Public health concerns were prominent during the COVID-19 pandemic, particularly regarding rising cases of anxiety and depression among adults. U.S. healthcare providers were especially affected by the unrelenting demands on their time and service. Psychiatric Mental Health Nurse Practitioners (PMHNPs) provided patient care during the pandemic to meet the increasing need for mental health services as people began experiencing mood disturbances such as anxiety, depression, and grief. The purpose of this qualitative study was to explore the perceived effect of the COVID-19 pandemic on the mental health of PMHNPs. A qualitative design using the interpretive description method allows researchers to use pre-existing knowledge to inform their research and actively participate in knowledge synthesis, focusing on variations in data. Individual interviews with 18 PMHNPs were conducted via video teleconferencing, and their data were evaluated and interpreted for meaning. After a thorough analysis of the interview transcripts, nine themes were identified: adaptive coping, improved access, support, self-care, work strain, complications, maladaptive coping, pandemic strain, and polarization. This study illuminated the challenges PMHNPs faced during the pandemic and the strategies they employed to cope with difficulties and will inform future research and practice in mental health care.

Background: In Taiwan, there were 7,038 reports of attempted suicide among people aged 24 or younger in 2018. Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older. Purpose: In this study, we compared United States (US) and Taiwanese college students’ spiritual well-being, psychological well-being, and suicidal ideation. Methods: A total of 661 college students (481 from the US and 180 from Taiwan) were recruited to complete the survey study. This was a cross-sectional comparative research design. SPSS 28.0 was used to do the data analysis. Chi-square tests, independent t-tests, Pearson Correlations, and Stepwise Multiple Regressions were used to examine the research questions. Results: Compared with Taiwanese college students, US college students had higher scores in spiritual well-being and psychological well-being. US and Taiwanese college students’ spiritual well-being had significant relationships with psychological well-being and suicidal ideation. The significant predictors for the US college students’ psychological well-being were Life Satisfaction/ self-actualization and Life/self-responsibility, while Taiwanese college students had total scores of Spiritual Well-being and Life Satisfaction/ self-actualization. Life Satisfaction/ self-actualization had a significantly negative association with Taiwanese college students’ suicidal ideation. Total scores of Spiritual Well-being and Faith/belief were predictors for US college students’ suicidal ideation and they had significant negative relationships. Conclusions/Implications for Practice: College students’ psychological well-being and suicidal ideation are often cited as important areas. Understanding factors that influence positive psychological well-being is important in order to institute protective factors and provide emotional support.

Purpose: In this study, we compared United States (US) and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression. Research Questions: 1. What were the differences in demographic characteristics, using alcohol, coping strategies, anxiety, and depression between US and Taiwanese college students? 2. What were the relationships between US and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression? 3. How much of US and Taiwanese college students’ anxiety and depression were predicted by their use of alcohol, coping strategies? Methods: Four hundred and one US and 180 Taiwanese college students were recruited in this study. This was a cross-sectional comparative research design. SPSS 28.0 was used to do the data analysis. The Descriptive data analysis, Chi-square tests, independent t-tests, Pearson Correlations, and Stepwise Multiple Regressions were used to examine the research questions. Results: More US college students were married, believed in Jesus Christ, had higher incomes, and were older than Taiwanese college students. Compared with Taiwanese college students, US college students had higher scores in using Problem-Focused Disengagement, but lower scores in Emotional-Focused coping strategies, depression, and using alcohol with negative emotions. The significant predictors for the US and Taiwanese college students’ anxiety and depression were using alcohol with negative emotion, using Problem-Focused Disengagement, using Emotion-Focused Engagement, and using Emotional-Focused Disengagement. Taiwanese college students had another significant predictor for depression which was Problem-Focused Engagement. Conclusions/Implications for Practice: The significant factors associated with anxiety and depression were found in this study.

It is widely supported that there are significant, positive relationships between the occurrence of some mental health symptoms and physical illnesses. Research indicates that the burden experienced by those with a physical and mental illness are magnified compared to individuals who do not experience an illness. More specifically, one of the burdens experienced by individuals is the monetary burden of affording the necessary health services to properly manage their illness. This study attempts to reveal a difference between mental health symptom count for individuals who do and do not experience difficulty affording health care for their physical problems. The first hypothesis states that the indication of medical problems will be associated with greater mental health symptoms. The second hypothesis states that the relationship between medical concerns and mental health symptoms will be moderated by difficulty affording health services. Lastly, the third hypothesis states that the indication of unhealthy behaviors, such as smoking and irregular exercise, will be associated with greater mental health symptoms. All data used in this study is archived data that was gathered by the Institute for Rural Health’s Mobile Health Units during free community health fairs from September 2012 to February 2014. The first hypothesis was supported because the incidence rate of mental health symptom count was increased with the presence of some physical problems. These findings supported previous research that indicated that the presence of physical illness increases the chance of developing a mental illness. The study results revealed that the second hypothesis was not supported since difficulty affording health services did not have a significant effect on the relationship between indicated physical illnesses and mental health symptom count. Previous research reports that there is monetary burden for individuals who experience a physical or mental illness when accessing appropriate health services. This research aimed to explore if that burden would significantly affect the relationship of those illnesses. Lastly, the third hypothesis was supported because mental health symptom count incidence rate was found to increase for individuals partaking in negative health behaviors, such as smoking, and decrease for individuals partaking in positive health behaviors, such as exercising.

