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Dang L, Ananthasubramaniam A, Mezuk B. Spotlight on the Challenges of Depression following Retirement and Opportunities for Interventions. Clin Interv Aging 2022; 17:1037-1056. [PMID: 35855744 PMCID: PMC9288177 DOI: 10.2147/cia.s336301] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/14/2022] [Indexed: 12/02/2022] Open
Abstract
As a major life transition characterized by changes in social, behavioral, and psychological domains, retirement is associated with numerous risk factors that can contribute to the development of depression in later life. Understanding how these risk factors intersect with overall health and functioning can inform opportunities for mental health promotion during this transition. The objective of this review is to summarize the literature on risk and protective factors for depression during retirement transitions, discuss challenges related to appropriate management of depression in later life, and describe opportunities for prevention and intervention for depression relating to retirement transitions, both within and beyond the health care system. Key implications from this review are that 1) the relationship between depression and retirement is multifaceted; 2) while depression is a common health condition among older adults, this syndrome should not be considered a normative part of aging or of retirement specifically; 3) the existing mental health specialty workforce is insufficient to meet the depression management needs of the aging population, and 4) therefore, there is a need for interprofessional and multidisciplinary intervention efforts for preventing and managing depression among older adults. In sum, both healthcare providers, public health practitioners, and community organizations have meaningful opportunities for promoting the mental health of older adults during such major life transitions.
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Affiliation(s)
- Linh Dang
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Briana Mezuk
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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2
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Guo J, Wang H, Ge L, Valimaki M, Wiley J, Whittemore R. Effectiveness of a nurse-led mindfulness stress-reduction intervention on diabetes distress, diabetes self-management, and HbA1c levels among people with type 2 diabetes: A pilot randomized controlled trial. Res Nurs Health 2021; 45:46-58. [PMID: 34741544 DOI: 10.1002/nur.22195] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/05/2021] [Accepted: 10/24/2021] [Indexed: 11/09/2022]
Abstract
People with diabetes frequently have elevated diabetes distress. Although mindfulness-based stress reduction (MBSR) therapy has been shown effective in reducing diabetes distress, it has only been delivered by psychologists or a multidisciplinary team with an attrition rate of up to 39%, which limits its dissemination to a broader audience. This study was aimed to pilot evaluate the feasibility of a nurse-led MBSR therapy and explore its potential efficacy amongst people with type 2 diabetes mellitus. A total of 100 participants were randomly allocated either to the intervention group (nurse-led MBSR therapy + regular diabetes education) or the control group (regular diabetes education). Data on diabetes distress, diabetes self-efficacy, and diabetes self-management were collected at baseline, 8 and 12 weeks. Hemoglobin A1c (HbA1c) was collected at baseline and 12 weeks. A generalized estimating equation analysis for repeated measures was used to determine intervention and time effects. As predicted, the nurse-led MBSR therapy had a significant time-by-group interaction effect on diabetes distress total score (95% confidence interval [CI]: 0.58-0.77, p < 0.001), diabetes self-efficacy (95% CI: -0.93 to -0.74, p < 0.001), diabetes self-management (95% CI: -10.80 to -7.83, p < 0.001), and HbA1c levels (95% CI: 0.04-1.14, p = 0.03) in the intervention group compared with the control group over 12 weeks. This is the first nurse-led MBSR therapy in a hospital setting that is feasible and has the potential to improve health outcomes. This approach may offer an innovative model to deliver MBSR therapy. A randomized controlled trial comparing the nurse-led MBSR plus usual diabetes education with usual diabetes education along with a mechanism to equalize intervention attention between the groups is indicated.
