Introduction and Background: Today, in 2022, there is a community that receives discrimination, lack of acceptance, and lack of equality. This is the LGBTQ community. They suffer from the indifferences of the way they express themselves resulting in a rise of mental health issues and overall health disparities. Purpose Statement: The purpose of this review is to explore the disparities in mental health for the LGBT community including young adolescents and older adults. The question that drives this review is how does being a member of the LGBT community effect mental health. Literature Review: This literature review utilized search engines such as PubMed, ETSU One Search, and Google Scholar. Articles were chosen from within the past five years and corresponded with disparities in mental health for the LGBT community and the effects of acceptance from others. Key words used during the search of articles included “LGBT”, “mental health”, “suicide”, and “nursing”. A total of four articles and one systematic review were selected. Findings: Adolescents who didn’t have acceptance from others had a higher risk of suicide. Many mental health and substance abuse facilities didn’t have LGBT-specific programs. Healthcare professionals expressed the lack of training with LGBT clients but were willing to learn as it is relevant to their practice. Conclusions: The United States is under pressure as we watch the LGBT community become victims of inequality and health disparities. There is a need for more training and cultural competency, and implications of programs and resources specifically for the LGBT community.

Abstract Introduction and Background: According to the Centers for Disease Control and Prevention (2020), “postpartum depression is depression that occurs after having a baby which is more intense and lasts longer than those of “baby blues,” a term used to describe the worry, sadness, and tiredness many women experience after having a baby.” It also states, “1 in 8 women report symptoms of depression after giving birth, about 1 in 5 (20%) women were not asked about depression during a prenatal visit, and over half (50%) of pregnant women with depression were not treated.” Purpose Statement: The purpose of this research is to investigate the connection between preventing postpartum depression or reducing postpartum depression with exercise interventions along with incorporating nursing and other healthcare professions. Literature Review: The design of studies included two randomized control trials, one randomized control trial with a prospective pretest-posttest experimental design, one cross-sectional descriptive design, and a population-based, prospective cohort design. These five articles were found through PubMed, Google Scholar, and the ETSU library database. Findings: Exercise interventions are beneficial to reduce postpartum depression symptoms. Nurses specifically can utilize this data to assist women with postpartum depression symptoms and provide better education throughout pregnancy and early postpartum to help prevent postpartum depressive symptoms. Conclusions: Future research is suggested to focus on the mode, frequency, intensity, and duration to describe the volume of physical activity in a given time frame that is needed to affect postpartum depression. Keywords: exercise, postpartum depression, nursing

Purpose LGBTQ patients experience marginalization and discrimination when seeking healthcare in the Southern Region of the United States. As a result, they experience negative healthcare outcomes. Collecting sexual orientation/gender identity (SOGI data) is vital in decreasing health disparities and improving hospitalized LGBTQ patients’ quality of care. Providers cannot adequately assess health risk factors or deliver culturally competent care without SOGI data knowledge. Aims The aim is to collect SOGI data during intake to implement a standard of care to promote LGBTQ health outcomes and decrease marginalization. Processes To understand how to provide high-quality care to LGBTQ patients, providers receive instruction on the importance of collecting SOGI data and cultural competency training using the Gay and Lesbian Medical Association (GLMA) guideline. After IRB determined the project as not research involving human subjects, SOGI data questions (your current gender identity is and describe your sexual orientation) were added to the EHR demographic health history section. Provider adoption of collecting SOGI data is measured by extracting data from the EHR. Results Results will determine the providers’ responsiveness to implementing SOGI data questions into the EHR. Limitations Provider having a choice of collecting SOGI data, the small sample size of providers, and the project’s location are limitations. Conclusions LGBTQ individuals have more health inequities and face marginalization when accessing healthcare. SOGI data collection is essential for assessing health risk factors, improving health outcomes, and creating a safe and inclusive healthcare environment for LGBTQ patients.

