Latinas have a greater chance of dying from diabetes than non-Latina Whites. As a population group, the literature has shown that Latinas do not meet physical activity (PA) guidelines. Motivational interviewing (MI) is a patient-centered... more
Latinas have a greater chance of dying from diabetes than non-Latina Whites. As a population group, the literature has shown that Latinas do not meet physical activity (PA) guidelines. Motivational interviewing (MI) is a patient-centered counseling method that promotes self-efficacy for behavior change. The purpose of the study was to examine the feasibility of using MI/PA counseling for self-management of type 2 diabetes mellitus with Latinas. Latinas ( n = 12) were recruited from an occupational program in Southern California. Two MI and PA sessions were conducted over 2 months. Feasibility measures included recruitment, retention, protocol adherence, and attrition. Impact outcomes included PA, PA stage of change, and waist circumference. Participants attended all sessions and completed all questionnaires. Half progressed into a later stage of change for PA. Results suggest MI and PA counseling is feasible for improving PA with Latinas at risk/diagnosed with type 2 diabetes mellitus.
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The Veterans Administration (VA) has been committed to academic affiliate training partnerships for nearly 70 years in efforts to enhance veteran-centric health care. One such effort, the VA Nursing Academy (VANA) program, was developed... more
The Veterans Administration (VA) has been committed to academic affiliate training partnerships for nearly 70 years in efforts to enhance veteran-centric health care. One such effort, the VA Nursing Academy (VANA) program, was developed in 2007 in response to the nationwide nursing shortage and began as a five-year pilot with funding competitively awarded to 15 partnerships between local VA medical centers and schools of nursing. The VANA program evolved into the VA Nursing Academic Partnership (VANAP) program following the initial pilot. This article describes the development and evolution of the Charleston VANAP, which includes the Ralph H Johnson VA Medical Center (RHJ VAMC) and the Medical University of South Carolina College of Nursing (MUSC CON). The VA Office of Academic Affiliations (OAA) funded a large portion of the initial five years of the Charleston VANAP. Once the national funding source ceased, the RHJ VAMC and the MUSC CON entered into a Memorandum of Understanding (...
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The purposes of this study were to measure the prevalence of, and identify factors associated with, cervical cancer screening among a sample of lesbian, bisexual, and queer women and transgender men. Past research has found that lesbian,... more
The purposes of this study were to measure the prevalence of, and identify factors associated with, cervical cancer screening among a sample of lesbian, bisexual, and queer women and transgender men. Past research has found that lesbian, bisexual and queer women underutilize cervical screening service. Because deficient screening remains the most significant risk factor for cervical cancer, it is essential to understand the differences between routine and non-routine screeners. A convergent-parallel mixed methods design. A convenience sample of 21-65 year old lesbian and bisexual women and transgender men were recruited in the United States from August to December 2014. Quantitative data were collected via a 48-item Internet questionnaire (N = 226), and qualitative data were collected through in-depth telephone interviews (N = 20) and open-ended questions on the Internet questionnaire. Seventy-three percent of the sample were routine cervical screeners. The results showed that a con...
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ABSTRACT
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Lesbian, bisexual, and queer (LBQ) women, as well as transgender men, are less likely than their heterosexual and female-identifying counterparts to access cervical cancer screening services. Although numerous factors that influence... more
Lesbian, bisexual, and queer (LBQ) women, as well as transgender men, are less likely than their heterosexual and female-identifying counterparts to access cervical cancer screening services. Although numerous factors that influence receipt of cervical screening have been identified, several gaps in research and knowledge merit additional research. The aims of this study were to examine cervical cancer screening behaviors of LBQ women and transgender men using American Cancer Society guidelines as the standards for comparison and to determine factors that influence participation in cervical cancer screening. A convenience sample of 21- to 65-year-old LBQ women and transgender men was recruited from the Internet and community events. Qualitative data were collected through in-depth telephone interviews and open-ended questions on an online questionnaire. A deductive-inductive content analysis approach was used. The sample was mostly non-Hispanic white women who identified as lesbian....
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Recent developments in health care reform suggest the importance of outcome data regarding the nature, costs, and documented effectiveness of various health care services. While psychiatric nurses believe in the value of the care they... more
Recent developments in health care reform suggest the importance of outcome data regarding the nature, costs, and documented effectiveness of various health care services. While psychiatric nurses believe in the value of the care they provide, the present climate requires that research be conducted to elaborate the outcomes of psychiatric nursing care. This article describes a pilot study conducted on two adult inpatient units of a teaching hospital. On the experimental unit, nurses used North American Nursing Diagnosis Association (NANDA) nursing process documentation that related to specific patient outcome criteria. On the control unit, nurses used a medical systems approach to documentation. Study results and important unanticipated findings are reported with implications for future nursing research and practice.