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Affiliation(s)
- Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hongjuan Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Lin Ge
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China.,Department of endocrinology, The Second People's Hospital of Hunan Province, Changsha, Hunan, China
| | - Maritta Valimaki
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - James Wiley
- Department of Family and Community Medicine, Institute for Health Policy Research, University of California, San Francisco, California, USA
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The internationally present perpetual policy themes inhibiting development of the nurse practitioner role in the primary care context: An Australian–USA comparison. Collegian 2017. [DOI: 10.1016/j.colegn.2016.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Nihart MA. Transformative Leadership in Action. J Am Psychiatr Nurses Assoc 2016; 22:411-2. [PMID: 27637988 DOI: 10.1177/1078390316658866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mary Ann Nihart
- Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC, American Psychiatric Nurses Association, Falls Church, VA, USA
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5
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Nihart MA. A Challenge for Leadership: Elevating Awareness Versus Tolerating Ignorance. J Am Psychiatr Nurses Assoc 2016; 22:242-4. [PMID: 27185654 DOI: 10.1177/1078390316646718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Mary Ann Nihart
- Mary Ann Nihart, MA, APRN, PMHCNS-BC, PMHNP-BC, American Psychiatric Nurses Association, Falls Church, VA, USA
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6
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Theophilos T, Green R, Cashin A. Nurse Practitioner Mental Health Care in the Primary Context: A Californian Case Study. Healthcare (Basel) 2015; 3:162-71. [PMID: 27417754 PMCID: PMC4934530 DOI: 10.3390/healthcare3010162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/10/2015] [Indexed: 11/22/2022] Open
Abstract
In America, mental health needs surpass the availability of specialized providers. This vulnerable population also has other obstacles for comprehensive care including gaps in medical coverage, stigma, economic barriers, and a geographical mal-distribution of qualified mental health professionals. A wide availability of primary care providers, including primary care and family nurse practitioners, are well-positioned to deliver integrated mental and physical health care. A case study from a Southern California Coachella Valley primary care clinic with integrated services is used to demonstrate the much-needed approach of care to address health disparities that face low-income immigrants, migrant workers, and others without access to specialized care centers and providers. It is argued that mental health care should be part of all holistic treatment provided by primary care and family nurse practitioners. This has implications for curricula and practice development.
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Affiliation(s)
- Theane Theophilos
- School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW 2480, Australia.
| | - Roger Green
- College of Health, Human Services, and Nursing, California State University Dominguez Hills, 1000 East Victoria Street, Carson, CA 90747, USA.
| | - Andrew Cashin
- School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW 2480, Australia.
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7
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McDougall GJ. The 2013 Doris Schwartz Gerontological Nursing Research Award: Eileen M. Sullivan-Marx, PhD, CRNP, RN, FAAN. J Gerontol Nurs 2014; 40:7-9. [PMID: 25275779 DOI: 10.3928/00989134-20140830-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Delaney C, Barrere C. Advanced practice nursing students' knowledge, self-efficacy, and attitudes related to depression in older adults: teaching holistic depression care. Holist Nurs Pract 2012; 26:210-20. [PMID: 22694866 DOI: 10.1097/hnp.0b013e31825852aa] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to examine the knowledge, attitudes, and self-efficacy of advanced practice nursing students toward depression in older adults. Findings suggest that advanced practice nursing students are interested in caring for the whole person and desired more information on the physical and emotional-spiritual needs of older patients with depression. Suggestions for holistic nursing depression care education are presented.
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Affiliation(s)
- Colleen Delaney
- University of Connecticut School of Nursing, Storrs, Connecticut 06269, USA.
