The current study assessed critical psychometric properties of self-reports by 46 adolescents enrolled in an eight week-long Summer Treatment Program (STP). Self-report instruments included the IOWA Conners ratings scales, self-ratings of the quality of interactions with peers and STP staff, and daily global ratings about overall performance. Counselors, teachers, and parents also completed ratings. Other dependent variables included measures of academic performance and direct observation of behaviors. All of the adolescents completed a double-blind, placebo-controlled, crossover study of the effects of methylphenidate. Test-retest reliability and, when applicable, internal consistency of adolescents' self-reports was assessed. The convergent and discriminant validity of the ratings was assessed with a factor analytic structural equations multi-trait multi-method analysis. Criterion validity was assessed with a repeated measures analysis of variance with medication as the independent variable. Concurrent and incremental validity of the adolescents' self-reports were assessed with a hierarchical regression analysis. The results of this study indicate that adolescents can provide reliable and valid information about their response to treatment for ADHD. Compared to adolescents' self-reports; however, reports by counselors and teachers are more sensitive to the effects of treatment with medication. Nevertheless, adolescent self-reports appeared to have some unique predictive value. Within the context of this study, reports by parents did not have any incremental validity. Treatments for adolescents with ADHD are in the early stages of development and this psychometric study could have important ramifications for hundreds of thousands of adolescents who receive treatment for ADHD. These results are most applicable to clinic-referred adolescents receiving intensive behavioral treatment and a trial of methylphenidate.

For most persons with schizophrenia (PWS), adherence with taking neuroleptic medication defines their course of illness. PWS who consistently take medication spend less time in the hospital, preserve recovery gains, and place less burden on families and society. Most extant research focuses on the correlation of discrete, provider-defined variables with the outcome of adherence. In contrast, this research used the person's perspective on the meaning of medication-taking to describe the complex phenomena of neuroleptic medication adherence by PWS. A phenomenological framework was used to examine the lived experience of neuroleptic medication-taking among PWS. Ten males and one female with a DSM-IV diagnosis of schizophrenia were interviewed regarding their experience of taking neuroleptic medication. Interviews were transcribed verbatim by the investigator and meanings were extracted that rendered a description of the essential structure of medication-taking by PWS. An audit trail was established that verified the research process and findings. Interview analysis showed their experience had three interconnected, overlapping theme categories Being-Out-of-Being, On a Rocky Road, and Making a New Way. In summary, the essential structure revealed that: Acquiring an unasked for and frightening being-out-of being was the genesis of the medication-taking experience, and although it brought some relief, medication never fully remitted the illness. Consistent medication-taking developed over time and in concert with finding the right medication. The right medication was one with tolerable side effects and that suppressed the illness enough so that PWS could recover a sense of self. With consistent medication-taking, PWS learned about their illness response, developed personal treatment plans, and decided medication-taking was essential for keeping their illness controlled. In the end, even when they took the medication, PWS had to endure the uncertainty of living with an ever-present but submerged illness that skewed their sense of the world. These findings provide a description of the little-researched experience of living with schizophrenia and its troublesome primary treatment, that may identify points of nursing intervention for aiding persons with schizophrenia in the difficult task of neuroleptic medication-taking.

The purpose of this study was to identify from the woman's point of view what factors facilitate or inhibit disclosure of psychological abuse. Physical and psychological symptoms arise from this abuse and women are reluctant to disclose the underlying cause. This is a significant problem for every specialty in the nursing profession. A qualitative study using grounded theory was conducted with four research participants from domestic violence shelters. The results suggest contextual and behavioral factors in the disclosure process and give descriptive supporting data of related concepts. A conceptual model for the disclosure process is proposed.

<p> Social service agencies often ignore death and dying issues (DDI). Direct care staff (DCS) are left to fend for themselves. They express themselves when it comes to DDI. Training on DDI and grief and loss issues (GLI) is scarce. Theories such as Symbolic Interactionism and Awareness theory help explain GLI and DDI. The methods used in this study include qualitative interviewing. Ten DCS were interviewed from a Fargo social service agency. They were asked questions about their beliefs in DDi and their work with clientele. Also addressed were how DDI effected them personally and their educational background. Results indicated that their were positive perceptions of the disabled people regarding DDI and GLI. The DCS believe that the disabled individual grieves adequately with staff and family assistance. Additionally the disabled persons with whom the DCS worked understood GLI and DDI. The staff at this agency were not trained for DDI until an incident ocured.</p>

<p> Culturally sensitive care is thought to take into account a person's specific cultural values and preferences when providing mental health care services. Latinos currently comprise 17% of the total U.S. population at 50.5 million and persons of Mexican heritage constitute over 66% of all Latinos in the United States. Persons of Mexican heritage experience higher rates of mental health issues and illness with 30% lifetime incidence versus 20% incidence for Anglos. Few studies have focused on the mental health treatment preferences for persons of Mexican heritage. Treatment preferences could reflect personal characteristics, acculturation perspective about mental health issues and illness, and experience with treatment. Mass media may also influence treatment preferences and mental health information-seeking. The purpose of this study was to describe preferences for mental health treatment services for persons of Mexican heritage living in the Southwest along the United States-Mexico border. Twenty-one participants were interviewed individually and their responses analyzed using Atlas-ti qualitative analysis software. The participants reported twenty-five mental health treatment preferences. The top six preferences&mdash;medication, going to the doctor, social and family support, counseling and herbal medicines, were consistent throughout demographic categories of age, gender, income, generational status, insurance status, education, and acculturation. Self-management interventions and integrative medicine were also reported as treatment preferences. Participants reported media use of television, internet, books and magazines, in-person interaction, and radio as primary mental health information sources. Media influences on mental health included education/information, hope, normalization, and a catalyst for conversation. Ascribed meanings for anxiety, depression, substance abuse, schizophrenia, and bipolar disorder included cognitive, behavioral, and interactional reports. Mental health services for persons of Mexican heritage should include varying holistic mental health treatment practices, recognizing the need for understanding of potential meanings for mental health issues and illness. Persons of Mexican heritage report the desire for the same types of allopathic care including medications and counseling as Anglos in the US. Additionally, self-management interventions and integrative medicine therapies, as well as innovative media outreach methods were reported as integral to the holistic treatment process of obtaining help for mental health issues and illness.</p>

