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Biomedical subjects

Ann M Mitchell

Publications and source records attributed to Ann M Mitchell.

14 recordsLinked to original sources
PubMed2006

Suicide in older adults: nursing assessment of suicide risk.

A fundamental objective of the National Strategy for Suicide Prevention is the prevention of suicide in older adults, especially elderly males, because these individuals are at higher risk for suicide than any other age group. Furthermore, they are the fastest growing segment of the population. The suicide rates for older Caucasian men are particularly high. Because nurses play an important role in the identification of persons at risk for suicide, it is important that they be cognizant of the complex risk factors involved in late life suicide. Toward that end, we review the prevalence of suicidal behaviors in older adults and discuss risk factors that contribute to completed suicide in these individuals. Lastly, we discuss the role of nurses in the identification of older adults at risk for suicidal behavior so that life-saving treatment measures can be implemented.

Activities of Daily Living↗
PubMed2006

Effective communication with bereaved child survivors of suicide.

TOPIC: While bereavement is considered by many to be among the most stressful life events, it becomes even more distressing when it is related to the suicide of a loved one. Further, the death of a parent is traumatic for anyone, but it may be especially intensified for young children. This points to a strong need for the recognition and treatment of psychiatric and social problems associated with childhood bereavement. PURPOSE AND SOURCES: The purpose of this paper is to review the literature and present a synopsis of the psychosocial outcomes of childhood suicide survivor bereavement and outline communication issues that emerge when talking with young suicide survivors. CONCLUSIONS: A case is made to develop and test interventions designed to meet the mental health needs of this important group of individuals.

Adaptation, Psychological↗
PubMed2005

Disaster care: psychological considerations.

Disasters are tragic events that disrupt the normal functioning ofa community and overwhelm personal and community resources. The people who experience or simply witness traumatic events can be affected emotionally and develop a range of physical and emotional responses, which in turn can produce psychological, social, and physiological dysfunction. The challenge for health care providers is to recognize the range of emotions and to be able to identify when professional help is indicated. This article provides an overview of the human stress response and describes sources of stress that follow disasters, acute stress disorder, post-traumatic stress disorder, and interventions and resources used to care for victims after disasters.

Crisis Intervention↗
PubMed2005

"It was haunting...": physicians' descriptions of emotionally powerful patient deaths.

PURPOSE: To understand the emotional experiences of physicians who care for dying patients and to identify educational opportunities for improving patient care and physician well-being. METHOD: Between 1999-2001, physicians at two quaternary care medical centers in Boston, Massachusetts, and Pittsburgh, Pennsylvania, participated in 90-minute, semistructured personal interviews on their most emotionally powerful patient death. Quantitative data was obtained through face-to-face surveys rated on ten-point scales that asked physicians about emotional characteristics of and emotional responses to the death. In the qualitative portion of the survey, physicians were asked to describe the details of the most emotionally powerful patient death, the types and sequence of their emotional reactions, their methods of coping, and subsequent changes in behavior. RESULTS: Physicians had powerful experiences with death during all stages of their careers. Experiences with patient death generally fit into one of three types: "good," "overtreated," or "shocking/unexpected." Housestaff often described coping in isolation with the disturbing emotions generated in the care of dying patients. Physicians learned how to care for and cope with dying patients from their experiences with patients whose deaths were most emotionally powerful and reported changes in their clinical behavior and career paths as a result. CONCLUSIONS: Physicians' emotional reactions to patient death can affect patient care and the personal lives of physicians. Supervising physicians have an opportunity to improve both the care of dying patients and house-staff coping with these deaths by using the "teachable moments" that are present for trainees as they care for the dying.

Adaptation, Psychological↗
PubMed2005

Complicated grief and suicidal ideation in adult survivors of suicide.

While the prevalence of complicated grief has been demonstrated to be elevated in survivors of suicide, the association between complicated grief and suicidal ideation among adult survivors of suicide has not been explored. The purpose of the present study is to examine the association between complicated grief and suicidal ideation in suicide survivors. The Inventory of Complicated Grief and the Beck Depression Inventory were administered to 60 adult survivors within 1 month of a death by suicide of a family member or significant other. Complicated grief was associated with a 9.68 (CI: 1.036, 90.417) times greater likelihood of suicidal ideation after controlling for depression, suggesting that syndromal complicated grief heightens vulnerability to suicidal ideation. Clinicians may provide more comprehensive assessments by recognizing the possibility of suicidal ideation in those with complicated grief.

Adult↗
PubMed2004

Complicated grief in survivors of suicide.

