1
|
Shattuck D, Sebastian R, Zamarin K, Acosta S, Ramos MM. School Nurse Management of Behavioral Health, Violence, and Trauma-Related Emergencies: Findings from a Statewide Survey. J Sch Nurs 2024; 40:536-546. [PMID: 35979606 DOI: 10.1177/10598405221120437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
School nurses are critical components of school-based interdisciplinary teams supporting student behavioral health. The purpose of the present study is to understand the extent to which school nurses in New Mexico across grade levels manage emergencies related to behavioral health, violence, and trauma. The study also seeks to identify which topics the school nurses received continuing education (CE) for, and which topics they consider to be important to their practice. Analyses of 2019 statewide survey data show a considerable number of school nurses in New Mexico provide management for behavioral health, violence, and trauma-related emergencies, and nurses in secondary schools are significantly more likely than nurses in primary schools to report managing these emergencies and to have received CE on behavioral health topics. Our findings reaffirm the essential role of school nurses in addressing emergent student health issues and underscore the need for practice- and competency-based behavioral health CE opportunities.
Collapse
Affiliation(s)
- Daniel Shattuck
- Pacific Institute for Research and Evaluation-Southwest, 851 University Boulevard, Albuquerque, NM, USA
| | - Rachel Sebastian
- Pacific Institute for Research and Evaluation-Southwest, 851 University Boulevard, Albuquerque, NM, USA
| | - Kim Zamarin
- Pacific Institute for Research and Evaluation-Southwest, 851 University Boulevard, Albuquerque, NM, USA
| | - Susan Acosta
- New Mexico Department of Health, Office of School and Adolescent Health, Albuquerque, NM, USA
| | - Mary M Ramos
- Department of Pediatrics, University of New Mexico, MSC11-6145, 1 University of New Mexico, Albuquerque, NM, USA
| |
Collapse
|
2
|
Price OA, Saunders B, Gibbons J, Sadlon R, Garibay L, Doe K, Nelson F, Wise T, Isaac E. School Nurses' Perceived Role and Capacity to Support School Behavioral Health Programs in DC Public and Public Charter Schools. J Sch Nurs 2024:10598405241266237. [PMID: 39051599 DOI: 10.1177/10598405241266237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
School nurses (SNs) practicing in DC public and public charter schools were surveyed to assess their perceived role and self-reported preparation to provide behavioral health prevention, early identification, and treatment services in schools. A total of 154 SNs completed a questionnaire about their role in the delivery of behavioral health services and supports. SNs reported they are primarily involved in the identification and referral of students to other school behavioral health professionals. Respondents also reported a lack of training in behavioral health and a desire for more information on related programs and services. This study offers recommendations for educating future SNs and highlights how the DC School Health Services Program utilized study findings to build capacity for SNs employed in practice. This study can help tailor educational opportunities for SNs to maximize their role in school behavioral healthcare process flows and ultimately improve outcomes for students and families.
Collapse
Affiliation(s)
- Olga Acosta Price
- Center for Health and Health Care in Schools, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA
| | - Breahnna Saunders
- Center for Health and Health Care in Schools, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA
| | - Julie Gibbons
- School of Nursing, the George Washington University, Washington, DC, USA
| | - Rachel Sadlon
- Center for Health and Health Care in Schools, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA
| | - Lori Garibay
- District of Columbia Department of Health, Washington, DC, USA
| | - Kafui Doe
- District of Columbia Department of Health, Washington, DC, USA
| | - Felicity Nelson
- District of Columbia Department of Health, Washington, DC, USA
| | - Tiffany Wise
- District of Columbia Department of Health, Washington, DC, USA
| | - Eartha Isaac
- District of Columbia Department of Health, Washington, DC, USA
| |
Collapse
|
3
|
Hoskote AR, Croce E, Johnson KE. The Evolution of the Role of U.S. School Nurses in Adolescent Mental Health at the Individual, Community, and Systems Level: An Integrative Review. J Sch Nurs 2023; 39:51-71. [PMID: 35019803 DOI: 10.1177/10598405211068120] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
School nurses are crucial to addressing adolescent mental health, yet evidence concerning their evolving role has not been synthesized to understand interventions across levels of practice (i.e., individual, community, systems). We conducted an integrative review of school nurse roles in mental health in the U.S. related to depressive symptoms, anxiety, and stress. Only 18 articles were identified, published from 1970 to 2019, and primarily described school nurses practicing interventions at the individual level, yet it was unclear whether they were always evidence-based. Although mental health concerns have increased over the years, the dearth of rigorous studies made it difficult to determine the impact of school nurse interventions on student mental health outcomes and school nurses continue to feel unprepared and under supported in this area. More research is needed to establish best practices and systems to support school nursing practice in addressing mental health at all levels of practice.
