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Purpose The purpose of this study was to compare diabetes psychosocial comorbidities among adults with type 1 diabetes (T1D) across the United States during the onset of COVID-19 pandemic.Methods Adults with T1D from 4 main US geographic regions including South (n = 367), West (n = 234), Northeast (n = 250), and Midwest (n = 247) completed a cross-sectional online survey between April and June 2020. Data collection was done on psychosocial measures, glycemic variability, sociodemographic characteristics, and various challenges related to the COVID-19 pandemic. Chi-square, Fisher’s exact, Kruskal-Wallis tests, ordinary least squares, proportional odds, and ordinal logistic regression methods were used for data analysis.Results In the South, 51.2% of participants had moderate to high levels of diabetes distress, and this was significantly (P= .03) higher than other regions. Northeast region had the lowest prevalence of moderate to severe diabetes burnout (19.8%), but this was not significantly different compared to the other regions. Participants in the South had also the highest mean score on the 8-item Patient Health Questionnaire, with 30.3% of them reporting moderate to severe depressive symptoms. However, there were no significant differences in depressive symptoms among the regions. Glycemic control, demographic characteristics, and COVID-19-related challenges were associated with different psychosocial comorbidities in different regions.Conclusions When providing information and support to individuals with diabetes in time of crisis like the COVID pandemic, providers should consider psychosocial aspects of diabetes care. Diabetes disparities and contextual factors vary geographically in the United States; these factors may impact the psychosocial comorbidities of diabetes in each region.

Byline: Lora Humphrey Beebe (University of Tennessee College of Nursing, lbeebe1@utk.edu); Kathlene Smith (Tennessee Wesleyan College, Fort Sanders Nursing Department, Knoxville, Tennessee); Carol Crye (Knoxville, Tennessee); Caryn Addonizio (University of [...]

Children, who enroll in hospice, have complex mental and behavioral health (MHBH) problems. There is limited literature on patterns of these problems among children at their end of life. Using the national database of 6195 children enrolled in hospice between January 1, 2011, and December 31, 2013, and latent class analysis, this study identified 4 distinctive classes of children. Neurodevelopment and anxiety class (26.5% of the sample) had 41.3% of children of 15 years or older, who had an average of 1.4 MHBH comorbidities and took 17 medications; 29.1% had physical health comorbidities, and 23% were dependent on technology. In the Behavior and Neurodevelopment class (20%), 53.1% of the children were between ages 6 and 14 years, who had an average of 2 MHBH comorbidities and took 17 medications. In the Physiology class (43.4%), 65.5% of children were younger than 5 years, had 1 MHBH comorbidity, and took 19 medications. In the Mood, Behaviors, and Anxiety class (10.2%), more than 90% of children were older than 6 years, had 4 MHBH comorbidities, and took 30 medications. In the latter 3 classes, approximately half of the children either had physical health comorbidities or were technology dependent. These findings highlight the importance of end-of-life care that accounts for the likely presence of complicated patterns of MHBH conditions.

Background:Of the 40 000 children who die annually in the US, thousands are admitted to hospice care. Little is known about the mental health and developmental disabilities of these children.Aims:To describe the mental health and developmental disabilities of children who are admitted to hospice care and compare this across age groups.Methods:The 2011 to 2013 US Medicaid files were used. The sample included 6195 children with a diagnosis of a mental health and/or developmental disability. Comparisons were calculated using the Pearson chi-square test.Results:Mental health conditions, including anxiety (31.0%), depression (33.1%), behavioural disorders (33.9%) and affective disorders (34.8%), were highest among children aged between 15 and 20 years. Developmental delays were common in children under a year, while intellectual disabilities were highest in the 15 to 20 years age group.Conclusions:Nurses have an important role in understanding the mental health and developmental disabilities of children admitted to hospice care.

The authors tested the long-term effectiveness of a cognitive-behavioral group intervention in reducing depressive symptoms, decreasing negative thinking, and enhancing self-esteem in 92 college women aged 18 to 24 years who ere at risk for clinical depression. The women were randomly assigned to either an experimental or a no-treatment control group. The experimental group participated in a 6-week cognitive-behavioral intervention that targeted identification and reduction of negative thinking, using such techniques as thought stopping and affirmations. Data on depressive symptoms, self-esteem, and negative thinking were collected before the intervention and at intervals of 1, 6, and 18 months postintervention. The women in the intervention group experienced a greater decrease in depressive symptoms and negative thinking and a greater increase in self-esteem than those in the control group. The beneficial effects continued over an 18-month follow-up period. These findings support the importance of thought stopping and affirmations as prevention interventions with at-risk college women. Key Words: college women, depression, negative thinking, self-esteem, We designed this study to test the long-term effectiveness of a cognitive-behavioral group intervention in reducing depressive symptoms, decreasing negative thinking, and enhancing self-esteem in college women at risk for [...]

