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ItemFamily Health Needs Study: Bi-National Community Participatory Research(2006-04-07T18:56:57Z) Riner, METhird lecture in a series: International Research Ethics. March 29, 2006. Lecture I. ItemThe Described Experience of Primary Caregivers of Children with Mental Health Needs(2012-10) Oruche, Ukamaka M.; Gerkensmeyer, Janis; Stephen, Linda; Wheeler, Corrine A; Hanna, Kathleen M.About 10% of our nation's children have serious mental health needs that result in significant functional impairments. Although research has found that primary caregivers of children with mental health needs have high levels of depressive symptoms and distress, little is known about the challenges these caregivers face. Focus groups with 20 caregivers of children with mental health needs between 2 and 17 years of age revealed these themes: struggling with care systems, living in fear, being burdened and exhausted, worrying about the rest of the family, and having good things happen. Caregivers described extreme challenges and many unmet needs that are important to consider in efforts to improve both children's and caregivers' well-being. ItemRecruitment Strategies for Caregivers of Children with Mental Health Problems(2012-07) Oruche, Ukamaka M.; Gerkensmeyer, Janis E.; Austin, Joan K.; Perkins, Susan M.; Scott, Eric; Lindsey, Laura M.; Mullins, KristenPURPOSE: The aim of this study was to describe strategies for recruiting participants into an intervention study that focused on improving problem-solving skills in caregivers of children with mental health problems. BACKGROUND: Caregivers of children with mental health problems report feeling physically and psychologically overwhelmed and have high rates of depression because of the demands of caregiving. Research on the needs of these caregivers and interventions to ameliorate their stress is needed. However, recruiting this population can be particularly difficult because of the stigma of mental illness. Available literature on recruitment of caregivers of persons with physical illness cannot be transferred to caregivers of children with mental health problems because of the different caregiving situations. There is a need to identify effective recruitment strategies to reduce cost and answer research questions. Clinical nurse specialists have the skills to facilitate the recruitment of research participants. We revised and expanded health system referrals, community outreach, and recruiting advertisement (ads). When these strategies did not increase recruitment, radio ads were used. The Andersen's Behavioral Model of Health Services Utilization was selected as a guiding framework. OUTCOME: Radio ads were the most effective strategy for recruiting caregivers of children with mental health problems for this study. CONCLUSION: Recruitment was ultimately successful because we were flexible and made decisions consistent with the Andersen's Behavioral Model of Health Services Utilization. IMPLICATIONS: Clinical nurse specialists who study this population of caregivers should really consider the use of radio ads and systematically track which recruitment strategies lead to the greatest number of participants screened, eligible, and enrolled into studies. ItemResearch With Cognitively Impaired Participants(2009-10) Oruche, Ukamaka M.Illnesses that cause cognitive impairment are a considerable health problem in the United States. These include Alzheimer's disease, Huntington's chorea, cerebrovascular disease, psychiatric disorders, chronic alcoholism, and AIDS dementia complex. Illness associated with cognitive impairment may cause great suffering to the affected patients and their families. Research involving individuals who may be at risk for or have cognitive impairment is necessary to improve our understanding of these illnesses. For example, this may occur during efforts to develop effective therapies to treat them. However, research with participants who have cognitive impairment presents additional ethical concerns because they may be vulnerable to coercion. Therefore, nurse researchers must not only understand the principles of informed consent (i.e., autonomy, beneficence, nonmaleficence, and justice), but also the additional safeguards provided in the common rule to protect cognitively impaired participants in research. These safeguards include advanced informed consent, legal representative, and assent. Gaps exist in federal regulations related to adhering to these safeguards such as how to assess for decision-making capacity and variations on who can be a legal representative. The nurse researchers have potential roles as educators and advocates in research involving participants with cognitive impairment. ItemPredicting Outcomes Among Adolescents With Disruptive Disorders Being Treated in a System of Care Program(2013-08) Oruche, Ukamaka M.; Gerkensmeyer, Janis E.; Carpenter, Janet S.; Austin, Joan