Rebecca Bouterie Harmon

A Systematic Review of the Relationship of Diabetes Mellitus, Depression, and Missed Appointments in a Low-Income Uninsured Population

The purpose of this systematic literature review was to determine the relationship between the diagnosis of diabetes and depression and missed appointments in a low-income, uninsured, racially heterogeneous, adult population. Research demonstrates that individuals with diabetes have an increased incidence of depression across socioeconomic and racial groups. Low-income individuals have an increased prevalence of depression. The cost and burden of diabetes are greatly increased among individuals with both diabetes and depression versus diabetes alone. The prevalence and effects of diabetes and depression in a low-income, uninsured, racially heterogeneous population have not been determined. Further research to explore the relationship of diabetes, depression, and missed appointments in this vulnerable population is needed before effective treatment models can be developed. Longitudinal studies are also needed to determine the cause and effect between diabetes and depression among all populations.

The Relationship Between Diabetes Mellitus, Depression, and Missed Appointments in a Low-Income Uninsured Population

Purpose The purpose of this project is to identify rates of depression and document mental health needs of adults with diabetes who obtained care in free clinics. Data were collected to determine if there is a relationship between diabetes and depression and missed appointments in a sample of patients who were low-income, uninsured, and represented a variety of racial groups. Methods A sample of 183 adults with diabetes participated by completing paper and computerized questionnaires. Instruments included the Patient Health Questionnaire 9 (to measure prevalence of depression), the RAND 36 Health Survey (to measure quality of health), the Audit of Diabetes Dependent Quality of Life (to measure diabetes-dependent quality of life), and the Diabetes Empowerment Scale (to measure self-efficacy). Results The prevalence of depression at a moderate or greater level in the sample was found to be 30.1%. Levels of quality of health and self-efficacy were found to be reduced among those with the presence of depression. A significant increase in the rate of depression was found among those who had attended the free clinic for a longer period. No significant differences were found in diabetes-dependent quality of life and missed appointments among those with depression compared with those without. Conclusions Rates of depression among adults with diabetes in a free clinic setting were found to be comparable with the highest rates reported by other studies of insured populations. Results of this study support the need to develop mental health treatment programs for free clinic settings.

Achieving Transformational Change: Using Appreciative Inquiry for Strategic Planning in a School of Nursing

To achieve transformational change, a transformational approach is needed. The Appreciative Inquiry (AI) summit is a method that has been used to achieve transformational change in business for at least 20 years, but this innovative alternative approach is unknown to nursing. At the University of Virginia School of Nursing, an AI Summit was designed to bring all staff, faculty, student representatives, and members of the community together to rewrite the schools strategic plan. New connections within the school, the university, and the community were made when 135 participants engaged in the appreciative, 4-step AI process of discovering, dreaming, designing, and creating the schools future. During the summit, 7 strategic teams formed to move the school toward the best possible future while building on the existing positive core. This article describes 10 steps needed to design an AI summit and implications for using this method at other schools of nursing.

Transforming Psychiatric Mental Health Nursing Education With Team Based Learning

The aim of this study was to evaluate the effect of the team-based learning (TBL) instructional approach on learning outcomes in an undergraduate psychiatric mental health (PMH) nursing course. An uncontrolled, before and after design was employed. Data were collected over eight consecutive semesters (N=347) before and after implementation of TBL. Two variables were selected for comparison before and after implementation: scores on PMH portion of the Evolve® practice exit examination and time (in hours) students reported preparing for class. After implementation, students scored higher on the PMH practice exit examination and reported increased study time. Qualitatively, students reported enjoying working in teams despite the increased study time required with the TBL method.

Outcomes Following Treatment of Veterans for Substance and Tobacco Addiction

Persons who use tobacco in addition to alcohol and other drugs have increased health risks and mortality rates. The purpose of this study was to evaluate the impact of participation in a tobacco cessation program on tobacco, alcohol, and other drug use in a population seeking treatment for substance use disorders (SUDs). Tobacco, alcohol, and other drug use were assessed by urine drug screens, breathalyzer readings, and self-report. Veterans (N=137) with a tobacco use disorder enrolled in inpatient program for the treatment of SUDs at the Salem Veterans Affairs Medical Center participated in tobacco cessation education as part of their treatment programming. Use of tobacco, drugs and/or alcohol was evaluated upon admission, 2 weeks following admission, at discharge and 1 month following graduation. The 1-month follow-up rate was 70.8%, with 97 veterans completing the follow-up assessment. Of those 97 veterans, 90.7% (n=88) reported abstinence from alcohol and 91.8% (n=89) reported abstinence from other drugs of abuse. Fourteen veterans (14.4%) reported abstinence from tobacco at the 1-month follow-up. The veterans reporting abstinence from tobacco use also reported abstinence from alcohol and other drugs at the 1-month follow-up.

Teaching Psychiatric Mental Health Nursing in the People's Republic of China

According to the World Health Organizations Health Policy Resource Book, mental disorders account for a high proportion of disability worldwide and are predicted to grow significantly in the coming years. This is especially true in developing countries such as the Peoples Republic of China (PRC) where, for historical social, political, and economic reasons, psychiatric mental health (PMH) nursing has not been an integral part of nursing curricula. As the number of persons in the PRC increases, so is the demand for mental health nurses, yet the PRC lacks experienced PMH nursing instructors. This article describes the challenges and opportunities that await Western PMH nursing specialists and faculty in the PRC.

NURSING CARE IN A STATE HOSPITAL BEFORE AND DURING THE INTRODUCTION OF ANTIPSYCHOTICS, 1950–1965

Oral history methods were used to describe the experiences of American nurses who practiced in a state mental hospital before and during the introduction of antipsychotic medications. The nurses described their responsibilities for supervising staff, administering patient care, and assisting with special psychiatric treatments. They expressed resignation and frustration with trying to provide care despite obstacles such as unqualified physicians, crowded wards, and inadequate personnel and supplies. The nurses adopted a Cartesian approach in which they focused on the patients body, instead of the patients mind, and developed camaraderie among nurses through which they found acceptance and were able to continue to do a thankless job.

Implementing healthy work environment standards in an academic workplace: An update

In 2005 the American Association of Critical Care Nurses defined six Healthy Work Environment (HWE) standards for the clinical setting (AACN, 2005), which were reaffirmed and expanded in 2016 (AACN, 2016). These clinical standards were adapted for use in the academic setting by Fontaine, Koh, and Carroll in 2012. The intention of this article is threefold: to present a revised version of the academic workplace standards which are appropriate for all School of Nursing (SON) employees, staff as well as faculty; to proposes the addition of a seventh standard, self-care, which provides the foundation for all standards; and to describe the continuing implementation of these seven standards at the University of Virginia School of Nursing (UVA SON).