Emergency Department-Initiated Interventions for Illicit Drug Overdose: An Integrative Review of Best Practices.

More than 20 million people in the United States have a substance use disorder (SUD), increasing their risk for overdose (OD). Patients arriving to emergency departments (EDs) with OD typically require lifesaving interventions, but inconsistencies exist regarding further intervention and discharge instructions. The purpose of the current integrative review was to determine best care practices for patients presenting to EDs with an illicit drug OD. A literature search included the databases PubMed, EBSCO Host, ProQuest Health and Medicine, and Google Scholar. Thirty-five articles outlined interventions for SUD/OD initiated in EDs; most for opioid OD. Best practice intervention components included psychiatric evaluations, SUD screening tools, buprenorphine initiation, naloxone distribution and training, OD prevention education, referrals to medication-assisted treatment, and harm reduction strategies. Barriers to implementation included legislation, insurance/costs, community resource availability, staffing, training, and potential stigma. With myriad approaches, nurses with SUD care experience can advocate for instituting best practices for patients in the ED and upon discharge. [Journal of Psychosocial Nursing and Mental Health Services, 61(6), 18-24.].

Lessons From the Field: Strategies for Success in Obtaining Grant Funding.

OBJECTIVE: To summarize a preconference workshop that focused on how to be successful in obtaining funding by making one's scholarship innovative and significant. METHOD: In 2021, at the annual American Psychiatric Nurses Association (APNA) Conference, a panel of nurse scholars reflected on and discussed how to make grant proposals innovative and significant. Two moderators posed questions to five panelists at different stages in their research trajectories about four key research concepts: idea conception, framing for the funding agency, significance, and innovation. RESULTS: Conceptualizing an innovative, scholarly idea starts with a passion for the topic, a team of experts and scholarly community, and time to think and delve into the literature. For funding opportunities, start small, read the funding announcements thoroughly and carefully, and make sure it is the right fit. Strategies to illustrate significance include avoiding generalizations, maintaining objectivity, being clear about impact, and using strength-based language. Contemplate the many facets of innovation as well as balance innovation and feasibility. CONCLUSIONS: Inclusion of challenges in composing significance and innovation sections of grant proposals offers knowledge for psychiatric nurse researchers to add to their toolkits as they seek funding and conduct research and scholarship.

Research Priorities in Psychiatric Mental Health Nursing: Funding Availability, Recently Published Work, and Future Directions for Advancing Our Science.

BACKGROUND: Identifying and sharing psychiatric mental health (PMH) research priorities can help identify gaps in the literature, determine training needs for nurses, and assist investigators in locating funding. AIMS: The aims for this project included: (1) identify PMH nursing specialty research priorities from large, public funding entities; (2) compare the identified research priorities and scholarly articles published in 2020; and (3) outline future directions for advancing the science of PMH nursing. METHODS: Strategic plans of funding entities for PMH research were reviewed for research priorities. Summarized priorities were then compared with publications from peer-reviewed PMH nursing journals. Work conducted in the United States was extracted and categorized as original research, evidence-based practice (EBP), or quality improvement (QI), then design and population. RESULTS: Priorities from 13 funding entities comprised three domains (education, research, and practice), with nine areas, 30 topics, and subtopics. Eight journals produced 432 articles with 99 (23%) conducted in the United States. Among these journals, publications fitting research priorities ranged from 1 to 33 articles. Of the 99 articles, 85% were original research and 15% were either EBP or QI. Descriptive articles comprised 64% and 23% tested interventions. Populations studied included workforce; adults; infants, children, and adolescents; and parents. CONCLUSIONS: All published articles by the U.S. PMH nurses matched the funding priorities, but not all funding priorities were addressed by 2020 publications. The majority of work was conducted outside of the United States and most published from the United States was descriptive, contrary to many United States funders' priorities for interventional research.

Parental opioid use disorder: Examining their children's experiences, needs, and road to resilience.

PROBLEM: Over 8 million children in the United States live with a parent with substance use disorder (SUD), inclusive of opioid use disorder (OUD). This is an adverse childhood experience (ACE), that often leads to poor outcomes such as developing SUD or mental illness. Interventions and research have focused more on the parent and not their children. Without emphasis on child's experiences, their needs, and building interventions toward developing resilience, the intergenerational cycle of SUD/OUD will persist. METHODS: Nine children (ages 12-17) in custody of Social Services, who experienced a parent with OUD, participated in this pilot study. The intervention was SAMHSA's Children's Program Kit: Supportive Education for Children of Addicted Parents. Thematic analysis of verbal responses/behaviors, observations, field notes, and any retained materials (i.e., handouts) was conducted over eight sessions. FINDINGS: Findings included three themes regarding participant's experiences: Meaning of a Parent; Others Involved; and Witnessing the Cycle. Two sub-themes also emerged: Ways to Cope and Support from Various Sources. CONCLUSIONS: Results support mental health nurses as forerunners in building, implementing, and evaluating child-focused interventions for children of parents with OUD. Interventions should focus on the needs of the children and use a strength-based approach to promote their resilience.