K.; Perkins, Susan M.; Wright, Eric RBACKGROUND: “Systems of care” are strengths-based approaches to treating adolescents and others with disruptive disorders. However, little is known about why some adolescents improve and others do not. OBJECTIVE: To examine changes in personal strengths and family functioning as predictors of behavioral and social functioning among adolescents with disruptive disorders who participated in a system of care program. DESIGN: Secondary analyses of data from 114 adolescents (12-17 years of age) with disruptive disorders and their caregivers who participated in the Dawn Project Evaluation Study. Caregivers completed in-depth interviews conducted by trained data collectors using standardized questionnaires. Baseline and 12- month data are reported here. RESULTS: Improvement in personal strengths was a significant predictor of improvement in adolescent behavioral and social functioning, controlling for demographics (p < .001). CONCLUSION: In adolescents with disruptive disorders, psychiatric nurses should focus on enhancing adolescents’ personal strengths to improve behavioral and social functioning. ItemBarriers and facilitators to treatment participation by adolescents in a community mental health clinic(2013-05-17) Oruche, Ukamaka M.; Downs, Sarah M.; Holloway, Evan D.; Burke Draucker, Claire; Aalsma, Matthew C.An estimated 40–60% of children in mental health treatment drop out before completing their treatment plans, resulting in increased risk for ongoing clinical symptoms and functional impairment, lower satisfaction with treatment, and other poor outcomes. Research has focused predominately on child, caregiver, and family factors that affect treatment participation in this population and relatively less on organizational factors. Findings are limited by focus on children between 3 and 14 years of age and included only caregivers’ and/or therapists’ perspectives. The purpose of this descriptive qualitative study was to identify organizational factors that influenced participation in treatment, with special attention to factors that contributed to dropout in adolescents. The sample included 12 adolescent–caregiver dyads drawn from two groups in a large public mental health provider database. Analysis of focus group interview data revealed several perceived facilitators and barriers to adolescent participation in treatment and provided several practical suggestions for improving treatment participation. Implications of the findings for psychiatric mental health nurses and other clinicians who provide services to families of adolescents with mental health concerns are discussed. ItemA nurse-physician led multidisciplinary team improves access, treatment, and management of diabetes and high blood pressure in adult residents of a rural community in Nigeria(Sigma Theta Tau International, 2012-08-01) Oruche, Ukamaka M.; Obiadazie, Okwudiri O; Obeime, MercyDeveloping countries have limited resources contributing to high morbidity and mortality rates from chronic diseases. The purpose of this presentation is to describe an innovative nurse-physician led international collaboration to increase access to health care and improve treatment and behavioral management of diabetes and hypertension in adult residents of a rural community in Nigeria, West Africa. ItemProblems and Goals Identified by Primary Caregivers of Children with Mental Health Problems During a Problem-solving Intervention(The 26th Annual Children's Mental Health Research & Policy Conference, 2013-03-03) Gerkensmeyer, Janis E.; Oruche, Ukamaka M.Building Our Solutions and Connections intervention focused on enhancing problem-solving skills of 44 primary caregivers of children with mental health problems. Problems and goals were identified by individual caregivers during a nine week problem-solving intervention that included a face-to-face one-hour intervention followed by eight half-hour telephone interventions. The problem identified most often was child behavior (43 times). A summary of the problems and goals selected by these primary caregivers has been described. ItemPredicting Treatment Response of Adolescents with Serious Emotional Disturbance(APNA 25th Annual Conference, 2011-10-20) Oruche, Ukamaka M.System of care (SOC) philosophy values child-guided and family-driven care and emphasizes that services must be delivered in a way that enhances dignity, respects wishes and goals, maximizes opportunities for active involvement for adolescents and their families. Our specific aim was to was to examine whether changes in adolescent personal strengths and family functioning over 12 months predicted changes in behavioral and social functioning for adolescents with disruptive disorders who participated in a SOC program. ItemProblem-solving Intervention for Caregivers of Children with Mental Health Problems(Midwest Nursing Research Society 37th Annual Research Conference, 2013-03-08) Oruche, Ukamaka M.