Collapse
Affiliation(s)
- Ashwini R Hoskote
- Robert Wood Johnson Foundation Future of Nursing Scholar, 12330University of Texas at Austin School of Nursing
| | - Emily Croce
- 12330The University of Texas at Austin School of Nursing; Dell Children's Medical Group, Austin, TX
| | | |
Collapse
|
4
|
Baur A, Carpenter DM, Driscoll K, Fromewick JC, Belden CM, Thomas KC. Implementing facilitative leadership to develop a school nurse research agenda in western North Carolina. THE JOURNAL OF SCHOOL HEALTH 2023; 93:158-161. [PMID: 36271593 DOI: 10.1111/josh.13250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/02/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Affiliation(s)
- April Baur
- Mountain Area Health Education Center, 121 Hendersonville Road, Asheville, NC, 28803
| | - Delesha M Carpenter
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, 1 University Heights, CPO 2125, Asheville, NC, 28804
| | - Katie Driscoll
- Mountain Area Health Education Center, 121 Hendersonville Road, Asheville, NC, 28803
| | - Jill C Fromewick
- Mountain Area Health Education Center, 121 Hendersonville Road, Asheville, NC, 28803
| | - Charles M Belden
- Department of Research, Mountain Area Health Education Center, 121 Hendersonville Road, Asheville, NC, 28803
| | - Kathleen C Thomas
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Kerr Hall 2212 CB #7573, Chapel Hill, NC, 27599
| |
Collapse
|
5
|
Munk K, Rosenblum R, Blackburn S, Donahue E. The Impact of Education and Implementation Tools on Pre-Service Teachers' Attitudes About Classroom-Based Mindfulness. J Sch Nurs 2021; 38:547-557. [PMID: 34792417 DOI: 10.1177/10598405211059189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A growing body of research suggests that incorporating classroom-based mindfulness interventions in elementary schools can lead to improvements in student behavior, self-regulation, and measures of mental health and wellness. This quality improvement project explored the impact of an educational intervention on pre-service teachers' perceptions, attitudes, and intentions to implement mindfulness interventions in their classrooms. A brief educational intervention and website resource were provided to multidisciplinary teaching credential students. Participants completed a pre- and post-intervention survey to evaluate their intentions to implement mindfulness practices, as well as their perceptions about the acceptability, reasonableness, and effectiveness of incorporating mindfulness interventions in the classroom. Significant differences in pre- to post-intervention survey scores indicate that exposure to mindfulness concepts, practices, and resources may increase the willingness of pre-service teachers to adopt these practices in their classrooms.
Collapse
Affiliation(s)
- Kirsten Munk
- Department of Nursing, 300424California State University, Northern California Consortium, Fresno and San Jose, CA, USA.,School of Nursing, 300424California State University, Sacramento, CA, USA
| | - Ruth Rosenblum
- Department of Nursing, 300424California State University, Northern California Consortium, Fresno and San Jose, CA, USA.,The Valley Foundation School of Nursing, San Jose State University, 7161San Jose, CA, USA
| | - Samantha Blackburn
- School of Nursing, 300424California State University, Sacramento, CA, USA
| | - Eden Donahue
- School of Nursing, 300424California State University, Sacramento, CA, USA
| |
Collapse
|
6
|
Kaskoun J, McCabe E. Perceptions of School Nurses in Addressing Student Mental Health Concerns: An Integrative Review. J Sch Nurs 2021; 38:35-47. [PMID: 34636656 DOI: 10.1177/10598405211046223] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Mental health disorders in school-aged children are on the rise. The need for mental health care is well recognized, and the provision of this care in schools is recommended. An integrative review explored how school nurses view their role in addressing students' mental health. Fourteen articles were identified, eleven using a qualitative design and three using a quantitative design. Findings suggest that school nurses see their role as trusted members of the school community. They perceive upholding standards of practice as an integral part of their position and recognize competence in mental health care to be highly important. Practice recommendations include providing school nurses with evidence-based training on managing the mental health needs of students, as well as ensuring access to school nurses who can provide mental health supervision in the community.
