Nonpharmacological therapeutic techniques to decrease agitation in geriatric psychiatric patients with dementia.

Agitation is not only a frequent and disturbing behavior for many patients with dementia, but it also troubles their caregivers and families. Many serious problems and side effects are associated with the use of medications to treat agitation; therefore, alternative approaches to treating agitation must be assessed. The current article presents results from a quality improvement pilot project that examined the usefulness of a specially designed, multisensory room intervention for geriatric psychiatric inpatients with mild to moderate agitation. Thirty-two visits to the sensory room were made by 13 inpatients with dementia. A significant decrease occurred in the Pittsburgh Agitation Scale (PAS) total scores over time from pre-room to post-room intervention, as well as 1-hour post-room intervention (F = 95.3, p < 0.001). Significant effects were found for all PAS subscales (i.e., aberrant vocalizations, motor agitation, and resistance to care), with the exception of the aggression subscale. The multisensory room intervention was effective in decreasing some symptoms of agitation in the geriatric psychiatric patient, thus contributing to positive patient, family, and nursing outcomes.

Sex differences in self-reported anxiety in rural adolescents.

An anxiety disorder affects 13 out of every 100 children. The purpose of this paper is to determine if there are differences in self-reported anxiety between male and female rural adolescents. In total, 193 students aged 14-17 years in three western Pennsylvania rural high schools, USA, were surveyed. The majority of participants were Caucasian (86.5%, n = 167), female (53.4%, n = 103), and aged 15.57 years (SD = 0.93). The females' mean self-reported anxiety score was higher than the males' score (P < 0.0001). The females' mean score was 25.09 (SD = 13.83; a score > or =25 may indicate the need for further evaluation for the presence of a potential anxiety disorder), while the males' mean score was 16.88 (SD = 10.81). Of interest, all the five factor (specific types of anxiety) scores were significantly different between males and females at P < 0.05. Evidence-based implications for the mental health nurse's practice will be discussed. Anxiety screening is promoted to identify adolescents who may need mental health treatment and referrals, especially rural female adolescents.

THE RELATIONSHIP BETWEEN WEIGHT PERCEPTION, GENDER, AND DEPRESSIVE SYMPTOMS AMONG RURAL ADOLESCENTS.

Research findings indicate a relationship between weight perception and depression in adolescents. This study explored the relationship between weight perception, gender, and depressive symptoms in rural adolescents. Among 623 rural adolescents who completed a health inventory and a depression scale, 75 participants (n = 62 females; n = 13 males) had depressive symptoms and were used in data analysis. A two-way ANOVA model was used to evaluate the effects of weight perception and gender on depressive symptoms in rural adolescents. Although the 2-way ANOVA was not significant, there was a statistical significant finding for females who reported perceived weight problems and depression. The interaction between gender and weight perception was of marginal statistical significance (p = 0.07). Females who perceived a problem with their weight had higher depressive scores compared to females who did not perceive a problem with their weight (p = 0.0002), however no difference was observed for males. Implications are for rural nurses to screen adolescents for depressive symptoms and their weight perception during health care visits, with emphasis on females.

Considerations to implement holistic groups with the elderly.

The group modality is a viable holistic treatment consideration for the elderly, given the steady increase in the elderly population, the presence of various psychiatric and/or medical conditions in this cohort, and cost concerns. The holistic nurse and group leader share similar role definitions of being a facilitator in the healing process. They embrace the concept that the person and group are greater than the sum of the parts. Using a group modality can increase the number of people served by one nurse, thereby making it cost-effective. Incorporating the holistic mind-body-spirit approach addresses the Healthy People 2010 goal of increasing the quality of life. Tips on conducting groups with the elderly are reviewed, including types of groups, setting, goals, composition, duration, and frequency. Theme-centered groups are discussed from a holistic perspective. Yalom's 11 therapeutic factors that account for group functions are explained, along with other group concepts that reflect holistic nursing concepts.

Anger correlated with psychosocial variables in rural youth.

Uncontrolled anger is a contributing force in the three leading causes of adolescent death: homicide, suicide, and injuries. Anger may be one of the early warning signs which could lead to violent behavior. The purpose of this study was to examine the relationship between anger experience and expression with the potential correlates of life events, perceived social support, self-esteem, optimism, drug use, anxiety, and depressive symptoms in rural adolescents. The participants (n = 193) were aged 14 to 17 years old in ninth through eleventh grades enrolled at three rural Western Pennsylvania public high schools. Participants completed nine questionnaires. Negative life events, anxiety, drug use, and depressive symptoms had significant positive correlations with anger. In addition, anger was found to have significant negative correlations with the adolescents' perceived family support, self-esteem, and optimism. With this knowledge, health promotion programs conducted by pediatric nurses can target anxiety, drug use, and depressive symptoms while bolstering family support, self-esteem, and optimism to promote anger management in adolescent health care.