Annette T. Maruca

Medication adherence among female inmates with bipolar disorder: results from a randomized controlled trial.

To describe the differences in medication adherence between 2 groups of inmates in the Connecticut Department of Correction diagnosed with bipolar disorder treated with either the Texas Implementation of Medication Algorithm (TIMA) for Bipolar Disorder or treatment as usual (TAU). Using a prospective longitudinal analysis of secondary data and chart data, a comparison was made between participants who were assigned either to TIMA or TAU and treated for 12 weeks for either Bipolar Disorder Type I or II. A secondary data set containing 12 weeks of medication data was combined with medical chart data, including medication administration records, which were retrospectively reviewed to determine numbers of psychotropic and other medications prescribed, number of doses per day prescribed, number of times the medications were taken, any patterns and reasons for missed doses, and side effects experienced. High rates of psychotropic medication nonadherence were observed among female inmates with bipolar disorder, with the mood stabilizers as the most frequently missed medications. Analyses revealed an interaction of Treatment Condition × Baseline Adherence × Time in Treatment × Biweekly Symptom Severity. Regardless of treatment condition, participants exhibiting high baseline adherence exhibited greater decreases in daily adherence over time; in addition, participants at Time 8 (Weeks 7 and 8) and later exhibited poorer adherence if they had more severe symptoms during those weeks. TIMA participants missed fewer doses than TAU participants. Future research is needed to uncover what factors most significantly contribute to psychotropic medication adherence.

Does simulation enhance undergraduate psychiatric nursing education? A formative assessment

Purpose – Alcohol withdrawal syndrome (AWS) is a serious condition that can result in death if it is not recognized and treated appropriately. A high fidelity simulation scenario on AWS was created for psychiatric nurses in an educational setting that focused on the recognition of alcohol withdrawal, implementation of the Clinical Institute Withdrawal Assessment (CIWA) and initiation of appropriate treatment and management of AWS.Design/methodology/approach – A formative assessment teaching strategy was used to evaluate the development and implementation of a high fidelity simulation (HFS) on alcohol withdrawal syndrome. The HFS was part of a baccalaureate undergraduate psychiatric nursing education designed to reinforce classroom theory and clinical application. Results were measured using a self‐report survey completed by students that focused on the details of content and performance.Findings – Feedback from the 38 nursing students who evaluated the HFS was overall positive. Survey results showed that ...

Using simulation to address care of the transgender patient in nursing curricula

This descriptive study explored the use of simulation as a means to increase cognitive and reflective practice as well as determining if simulation can alter perceptions and attitudes related to the lesbian, gay, bisexual and transgender (LGBT) community. This manuscript describes how student nurses perceive their role when providing care to and, more specifically, the care of transgender patients. The research question asks: How does a transgender simulation impact the attitudes and beliefs of nursing students related to the LGBT community? One-hundred and fifty-nine students, with a subset of 120 students attending a school in central Florida and 50 students attending a Connecticut programme, participated in the completion of the instruments. The Gender Affirmative Practice (GAP) scale was used to evaluate their attitudes and practice concerning LGBT issues. Findings suggest that the majority of the students rarely or never discuss pertinent sexual orientation issues. Students are not comfortable creating a climate that allows for self-identification by gay/ lesbians, despite admitting to being open and accepting the LGBT community with their faculty. Limitations were based on multisite location and the use of the GAP. It is important for nursing students, and healthcare providers, to acknowledge and recognise the unique vulnerabilities of transgender persons who are seeking healthcare. The exposure to transgender individuals in a clinical setting may be limited; therefore, the use of simulation will offer the opportunity to examine their beliefs and reflect on their attitudes towards this population. Simulation incorporating mental health issues is a newer training technique in which psychosocial aspects of healthcare are addressed.

Enhancing Empathy in Undergraduate Nursing Students: An Experiential Ostomate Simulation

AIM The aim of this study was to implement and evaluate an experiential learning simulation created to enhance nursing students’ empathy during patient care encounters. BACKGROUND The investigators proposed that an ostomy simulation experience would be an efficient method for providing this educational content. METHOD Content analysis was conducted on essays using Krippendorffs technique to quantify the simulation. RESULTS Each unit of measure, or paper, contained between 1 to 14 empathic comments. Of the total sample, 22.8 percent had three or five empathic comments; 10 percent had four, and 9 percent had six or more comments per paper. Eighty‐five percent of participants felt this simulation experience was beneficial for enhancing empathy in clinical practice. CONCLUSION The assignment was an effective, objective method that utilized simulation to teach empathy to baccalaureate nursing students.

Addressing methodological issues in correctional health research: a case report.

ABSTRACT This case study describes the experiences of a novice correctional nurse researcher’s application of the recommended strategies from the correctional literature to improve the conduct of research in a correctional institution. An innovative booster intervention was implemented and evaluated as a pilot study in a state correctional institution. Correctional nurse researchers encounter many challenges when conducting research in a correctional facility. This case study shares challenges that persisted and concludes by recommending ways to strengthen and improve on learned strategies proposed by experienced correctional nurse researchers.

Correctional Nursing Interventions for Incarcerated Persons with Mental Disorders: An Integrative Review

The authors explore the current state-of-the art of correctional nursing by summarizing the types of interventions employed by nurses, across studies, designed to assist this challenging group of patients. This examination of evidence-based interventions implemented and tested by correctional nurses provides a better understanding of their role and function. Correctional health is a nurse driven system, yet a minimal amount is known about the nurses who practice in these environments or about their contributions to the practice of mental health nursing in correctional environments. An integrative review utilizing PRISMA guidelines examined five databases (Medline/PubMed, PsycInfo, PsychArticles, Sage Criminology, and Academic Search) for peer-reviewed articles that fit selected criteria. Of 324 references identified, 16 studies met criteria. Following assessment of strength of evidence, only eight studies offered scientific proof of the effectiveness of nursing interventions. Nursing interventions implemented in correctional settings targeted incarcerated persons with behavioral and psychological symptoms. Interventions included psycho-education, environmental adaptations, and behavior therapies. The centrality of nurses in correctional health care emphasizes the significance of understanding their role and function in this setting. This integrative review revealed that correctional nurses are actively engaged in providing therapeutic, evidence-based interventions in the health care of incarcerated persons. Of interest, seven of the eight studies focused on incarcerated persons with mental health or substance use issues. Nurse led interventions such as CBT, labyrinth walking, and yoga aim to improve coping and adaptation of incarcerated persons.

Self Care management in Corrections: Perspectives from Persons with an Incarceration Experience

The purpose of this study was to explore the perceptions and beliefs of what self-care management looks like for a person with an incarceration experience. This is the first phase of a two-phase study. This qualitative study, held in three county jails in Massachusetts, utilized a focus group methodology. The Rediscovery of Self-Care: A Care Intervention for Persons with Incarceration Experience (RSC) model served as the framework for this study. On the basis of a priori constructs from the RSC model, a protocol was established and targeted questions outlined. The results from these focus groups support the constructs of the RSC model. Participants in all focus group interviews reported that self-care was very important and defined self-care, most of the time, in terms of meeting physical needs such as exercising and eating healthy and, more importantly, self-identified mental health and substance use needs such as individual or group counseling. In conclusion, open-ended questions used to identify all instances of potential categories of self-care management supported the central concepts of the RSC model and will inform treatment interventions and modification of an existing self-care management instrument or provide the foundation for the development of a new instrument.