Compassionate care, or humanism, should be available to all patients, but the stigma associated with mental illness is a barrier to many people receiving the appropriate care. Views held by Bachelor of Science in Nursing (BSN) students can vary from custodial, or the belief in a traditional medical model which involved a highly controlled setting for all mentally ill patients, to humanistic, or viewing the hospital as a therapeutic community for the human needs of a patient. This study examines the views of BSN students before their psychiatric clinical experience through a pretest and post-test survey and analyzes for a shift in opinion following the psychiatric clinical experience. This study’s aim is to identify the effect of exposure to mentally ill patients on BSN students’ opinions of mental illness. A convenience sample of 56 BSN students from the University of Central Florida College of Nursing was used; recruitment happened through an announcement made during the psychiatric mental health lecture. An online survey was distributed before the psychiatric mental health clinical experience, and a post-test survey was done following the conclusion of this clinical experience. Results showed an overall shift toward humanistic views following exposure to mental illness. These results demonstrate the value of the psychiatric mental health clinical experience in developing humanistic views among BSN students. The results of this study complement past research, which has shown that people who have not had experience with mentally ill persons tend to show more negative, custodial views. However, knowledge and experience can shape one’s view in a more humanistic way, opening up nurses to provide compassionate care.

Substance abuse is a global problem that has contributed to a variety of societal, financial, health, and familial strains. An increasing prevalence of illicit drug, prescription opioids, and alcohol abuse has created a need for re-evaluation of recovery and relapse treatments. This literature review examines the efficacy of meditation-based treatments for relapse prevention in persons recovering from Substance Use Disorders (SUDs). A comparative analysis of Mindfulness Based Relapse Programs (MBRP), an adapted MBRP-W program, and a Transcendental Meditation (TM) intervention was used to examine the success of meditation-based interventions. Research supports improvements associated with the meditation-based interventions including significant reductions in substance use, craving, stress, and negative affect. Meditation-based therapy may provide the emotional self-regulation and decreased impulsivity required for long-term abstinence from substance use. Consistent meditative practice was associated with greater improvements. Altering current meditation-based therapy treatment programs to encourage adherence and participation may increase success. Additional research is needed to evaluate long-term relapse prevention potential. Research incorporating meditation-based supportive therapies that promote well-being, emotion regulation, and stress relief are important for the future of successful SUD treatment.

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.

No / Improving Inclusion: Developing An Innovative Technology Assisted Learning Package for a UK Recovery College for Mental Health Service Users. Recovery Colleges in the UK represent a new initiative in providing support and psycho-educational interventions for people with mental health difficulties as part of the 'Recovery movement' (Williams, 2016; Perkins and Slade, 2012). Multiple barriers exist for people with mental health difficulties, particularly among ethnic minorities) in accessing such services and include (but are not limited to) -financial problems, difficulties with transport, condition-related difficulties - (e.g. poor motivation, organisational difficulties or feeling unwell) (Memon et al.,2015). To overcome this we put together a collaborative research project with a technology business partners service users and service providers to develop a new technology assisted learning project to ease access to the College's taught sessions. This involved developing sophisticated video-recording and streaming software and hardware that could 64 live-broadcast college sessions to users in their own homes via a variety of hardware platforms. Users could participate in the taught sessions by means of the video/sound interactive software on tablets, mobile devices or their home computer. The innovative features of the TAL package are described, and the impact this facility had on user participation in the college programme evaluated. Particular attention is paid to the development and partnership nature of the project development. The implications for Recovery College and mental health service provider practice is discussed with particular reference to the potential future wider application of TAL packages to promoting access across other domains of mental health care.

Background: A diagnosis of cancer causes physical and psychological implications that continue throughout the cancer treatment trajectory. Psychological distress, including depression, is one of the most common negative effects experienced by adults with cancer and often remains untreated despite positive screening. Psychosocial interventions are an appropriate method to address depression and can be implemented in the acute care setting, outpatient clinics, or patients’ homes by a registered nurse. Methods: A comprehensive search of CINAHL, MEDLINE, and APA PsycINFO was conducted, and articles were screened for appropriateness. A total of eight randomized controlled trials that met inclusion criteria and contained a rigorous methodological design were analyzed. Results: Implementation of nurse-led psychosocial interventions in adults with cancer indicated a positive correlation in the mitigation of depressive symptoms; however, feasibility (defined as an adherence rate of greater than 80% in the intervention group) remains inconclusive. While four of the articles analyzed showed promise of the feasibility of a nurse-led psychosocial intervention, the remaining articles did not include enough detail about adherence to analyze. Conclusions: To transition nurse-led psychosocial interventions into clinical practice, more primary research documenting strict adherence and withdrawal rates must be conducted to determine feasibility. Additional analysis should seek to examine definitive training required by registered nurses prior to implementation to account for resource barriers that may impact success of this type of intervention in the clinical setting.

This thesis examines the implications of the changes introduced by the NHS and Community Care Act 1990 for mental health services. It focuses on two main issues. Firstly, the impact on mental health services of the 'market' system of purchasers and providers introduced by the 1990 Act. Second.ly, the extent to which the 1990 changes had led to any increase in user participation and involvement in the planning and delivery of psychiatric services. Analysis of the existing theoretical literature found that there had been little research which focused on the specific implications of health care 'markets' for mental health services. In addition, much of the work on the development of psychiatry had not focused on the role of the local context in influencing the nature of mental health service provision. In this thesis these issues are explored through a case study of the mental health services of one English county. Semistructured, qualitative interviews were und.ertaken with managers, professionals and individuals in purchaser, provider and voluntary sector organisations. People using community mental health services in the county were also interviewed. This contrasts with many previous studies which have tended to concentrate exclusively on users of in-patient services. The study found that local circumstances played a significant role in the relationships between those purchasing, providing and participating in mental health services. The imminent closure of a large Victorian psychiatric hospital and the uncertainty about which services would replace it had been a source of tension between the newly formed purchaser and provider organisations in the county under study. The lack of any strong existing groups in the local area representing users of mental health services was also significant. It meant that increased user participation in the county after the 1990 Act was reliant on initiatives by managers and professionals rather than organised pressure from user groups and users themselves. The variety of different local mental health agencies purchasing and providing mental health services in the county called for a degree of cooperation between organisations which conflicted with the competition encouraged by the 'market' system introduced by the 1990 Act. The focus, first, on psychiatric services in the examination of 'markets' and, second, the importance of the local context in mental health service development provides the basis for the study's contribution to theoretical and policy debates both about the 1990 Act and psychiatric services in general.

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.