This chapter provides an overview of the nonprofit organization in the United States, the main characteristics of nonprofit organizations, and the reality of the nonprofit sector today. It describes the differences between a nonprofit and a for-profit corporation. Nonprofit organizations have existed for many centuries, especially through religious groups or religious-based activities. The nongovernmental sector is growing throughout the world. Increasingly, these organizations are playing key roles in the economic and social contexts of their countries. Unlike private-sector organizations concerned primarily with making a profit, nonprofit organizations are focused on carrying out a specific public-service mission. Successful nonprofit organizations require substantial capability in key areas of management: developing strong boards of directors, recruiting and motivating talented staff and volunteers, creating plans to focus resources on relevant goals and innovative programs, winning the support of diverse stakeholders, raising funds, and wisely managing fiscal and human resources.
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This chapter discusses the term “service delivery” and describes a service delivery system in the context of a nonprofit organization. Servitization is the process whereby an organization develops creative and innovative ways to create a product-service system that integrates value-based products and service offerings. The chapter discusses the roles of client-centeredness, decision making, scheduling, priority setting, effective and efficient flow of services or activities, quality assurance, and continuing quality improvement, and how these factors contribute in their own context to influence positively or negatively the financial sustainability of a nonprofit organization. A customer-centric service design is a service delivery system that focuses on providing the best quality service possible to customers or clients or the service target, based on a service concept, a service decision path, service sustainability, and service quality. The chapter explains the relationship between service delivery and financial sustainability.
This chapter focuses on women, who are HIV positive, from a global perspective. It illustrates more easily what makes groups of people, and in this case women, vulnerable and then consider vulnerability from a global health (GH) perspective using the chronic illness, HIV. The chapter presents some examples of situations that make women vulnerable to HIV and, once infected, vulnerable for life, and use a case-based approach to highlight women as a vulnerable population. It also focuses on the real ethical issues that occurred with each case, which one anticipate will help prepare the new GH nurse for practice in the global environment. The chapter demonstrates by using an exemplar of HIV-positive women, vulnerable populations exist both within and outside the United States. Reasons for vulnerability may include stigma, victimization, mental illness, migration, limited access to needed health care or food, or substance use.
Divorce is a lengthy developmental process and, in the case of children and adolescents, one that can encompass most of their young lives. This chapter explores the experience of divorce from the perspective of the children, reviews the evidence base and empirical support for interventions. It provides examples of three evidence-based intervention programs, namely, Children in Between, Children of Divorce Intervention Program (CODIP), and New Beginnings, appropriate for use with children, adolescents, and their parents. Promoting protective factors and limiting risk factors during childhood and adolescence can prevent many mental, emotional, and behavioral problems and disorders during those years and into adulthood. The Children in Between program is listed on the Substance Abuse and Mental Health Services Administration (SAMHSA) National Registry of Evidence-Based Programs and Practices. The CODIP and the New Beginnings program are also listed on the SAMHSA National Registry of Evidence-Based Programs and Practices.
Children and youth with serious emotional, behavioral, and social difficulties present challenges for teachers, parents, and peers. Youth who are at risk for emotional and behavioral disorders (EBD) are particularly vulnerable in the areas of peer and adult social relationships. The emphasis on meeting academic standards and outcomes for children and youth in schools has unfortunately pushed the topic of social-emotional development to the proverbial back burner. This chapter emphasizes that social skills might be considered academic enablers because these positive social behaviors predict short-term and long-term academic achievement. Evidence-based practices are employed with the goal of preventing or ameliorating the effects of disruptive behavior disorders (DBD) in children and youth. An important distinction in designing and delivering social skills interventions (SSI) is differentiating between different types of social skills deficits. Social skills deficits may be either acquisition deficits or performance deficits.
Eating disorders (EDs) are a complex and comparatively dangerous set of mental disorders that deeply affect the quality of life and well-being of the child or adolescent who is struggling with this problem as well as those who love and care for him or her. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specific criteria for the diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding or ED. Treatment of eating disordered behavior typically involves a three-facet approach: medical assessment and monitoring, nutritional counseling, and psychological and behavioral treatment. Cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are also evidence-based approaches to treatment for AN. The treatment of EDs should be viewed as a team effort that integrates medical, nutritional, and mental health service providers.
