MSN- Psychiatric nurse practitional
Note -Rubric must be used 100%
Plagiarism should be less than 5% for this work to be accepted.

Using the Data/Information/Knowledge/Wisdom Continuum
Have you ever gone online to search for a journal article on a specific topic? It is amazing to see the large number of journals that are available in the health care field. When you view the library in its entirety, you are viewing untapped data. Until you actually research for your particular topic, there is little structure. Once you have narrowed it down, you have information and once you apply the information, you have knowledge. Eventually, after thoughtful research and diligent practice, you reach the level of wisdom?knowledge applied in meaningful ways.

Are there areas in your practice that you believe should be more fully explored? The central aims of nursing informatics are to manage and communicate data, information, knowledge, and wisdom. This continuum represents the overarching structure of nursing informatics. In this Assignment, you develop a research question relevant to your practice area and relate how you would work through the progression from data to information, knowledge, and wisdom.
To prepare:
Review Nursing Informatics and the Foundation of Knowledge.

Develop a clinical question related to your area of practice that you would like to explore.

Consider what you currently know about this topic. What additional information would you need to answer the question?

Using the continuum of data, information, knowledge, and wisdom, determine how you would go about researching your question.

Explore the available databases in the Walden Library. Identify which of these databases you would use to find the information or data you need.

Once you have identified useful databases, how would you go about finding the most relevant articles and information?

Consider how you would extract the relevant information from the articles.
How would you take the information and organize it in a way that was useful? How could you take the step from simply having useful knowledge to gaining wisdom?

Write a 3- to 4-page paper that addresses the following:
Summarize the question you developed, and then relate how you would work through the four steps of the data, information, knowledge, wisdom continuum. Be specific.
Identify the databases and search words you would use.

Relate how you would take the information gleaned and turn it into useable knowledge.

Can informatics be used to gain wisdom? Describe how you would progress from simply having useful knowledge to the wisdom to make decisions about the information you have found during your database search.
Your paper must also include a title page, an introduction, a summary, and a reference page.

***** Rubric

27 (27%) - 30 (30%)
Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics.

5 (5%) - 5 (5%)
A clear and comprehensive purpose statement is provided which delineates all required criteria.

9 (9%) - 10 (10%)
Demonstrates the ability to critically appraise and intellectually explore key concepts

18 (18%) - 20 (20%)
Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view.

18 (18%) - 20 (20%)
Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.


5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity
5 (5%) - 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors

5 (5%) - 5 (5%)
Uses correct APA format with no errors.

- 500 word graduate admission essay for psychiatric nurse practitioner program.

Currently work in an intensive care unit. There are increasing more and more HIV
patients with mental health issues. Many are ill equipped to deal with their illness and feel ashamed by their diagnosed. Furthermore medical staff members without psychiatric training are ill equiped to deal with the mental health of these patients. Often their mental health issuses are often ignored.


Patients are often stigmatized because they are HIV and have a mental illness. This in turn may obstruct their ability to seek expert care. I desire to be nurse psychiatric practitioner working with this population. Rightly trained in ths field, I can make a difference in helping patients deal with their reality and seek the resources needed for care.


My commitment to this filed evidence by taking attending classes with the Columbia University HiV Mental Health Training Project and the NY / NJ AIDS Education Training Center for exposure in dealing with these patients.

I would like a 20 page paper (includes table of contents, and references page), written in APA, containing an abstract and table of contents and opening and conclusion on the following.
Titled - The importance of spirituality to Psychiatric Nursing

Using Betty Neuman''s Systems Model I wish to have the following covered. Subjects that can be used to address the importance are:

-Role of theory in practice; role and function of psych nurses in a service system using key concepts such as role theory, change theory, case management principles and issues; therapeutic agent, therapeutic use of self, therapeutic relationships, advocacy, consultation, referrals and networking.
-Analyze concepts and their interrelationships relevant to client and services and service systems such as collaboration, coordination, consultation, referral, conflict resolution, and networking.
-Analyze concepts related to the role of psychiatric nurses such as leadership style, power and influence, lobbying, gender issues in practice the politics of nursing and other systems, professional issues, personal versus professional role expectations and burnout.
-Analyze roles and functions of agencies and personnel within the service system such as mission statements, philosophy, goals, mandate, accreditation standards, relationships intrasystem, intersystem and extrasystem, professional codes and standards.
Some concepts do not have to be addressed directly then can be implied. eg: networking, referrals, mission statements, philosophy, mandate accreditation standards,.
Is it at all possible to have such a paper?

Using the following references: 6-7 references may be added

The Tapestry of Hospice: Mary Ann Krisman=Scott Holistic Nurs Pract 2002(16(2)
Are we wired for spirituality or religion: http://www.iona.edu/academic/arts_sci/orgs/resiliency/cremins.htm
The commonality and synchronicity of mental health nruses and palliative care nurses: closer than you think? Part One Journal of Psych & Mental Health Nursing 2001, 8-53-59
The commonality and synchronicity of mental health nruses and palliative care nurses: closer than you think? Part Two Journal of Psych & Mental Health Nursing 2001, 8 61-66
Spirituality as a Part of Nursing Journal of Hospice and Palliative Nursing Vol2 No3 Jul-Sept 2000
A comparative Study of the spiritual perspectives and interventions of mental health and parish nurses Issues in Mental Health Nurs. 2 2:593-605, 2001
Should we give palliative care to all those that need it? Intern. Jrnl of Palliative Nursing 2002, Vol 8 No 2
Spirituality in palliative care: what language do we need? Int Jrnl of Palliative Nursing 2002, Vol 8, No 2

The Term Paper
In consult. with tutuor you''ve decided on topic and sub-themes to be included. This paper demonstrates critical analysis of your topic and relevant sub-themes/concepts incl implicationas for psychiatric/mental health nursing practice. It may further the development of your work in your essay or it may be a separate topic area. Using your annot. biblio articles (mentioned above), the paper will enable you to articulate rationales to support your point of view (that spirituality is very important in psyc nursing) or perspectives around issues related to your topic.
Method & Eval:
Submit a 20 pg paper providing a full yet succinct and well referenced discussion and analysis of issues related to your chosen topic area. You are expected to integrate your own perspectives on the topic (that spirituality is very important in psyc nursing) and related themes/concepts into the paper and support your rationaless with referecne to the literature.
Prepare and abstract of 300 words or less and attach the abstract to the front of the paper.

I will be sending the PDA Journal article "Culturally Competent phsyciatric nursing care" But I will need the Author to provide remaining 4 references.

Psychiatric Nursing
Essay: Systematic Review of an Approved Journal Article "Culturally competent psychiatric nursing care"

Criteria:
Describe the authors purpose of the journal article
Describe the methodology used, type of research (qualitative or quantitative), and any statistics given.
Depict the conceptual framework used by the authors and the nursing theory application.
Concluding paragraph: Do you agree or disagree with the authors conclusion. Substantiate validate/prove) your response with citation/s.
No more than 1 direct quote (APA format)
Must include abstract:
Length: 7 (excluding title page, abstract, reference page and appendix if used) .
References: At least 5 references (one is your chosen journal article, a second can be the text for this class). The other 3 references must be academic sources (journal articles, web pages ending with .org, .edu, or .gov)
APA format (title page, reference page, headings, subheadings, citations in text)
Spelling & Grammar (put it through spell check before submitting).

There are faxes for this order.

http://news.bbc.co.uk/2/hi/programmes/panorama/4701651.stm
http://www.southerneditorial.co.uk/bulletin/july05/breaknews.htm

http://www.nursingtimes.net/Journals/1/Files/2009/4/17/haywood_NMCruling.pdf

http://jme.bmj.com/content/36/8/469.abstract

With reference to the case material below, identify what you think should have been done in relation to the poor care on the ward. Present your arguments in report format and include at least one diagram.
Case material
Margaret Haywood interview
?A double agent, that's what I was?
You may wish to search the internet for additional material relevant to this case.



Margaret Haywood interview

Margaret is a state-registered nurse who spent three months working for Panorama undercover secretly recording her experience working on an acute medical ward in a failing hospital.
What follows is an edited transcript of an interview with her about her experiences and her reasons for chosing to do so.
Why did you decide to go undercover for Panorama?
First and foremost, we were acting on complaints, complaints we had heard from people whose elderly relatives have been patients at the Brighton and Sussex University Hospitals NHS Trust. A lot of thought and planning went into this and I worked on the ward without a camera before we decided that I should begin to film.
The public needs to be aware of exactly what's going on in these places, in these wards. We didn't have another way of telling them.
I feel strongly about nursing standards and I think nursing standards have just declined over the past few years. Hopefully some good will come out of this film. My ultimate aim is that the standards will improve and things will get better.
What was it like filming undercover?
Initially when I went in with a camera concealed in my uniform I felt a bit apprehensive. I had never done anything like filming undercover before, so it was worrying that I might get caught.
But first and foremost I'm a nurse. The nursing always came first when I was on the ward, the filming was a secondary thing.
Tell us about your time working at the Royal Sussex. What broadly did you discover there?
The staffing levels were low in my opinion. Sometimes on a shift I was left on my own looking after 12 patients. Some of the patients were highly dependent and some of them weren't able to communicate and tell me what they needed.
I've been qualified for 20 years. I've worked in highly stressful areas like accident and emergency and intensive care. But this is by far the worst thing I've ever done in all my life. I was completely exhausted at the end of shifts.
I really did do my best while I was there. I worked really hard to make sure that patients were getting good care, the care that they deserved and were entitled to, but sometimes we were so short staffed I could only give them the most basic of care.
What's the one memory you'll take away from this experience?
The memory which will haunt me for the rest of my life, is of a lady who was terminally ill with cancer, crying out in pain because she hadn't been given her pain relief on time. That was just so heartbreaking, it really upset me. When I did a couple of shifts in a row, I was able to make sure she got her pain relief on time and the change in her was sometimes quite remarkable. There was no good reason why it hadn't been given to her. Staff were busy and no one had checked, which is awful.
What other examples of bad nursing practice did you see while you were there?
Patients who found it hard to feed themselves were not always receiving the help they needed, or it took a long time. Some of the patients were really quite thirsty.
Some patients' fluid charts were not being filled in. On a few occasions I started fluid charts and feed charts but I think that it was only me and a couple of others who actually filled them in. Weighing the patients is important as well, to make sure that they're not losing weight and that wasn't always happening.
There were patients who were not getting their medication. Patients were not being helped out of bed. Instead some were being nursed in bed in these awful gowns with splits up the back which is degrading. Patients ought to have the freedom to wear their own nightwear or their own clothes.
You weren't there all the time, so it may be that things were being done better when you weren't there. Is it possible that the impression you've got is a rather unfavourable one?
That's always possible but I think I have a good overview of what's been going on there. It was clear from looking at the patients' reports, which should smooth the handover from nurse to nurse, that communication was poor. Nursing is all about communicating - with your patients and with your colleagues.
None of the patients had any care plans so there was no easy way to check that the care they had been receiving was effective.
If you were starting out in nursing now and this was your first ward experience, what kind of impression would you have of nursing as a career?
I think I would have left. I couldn't have coped with it at all. There's no way I could go through that or watch patients going through that. It's not what nursing is about. The morale was really quite low, everybody seemed to be complaining. It wasn't a happy place to be at all.
What's the single most important thing you'd like to see changed on the ward?
Patients should be given care, allowed their dignity and treated with respect. Nurses should make sure that patients are not left in pain or left in their own dirt. That would be a good start.
Could you have believed anything like this had you not seen it for yourself?
No, nothing could have prepared me for what I've seen. Nothing. Someone has to speak up for these people. It really has opened my eyes.
What risks have you taken to get this film on screen?
The risk that I am taking is that my professional registration might be taken away from me because I have broken confidentiality clauses, which are part of a nurse's code of conduct.
I've been a qualified nurse for 21 years and during that time a lot of people have told me things in confidence and those things have never gone any further. But for this programme it couldn't be like that.
So I had to go back to some of the patients I had nursed once the filming was over and tell them that I had been filming.
I was very worried that the patients or their relatives would feel I had been a double agent and that I had betrayed them or betrayed their confidence but mostly, I had a really positive response. People said that if it would help in the long term to improve care then we should go for it and show what we had filmed.
And the bottom line is that you're prepared to lose your professional registration as a nurse?
Yes. I worked hard to get my registration. I've worked hard all my life and I've earned a lot of respect along the way. I agreed to do the programme because I wanted to improve things in the long-term.
I think it is justified by what I've seen and what will be shown. People will understand. I think most good nurses and good doctors will appreciate what I have done.