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The authors evaluated the reliability and preliminary validity of the Charleston Psychiatric Outpatient Satisfaction Scale, a 15-item measure of patients' satisfaction designed for use in outpatient settings. The instrument uses a... more
The authors evaluated the reliability and preliminary validity of the Charleston Psychiatric Outpatient Satisfaction Scale, a 15-item measure of patients' satisfaction designed for use in outpatient settings. The instrument uses a 5-point Likert-type response format that minimizes positive response bias and optimizes variability and predictive validity. The Charleston Psychiatric Outpatient Satisfaction Scale was administered to 282 patients seen in psychiatric outpatient clinics affiliated with a public-academic psychiatric institution over a one-week period in 1995. The internal reliability of the instrument was high (alpha=.87), and its convergent validity was supported by the significant correlation of all items with anchor items that measured overall satisfaction with care and likelihood of recommending the clinic to others. The best predictors of overall ratings of care were the items measuring patients' satisfaction with helpfulness of the services and with the respect shown for patients' opinions about treatment. The best predictors of recommendation of the program to others were the items measuring satisfaction with matching of the treatment plan to patients' individual needs and with the respect shown for patients' opinions about treatment. Mean scores for all items ranged from 3.6 (satisfaction with parking) to 4.5 (satisfaction with helpfulness of the secretary and with the overall quality of care), indicating that overall satisfaction in this sample was high. The results provide preliminary support for the reliability and validity of the Charleston Psychiatric Outpatient Satisfaction Scale:
Research Interests: Psychiatry, Psychometrics, Community-Based Mental Health Services, Humans, South Carolina, and 13 moreFemale, Male, Reliability, Patient Satisfaction, Validity, Mental Disorders, Questionnaires, Adult, Public health systems and services research, Psychiatric Services, Reproducibility of Results, Psychiatric, and Likert Scale
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Psychiatric nurses in inpatient settings play a critical role in the management of potentially violent patients. One of their primary objectives is to ensure the safety of patients and staff 24 hours a day. This requires skillful... more
Psychiatric nurses in inpatient settings play a critical role in the management of potentially violent patients. One of their primary objectives is to ensure the safety of patients and staff 24 hours a day. This requires skillful observation of patients' motor behavior, verbal clues, and change in mental status, which may indicate an increase in agitation or possible aggressive behavior. It requires experience in prevention strategies and skill in acute crisis intervention techniques. To effectively intervene with potentially violent patients, psychiatric nurses must be able to work well under stress and be able to organize and execute a plan of immediate action. After the acute stage of the patient's illness, nurses should focus their work on assisting patients to manage their own behavior and supporting their newly acquired skills.
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The effectiveness of using senior-level nursing students as teachers to junior-level students in simulated learning was examined in a prelicensure nursing program. Simulation requires considerable financial resources in faculty time and... more
The effectiveness of using senior-level nursing students as teachers to junior-level students in simulated learning was examined in a prelicensure nursing program. Simulation requires considerable financial resources in faculty time and effort. It was theorized that using senior students as teachers for junior students in peer-assisted simulation for learning health assessment clinical skills would offer an equally effective learning experience as faculty instructors. A total of 60 junior-level students were randomized into a simulated learning experience taught by 20 senior-level students or nursing faculty. Evaluation of junior students' clinical performance, postsimulation debriefing assessment, and satisfaction with the simulation learning experience indicated that senior nursing students were equally effective as faculty simulation instructors. Findings suggest that the Senior Students as Teachers program, using the train-the-trainer model, was successful in preparing students as simulation instructors and has the potential for reducing faculty time and cost, as well as enhance student peer-to-peer learning.
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This study examined the professional, work and organizational characteristics, and the actual and preferred work activities of nurses employed by one state mental health agency. Findings include neutral ratings by this older and... more
This study examined the professional, work and organizational characteristics, and the actual and preferred work activities of nurses employed by one state mental health agency. Findings include neutral ratings by this older and experienced group of nurses in relation to job satisfaction, work autonomy, and organizational commitment regardless of educational background or work setting. Specific activities of the nurses varied appropriately based on education, but differences emerged among functions performed by nurses in inpatient and community settings. All nurses preferred to increase their direct care activities and significantly reduce their clerical activities. Factors related to the appropriate utilization of public sector psychiatric nurses are analyzed.