This chapter reviews prevention, including genetic counseling. It discusses genetic testing for diagnosis as opposed to screening and the treatment for genetic disease. Methods of prevention begin with education of the public and health care professionals and identification of those at risk. Genetic counseling is the process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. The malignant cells often exhibit aneuploidy as well as translocations that are found only within the tumor cells. Genetic errors that arise from specific cell lines are somatic mutations. It is suggested that there is a thorough collection of family, genetic, and medical history for children entering the adoption process. Nurses may play a variety of roles in genetic counseling that reflect their preparation, area of practice, primary functions, and setting. The chapter explains the incidence of chromosome abnormalities.
An individual’s identity development, including his or her preferred gender identity, is a lifelong process, which starts with the earliest interactions with the world. The concepts of gender identity have been explored, studied, debated, and discussed for decades and are currently going through a resurgence of examination, especially in Western cultures. This chapter provides an overview of gender identity development, beginning with an explanation of terms, followed by an exploration of theoretical perspectives which includes cognitive developmental theory, social learning theory, gender schema theory and feminist theory. Topics include current research and perspectives on how gender identity evolves in children and recent shifts in understanding atypical gender identities, including transgender, gender neutral, and gender fluid identification. Finally, implications and strategies for mental health professionals are discussed, especially related to counseling those who are experiencing conflict or distress surrounding issues of gender and gender identity.
- Go to chapter: Next Steps Toward Practice Knowledge Development: An Emerging Epistemology in Nursing
This chapter focuses on introductory arguments about the Doctor of Nursing Practice (DNP) student and graduate’s clinical scholarship, a future practice-oriented nursing epistemology. It explores a model of scientific inquiry and stewardship for the nursing discipline through the development of a body of practice-oriented nursing knowledge to improve health. There is a very strong case to be made that the “good science” evolving from the DNP programs where nursing epistemology and practice knowledge development is valued is indeed being conducted within the framework of a Mode 2 knowledge production paradigm. Finally, there is an operational concern for how practice knowledge is made formal within the academy before it is then further synthesized, reduced, and disseminated in journal format and oral presentation. Practice knowledge generation only needs rigor, proper mentoring, an inquiring mind, and some creativity.
This chapter explores how practicum training may be enhanced through effective collaboration between trainers and field supervisors. Successful practicum training requires strong collaboration between the trainee’s university or institution and the supervising field psychologist. Successful collaboration between the university and field site includes consideration of site development and maintenance, effective communication, and training and support across settings. Field placement and coordination play a critical role in the training of school psychologists. The individual fulfilling this role may be recognized with a variety of formal titles, such as field placement coordinator, clinical professor, or director of clinical training (DCT). One of the primary responsibilities of the DCT is the coordination and supervision of practica-related activities, including the placement of candidates in appropriate training sites. The chapter focuses on how supervisors can address trainee problems of professional competence, develop and use remediation plans successfully, and help trainees balance fieldwork with coursework.
This book integrates theory and practice, and addresses the key principles of sport, exercise, and performance psychology. It reflects the broadening of sport psychology studies to encompass more widespread human performance research. Chapters address such essential concepts as the key principles of sport, exercise, and performance psychology, individual differences, identity development, individual differences associated with personality, motivation, self-efficacy, stress and coping, injury, decision making, job opportunities, and burnout in the context of human performance. Motivation is likely one of the most critical variables in determining one’s behaviors and ultimate success because it impels them to act or sit still. Self-efficacy is said to influence whether people are optimistic or pessimistic, the goals they select, and their willingness to persist in the face of failure. Stressors fall into one of three possible categories-bioecological, psychointrapersonal, and/or social. Bringing these topics to life are companion “Applying the Concepts” chapters demonstrating how these principles are directly applied in real-life situations. The text focuses on the core theories underpinning sport psychology. Interviews with researchers, coaches, athletes, and other individuals from performance-intensive professions vividly reinforce the book’s content. Additionally, the book contains insights on theories and research findings that students can apply to their own experience.
This chapter addresses the key principles of sport, exercise, and performance psychology. It reflects the broadening of sport psychology studies to encompass more widespread human performance research. The topic of decision making has been covered in psychology, economics, and motor learning but addressed very sparsely in sport, exercise, and performance psychology. Rational decision making requires defining the problem, identifying criteria, weighing those criteria, generating alternative solutions, and ultimately computing the optimal decision. The chapter introduces the literature on decision making and provides examples of factors that influence the choices people make. The decision to act, move, or what move to make is decided in the response selection stage, and the final stage is when one’s brain and muscles are organized to make the actual move. The key to improve the decision-making over time is to increase personal awareness of own limitations and keep learning and collecting information from reliable sources.