Social support is the collection of tangible and intangible experiences that surround people as they cope with daily stressors. High quality social support is important among patients with cardiovascular disease (CVD) because it has positive effects on social, psychological and physical well-being, and those with good social support cope better with the travails of CVD. Although there are many studies of social support in CVD, little work has been done on the topic of discrepancies between desired and received social support in the context of gender. The purpose of this dissertation was to determine if there are gender differences in the discrepancies between CVD patients’ desired and received social support. If gender differences exist in desired and received needs for social support, it is necessary to identify how these differences might affect rehospitalization and mortality rates. Three manuscripts are included in this dissertation: 1) a comprehensive review of the literature to examine gender differences in CVD patients’ perception of the concordance between desired and received social support and if gender differences in patients’ perception of concordance are associated with differences in health outcomes; 2) a secondary analysis of a cross-sectional observational study to determine whether there is a differential relationship between perceived social support and depression in African American and Caucasian patients with heart failure (HF), and 3) a longitudinal observational study to determine if the discrepancy between desired and received support for individuals hospitalized with an exacerbation of HF is associated all-cause event-free survival. I identified a gap in the literature regarding the differences in received and desired levels of social support between genders that warrants further investigation. In the secondary analysis, I found that race moderates the relationship between perceived social support and depressive symptoms. Higher levels of perceived social support were associated with lower levels of depressive symptoms among Caucasians who had higher levels of depression. Among African Americans, depression levels were lower and were unaffected by level of social support. In the longitudinal observational study, 157 participants identified desired and received support upon enrollment. The participants had follow-up at one- and three-month post discharge intervals to determine if they had experienced rehospitalization or mortality during the period. In unadjusted and adjusted analyses neither gender nor social support congruency score group were predictive of all-cause event-free survival. This finding belies the common belief that too much support will smother the patient, causing cardiac invalidism. Despite this, further research is needed to continue to evaluate ongoing discrepancies between genders of desired and received support and their impact on health outcomes. Further research is also needed to establish accuracy in more appropriately matching social support received with the social support desired.

The purpose of this qualitative descriptive study is to describe men’s experiences of depression in order to provide direction for future research of the screening, diagnosing, and treatment of men's depression. Previous research indicates that men experience different depressive symptoms than women, and there is a possibility that men's depression is not being adequately captured by current screening standards, which would theoretically lead to a large number of men with unrecognized, undiagnosed, and untreated depression. If this is the case, this may explain the disproportionately low number of men diagnosed with depression compared to women, in contrast to the disproportionately high number of men who complete suicides. There is a need in the literature for descriptions of depression experienced by men in order to determine the adequacy of current psychometric screening tools and approaches to treatment which are currently in practice. This qualitative study seeks to begin to fill in this gap in the literature. Key findings indicate that intentionally and unintentionally hide their feelings of depression, and that men experience anger as an early sign of depression. In addition, men often do not recognize their distress as depression until someone else suggests they seek professional help; and men use various methods of distraction to cope with their distress, including excessive working, sleeping, eating, TV watching, and alcohol consumption. Recommendations for further research are discussed.

Purpose To examine the effects of Animal Assisted Therapies with Farm Animals (AATF) with domesticated ducks on depression and anxiety. Aim The proposed study will use single-group time series design and collect survey data to explore the changes in anxiety and depression in patients exposed to AATF. The study will be guided by the Self-Efficacy Theory. The study will involve 30 patients with TBI living in The Crumley House Rehabilitation Center in Limestone, TN. Hypothesis. Engaging in AATF with domesticated ducks will be associated with decrease in anxiety and depression. Approach - Theoretical Framework. Bandura’s Self-Efficacy Theory will be used to guide this study examining AATF effects on anxiety and depression in patients with TBI. Salutogenesis, Social Support, and Self-Efficacy theories were compared in order to select the best theoretical framework for this study. Methods Time series Quasi-experimental design. The study will examine the effects of AATF on anxiety and depression among patients with traumatic brain injury (TBI). Because of the unique characteristics of the patient population (all patients have history of TBI) in this facility no other rehabilitation center can be utilized for comparison. Time series design will ensure that all of the participants will be exposed to the therapeutic intervention, it will not be affected by the conventional treatments the participants are receiving. Projected Results and Anticipated Limitations It is expected that AATF will be effective in reduction of Anxiety and Depression symptoms in the patient with TBI Limitations • Possibility of dropouts may compromise sample size and lead to lower statistical power. • AATF based intervention is impossible to conduct in blinded environment. That in turn may contribute to participant’s expectation of positive outcomes of the interventions in this study. This may be considered an example of subject bias. • AATF treatment cannot be completely standardized. Because the treatment is based on interaction with live animals, animal behavior may be different during each visit to the duck pen. Because of that there is a possibility that the study cannot be exactly replicated. • The participants may have different duration or complexity of treatments for anxiety and depression. This may present a confounding factor that we are not able to control in this study. Conclusion This is a pilot study to examine the effects of AATF with domesticated ducks. This study may serve as a basis in developing more research on this topic with expanding the methodology and sampling in the future.