'A double agent, that's what I was'
Margaret Haywood was struck off as a nurse after she secretly filmed the neglect of elderly patients on an NHS ward. Four years on, she's finally been reinstated, and is about to start work



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Aida Edemariam
The Guardian, Saturday 14 November 2009
Article history
Margaret Haywood near her home in Liverpool. Photograph: Christopher Thomond
The leaf-strewn streets are empty in the afternoon, and a visitor to this modest terrace cannot be missed; Margaret Haywood comes to the door and lets me in before I have a chance to knock. She lives just round the corner from Anfield stadium in Liverpool, but even as she makes a cup of tea, before she sits down on the pale leather sofa, she makes it clear that is not where her loyalties lie. Three walls in her living room are taken up with framed memorabilia from Goodison Park ? a picture of legendary Everton centre-forward Dixie Dean, along with a copy of his birth certificate, a signed team photo and a ticket to a first-team training session.
Light flickers in the fireplace, and the front window is filled with a fresh bouquet of flowers ? orange-red roses and lilies. She is just back from an awards ceremony in London. "Oh, it was absolutely fabulous," she says, still enjoying the afterglow. "Very glitzy and glamorous black-tie event." What did she wear? "Oh, a long black dress from Monsoon. Cost me a fortune. And I had all the bling on as well. Oh, it was lovely ? free-flowing champagne, and a lovely meal. And then I realised I had to get up on the stage and go and collect my award, and my knees were knocking!"
The Nursing Standard Patient's Choice award is just that ? an award for the British nurse that patients believe must be recognised for the work she or he has done for them. The vote is public, and thus unambiguous approval for Haywood, who was, earlier this year, struck off the nursing register for placing her loyalty to patients above her loyalty to colleagues by filming undercover on a failing NHS ward while she worked there between November 2004 and May 2005. The resulting Panorama documentary, Undercover Nurses, aired in July 2005, showed one elderly cancer patient screaming in pain because medication hadn't been administered for hours; incontinent patients left lying in their own urine; a woman with cancer who did not eat because there was no one to help her (she died alone, unnoticed); Ivy, a dehydrated and deaf 96-year-old who wanted nothing more than to be allowed to go. Where? Haywood asked her. "To heaven." More than 4 million people watched it and more than 2,000 viewers phoned in, questions were asked in the Commons, the Royal College of Nursing began urgent research into issues of patient dignity and a whistleblowers' hotline was established.
Haywood did not go to work until after she married and had three children (she has seven grandchildren as well now, ranging in age from 20 months to 19 years). But since she married young, at 19, that meant she began at 25 in the kitchens of "what used to be called a hospital for mentally handicapped kids ? learning disabilities, now". Her manager was a psychiatric nurse, and when she told him she had always wanted to be a nurse too, he encouraged her to try.
Her father, a taxi driver, encouraged her too, and when the hospital across the road offered her a training place he was thrilled. But then he was diagnosed with lung cancer, "probably because of all the smoking the Woodbines he'd done for years. And the way it worked out my dad got buried on the Friday and I started my training on the Monday. And the very first ward I was allocated on was the ward where my dad had died." She had a serious wobble. "I started thinking, 'Can I do this, after all that?' And I thought, 'Well, he was happy that I'd got in, so yes ? I'll do it for him.'"
She qualified in two years, and worked with the elderly and in orthopaedics before moving to A&E. Her career since seems to have consisted of a series of happy side-trackings. She became a registered nurse specialising in intensive care, which she loved. This was followed by a job managing the occupational health unit at Cammell Lairds shipyard in Birkenhead, then another with a private health company, which sent her all over the country screening Ministry of Defence staff for cardiovascular disease. After Panorama aired she went to work in a care home in Sheffield, where she became a manager, and then training manager, which she liked so much she has now got herself a teaching qualification.
Along the way she picked up coping strategies ? gratefulness for the camaraderie of colleagues, the ability to balance the need to care with the need to stay a step away from complete emotional involvement, and a tendency to chat to patients, tell them jokes, even if they were on life support and couldn't hear or reply. Even "when somebody's died, you're encouraged to talk to them as though they're still here. I think that helps you deal with it. So when you're washing them you say, 'I'm just going to wash your hands and face now.'"
Methods of training have changed a great deal since she qualified, and she is ambivalent about the results. She was pitched straight on to the wards, and taught theory in tandem, to consolidate what she'd seen and heard; these days, she says, nurses can receive up to 18 months of theory, which can change their relationship with their duties. "I've heard the statement, 'too posh to wash'. I've certainly come across that. They expect the healthcare assistants to give the bedpans out and to help wash the patients. That's part of holistic care, but some of the newly qualified nurses don't see it like that."
What does she think of the government's announcement, this week, that as of 2013 all nurses will be required to attain degree-level education? "To be honest I think all you need as a nurse is common sense, and I think sometimes people with a degree can be a bit lacking in common sense. The basic requirement is that you need to be a caring person, and to have a bit of empathy. I do think the vetting system could be better, at interview level. To try and establish what kind of person they actually are in the first place. [As for theory] you can learn as you go along. All you need at the moment is five GCSEs. And that is really all you need." She sees the new rules as a cost-cutting exercise. "They're training health assistants up to do more practical work in the same way that they're training nurses up to be like junior doctors."
There are worries about the debt young nurses will incur, that this will make it even harder to recruit. One of the problems on the ward Haywood filmed was understaffing ? nurses were so overworked that a couple were signed off with stress, and "one or two just sort of ducked and let it all happen ? their coping strategy was 'I don't care anymore, let it go over my head, let it go on until somebody else does something.'"
Her first contact with the BBC was as a consultant on a TV programme about care homes, which prompted thousands of letters and emails pointing out similar problems in the NHS. The BBC wondered if she was interested in helping them investigate, and when she said yes, they put her on contract. She became a bank nurse ? like supply teachers, bank nurses fill in when wards are short-staffed ? and applied for jobs in seven or eight failing hospitals across the country. She had worked in five or six by the time she came to the Peel and Stewart wards in the Royal Sussex county hospital in Brighton.
"As soon as I walked on that ward I knew there were problems. It was the smell of urine and faeces. Blood on the curtains in between the patients. A certain lack of staff. No real managerial support most of the time. None of the patients had a care plan, so none of the patients had continuity of care. Some of the patients weren't getting appropriate nutrition, or any drinks. One lady was blind and she just got her meals on a tray in front of her and then somebody came along half an hour later and said, 'Oh, aren't you hungry?' They weren't even aware that this lady was blind. So I went back to the BBC and we decided I needed to get the evidence. Because what was going on there was abuse and neglect."
The lens of the camera they gave her was disguised in an ink spot on the front of her uniform. The controls were in her pockets, and "I didn't film anything intimate. I could turn the camera off and on when I wanted to. I always made it clear to the BBC, right from the very start, that my professional responsibilities and accountabilities always came first ? the filming was a secondary issue." She had to learn to stand 6ft away to get people in shot, and, because batteries and film only lasted an hour or so, colleagues thought she had a urinary infection, she said.
One of the arguments against her, once the programme had been aired, was that she should have informed a manager. "I informed the manager. When I could find her." But shouldn't she then have gone up the ranks, looking for someone internal who might listen? "Yeah, but again, what I was afraid of was that it would have been brushed under the carpet, that they would have just got rid of me and carried on."
It was a legitimate fear. A May 2009 poll by the Royal College of Nursing (RCN) found that while 63% of nurses said they had reported concerns about patient safety or neglect, only 29% said their employer took immediate action. "Worryingly," noted the RCN, "more than a third (35%) said no action was ever taken." Three-quarters of those polled said they feared victimisation or reprisals, while more than a fifth had been actively discouraged from reporting concerns. Just this month the Independent on Sunday reported that some NHS trusts were spending millions of pounds gagging whistleblowers; according to the independent whistleblowing authority, Public Concern at Work, two-thirds of health workers are accepting non-disclosure clauses in severance agreements, to avoid years of financial and emotional distress.
"The legal protection for whistleblowers does not work," Peter Gooderham, lecturer in law and bioethics at the University of Manchester told the paper. "The NHS is littered with whistleblowers whose lives have been destroyed."
How about the issue of confidentiality ? the reason she was struck off by the Nursing and Midwifery Council? Haywood had been expecting official censure for the last four years, so there is a vociferousness to her answer that isn't necessarily prompted by my question. "Part of my professional code of conduct is to maintain the confidentiality of the patient, and I've always maintained the code of practice, and I've always maintained confidentiality, but for this it couldn't be like that, because confidentiality is a secondary issue if we're talking about neglect. The neglect and the abuse has to take priority."
Did she not feel she was betraying her colleagues, hanging their collective dirty linen out in public? "Um ? I did, yeah. I did feel like a double agent and that's exactly what I was. But I had to keep in mind that there was a good reason why I was doing this. I was convinced it was the right thing to do. I'm still convinced it was the right thing to do."
So convinced you were happy to risk your job? "Absolutely. Absolutely. I had to have the courage of my convictions."
Realistically, however, she thought the most she would get was a year's caution, so when she was finally struck off, in April, she was shocked. "Nursing's been a big part of my life for 25 years. I worked hard, and always acted in the patients' best interests. It was devastating." She wells up as she remembers going home, in a daze, and looking up who else the council had struck off. "People who'd had inappropriate sexual relationships with patients. Nurses who had administered the wrong drugs. One was even charged with manslaughter. To put me in the same bracket as them! It really upset me."
The first days afterwards were "awful, and without the support of family and friends I would have been ill". People wrote to her from all over the country. The BBC put her on a temporary four-month contract to tide her over until her appeal was heard. The RCN set up a petition to gauge public support, and nearly 40,000 people signed it. Ben Bradshaw, then health minister, described the penalty as "unduly harsh".
What would she have done if her appeal had been rebuffed? "I tried not to think of the worst case scenario because I think that would have tipped me over the edge." But when she heard last month that the appeal had been successful (a negotiated agreement, eventually, which sees her receiving a one-year caution that expires next year), she cried. "I was just so relieved. I thought, 'Now I can get my life back in order.'"
On Monday she begins a new job, training nurses and carers for a private company in Birmingham. Would she ever go back to ward nursing? "It's difficult. It depends in what capacity. I enjoy the training as well as the nursing, and with this job I can do both."
And the NHS? A pause. "I don't know if they'd have me in the NHS now. And I suppose that's understandable."

This paper is a combination of 3 projects and then an additional page for the summary of the whole project.

You will combine Parts 1, 2, and 3 of your Course Project (assigned in Weeks 2, 4, and 8 respectively) into one cohesive and cogent paper.

Note: In addition, include a 1-page summary of your project.

For this final iteration you will need to:

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week?s Learning Resources). All papers submitted must use this formatting.
Note: The Course Project will be your Portfolio Assignment for this course.


Week 2
Suicide in psychiatric patients
Suicide rates are remarkably high worldwide and nationally, making suicide one of the leading causes of death (Schwartz-Lifshitz, Zalsman, Giner et al, 2012; Tillman, 2014). Although most suicides do not occur in the hospital setting, psychiatric disorders?especially mood disorders and psychotic disorders?are risk factors that increase the likelihood of a suicidal event (Appleby, 1992; Sarzetto, Delmonte, Seghi, et al, 2017). Suicide not only affects the patient, but reverberates throughout the patient?s family and social circle, also causing distress and potential performance issues among clinical staff (Tillman, 2014). Therefore, it is important that psychiatric nurses understand how to recognize risk factors, and establish a clinical practice environment that prevents suicide. Minimizing suicidal tendencies requires different types of treatment interventions individually tailored for at-risk patients, as well as implementing best practices for creating a clinical environment that reduces risk. Best practices may also include preparing, teaching, and training nursing staff, especially when working with at risk populations.
Both psychiatric patients and psychiatric nursing staff can be considered target populations for an intervention designed to prevent suicide in the clinical setting. Preliminary research questions using the PICO (patient/population, intervention/issue, comparison, and outcome) model include the following:
1. Among psychiatric patients (P), do mandatory intake assessments specifically for suicide risk (I) reduce rates of suicide (O) versus institutions without such policies (C)? This is a reasonable PICO question, but one that would require a large-scale assessment of different psychiatric institutions. Therefore, it might be too difficult to find sufficient evidence to make an informed decision for evidence-based practice.
2. Among psychiatric patients with mood disorders and other high-risk populations (P), do pharmacological interventions (I) reduce rates of suicide (O) versus patients who only receive talk or group therapies (C)? This is a commonly posed question related to suicide in the population group. The problem with this PICO question is there are too many different pharmacological interventions and individual differences among patients to come up with a clear, definitive guide for evidence-based practice.
3. Among psychiatric patients with suicidal ideations or a history of suicidal behavior (P), does family and group therapy (I) reduce risk (O) versus patients who do not receive any family or group therapy (C)? This is one of the most feasible PICO questions to use because family and group therapy options might offer some sound solutions for preventing suicide and reducing long-term risks.
4. Do community awareness, public service announcements, and other means of education and communication (I) help reduce rates of suicide (O) among discharged psychiatric patients (P) versus communities that do not receive such public relations services (C)? This is an important avenue of research for evidence-based practice in the community, helpful from a public health perspective. However, methodologically such interventions are less feasible.
5. Does mindfulness meditation (I) reduce long-term risk factors and suicidal behaviors (O) among high risk psychiatric patients (P) versus those who do not participate in the meditation programs (C)? As with question three, this is a suitable line of inquiry, which could actually lead to evidence-based practice guidelines for psychiatric institutions. Therefore, I will select this PICO question for the remainder of my research.
PICO Question: Does mindfulness meditation (I) reduce long-term risk factors and suicidal behaviors (O) among psychiatric patients (P) versus those who do not participate in the meditation programs (C)?
The patient population (P) can include all psychiatric patients on any given unit or within any given institution. Alternatively, the patient population can include psychiatric patients who have been diagnosed with one or more conditions known to increase risk of suicide: those conditions being mood disorders, psychotic disorders, substance use disorders, and personality disorders (Schwartz-Lifshitz, Zalsman, Giner, et al, 2012). This would allow the researcher to compile evidence from multiple studies.
The intervention (I) in this PICO question is mindfulness meditation. It is important to clarify exactly what this would mean, such as how many hours per day or per week of meditation, and which specific meditation instructions were given. The addition of the time (T) variable to the PICOT analysis might also be helpful. For example, does the meditation intervention yield results after three months, six months, or one year?
The comparison (C) is like a control group in this case, consisting of psychiatric patients who are not meditating formally within the designated intervention. Finally, the outcome (O) can be measured in different ways such as overall rates of suicide or surveys of patients regarding their subjective assessments of suicidal ideation.
The following keywords that can be used for conducting a literature search include: major depressive disorder, mood disorders, psychotic disorders, DSM-V, suicidal behavior, suicide, suicidal ideation, mindfulness, mindfulness meditation, meditation, suicide risk, and psychiatric patients.
References