Complicated grief is a newly defined and distinctive psychiatric disorder that occurs in response to a significant loss through death. New findings suggest that survivors who were close to the deceased are at heightened risk for complicated grief. Little is known about whether close kinship (spouses, parents, children, siblings, vs. in-laws, aunts/uncles, nieces/nephews, friends, or coworkers) to a suicide victim also represents a heightened risk for complicated grief. Assessing for complicated grief is important, especially with survivors of suicide, because of the potential for associated health risks. This report contains preliminary data from an exploratory, descriptive pilot study examining complicated grief in adult survivors of suicide. Sixty bereaved subjects, within one month after the suicide of a family member or significant other, were assessed for complicated grief symptoms. Statistically significant differences, as measured with the Inventory of Complicated Grief, were noted between closely related and distantly related survivors of the suicide victim. These preliminary results indicate that health care professional's assessments and interventions for complicated grief should take into consideration the bereaved's familial and/or social relationship to the deceased. The closely related survivors of suicide had higher levels of complicated grief and could be at risk of developing physical and/or mental health problems, including suicidal ideation, in the future.

Adolescent↗
PubMed2003

Doctors' emotional reactions to recent death of a patient: cross sectional study of hospital doctors.

OBJECTIVES: To describe doctors' emotional reactions to the recent death of an "average" patient and to explore the effects of level of training on doctors' reactions. DESIGN: Cross sectional study using quantitative and qualitative data. SETTING: Two academic teaching hospitals in the United States. PARTICIPANTS: 188 doctors (attending physicians (equivalent to UK consultants), residents (equivalent to UK senior house officers), and interns (equivalent to UK junior house officers)) who cared for 68 patients who died in the hospital. MAIN OUTCOME MEASURES: Doctors' experiences in providing care, their emotional reactions to the patient's death, and their use of coping and social resources to manage their emotions. RESULTS: Most doctors (139/188, 74%) reported satisfying experiences in caring for a dying patient. Doctors reported moderate levels of emotional impact (mean 4.7 (SD 2.4) on a 0-10 scale) from the death. Women and those doctors who had cared for the patient for a longer time experienced stronger emotional reactions. Level of training was not related to emotional reactions, but interns reported needing significantly more emotional support than attending physicians. Although most junior doctors discussed the patient's death with an attending physician, less than a quarter of interns and residents found senior teaching staff (attending physicians) to be the most helpful source of support. CONCLUSIONS: Doctors who spend a longer time caring for their patients get to know them better but this also makes them more vulnerable to feelings of loss when these patients die. Medical teams may benefit from debriefing within the department to give junior doctors an opportunity to share emotional responses and reflect on the patient's death.

Adaptation, Psychological↗
PubMed2002

Overview of post-traumatic stress.

The purpose of this article is to provide an overview of the acute stress response with additional information on post-traumatic stress. There is an emphasis on the theoretical foundations and post-traumatic stress disorder symptoms. Risk factors, symptom clusters, and the diagnostic criteria for post-traumatic stress disorder are described as a foundation for clinical implications and a focused nursing assessment.

Humans↗
PubMedDate not supplied

Critical incident stress debriefing: implications for best practice.

Critical incidents disrupt people's lives by creating strong emotional reactions, which may range from normal stress reactions to post-traumatic stress disorders. Critical incident stress debriefing (CISD) has been used since 1983 as a component of Critical Incident Stress Management. The processes are intended to help individuals manage their normal stress reactions to abnormal events. Although used extensively, research findings to date yield mixed results. Meta-analyses of research studies are reviewed to identify the methods, results, strengths, and weaknesses of the studies that can be used for evidence-based practice.

Crisis Intervention↗
PubMedDate not supplied

Client narratives: a theoretical perspective.

The role of subjective client narratives in health care represents a clinical and therapeutic tool, useful in complementing objective, scientific data. Of particular interest to mental health practitioners is the role narratives play as a therapeutic tool to guide clinical practice. This paper lays a foundation for understanding the importance of narrative in the psychotherapeutic process. It provides a brief overview of narrative theory and methods of structural analysis in order to provide a theoretical approach that can be utilized by nurses to address clients' needs.

Assertiveness↗
PubMedDate not supplied

The use of narrative data to inform the psychotherapeutic group process with suicide survivors.

While bereavement is considered by many to be among one of the most stressful life events, it becomes even more distressing when it is related to the suicide of a loved one. A synopsis of psychosocial outcomes of suicide survivor bereavement is presented along with an overview of group interventions designed to help these survivors cope with their grief. The structure of an ongoing eight-week bereavement support group is described to lay a foundation for the application of narrative theory within the group process. Using narrative theory and structural analysis, the discourse of group members is presented and various themes are discussed in an effort to contribute to the task of developing effective psychotherapeutic group interventions for survivors of suicide.

Adaptation, Psychological↗
PubMedDate not supplied

Critique of transcultural practices in end-of-life clinical nursing practice.

TOPIC: Transcultural nursing practices for terminally ill patients. PURPOSE: To examine several criticisms of transcultural nursing theory in end-of-life care. SOURCES: Published literature and interviews with nurses. CONCLUSIONS: Nurses often encounter barriers that impede their ability to provide ideal end-of-life care.

Adult↗