Putting the Ducks in a Row: Development of a Duck-assisted Green Care Intervention for Persons with Traumatic Brain Injury

Green Care therapies are defined as the engagement of a patient with the nature, exposing patients to a nature based therapeutic setting that may facilitate their recovery. Such therapies became popular at the end of the twentieth century. This therapeutic approach may include therapeutic horticulture, nature therapies, care farming, facilitated exercise, and animal-assisted therapies with farm animals (AATF). This paper describes the processes of planning and creating an AATF-based clinical intervention wherein persons with TBI interacted with ducks (in twice weekly, 1-hour groups) for 12 wk at a TBI rehabilitation facility. The discussion includes site identification, stakeholder engagement, intervention design and human and animal safety procedures. The research methods, theoretical framework, ethical consideration, and risk reduction strategies for human participants and ducks are discussed. Also, description of challenges and blueprints of possible solutions for other researchers interested in developing similar initiatives. This program will serve as a study site for examining effects of AATF-based interventions on self-efficacy, depression, and anxiety in persons with TBI. If the study suggests that AATF interventions with ducks may lead to positive changes, the proposed study will be followed with studies that include larger samples at multiple sites. Findings in this paper may contribute to the implementation science body of knowledge. Because of that, the information in this paper may benefit the researchers outside of the healthcare arena. From that perspective methods described in this paper may help to develop studies that focus on policy development, program expansion, or individual project implementation.

Use of Digital Health Resources by Sexual and Gender Minority Caregivers of Older Adults: Findings From the 2020 Caregiving in the U.S. Survey

We applied Andersen's Behavioral Model of Health Services Use to investigate the health needs and use of digital health resources among sexual and/or gender minority (SGM) caregivers. Data were from the Caregiving in the U.S. 2020 survey. Regression analyses were used to describe associations between predisposing, enabling, and need factors and usage of digital health resources. SGM caregivers provided more hours of care per week, reported higher levels of care intensity, and reported higher physical, emotional, and financial strain compared with non-SGM caregivers. Regression analyses indicated SGM status was a significant predictor of overall use of digital health resources. Younger caregivers, racial minority caregivers, those providing higher levels of care, and those reporting a poorer health status were more likely to use digital health resources. Digital health resources may be useful tools for SGM caregivers of older adults. More research is needed to investigate the reasons SGM caregivers use these resources.

Animal-Assisted Green Care Farming for Patients With Mental and Physical Disorders: A Narrative Review

Green care is an umbrella term that includes numerous therapeutic interventions that immerse the patient into nature and natural environments. Animal-assisted therapy (AAT) with farm animals is a component of green care that may benefit patients with mental health disorders. While the majority of research exploring farm AATs originated in Europe, interest in this therapeutic intervention is emerging in the United States. While there are green care farms utilizing animal therapies in the United States, these therapeutic interventions have not been reported in the scientific literature. Further exploration of this topic in the United States may benefit various patient populations and contribute to overall better health care. A literature review found that farm AATs may be beneficial for patients with mental health disorders, but did not identify any studies addressing AAT with farm animals in the context of physical health disorders. This may be a desirable direction for future research.

Using pedometers to document physical activity in patients with schizophrenia spectrum disorders: a feasibility study

Identification of procedures to document physical activity is critical to developing interventions to improve physical health. The purpose of this pilot study was to describe the feasibility and acceptability of pedometers to document physical activity in patients with schizophrenia spectrum disorders (SSDs). Twenty-four outpatients were provided with extended-wear pedometers and instructed to wear them daily for 1 week without altering their usual activities. All participants completed the 1-week data collection period. Twenty-one (87.5%) participants wore their pedometer at least 6 of the 7 days. Difficulties with the pedometers were few and minor. These preliminary findings indicate that a majority of individuals with SSDs are willing to wear pedometers for activity monitoring and can do so with few problems. Possible barriers to the use of extended-wear pedometers in this group include cognitive and memory deficits. Future investigations should test concurrent validity by examining the correlations between pedometer data and self-reported activity level.

Community nursing support for clients with schizophrenia

A true experimental, posttest only, control group design was used to pilot test the effectiveness of a telephone nursing intervention in increasing community survival, and decreasing the number and length of rehospitalizations for persons with schizophrenia. The vulnerability model was used as a framework for the study. The intervention was hypothesized to function as a moderating factor to reduce the effects of stress on vulnerable persons with schizophrenia. Experimental subjects received telephone nursing intervention weekly for 3 months; control subjects received informational calls at weeks 6 and 12. Readmission rates were 13% (n = 2) for experimental subjects and 23% (n = 5) for controls. Compared with controls, experimental subjects experienced a 4% increase in community survival and a 27% reduction in length of stay if readmission occurred. These preliminary data suggest that telephone intervention can increase community survival in persons with schizophrenia. Future studies should focus on increasing sample size and refining the intervention.

Preventing depression in high-risk college women: a report of an 18-month follow-up

The authors tested the long-term effectiveness of a cognitive-behavioral group intervention in reducing depressive symptoms, decreasing negative thinking, and enhancing self-esteem in 92 college women aged 18 to 24 years who ere at risk for clinical depression. The women were randomly assigned to either an experimental or a no-treatment control group. The experimental group participated in a 6-week cognitive-behavioral intervention that targeted identification and reduction of negative thinking, using such techniques as thought stopping and affirmations. Data on depressive symptoms, self-esteem, and negative thinking were collected before the intervention and at intervals of 1, 6, and 18 months postintervention. The women in the intervention group experienced a greater decrease in depressive symptoms and negative thinking and a greater increase in self-esteem than those in the control group. The beneficial effects continued over an 18-month follow-up period. These findings support the importance of thought stopping and affirmations as prevention interventions with at-risk college women.

Reframe Your Outlook on RECIDIVISM

1. Deinstitutionalization has placed many chronically mentally ill people in communities that are not prepared to care for them. A lack of fit between clients and the programs provided often results in repeated visits to psychiatric emergency services. 2. Repeated visits to a community program can be viewed positively: community services carry less stigma than hospital admissions, they are less expensive, and they are directly linked with the community. 3. By encouraging a return to a community program before decompensation necessitates a hospital admission, it becomes possible to focus on how a client can cope with, rather than simply react to, the illness.