Bonnie Kenaley

Outcomes of a Telehealth Intervention for Homebound Older Adults With Heart or Chronic Respiratory Failure: A Randomized Controlled Trial

Zvi D. Gellis et al. — Wed, 07 Mar 2012 08:56:35 PST

Purpose: Telehealth care is emerging as a viable intervention model to treat complex chronic conditions, such as heart failure (HF) and chronic obstructive pulmonary disease (COPD), and to engage older adults in self-care disease management. Design and Methods: We report on a randomized controlled trial examining the impact of a multifaceted telehealth intervention on health, mental health, and service utilization outcomes among homebound medically ill older adults diagnosed with HF or COPD. Random effects regression modeling was used, and we hypothesized that older adults in the telehealth intervention (n = 51) would receive significantly better quality of care resulting in improved scores in health-related quality of life, mental health, and satisfaction with care at 3 months follow-up as compared with controls (n = 51) and service utilization outcomes at 12 months follow-up. Results: At follow-up, the telehealth intervention group reported greater increases in general health and social functioning, and improved in depression symptom scores as compared with usual care plus education group. The control group had significantly more visits to the emergency department than the telehealth group. There was an observed trend toward fewer hospital days for telehealth participants, but it did not reach significance at 12 months. Implications: Telehealth may be an efficient and effective method of systematically delivering integrated care in the home health sector. The use of telehealth technology may benefit homebound older adults who have difficulty accessing care due to disability, transportation, or isolation.

Faculty Empowerment of Students to Foster Civility in Nursing Education: A Merging of Two Conceptual Models

Cynthia Clark et al. — Mon, 05 Dec 2011 15:25:46 PST

Academic incivility negatively impacts faculty and student well-being, weakens professional relationships, and impedes effective teaching and learning. This article addresses the prevalent concern of student incivility and provides useful strategies for faculty to empower students. Two conceptual models, Fostering Civility in Nursing Education and an Empowerment Model, were merged to illustrate how the concepts of civility and empowerment can be combined to foster civility in nursing education. Empowerment domains of motivation, psychic comfort, problem-solving, and self-direction are explored as influential factors promoting constructive reciprocal engagement and civility and, ultimately, enhancing professionalism in a complex and ever-changing health system.

Learning from Vertical NORCs: Challenges and Recommendations for Horizontal NORCs

Laura Bronstein et al. — Mon, 05 Dec 2011 15:25:43 PST

Maximizing quality of life for older adults poses challenges for formal service providers. One strategy to identify and address factors influencing physical and mental health and to promote autonomy of community-dwelling older people is through a naturally occurring retirement community (NORC), a community development model of formal and informal home and community-based support. This descriptive article provides a review of the literature relevant to the NORC concept and a comparison of the dimensions of structure, design and location, management, cost and affordability, and socialization between vertical NORCs (high-rise apartments) in major metropolitan cities and horizontal NORCs in small cities and suburban and rural communities. Implications and suggestions for horizontal NORCs are discussed.

Do Some Interventions Work Better Than Others? A Review of Comparative Social Work Experiments

William J. Reid et al. — Mon, 28 Feb 2011 12:20:58 PST

Knowledge of which interventions are more efficacious than others for given problems is central to evidencebased practice. Attempts to build this knowledge have been confined largely to reviews and meta-analyses of experiments comparing methods of psychotherapy. This literature has suggested that different methods tend to have equivalent results. The authors reviewed all experiments comparing 39 social work programs that were published between 1990 and 2001. Contrary to findings for psychotherapy experiments, a large majority of the social work comparisons showed differential effects. The role of common factors appeared to be diminished by departures of most the social work programs from traditional psychotherapeutic models. Lack of statistical power appeared to be influential only in a few small-sample experiments. The findings support the use of comparative experimental designs to strengthen the empirical base of social work practice.

A Neighborhood Naturally Occurring Retirement Community: Views From Providers and Residents

Laura Bronstein et al. — Mon, 31 Jan 2011 12:50:09 PST

Maximizing quality of life for older adults poses challenges for formal service providers. One strategy to identify and address factors influencing health/mental health and promoting autonomy of community-dwelling older people is through a Neighborhood Naturally Occurring Retirement Community (NNORC), a community development model of formal and informal home and community-based support. This article uses qualitative methods to report on critical themes generated from an initial evaluation of an NNORC using individual interviews with community partners that developed the program and Resident Council members living in the NNORC community. Findings reveal the need to support older adults aging in place, the importance of informal systems of care, access to trustworthy concrete service providers, and improved models of collaboration.