Traumatic brain injury (TBI) causes two injury types: primary and secondary. In infants and young children, nonaccidental TBI is an important etiology of brain injury and is commonly a repetitive insult. TBI is by far the most common cause of acquired brain injury (ABI) in children and is the most common cause of death in cases of childhood injury. In 2009, the Pediatric Emergency Care Applied Research Network (PECARN) issued validated prediction rules to identify children at very low risk of clinically important TBI, which is defined as TBI requiring neurosurgical intervention or leading to death. The range of outcomes in pediatric TBI is very broad, from full recovery to severe physical and/or intellectual disabilities. Children and adolescents who have suffered a TBI are at increased risk of social dysfunction. Studies show that these patients can have poor self-esteem, loneliness, maladjustment, reduced emotional control, and aggressive or antisocial behavior.
Objectives have been used for decades in nursing education to set the stage for what is expected of students and to guide faculty in planning teaching and assessment. However, nursing education is evolving and the timeworn practices used to write objectives must evolve as well. This chapter focuses on how to write broad behavioral objectives to support learning in a constructivist, learner-centered online environment to guide teaching and learning that are in step with today’s innovations in education and that follow the call for radical transformation in nursing education. Objectives focused on the desired learning outcomes or intended behavior changes, termed performance. The psychomotor domain is the skills domain in the narrow sense of the word, in that this domain provides a means of identifying outcomes that involve fine, manual, and gross motor movements.
This chapter provides a guide to conducting a life history from conceptualization to dissemination. Life history is used to explain an individual’s understanding of social events, movements, and political causes, that is, how individual members of groups or institutions see certain events and how they experience and interpret those events. As it is unlikely that nurses will be conducting traditional fieldwork to gather life histories because of the extensive periods of time involved, the chapter describes the process for collecting focused life histories by researchers whose only purpose is to document the story of the participant and not to frame this life history within a broader ethnography. It considers life history as a sociocultural methodology and leave oral history on historical research and life review to the one on clinical literature.
This chapter presents an overview of the state of the art ethnographies conducted by nurses and highlights a few works by the early generation. An extensive search of the literature was conducted to identify ethnographies completed by nurses. Nursing knowledge was a common thread throughout the literature reviewed. The literature review revealed the progress nursing is making in recognizing this gap and attempting to close it. Nursing knowledge is essential in patient care. Using the ethnographic method of inquiry, nurses have been able to identify areas of need both in knowledge and practice and make recommendations for enhanced practice. Caring and patient advocacy were other common themes in the literature. Caring is the essence of nursing and consequently should be incorporated in nursing research. The common purpose of the ethnographic studies reviewed was to explain or understand a phenomenon to increase nursing knowledge.
Teaching Cultural Competence in Nursing and Health Care, 3rd Edition:Inquiry, Action, and Innovation
Preparing nurses and other health professionals to provide quality health care in the increasingly multicultural and global society of the 21st century requires a comprehensive approach that emphasizes cultural competence education throughout professional education and professional life. The ideas and suggestions presented in this book are offered to stimulate new ideas and invite health professionals to explore new paths on the journey to developing cultural competence in themselves and in others. The book is divided into five parts. Part I is composed of three chapters filled with resources to help educators begin teaching cultural competence. Essential background information about the multidimensional process of teaching cultural competence offers a valuable guide for educators at all levels who are planning, implementing, and evaluating cultural competence education. Educators and researchers are continually challenged to measure outcomes following educational interventions. Part II addresses this challenge by introducing several quantitative questionnaires and assessment tools and discussing implementation and data interpretation strategies in a detailed, user-friendly approach that can be easily adapted by novice and advanced researchers. The tools include Transcultural Self-Efficacy Tool (TSET) and Clinical Setting Assessment Tool-Diversity and Disparity (CSAT-DD). Parts III, IV, and V offer a wide selection of educational activities that can easily be applied by educators everywhere. Three chapters provide a general overview and a menu of activities for use in three areas: the academic setting, the health care institution, and professional associations. Five chapters creatively link strategies via detailed case exemplars that spotlight various populations and settings. The book’s final chapter presents important implications for educators everywhere.
In this chapter, the author began working in international medical humanitarian aid, with an organization called Medecins Sans Frontieres/Doctors without Borders (MSF). Pediatrics and Pediatric Intensive Care are where the author’s nursing career had started. With assignments in the Democratic Republic of the Congo (DRC), Haiti, and South Sudan, the author have provided care for people who have been displaced due to conflict, victims of war trauma, women with high-risk pregnancies, malnourished and critically ill children, and people with HIV and tuberculosis, and responded to outbreaks of preventable illnesses such as measles and cholera. MSF opened the Sibut project, with a focus on providing care for young children and women of child-bearing age. The security system includes daily contact with all of the village leaders in Sibut, including the Catholic priests, the imams at the Muslim mosque, the village elders, and the militia leaders.