Research Interests: Psychology, Mental Health, Organizational Commitment, Job Satisfaction, Public sector, and 15 moreNursing Process, Humans, Public Health Administration, United States, Psychiatric Nursing, Mental Disorders, Public Health Nursing, Clinical Sciences, Middle Aged, Questionnaires, Professional Autonomy, Adult, Specific Activity, Nursing staff, and Job Description
There are few reports from the behavioral health field that focus on educational best practices. This article summarizes a panel presentation from the Annapolis Conference in which four different programs were described: (1) a provider... more
There are few reports from the behavioral health field that focus on educational best practices. This article summarizes a panel presentation from the Annapolis Conference in which four different programs were described: (1) a provider educational initiative, (2) a tool-kit project related to evidence-based services, (3) a multidisciplinary faculty training program in addictions, and (4) an AIDS education project. While such innovative educational practices appear to be the exception rather than the norm, they do offer ideas and strategies for challenging and energizing current educational practices in behavioral health.
Research Interests: Psychology, Community-Based Mental Health Services, Quality of Mental Health Care, Behavioral Medicine, Benchmarking, and 12 moreHumans, Best practice, United States, Mental Disorders, Clinical Sciences, Educational Models, Public health systems and services research, Training Program, Community Based Mental Health Services, Substance-Related Disorders, Acquired immunodeficiency syndrome, and Quality of health care
Advances in technology can have direct and indirect benefits to clinical practice. The challenge that clinicians face is to properly match resources and outcomes, along with patient preferences. This article explores the use of an... more
Advances in technology can have direct and indirect benefits to clinical practice. The challenge that clinicians face is to properly match resources and outcomes, along with patient preferences. This article explores the use of an innovative interactive voice response system to increase patient compliance with antidepressant medication prescribed in primary care settings. The development of the interactive voice response system, its implementation, and clinical outcomes are described. The findings underscore the need to carefully match intervention strategies with the needs of specific patient populations, and the importance of human dialog in the context of healing.
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The mental health and addiction workforce has long been plagued by shortages, high turnover, a lack of diversity, and concerns about its effectiveness. This article presents a framework to guide workforce policy and practice, emphasizing... more
The mental health and addiction workforce has long been plagued by shortages, high turnover, a lack of diversity, and concerns about its effectiveness. This article presents a framework to guide workforce policy and practice, emphasizing the need to train other health care providers as well as individuals in recovery to address behavioral health needs; strengthen recruitment, retention, and training of specialist behavioral health providers; and improve the financial and technical assistance infrastructure to better support and sustain the workforce. The pressing challenge is to scale up existing plans and strategies and to implement them in ways that have a meaningful impact on the size and effectiveness of the workforce. The aging and increasing diversity of the US population, combined with the expanded access to services that will be created by health reform, make it imperative to take immediate action.
Research Interests: Demography, Health Policy, Applied Economics, Policy making, Health Care reform, and 10 moreHumans, Federal Government, Personnel Selection, United States, Mental Disorders, Mental health services, Public health systems and services research, Professional Competence, Substance-Related Disorders, and Health affairs
1. A part of the commitment to holistic nursing care is meeting the mental health needs of its clients. 2. There exists a great need to deal with both mental and physical problems in older persons. Moreover, geropsychiatry is greatly... more
1. A part of the commitment to holistic nursing care is meeting the mental health needs of its clients. 2. There exists a great need to deal with both mental and physical problems in older persons. Moreover, geropsychiatry is greatly lacking in the policy and practice of nursing education. 3. Graduate-level courses must focus on both mental health promotion and disease prevention, particularly for the older persons who are consumers.
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Across all sectors of the behavioral health field there has been growing concern about a workforce crisis. Difficulties encompass the recruitment and retention of staff and the delivery of accessible and effective training in both... more
Across all sectors of the behavioral health field there has been growing concern about a workforce crisis. Difficulties encompass the recruitment and retention of staff and the delivery of accessible and effective training in both initial, preservice training and continuing education settings. Concern about the crisis led to a multiphased, cross-sector collaboration known as the Annapolis Coalition on the Behavioral Health Workforce. With support from the Substance Abuse and Mental Health Services Administration, this public-private partnership crafted An Action Plan for Behavioral Health Workforce Development. Created with input from a dozen expert panels, the action plan outlines seven core strategic goals that are relevant to all sectors of the behavioral health field: expand the role of consumers and their families in the workforce, expand the role of communities in promoting behavioral health and wellness, use systematic recruitment and retention strategies, improve training an...