Promoting resilience for children of parents with opioid use disorder: A pilot study of a directed intervention.

PROBLEM: Having a parent with Opioid Use Disorder (OUD) is a childhood adverse experience (ACE), magnified by other accompanying ACEs. Outcomes for these children tend to include developing mental illness and/or Substance Use Disorders themselves. Few studies address these children's experiences and needs. Without child-focused interventions to foster their resilience, generational ramifications of the OUD crisis will persist. METHODS: Nine children (ages 12-17), in Department of Social Services' custody, participated in this pilot study. The intervention delivered was Substance Abuse and Mental Health Administration's Children's Program Kit (CPK): Supportive Education for Children of Addicted Parents. Measures included OUD knowledge pre/posttests and the Behavioral and Emotional Rating Scale (BERS-2). FINDINGS: Findings from paired-samples t tests showed a significant increase in youth OUD knowledge from pre to posttest. Affective strength on the parent version (foster parent or social worker's perception of participant) and overall strength index on the youth's version BERS-2 increased significantly from pre to posttest. Career strength, a separate strength index, showed significant increased scores on both youth and parent BERS-2 versions pre to posttest. CONCLUSIONS: Results support Psychiatric Mental Health nurses to lead development and implementation of interventions, such as the CPK, with a strength-based approach to promote the knowledge and resilience of these children.

Children of Parents With Opioid Use Disorder.

Substance use disorders (SUDs) have been a priority public health concern for decades, with most recent conversations focusing on the opioid use disorder (OUD) epidemic. Children of parents with OUD have been impacted through poverty, violence, neglect, and emotional and physical abuse. Although treatment programs may address the family and parental role, few focus on the children. Without building resiliency in a child's mental and physical health, the far-reaching impact of the opioid epidemic will continue. The goal of the current literature review was to critique available intervention programs that focus on children of parents with SUD/OUD and provide recommendations for best practice. A literature search found six child-focused intervention programs dated in the 1990s and early 2000s and generalized to parents with SUDs. No intervention was found specific to children of parents with OUD. Nurses and other health professionals can use these findings to determine which evidence-based intervention is most appropriate for the needs of this specific population. [Journal of Psychosocial Nursing and Mental Health Services, 59(3), 28-34.].

Correction to: Losing to Gain: The Effects of a Healthy Lifestyle Intervention on the Physical and Psychosocial Well-being of Clients in a Community-based Mental Health Setting.

The original version of this article unfortunately contained an error in author group. The second author Tamatha Arms was inadvertently missed to include in the author group.

Losing to Gain: The Effects of a Healthy Lifestyle Intervention on the Physical and Psychosocial Well-being of Clients in a Community-based Mental Health Setting.

Individuals with severe and persistent mental illness (SPMI) encounter both poorer physical health and psychosocial well-being in comparison to the general population. Obesity, hypertension, heart disease, and diabetes can result from the symptoms of mental illness, the side effects from psychotropic medications, as well as disparities associated with being mentally ill. Mental health nurses are in a prime position to implement healthy lifestyle interventions (HLIs). This study tested a HLI (physical exercise and nutrition) and examined the effects on physical and psychosocial outcomes in clients obtaining mental health services at a community-based facility. Key findings included a decrease in anxiety and depressive symptoms at 3 months and consistent improvement in self-efficacy for exercise in the intervention group. Bridges and barriers to achieving optimal results in physical and psychosocial well-being were identified. Findings from this study offer insight into designing and executing more effective HLIs with individuals who have SPMI.

Applying ambiguous loss theory to children of parents with an opioid use disorder.

PROBLEM: Opioid use disorder (OUD) has reached epidemic proportions in the United States. Children of parents with OUD are an unrepresented population, who often suffer consequences from their parent's substance abuse disorder. Such children may incur numerous psychosocial and physical losses. Without intervention, they are more likely to be diagnosed with a mental illness and/or substance use disorder (SUD). METHODS: This paper examines the experiences of children of parents with OUD using Boss's theory of ambiguous loss (AL) as a lens. FINDINGS: Children growing up with a parent who has an OUD experience AL through that parent's physical absence and psychological presence (e.g., the parent is out opioid-seeking or in rehab or jail) and psychological absence but physical presence (e.g., the parent is high or in withdrawal, or is preoccupied with obtaining opioids). Evidence supports the fact that OUDs affect parenting, produce changes in the parent-child relationship, and often impact child development. Interventions that are child-focused are lacking. CONCLUSIONS: The application of AL theory to this problem can enhance health professionals' understanding and need for developmentally specific interventions to care for this population. Interventions should focus on diminishing stigma and promoting psychosocial wellness and resiliency for children of parents with an OUD.

American College Students' Views of Depression and Utilization of On-Campus Counseling Services.