The author worked in a public health research lab, after graduation from college. She liked the flexibility of nursing and the promise to always have a job. She was fascinated by the intricacy of the mind-body intersection and how horribly wrong things could get with seemingly small perturbations. She felt that nursing school discouraged any consideration of a career in psychiatric nursing, as a mentor shared a comment by one of her advisors years ago that “only the bad nurses go into psychiatry”. A common occurrence was the admission of patients with psychiatric needs in addition to medical comorbidities. She cared for patients who had anxiety as a consequence of hospitalization, depression due to chronic illness, persons suffering from acute delirium, as well as someone with dementia secondary to HIV. Later she accepted a job at a local community health center that serves a predominance of Latino immigrants.
Today’s culture change movement is the result of an effort to change the impersonal nature of the nursing home environment and the “institutionalization” of individuals who reside in this setting. This chapter describes signs of “institutionalization” and explains the risks associated with individuals becoming institutionalized. It identifies similarities between institutional life and homelessness and describes core elements of culture change. The chapter reviews positive outcomes associated with culture change and describes the four stages of culture change. The stages of culture change are: the institutional model, the transformational model, the neighborhood model, and the household model. The chapter also describes the actions nurses can take to support culture change. Heightened interest in creating a different style of nursing home life is driving a transformation in this setting. Nurses need to be actively engaged in this process to ensure that change occurs thoughtfully and is based on sound evidence.
The Minimum Data Set (MDS) provides a uniform approach to conducting a comprehensive assessment that is recorded on a standardized tool. This chapter identifies the times when an MDS assessment must be completed. A registered nurse (RN) must conduct or coordinate the assessment with the input of other health team members and the resident. Upon completion, the MDS is electronically transmitted to the quality improvement evaluation system assessment submission and processing system designated by Centers for Medicare and Medicaid Services (CMS). The MDS offers a standardized approach for collecting assessment data. The chapter describes the data that are collected in the MDS assessment tool and explains the Care Areas and their purpose. It also describes the time period for which MDS assessments must be maintained by the nursing home.
Grief is the process that occurs before people come to acceptance. It can be a painful experience involving many different feelings. Losses includes health issues, loss of a career, loss of relationships, an unborn child, and/orability or desire to have children. Experiencing loss and grieving may include physical, emotional, social, and spiritual responses. Grieving is essential for coming to terms with and processing the trauma and resultant losses. Trauma and its accompanying sense of loss may result in a terrible sense of disappointment and failure. Working with mental health professionals and other survivors can be extremely helpful in working through the grieving process. The grieving process involves acknowledgment and acceptance of loss. Psychotherapy is a process of “re-parenting” the inner child who may have had less than ideal caretaking. The neural connections in the brain can heal and change with new experiences.
- Go to chapter: ACT-AS-IF and ARCHITECTS Approaches to EMDR Treatment of Dissociative Identity Disorder (DID)
This chapter describes key steps, with scripts, for the phases of therapy with a dissociative identity disorder (DID) client, and for an eye movement desensitization and reprocessing (EMDR) session with a DID client. In brief, the method employs the artful use of EMDR and ego state therapy for association and acceleration, and of hypnosis, imagery, and ego state therapy for distancing and deceleration within the context of a trusting therapeutic relationship. It is also endeavoring to stay close to the treatment guidelines as promulgated by the International Society for the Study of Trauma and Dissociation. The acronym ACT-AS-IF describes the phases of therapy; the acronym ARCHITECTS describes the steps in an EMDR intervention. Dual attention awareness is key in part because it keeps the ventral vagal nervous system engaged sufficiently to empower the client to sustain the painful processing of dorsal vagal states and sympathetic arousal states.
The important elements of the Eye Movement Desensitization and Reprocessing (EMDR) and Phantom Pain Research Protocol are client history taking and relationship building, targeting the trauma of the experience, and targeting the pain. This protocol is set up to follow the eight phases of the 11-Step Standard Procedure. This chapter presents a case series with phantom limb patients obtained a few before and after EMDR magnetoencephalograms (MEGs) at the University of Tübingen, Germany on arm amputees that show the presence of phantom limb pain (PLP) in the brain images before EMDR and the absence of it after EMDR. In these case series, it is found that PLP in leg amputations is much easier to treat than arm amputations, likely due to the much more extensive and complex arm and hand representation in the sensory-motor cortex compared to the leg and foot representation.