Problem-Solving Therapy for Depression in Adults: A Systematic Review

Zvi D. Gellis et al. — Mon, 31 Jan 2011 12:40:22 PST

Objectives: This article presents a systematic review of the evidence on problem-solving therapy (PST) for depressive disorders in noninstitutionalized adults. Method: Intervention studies using randomized controlled designs are included and methodological quality is assessed using a standard set of criteria from the Cochrane Collaborative Review Initiative. Results: Twenty-two studies investigating PST for adult depression are compiled and examined. Studies differ in scope and methodological rigor. Sample sizes vary widely; all study outcomes include depression measures; problems in masking of group assignment and randomization are noted. Conclusions: Mixed evidence for PST as a depression treatment is found. The combined use of PST and antidepressant treatment has more favorable outcomes compared with PST alone for social work practice.

Integrative Community Support Model (ICSM) for the Severe and Persistently Mentally Ill (Paper Presentation)

Bonnie Kenaley et al. — Tue, 09 Nov 2010 14:34:17 PST

Gender and Developmental Differences in Relation to the Effects of Child Abuse (Symposium)

Bonnie Kenaley — Tue, 09 Nov 2010 14:25:47 PST

Psychological Distress in Residents of a Neighborhood Naturally Occurring Retirement Community

Zvi D. Gellis et al. — Tue, 09 Nov 2010 14:23:23 PST

Households with one or more residents age 65 and over make up 47% of the Neighborhood Naturally Occurring Retirement Community (NNORC) of Albany, New York. This two-square-mile area is served by a NNORC interfaith partnership of several religious, health, educational and other community service organizations providing supportive services, social activities, and enhanced access to health and social services. This survey was designed to identify potential areas of need requiring new or expanded services. A total of 226 NNORC residents age 60 and over completed questionnaires measuring demographics, aspects of health, help-seeking, mastery, loneliness, health locus of control, and psychological distress. Approximately 18% of the residents reported at least one symptom of depression during the previous week, while 50% reported at least one symptom of anxiety during the past month. The best-fitting linear regression model indicated that overall psychological distress was significantly higher in residents who were younger, living alone, and reported higher levels of loneliness, lower levels of mastery, worse general health, or a negative change in health over the last year (F = 17.823, p = .000). Over the past year, very few respondents reported accessing help from most sources. Although 67% reported receiving help from their personal care physicians, less than 5% reported help from religious leaders, counselors, social workers, psychiatrists, support group programs, or the NNORC. These findings imply that more vigorous outreach efforts may be needed to identify and link at-risk residents to mental health and other support services available through NNORC.

Gender and Developmental Differences in Relation to the Effects of Child Sexual Abuse

Bonnie Kenaley — Tue, 09 Nov 2010 14:06:55 PST

The aims of this study were to determine the relationship between the dimensions of child sexual abuse (CSA) (age at onset, frequency, duration, severity, and victim-perpetrator relationship) and the short-term behavioral/psychological sequelae, considering the victim's gender and developmental level and determine if a relationship exists between each CSA dimension and the sequelae, whether a minimal, moderate, or severe level of CSA. This national two-stage stratified probability study entailed a secondary data analysis using the National Child and Adolescent Well-being Survey (NSCAW) dataset. The sample consisted of 442 boys and girls between the ages of 6 and 16 years old investigated by child protective service agencies for allegations of child sexual abuse. Logistic regression analyses examined the associations between CSA dimensions and CSA-related sequelae, controlling for gender, developmental level, and prior history of abuse. The CSA-related sequelae were measured with the Child Behavior Checklist (Achenbach, 1991).

Over half of the sample scored in the clinical level for Total Problems, whereas no more than one third had clinical level syndrome subscale scores. CSA dimensions were found to be associated with attention and thought problems, aggressive and delinquent behaviors, sexual problems, and a decline in overall functioning. An unexpected finding was the identification of critical thresholds for the occurrence of symptoms. Boys were found to be as or more traumatized compared with girls considering the relationship between the CSA dimensions and sequelae. Adolescents were found to have shorter durations, more frequent episodes, and suffer more severe sexually abusive behaviors compared with middle childhood children. Forty-four percent of the children had scores within normal range, suggesting the presence of protective factors.

A Preliminary Evaluation: Demographic and Clinical Profiles and Changes in Functioning in Children Receiving Psychosocial Rehabilitation

Bonnie L. Davis Kenaley et al. — Mon, 08 Nov 2010 14:37:10 PST

The present study is the first to examine the demographic and clinical profiles at intake of children with emotional disturbances who received Child Psychosocial Rehabilitation (CPSR), a relatively new treatment for children suffering with emotional disturbance(ED). Fifty-three children ranging in age from 4 to 18 years received CPSR from a for-profit outpatient child and adolescent mental health clinic located in southwestern Idaho for a minimum of six months. The children's demographic and clinical profiles were examined. In addition, the relationship between the relative change in psychological, emotional, and behavioral functioning as measured by CAFAS (Hodges, 1989, 1994) and PECFAS (Hodges, 1994) scores and the children's age, gender, ethnicity, current living arrangement, type of mental health diagnosis, and severity of impairment at intake were evaluated. Significant improvement in the children's overall functioning was found after six months of treatment. No significant between-group differences were found for gender, age, ethnicity, living situation, diagnosis, number of diagnoses, and overall impairment at intake.