Appleby, L. (1992). Suicide in psychiatric patients. British Journal of Psychiatry 1992(161): 749-758.
Jacobs, D.G., Baldessarini, R.J., Conwell, Y., et al (2010). Practice guideline for the assessment and treatment of patients with suicidal behaviors. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/suicide.pdf
Sakinofsky, I. (2014). Preventing suicide among inpatients. Canadian Journal of Psychiatry 59(3): 131-140.
Sarzetto, A., Delmonte, D., Seghi, F. et al (2017). Suicide in depressed patients. European Psychiatry 41(April 2017 Supplement): S891-S892.
Schwartz-Lifshitz, M., Zalsman, G., Giner, L., et al (2012). Can we really prevent suicide? Current Psychiatry Reports 14(6): 624-633.
Tillman, J.G. (2014). Patient suicide: impact on clinicians. Psychiatric Times. Dec 31, 2014. http://www.psychiatrictimes.com/special-reports/patient-suicide-impact-clinicians



Week 4 : Literature review of week 2 project

A synthesis of what the studies reveal about the current state of knowledge on the question developed

The mindfulness meditation theory appears to have the potential to treat addictive disorder patients. Zgierska and coworkers (2009) state that such models seem to be safe if implemented within the context of clinical studies. One can find considerable methodological shortcomings in a majority of existing works on the subject. Further, which addiction-diagnosed individuals may derive maximum benefits out of mindfulness meditation isn?t clear. But, of late, related initiatives and practices in the role of complementary clinical aids for treating multiple physical and psychological ailments have grown in popularity. MBCT (mindfulness-based cognitive therapy) and MBSR (mindfulness-based stress reduction) as clinical initiatives have specifically been analyzed, with a sound evidential pool recording their efficacy. Integration of the latter initiative?s aspects and cognitive behavioral therapy and cognitive psychology strategies resulted in the former?s creation. At first, MBCT was labeled Attentional Control Training, concentrating chiefly on psychiatric disorder treatment. Xie and colleagues (2014) claim that the general psychological health improvements depicted by individuals undergoing MBCT may stem from various training-related advantages. Thus, anxiety and depression diagnosed individuals may profit from MBCT during rehab, for facilitating long-run maintenance of improved QOL (quality of life).
Being deployed to the battlefield is linked to an appreciable growth in fresh onset substance use disorder, PTSD (post-traumatic stress disorder), chronic pain and MDD (major depressive disorder). Vythilingam and Khusid (2016) note that a growing number of ex-servicemen have been increasingly recognizing mindfulness as being easily understandable, safe, inexpensive, and substantiated by an increasing pool of evidence. The absence of adequate quality patient-focused proofs hints at adjunctive MBCT?s benefits for patients experiencing a depressive spell, and in the form of a maintenance or continuation treatment among individuals who have recovered from MDD. Moreover, existing proofs support the adoption of adjunctive MBSR in managing PTSD.
MBC therapy is targeted at individuals undergoing remission from MDD. The goal is allowing them a chance at practicing the cultivation of non-judgmental awareness connected with harmless feelings, bodily sensations and thoughts, prior to trying to use similar processing in case of negative feelings, bodily sensations and thoughts. But in case of individuals who might mull over or attempt at long-term suppression of such negative emotions, embracing this sort of drastically different strategy might prove intimidating. In fact, certain individuals whose negative emotions are extremely near the surface might have to instantly face challenging emotions upon commencement of meditation (Crane & Williams, 2010).
In the last few decades, a considerable growth in interest has been witnessed in the area of scrutinizing mindfulness as both a clinical initiative and psychological construct. Villatte and Luoma (2012) assert that it is possible to readily arrive at the conclusion that mindfulness has numerous positive psychological impacts such as enhanced perceived well-being and conduct regulation and a decrease in emotional reactivity and psychological symptoms.
Inconsistencies and contradictions in the literature, and possible explanations for inconsistencies
Zgierska and coworkers (2009) reveals a lack of conclusive information linked to mindfulness meditation as addiction therapy. But the preliminary proofs suggest mindfulness meditation?s effectiveness. Clinical trials in the future need to have a sufficiently large sample size for successfully answering a given clinical issue. Furthermore, they need to encompass thoroughly-designed comparison clusters for allowing evaluation of mindfulness meditation?s means of action as well as impact size. Williams and Crane (2010) indicate that people exhibiting superior cognitive reactivity, depressive rumination and brooding levels might struggle a lot with MBCT engagement. However, puzzlingly, they depict the likelihood of profiting most from mindfulness skill acquisition if they continue to attend class. Dealing with how best to equip these individuals for therapy and support them in continuing therapy in the event of difficulties constitutes a major challenge.
As the mindfulness construct has its roots in Buddhist religious teachings, and lacks a sufficiently long history in the psychological science of the West, the fact that appreciable challenges exist in its definition, quantification and operationalization is not surprising. While numerous self-report repertoires for mindfulness evaluation have been created, they differ considerably in their factor and content structure, revealing inconsistencies in its nature and meaning. To date, scant information exists with regard to the conditions under which, and the individuals for whom, mindfulness training proves most effectual; however, one can find certain preliminary proofs indicating that its efficacy differs based on individual variances (Keng, Smoski & Robins, 2011).

Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry
While the need for further studies on the topic has been identified, the mindfulness approach seems to have the potential to aid individuals considering ending their lives and thus ending their suffering. Positive preliminary proofs indicate therapists may promote mindfulness within a fairly short duration; additionally, it may influence various processes apparently contributing to suicide (Luoma and Villatte, 2012). On the basis of an assessment of empirical studies over numerous methodologies, the review reaches the conclusion that mindfulness meditation and its adoption aids adaptive psychological operation. In spite of extant methodological inadequacies in individual literature works, one may find an explicit convergence of results of correlational researches, experimental, lab-based mindfulness researches and clinical intervention researches which all indicate a positive link between psychological health and mindfulness. Furthermore, mindfulness training can lead to positive psychological impacts which extend from enhanced behavioral regulation to enhanced subjective wellbeing and decreased emotional reactivity and psychological symptoms (Keng, Smoski & Robins, 2011). Lastly, enhanced behavioral self-regulation and values clarification might prove to be additional means by which this strategy betters psychological health.




References
Crane, C., & Williams, J. M. G. (2010). Factors Associated with Attrition from Mindfulness-Based Cognitive Therapy in Patients with a History of Suicidal Depression. Mindfulness, 1(1), 10?20. http://doi.org/10.1007/s12671-010-0003-8
Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical psychology review, 31(6), 1041-1056.
Khusid, M. A., & Vythilingam, M. (2016). The emerging role of mindfulness meditation as effective self-management strategy, part 1: clinical implications for depression, post-traumatic stress disorder, and anxiety. Military medicine, 181(9), 961-968.
Luoma, J. B., & Villatte, J. L. (2012). Mindfulness in the Treatment of Suicidal Individuals. Cognitive and Behavioral Practice, 19(2), 265?276. http://doi.org/10.1016/j.cbpra.2010.12.003
Xie, J. F., Zhou, J. D., Gong, L. N., Iennaco, J. D., & Ding, S. Q. (2014). Mindfulness-based cognitive therapy in the intervention of psychiatric disorders: A review. International Journal of Nursing Sciences, 1(2), 232-239.
Zgierska, A., Rabago, D., Chawla, N., Kushner, K., Koehler, R., & Marlatt, A. (2009). Mindfulness Meditation for Substance Use Disorders: A Systematic Review. Substance Abuse?: Official Publication of the Association for Medical Education and Research in Substance Abuse, 30(4), 266?294. http://doi.org/10.1080/08897070903250019


Week 8: Translating Evidence from week 2 project to Practice
Suicide in psychiatric patients
Suicide rates are remarkably high worldwide and nationally, making suicide one of the leading causes of death (Schwartz-Lifshitz, Zalsman, Giner et al, 2012; Tillman, 2014). Although most suicides do not occur in the hospital setting, psychiatric disorders?especially mood disorders and psychotic disorders?are risk factors that increase the likelihood of a suicidal event (Appleby, 1992; Sarzetto, Delmonte, Seghi, et al, 2017). Suicide not only affects the patient, but reverberates throughout the patient?s family and social circle, also causing distress and potential performance issues among clinical staff (Tillman, 2014). Therefore, it is important that psychiatric nurses understand how to recognize risk factors, and establish a clinical practice environment that prevents suicide. Minimizing suicidal tendencies requires different types of treatment interventions individually tailored for at-risk patients, as well as implementing best practices for creating a clinical environment that reduces risk. Best practices may also include preparing, teaching, and training nursing staff, especially when working with at risk populations.
Both psychiatric patients and psychiatric nursing staff can be considered target populations for an intervention designed to prevent suicide in the clinical setting. Preliminary research questions using the PICO (patient/population, intervention/issue, comparison, and outcome) model include the following:
1. Among psychiatric patients (P), do mandatory intake assessments specifically for suicide risk (I) reduce rates of suicide (O) versus institutions without such policies (C)? This is a reasonable PICO question, but one that would require a large-scale assessment of different psychiatric institutions. Therefore, it might be too difficult to find sufficient evidence to make an informed decision for evidence-based practice.
2. Among psychiatric patients with mood disorders and other high-risk populations (P), do pharmacological interventions (I) reduce rates of suicide (O) versus patients who only receive talk or group therapies (C)? This is a commonly posed question related to suicide in the population group. The problem with this PICO question is there are too many different pharmacological interventions and individual differences among patients to come up with a clear, definitive guide for evidence-based practice.
3. Among psychiatric patients with suicidal ideations or a history of suicidal behavior (P), does family and group therapy (I) reduce risk (O) versus patients who do not receive any family or group therapy (C)? This is one of the most feasible PICO questions to use because family and group therapy options might offer some sound solutions for preventing suicide and reducing long-term risks.
4. Do community awareness, public service announcements, and other means of education and communication (I) help reduce rates of suicide (O) among discharged psychiatric patients (P) versus communities that do not receive such public relations services (C)? This is an important avenue of research for evidence-based practice in the community, helpful from a public health perspective. However, methodologically such interventions are less feasible.
5. Does mindfulness meditation (I) reduce long-term risk factors and suicidal behaviors (O) among high risk psychiatric patients (P) versus those who do not participate in the meditation programs (C)? As with question three, this is a suitable line of inquiry, which could actually lead to evidence-based practice guidelines for psychiatric institutions. Therefore, I will select this PICO question for the remainder of my research.
PICO Question: Does mindfulness meditation (I) reduce long-term risk factors and suicidal behaviors (O) among psychiatric patients (P) versus those who do not participate in the meditation programs (C)?
The patient population (P) can include all psychiatric patients on any given unit or within any given institution. Alternatively, the patient population can include psychiatric patients who have been diagnosed with one or more conditions known to increase risk of suicide: those conditions being mood disorders, psychotic disorders, substance use disorders, and personality disorders (Schwartz-Lifshitz, Zalsman, Giner, et al, 2012). This would allow the researcher to compile evidence from multiple studies.
The intervention (I) in this PICO question is mindfulness meditation. It is important to clarify exactly what this would mean, such as how many hours per day or per week of meditation, and which specific meditation instructions were given. The addition of the time (T) variable to the PICOT analysis might also be helpful. For example, does the meditation intervention yield results after three months, six months, or one year?
The comparison (C) is like a control group in this case, consisting of psychiatric patients who are not meditating formally within the designated intervention. Finally, the outcome (O) can be measured in different ways such as overall rates of suicide or surveys of patients regarding their subjective assessments of suicidal ideation.
The following keywords that can be used for conducting a literature search include: major depressive disorder, mood disorders, psychotic disorders, DSM-V, suicidal behavior, suicide, suicidal ideation, mindfulness, mindfulness meditation, meditation, suicide risk, and psychiatric patients.
References

Appleby, L. (1992). Suicide in psychiatric patients. British Journal of Psychiatry 1992(161): 749-758.
Jacobs, D.G., Baldessarini, R.J., Conwell, Y., et al (2010). Practice guideline for the assessment and treatment of patients with suicidal behaviors. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/suicide.pdf
Sakinofsky, I. (2014). Preventing suicide among inpatients. Canadian Journal of Psychiatry 59(3): 131-140.
Sarzetto, A., Delmonte, D., Seghi, F. et al (2017). Suicide in depressed patients. European Psychiatry 41(April 2017 Supplement): S891-S892.
Schwartz-Lifshitz, M., Zalsman, G., Giner, L., et al (2012). Can we really prevent suicide? Current Psychiatry Reports 14(6): 624-633.
Tillman, J.G. (2014). Patient suicide: impact on clinicians. Psychiatric Times. Dec 31, 2014. http://www.psychiatrictimes.com/special-reports/patient-suicide-impact-clinicians

Rubric
Excellent
Quality of Work Submitted:
The extent of which work meets the assigned criteria and work reflects graduate level critical and analytic thinking.
27 (27%) - 30 (30%)
Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics.
24 (24%) - 26 (26%)
Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.

---Quality of Work Submitted:
The purpose of the paper is clear.
5 (5%) - 5 (5%)
A clear and comprehensive purpose statement is provided which delineates all required criteria.


----Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student\'s ability to:

Understand and interpret the assignment\'s key concepts.
9 (9%) - 10 (10%)
Demonstrates the ability to critically appraise and intellectually explore key concepts.

---Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student\'s ability to:


Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources.
18 (18%) - 20 (20%)
Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view.

---Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student\'s ability to:

Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.
18 (18%) - 20 (20%)
Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.

---Written Expression and Formatting

Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused--neither long and rambling nor short and lacking substance.
5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity
---Written Expression and Formatting

English writing standards: Correct grammar, mechanics, and proper punctuation
5 (5%) - 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.

Contains many (? 5) grammar, spelling, and punctuation errors that interfere with the reader?s understanding.

---Written Expression and Formatting

The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 (5%) - 5 (5%)
Uses correct APA format with no errors.


Plagiarism should be less than 8%

I work with enlisted soldiers and some have been deployed to Iraq/Afghanistan. I work on an inpatient psychiatric nursing unit. My Research Nurse helped me come up with this topic and area to study. To Look at what percentage of our admissions (or Military psych admissions in general if this is easier to capture) who are admitted with dx of Adjustment D/O sometimes along with identifiers such as with Depressed Mood or Mixed Emotional Disturbance of Conduct are discharged or separated from the army for Mental Health reasons. I'm am guessing we would look @ the relationship between adjustment and maladaptive characteristics. I need help in making a research question out of that statement.The assignment ask for 1 Development of a Quantitative Research Study with comparison to a Qualitative research study. Further explanation states to design a quant. study using Box 10.3 as guideline. I will fax you a copy of the Box from my textbook.
What this box shows is actually an example of a completed research study outline to follow. The areas that are addressed are: I. Significance of the Problem II. Specific Aim with Research Question/Hypothesis. III. Theoretical/Conceptual Framework (I would like to use Callista Roy's Adaptation Model) IV. Study Design V. Subjects a)Sampling Criteria b) Sampling Design VI.Variables a)Independent variable(s) b)Dependent Varible(s) (c) Mediating variable if applic. (d) Confounding or Extraneous Variable(s) VII. Statiscal Issues a) sample size (b) Approach to Analysis
There are faxes for this order.

General Guidelines:
-Group paper ??" one paper submitted per group. Submit via the Assignment Link in Blackboard.
-Dont answer just yes or no to the questions: give examples from the study and rationale from your textbook(s) to support your statements
-Identify strengths as well as weaknesses
-No particular paper length ??" will probably be approximately 12-15 pages excluding title page and reference list
-Reference according to current APA format, citing reference of study as well as material from textbook(s)
-The paper will have 4 points allotted to APA formatting, grammar, punctuation, and organization.
-Pay attention to point values

This is what i have to address in the paper

Introduction
Why was the study done? Has to do with purpose
-List any objectives, questions, or hypotheses.
- If a hypothesis is stated for the study, identify if the hypothesis is:
Associative or causal,
Simple or complex
Directional or nondirectional
Research or null
This is the link for the article that has to be critically appraised, so this has to be one of my references please

Zauszniewski, J.A., Bekhet, A. K., & Bonham, E. (2010). Psychometric testing of the childrens resourcefulness scale. Journal of Child and Adolescent Psychiatric Nursing, 23(3), 181-188.

There are faxes for this order.

Course Project: Introduction to Course Project
Evidence-based practice involves a great deal more than simply reading nursing periodicals on a regular basis. Nurses can take a more proactive approach to evidence-based practice by identifying authentic problems and concerns, and then using that to guide their inquiries into current research. In this way, nurses can connect the results of relevant research studies to their nursing practice.
For the Course Project, you identify and apply relevant research to a specific nursing topic or problem. You begin by formulating an answerable question that is relevant to nursing and evidence-based practice. In later weeks of this course, you continue the Course Project by conducting a literature review and then determining how the evidence from the literature can be applied to nursing practice.
Before you begin, review the Course Project Overview document located in this weeks Learning Resources.
Note: This Course Project will serve as the Portfolio Assignment for the course. In addition to submitting portions of this Project in Weeks 2 and 5, you will turn in all three deliverables inWeek 10.
Project: Course Project: Part 1??"Identifying a Researchable Problem
One of the most challenging aspects of EBP is to actually identify the answerable question.
??"Karen Sue Davies
Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results.
In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICO model??"patient/population, intervention/issue, comparison, and outcome??"outlined in the Learning Resources to design your questions.
To prepare:
Review the article, Formulating the Evidence Based Practice Question: A Review of the Frameworks, found in the Learning Resources for this week. Focus on the PICO model for guiding the development of research questions.
Review the section beginning on page 75 of the course text, titled, Developing and Refining Research Problems in the course text, which focuses on analyzing the feasibility of a research problem.
Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.
Generate at least five questions that relate to the issue which you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.
Formulate a preliminary PICO question??"one that is answerable??"based on your analysis. What are the PICO variables (patient/population, intervention/issue, comparison, and outcome) for this question?
Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.
Using the PICO variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.
To complete:
Write a 3- to 4-page paper that includes the following:
A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice
The 5 questions you have generated and a description of how you analyzed them for feasibility
Your preliminary PICO question and a description of each PICO variable relevant to your question
At least 10 possible keywords that could be used when conducting a literature search for your PICO question and a rationale for your selections
This Project Assignment is due by Day 7. It will also be a component of your Portfolio Assignment for this course, which is due by Day 7 of Week 10.
Reference:
Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75??"80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144



Required Resources
Note: To access this week's required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Readings
Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (Laureate Education, Inc., custom ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
o Chapter 3, Key Concepts and Steps in Qualitative and Quantitative Research (for review)
o Chapter 4, Research Problems, Research Questions, and Hypotheses

This chapter focuses on the steps in planning a study to generate evidence. These include developing a research question, identifying variables, articulating a problem statement, and generating hypotheses.
o Chapter 7, Ethics in Nursing Research

In this chapter, the focus is on the ethical dilemmas that occur when planning and conducting research and the ethical principles that have been enacted for protecting study participants.
Fouka, G., & Mantzorou, M. (2011). What are the major ethical issues in conducting research? Is there a conflict between the research ethics and the nature of nursing? Health Science Journal, 5(1), 3??"14.
Retrieved from the Walden Library databases.

This article describes a literature review conducted to determine the most important ethical issues that nurses encounter when undertaking or participating in research. The authors detail the results of the review and make recommendations for solving some of the problems highlighted.
Newcomb, P. (2010). Evolving fairness in research on human subjects. Journal of Child and Adolescent Psychiatric Nursing, 23(3), 123??"124.
Retrieved from the Walden Library databases.

In this article, the author describes some of the ethical controversies that may arise in conducting research in human subjects, especially with respect to ownership of genes. The author also stresses the importance of educating research subjects and their families about the ultimate purpose of research.
Yakov, G., Shilo, Y., & Shor, T. (2010). Nurses' perceptions of ethical issues related to patients' rights law. Nursing Ethics, 17(4), 501??"510.
Retrieved from the Walden Library databases.

The authors of this article detail a study conducted to determine how nursing staff deal with ethical issues in relation to the law. The article emphasizes the difficulty staff had in distinguishing between legal and ethical problems. The authors make several recommendations to deal with legal and ethical problems.
Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks.Evidence Based Library and Information Practice, 6(2), 75??"80. Retrieved fromhttps://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

This article reviews the frameworks commonly used to assist in generating answerable research questions. The author recommends considering the individual elements of the frameworks as interchangeable (depending upon the situation), rather than trying to fit a situation to a specific framework.
Delwiche, F. (2008). Anatomy of a scholarly research article in the health sciences. Retrieved fromhttp://danaguides.uvm.edu/content.php?pid=41591&sid=3177873

This article highlights the primary components of scholarly research articles. The article details the distinguishing factors of scholarly journals, the peer-review process, and the definition of primary literature.
American Nurses Association. (2001). Code of ethics for nurss with interpretive statements.
Retrieved fromhttp://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics.pdf

This website provides the code of ethics for nurses to be used in carrying out their responsibilities. There is also a detailed explanation of each provision.
Document: Course Project Overview (Word document)
Note: You will use this document to complete the Project throughout this course.
Media
Laureate Education, Inc. (Executive Producer). (2012a). Anatomy of a research study. Baltimore, MD: Author.

This multimedia piece explains the anatomy of both quantitative and qualitative research studies. In addition, there is a brief quiz at the end of the tutorial to measure knowledge about research articles.
Laureate Education, Inc. (Executive Producer). (2012d). Evidence-based practice and research.Baltimore, MD: Author.

In this video, Dr. Marianne Chulay talks about the significance of evidence-based practice and research in nursing. She explains how nurses should apply research findings to health care decisions to improve outcomes.
Laureate Education, Inc. (Executive Producer). (2012h). Overview of evidence-based practice.Baltimore, MD: Author.

In this video, Dr. Kristen Mauk explains evidence-based practice and its importance to nursing. She also provides a brief overview of the process of conducting original research.
Optional Resources
National Institutes of Health Office of Extramural Research. (2011). Protecting human research participants. Retrieved from http://phrp.nihtraining.com/users/login.php

This website provides a course on ethical research for those involved in research in human subjects. The course supplies basic concepts, principles, and issues relevant to protecting research participants.
University of Oxford. (2005). PICO: Formulating an answerable question. Retrieved fromhttp://learntech.physiol.ox.ac.uk/cochrane_tutorial/cochlibd0e84.php
Please proceed to the Discussion.
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Evidence Based Library and Information Practice
Commentary
Formulating the Evidence Based Practice Question: A Review of the Frameworks
Karen Sue Davies?Assistant Professor, School of Information Studies University of Wisconsin??"Milwaukee?Milwaukee, Wisconsin, United States of America Email: [email protected]
Received: 17 Jan. 2011 Accepted: 04 Apr. 2011
2011 Davies. This is an Open Access article distributed under the terms of the Creative Commons-Attribution- Noncommercial-Share Alike License 2.5 Canada (http://creativecommons.org/licenses/by-nc-sa/2.5/ca/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly attributed, not used for commercial purposes, and, if transformed, the resulting work is redistributed under the same or similar license to this one.
Evidence Based Library and Information Practice 2011, 6.2






Introduction
Questions are the driving force behind evidence based practice (EBP) (Eldredge, 2000). If there were no questions, EBP would be unnecessary. Evidence based practice questions focus on practical real-world problems and issues. The more urgent the question, the greater the need to place it in an EBP context.
One of the most challenging aspects of EBP is to actually identify the answerable question. This ability to identify the question is fundamental to then locating relevant information to answer the question. An unstructured collection of keywords can retrieve irrelevant literature, which wastes time and effort eliminating inappropriate information. Successfully retrieving relevant information begins with a clearly defined, well-structured question. A standardized format or framework for asking questions
helps focus on the key elements. Question generation also enables a period of reflection. Is this the information I am really looking for? Why I am looking for this information? Is there another option to pursue first?
This paper introduces the first published framework, PICO (Richardson, Wilson, Nishikawa and Hayward, 1995) and some of its later variations including ECLIPSE (Wildridge and Bell, 2002) and SPICE (Booth, 2004). Sample library and information science (LIS) questions are provided to illustrate the use of these frameworks to answer questions in disciplines other than medicine.
Booth (2006) published a broad overview of developing answerable research questions which also considered whether variations to the original PICO framework were justifiable and worthwhile. This paper will expand on that work.
75
Question Frameworks in Practice
PICO
The concept of PICO was introduced in 1995 by Richardson et al. to break down clinical questions into searchable keywords. This mnemonic helps address these questions:
P - Patient or Problem: Who is the patient? What are the most important characteristics of the patient? What is the primary problem, disease, or co-existing condition??I ??" Intervention: What is the main intervention being considered??C ??" Comparison: What is the main comparison intervention??O - Outcome: What are the anticipated measures, improvements, or affects?
Medical Scenario and Question: An overweight woman in her forties has never travelled by airplane before. She is planning an anniversary holiday with her husband including several long flights. She is concerned about the risk of deep vein thrombosis. She would like to know if compression stockings are effective in preventing this condition or whether a few exercises during the flight would be enough. P ??" Patient / Problem: Female, middle-aged, overweight?I ??" Intervention: Compression stockings?C ??" Comparison: In-flight exercises?O ??" Outcome: Prevent deep vein thrombosis
The PICO framework and its variations were developed to answer health-related questions. With a slight modification, this framework can structure questions related to LIS. The P in PICO refers to patient, but substituting population for patient provides a question format for all areas of librarianship. The population may be children, teens, seniors, those from a specific ethnic group, those with a common goal (e.g., job-seekers), or those with a common interest (such as a gardening club). The intervention is the new concept being considered, such as longer opening hours, a reading club, after-school activity, resources in a particular language, or the introduction of wi-fi.
LIS Scenario and Question: Art history masters students submit theses with more bibliography errors than those from students of other faculties. The Dean of art history raised this issue with the head librarian. The head librarian suggested that database training could help.?P ??" Population: Art History masters students I ??" Intervention: database searching training C ??" Comparison: students with no training or students from other Faculties?O ??" Outcome: Improved bibliographic quality
Table 1 illustrates the different components introduced in several PICO framework variations. Fineout-Overholt and Johnson (2005) considered the questioning behavior of nurses. They suggested a five-component scheme for evidence based practice questions using the acronym PICOT, with T representing timeframe. This refers to one or more time-related variables such as the length of time the treatment should be prescribed or the point at which the outcome is measured. A PICOT question in the LIS field is: In a specialist library, does posting the monthly library bulletin on the Website instead of only having printed newsletters available result in increased usage of the library and the new resources mentioned in the bulletin? In this question, the timeframe refers to a month.
Petticrew and Roberts (2005) suggested PICOC as an alternative ending to PICOT, with C representing context. For example, what is the context for intervention delivery? In LIS, context could be a public library, academic library, or health library.
A variation similar to PICOT is PICOTT. In this instance, neither T relates to timeframe. The Ts refer to the type of question and the best type of study deign to answer that particular question (Schardt, Adams, Owens, Keitz, and Fontelo, 2007). An example LIS question is: In a specialist library, does instant messaging or e-mail messaging result in the greatest customer satisfaction with a virtual reference service? This type of question is user analysis, and a relevant type of study design is
Evidence Based Library and Information Practice 2011, 6.2
76
Evidence Based Library and Information Practice 2011, 6.2