A faculty team developed the 4-week Recovery-Based Interprofessional Distance Education (RIDE) rotation for graduate students in their disciplines. The evaluation team identified the Team Development Measure (TDM) as a potential alternative to reflect team development during the RIDE rotation. The TDM, completed anonymously online, was piloted on the second student cohort (A faculty team developed the 4-week Recovery-Based Interprofessional Distance Education (RIDE) rotation for graduate students in their disciplines. The evaluation team identified the Team Development Measure (TDM) as a potential alternative to reflect team development during the RIDE rotation. The TDM, completed anonymously online, was piloted on the second student cohort (N= 18) to complete the RIDE rotation. The overall pretest mean was 60.73 points (SD= 11.85) of a possible 100 points, indicating that students anticipated their RIDE team would function at a moderately high level during the 4-week rotation. The overall posttest mean, indicating student perceptions of actual team functioning, was 72.71 points (SD= 23.31), an average increase of 11.98 points. Although not statistically significant, Cohen's effect size (d= 0.43) indicates an observed difference of large magnitude. No other published work has used the TDM as a pre-/posttest measure of team development. The authors believe the TDM has several advantages as a measure of student response to interprofessional education offerings, particularly in graduate students with prior experience on health care teams. Further work is needed to validate and extend the findings of this pilot study. [Journal of Psychosocial Nursing and Mental Health Services, 56(4), 18–22.]

ABSTRACTHypertensive older adults will benefit if there is a clear understanding of the factors related to sodium reduction. That would raise awareness of the causes, consequently reducing many health risks, lowering health care costs, and diminishing economic and social burden from high blood pressure. This study explored predictors of urinary sodium excretion. A cross-sectional, correlational study was conducted in 312 hypertensive older Thai adults. Questionnaires related to knowledge, self-care agency, self-care behavior of sodium reduction, and 24-hour urinary sodium analyses were used, followed by the application of structural equation modeling and the Analysis of Moment Structures program. Self-care agency, knowledge, self-care behavior, rural/urban location, and education accounted for 61% of urinary sodium excretion. Self-care agency, knowledge, and self-care behavior were the main predictors in the urinary sodium excretion model. This study suggests establishing supportive educative sodium reduction-related programs that improve knowledge and enhance self-care agency, as well as a comparison of the changes of sodium reduction self-care behavior and urinary sodium excretion over time after the intervention.

The purpose of this study was to describe the procedure and results of salivary cotinine testing and to examine correlations between cotinine levels, self-reported smoking behavior, and other demographic variables in outpatients with schizophrenia spectrum disorders (SSDs). Twenty-one participants completed salivary cotinine measures. Sixteen reported smoking cigarettes (mean = 1.2 packs per day; The purpose of this study was to describe the procedure and results of salivary cotinine testing and to examine correlations between cotinine levels, self-reported smoking behavior, and other demographic variables in outpatients with schizophrenia spectrum disorders (SSDs). Twenty-one participants completed salivary cotinine measures. Sixteen reported smoking cigarettes (mean = 1.2 packs per day; SD= 0.8; range = 0.25 to 3.0) for a mean of 27.4 years (SD= 16.3 years, range = 1 to 46 years). Age was significantly positively correlated with self-report of packs smoked per day (r= 0.52; p= 0.04) and years smoked (r= 0.63; p= 0.02). There was no clear pattern of relationship between salivary cotinine level and self-reported smoking behavior. This pilot study adds to a small body of literature describing salivary cotinine measures in individuals with SSDs, yet further investigation is warranted to definitively determine the utility of this objective measure of nicotine use. [Journal of Psychosocial Nursing and Mental Health Services, 51(8), 33–38.]

Nearly 2 million Americans suffer from schizophrenia, which is considered the most chronic and disabling of the severe mental disorders. In addition to psychotic symptoms, cognitive deficits, and social impairments, persons with schizophrenia are faced with multiple barriers to the achievement of optimal health. Psychiatric nurses must assess physical and psychological risk factors, monitor medication responses and side effects, and provide health promotion strategies for persons with schizophrenia. After providing a brief summary of the diagnostic criteria and clinical features of schizophrenia, this article reviews medication management with atypical agents and serious drug reactions.

Although cognitive-behavioral interventions have been successful in treating depression, no studies were found that focused solely on reducing negative thinking via group intervention as a means of preventing depression in at-risk groups. The purpose of this randomized controlled trial was to test the effectiveness of a cognitive-behavioral group intervention in reducing depressive symptoms, decreasing negative thinking, and enhancing self-esteem in young women at risk for depression.