Weight-loss maintenance is widely accepted to be a difficult and often elusive process. The trans... more Weight-loss maintenance is widely accepted to be a difficult and often elusive process. The transtheoretical model (TTM) provides a useful description of five stages of change. Applied to weight management, weight loss occurs during the action stage and weight-loss maintenance occurs during the maintenance stage. Despite its broad utility, the TTM does not adequately explain the complexity involved with a shift from action to maintenance. Based on Engel's (G. L. Engel, 1977, The need for a new medical model: A challenge for biomedicine, Science, Vol. 196, pp. 129-136) biopsychosocial model and family systems theory, a shifting processes model is proposed to describe the potential differences and shift that occurs between weight loss and weight-loss maintenance processes within relational contexts.
Http Dx Doi Org 10 1080 01926180490255800, Aug 17, 2010
ABSTRACT The incidence of childhood sexual abuse (CSA) in the general population, as well as the ... more ABSTRACT The incidence of childhood sexual abuse (CSA) in the general population, as well as the greater prevalence of CSA survivors among those who enter therapy, mean that therapists are likely to treat sexual abuse survivors in their clinical work. A modified Delphi study was used to collect data to determine how American Association of Marriage and Family Therapy (AAMFT) Approved Supervisors make treatment decisions following client disclosures of CSA. Three rounds of data were collected. The results suggested that there are several issues to address in therapy regardless of treatment modality and disclosure type. Suggestions for treatment were provided depending on the disclosure scenario.
Patients who present with medically unexplained illnesses or medically unexplained symptoms (MUI/... more Patients who present with medically unexplained illnesses or medically unexplained symptoms (MUI/S) tend to be higher utilizers of health care services and have significantly greater health care costs than other patients, which add stress and strain for both the patient and provider. Although MUI/S are commonly seen in primary care, there is not sufficient information available regarding how providers can increase their level of confidence and decrease their level of frustration when working with patients who present with MUI/S. The goal of this article is to present findings from a qualitative phenomenology study, which highlights medical residents' experiences of caring for patients with MUI/S and the personal and professional factors that contributed to their clinical approaches. Results from these studies indicate that residents often experience a lack of confidence in their ability to effectively treat patients with MUI/S, as well as frustration surrounding their encounters...
Objective:Due to multiple issues, integrated interdisciplinary palliative care teams in a neonata... more Objective:Due to multiple issues, integrated interdisciplinary palliative care teams in a neonatal intensive care unit (NICU) may be difficult to access, sometimes fail to be implemented, or provide inconsistent or poorly coordinated care. When implementing an effective institution-specific neonatal palliative care program, it is critical to include stakeholders from the clinical, operational, and financial worlds of healthcare. In this study, researchers sought to gain a multidisciplinary perspective into issues that may impact the implementation of a formal neonatal palliative care program at a tertiary regional academic medical center.Method:In this focused ethnography, the primary researcher conducted semistructured interviews that explored the perspectives of healthcare administrators, finance officers, and clinicians about neonatal palliative care. The perspectives of 39 study participants informed the identification of institutional, financial, and clinical issues that impact the implementation of neonatal palliative care services at the medical center and the planning process for a formal palliative care program on behalf of neonates and their families.Results:Healthcare professionals described experiences that influenced their views on neonatal palliative care. Key themes included: (a) uniqueness of neonatal palliative care, (b) communication and conflict among providers, (c) policy and protocol discrepancies, and (d) lack of administrative support.Significance of results:The present study highlighted several areas that are challenging in the provision of neonatal palliative care. Our findings underscored the importance of recognizing and procuring resources needed simultaneously from the clinical, operational, and financial worlds in order to implement and sustain a successful neonatal palliative care program.