Collapse
Affiliation(s)
- Jeannine Kaskoun
- Department of Nursing, 14772The Graduate Center, City University of New York, New York, New York
| | - Ellen McCabe
- Hunter College School of Nursing, 5924Hunter College, New York, New York The authors wish to recognize the support and guidance from Dr. Shiela Strauss, the CUNY Graduate Center faculty, especially Dr. Steven Baumann, Dr. Kathleen Nokes, and Dr. Lorie Goshin. Additionally, Hunter College librarian John Carey, and CUNY Graduate Center librarian Beth Posner
| |
Collapse
|
7
|
Conroy K, Salem H, Georgiadis C, Hong N, Herrera A, Furr JM, Greif Green J, Comer JS. Gauging Perceptions and Attitudes About Student Anxiety and Supports Among School-Based Providers. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09470-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
8
|
Buduhan VH, Woodgate RL. Public health nurses in Canadian schools: An opportunity to build capacity and nursing scholarship. Public Health Nurs 2021; 38:637-644. [PMID: 33715203 DOI: 10.1111/phn.12891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/16/2021] [Accepted: 02/22/2021] [Indexed: 11/28/2022]
Abstract
Public health nurses (PHNs) in Canada have the potential to significantly benefit the health and academic outcomes of school age children with its impact lasting into adulthood. Unfortunately, cuts in government funding over the years have diminished the presence of PHNs in schools and their ability to practice to their full scope. In the midst of a pandemic, having a strong nursing presence in schools may facilitate public health efforts and reduce the burden on teachers and administration. This discussion paper will explore the current role of nurses in Canadian schools in relation to school nurses in other parts of the world. An overview of the literature looking at the impact of the school nurse on school health (i.e., student health and academic outcomes) will be presented to provide evidence in support of rebuilding nursing capacity in Canadian schools. Finally, the Framework for 21st Century School Nursing Practice will be introduced as a viable nursing theory to facilitate rebuilding PHN capacity in schools.
Collapse
Affiliation(s)
- Vanessa H Buduhan
- College of Nursing, Rady Faculty for Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Roberta L Woodgate
- College of Nursing, Rady Faculty for Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Canadian Research Chair (Tier 1) in Child and Family Engagement in Health Research and Healthcare, Canada
| |
Collapse
|
9
|
Supporting Student's Mental Health: A Cross-Sectional Survey for School Nurses. CHILDREN-BASEL 2021; 8:children8020129. [PMID: 33578860 PMCID: PMC7916560 DOI: 10.3390/children8020129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 11/17/2022]
Abstract
Children's and adolescents' health problems are often related to mental health, and their wellbeing should be supported in schools. This study describes school nurses' role and how equipped they are in recognizing students' mental health needs and in supporting students' mental health. Moreover, we explored the methods used and the barriers that exist for supporting students' mental health. A national survey for members of the Finnish Public Health Association working as school nurses was conducted (n = 136/648, 21%). The survey questionnaire was analyzed using descriptive statistics and qualitative data using manifest content analysis. Participants (n = 127/133, 96%) agreed that they had an important role in ensuring that students' mental health needs are met on time. Around one-third reported training needs for mental health interventions (n = 42/115, 36%), and a similar proportion (n = 42/136, 31%) indicated lacking adequate knowledge and skills for supporting mental health among culturally diverse students. Identified barriers for students getting help were a lack of options for sending students to mental health services (n = 92/134, 69%) and a lack of adequate training (n = 81/134, 68%). School nurses are key in providing early mental health support to students. Therefore, the availability of intervention education and training on assessing and supporting students' mental health is needed and should be improved.