Evidence Based Health Promotion Scientific Abstract Introduction & Background: Mental Health resources are scarce in rural areas. In 2020, suicide was the third leading cause of death for African Americans ages 15 to 24; this is only one example of the mental health disparities experienced by minority groups. Purpose Statement and Research Question: We saught to answer: “Are there greater mental health disparities among sexual and ethnic minorities, such as LGBTQ+ groups or Middle Eastern women, compared to their heterosexual, majority counterparts; if so, is there anything we can do about the issue as nurses?” Literature Review: To match the guidelines for our assignment, which were to have an article younger than five years with an author who has nursing credentials. We used terms such as “mental health issues” and “minority groups” to drive our search, and from there we chose articles that best fit our own individual interests. Findings: From our research, we found that these groups tend to have a much poorer mental health status compared to their majority counterparts. In healthcare settings, sexual minorities tend to be generalized and treated without understanding of their differences; the same can be said for ethnic minorities, who are often treated by uneducated or biased healthcare workers. Conclusions and Nursing Interventions: There is a severe lack of specialized mental health teaching being given to healthcare workers. In implementing comprehensive care teaching programs, we could greatly improve the therapeutic mental health services being provided to these minority groups.

Aim: To determine if a significant relationship exists between a) nurse-driven interventions to foster collaborative psychiatric and oncology care and b) higher rates of cancer treatment adherence and lower healthcare utilization rates in patients with serious mental illness (SMI) and cancer. Background: It is not uncommon for patients with SMI to suffer from treatment noncompliance and present in the acute care setting, such as the emergency department. Patients with cancer and SMI pose a unique challenge to nurses and providers due to the psychological effect of a cancer diagnosis as well as side effects experienced from psychotropic medications and oncology treatments alike. As a result, these patients are less likely to maintain cancer treatment regimens and present with advances stages of cancer in the acute care setting. Methods: An extensive electronic literature search in the CINAHL Plus and APA PsycINFO databases was completed and included the keywords: cancer, neoplasms, carcinoma, serious mental illness, chronic mental illness, mental disorders, mental disorders, chronic, psychiatric illness, psychiatric disability, cognitive behavioral therap*, intervention*, mindful*, and mental health. Inclusion criteria included: published in the years 2012-2022. The available literature was carefully examined for interventions performed with SMI and cancer for ultimate results to be finalized as a written report. Significance: The results of this research can optimize healthcare and prognosis for the population of mental health patients with cancer and also reduce costs to the healthcare system. Conclusion: The 10 studies reviewed indicated that collaborative psychiatric-oncology care with specific Registered Nurse (RN)-led interventions, such as medication management programs and behavioral counseling, was associated with increased rates of cancer treatment adherence and lower rates of healthcare utilization. Conclusions were based on data collected in cohort studies, randomized control trials, pre- and post-intervention assessments, and clinic data from quality improvement projects. More research is needed to explore the implementation of collaborative care practices.

The improvement in cancer remission rates in children and adolescents due to advances in cancer treatment and therapy has led to the development of guidelines that address long-term follow up for survivors of childhood cancers. Adolescents often experience negative emotions related to the fear of uncertainty about long-term survival after cancer remission, yet often report feelings of hope and optimism for the future more than adult cancer survivors. The purpose of this study was to understand the role of self-efficacy and coping in adolescents after remission of cancer. A secondary purpose was to analyze which coping strategies supported long-term survival goals after cancer remission in adolescent populations. A systematic literature review was conducted from the following online databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature On-line (MEDLINE), Education Resources Information Center (ERIC), and PsycInfo. Selected articles included those published between 2000-2016 that were written in English and were peer-reviewed. The results of the study revealed that most adolescents with cancer remission do not experience long term psychosocial issues related to their cancer diagnosis and treatment. However, a large percentage of adolescent cancer survivors report intermittent depression, suicidal ideation and a lower quality of life due to survival after remission. The literature indicates that multiple, integrative forms of behavioral therapy: cognitive, psychosocial, and family based treatment models, help to enhance long term quality of life in adolescent cancer survivors. Strategies that use positive coping methods and improve self-efficacy related to long term survival after remission have demonstrated improvement in psychosocial behaviors in adolescents and promote a better outlook on planning for the future. Future research that analyzes the most effective coping skills to practice after cancer remission and that optimize self-efficacy related to long term survival can positively influence quality of life for adolescent cancer survivors.