BACKGROUND: College students are becoming increasingly depressed; however, many do not attend university counseling to seek help. OBJECTIVES: What is the relationship between young adults' mental health literacy, perceived stigma of depression and treatment, knowledge of treatment benefits and risks, beliefs about alternative therapies, and influence of his or her social network with usage of university counseling? STUDY DESIGN: A survey was administered to N = 107 American undergraduate college students to ascertain the students' understanding of depression and their views of counseling services on campus. RESULTS: Both likelihood of using alternative therapies and perceived discrimination of social network accounted for 18% of the variance for likelihood of participants seeking campus counseling. CONCLUSIONS: When a young adult college student perceives stigma or discrimination of depression from family and friends, then they may be less likely to seek university counseling for depression as well as possible applications with alternative therapies as a favorable option.

Eating disorders and spirituality in college students.

Associations were examined between eating disorder symptoms and spiritual well-being in a convenience sample of college students. Undergraduate nursing students at a university in a Mid-Atlantic coastal beach community were recruited for the study. A total of 115 students completed the Spiritual Well-Being Scale (SWBS); the Sick, Control, One Stone, Fat, Food (SCOFF) screening questionnaire; and the Eating Attitudes Test (EAT-26). Approximately one quarter of students had positive screens for an eating disorder, and 40% admitted to binging/purging. SWBS scores reflected low life satisfaction and a lack of clarity and purpose among students. A significant association was found between EAT-26 scores and SWBS Existential Well-Being (EWB) sub-scale scores (p = 0.014). SCOFF scores were significantly associated with SWBS EWB scores (p = 0.001). Symptoms of eating disorders were pervasive. Future research that assesses the impact of spiritual factors on eating disorders may help health care providers better understand the unique contributions to the development of eating disorders. [Journal of Psychosocial Nursing and Mental Health Services, 53(1), 30-37.].

E-cigarettes: a rising trend among youth.

Electronic cigarettes, known as "e-cigarettes," were designed as a smoking cessation tool for adults. An unintended audience for the product has been found with adolescents, many of whom have never used conventional cigarettes. Broad consequences of e-cigarettes on adolescent health include nicotine addiction-and later nicotine withdrawal-and potential for nicotine overdose. U.S. Food and Drug Administration regulations are non-existent; empirical evidence regarding e-cigarettes is limited; and studies conducted with adolescent e-cigarette use are even less common. Prevention measures must target the manufacturers and retailers of these devices as well as adolescents, parents, schools, and health care professionals. Psychiatricmental health nurses are well positioned to raise awareness of the dangerous consequences of e-cigarette use in teens.

The choking game: a risky behavior for youth.

Nurses working with children and adolescents should be cognizant of choking games, risky acts in which pressure is applied to the neck and the airway is obstructed to achieve a high. Evidence supports that many children and adolescents do not understand the grave consequences of choking games nor do they view participation as dangerous. Parents, teachers, pediatricians, nurses, and psychiatric-mental health professionals are not always aware that children and adolescents are engaging in choking games. The purpose of this article is to describe the signs, changes over the years, consequences, and educational resources available for addressing this behavior in children and adolescents. Understanding the nomenclature of choking games, how to assess, and how to intervene when participation in this behavior is suspected are also addressed.

Sexting: serious problems for youth.

Youth engaging in sexting (texting plus sex) includes behaviors such as sending, receiving, or forwarding of nude or partially nude images via cell phones. The true prevalence of tweens and teens engaging in sexting is unclear. This might be because of the general secrecy of the behavior, the rapid advances in technology, and the lack of a clear definition that accounts for the added developmental factors (e.g., peak sexual development, impulsivity). Additionally, there is a lack of recognition of the consequences and increased risks of sexting (e.g., shame and guilt, earlier sexual behavior, bullying, incarceration, substance abuse, depression, suicide) for youth as a vulnerable population. The purpose of this article is to examine sexting behaviors among youth by exploring factors specific to today's adolescent population that may influence the prevalence and outcomes of sexting behavior. Implications for nursing practice, including the assessment, intervention, and evaluation that is needed to treat adolescents affected by sexting, are discussed.

Promoting cultural awareness in nursing education through international videoconferences.

This paper describes a highly successful, 10 year long international videoconference exchange between nursing students in Iwate Prefectural University in northern Japan and the University of North Carolina Wilmington in the United States. A summary of the literature on the use of videoconferencing in nursing education is presented, as well as a brief overview of the collaborative partnership that led to the development of the annual videoconference series. A description of the process for conducting the annual real-time sessions is included along with student perspectives about their experiences. Planning, support and open-mindedness on the part of both students and nursing faculty have contributed to the success of this collaborative effort.

The experiences of youth serving as caregivers for mentally ill parents: a background review of the literature.

Young caregivers of mentally ill parents are a vulnerable population. These vulnerabilities include risks for developmental issues, poor socialization, and poor school performance. The purpose of this background review of the literature is to explore the experiences of young caregivers of mentally ill parents and detect the gaps in the literature. The guiding research questions were: What is the experience of young caregivers of mentally ill parents? and What is the experience for those who witness or must assist their parent during a crisis? The majority of research has been conducted outside the United States, primarily in the United Kingdom, and studies have focused mostly on young caregivers of parents with physical rather than mental illness. No studies focused on young caregivers who witnessed or assisted their mentally ill parent in crisis. Information gained through this review will add to the body of knowledge for child mental health and build a case for additional research.