Collapse
|
10
|
Putkuri T, Salminen L, Axelin A, Lahti M. Good interaction skills are not enough - competency in mental health issues in child health clinics and school health services. Scand J Caring Sci 2021; 35:988-997. [PMID: 33403712 DOI: 10.1111/scs.12956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/13/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Mental health problems among children and adolescents are a worldwide issue of concern. Health professionals who have sufficient competency in mental health issues are crucial for responding to this situation. AIM The aim of the study was to describe the competency in mental health issues required by the work of public health nurses in child health clinics and school health services. METHODS This qualitative, descriptive study was conducted with focus group interviews in March 2018. The sample consisted of public health nurses (n = 24) who were working in child health clinics or school health services in Finland. The data were analysed using inductive and deductive content analysis. RESULTS The competency in mental health issues required by the work of public health nurses was formulated from the identified strengths and topics required in continuing education. In total, 18 competencies were identified as covering mental health promotion, as well as the alleviation and treatment of symptoms and disorders. Intuitive and interpersonal competency was identified as the main strength of public health nurses. The theoretical and evidence-based competency regarding mental health issues was identified as a main topic needed in continuing education. CONCLUSION Public health nurses in child health clinics and school health services need competency in mental health issues for the promotion of mental health, the alleviation of symptoms and treatment of disorders. The results indicate that good interactional skills are not enough: the current competency of public health nurses in mental health issues is insufficient and does not meet the requirements of the work. The results were consistent with existing knowledge, but also provide a more comprehensive and precise insight into the current situation. In the future, the results should be verified with more studies. There is also a need for intervention studies aiming to improve competency in mental health issues.
Collapse
Affiliation(s)
- Tiina Putkuri
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Leena Salminen
- Department of Nursing Science, University of Turku and Turku University Hospital, Turku, Finland
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Mari Lahti
- Department of Nursing Science, University of Turku and Turku University of Applied Science, Turku, Finland
| |
Collapse
|
11
|
Anttila M, Ylitalo M, Kurki MH, Hipp K, Välimäki M. School Nurses' Perceptions, Learning Needs and Developmental Suggestions for Mental Health Promotion: Focus Group Interviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249503. [PMID: 33353022 PMCID: PMC7767091 DOI: 10.3390/ijerph17249503] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 01/03/2023]
Abstract
School nurses have a key role in promoting the mental health of adolescents at school. However, there is still a lack of comprehensive understanding of the role and experiences of school nurses as they promote mental health at schools. A qualitative research design employing focus group interviews was used. School nurses (n = 21) were purposively sampled from one city in Southern Finland. The data were analyzed using inductive content analysis, resulting in seven categories describing school nurses’ perceptions, needs and suggestions for development of mental health promotion in school health care. School nurses perceived health care at school as a low-threshold service. Mental health problems are often first identified by a school nurse. However, school nurses felt that extra effort is needed to recognise mental health problems, build trusting relationships, and motivate adolescents to attend regular health check-ups. Specific core learning competencies such as communication skills, being present, keeping confidentiality, and the ability to motivate adolescents to regularly visit the school health clinic are needed. However, school nurses often lack basic resources for mental health promotion. The areas of mental health development included cooperation with stakeholders and parents, and development of anonymous, easy-access services. It is important that school nurses have the skills needed and enough resources to fulfil their demanding tasks in school health care services.
Collapse
Affiliation(s)
- Minna Anttila
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; (M.A.); (M.Y.); (M.H.K.); (K.H.)
| | - Milla Ylitalo
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; (M.A.); (M.Y.); (M.H.K.); (K.H.)
- Laurea University of Applied Sciences, 01300 Vantaa, Finland
| | - Marjo H. Kurki
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; (M.A.); (M.Y.); (M.H.K.); (K.H.)
- Itla Children’s Foundation, 00180 Helsinki, Finland
| | - Kirsi Hipp
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; (M.A.); (M.Y.); (M.H.K.); (K.H.)
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; (M.A.); (M.Y.); (M.H.K.); (K.H.)