ABSTRACT This paper reviews and describes the use of 'virtual' (i.e., persons int... more ABSTRACT This paper reviews and describes the use of 'virtual' (i.e., persons interacting in different geographic locations) technologies in clinical supervision. First, a rationale for using such technologies as a tool for doing clinical supervision is presented. Second, a review and description of available technological resources is offered. These include: e-mail, computer-mediated communication, videoconferencing, Internet or World Wide Web, and WebTV. Third, some of the settings that have utilized such technological resources in conducting clinical supervision (i.e., psychiatry, medicine, education) and therapy are reviewed. Ethical issues in using these technologies and implications for supervision are explored. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Page 1. Satisfaction with Life and Psychosocial Factors among Underserved Minorities with Type 2 ... more Page 1. Satisfaction with Life and Psychosocial Factors among Underserved Minorities with Type 2 Diabetes Kenneth W. Phelps • Jennifer L. Hodgson • Angela L. Lamson • Melvin S. Swanson • Mark B. White Accepted: 6 February ...
ABSTRACT Parenting measures have been used most commonly for research and clinical evaluation, wi... more ABSTRACT Parenting measures have been used most commonly for research and clinical evaluation, with little practical application for parent self-evaluation and education. To help parents assess their parenting strengths and skills and be better directed in their information seeking the Parent Self-evaluation Instrument was developed. The framework and dimensions of this scale are based on the National Extension Parent Education Model. A panel of 23 parenting experts reviewed the scale for content validity. Evaluations of the scales' validity were consistently high.
The primary aim for this research was to explore the overlap and differences between the concepts... more The primary aim for this research was to explore the overlap and differences between the concepts related to secondary traumatization: posttraumatic stress disorder (PTSD), secondary traumatic stress (STS), compassion fatigue (CF), and burnout (BRN). A secondary aim for this research was to examine the impact of secondary traumatization and some of the personal and professional elements that affect how pediatric healthcare providers experience PTSD, STS, CF, and BRN. An online survey was sent via e-mail to numerous list serves for healthcare providers who had worked on PICU, NICU, or PEDS units within the last year. The analyses revealed that a significant overlap existed between the terms of STS, PTSD, BRN, CS, and CF for PICU, NICU, and PEDS providers. However, a hierarchical linear regression revealed a significant amount of unique contributions to the variance in CF based on each of the measured concepts. Despite previous literature that indicates that the terms STS and CF can b...
With the Journal of Veterinary Medical Education&... more With the Journal of Veterinary Medical Education's recent summer 2005 theme issue on stress, the mental-health concerns of veterinary medical students has been brought to the forefront of the field. Since it is anticipated that research on this topic will continue and that educational institutions may implement changes based upon these results, it is of the utmost importance that this research be of the highest quality. Of particular concern with human-subject inquiries are response rates and confidentiality. In order to accommodate these concerns, an example of a survey research protocol that promotes high response rates and minimizes threats to internal validity influenced by student mistrust in assurances of confidentiality is presented. Specifically, the protocol is designed to ensure anonymity and to preserve the ability to track students longitudinally through the use of anonymous longitudinal identifiers. This protocol was tested with the first-year class of veterinary medical students at Kansas State University in October 2004 and March 2005. The two data collection periods yielded 90% and 76% response rates, respectively. The matching rate of participants, according to the anonymous longitudinal identifiers from Time 1 to Time 2, was 88%.
The present study evaluated the impact of academic and non-academic stressors on depression level... more The present study evaluated the impact of academic and non-academic stressors on depression levels in a longitudinal investigation of 78 first-year veterinary medical students enrolled at Kansas State University (KSU). Students completed the Center for Epidemiological Studies Depression Scale during their first and second semesters to evaluate the dependent variable, depression. Students provided information about specific stressors and relevant demographic variables that yielded independent variables. One-third of veterinary medical students surveyed in their first and second semesters reported depression levels above the clinical cut-off; 15% of the sample experienced an increase in depression of at least one standard deviation, despite the apparent stability of the proportion of students experiencing significant depressive symptoms. Students whose depression scores increased by one standard deviation or who maintained scores above the clinical cut-off score were identified as str...