The CARES tool, in addition to assisting nurses with delivery of evidence-based care of the dying and viewing the care of the dying as an acute event, also needed to be portable and readily accessible. An extensive review of the literature found the most basic common needs of the dying included pain management and comfort measures, breathing assistance, control of delirium, emotional and spiritual support, and self-care for caregivers. This chapter discusses some issues: Nurses receive little to no education on care of the dying and feel they have minimal time to attend in-services, and can be resistant to learning new skills; communication is the foundation for end-of-life care; the nurses’ past personal and professional experiences with death can greatly impact the care they provide dying patients and their families. These issues and concerns helped organize and shape the final version of the CARES tool.
Embracing the role of a nurse practitioner with a doctorate in nursing practice (DNP) requires taking on the additional challenge of acting as an effective change agent. A DNP’s primary role is to act as a bridge between research and the bedside nurse. A strong clinical background assists in translating research findings into realistic evidence-based practices that nurses can readily incorporate into their daily routines. Nurses needed to learn what resources were available to meet the specific needs of the dying and how to promote a peaceful death. The CARES tool attempts to give some sense of order and structure to the care of the dying. The CARES tool is based on the immense educational resources provided by experts from the End-of-Life National Education Consortium (ELNEC), the National Consensus Project for Quality Palliative Care, and from evidence-based literature reviews.
This chapter presents an overview of the restorative justice movement in the twenty-first century. Restorative justice, on the other hand, offers a very different way of understanding and responding to crime. Instead of viewing the state as the primary victim of criminal acts and placing victims, offenders, and the community in passive roles, restorative justice recognizes crime as being directed against individual people. The values of restorative justice are also deeply rooted in the ancient principles of Judeo-Christian culture. A small and scattered group of community activists, justice system personnel, and a few scholars began to advocate, often independently of each other, for the implementation of restorative justice principles and a practice called victim-offender reconciliation (VORP) during the mid to late 1970s. Some proponents are hopeful that a restorative justice framework can be used to foster systemic change. Facilitation of restorative justice dialogues rests on the use of humanistic mediation.
This chapter describes some of the recent restorative justice innovations and research that substantiates their usefulness. It explores developments in the conceptualization of restorative justice based on emergence of new practices and reasons for the effectiveness of restorative justice as a movement and restorative dialogue as application. Chaos theory offers a better way to view the coincidental timeliness of the emergence of restorative justice as a deeper way of dealing with human conflict. The chapter reviews restorative justice practices that have opened up areas for future growth. Those practices include the use of restorative practices for student misconduct in institutions of higher education, the establishment of surrogate dialogue programs in prison settings between unrelated crime victims and offenders. They also include the creation of restorative justice initiatives for domestic violence and the development of methods for engagement between crime victims and members of defense teams who represent the accused offender.
Nursing practice is a symbiotic relationship between the art and science of professional care. One cannot exist in isolation from the other. Nurses are inclined to connect the art of nursing with terms such as compassion, caring attitudes, the therapeutic relationship, presence, professionalism, advocacy, and competence, otherwise known as the “soft or caring side of nursing”. The greatest threat to the disappearance of the art of nursing lies with the perceived “big three”: time, fiscal restraint, and failure of the system to support a full staff of nurses, so those employed are working at full capacity. It is important to recognize that different practice settings have varying needs. One size does not fit all. Yet the requirements for nursing assessments, developing a plan of care, coordinating care with other health care providers, implementing interventions, and evaluating care outcomes are a requirement of all.
This chapter discusses both successes and failures in affiliation and collaboration techniques among nonprofits, including details on what the parties involved found to be the most valuable or most problematic aspects of the affiliations. It explores an overview of what has been and is versus what could be in the business models for both the nonprofit and the for-profit sectors, with the aim of shaking things up in the nonprofit world’s business-as-usual model. Clearly, a new business model is needed for the new paradigm, one that enables nonprofit organizations to adapt to the industry’s greater demands and the emerging market for corporate control without sacrificing core values. Capitalizing on the opportunities presented by the new human service paradigm will require nonprofit providers to adopt a new business model that is both capable of pursuing traditional consolidation strategies and supported by innovative organizational and financial designs.