Table 1?
Components of the Different PICO-based Frameworks
Richardson et al., 1995 Fineout- Overholt & Johnson, 2005 Petticrew & Roberts, 2005 Schardt et al., 2007 ADAPTE Collaboration, 2009
Dawes et al., 2007?Schlosser & O'Neil-Pirozzi, 2006
DiCenso, Guyatt, & Ciliska, 2005
a questionnaire. The PICOTT framework may be too restrictive when searching. If you are searching for effective Websites then transaction log analysis would be a reasonable type of study design. By limiting to that study type you would miss user observation studies, focus groups, and controlled experiments. These frameworks should focus the search strategy, while not excluding potentially useful and relevant information.
Specifically developed for building and adapting oncology guidelines is PIPOH (ADAPTE Collaboration, 2009). The second P refers to professionals (to whom the guideline will be targeted) and H stands for health care
setting and context (in which the adapted guideline will be used). An example of this in the LIS setting would be:?What is appropriate training for fieldwork students working on the librarys issue or circulation desk??P ??" Population: Library users?I ??" Intervention: Training?P ??" Professionals: Fieldwork students?O ??" Outcome:?S ??" Setting: Issue or circulation desk
Dawes et al. (2007) developed PECODR and undertook a pilot study to determine whether this structure existed in medical journal abstracts. E refers to exposure, replacing

77
Patient / Population Intervention Comparison Outcome Timeframe
Context?Type of Question Type of Study Design Professionals?Health Care Setting Exposure?Duration?Results?Environment Stakeholders Situation
intervention to allow the inclusion of different study types such as case control studies and cohort studies. The D stands for duration, either the length of time of the exposure or until the outcome is assessed. The R refers to results. Here is a sample LIS question:
Does teaching database searching skills to postgraduate students in a hands-on workshop compared to a lecture result in effective skills to utilize throughout two or more years of study? Duration would be the length of the postgraduate course (2+ years), and results could be defined as effective searching skills.
Schlosser and O'Neil-Pirozzi (2006) proposed PESICO which applied to the field of fluency disorders and speech language pathology. E refers to the environment or the context in which the problem occurs, and S stands for stakeholders. Stakeholders are an important consideration in certain library settings.
LIS Scenario and Question: Each year, library staff accompany new university students on an introductory library tour. The tour is time- consuming and may not be appropriate for new students who have much information to absorb in their first few days. Library staff and student instructors suggested that staff post a virtual library tour on the Website. It can be accessed at a time and place to suit the student,andmay improvetheir understanding of library services.
P ??" Population: New university students E ??" Environment: Library?S ??" Stakeholders: Library staff and student instructors?I ??" Intervention: Virtual library tour?C ??" Comparison: Physical library tour?O ??" Outcome: Improved understanding of library services
Many of the adapted PICO frameworks introduce terms worth consideration depending on the subject, area, topic, or question. The elements which are additions to the original PICO framework could serve as filters to be reviewed after gathering the initial PICO search results. They can help determine the relevance of initial search results. For
example, consider filtering on context when determining if the results from a rural public library service are directly applicable to a large endowed university library.
DiCenso, Guyatt, and Ciliska (2005) suggested that questions which can best be answered with qualitative information require just two components. Such questions may focus on the meaning of an experience or problem.
P ??" Population: The characteristics of individuals, families, groups, or communities S ??" Situation: An understanding of the condition, experiences, circumstances, or situation
This framework focuses on these two key elements of the question. An LIS example is: In a public library, should all library staff who have face-to-face, telephone, or e-mail contact with users attend a customer awareness course??P - Population: Library staff with user contact S - Situation: Customer awareness course
ECLIPSE
PICO and its variations were all developed to answer clinical questions. Within the medical field there are other types of questions which need to be answered. ECLIPSE was developed to address questions from the health policy and management area (Wildridge and Bell, 2002).
E ??" Expectation: Why does the user want the information??C - Client Group: For whom is the service intended?
L ??" Location: Where is the service physically sited??I ??" Impact: What is the service change being evaluated? What would represent success? How is this measured? This component is similar to outcomes of the PICO framework. P ??" Professionals: Who provides or improves the service?
SE ??" Service: What type of service is under consideration?
Evidence Based Library and Information Practice 2011, 6.2
78
LIS Scenario and Question: There have been user complaints about the current Interlibrary Loan (ILL) service. What alternatives might improve customer satisfaction?
E ??" Expectation: Improve customer satisfaction C - Client group: Library users who request ILLs?L ??" Location: Library
I ??" Impact: Improve the ILL service P ??" Professionals: ILL staff?SE ??" Service: ILL
SPICE
The previous frameworks can all be adapted to answer LIS questions. One framework, SPICE, was developed specifically to answer questions in this field (Booth, 2004):
S ??" Setting: What is the context for the question? The research evidence should reflect the context or the research findings may not be transferable.?P ??" Perspective: Who are the users, potential users, or stakeholders of the service??I ??" Intervention: What is being done for the users, potential users, or stakeholders??C ??" Comparison: What are the alternatives? An alternative might maintain the status quo and change nothing.?E ??" Evaluation: What measurement will determine the interventions success? In other words, what is the result?
The SPICE framework specifically includes stakeholders under P for perspective and is therefore similar to the PESICO framework.
LIS Question: In presentations to library benefactors, does the use of outcome-based library service evaluations improve their perceptions of the importance and value of library services?
S ??" Setting: Library presentation to funders P ??" Perspective: Library benefactors?I ??" Intervention: Outcome-based evaluations of library services?C ??" Comparison: Other evaluations?E ??" Evaluation: Improved perception of the importance and value of library services
Some of these additional concepts are related. Context, environment, and setting have similar connotations, and duration is similar to timeframe. This suggests that the options for constructing well-defined questions are not as numerous as Table 1 suggests.
Combining comparable and related terms would provide the following concepts:?P ??" Population or problem?I ??" Intervention or exposure
C ??" Comparison?O ??" Outcome?C ??" Context or environment or setting?P ??" Professionals?R ??" Research ??" incorporating type of question and type of study design R ??" Results?S ??" Stakeholder or perspective or potential users?T ??"Timeframe or duration
Conclusion
These frameworks are tools to guide the search strategy formation. A minor adaption to the medical question frameworks, usually something as simple as changing patient to population, enables the structuring of questions from all the library and information science domains.
Rather than consider all of these frameworks as essentially different, it is useful to examine the different elements: timeframe, duration, context, (health care) setting, environment, type of question, type of study design, professionals, exposure, results, stakeholders, and situation. These can be used interchangeably when required. Maintaining an awareness of the different options for structuring searches broadens the potential uses of the frameworks. Detailed knowledge of the frameworks also enables the searcher to refine strategies to suit each particular situation rather than trying to fit a search situation to a framework.
Evidence Based Library and Information Practice 2011, 6.2
79
References
The ADAPTE Collaboration. (2009). The ADAPTE process: Resource toolkit for guideline adaption (version 2). Retrieved from http://www.g-i- n.net/document-store/adapte- resource-toolkit-guideline-adaptation- version-2
Booth, A. (2004). Formulating answerable questions. In A. Booth & A. Brice (Eds.), Evidence based practice for information professionals: A handbook (pp.61-70). London: Facet Publishing.
Booth, A. (2006). Clear and present questions: Formulating questions for evidence based practice. Library Hi Tech, 24(3), 355-68. doi:10.1108/07378830610692127
Dawes, M., Pluye, P., Shea, L., Grad, R., Greenberg, A., & Nie, J.Y. (2007). The identification of clinically important elements within medical journal abstracts: Patient population problem, exposure intervention, comparison, outcome, duration and results (PECODR). Informatics in Primary Care, 15(1), 9-16.
DiCenso, A., Guyatt, G., & Ciliska, D. (2005).
Evidence-based nursing: A guide to clinical practice. St Louis, MO: Elsevier Mosby.
Eldredge, J. D. (2000). Evidence-based librarianship: An overview. Bulletin of the Medical Library Association, 88(4), 289-302.
Fineout-Overholt, E., & Johnson, L. (2005). Teaching EBP: Asking searchable, answerable clinical questions. Worldviews on Evidence-Based Nursing, 2(3), 157-60. doi: 10.1111/j.1741- 6787.2005.00032.x
Nollan,
R., Fineout-Overholt, E., & Stephenson, P. (2005). Asking compelling clinical questions. In B. M. Melnyk & E. Fineout-Overholt (Eds.). Evidence-based practice in nursing and healthcare: A guide to best practice (pp.25-37). Philadelphia: Lippincott, Williams & Wilkins.
Evidence Based Library and Information Practice 2011, 6.2




Petticrew M., & Roberts, H. (2005). Systematic reviews in the social sciences: A practical guide. Malden, MA: Blackwell Publishing.
Richardson, W. S., Wilson, M. C., Nishikawa, J., & Hayward, R. S. A. (1995). The well-built clinical question: A key to evidence-based decisions. ACP Journal Club, 123, A12-13.
Schardt, C., Adams, M. B., Owens, T., Keitz, S., & Fontelo, P. (2007). Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Medical Informatics and Decision Making, 7, 16. doi:10.1186/1472-6947-7-16
Schlosser, R. W., & O'Neil-Pirozzi, T. (Spring, 2006). Problem formulation in
evidence-based practice and systematic reviews. Contemporary Issues in Communication Sciences and Disorders, 33, 5-10.
Wildridge, V., & Bell, L. (2002). How CLIP became ECLIPSE: A mnemonic to assist in searching for health policy/management information. Health Information and Libraries Journal, 19(2), 113-115. doi: 10.1046/j.1471- 1842.2002.00378.x

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Question 1. one page paper. Many sources exist that are triggers for theory development through the study of concepts and their related propositions. One such trigger is the research process, which, while it answers many questions, generates others based on research outcomes. Identify some possible questions for research study, the answers to which would serve to generate theory.


Question 2. One page paper.Choose a theory that finds practical application in critical care/pediatric/psychiatric nursing and discuss the origins of the theory based on the following criteria:
How did the happenings of the nursing profession impact the origin of this theory?
What values, evidence, or existing knowledge did the theorist cite to support the theory?
What was the theorists motivation behind writing the theory?

Please use this book for one the reference: Philosophies and Theories for Advanced Nursing Practice(Butts)

Please respond to both separately.

Writer?s Assco5522, rbwpenn, betty, philipj

1. Boyers scholarship of integration ?seeks to interpret, draw together, and bring new insight to a research study. It includes discovering patterns and making connections between nursing and other disciplines, which brings meaning to the original work. The actions of locating and using evidence-based practice guidelines are within the scholarship scope of integration (Conrad & Pape, 2014).?

Conrad & Pape provide the current state for nurse educators, with applications to a multidisciplinary approach to caring for pediatric asthma clients in a community

Whereas, Maurana, Wolff, Beck & Simpson (2001) reviews four evidence-based models to document and evaluate scholarly activities that are applicable to community scholarship and propose a new model. Though this is an older article, it provides a historical perspective on community scholarship, along with a ?new? model. The new model extends the definition of a local community to create a national toolkit for the scope of integration. For myself, it provides an appreciate of the journey of the nurse educator.

As I grew up in a rural Midwestern farming community, this type multidisciplinary collaboration/scholarship was a basic necessity due to the lack of healthcare resources. A formal position of nurse educator was nonexistant, every nurse performed as an educator in the only 45 bed hospital in the entire county. Each nurse had to function as a nurse of all areas with an eye towards grassroots networking for innovative solutions.

As psychiatric nurse, mental health is a key community issue to me. The stigma and fear around mental illness persists. As Nurse educators, we each can encourage nurses at all levels of practice to partake in NAMI?s free training for healthcare professionals to improve collaborative care on the clients path to recovery. For nursing students to experience, sitting in a community setting, having persons with mental illness be the experts/scholars is a powerful learning experience. The Nurse educator can assist the students with reflection, discussion and integration of the experience as a foundational learning touchstone.

- Competent Caring: When Mental Illness Becomes a Traumatic Event is an educational video/DVD that was developed through a collaborative effort between NAMI and the Hospital Corporation of America for continuing education training for healthcare staff. The DVD highlights the experience of an individual living with a mental illness, as well as the staff response when he seeks treatment for a mental health crisis in an Emergency Room setting.

- The NAMI Provider Education program helps people who work with individuals living with mental illness understand the experience of mental illness from individual and family perspectives. Through exposure to personal stories, participants may gain tools that increase their empathy and professional skills thereby improving patient care.

Within the hospital setting, the NAMI peer to peer program comes onto the inpatient unit. This provides an entry point to community resources for the inpatient client, families and support system.

NAMI is a powerful partner in community collaboration.

Conard, P. L., & Pape, T. (2014). Roles and Responsibilities Of the Nursing Scholar. Pediatric Nursing, 40(2), 87-90.

Maurana, C., Wolff, M., Beck, B., & Simpson, D. (2001). Working with Our Communities: Moving from Service to Scholarship in the Health Professions. Education for Health: Change in Learning & Practice (Taylor & Francis Ltd), 14(2), 207-220.

