Hospital-to-community transitions. A bridge program for adolescent mental health patients

Making the transition from the hospital to a community setting can be extremely challenging for patients with acute mental health conditions. Transitional services have been created to help patients overcome difficulties associated with this transition. Nurses frequently play an integral role in the success of these services. By providing patients with individualized support during such transitions, nurses act as clinical liaisons and directly contribute to an increase in positive patient and system-level outcomes. This article describes a transitional service called the Bridge Program, designed to help adolescents make a successful transition from the hospital to the community. An overview of the Bridge Program is provided, and the results of an evaluation of this program are presented. Results suggest that the Bridge Program contributes to a decrease in the length of hospital stays and improves continuity of care for patients and their families.     

Mindfulness: an intervention for anxiety in schizophrenia

Despite evidence that individuals with schizophrenia spectrum disorders experience significant and persistent symptoms of anxiety, there are few reports of the use of empirically supported treatments for anxiety in this population. This article describes how we have tried to adapt mindfulness interventions to help individuals with schizophrenia who experience significant anxiety symptoms. Although mindfulness has been widely used to help individuals without psychosis, to our knowledge, this is the first study adapting it to help those with schizophrenia manage worry and stress. We provide an overview of the intervention and use an individual example to describe how our treatment development group responded. We also explore directions for future research of mindfulness interventions for schizophrenia.     

Adolescent self-mutilation: diagnosis & treatment

Self-mutilation is complicated and difficult to diagnose. Its incidence among adolescents has increased during the past 10 years. Most mental health professionals discover that the behavior has been part of patients' lives long before their initial visit and that patients have become very good at hiding their behavior. The literature on self-mutilation is increasing, but newer statistics, specifically about cutting and picking behaviors, need to be assessed. The disorder often co-exists with another disorder that requires psychotropic medications, the administration of which should be managed by psychiatric clinicians who specialize in children and adolescents. A multidisciplinary team is necessary to achieve the best outcomes.     

Do hostile sexual beliefs affect men's perceptions of sexual-interest messages?

This study tested the distorted cognitions component of Hall and Hirschman's (1991) quadripartite model of sexual aggression. Men (N = 107) with and without hostile sexual beliefs viewed erotic slides with a female partner who provided one of four patterns of feedback: clear disinterest, token disinterest, compliant interest, and clear interest. Hostile men reported fewer differences between women, were unresponsive to their partner's perceived embarrassment, and reported a consistent positive mood regardless of her feedback. Conversely, nonhostile men were more responsive to feedback, mirrored the partner's embarrassment, and experienced a less positive mood when she communicated clear disinterest in the erotica. These findings support the distorted cognitions component of the quadripartite model of sexual aggression. The authors also discuss the strengths and limitations of this study's methodology.     

Point subtraction aggression paradigm: validity of a brief schedule of use

The Point Subtraction Aggression Paradigm (PSAP) is a validated behavioral measure of aggression in response to provocation. Canonically, multiple sessions continue until performance asymptotes, requiring significant time. We sought to examine whether use of the PSAP-first-session ("PSAP-FS") had acceptable construct validity for group data, potentially expanding the settings in which the PSAP may be useful. One hundred male and female young adult subjects completed the PSAP-FS and additional behavioral measures of aggression, and provided information related to risk factors. The PSAP-FS correlated significantly with known risk factors of aggression. The PSAP-FS, which measures aggression in the present, correlated well with measures of recent aggression and less strongly with life history of aggression. The PSAP-FS had satisfactory validity properties for use where group-level data are of interest.     

Examining the correlates of engagement and disengagement coping among help-seeking battered women

This study examined several potential correlates of engagement and disengagement coping, including abuse-related factors, socioeconomic and social coping resources, and childhood trauma variables among a sample of battered women (N = 388). Relationship abuse frequency, particularly psychological aggression, and peritraumatic dissociation were the strongest positive predictors of the use of disengagement coping. Social coping resources, including tangible support and appraisals of social support and belonging, were associated with higher engagement coping and lower disengagement coping. A positive association was also found between interparental domestic violence and disengagement coping, and negative associations were found between both childhood physical and sexual abuse and engagement coping. Results suggest that coping strategies used by battered women are multidetermined and deserve further exploration.     

Relationship of interpersonal behaviors and health-related control appraisals to patient satisfaction and compliance in a university health center

OBJECTIVE: The authors' aim was to evaluate patient-provider relationships in a college health center. PARTICIPANTS: Eighty student patients and their health-care providers. METHODS: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before and after the consultation. They evaluated their satisfaction with care and compliance after the consultation and again 2 weeks later. Providers completed measures of their participatory behavior and patients' interpersonal behavior after the consultation. RESULTS: Patients preferred to be well informed and to have their preferences taken into account, and generally felt competent at managing their own health affairs. They indicated they obtained the high level of participation they desired. Patients desired and actually experienced friendly and submissive providers. Degree of match between patients' desired and actual level of involvement in their care was associated with greater satisfaction. A greater match between the extent to which they desired the provider to be affiliative and the provider's actual affiliative behavior was associated with more satisfaction. No variables were predictive of patient compliance. CONCLUSION: The authors discuss results in terms of the influence of situational factors characteristic of a college health center.     

Developing and testing a satisfaction survey for nursing home residents: the Ohio Experience

Input from consumers has become an important part of quality improvement in long-term care and for consumer decision-making. This paper documents the development of the Ohio Nursing Home Resident Satisfaction Survey (ONHRSS) through a partnership of state government, research, and industry experts. The instrument was tested and refined through two waves of data--a pretest phase and later with statewide data. Exploratory and confirmatory analyses with statewide data identified eight primary factors along with an underlying, secondary Global Satisfaction factor. Reliability of the domains ranged from .69 to .95. Recommendations for further refinement and testing of the instrument are discussed along with policy and practice implications.