- Go to chapter: Administrative Consolidations, Administrative Services Organizations, and Joint Programming
This chapter focuses on a series of case studies and best practices for partnerships that discuss in detail the provision of back-office support for nonprofit partners. Public Health Management Corporation (PHMC) is a nonprofit public health institute that creates and sustains healthier communities using best practices to improve community health through direct service, partnership, innovation, policy, research, technical assistance, and a prepared work force. Traditional back-office services are usually designed to address many of the challenges of today’s changing nonprofit environment. Services depend on the level of organizational need and affordability, but are usually identified through a comprehensive organizational assessment of the nonprofit client. The Urban Affairs Coalition (UAC) is a Philadelphia-based nonprofit that was founded in 1969 following a historic meeting between the city’s business and community leaders. Most nonprofits never rise to the scale of having a full internal administrative staff and purchased equipment.
For nonprofit agencies, there are generally two ways of growing: organically, which takes longer and is more detailed, or through strategic partnerships with other nonprofits. This chapter focuses on a wide range of strategic partnerships. Few nonprofits in the sector, other than hospitals and insurers, enter into strategic partnerships, and far fewer merge or affiliate with other nonprofits. The Public Health Management Corporation (PHMC), however, is one of the rare nonprofit health and human service organizations that has been engaged in mergers and affiliations in the past 20 years. Environmental factors such as increased organizational competition or decreased foundation or donor funding encourage nonprofits to contemplate mergers. Nonprofit mergers provide a variety of benefits including the opportunity for expanded social impact. Merged nonprofits can roll together annual audits, combine insurance programs, and consolidate staffs and boards. Mergers and affiliations are one way that organizations are attempting to temper competition.
This chapter provides examples of programs and services beyond the foundational elements and global resources that can be used to overcome traditional nursing research barriers. It is assumed that at least one doctorate-prepared nurse researcher is available to facilitate research opportunities and educate nurses about research and evidence-based practice. Many clinical nurses fully understand their clinical roles but are completely unaware of opportunities and resources in nursing research within their hospital. Since contributions of nursing research are vital to the science and art of nursing and provide foundation for evidence-based practices, it is important to overcome the traditional cluster of barriers that include problems with nursing research visibility/priority, time and money, and research education. Nurses need confirmation that nurse leaders support research; when it is visible, it is valued. Moreover, nurses need time, education, and resources to complete rigorous research that leads to discoveries and answers to important clinical problems.
This chapter addresses the need for dissemination of research and focuses on dissemination both inside the hospital organization and outside. Disseminating results of research is often the most exciting phase of the process, as it is the culmination and highlight of countless hours of work. Common areas for dissemination internally include presentations to colleagues on people’s unit, as well as across hospital organization. Internal presentations offer a direct way for people to provide new evidence for practice in their hospital organization. In addition, however, it is important that results of their research reach nurses and other health professionals nationally and internationally. Thus, people want to participate in media dissemination of their research, systematically look for calls for abstracts to present at professional conferences, and disseminate their research through professional publications. Disseminating results, whether internally or externally, by media, poster, oral presentation, or publication, requires effort and attention to detail.
- Go to chapter: When the Unthinkable Happens: A Mindfulness Approach to Perinatal and Pediatric Death
This chapter explores traumatic grief and loss and discusses various treatments for it. It focuses on mindfulness-based interventions for specific use in traumatic grief with bereaved parents. Traumatic grief appears relatively responsive to the psychosocial approach, particularly when it includes exposure elements, such as retelling the story of the loss, reutilization, and building tolerance to the emotions associated with loss. More recently, Thieleman, Cacciatore, and Hill have presented evidence for a mindfulness-based, psychosocial approach for specific use in traumatic grief with bereaved parents. Western culture’s interest in mindfulness has grown exponentially, and practices have been integrated into a variety of general, psychotherapeutic treatment approaches including acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), mindful- ness-based cognitive therapy (MBCT), and mindfulness-based stress reduction (MBSR). Of all mindfulness practices, one of the most cost-effective strategies to help providers working with bereaved parents is meditation.