National Alliance for Mentally Illness(NAMI). Educational Program information. Retrievedhttp://www.nami.org/template.cfm?section=Education_Training_and_Peer_Support_Center/



2. Effective care requires a multi-disciplinary approach to be successful. In order to manage, or prevent disease and maintain health, we must treat the whole patient. Illness doesn't just happen. Family history, behaviors, environmental factors, cognition, psychological state and cultural beliefs all impact the health of patients.

Prevention of childhood obesity has become a passion for me. Childhood obesity is caused by a lack of good nutrition and exercise. This can be due to the parent or parents having limited financial resources, unsafe neighborhoods, lack of recreational facilities, depression, food preparation and many other components.

I would love to collaborate with members of the community, the local health clinic, parents, nutritionist, therapists, fitness trainers, doctors, nurses and students to develop a healthy futures campaign. The services would be provided at a reduced cost or free, if possible.

The benefit to the healthcare organization would be the improved community relationship, increased funding, and improving the health of the community. The benefit to the community would be prevention of chronic illness associated with obesity. We would all benefit from the research gathered.

I would integrate student learning by having the students participate in interdisciplinary conferences regarding the patients. I would ask the students questions to promote critical thinking and their understanding of the role of other disciplines in the care of the patients. The multidiscipline approach to obesity would be designed to promote collaboration, and develop an intervention to alter behavior, and lifestyle factors that promote obesity (Lesovic, 2012). Student activities would include interprofessional collaboration to improve communication and teamwork skills (O'keefe, Burgess, McAllister, & Stupans, 2012).

References:

Lesovic, S. (2012). Clinical and laboratory findings in adolescents in "Cigotica" programme from 2008 to 2012. Medicinski Glasnik/ Medial Gazzette, 17(46), 117-128.

O'Keefe, M., Burgess, T., McAllister, S., & Stupans, I. (2012). Twelve tips for supporting student learning in multidisciplinary clinical placements. Medical Teacher, 34(11), 883-887. doi:10.3109/0142159X.2012.700431

This is a request for an article abstract. Article must be related to health care law. Articles should have been published within the past 4 years. Abstract should be formatted in this way:
- Article title
-Author(s) name
-Journal in which article is published, including date, volume and issue # and page numbers
-Synopsis: provide a 3-4 paragraph synopsis of the article. In the synopsis, discuss the major points and/or content of the article.
-Evaluation: provide content related to your evaluation of the article. Rate the article for clarity, usefulness, up to date content, etc.
-Reaction: provide content regarding your reaction to the article. How did you feel reading it, do you support the author's contention or stand on the issue(s), if you were authoring the article how would you have approached the topic, what else would you have included.
-Applicability: provide content related to the applicability of the article to health care practice. You may discuss the applicability related to health care education, community programs, teaching, management or research. Discuss how you might personally use the information in your practice as Psychiatric Nurse Practitioner or future practice after receiving your degree.

1) a 5-page research paper, and 2) a 5-page research experiment addressing bi-polar. I need an abstract, title page and a reference page.
2) The research paper will focus on synthesizing various scholarly sources to support a thesis statement and will conclude by posing an original research question for further study. The research experiment follows directly from the conclusion of the research paper by explaining a plan for answering the proposed research question. The experiment is hypothetically explained based on educated predictions.
3) 6th edition APA.
4) References should be within the last 5 years. Also Use these references :Kutscher, Martin L. Attwood, Tony and Wolff, Robert R. Kids in the Syndrome Mix of ADHD, LD, Asperger's, Tourette's, Bipolar, and More! The One Stop Guide for Parents, Teachers, and Other Professionals(Philadelphia: Jessica Kingsley, 2006)
Kinsella, Caroline and Kinsella, Connor Introducing Mental Health: A Practical Guide (London: Jessica Kingsley, 2006)
McDougall, Tim "Nursing Children and Adolescents with Bipolar Disorder: Assessment, Diagnosis, Treatment, and Management,"Journal of Child and Adolescent Psychiatric Nursing 22.1 (2009)
Steinkuller, Andrea and Rheineck, Jane E. "A Review of Evidence-Based Therapeutic Interventions for Bipolar Disorder," Journal of Mental Health Counseling31.4 (2009)
Young, Barbara "The Role of Psychotherapy in the Bipolar Disorders: Dynamic Psychotherapy as an Adjunct to Pharmacotherapy," Annals of the American Psychotherapy Association 13.1 (2010)

RESEARCH PAPER

The research paper content should be 5 pages long and should incorporate information from the the Bible, and at least five scholarly sources. Topic should be well defined and the information from your research sources should be clearly integrated into the outline.

The paper should have about 5 sections: an introduction, 3??"4 main points, and a conclusion. The paper should summarize and synthesize the findings while researching other authors' writings and studies; the paper should not contain any direct quotes, but should paraphrase your sources.

Begin the paper by introducing the learning problem and presenting some background information. Then, discuss about 3??"4 main points about the topic/problem and what the latest research is saying about it. The final paragraph of the paper should point to the original research experiment by exposing a lack of research in a specific area and posing a research question that would like to solve through the original research experiment. You can either state formal hypotheses or informal intentions for research.

RESEARCH EXPERIMENT

The original research experiment is a 5-page report, describing and explaining a test or survey that could lead to original research for bi-polar. conduct some original research to further investigate your topic.

The experiment is hypothetical. you can make it as large and scientific as you like.

create a design for the experiment (in your Methods section), record the results the best hypothetical projections from the research??"??"(in the Results section), and then discuss what the findings are and where more research could be done (in your Discussion section).

Carefully plan the people (Subjects) you will test, the instruments (Materials: e.g., survey, scores, game, test) you will use with the subjects, and the time, place, and steps involved in the Procedure. Describe these aspects of the Method in minute detail; The Results should only state the numbers, scores, or other responses without comment or explanation. The Discussion should explain the Results by means of the research sources cited in the research paper and in the References.

You are asked to read The journal article I chose (Ethical and Legal Issues In Acting as a Client Advocate) you can retrieve this paper by using this link http://psychnursing.tripod.com/clientadvocate.html it relates to an ethical issue in psychiatric nursing practice. After reading this article, write a critique of it based on the readings I provide you, one of which must be used www.crpnbc.bc.ca, the standards of practice and the code of ethics for Registered Psychiatric Nursing in BC, and 3 others i will provide.
This paper should be no longer than 4 double-spaced, typed pages, excluding references. The usual conventions of orthographics should be adhered to i.e. spelling, grammatical construction, format and appearance. Any references should be identified in the text and stated in full in the reference section at the end of the document. Though you are not required to use any particular reference system, you should be consistent in how you present and record references. Any sources of ideas/thinking not cited directly in the text should be identified in the bibliography list after the references. The journal article I choose should be attached to your references. Please keep in mind its all based on psychiatric nursing and a introduction, conclusion and references are necessary!

LAURA JO ONLY TAKE THIS PAPER!!!

I need to send via attachment assignment instructions from my instructor in an attachment.

Here are my specific instructions along with my references:

The role of balanced diet in preventing weight gain in population of Severely Mentally Ill (SMI).

The title can be change.

Introduction.
? The definition of SMI (Colton & Manderscheid, 2006)
? Stress the high number of morbidity and mortality (Bushe & Holt, 2004; Chafetz, White, Collins-Bride, & Nickens, 2005; Colton & Manderscheid, 2006; Hannerz & Borga, 2000; Miller, Paschall, & Svendsen, 2006; Neeleman, 2001; Perese & Perese, 2003)
? All these problems can be combined to the one ?? metabolic syndrome (Kato, Currier, Gomez, Hall, & Gonzalez-Blanco, 2004; Toalson, Ahmed, Hardy, & Kabinoff, 2004)
? One of the causes is antipsychotic treatment (Ascher-Svanum, Stensland, Zhao, & Kinon, 2005; Chue & Cheung, 2004; Tirupati & Ling-Ern, 2007)
? Another cause is poor diet (Brown, Birtwistle, Roe, & Thompson, 1999)
The problem.
? How to help. The long-term educational program about dieting with clients with SMI and their families?? involvement. Nurses and dietitians will play the main roles.
? There are positive experiences of the long-term program in population of diabetes and weight loss (Albarran, Ballesteros, Morales, & Ortega, 2006; Boltri et al., 2007; Lang & Froelicher, 2006)
? Dietetic association is ready to participate (Hampl, Anderson, Mullis, & Mullis, 2002)
? The previous experiences in SMI weight gain were successful in the short-term and the necessity to provide this nursing implementation is vital (Centorrino et al., 2006; El-Mallakh, 2006; Houltram & Scanlan, 2004; Klam, McLay, & Grabke, 2006; Littrell, Hilligoss, Kirshner, Petty, & Johnson, 2003; Muir-Cochrane, 2006; O'Melia, Shaw, & Dickinson, 2004; Timmerman, Reifsnider, & Allan, 2000; Usher, Foster, & Park, 2006; Vreeland & Kim, 2004; Weber & Wyne, 2006)
The conclusion.
The importance such an intervention is to improve and expend the lives of SMI, to decrease number of diseases and expense for the treatment.
References


Albarran, N. B., Ballesteros, M. N., Morales, G. G., & Ortega, M. I. (2006). Dietary behavior and type 2 diabetes care. Patient Education and Counseling, 61(2), 191-199.
Ascher-Svanum, H., Stensland, M., Zhao, Z., & Kinon, B. (2005). Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia. BMC Psychiatry, 5(3), 1-13.
Boltri, J. M., Okosun, I., Davis-Smith, Y. M., Seale, J. P., Roman, P., & Tobin, B. W. (2007). A simple nurse-based prompt increases screening and prevention counseling for diabetes. Diabetes Research and Clinical Practice, 75(1), 81-87.
Brown, S., Birtwistle, J., Roe, L., & Thompson, C. (1999). The unhealthy lifestyle of people with schizophrenia. Psychological Medicine, 29(3), 697-701.
Bushe, C., & Holt, R. (2004). Prevalence of diabetes and impaired glucose tolerance in patients with schizophrenia. British Journal of Psychiatry, 186(47), 67-71.
Centorrino, F., Wurtman, J., Duca, K., Fellman, V., Fogarty, K., Berry, J., et al. (2006). Weight loss in overweight patients maintained on atypical antipsychotic agents. International Journal of Obesity, 30, 1011-1016.
Chafetz, L., White, M. C., Collins-Bride, G., & Nickens, J. (2005). The poor general health of the severely mentally ill: impact of schizophrenic diagnosis. Community Mental Health Journal, 41(2), 169-184.
Chue, P., & Cheung, R. (2004). The impact of weight gain associated with atypical antipsychotics use in schizophrenia. Blackwell Munkgaard. Acta Neuropsychiatrica, 16, 113-123.
Colton, C. W., & Manderscheid, R. W. (2006). Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states, Preventing Chronic Disease (Vol. 3).
El-Mallakh, P. (2006). Evolving self-care in individuals with schizophrenia and diabetes mellitus. Archives of Psychiatric Nursing, 20(2), 55-64.
Hampl, J. S., Anderson, J. V., Mullis, R., & Mullis, R. (2002). Position of the American Dietetic Association: the role of dietetics professionals in health promotion and disease prevention. Journal of the American Dietetic Association, 102(11), 1680-1687.
Hannerz, H., & Borga, P. (2000). Mortality among persons with a history as psychiatric inpatients with functional psychosis. Social Psychiatry and Psychiatric Epidemiology, 35(8), 380-387.
Houltram, B., & Scanlan, M. (2004). Care map 1 : atypical antipsychotics. Weight gain. Nursing Standard, 18(37), 41-42.
Kato, M., Currier, M., Gomez, C., Hall, L., & Gonzalez-Blanco, M. (2004). Prevalence of metabolic syndrome in Hispanic and Non-Hispanic patients with schizophrenia. Primary Care Companion Journal Clinical Psychiatry, 6(2), 74-77.
Klam, J., McLay, M., & Grabke, D. (2006). Personal empowerment program: addressing health concerns in people with schizophrenia. Journal of Psychosocial Nursing and Mental Health Services, 44(8), 20-28.
Lang, A., & Froelicher, E. S. (2006). Management of overweight and obesity in adults: behavioral intervention for long-term weight loss and maintenance. European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 5(2), 102-114.
Littrell, K. H., Hilligoss, N. M., Kirshner, C. D., Petty, R. G., & Johnson, C. G. (2003). The effects of an educational intervention on antipsychotic-induced weight gain. Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau, 35(3), 237-241.
Miller, B., Paschall, B., & Svendsen, D. (2006). Mortality and medical comorbidity among patients with serious mental illness. Psychiatric Services, 57(10), 1482-1487.
Muir-Cochrane, E. (2006). Medical co-morbidity risk factors and barriers to care for people with schizophrenia. Journal of Psychiatric and Mental Health Nursing, 13(4), 447-452.
Neeleman, J. (2001). A continuum of premature death. Meta-analysis of competing mortality in the psychosocial vulnerable. International Epidemiological Association, 30, 154-162.
O'Melia, J., Shaw, P., & Dickinson, C. (2004). A Meaningful Day Group approach to weight gain from antipsychotic medication. Journal of Psychiatric and Mental Health Nursing, 11(1), 112-116.
Perese, E., & Perese, K. (2003). Health problem of women with sever mental illness. Journal of the American Academy of Nurse Practitioners, 15(5), 212-219.
Timmerman, G., Reifsnider, E., & Allan, J. (2000). Weight management practice among primary care providers. Journal of the American Academy of Nurse Practitioners, 12(4), 113-116.
Tirupati, S., & Ling-Ern, C. (2007). Obesity and metabolic syndrome in a psychiatric rehabilitation service. The Australian and New Zealand Journal of Psychiatry, 41(7), 606-610.
Toalson, P., Ahmed, S., Hardy, T., & Kabinoff, G. (2004). The metabolic syndrome in patients with severe mental illnesses. Prim Care Companion Journal Clinical Psychiatry, 6(4), 152-158.
Usher, K., Foster, K., & Park, T. (2006). The metabolic syndrome and schizophrenia: the latest evidence and nursing guidelines for management. Journal of Psychiatric and Mental Health Nursing, 13, 730-734.
Vreeland, B., & Kim, E. (2004). Managing the clinical consequences of psychiatric illness and antipsychotic treatment: a discussion of obesity, diabetes, and hyperprolactinemia. Journal of American Psychiatric Nurses Association, 10(3), S17-S24.
Weber, M., & Wyne, K. (2006). A cognitive/behavioral group intervention for weight loss in patients treated with atypical antipsychotics. Schizophrenia Research, 83(1), 95-101."