Historically, veterinary medical students&amp... more Historically, veterinary medical students' mental health has rarely been investigated, but recently there has been renewed interest in this topic. The present study evaluated depression and anxiety levels in a cross-sectional investigation of 93 first-year veterinary medical students enrolled at Kansas State University (KSU). During their first semester, students completed the Center for Epidemiological Studies Depression Scale (CES-D) and the Mental Health Inventory's Anxiety Scale (MHI-A). Results indicate that 32% of these first-year KSU veterinary students were experiencing clinical levels of depressive symptoms. Additionally, students reported elevated anxiety scores. Predictors of depression and anxiety levels include homesickness, physical health, and unclear instructor expectations. Areas of intervention with a focus on improving veterinary medical student well-being are discussed.
... My wife Laura was spending a lot of time with the baby when Jennifer was approaching two. ...... more ... My wife Laura was spending a lot of time with the baby when Jennifer was approaching two. ... Laura couldn't do the same thing that I could do, maybe because of my size, but I always felt from a very young age, that we had a bit of a bond. (Matt) ...
This literature review offers a response to the current paediatric palliative care literature tha... more This literature review offers a response to the current paediatric palliative care literature that will punctuate the need for a framework (i.e. the three world view) that can serve as an evaluative lens for nurse managers who are in the planning or evaluative stages of paediatric palliative care programmes. The complexities in providing paediatric palliative care extend beyond clinical practices to operational policies and financial barriers that exist in the continuum of services for patients. This article offers a review of the literature and a framework in order to view best clinical practices, operational/policy standards and financial feasibility when considering the development and sustainability of paediatric palliative care programmes. Fifty-four articles were selected as representative of the current state of the literature as it pertains to the three world view (i.e. clinical, operational and financial factors) involved in providing paediatric palliative care. In developing efficient paediatric palliative care services, clinical, operational and financial resources and barriers need to be identified and addressed. Nursing management plays a crucial role in addressing the clinical, operational and financial needs and concerns that are grounded in paediatric palliative care literature.
Weight-loss maintenance is widely accepted to be a difficult and often elusive process. The trans... more Weight-loss maintenance is widely accepted to be a difficult and often elusive process. The transtheoretical model (TTM) provides a useful description of five stages of change. Applied to weight management, weight loss occurs during the action stage and weight-loss maintenance occurs during the maintenance stage. Despite its broad utility, the TTM does not adequately explain the complexity involved with a shift from action to maintenance. Based on Engel's (G. L. Engel, 1977, The need for a new medical model: A challenge for biomedicine, Science, Vol. 196, pp. 129-136) biopsychosocial model and family systems theory, a shifting processes model is proposed to describe the potential differences and shift that occurs between weight loss and weight-loss maintenance processes within relational contexts.
Http Dx Doi Org 10 1080 01926180490255800, Aug 17, 2010
ABSTRACT The incidence of childhood sexual abuse (CSA) in the general population, as well as the ... more ABSTRACT The incidence of childhood sexual abuse (CSA) in the general population, as well as the greater prevalence of CSA survivors among those who enter therapy, mean that therapists are likely to treat sexual abuse survivors in their clinical work. A modified Delphi study was used to collect data to determine how American Association of Marriage and Family Therapy (AAMFT) Approved Supervisors make treatment decisions following client disclosures of CSA. Three rounds of data were collected. The results suggested that there are several issues to address in therapy regardless of treatment modality and disclosure type. Suggestions for treatment were provided depending on the disclosure scenario.
Patients who present with medically unexplained illnesses or medically unexplained symptoms (MUI/... more Patients who present with medically unexplained illnesses or medically unexplained symptoms (MUI/S) tend to be higher utilizers of health care services and have significantly greater health care costs than other patients, which add stress and strain for both the patient and provider. Although MUI/S are commonly seen in primary care, there is not sufficient information available regarding how providers can increase their level of confidence and decrease their level of frustration when working with patients who present with MUI/S. The goal of this article is to present findings from a qualitative phenomenology study, which highlights medical residents' experiences of caring for patients with MUI/S and the personal and professional factors that contributed to their clinical approaches. Results from these studies indicate that residents often experience a lack of confidence in their ability to effectively treat patients with MUI/S, as well as frustration surrounding their encounters...
