Person-centered older military veteran care when there are consequences

Veteran Competencies in Nursing Textbooks: Implications for Educators

AIM

The aim of this study was to examine the adequacy of military/veteran-related content in nursing textbooks used in prelicensure programs.

BACKGROUND

With increased numbers of veterans receiving care in civilian settings, nurses may lack essential knowledge, skills, and attitudes outlined in competencies required to provide culturally sensitive veteran-centered care. One explanation for this may be inadequate preparation during prelicensure nursing education.

METHOD

A quantitative, descriptive study guided the analysis and rating of 32 key words in 24 textbooks across eight content areas.

RESULTS

Key words were included in most textbooks but frequently not connected to military service or veterans. The key word with the highest mean rating was posttraumatic stress disorder; the highest rated content area was psychiatric/mental health.

CONCLUSION

With limited textbook resources, nurse faculty must engage in deliberate efforts to include veteran content in nursing curricula. As competency-based education trends evolve, these findings are relevant and should be considered in curricular design and revision.

Innovating Parkinson's Care: A Randomized Controlled Trial of Telemedicine Depression Treatment

BACKGROUND

For several decades, a myriad of factors have contributed to the inadequate diagnosis and management of depression in Parkinson's disease (PD), leaving up to 60% of significantly symptomatic patients untreated. Poor access to evidence-based neuropsychiatric care is one major barrier to achieving optimal Parkinson's outcomes.

OBJECTIVE

The goal of this study was to compare the efficacy of individual Parkinson's-informed, video-to-home cognitive-behavioral therapy (experimental group), to clinic-based treatment as usual (control group), for depression in PD.

METHOD

Ninety United States military veterans with clinical diagnoses of both depression and PD were computer-randomized (1:1) to either the experimental or control group; randomization was stratified by baseline antidepressant use and blind to all other baseline data. The acute treatment period spanned 10 weeks and was followed by a 6-month extension phase. The Hamilton Depression Rating Scale was the a priori primary outcome. Depression treatment response was defined as a score ≤2 on the Clinical Global Impression Improvement Scale. All statistical analyses were intent to treat.

RESULTS

Video-to-home cognitive-behavioral therapy outperformed clinic-based treatment as usual across three separate depression measures (P < 0.001). Effects were observed at the end of acute treatment and maintained through 6-month follow-up. Number needed to treat (based on treatment response classification) was 2.5 with an absolute risk reduction of 40%.

CONCLUSION

Video-to-home cognitive-behavioral therapy may be an effective intervention to bypass access barriers to specialized, evidence-based depression care in PD and to address the unmet neuropsychiatric treatment needs of the Parkinson's community. © 2021 International Parkinson and Movement Disorder Society.