There are faxes for this order.

write a summary on the well known movie "A Girl Interrupted"
1-did you enjoy the movie? why? why not?
2-do you feel it was well written/developed as a plot? why? why not?
3-what points in the movie are applicable to psychiatric nursing practice?
4-state your opinion as to what you gained by seeing the movie.
the review must be at least 250 words in APA format (you can do either 1 or 2 pages, up to you)
the paper must demonstrate clarity and organization of ideas

Determine what type of communication style is being used by the following personnel.
1. Rashad attended the team meeting with all the rest. When the topic of role clarification for assistive personnel came up, he stated that he thought part of his role was to anticipate the needs of the patients for toileting and personal hygienic care. Robin, one of the staff RNs in their psychiatric care group home, raised her voice as she firmly stated, ?You are only an aide. That is in the RN role. We don?t expect you to think, just to do what we tell you to when we tell you.? Rashad sat quietly without responding because he needed to keep his job but began his plan on how he?d make Robin pay for her statement. Maybe he wouldn?t do anything without being told.

2. Pamela, one of the school nurses in a rural county, was following up on some vision and hearing testing done by one of the volunteers, Brigite. She was concerned about the accuracy of the work due to the way these readings compared to previous readings. Instead of discussing this with Brigite, she decided to do it all herself and retest everyone.


3. Rosa managed the ambulatory care surgical center for a large healthcare conglomerate. Mabel, one of the surgical technicians, told her that she would not consider scrubbing in any orthopedic cases. Her rationale was that they were too physically stressful. When Rosa mentioned that, although she wanted the staff to work together as a team, with everyone using his or her strengths to bring the best care for the patients, and that being involved in orthopedic cases was a part of Mabel?s job description, Mabel told her menacingly that she was the granddaughter of the chairman of the board and that she?d ?get Rosa?s head on a platter.?
1. The psychiatric nurse was being aggressive. Rashad responded by being passive but planned to be passive?aggressive in the future.
2. This school nurse was being nonassertive.
3. Mabel was aggressive. Her boss was being assertive.
Describe the scenario and communication style. If you could do this over again, how could you improve the communication? How was communicating effectively important in the health care profession and to the outcome of this interaction?

Write a 200- to 350-word analysis for each of the three scenarios

Format your analyses consistent with APA guidelines.

Please use the following article for review: Understanding Runaway Teens
Journal of Child and Adolescent Psychiatric Nursing, May 2006 by Martinez, Ruby J

I need part two of this project done, Masters level
I have posted the part one of the project just as a guide for part two which I need help with. PLEASE SCROLL DOWN TO PART TWO THAT IS WHERE I NEED WORK THE FIRST PART HAS BEEN DONE AND GRADED

Course Project: Introduction to Course Project PART 1

Evidence-based practice involves a great deal more than simply reading nursing periodicals on a regular basis. Nurses can take a more proactive approach to evidence-based practice by identifying authentic problems and concerns, and then using that to guide their inquiries into current research. In this way, nurses can connect the results of relevant research studies to their nursing practice.

For the Course Project, you identify and apply relevant research to a specific nursing topic or problem. You begin by formulating an answerable question that is relevant to nursing and evidence-based practice. In later weeks of this course, you continue the Course Project by conducting a literature review and then determining how the evidence from the literature can be applied to nursing practice.

Before you begin, review the Course Project Overview document located in this week?s Learning Resources.

Note: This Course Project will serve as the Portfolio Assignment for the course. In addition to submitting portions of this Project in Weeks 2 and 5, you will turn in all three deliverables in Week 10.

Course Project: Part 1?Identifying a Researchable Problem
One of the most challenging aspects of EBP is to actually identify the answerable question.

?Karen Sue Davies

Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results.

In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model?patient/population, intervention/issue, comparison, and outcome?outlined in the Learning Resources to design your questions.

To prepare:

Review the article, ?Formulating the Evidence Based Practice Question: A Review of the Frameworks,? found in the Learning Resources for this week. Focus on the PICOT model for guiding the development of research questions.
Review the section beginning on page 71 of the course text, titled, ?Developing and Refining Research Problems? in the course text, which focuses on analyzing the feasibility of a research problem.
Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.
Generate at least five questions that relate to the issue which you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.
Formulate a preliminary PICO question?one that is answerable?based on your analysis. What are the PICO variables (patient/population, intervention/issue, comparison, and outcome) for this question?
Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.

Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.
To complete:

Write a 3- to 4-page paper that includes the following:

A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice
The 5 questions you have generated and a description of how you analyzed them for feasibility
Your preliminary PICOT question and a description of each PICOT variable relevant to your question
At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections:

This was the week 2 paper PART I ( ALREADY GRADED)

Suicide in psychiatric patients
Suicide rates are remarkably high worldwide and nationally, making suicide one of the leading causes of death (Schwartz-Lifshitz, Zalsman, Giner et al, 2012; Tillman, 2014). Although most suicides do not occur in the hospital setting, psychiatric disorders?especially mood disorders and psychotic disorders?are risk factors that increase the likelihood of a suicidal event (Appleby, 1992; Sarzetto, Delmonte, Seghi, et al, 2017). Suicide not only affects the patient, but reverberates throughout the patient?s family and social circle, also causing distress and potential performance issues among clinical staff (Tillman, 2014). Therefore, it is important that psychiatric nurses understand how to recognize risk factors, and establish a clinical practice environment that prevents suicide. Minimizing suicidal tendencies requires different types of treatment interventions individually tailored for at-risk patients, as well as implementing best practices for creating a clinical environment that reduces risk. Best practices may also include preparing, teaching, and training nursing staff, especially when working with at risk populations.
Both psychiatric patients and psychiatric nursing staff can be considered target populations for an intervention designed to prevent suicide in the clinical setting. Preliminary research questions using the PICO (patient/population, intervention/issue, comparison, and outcome) model include the following:
1. Among psychiatric patients (P), do mandatory intake assessments specifically for suicide risk (I) reduce rates of suicide (O) versus institutions without such policies (C)? This is a reasonable PICO question, but one that would require a large-scale assessment of different psychiatric institutions. Therefore, it might be too difficult to find sufficient evidence to make an informed decision for evidence-based practice.
2. Among psychiatric patients with mood disorders and other high-risk populations (P), do pharmacological interventions (I) reduce rates of suicide (O) versus patients who only receive talk or group therapies (C)? This is a commonly posed question related to suicide in the population group. The problem with this PICO question is there are too many different pharmacological interventions and individual differences among patients to come up with a clear, definitive guide for evidence-based practice.
3. Among psychiatric patients with suicidal ideations or a history of suicidal behavior (P), does family and group therapy (I) reduce risk (O) versus patients who do not receive any family or group therapy (C)? This is one of the most feasible PICO questions to use because family and group therapy options might offer some sound solutions for preventing suicide and reducing long-term risks.
4. Do community awareness, public service announcements, and other means of education and communication (I) help reduce rates of suicide (O) among discharged psychiatric patients (P) versus communities that do not receive such public relations services (C)? This is an important avenue of research for evidence-based practice in the community, helpful from a public health perspective. However, methodologically such interventions are less feasible.
5. Does mindfulness meditation (I) reduce long-term risk factors and suicidal behaviors (O) among high risk psychiatric patients (P) versus those who do not participate in the meditation programs (C)? As with question three, this is a suitable line of inquiry, which could actually lead to evidence-based practice guidelines for psychiatric institutions. Therefore, I will select this PICO question for the remainder of my research.
PICO Question: Does mindfulness meditation (I) reduce long-term risk factors and suicidal behaviors (O) among psychiatric patients (P) versus those who do not participate in the meditation programs (C)?
The patient population (P) can include all psychiatric patients on any given unit or within any given institution. Alternatively, the patient population can include psychiatric patients who have been diagnosed with one or more conditions known to increase risk of suicide: those conditions being mood disorders, psychotic disorders, substance use disorders, and personality disorders (Schwartz-Lifshitz, Zalsman, Giner, et al, 2012). This would allow the researcher to compile evidence from multiple studies.
The intervention (I) in this PICO question is mindfulness meditation. It is important to clarify exactly what this would mean, such as how many hours per day or per week of meditation, and which specific meditation instructions were given. The addition of the time (T) variable to the PICOT analysis might also be helpful. For example, does the meditation intervention yield results after three months, six months, or one year?
The comparison (C) is like a control group in this case, consisting of psychiatric patients who are not meditating formally within the designated intervention. Finally, the outcome (O) can be measured in different ways such as overall rates of suicide or surveys of patients regarding their subjective assessments of suicidal ideation.
The following keywords that can be used for conducting a literature search include: major depressive disorder, mood disorders, psychotic disorders, DSM-V, suicidal behavior, suicide, suicidal ideation, mindfulness, mindfulness meditation, meditation, suicide risk, and psychiatric patients.
References

Appleby, L. (1992). Suicide in psychiatric patients. British Journal of Psychiatry 1992(161): 749-758.
Jacobs, D.G., Baldessarini, R.J., Conwell, Y., et al (2010). Practice guideline for the assessment and treatment of patients with suicidal behaviors. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/suicide.pdf
Sakinofsky, I. (2014). Preventing suicide among inpatients. Canadian Journal of Psychiatry 59(3): 131-140.
Sarzetto, A., Delmonte, D., Seghi, F. et al (2017). Suicide in depressed patients. European Psychiatry 41(April 2017 Supplement): S891-S892.
Schwartz-Lifshitz, M., Zalsman, G., Giner, L., et al (2012). Can we really prevent suicide? Current Psychiatry Reports 14(6): 624-633.
Tillman, J.G. (2014). Patient suicide: impact on clinicians. Psychiatric Times. Dec 31, 2014. http://www.psychiatrictimes.com/special-reports/patient-suicide-impact-clinicians




-----THIS ASSIGNMENT IS THE CONTINUATION OF THE ABOVE PROJECT FROM WEEK 2. I HAVE POSTED THE WEEK 2 WORK TO GUIDE THE FOLLOWING ASSIGNMENT.

Course Project: Part 2?Literature Review
This is a continuation of the Course Project presented in Week 2. Before you begin, review the Course Project Overview document located in the Week 2 Resources area.

The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.

To prepare:

Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.
Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library?s databases.
Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week?s Learning Resources.
Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.
To complete:

Write a 3- to 4-page literature review that includes the following:

A synthesis of what the studies reveal about the current state of knowledge on the question that you developed
Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.
Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry
Your literature review summary table with all references formatted in correct APA style
Note: Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study?s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.



Plagiarism less than 8%

Rubric
27 (27%) - 30 (30%)
Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics.

5 (5%) - 5 (5%)
A clear and comprehensive purpose statement is provided which delineates all required criteria.

9 (9%) - 10 (10%)
Demonstrates the ability to critically appraise and intellectually explore key concepts.

18 (18%) - 20 (20%)
Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view.

18 (18%) - 20 (20%)
Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.

5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity

The project must include an intervention appropriate to nursing practice and consistent with your MSN role option. An alternative to the above includes the selection of a specialty organization to focus research proposals based on the priorities of that organization. Examples of these organizations could include (but are not limited to): Sigma Theta Tau International, American Nurses' Foundation, Oncology Nursing Society, Association of Nurses in AIDS Care, American Psychiatric Nursing Association, American Association of Critical Care Nurses, National Association of Pediatric Nurse Associates and Practitioners, National League For Nursing, etc. This paper is to be developed in APA format/style using the outline below as level headings and not to exceed 15 pages (excluding title page/references/appendices).

Criteria:

Introduction

Background and Significance of Problem
Statement of the Problem and Purpose of the Study
Literature Review

Summary of the Evidence for the Proposed Study
Research Question, Hypothesis and Variables with Operational Definitions
Theoretical Framework

Overview and Guiding Propositions(s) Described in Theory
Application of Theory to Your Studys/Projects Focus
Methodology

Sample/Setting: Number and criteria for inclusion and description of place in which data will be collected.
Sampling Strategy
Research design: Type (e.g., Quasi-Experimental), description and rationale for selection.
Extraneous Variables (and plan for how controlled).
Instruments: Description, validity and reliability estimates, which have been performed (on a pre-established measure). Include plans for testing validity and reliability of generating your own instrument(s).
Description of the Intervention
Data Collection Procedures
Data Analysis Plans
Describe plan for data analysis for demographic variables (descriptive statistical tests).
Describe plan for data analysis of study variables (descriptive and inferential statistical tests).
Ethical Issues

Describe ethical considerations and your plan to protect human rights. When describing informed consent, provide reading level score (see Burns & Grove).
Limitation of Proposed Study
Implications for practice
References
Appendices

Informed Consent Letter
Procedure section is clear, described in detail, specific, and all inclusive. Written in lay language (as documented by reading level score). Includes risks & benefits relevant to study. Address assent (if applicable).