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Hanrahan NP, Delaney KR, Stuart GW. Blueprint for development of the advanced practice psychiatric nurse workforce. Nurs Outlook 2012; 60:91-104. [DOI: 10.1016/j.outlook.2011.04.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 04/06/2011] [Accepted: 04/13/2011] [Indexed: 11/30/2022]
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Molina D, Tingle LE, Lu X. Aripiprazole as the causative agent of neuroleptic malignant syndrome: a case report. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2011; 9:148-50. [PMID: 17607339 PMCID: PMC1896300 DOI: 10.4088/pcc.v09n0211b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hanrahan NP, Delaney K, Merwin E. Health care reform and the federal transformation initiatives: capitalizing on the potential of advanced practice psychiatric nurses. Policy Polit Nurs Pract 2010; 11:235-44. [PMID: 21233135 PMCID: PMC3392024 DOI: 10.1177/1527154410390381] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In the last decade the US federal government proposed a transformation vision of mental health service delivery; patient-centered, evidence-based and recovery oriented treatment models. Health care reform brings additional expectations for innovation in mental/substance use service delivery, particularly the idea of creating systems where physical health, mental health and substance use treatment is fully integrated. Psychiatric nurses, as one of the four core US mental health professions, have the potential to play a significant role in the both the transformation initiative and health care reform vision. However, psychiatric nurses, particularly advanced practice psychiatric nurses, are an untapped resource due in part to significant state regulatory barriers that limit their scope of practice in many states. The purpose of this paper is to document what is currently known about advanced practice psychiatric nurses and discuss policy implications for tapping into the strengths of this workforce. Strategies for facilitating utilization of advanced practice psychiatric nurses discussed.
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Affiliation(s)
- Nancy P Hanrahan
- University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104, USA.
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Bourbonniere M, Mezey M, Mitty EL, Burger S, Bonner A, Bowers B, Burl JB, Carter D, Dimant J, Jerro SA, Reinhard SC, Ter Maat M, Nicholson NR. Expanding the knowledge base of resident and facility outcomes of care delivered by advanced practice nurses in long-term care: expert panel recommendations. Policy Polit Nurs Pract 2009; 10:64-70. [PMID: 19383619 DOI: 10.1177/1527154409332289] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In 2003, a panel of nationally recognized experts in geriatric practice, education, research, public policy, and long-term care convened to examine and make recommendations about care quality and safety issues related to advanced practice nurses (APNs) in nursing home practice. This article reports on the panel recommendation that addressed expanding the evidence base of resident and facility outcomes of APN nursing home practice. A review of the small but important body of research related to nursing home APN practice suggests a positive impact on resident care and facility outcomes. Recommendations are made for critically needed research in four key areas: (a) APN nursing home practice, (b) relative value unit coding, (c) outcomes related to geropsychiatric and mental health nursing services, and (d) outcomes related to geriatric specialization. The APN role could be significantly enhanced and executed if its specific contribution to resident and facility outcomes was more clearly delineated through the recommended rigorous research.
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Baker TB, McFall RM, Shoham V. Current Status and Future Prospects of Clinical Psychology: Toward a Scientifically Principled Approach to Mental and Behavioral Health Care. Psychol Sci Public Interest 2008; 9:67-103. [PMID: 20865146 PMCID: PMC2943397 DOI: 10.1111/j.1539-6053.2009.01036.x] [Citation(s) in RCA: 195] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The escalating costs of health care and other recent trends have made health care decisions of great societal import, with decision-making responsibility often being transferred from practitioners to health economists, health plans, and insurers. Health care decision making increasingly is guided by evidence that a treatment is efficacious, effective-disseminable, cost-effective, and scientifically plausible. Under these conditions of heightened cost concerns and institutional-economic decision making, psychologists are losing the opportunity to play a leadership role in mental and behavioral health care: Other types of practitioners are providing an increasing proportion of delivered treatment, and the use of psychiatric medication has increased dramatically relative to the provision of psychological interventions. Research has shown that numerous psychological interventions are efficacious, effective, and cost-effective. However, these interventions are used infrequently with patients who would benefit from them, in part because clinical psychologists have not made a convincing case for the use of these interventions (e.g., by supplying the data that decision makers need to support implementation of such interventions) and because clinical psychologists do not themselves use these interventions even when given the opportunity to do so. Clinical psychologists' failure to achieve a more significant impact on clinical and public health may be traced to their deep ambivalence about the role of science and their lack of adequate science training, which leads them to value personal clinical