Pediatric anxiety disorders characterized as Generalized, Separation, and Social Anxiety Disorders, are chronic debilitating conditions that leave children feeling tense and isolated, both physically and emotionally. Selective serotonin reuptake inhibitors (SSRIs) are a classification of antidepressants that can be prescribed to children diagnosed with these disorders. SSRIs have been shown to be effective in treating anxiety disorders in children. The purpose of this literature review was to examine and determine if there are more risks or benefits associated with SSRIs, as well as evaluate teaching and education regarding anxiety disorder medication compliance in both children and parents. A secondary purpose of this research was to provide recommendations in nursing practice to allow children to feel more involved in their medical regimen. The following databases were used for the search: CINAHL, Academic Search Premier, and Web of Science. Key terms used in the search include but are not limited to: child* and anxiety, not autism, and selective serotonin reuptake inhibitors, OR SSRI*, OR adolsecen*, not med*, pediatric*, OR side effects. The results suggest that the benefits of SSRI therapy in children with anxiety disorder, when taken on a regularly scheduled basis, outweigh the risks, however more research aimed at compliance with SSRI therapy in children and parents is necessary. Further research analyzing children with anxiety disorders is needed to assess SSRI usage based specifically on their developmental age, and the inclusion of appropriate teaching and explanation related to their diagnoses to identifying stressors that can include behavioral therapy as well.

A sizeable number of U.S. veterans of all ages experience post-traumatic stress disorder (PTSD) which can impact their quality of life; physically, mentally and socially. Consequences of PTSD are associated with physical and emotional disabilities, including ideation of self-harm and even suicide. Increasingly, animal-assisted therapies (AAT) are used to treat PTSD and other physical and behavioral conditions in veterans. Over the decades, AATs have used dogs, cats, horses, and dolphins among other animals. The purpose of this integrative review is to examine the use of AAT focusing on canine assisted therapy (CAT) among veterans diagnosed with PTSD. The methodology involved database searches, including MEDLINE, PubMed, PsychInfo, EBSCOhost, along with textbooks and popular media published from 2000 to 2016. Associated with the lack of more recent research, relevant articles published before 2000 were included in the review. Search terms included, ‘veterans,’ ‘service dogs,’ ‘service animals,’ ‘animal-assisted therapy,’ ‘canine therapy,’ ‘PTSD,’ ‘post-traumatic stress disorder,’ ‘psychiatric,’ ‘U.S. veterans,’ ‘equine therapy,’ ‘horse therapy,’ ‘pet therapy,’ and ‘military veterans.’ A total of ten relevant studies were identified which focused on the use of AAT among veterans diagnosed with PTSD. Different populations diagnosed with PTSD and other behavioral and psychiatric health conditions using AAT were examined as well. These articles were read, analyzed, and synthesized. Results of the review offer some support that AAT has psychological, physiological and psychosocial benefits for some populations across the lifespan with various diagnoses. Consistent and conflicting findings along with gaps in the literature are highlighted. Limitations and implications for nursing practice, research, policy and education also are noted in this thesis.

The purpose was to examine the effect of a self-care educational intervention on nursing student resilience and thus the potential for compassion fatigue, depersonalization, burnout, depression, and inadequate self-care. A one-group pretest-posttest research design was applied to a convenience sample of 104 nursing students near the end of their last semester in a baccalaureate nursing program. The measurements were demographics, a psychometric resilience scale, program evaluation, and reflection question. The intervention was a standardized, intensive 30 min training program on the high degree of stress and burnout nurses face and the core self-care methods that can promote resilience to these hazards. The educational intervention had a strong positive effect on resilience scores (effect size of r=72%; p < 0.05). Eighty-six percent of the participants believed that the intervention increased their capabilities for self-care, especially in sleep, spending time outside, hydration, nutrition, and physical stretching exercises but not in journaling. Eighty-one percent stated that they would be likely to seek professional help if needed. Although this study must be repeated in other samples before it be implemented with full confidence, the standardized, high intensity, short duration, resilience training session can be recommended to nursing programs just prior to graduation and to hospitals for nurse orientation programs.

Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care. Methods: A total of 768 articles were found in a literature search including all literature from 2005 to 2016 from all countries using the databases CINAHL Plus, MEDLINE, PsycINFO, and Academic Search Premier. These were further narrowed down based on relevancy by topic or reading abstracts. A total of 13 articles utilizing the inclusion and exclusion criteria of the literature search were included in the final literature synthesis. Results: In addition to general ICU admission criteria several other criteria and scores can be helpful in admitting patients with cancer to the ICU including cancer specific criteria, mortality predictor tools, performance status, and ICU trials. Mortality predictors, in combination with other patient characteristics, demonstrated effectiveness to predict outcomes in patients with cancer. Survival rates in hematological and solid tumor cancers have improved from the past, and lower prognostic scores can predict who will have better outcomes. Conclusion: Cancer specific criteria, mortality predictor tools, performance status, and ICU trials in addition to general ICU criteria should be used for admission of cancer patients into ICU. Practitioners and nurses should become familiar with the newest outcomes in patients with cancer to make collaborative informed decisions about ICU admission.

Limited research exists about the experiences of nurses’ caring for patients during the COVID-19 pandemic post hoc. To understand nurses’ realities of caring for patients with COVID-19, I aimed to understand the lived experience of nurses caring for patients with COVID-19 in the United States. A qualitative design with a hermeneutic phenomenological methodology was used. Sixteen participants were recruited via purposive sampling, augmented with snowball sampling. Data were collected through unstructured interviews and were analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Nurses’ experiences of caring for patients with COVID-19 in the U.S. were consolidated into four themes: “a living hell”; “rationing patient safety”; “mental aftermath of the war zone”; and “post-pandemic pride”. Nurses provided patient care amidst challenging environments of limited to no resources, with extensive, large-scale critically ill patients, and patient deaths. Due to overwhelming patient care demands, nurses were unable to provide safe patient care to everyone in need, resulting in patient deterioration and death. These experiences caused nurses to endure maladaptive mental effects, such as compassion fatigue and moral suffering, which can threaten the safety of patients. Despite these undesirable results, nurses continued to provide patient care and expressed feelings of pride in the profession of nursing for surviving the COVID-19 pandemic. However, this study demonstrates the persistent impacts on nurses’ abilities to provide safe care after the crisis years. Support for nurses is recommended to preserve patient safety.

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression and the GAD-7 for anxiety, along with additional demographic information and mental health service usage questions, was sent to and completed by participants. A total of n = 173 responses were received. Of these responses n = 99 or 57.2 percent were nursing students, a participation rate of 9.6 percent, and n = 74 or 42.8 percent were pre-nursing students. The research revealed that depression and anxiety scores were above the cutoff for moderate depression and anxiety in both groups, as well as identified a deficit in availability of mental health resources, with over 10 percent of students unable to access counseling or psychiatric services. Contraindicatory to literature, which predicted improving mental health in the progression through university studies, this study reveals a variable and even worsening trajectory of mental health as students transition into the nursing program and progressed through college.

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: ‘student*’, ‘nurs* student*’, ‘cardiopulmonary resuscitation (CPR)’, ‘Basic Life Support (BLS)’, ‘Advanced Life Support (ALS)’, ‘Advanced Cardiac Life Support (ACLS)’, and ‘Retention’. Results: The initial database search yielded a total of sixty-seven articles; of which, nine articles met the inclusion criteria and were utilized in the final analysis. The articles analyzed explored the effectiveness of different training modalities including: self-directed, CD-based, low-fidelity simulation, high-fidelity simulation, collaborative high-fidelity simulation, and deliberate practice. Conclusion: Current training is ineffective both in promoting long-term retention and in delaying the decay of previously learned information. The most effective training modality identified was high-fidelity simulation in conjunction with deliberate practice. The use of collaborative simulation through ‘mock codes’ maximizes the acquisition and retention of CPR knowledge and skill by providing the highest degree of fidelity. Deliberate practice was the only modality, which resulted in improvement of knowledge and skill over time. The absence of individualized feedback diminishes the effects of repeated practice. Practical experience is also susceptible to the detrimental effects exerted by the lack of feedback.