Research Interests: Mental Health, Leadership, Public Health, Health Services Research, Health Policy, and 15 moreComorbidity, Policy making, Humans, Child, Partnership, Personnel Selection, Mental Disorders, Mental health services, Action Plan, Adult, Private Sector, Psychiatric Services, Patient Participation, Psychiatric, and Professional Competence
Much of the behavioral health care delivered to people with serious mental illnesses and chronic addictive disorders is provided by front-line or direct service mental health workers. Issues related to the qualifications, training, and... more
Much of the behavioral health care delivered to people with serious mental illnesses and chronic addictive disorders is provided by front-line or direct service mental health workers. Issues related to the qualifications, training, and ongoing evaluation of the competencies of this important provider group have received scant attention in the behavioral health field. This paper explores the educational needs and best practices of the consumers and families who carry much of the burden of caring for disabled populations, as well as the front-line staff, many of whom are employed in state psychiatric hospitals and community mental health or addiction treatment systems. Within the overall context of culturally competent behavioral health care, specific recommendations are proposed in an attempt to move the field forward.
Research Interests: Psychology, Mental Health, Health Care, Cultural Competence, Health Education, and 15 morePublic sector, Humans, Best practice, United States, Addiction Treatment, Training and Education, Mental Disorders, Caregivers, Clinical Sciences, Serious Mental Illness, Adult, Public health systems and services research, Consumer Advocacy, Substance-Related Disorders, and Allied Health Personnel
Practice guidelines have proliferated in mental health and addiction services; more than 40 organizations have developed guidelines in the field. However, much confusion, controversy, and contextual issues remain, particularly regarding... more
Practice guidelines have proliferated in mental health and addiction services; more than 40 organizations have developed guidelines in the field. However, much confusion, controversy, and contextual issues remain, particularly regarding effective dissemination and the clinical, financial, political, and ethical issues that emerge when evidence-based behavioral health practice guidelines are implemented in systems of care. The American College of Mental Health Administration (ACMHA) focused on these problems in their 1999 and 2000 Santa Fe Summits and produced a number of specific outcomes that contribute to thinking in the field. These include the following: (a) a taxonomy of building blocks for informed decision-making in behavioral health assessment and treatment; (b) a paradigm for the development of practice guidelines; (c) characteristics of a good practice guideline; (d) strategies for disseminating and implementing practice guidelines; and (e) areas in need of future research.
Research Interests: Psychology, Algorithms, Decision Making, Mental Health, Evidence Based Medicine, and 11 moreEvidence Based Practice, Humans, Best practice, United States, Mental Disorders, Mental health services, Clinical Sciences, Public health systems and services research, Ethical Issues, Good Practice, and Substance-Related Disorders
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Research Interests: Psychiatry, Typology, Mental Health, Methodology, Evidence Based Medicine, and 13 moreEvidence Based Practice, Treatment, Public Health, Teaching, Curriculum, Humans, Mental Disorders, Social Environment, Mental health services, Mentors, Psychiatric Clinics of North America, Psychology and Cognitive Sciences, and Medical and Health Sciences
The mental health system is inefficient and ineffective in providing behavioral health care services to the 1 in 4 Americans who have a mental illness or a substance abuse problem. Current health care reform initiatives present a... more
The mental health system is inefficient and ineffective in providing behavioral health care services to the 1 in 4 Americans who have a mental illness or a substance abuse problem. Current health care reform initiatives present a significant opportunity for advanced practice psychiatric nurses-psychiatric mental health (APRN-PMH) to develop action-oriented recommendations for developing their workforce and thereby increasing access to high-quality and full-spectrum behavioral health care services. If endorsed by the professional nursing associations and the APRN-PMH workforce, the strategies presented in this paper provide a blueprint for developing the APRN-PMH workforce. Achieving these goals will significantly reform the APRN-PMH workforce, thereby contributing to the overall goal of supporting an integrated model of behavioral health care. No change has as much potential to influence the APRN-PMH workforce as the uniting of all APRN-PMHs in a "Blueprint for APRN-PMH Workforce Development."
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There is growing evidence that physical health problems are caused and exacerbated by psychological factors. Research indicates that psychological distress leads to physical disease through impairment of the neuroendocrine system and its... more
There is growing evidence that physical health problems are caused and exacerbated by psychological factors. Research indicates that psychological distress leads to physical disease through impairment of the neuroendocrine system and its interface with the body's immune response. However, the current health care delivery system splinters care into "psychiatric" and "physical" health silos. New approaches are needed to assure adequate professional knowledge of behavioral health at basic licensure, to increase the use of advanced practice psychiatric-mental health nurses in primary care settings, to identify and teach behavioral competencies for primary care providers, and to fund the design and evaluation of integrative models of care.
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The most desirable basis to substantiate clinical practice is the evidence of well-established research findings. Developing evidence-based care involves defining the clinical question, finding the evidence, analyzing the evidence, using... more
The most desirable basis to substantiate clinical practice is the evidence of well-established research findings. Developing evidence-based care involves defining the clinical question, finding the evidence, analyzing the evidence, using the evidence, and evaluating the outcome. Practice guidelines and clinical algorithms are useful tools for applying research findings in a practical way. Other mental health professionals are actively incorporating an