<p> This study examined sociocultural predictors of mental health treatment utilization among a combined clinical and community sample of Black older adults experiencing depression, anxiety and/ or traumatic events. A secondary analysis of a cross-sectional study that investigated the prevalence of depression and the factors associated with it among African Americans, and Caribbean Blacks over the age of 55 living in New York City using binominal logistic regression analyses. The current study investigated how the sociocultural factors of ethnicity, mental health beliefs, ethnic identity, spirituality, and religiosity predicted utilization of formal and informal mental health treatment services. The findings highlight the significance of ethnicity, depression, mental health beliefs and spirituality as predictors of utilization of mental health services. Caribbean Black older adults underutilized mental health treatment services of any type. The current study suggests that attitudes and beliefs about mental illness and health practices is a factor that should been taken into account by clinicians when assessing, diagnosing, treating and trying to maintain adherence to services of older Black adults. </p>

<p> It is estimated that by the year 2050 more than 100,000 professional social workers will be needed to meet the demands of the aging population. This qualitative study explored Master of Social Work (MSW) students' perceptions of stress and coping in family caregiving and their preparedness to meet the needs of family caregivers at home as well as in their future roles as social workers. The researcher met individually with 22 MSW students to conduct a structured interview to help identify trends and themes related to these issues. Findings were consistent with literature in identifying stress in anticipation of family caregiving. The results of the study suggest that although most participants are prepared for their roles as future social workers, many are not prepared for the role of a family caregiver. With regard to coping and their preparedness, many anticipate using family resources and building on skills learned throughout their MSW program. Social work implications for education and practice are discussed as are directions for future research. </p>

<p> The purpose of this project was to locate a potential funding source and write a grant to support funding for the Emergency Response Team (ERT) program. The ERT will use solution-based practices within the Mendocino County Health and Human Services Agency to support family stabilization. An ERT would enable children and families to access multidisciplinary team services, including mental health and alcohol/drug services, immediately after a referral to Child Protective Services. This approach will allow families to address their needs for stabilization and ensure streamlined support, thus reducing the potential for children to be removed from the home or shorten the duration of the removal. Ultimately, this approach will ensure families access to appropriate levels of mental health and alcohol or drug service supports to enhance the well being of children, families, and the community. The actual submission and/or funding of this grant were not a requirement for the successful completion of this project.</p>

<p> This study examined hospice physicians' understanding of and attitudes toward existential suffering and palliative sedation, including their understanding of existential suffering, their responses to existential suffering, their use of palliative sedation as a treatment for existential suffering, and the influences on physicians' attitudes and behaviors about palliative sedation. Data were collected through a semi-structured, one-on-one, in-person interview conducted with five physicians employed at one hospice. Each interview was audio-recorded and lasted approximately 60 minutes. The data were examined using thematic analysis. The physicians had consistent views regarding the complex nature of existential suffering and agreed that it is difficult to define and diagnose. They explained that they alleviate existential suffering by helping patients work through it through conversation over time (usually with other hospice team members). The physicians unanimously emphasized that palliative sedation should be a last resort&mdash;and typically given only for intractable physical suffering. Examination of the influences on physicians' decisions to administer palliative sedation revealed that their background, training, and experiences, as well as their personal values and beliefs, countertransference, their assessment of patient's actual need, and ethical concerns influenced their decisions about palliative sedation. Four recommendations are offered based on the study results: Increase physicians' comfort and competence with patients' existential suffering, incorporate training in the use of self for physicians, destigmatize the intervention of palliative sedation, and revisit the terminology of palliative sedation. Limitations affecting the study include small sample size as well as possible researcher bias due to her experience as a hospice social worker and views about palliative sedation. Continued qualitative research throughout the medical field is recommended to further build the body of knowledge about physicians' understanding of and response to patients' existential suffering.</p>

<p> This study used Interpretive Phenomenological Analysis to explore the lived experiences of women with autoimmune diseases who felt dismissed by their physicians when seeking diagnosis of their symptoms. Six women with medically diagnosed autoimmune diseases were each interviewed twice in a semi-structured format. Participants reported lasting harm from negative emotional and psychological states that resulted from disruptions in intrapsychic processes, including challenges to embodied material reality and self-concept due to physicians' dismissive attitudes. A description of a unique phenomenon, named here as physician dismissiveness, emerged from the data. Participants also reported that experiencing physician dismissiveness made coping with symptoms more difficult during the quest for accurate diagnosis. These findings raise important questions regarding mind-body awareness, the nature of embodiment, authority over the body, and the role of expert others in holistic functioning. Background of the study includes elements of healing theory put forth by Rogers, as well as theory of the body as described by Merleau-Ponty.</p>