Preventing depression in high-risk college women: a report of an 18-month follow-up.

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.

Negative thinking mediates the effect of self-esteem on depressive symptoms in college women.

BACKGROUND: One of every three women between 18 and 24 years of age may be significantly depressed. Younger women have shown increasing rates of unipolar depression since the 1950s, and the average age of onset continues to decline. OBJECTIVES: To examine the prevalence and correlates of high depressive symptoms in single college women 18 to 24 years of age. Negative thinking was posited to mediate the relationship between self-esteem and depressive symptoms. METHODS: A sample of 246 women was recruited from a university student body. Each woman completed a survey that included the Center for Epidemiologic Studies-Depression Scale, the Beck Depression Inventory, the Rosenberg Self-esteem Scale, the Crandell Cognitions Inventory, and the Automatic Thoughts Questionnaire. RESULTS: Of the women, 35% had high depressive symptoms. Negative thinking mediated the relationship between self-esteem and depressive symptoms. However, self-esteem also showed a weak direct effect on depressive symptoms. CONCLUSION: The findings suggest that negative thinking may play an important role in the development of depressive symptoms in college women.

Reducing negative thinking and depressive symptoms in college women.

PURPOSE: 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. DESIGN: A randomized controlled trial with 92 college women ages 18 to 24 who were at risk for depression was conducted. METHOD: Participants were randomly assigned to either the control or experimental group. The experimental group participated in a 6-week cognitive-behavioral group intervention. Data on self-esteem, depressive symptoms, and negative thinking were collected via self-report questionnaires from control and experimental groups at baseline, 1 month after the intervention, and at 6-month follow-up. Data were analyzed using mixed-model methodology and the Cochran-Mantel-Haenszel chi-square test. FINDINGS: Compared to those in the control group, women who received the intervention had a greater decrease in depressive symptoms and negative thinking and a greater increase in self-esteem, and these beneficial effects were maintained over 6-months. CONCLUSIONS: The findings document the effectiveness of this cognitive-behavioral group intervention and indicate empirical support for the beneficial effects of reducing negative thinking by the use of affirmations and thought-stopping techniques on women's mental health.

Evidence-based practice and the advanced practice nurse: a curriculum for the future.

The concept of evidence-based practice has gained increased attention throughout the 1990s as a strategy for linking the best scientific findings with clinical judgment to improve health outcomes. Because the concept implies finding, evaluating, summarizing, and using research results, a high level of clinical reasoning skills is required. Effective evidence-based practice also requires the incorporation of new practices into clinical and organizational settings, thereby demanding advanced leadership skills. Competencies in clinical reasoning, leadership, and clinical practice are critical for advanced practice nurses. This article describes a master's-level curriculum supportive of evidence-based practice and includes recommendations for developing curricula of this type.

The evolution of an intervention--the use of Peplau's process of practice-based theory development.

In 1969, at the first Nursing Theory Conference, Hildegard Peplau proposed a research methodology that would guide the development of nursing knowledge. To direct nurses in the development of practice-based theory, Peplau proposed a three-step process that would assist in this pursuit. The purpose of this paper is to describe the use of Peplau's process of practice-based theory development as it has directed a program of research in the area of depression. Peplau's ideas related to practice-based theory development came at a time in nursing when grand theories were being developed and theoretical nursing was highly valued. Peplau, ahead of her time, proposed an approach that valued the development of nursing knowledge in practice, while also combining both qualitative and quantitative methods. This research methodology deserves recognition today, as one that can guide knowledge development in psychiatric nursing.

Recovering from depression: a one-year follow-up.

The purpose of this research was to further describe the process of recovering in women who have been depressed. In prior research, recovering from depression consisted of eight categories within three distinct phases and was initiated by a crisis or 'Turning Point' experience. In-depth follow-up interviews with the seven women who participated in a study that had been performed one year earlier were conducted in order to: (i) determine their status in the recovering process; (ii) describe in greater depth the antecedents of the recovering process; (iii) identify potential interventions to assist women in recovering. No new phases of the recovering process were identified in the present study. Interventions that assisted recovering were psychoeducational in nature, instilled hope, and provided for individualized treatment. Recommendations for further research are included in this study. Little empirically based information is available on the process or recovering among women who experience depression. This research is a one-year follow-up of women who participated in an earlier qualitative study of the process of recovering in women who had been depressed. In the previous study, recovering from depression was found to consist of eight categories within three distinct phases, and to be initiated by a crisis or Turning Point experience. The purpose of this present study were to: (i) determine the status of the recovering process one year later; (ii) more fully describe the antecedents of the process; and (iii) propose testable nursing interventions to assist women with depression toward recovering.

Up from depression: strategies used by women recovering from depression.

Depression has reached epidemic proportions among women. It is estimated that one out of every three women between 18 and 24 years is significantly depressed. The purpose of this paper is to describe treatment strategies, interventions, and skills used by women to recover from depression. Three distinct categories of effective strategies that enhanced recovery are described. These include cognitive strategies, active behavioral strategies, and information seeking. In order to deliver quality psychiatric nursing care, nurses must have knowledge of the strategies used by women who are recovering from depression.

Music: making the connection with persons who are homeless.

1. Persons who are homeless experience isolation and loneliness; many lack social skills or the ability to interact comfortably with others. A music program designed to increase socialization and relaxation of homeless persons using a multiservice shelter is described. 2. The use of music provides the psychiatric nurse an entry into therapeutic relationships and an opportunity to establish relationships with persons who often do not initiate contact with others. 3. Music promotes relaxation and interaction with others. Listening to music decreases loneliness and isolation. The music program was effective in fostering a sense of well-being and allowing the participants to join together in a meaningful activity.

Recovering in depressed women: research with Peplau's theory.

The purpose of this research was to describe the process of recovering in women who have been depressed. The descriptive research design for this study was guided by Peplau's interpersonal theory of nursing. The sample consisted of seven women who had at one time been hospitalized with a diagnosis of depression and who now considered themselves to be recovering. Audiotaped interviews were conducted in the women's homes. Verbatim transcripts were analyzed using content analysis. The analysis revealed that the process of recovering as described by the seven depressed women consisted of eight categories which comprised three phases. Recovering was initiated by a crisis or turning point experience. Phase I consists of the turning point and professional support; phase II consists of determination, work-over-time, support of family and friends, and successes; and phase III consists of self-esteem and maintaining balance. The process of recovering is internal and ongoing. Further research is suggested.

After menopause.

Women of 50 today have roughly the same number of years to look forward to as they have already lived as reproductive women. Many women will live 30,40 or even 50 years post menopause. This very important period in women's lives has been studied little and viewed negatively by the medical profession and society at large. The purpose of this paper is to examine the psychological and physiological concerns of women at menopause. Self-help measures that are effective in managing the physical and psychological aspects of menopause are discussed. Hormone replacement therapy as a method of managing menopause is examined. Women are challenged to sort out the myths surrounding menopause, to take charge of their health and to move into this second season of their lives filled with vitality and joy.

Transfer of continuing education to practice: testing an evaluation model.

A continuing education (CE) program is successful only to the extent that a recommended practice or behavior is implemented. The social system in which the nurse practices and the nurse's own receptiveness to change also influence the application of new knowledge.