Objective:Due to multiple issues, integrated interdisciplinary palliative care teams in a neonata... more Objective:Due to multiple issues, integrated interdisciplinary palliative care teams in a neonatal intensive care unit (NICU) may be difficult to access, sometimes fail to be implemented, or provide inconsistent or poorly coordinated care. When implementing an effective institution-specific neonatal palliative care program, it is critical to include stakeholders from the clinical, operational, and financial worlds of healthcare. In this study, researchers sought to gain a multidisciplinary perspective into issues that may impact the implementation of a formal neonatal palliative care program at a tertiary regional academic medical center.Method:In this focused ethnography, the primary researcher conducted semistructured interviews that explored the perspectives of healthcare administrators, finance officers, and clinicians about neonatal palliative care. The perspectives of 39 study participants informed the identification of institutional, financial, and clinical issues that impact the implementation of neonatal palliative care services at the medical center and the planning process for a formal palliative care program on behalf of neonates and their families.Results:Healthcare professionals described experiences that influenced their views on neonatal palliative care. Key themes included: (a) uniqueness of neonatal palliative care, (b) communication and conflict among providers, (c) policy and protocol discrepancies, and (d) lack of administrative support.Significance of results:The present study highlighted several areas that are challenging in the provision of neonatal palliative care. Our findings underscored the importance of recognizing and procuring resources needed simultaneously from the clinical, operational, and financial worlds in order to implement and sustain a successful neonatal palliative care program.
ABSTRACT This paper reviews and describes the use of 'virtual' (i.e., persons int... more ABSTRACT This paper reviews and describes the use of 'virtual' (i.e., persons interacting in different geographic locations) technologies in clinical supervision. First, a rationale for using such technologies as a tool for doing clinical supervision is presented. Second, a review and description of available technological resources is offered. These include: e-mail, computer-mediated communication, videoconferencing, Internet or World Wide Web, and WebTV. Third, some of the settings that have utilized such technological resources in conducting clinical supervision (i.e., psychiatry, medicine, education) and therapy are reviewed. Ethical issues in using these technologies and implications for supervision are explored. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Page 1. Satisfaction with Life and Psychosocial Factors among Underserved Minorities with Type 2 ... more Page 1. Satisfaction with Life and Psychosocial Factors among Underserved Minorities with Type 2 Diabetes Kenneth W. Phelps • Jennifer L. Hodgson • Angela L. Lamson • Melvin S. Swanson • Mark B. White Accepted: 6 February ...
ABSTRACT Parenting measures have been used most commonly for research and clinical evaluation, wi... more ABSTRACT Parenting measures have been used most commonly for research and clinical evaluation, with little practical application for parent self-evaluation and education. To help parents assess their parenting strengths and skills and be better directed in their information seeking the Parent Self-evaluation Instrument was developed. The framework and dimensions of this scale are based on the National Extension Parent Education Model. A panel of 23 parenting experts reviewed the scale for content validity. Evaluations of the scales' validity were consistently high.
The primary aim for this research was to explore the overlap and differences between the concepts... more The primary aim for this research was to explore the overlap and differences between the concepts related to secondary traumatization: posttraumatic stress disorder (PTSD), secondary traumatic stress (STS), compassion fatigue (CF), and burnout (BRN). A secondary aim for this research was to examine the impact of secondary traumatization and some of the personal and professional elements that affect how pediatric healthcare providers experience PTSD, STS, CF, and BRN. An online survey was sent via e-mail to numerous list serves for healthcare providers who had worked on PICU, NICU, or PEDS units within the last year. The analyses revealed that a significant overlap existed between the terms of STS, PTSD, BRN, CS, and CF for PICU, NICU, and PEDS providers. However, a hierarchical linear regression revealed a significant amount of unique contributions to the variance in CF based on each of the measured concepts. Despite previous literature that indicates that the terms STS and CF can b...
