Morris, Andrea McCarter, Colin S Muething, Alexis C Pavlov, Thomas Chun, Nathan A Call
{"title":"The Development and Acceptability of a Comprehensive Crisis Prevention Program for Implementation in Health Care Settings.","authors":"Alec M Bernstein, Seth B Clark, Amy E Pattishall, Claudia R Morris, Andrea McCarter, Colin S Muething, Alexis C Pavlov, Thomas Chun, Nathan A Call","doi":"10.1177/10783903221093578","DOIUrl":"10.1177/10783903221093578","url":null,"abstract":"<p><strong>Introduction: </strong>Behavioral crises are increasingly prevalent in health care settings. Existing programs, however, include procedures that lack adaptability, omit critical components, and deviate from clinical best-practice recommendations. Health care employees also continue to report lacking confidence for safely managing behavioral crises.</p><p><strong>Aims: </strong>We described the development and acceptability of a comprehensive crisis prevention program and its modification for a large pediatric health care system to help remediate the limitations of existing programs.</p><p><strong>Method: </strong>Chi-square analyses evaluated the acceptability of the crisis prevention program pre- versus post-training and at 3- and 6-month follow-up times. For insignificant outcomes, logistical regressions identify whether responses differed between emergency-department and nonemergency-department employees.</p><p><strong>Results: </strong>Chi-square analyses were significant for 10 of 15 questions suggesting that employees were more confident in managing and communicating during behavioral crises post-training, and that this confidence was maintained. Logistic regressions found that emergency-department employees differed in some responses to the acceptability questionnaire than nonemergency-department employees over time.</p><p><strong>Conclusion: </strong>The present crisis prevention program is adaptable to various settings and patients, and it is well received overall by employees. The safety of patients and employees is integral to the delivery of quality care and improving patient-provider relations.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":"1 1","pages":"424-433"},"PeriodicalIF":2.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45711944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Men's Depression and Anxiety: Contributing Factors and Barriers to Intervention.","authors":"Mary Molewyk Doornbos, Gail Landheer Zandee","doi":"10.1177/10783903241226718","DOIUrl":"10.1177/10783903241226718","url":null,"abstract":"<p><strong>Background: </strong>Urban, ethnically/racially diverse, impoverished men are predisposed to experience unaddressed depression and anxiety. The overlap of these factors creates significant mental health inequity.</p><p><strong>Aims: </strong>This study sought to capture men's impressions of the factors that contributed to their experience of depression and anxiety as well as barriers that they experienced in pursuing intervention.</p><p><strong>Methods: </strong>Using community-based participatory research, in the context of long-term partnerships between a department of nursing and three urban, racially/ethnically diverse, and impoverished neighborhoods, the researchers recruited 50 men ages 23-83 years. Data were collected via six homogeneous, Zoom-based focus groups composed of Black, Hispanic, and White men, respectively.</p><p><strong>Results: </strong>The men identified multiple themes pertaining to modifiable and non-modifiable contributing factors that played a role in their development of depression and anxiety as well as barriers related to stigma, resource issues, and a lack of knowledge of mental illness that they faced when seeking intervention.</p><p><strong>Conclusions: </strong>Understanding men's perspectives on the contributing factors and barriers to mental health intervention can provide an evidence base with which to address mental health inequity via tailored care, policy, and research agendas.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"199-209"},"PeriodicalIF":2.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}