Creativity must represent something different, new, or innovative. It has to be different and also be appropriate to the task at hand. The first chapter of the book deals with the Four-Criterion Construct of Creativity, which attempts to integrate both Western and Eastern conceptions of creativity. This is followed by a chapter which addresses how creativity operates on individual and social/environmental levels, and the effects and outcomes of the creative mind. Chapter 3 discusses the structure of creativity. A key work on creative domains is that of Carson, Peterson, and Higgins, who devised the creativity achievement questionnaire (CAQ) to assess 10 domains. The fourth chapter discusses measures of creativity and divergent thinking tests, Torrance Tests, Evaluation of Potential Creativity (EPOC) and Finke Creative Invention Task. Some popular personality measures use different theories, such as Eysenck’s Personality Questionnaire, which looks at extraversion, neuroticism and psychoticism. Chapter 6 focuses on a key issue, intrinsic versus extrinsic motivation and their relationship to creativity. While the seventh chapter deals with the relationship between creativity and intelligence, the eighth chapter describes three ’classic’ studies of creativity and mental illness which focus on the connection between bipolar disorder and creativity, usage of structured interviews and utilization of historiometric technique. One school admissions area that already uses creativity is gifted admissions—which students are chosen to enter gifted classes, programs, or after-school activities. The book also talks about creative perceptions and dwells upon the question whether creativity is good or bad.
As everyone knows, true creativity comes from simple formulas and the memorization of data. This chapter focuses on divergent thinking tests, which are still the most common way that creativity is measured. Guilford derived the core ideas behind divergent thinking as well as many popular measures. The people who score the Torrance Tests are specifically trained to distinguish responses that are truly original from those that are just bizarre. There are other tests that measure creativity, but most are either a variation on divergent thinking or use some type of raters. For example, the Evaluation of Potential Creativity (EPOC) has begun to be used in some studies and may be promising, but is still largely rooted in a mix of divergent thinking scoring and raters. Another test is the Finke Creative Invention Task, which is clever but also requires raters for scoring.
The Big Five, which this chapter discusses in more detail, are extraversion, neuroticism, agreeableness, conscientiousness, and openness to experience. Each of these five factors represents a continuum of behavior, traits, and inclinations. There are some popular personality measures that use different theories, such as Eysenck’s Personality Questionnaire, which looks at extraversion and neuroticism as well as psychoticism. The personality factor most associated with creativity is openness to experience. Indeed, one way that researchers study creativity is by giving creative personality tests. Being open to new experiences may also help creative people be more productive. King found that people who were creative and high on openness to experience were more likely to report creative accomplishments. DeYoung and S. B. Kaufman, of course, are not the only people to blend or split different factors of personality to present new models. Fürst, Ghisletta, and Lubart suggest three factors: plasticity, divergence, and convergence.
This chapter explores three ’classic’ studies of creativity and mental illness. The first is Jamison whose focus is on the connection between bipolar disorder and creativity. The second is Andreasen, who used structured interviews to analyze 30 creative writers, 30 matched controls, and first-degree relatives of each group. The writers had a higher rate of mental illness, with a particular tendency toward bipolar and other affective disorders. The third major work is Ludwig, who utilized the historiometric technique. All three studies have come under serious criticism. Many of the studies of Big-C creators are historiometric, akin to Ludwig’s work. Some such studies claim that eminent creators show higher rates of mental illness. A much more common approach is to look at everyday people and give them measures of creativity and mental health. Typically, researchers look at what are called subclinical disorders—in other words, they’re not clinically significant.
One school admissions area that already uses creativity is gifted admissions—which students are chosen to enter gifted classes, programs, or after-school activities. Both education and business play great lip service to creativity. Puccio and Cabra review the literature on creativity and organizations and do a nice job of highlighting how every couple of years, a new report from industry emphasizes the importance of creativity. It is important to note that there is a large inconsistency between gender differences on creativity tests and actual creative accomplishment. Although gender differences on creativity tests are minor or nonexistent, differences in real-world creative accomplishment are large and significant. This chapter shows how creativity can play a role in admissions and hiring. Hiring measures tend to have better validity, even the general mental ability (GMA) measures; even if minorities score lower, the accuracy of prediction is consistent by ethnicity.
Creative people are also often seen as being outsiders and eccentric. Sen and Sharma’s examination of creativity beliefs in India tested beliefs about the Four P’s and found that creativity was more likely to be described as a holistic essence of an individual, and less likely to be focused on the product or process. Romo and Alfonso studied Spanish painters and found that one of the implicit theories that the painters held about creativity involved the role of psychological disorders. Plucker and Dana found that past histories of alcohol, marijuana, and tobacco usage were not correlated with creative achievements; familial drug and alcohol use also was not significantly associated with creative accomplishments or creative personality attributes. Humphrey, McKay, Primi, and Kaufman did find that illegal drug use predicted self-reported creative behaviors even when openness to experience was controlled.