With the Journal of Veterinary Medical Education&... more With the Journal of Veterinary Medical Education's recent summer 2005 theme issue on stress, the mental-health concerns of veterinary medical students has been brought to the forefront of the field. Since it is anticipated that research on this topic will continue and that educational institutions may implement changes based upon these results, it is of the utmost importance that this research be of the highest quality. Of particular concern with human-subject inquiries are response rates and confidentiality. In order to accommodate these concerns, an example of a survey research protocol that promotes high response rates and minimizes threats to internal validity influenced by student mistrust in assurances of confidentiality is presented. Specifically, the protocol is designed to ensure anonymity and to preserve the ability to track students longitudinally through the use of anonymous longitudinal identifiers. This protocol was tested with the first-year class of veterinary medical students at Kansas State University in October 2004 and March 2005. The two data collection periods yielded 90% and 76% response rates, respectively. The matching rate of participants, according to the anonymous longitudinal identifiers from Time 1 to Time 2, was 88%.
The present study evaluated the impact of academic and non-academic stressors on depression level... more The present study evaluated the impact of academic and non-academic stressors on depression levels in a longitudinal investigation of 78 first-year veterinary medical students enrolled at Kansas State University (KSU). Students completed the Center for Epidemiological Studies Depression Scale during their first and second semesters to evaluate the dependent variable, depression. Students provided information about specific stressors and relevant demographic variables that yielded independent variables. One-third of veterinary medical students surveyed in their first and second semesters reported depression levels above the clinical cut-off; 15% of the sample experienced an increase in depression of at least one standard deviation, despite the apparent stability of the proportion of students experiencing significant depressive symptoms. Students whose depression scores increased by one standard deviation or who maintained scores above the clinical cut-off score were identified as str...
Historically, veterinary medical students&amp... more Historically, veterinary medical students' mental health has rarely been investigated, but recently there has been renewed interest in this topic. The present study evaluated depression and anxiety levels in a cross-sectional investigation of 93 first-year veterinary medical students enrolled at Kansas State University (KSU). During their first semester, students completed the Center for Epidemiological Studies Depression Scale (CES-D) and the Mental Health Inventory's Anxiety Scale (MHI-A). Results indicate that 32% of these first-year KSU veterinary students were experiencing clinical levels of depressive symptoms. Additionally, students reported elevated anxiety scores. Predictors of depression and anxiety levels include homesickness, physical health, and unclear instructor expectations. Areas of intervention with a focus on improving veterinary medical student well-being are discussed.
... My wife Laura was spending a lot of time with the baby when Jennifer was approaching two. ...... more ... My wife Laura was spending a lot of time with the baby when Jennifer was approaching two. ... Laura couldn't do the same thing that I could do, maybe because of my size, but I always felt from a very young age, that we had a bit of a bond. (Matt) ...
This literature review offers a response to the current paediatric palliative care literature tha... more This literature review offers a response to the current paediatric palliative care literature that will punctuate the need for a framework (i.e. the three world view) that can serve as an evaluative lens for nurse managers who are in the planning or evaluative stages of paediatric palliative care programmes. The complexities in providing paediatric palliative care extend beyond clinical practices to operational policies and financial barriers that exist in the continuum of services for patients. This article offers a review of the literature and a framework in order to view best clinical practices, operational/policy standards and financial feasibility when considering the development and sustainability of paediatric palliative care programmes. Fifty-four articles were selected as representative of the current state of the literature as it pertains to the three world view (i.e. clinical, operational and financial factors) involved in providing paediatric palliative care. In developing efficient paediatric palliative care services, clinical, operational and financial resources and barriers need to be identified and addressed. Nursing management plays a crucial role in addressing the clinical, operational and financial needs and concerns that are grounded in paediatric palliative care literature.
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