Spotlight: Publications

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Family Caregivers with Depression and Anxiety May Be More Vulnerable to Sustained Lower Sleep Efficiency

Caregiving responsibilities put family members at high risk of psychological distress and low sleep efficiency, according to a study by Assistant Professor Soojung Ahn and colleagues in the Journal of Behavioral Medicine. Using Markov chain models, which predict the probability of a sequence of events based on the most recent event, they examined transitions of sleep efficiency divided into three states: S1: less than 75% of time in bed spent sleeping, S2: 75–84% of time in bed spent sleeping, and S3: 85% or more of time in bed spent sleeping. With S3 being considered normal, the team looked at how depression and anxiety affected 33 caregivers’ sleep efficiency over one week. The team found that on average, it took 3.6 to 5.1 days for caregivers to return to a night of normal sleep efficiency after lower states of sleep efficiency. Caregivers tend to stay in the same sleep efficiency from night to night—and caregivers with depression or anxiety were less likely to return to and achieve normal sleep efficiency, taking a longer time to recover and return to normal sleep, than caregivers without depression or anxiety. Based on their initial research, Ahn and her colleagues recommend that “[t]o prevent a long-term suboptimal sleep quality level, assessing sleep trajectories and psychological health may help identify vulnerable caregiver groups in need of interventions.”

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How Diversion Programs Can Stop a Mental Health Crisis from Becoming an Emergency

Diversion programs help keep people experiencing behavioral crises out of jail and emergency departments (EDs) when those outcomes are not necessary, especially as law enforcement officers are often the first to respond. But how well do we understand the factors that influence whether or not a person in crisis is diverted? In a study published in Archives of Psychiatric Nursing, Victor Petreca, assistant professor and the director of CSON’s state-funded Center for Police Training in Crisis Intervention, and colleagues sought to identify predictors of ED diversions. Using logistic regression and machine learning techniques, the team analyzed health crisis incident records in Massachusetts. They found that co-response clinicians (mental health professionals trained in de-escalation who work alongside police during a crisis response) achieved the highest diversion rates. “Mental health nurses have unique and valuable skills that may help bridge the current gap in adequate assessment of mental and physical health concerns,” Petreca and his co-researchers write. They emphasize that police-led diversion programs that intersect with mental health nursing practice offer a promising avenue for intervention by alleviating the burden on emergency rooms, providing community care, and more. This study is the first to analyze data from the Center for Police Training in Crisis Intervention.

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Role-Playing Simulation Helps Pediatric Nurse Practitioners Build Genomic Competency

From genetic testing to better understanding the genetic causes of diseases, high-quality pediatric care requires genomic competency. Because nurse practitioners (NPs) play a critical role in comprehensive pediatric care, genomics should be thoughtfully integrated into their education, according to Associate Professor of the Practice Laura White, Assistant Professor Brittney van de Water, and Associate Professor Andrew Dwyer. In a study for the Journal of Pediatric Nursing, they describe a novel simulation they developed focusing on genomic nursing competencies for pediatric NP students that emphasized learning through experience and reflection. The simulation involved two scenarios with children who presented with often-overlooked conditions. Students role-played as parents and NPs in a pediatric setting—greeting the “parent,” ordering labs, and discussing findings and plans of care. During the debrief, students said they felt more confident in understanding their scope of practice as NPs. The researchers note that “this novel pediatric genomic simulation provides a new avenue to scaffold learning and building genomic competency in pediatric NP students.”

Spotlight: Presentations

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Pilot Study Looks at How to Manage Patients with Palliative Care Needs and Substance Use Disorder

Palliative care clinicians face unique challenges when providing care for patients with cancer-related pain and concurrent substance use disorder (SUD), including a gap in knowledge, abilities, and skills regarding patient management. Assistant Professor of the Practice Sarah Given and her co-researchers at Dana-Farber Cancer Institute developed a team approach called the Complex Pain Board (CPB) to address this gap. They created a forum in which clinicians could discuss patients with concurrent SUD and/or psychosocial complexity and receive feedback from an interdisciplinary team to help them come up with an actionable plan of care. CPB participants included palliative care clinicians and specialists in social work, oncology, interventional pain, psychology, patient and family relations, and addiction medicine. For the pilot study, presented at the 2024 Annual Assembly of Hospice and Palliative Care, Given and her co-researchers looked at feasibility (whether there were sufficient cases) and acceptability (if attendees were likely to continue coming to meetings) of the CPB. They found both, with 28 cases presented through the CPB and 95% of attendees saying they were likely or highly likely to continue going to CPB meetings.

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Personalized Approach Helps Assisted Living Staff Improve Quality of Life for Older Adults with Cognitive Impairment

Associate Professor of the Practice Beth McNutt-Clarke served as the faculty mentor for a quality improvement project team, comprising Molly Abate, D.N.P. ’26, Courtney Mulvaney ’19, D.N.P. ’25, and Nadia Polad, M.Ed. ’06, D.N.P. ’25, that presented at the 37th Annual Scientific Sessions of the Eastern Nursing Research Society Conference in April. The project focused on developing tools to help the staff of an assisted living facility offer residents with cognitive impairment care that prioritizes their quality of life and improves their feelings of well-being. In addition to conducting Quality of Life-Alzheimer’s Disease (QoL-AD) and Geriatric Depression Scale (GDS) interviews with the residents, the students developed and provided staff with updated report sheets for shift handoff, a QoL-focused binder, and a communications sheet, all personalized for each resident. The team found that the specialized QoL-oriented tools helped staff better understand residents’ needs and comfort in assessing QoL—highlighting the importance of policy changes that would reduce barriers to implementing such tools. They also found that shorter, simpler, and more objective QoL tools are helpful for assessing older adults with cognitive impairment. 

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Public Health and Peace Work as a Primary Prevention to War

During the Peace Caucus panel at the 2024 American Public Health Association (APHA) Annual Meeting, Shelley K. White, associate professor of the practice and director of experiential learning, spoke about the need for public health professionals to advance conditions for peace that are based in assuring social and structural determinants of health. The Peace Caucus works with APHA to promote peace and prevent war as baseline conditions for the public's health, highlighting the intersections of militarism, war, social justice and conflict. White, a founder of the caucus’s Public Health Working Group on Primary Prevention of War, shared a competency framework the group created for understanding militarism within society and expanding peace advocacy and research skills. White says that while peace work and anti-war activism are connected, they are not the same—and that it’s incumbent on public health professionals to focus on promoting peace work.

Faculty Publications and Presentations, Spring 2023

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