This chapter explains the seminal Institute of Medicine (IOM) report: The Future of Nursing (
FoN): Leading Change, Advancing Health and the background organizations that wrote it. It demonstrates some key recommendations of FoN: Leading Change, Advancing Health report and its “fit” with Indian Country. The chapter differentiates between challenges in obtaining nursing education in Indian Country and those in dominant culture settings. The IOM’s effort with the Robert Wood Johnson Foundation (RWJF) on the FoN has been noticed by many, yet direct care nurses are largely unaware of the report. The chapter outlines the FoN recommendations into two groups: gaining education, practicing to its fullest scope, and pushing for more, including lifelong learning; and shaping policy, being at the table as full partners in health care redesign, and leading change. For American Indian/Alaska Native (AI/AN) nurses graduating from tribal colleges and universities (TCU), the majority will have an associate’s degree.
The medical model in psychiatry assumes medical intervention is the treatment of choice for the constellations of diagnosed symptoms that comprise various mental disorders. These treatments may include pharmacotherapy, electroconvulsive treatment, brain stimulation, and psychosurgery. Therefore, psychopharmacology for older adults can be considered palliative rather than a cure for a brain disease causing psychopathology. Older adults experience many psychopathological problems, including anorexia tardive, anxiety disorders, delusional disorders, mood disorders, personality disorders, schizophrenia, and co-occurring disorders with substance abuse/dependence disorders. Therefore, it is critical for the social worker to understand the various manifestations of psychological problems in older adults from the perspective of an older adult, rather than extrapolating information commonly taught in social work programs that neglect to focus on older adults and restrict teaching to psycho-pathological problems in younger and middle-aged adults.
For older adults, the phenomenon of death is accepted and does not induce the fear experienced by younger adults. Older adults who do not engage in end-of-life planning may receive unwanted, unnecessary, costly, and painful medical interventions or withdrawal of desired treatment. Many older people feel that the goal of palliative care is to make the best possible dying experience for the older adult and his/her family. In addition to palliative care, an older adult will most likely find himself or herself in an intensive care unit as part of his or her terminal care. Euthanasia, or hastened death, is seen by some as an alternative to palliative care. A psychological aspect of death that an older adult is concerned with, in addition to place of death, is whether he or she will die in his or her sleep or die suddenly, making the death experience an individual phenomenon.
Dorothea Lynde Dix was born into an upper-class, highly educated, intelligent, and politically connected Bostonian family. These opportunities provided the foundation necessary to propel her into a leadership role as national and international advocate for the most vulnerable groups in the mid-1800s. Dorothea utilized her Methodist father’s background to augment the teachings of her adopted religious calling, Unitarianism, which promises salvation through leading a directed life. This chapter explores her leadership role in this period of American history. It also shows how her family background, pursuit of education, personality, and religious commitment to humanitarianism enabled her to confront seemingly insurmountable obstacles to implement national and international reform of care for psychiatrically disabled and imprisoned populations. In the final phase of her career, Dorothea was chosen for a national role to lead nursing during the American Civil War, a role that she considered as within her scope of knowledge and skills.
Multiple physical changes can impair the mental health of the aging individual. These changes include: acid-based imbalances, dehydration, electrolyte changes, hypothermia or hyperthermia, and hypothyroidism. This chapter reviews the most common mental health disorders affecting the elderly population and trends affecting care delivery. Moreover, chronic, unresolved pain has been associated with an increased risk of a mental health disorder such as depression, suicide, or anxiety. The aging individual may exhibit signs and symptoms of insomnia such as sleeping for short periods during the night, sleeping during times of normal social activities, arising early in the morning while others sleep, and experiencing daytime sleepiness. The chapter concludes by applying the nursing process from an interpersonal perspective to the care of an elderly patient with a mental health disorder.
Musculoskeletal disorders are some of the most common causes of illness and hospitalization in children due to their active nature. This chapter reviews common pediatric musculoskeletal disorders, etiology of pediatric musculoskeletal disorders, and pediatric-specific care of musculoskeletal disorders. The musculoskeletal system supports the body structure and provides for client movement. Skeletal growth is most rapid during infancy and adolescence. Injury to the epiphysis can affect bone growth. The most common pediatric musculoskeletal disorders involve pediatric trauma. Torticollis is a symptom that causes a child’s chin to be rotated to one side and the head to the other side. The two most common disorders that can cause torticollis include: Congenital muscular torticollis, and Acquired torticollis. Osteomyelitis is an infection of the bone that occurs most often in infancy or between the ages of 5 and 14 years.