Kathleen Scharer

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.

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 childs 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.

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 ones 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.

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.

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 Jaccards 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.

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.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.

Blending Specialist and Practitioner Roles in Psychiatric Nursing: Experiences of Graduates:

BACKGROUND: Blended roles in advanced practice nursing have generated much discussion but little study. As role modifications emerge in nursing, there is a need to explore their implementation. OBJECTIVE: This descriptive study examined the experiences of nurses who were implementing blended roles as psychiatric clinical specialists and adult nurse practitioners. DESIGN: Four master of science in nursing and 10 postmasters nurses who had been practicing in blended roles for 1 to 2 years were interviewed about their experiences in implementing their roles. Interviews were tape recorded, transcribed, and content analyzed. RESULTS: Respondents believed they were practicing holistically, were able to appropriately integrate physical and psychological care of the patient, and found chronic psychiatric patients to have more complex physical illnesses than they had anticipated. In addition, the advanced practice nurses were satisfied with their roles, felt supported by their physician preceptors, and described cross-consultation with physicians and nonpsychiatric nurse practitioners. CONCLUSIONS: There are roles for advanced practice nurses who blend clinical specialist and adult nurse practitioner skills in the care of psychiatric and primary care patients.

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 masters 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.