experience over research evidence, use assessment practices that have dubious psychometric support, and not use the interventions for which there is the strongest evidence of efficacy. Clinical psychology resembles medicine at a point in its history when practitioners were operating in a largely prescientific manner. Prior to the scientific reform of medicine in the early 1900s, physicians typically shared the attitudes of many of today's clinical psychologists, such as valuing personal experience over scientific research. Medicine was reformed, in large part, by a principled effort by the American Medical Association to increase the science base of medical school education. Substantial evidence shows that many clinical psychology doctoral training programs, especially PsyD and for-profit programs, do not uphold high standards for graduate admission, have high student-faculty ratios, deemphasize science in their training, and produce students who fail to apply or generate scientific knowledge. A promising strategy for improving the quality and clinical and public health impact of clinical psychology is through a new accreditation system that demands high-quality science training as a central feature of doctoral training in clinical psychology. Just as strengthening training standards in medicine markedly enhanced the quality of health care, improved training standards in clinical psychology will enhance health and mental health care. Such a system will (a) allow the public and employers to identify scientifically trained psychologists; (b) stigmatize ascientific training programs and practitioners; (c) produce aspirational effects, thereby enhancing training quality generally; and (d) help accredited programs improve their training in the application and generation of science. These effects should enhance the generation, application, and dissemination of experimentally supported interventions, thereby improving clinical and public health. Experimentally based treatments not only are highly effective but also are cost-effective relative to other interventions; therefore, they could help control spiraling health care costs. The new Psychological Clinical Science Accreditation System (PCSAS) is intended to accredit clinical psychology training programs that offer high-quality science-centered education and training, producing graduates who are successful in generating and applying scientific knowledge. Psychologists, universities, and other stakeholders should vigorously support this new accreditation system as the surest route to a scientifically principled clinical psychology that can powerfully benefit clinical and public health.
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Delaney KR. Depiction of psychiatric nursing in federal reports: the good news and the bad news. Arch Psychiatr Nurs 2008; 22:104-6. [PMID: 18346567 DOI: 10.1016/j.apnu.2007.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Kathleen R Delaney
- Rush College of Nursing, Child Inpatient Unit, Rush University Medical Center, Chicago, IL 60612, USA.
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Graduate education in geropsychiatric nursing: findings from a national survey. Nurs Outlook 2008; 55:303-10. [PMID: 18061015 DOI: 10.1016/j.outlook.2007.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2006] [Indexed: 11/22/2022]
Abstract
By 2030, the numbers of older adults with mental illness will strain our health care system. Sufficient advanced practice nurses (APNs) with specialized knowledge to provide care will be critical. All 339 graduate nursing programs in the US were surveyed regarding the extent and nature of geropsychiatric nursing (GPN) content in their curricula. Of 206 schools responding, 15 reported having a GPN subspecialty. Regarding the 60 schools with a psychiatric/mental health nursing (PMHN) graduate program, only one third (n = 23) included some GPN content, while more than half (n = 116) of all schools reported integration of GPN content in a non-psychiatric nurse practitioner program. Thus, currently, the greatest numbers of APNs receiving education on mental health needs of older adults are prepared in non-psychiatric nurse practitioner programs. This article discusses the implications for nursing education and practice.
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Abstract
Community mental health nurses practice in a range of behavioral health care settings, including community mental health centers, detoxification centers, group homes for individuals with mental retardation or serious mental illnesses, and residential substance abuse treatment programs. As the population for whom they care grows and ages and with an increase in comorbid conditions, different skills may be needed or different roles may require emphasis. This can present challenges related to role competencies and nursing preparation and to the allocation of their time. The overall purposes of this project were to compare the competencies of basic and advanced practice nurses with accepted psychiatric-mental health nursing competencies and to assess the nurses' roles and division of work time among various roles. The findings support the need for changes related to nursing roles and job descriptions. Specific recommendations have been implemented based on the findings.
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Affiliation(s)
- Mary W Kudless
- Fairfax-Falls Church Community Services Board, Fairfax, Virginia 22035, USA.
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Delaney KR, Hanrahan NP, Merwin EI. Using data to increase the national presence of psychiatric mental health nursing. Arch Psychiatr Nurs 2007; 21:112-5. [PMID: 17397693 DOI: 10.1016/j.apnu.2006.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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