- Xiangya School of Nursing, Central South University, Changsha 410013, China
- Correspondence:
| |
Collapse
|
12
|
Providers’ Experiences with Delivering School-Based Targeted Prevention for Adolescents with Anxiety Symptoms: A Qualitative Study. SCHOOL MENTAL HEALTH 2020. [DOI: 10.1007/s12310-020-09382-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractThe school setting is important for delivering targeted prevention to adolescents with anxiety. However, schools may not have available providers with training or experience in delivering evidence-based interventions, e.g., school psychologists. Training providers available in the schools, e.g., school nurses, is important. Further, to investigate their experiences in delivering targeted prevention to adolescents with anxiety could help understand factors promoting implementation success. A qualitative study including focus groups with providers of school-based targeted prevention cognitive-behavioral therapy for anxiety in adolescents was conducted. Focus group interviews were audiotaped and transcribed verbatim. Systematic Text Condensation, a method for thematic cross-case analysis was used. The Active Implementation Framework (AIF) was used to contextualize the results. Seventeen providers participated in the study. They reported several facilitators contributing to successful implementation: Their feeling of competence in delivering the interventions were built through skills-based training, supervision, and collegial support. Conducting initial assessment of each adolescent helped the providers individualize the interventions. Seeing positive outcomes in adolescents gave the providers motivation to continue implementation. Further, collaborating with teachers facilitated both recruitment of adolescents and administering group sessions. Minimal leadership-oriented factors were reported. Overall, the findings correspond to some of the drivers in AIF. This study offers providers’ perspectives on implementation of targeted prevention for anxiety in the school setting. Our results show that providers experience mastery in delivery when receiving support, training, and supervision. This seems to be essential facilitators for implementing much needed targeted prevention for youth with anxiety.
Collapse
|
13
|
Morse BL, Anderson L, Combe LG, Delack S, Ondeck L, Homme C. U.S. School Nursing Job Analysis. J Sch Nurs 2020; 38:126-137. [PMID: 32508198 DOI: 10.1177/1059840520930075] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The complexity and demands of the school nurse role have changed greatly over time. Our aims included determining tasks and knowledge relevant to modern school nursing in the United States, identifying continuing education needs of school nurses, and describing anticipated changes to the professional role. A secondary analysis of a cross-sectional web-based survey of 750 school nurses was performed. The study team evaluated calculations of mean importance and frequency for school nursing task and knowledge statements. Conventional content analysis was used to analyze open-ended responses. School nurses rated most tasks and knowledge as relevant to practice, underscoring the great depth and breadth of education and training school nurses need to meet the demands of students today. The results of this secondary analysis may be leveraged to accurately describe the school nurse role, advocate for nursing services, and support school nurses as they strive to better the health of school communities.
Collapse
Affiliation(s)
- Brenna L Morse
- Solomont School of Nursing, University of Massachusetts Lowell, MA, USA
| | - Lori Anderson
- School of Nursing, University of Wisconsin-Madison, WI, USA
| | | | | | - Lynnette Ondeck
- Nooksack Valley School District, Everson, Washington, DC, USA
| | - Carissa Homme
- Competency and Credentialing Institute, Denver, CO, USA
| |
Collapse
|
14
|
Caron EB, Drake KL, Stewart CE, Muggeo MA, Ginsburg GS. Intervention Adherence and Self-Efficacy as Predictors of Child Outcomes in School Nurse-Delivered Interventions for Anxiety. J Sch Nurs 2020; 38:249-258. [PMID: 32410495 DOI: 10.1177/1059840520925522] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined the association between two implementation factors, nurse-reported intervention adherence and self-efficacy, and children's outcomes in school nurse-delivered anxiety interventions. Data were collected in a pilot randomized controlled effectiveness trial with 54 children and 21 school nurses. Nurses implemented either a cognitive behavioral or relaxation-skills-only intervention. Nurse questionnaires assessed implementation factors. Independent evaluators assessed changes in children's anxiety symptoms at postintervention and at 3-month follow-up using clinical improvement and global functioning scales. Regression analyses indicated that greater intervention adherence was associated with greater anxiety symptom improvement at follow-up. Nurse self-efficacy interacted with intervention group, such that nurses with higher self-efficacy who implemented the cognitive behavioral intervention tended to have children show improvement and higher postintervention functioning. The impact of implementation factors on children's outcomes may differ depending on intervention type. Self-efficacy may be important for nurses using relatively complex interventions. Intervention adherence should be supported through training and consultation.
Collapse
Affiliation(s)
- E B Caron
- Department of Psychological Science, Fitchburg State University, MA, USA
| | - Kelly L Drake
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.,Anxiety Treatment Center of Maryland, Columbia, MD, USA
| | - Catherine E Stewart
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Golda S Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine, West Hartford, CT, USA
| |
Collapse
|