Customer is requesting that (rbwpenn) completes this order.

ARTICLE NAME: Trauma, Posttraumatic Stress Disorder
Symptom Clusters, and Physical Health
Symptoms in Postabused Women
Stephanie J. Woods and N. Margaret Wineman

Archives of Psychiatric Nursing, Vol. XVIII, No. 1 (February), 2004: pp 26-34

I don't think the following qualifies for your "statistical analysis", but if you need to add it, go ahead. NW


Research Critique Paper (20% of Grade)
This assignment may be submitted by the student or group. Article will be posted on Springboard. Using the criteria discussed in class and in the book, the student/group will complete a written critique. This paper is 3 pages maximum, double spaced, 12 point font, 1 inch margins, but not APA format. There will be a penalty for going over 3 pages. Submit your groups research critique the day its due according to the course calendar.

CRITERIA MAXIMUM POINTS POINTS EARNED
Evaluate the problem and purpose statements. Is the case made that the problem is compelling? 10
What are the independent and dependent variables? Are they clearly stated? 3
Critique the hypotheses/research questions. Are all variables explicit? Are variables consistent with the research problem? 5
Evaluate the review of the literature. Was it recent? Relevant: Primary source evident? 10
Indentify and critique the conceptual framework. Does it relate well to the problem and variables? 5
Evaluate the sampling plan and procedures. Was coercion adequately prevented? 5
Evaluate the design and its appropriateness to the study. Was it experimental, quasi-experimental, descriptive, and what level? 10
Evaluate the reliability and validity of the research instrument(s). Are the psychometric properties were provided? 5
Evaluate the statistical procedures used in the study. Is alpha stated and is it too stringent for the design? 7
Briefly discuss the findings and evaluate the clarity of the author(s) presentation. Were p-values given for each DV? Were findings consistent with previous findings in the area? 10
Are the findings adequately related back to the studys conceptual framework? 5
Were possible confounding variables accounted for? 5
Evaluate the implications of the study for future research as presented in the article 5
Was the authors discussion of the implications for nursing practice consistent with the strengths/weaknesses of the study? 10
Discuss the value of the study for nursing practice 5
TOTAL POINTS 100

1-indicate what aspects of the article you enjoyed reading.
2-explain the elements in the article that are relevant to psychiatric nursing practice.
3-state your opinion as to what you gained by reading the article

the review must be double spaced with 12 font size in APA format (abstract, introduction, body, conclusion)
the paper must demonstrate clarity and organization of ideas

Please write this paper as though you have attended an AA meeting. I'm suppose to attend and observe an AA meeting and write about it for my Psychiatric Nursing class. The paper requires discussion about disabilities and disorders related to alcoholism. Here's a couple web site: AA.org and righthealth.com. Discussion of group type (which was an open group which are ongoing and run indefinitely, allowing members to join and leave the group as they need to) and their goal process (involvement and behavior of group members). You can create a couple fictional people and discuss their disorders and how how they behaved during the meeting. Discuss group leaders and their effectiveness (again create a group leader who is an effective and an empathetic leader). Synopsis of group content. I'm also supposed to write how I felt about the meeting. I think that AA is beneficial for those who have accepted that they have a problem. It gives that person time to heal and seek help from others who suffer from the same disorders or problems.

Please access the internet site:
http://www.stti.iupui.edu/library/jns/2000/4-347.pdf

The article, "Effects of group therapy on chemically dependent women's self-efficacy" is to be critiqued following the guidelines listed below.

Write an 8 page Quantitative research critique of the following article from the cited source: Washington,O. (2000). "Effects of group therapy on chemically dependent women's self-efficacy" from the Journal of Nursing Scholarship,32 (4), 347-352.

ABSTRACT:
Washington OGM. Using brief therapeutic interventions to create change in self-efficacy and personal control of chemically dependent women. Archives of Psychiatric Nursing 15(1): 32-40, 2001. (32 refs.)
This experimental study examined effectiveness of two group therapy models on chemically dependent women's perceptions of self-efficacy and personal control. Participants were randomly assigned to two therapeutic approaches (experiential or cognitive) or the control group. Experimental and control groups were pre- and post tested on self-efficacy and personal control. Significant differences were found for social self-efficacy, with the cognitive and experiential groups having higher scores than the control group, Changes from pre- to posttest in social self-efficacy were greatest for the cognitive group. This study indicated that additional brief therapeutic interventions beyond those generally offered in drug rehabilitation programs are modestly useful.
Copyright 2001, W.B. Saunders Co.

Purpose: To determine effects of experiential and cognitive group therapy on self-efficacy of chemically dependent women.
Methods: This quasi-experimental study indicated differences in the effects of cognitive and experiential group therapy on perceptions of general and social self-efficacy in 52 recovering chemically dependent women living in a Midwestern urban area of the United States. Two additional groups of women were recruited for control groups. One control group (n = 34) consisted of chemically dependent women from the same sites who did not participate in the treatment programs. The second control group consisted of working women (n = 35) who were matched to the chemically dependent women on age, race, and gender, and who self-reported not being chemically dependent ...


Please use for a heading the phrase after the number & prior to the colon.*
Provide a rationale for all answers. The paper is to be 8 pages long and no more, with 1 inch margins in 12 pitch Times New Roman, APA format.

Exp. * Statement of problem and purpose


1. Statement of the problem and purpose to include: What is the specific purpose for this study? Is the purpose explicitedly stated? Or did you have to infer the purpose? Evaluate the extent to which the purpose statement narrows & clarifies the research problem [e.g. population of interest, setting, specific variable of interest.] What are the major concepts/variables of interest in the study according to the problem statement and purpose of the study. Does the problem statement provide information about the significance of the problem? Does it indicate how the study will contribute new knowledge> Explain.

2. Review of the literature & conceptual framework: What are the major concepts presented in the literature review? Evaluate the extent to which the literature review/framework presents the relationships among the concepts and relates them to the variables of the study. Evaluate the fit with the purpose of the study & the research questions/hypotheses. Is the conceptualization of concepts and/or theory consistent with the research problem? Evaluate the literature review [Is it logically organized? Are the major concepts/variables addressed?] Does it present a progression of ideas based on previous research? Evaluate the extent to which the literature review provides a justification for undertaking the study.] Evaluate the study framework. Some points to consider: Is the framework explicitly expressed or do you have to figure it out from the literature review? Is a particular model or theory identified?, If so, what is it? Are propositions from the framework that directed the study identified? Is a map of the framework provided? If a map is not provided, diagram the framework based on your understanding of the study. Evaluate the extent to which a critical appraisal of existing literature is provided. Evaluate the extent to which gaps in literature were identified. How does the study propose to fill those gaps?

3. Research questions/hypotheses: What are the research questions/hypotheses/ Are they implicit or explicit? Evaluate the extent to which the major concepts previously identified are included in the questions/hypotheses? Are the research questions/hypotheses consistent with the evidence presented in the literature review? Are the research questions/hypotheses clearly written? What are the independent&dependent variables?

4. Appraisal of the study design? Identify the design used in the study. Evaluate the appropriateness of the design. [Does it flow from the purpose, framework, lit review and questions/hypotheses?] Evaluate the adequacy of strategies used to control for extraneous variables. [What potential extraneous variables were the authors concerned about? What was done to control the extraneous variables? What additional extraneous variables should the authors have been concerned about?]What are the strengths/limitations of the design selected?Dicuss the threats to internal validity of this study. Clearly state the threats that have been minimized by the design & those that remain a concern.

5. Sample and sampling methods: What are the target population & accessible population? Is the accessible population appropriate, given the research questions/hypotheses? What inclusion & exclusion criteria were used? Evaluate appropriateness given the purpose of the study. How was the sample selected? Evaluate the sampling method. What are potential sources of sampling bias? Discuss threats to external validity. How do the authors justify their sample size? (e.g., by power analysis)?

6. Data collection methods: Evaluate the construct validity of this study. Are variables appropriately operationalized? From your perspective, evaluate the fit between the operational definitions & conceptual definitions. Evaluate the fit between the conceptual framework & the intervention [if applicable]. Evaluate the quality of the measures selected for the study. [Are the measures used reliable & valid? Provide rationale for your answer.] Are data collection procedures clearly spelled out? Who collected the data? What kind of quality control measures were used? What steps were taken to protect the rights of human subjects?

7. Discussion: Evaluate the author[s] presentation of strengths & limitations. Discuss the author[s] presentation of alternative explanations for the findings. In the discussion section, evaluate the degree to which the findings are described within the context of the study framework. Evaluate the extent to which the study findings were linked to existing knowledge in terms of the similarities & differences from other research findings. Evaluate the author[s] presentation of implications for practice & future research.

8. Conclusion: Recognizing the articles have strengths & weaknesses, reflect on your critique of the selected article. Summarize your overall evaluation of the article-discuss whether or not you would recommend using the findings in psychiatric advanced nursing practice & explain your position.



There are faxes for this order.

Tasks:
- Consider one of the following case studies and set out the ethical landscape for it. What do you see as the ethical issues in these cases? Why? What information is needed, and what is given in order to make a proper decision? What principles or approaches are relevant to that decision? How would you handle the case?
- Your comments about resolution should take the form of suggestions for which you can give reasons. One important academic journal for the field is Philosophy, Psychiatry and Psychology. There is also an on-line Journal of Ethics in Mental Health, edited at McMaster University. Since you could become a greater expert in the area you choose than either the instructor or the marker, you should engage in careful exposition of your subject. Do not however, assume that the reader of your paper is completely uninformed about the area of discussion
* FOCUS on clarity and setting up the ethical landscape explicitly !

Options:
a. Recognizing the stressful and demanding nature of the clerical life, the Roman Catholic archdiocese of N. has appointed you to provide counseling to troubled priests. Using the service is purely voluntary, although strong encouragement is given to priests who have had some prior problems (e.g. drinking problems) to use it. Father X has come to you, and has admitted that over the years he has had to struggle with a powerful sexual attraction to young men and boys. He does not seem to be a predator by nature, but he has disclosed that he has engineered opportunities to have sex with altar servers in some previous postings. He has never admitted this to any archdiocesan official (at least not outside the confessional), and he is struggling once again with an attraction to certain early adolescents in his current parish. Actually acting on this attraction would, of course be an offense under the Criminal Code, and bring (more) disrepute to the Church. What should you do about this?

b. Mr. Y has been under treatment with you for deep bouts of depression. When he has been depressed in the past, he has had trouble complying with treatment provisions. To put it bluntly, once his mood improves and stabilizes, he goes off his medication. Lately, however, this tendency has been limited by the fact the prescribed anti-depressives have had little effect, and he has abandoned them even sooner. He has said that if he continues to feel this bad, he may as well just stop living, and he has considerable difficulty managing the activities of daily living. Only family pressure even gets him out of bed in the morning. You have raised the possibility of Electro-convulsive therapy (ECT) with him. While he has shown some interest in it because of the reported success in cases of severe depression, he has also expressed serious misgivings: I hear it scrambles your brain, he says, and people lose many of their memories from all stages of their lives. Would you pursue the possibility of this treatment further with him? If not, why not? If so, why, and how would you deal with the misgivings? What rights does Mr. Y have in the case? Are there any alternative therapies available in such cases? What would justify proposing one?

c. As a psychiatric nurse in a hospital, you have been assigned the duty of administering prescribed medication to Ms. Z, for her extreme and debilitating anxiety. Because you have had the opportunity to observe her on every shift you have worked since her admission, you have noticed a distinct worsening of her condition. There has been both physical and mental/emotional deterioration since admission. While a small amount of the decline took place before the medication was prescribed, it has moved on much more quickly since the course of medication began. Your fellow nurses have also noticed it, and the symptoms, such as insomnia, severe mood swings and violent outbursts have made patient management a real problem. You suspect that the medication may be involved, and you have taken the matter up with the attending psychiatrist, Dr. Q, who insists that the condition cannot be as bad as it is presented, and that whatever irregularities there are will stabilize once the patient becomes acclimatized to the medication. However, Dr. Q has many patients and so has only carried out brief, cursory examinations of Ms. Z since the medication began. The psychiatric resident supports Dr. Qs view, noting the doctor is the local authority on the treatment of this condition. What would you do about this case?

d. You have been working for some time with a famous (and award winning) laboratory scientist, Professor L., who has been diagnosed with Bipolar Personality Disorder. As is common with the condition, he has periods both of extreme elation, and deep depression, and sometimes the transitions between the periods are abrupt. His condition can be managed medically, but he has had the experience of achieving a great deal during the periods of elation. In fact he has told you that those have been the periods when he can do the most work, and solve the most difficult problems in his research. It appears that he is right about this. Consequently he goes off his medication whenever there is work pressure or he suspects that doing so will induce an up phase. He is quite definite that this action is necessary for his scientific success. Unfortunately, he is also an addictive personality and has a history of alcoholism. When he reaches his peak moods, he begins to binge drink and becomes abusive, even violent towards those with whom he lives and works. As the depressive phase sets in, the drinking continues, perhaps as an attempt to self-medicate. He becomes incoherent, misses appointments, and does embarrassing things when he does show up at a class or academic function. His work grinds to a halt, and he has been known to try to destroy some of the output of the peak-mood period. Colleagues have to cover for him in classes and make excuses on his behalf at conferences and lectures. His own sense of the futility of this depressive phase induces him to seek help. The chair of his department suspects that you have been seeing the man, and she has asked you to intervene, if you are seeing him, in order to ensure that his moods are kept even. Nevertheless, the departments promotional material always mentions this professors achievements prominently. What should you do?