Kathryn R. Puskar

Optimism and its relationship to depression, coping, anger, and life events in rural adolescents

Optimism is a stable personality trait that has important implications for behavior, yet little attention has been given to examining optimism in adolescents. This article describes levels of optimism in rural adolescents and the relationship of optimism with depression, coping, anger, and life events. The identification of optimism may be a vulnerability factor when screening adolescent mental health and, as such, has implications for the psychiatric nurse clinician.

Maintaining reality: Relational agents for antipsychotic medication adherence

We describe an animated, conversational computer agent designed to promote antipsychotic medication adherence among patients with schizophrenia. In addition to medication adherence, the agent also promotes physical activity and system usage, and includes verbal and nonverbal behavior designed to foster a therapeutic alliance with patients. We discuss special considerations in designing interventions for this patient population, and challenges in developing and evaluating conversational agents in the mental health domain. Results from a pilot evaluation study of the agent indicate that it is accepted and effective.

Effectiveness of Cognitive-Behavioral Therapy on Depressive Symptomatology, Stress and Coping Strategies among Jordanian University Students

The study examined the effectiveness of cognitive behavioral therapy (CBT) with university students suffering from moderate to severe depressive symptoms in Jordan. Eighty-four university students were recruited and assigned randomly to control and intervention groups. Intervention impact was assessed on measures of depressive symptoms, perceived stress, and coping strategies at three time points; baseline, postintervention, and 3-months postintervention. The interventional model used was the Modified Teaching Kids to Cope (MTKC), and the control group received no treatment. Overall, using CBT showed a significant improvement in the outcome measures. At postintervention, students had lower scores on perceived stress, lower depressive symptoms, less use of avoidance coping strategies, and more use of approach coping strategies. The findings are discussed in terms of treatment implications and recommendations for use at academic and health care settings.

Self-esteem and optimism in rural youth: Gender differences

Abstract Aim: To identify and describe gender-related differences in the self-esteem and optimism levels of rural adolescents. Background: Self-esteem and optimism have been broadly examined and are associated with health-practices, social interaction, attachment, resiliency, and personal identity. Information describing the relationship of self-esteem and optimism as it relates to gender is limited. Methods: Using a cross-sectional survey design, students (N = 193) from three high-schools in rural Pennsylvania, USA completed the Rosenberg Self-Esteem Scale and the Optimism Scale-Life Orientation Test-Revised as part of a National Institute of Health, National Institute of Nursing Research funded study. Results: Both instruments’ mean scores were in the range of average for this population, with females scoring lower than males in both self-esteem (p < 0.0001) and optimism (p < 0.0001). The results of this study have nursing implications for evidenced based interventions that target self-esteem and optimism. Attention to self-esteem and optimism in female youth is recommended.

Relationships Between Depressive Symptoms and Perceived Social Support, Self-Esteem, & Optimism in a Sample of Rural Adolescents

Stress, developmental changes and social adjustment problems can be significant in rural teens. Screening for psychosocial problems by teachers and other school personnel is infrequent but can be a useful health promotion strategy. We used a cross-sectional survey descriptive design to examine the inter-relationships between depressive symptoms and perceived social support, self-esteem, and optimism in a sample of rural school-based adolescents. Depressive symptoms were negatively correlated with peer social support, family social support, self-esteem, and optimism. Findings underscore the importance for teachers and other school staff to provide health education. Results can be used as the basis for education to improve optimism, self-esteem, social supports and, thus, depression symptoms of teens.

Effects of Screening, Brief Intervention, and Referral to Treatment (SBIRT) Education and Training on Nursing Students’ Attitudes Toward Working With Patients Who Use Alcohol and Drugs

ABSTRACT Background: Screening, Brief Intervention, and Referral to Treatment (SBIRT) can reduce alcohol use and negative health outcomes in patients with risky substance use. However, negative attitudes that some health care professionals have toward patients who use substances are a barrier to implementing SBIRT. Methods: The University of Pittsburgh School of Nursing, in partnership with the Institute for Research, Education, and Training in Addictions (IRETA), developed a curriculum to train baccalaureate student nurses to deliver SBIRT. Results: Following SBIRT education and training, students’ perceived attitudes toward patients who use alcohol became more positive. Less robust changes were found for attitudes related to patients who use drugs. Conclusions: Nurses composing the largest group of healthcare workers are in key positions to screen, intervene, and provide education about substance use.

Screening and predicting adolescent depressive symptoms in rural settings.

Adolescent depression with related suicidal behavior is a serious health problem. This article describes depressive symptoms, reported life events, and demographic risk factors in 846 rural adolescents. The results indicate that self-reported depressive symptoms in rural adolescents is significantly (p < .05) related to gender, death in the family, and the perceived positive and negative impact of life events, as well as the specific events of losing a close friend, an increase in number of arguments with parents, trouble with classmates, and trouble with police. The type of school program and trouble with siblings was marginally significant (p < .10). These demographic factors and life events may assist health-care professionals in identifying adolescents at risk for depressive symptoms.

Life Events, Problems, Stresses, and Coping Methods of Adolescents

The purpose of this pilot study is to explore the life events, problems, stressful situations, and coping methods used by adolescents. A sample of 69 volunteer adolescents age 16-18 was obtained from a rural western Pennsylvania high school. The following instruments were administered: The Life Event Scale, senior high version (Coddington, 1972); Mooney Problem Checklist (1951); Stress Questionnaire (Lazarus & Folkman, 1984); and the Ways of Coping Questionnaire (Folkman & Lazarus, 1988). Descriptive statistics revealed the most frequent life event listed was breaking up with a boyfriend/girlfriend; most frequent problems were related to adjustment to school; and most common stress situations related to family. Coping methods were delineated with a few gender differences noted. The most common method of coping was self-control. The adolescent population has many issues to deal with during a time of psychosocial and physiological change and vulnerability. The psychiatric-mental health nurse specialist could be a valuable asset to help school systems teach health promotion and prevention concepts about mental health, identify students at high risk for mental health disorders, and offer counseling and guidance for students and consultative services for both teachers and parents.

Implementing Information Technology in a Behavioral Health Setting

The art and practice of nursing in todays health care arena is becoming increasingly complex. One of the newest challenges in the field of behavioral health is the integration of quality health care with information technology. The authors of this paper examine four emerging aspects of information technology: the electronic medical record, automated medication distribution systems, computerized charting, and hand-held computers. The benefits, costs, uses of these technologies, and the potential problems they can provide in the field of behavioral health are discussed. Implications for nursing practice also are explored.

Dilemmas and directions for psychiatric nursing in the 1990s

Problems with the recruitment of nurses to the specialty area of psychiatric nursing have stimulated much debate and discussion in the field. This article explores dimensions of psychiatric nursing education, science, and practice and their impact on the future of this specialty area of nursing. It proposes that the present task is to define more precisely the continuum of psychiatric mental health nursing both to differentiate between psychosocial (mental health) and psychiatric (mental illness) components of the role and balance the priority that psychiatric nurses give to each in educational curricula, research agendas, and practice settings.