Washburn University Institutional Repository
The Washburn University Institutional Repository (WU IR), managed by the University Libraries, is a digital repository offering a central location for the deposit, maintenance and long-term preservation of the research and other scholarly production of the Washburn University Community. WU IR also holds digitized items of value from the University Libraries Department of Special Collections and Archives that highlight the history, nature and culture of the University. One of our key missions is to ensure that these scholarly and creative endeavors are accessible to the widest possible audience. Candidates for deposit in WU IR include journal articles, conference papers, instructional resources, student projects, theses, dissertations, university archival materials, and more. For more information about submitting your work to WU IR, please contact us at wuir@washburn.edu.
Recent Submissions
Item Childhood Homelessness as an Adverse Childhood Experience (ACE): Adult Mental Health Outcomes(Washburn University, 2024-04-25)Adverse childhood experiences (ACEs) are experiences of abuse, neglect, and other household problems occurring before age 18 and contribute to the development of both physical and mental health concerns. People experiencing homelessness report disproportionately higher rates of ACEs and negative mental health concerns; however, little research has been conducted regarding the relationship between ACEs and mental health outcomes specifically for homeless populations. A dearth of research also exists regarding how childhood experiences of homelessness interact with ACEs and mental health outcomes. The present study examined the mental health outcomes for people experiencing homelessness, as well as how childhood experiences of homelessness may fit into the ACEs model using archival data. People experiencing homelessness (n = 100) completed the ACEs questionnaire, a demographics questionnaire, and a health appraisal questionnaire. Results found ACEs significantly predicted negative mental health outcomes for people experiencing homelessness. Childhood experiences of homelessness were predictive of negative mental health outcomes; however, this relationship became negligible when acting as a covariate with ACEs. This result suggests perhaps the ACEs framework adequately explains the traumatic events that may occur to a child experiencing homelessness and the subsequent negative mental health outcomes.Item Exploring Opportunities to Improve Health Services Post-COVID 19 Pandemic for Students Attending a Northeast Kansas University(Washburn University, 2024-05-10)Nearly 40% of college students report at least one mental and/or social health concern. Emerging research demonstrates the COVID-19 pandemic has increased the number of college students with mental and/or social health concerns. College health centers (CHC) and other campus-based resources (such as counseling services) may not be adequately equipped to screen and treat students following the COVID-19 pandemic. The purpose of this quality improvement project was two-part. The first objective was to assess the mental and social health impact of COVID-19 within college students seeking care at a CHC. The second objective was to collaborate with key campus-based stakeholders to increase awareness of current student mental/social climate, evaluate current services offered verses current student needs, and to increase student awareness of services available on-campus.Item Implementation of Depression Screening Tools for Patients with Substance Use Disorder in an Outpatient Psychiatric Clinic(Washburn University, 2024-03-01)Background: Substance use disorder (SUD) is a major public health crisis in the United States (US). SUD is one of the primary causes of morbidity and mortality, accounting for nearly 92,000 overdose deaths in the US in 2020. About 43% of people with SUD have mental illnesses, with depression the most common diagnosis. Identifying depression in persons with SUD is critical to treatment and optimal patient outcomes (McGovern et al., 2023). Purpose: This quality improvement project aims to implement and evaluate evidence-based depression screening tools (PHQ-2, PHQ-9) to identify adult patients with depression who present to the outpatient clinic for SUD treatment. Methods: The project was conducted at an outpatient psychiatric clinic in the Midwest that specializes in treating patients with SUD and mental illnesses. A before-and-after study design was used to determine the rate of depression screening and treatment prior to and following project implementation. A two-step screening process was used at check-in. Patients with a positive PHQ-2 screen were administered a PHQ-9 questionnaire. Patients with positive PHQ-9 were treated with medication, referred for counseling, referred to psychiatry, or wait and see. Results: Ten clinical staff members participated in the project: six FNPs, three MAs, and one physician. All ten clinical staff members completed the knowledge assessment survey and the educational training. Of the 45 charts audited pre-implementation, zero had a depression screening. 38 of 45 post-implementation charts audited had a PHQ-2, and 31 had a PHQ-9. Depression diagnoses and treatment increased from 20% to 60%, and from 16% to 47 % respectively.Item Improving the Utilization of Cultural Competency Tools by Healthcare Providers in a University Health Center(Washburn University, 2024-05-10)Background: Providers’ cultural awareness and competence influence the utilization of healthcare services, compliance with health promotion behaviors, and barriers that interfere with desired health outcomes. According to the American College Health Association, healthcare disparities and barriers to equitable quality care exist despite college/university students having access to student counseling and health centers (2022). Methods: Participants in this quality improvement pilot project were APRNs staffed at a university health center. The project used a pre- and post-assessment strategy as an outcome measure and a survey of participant experience as a process measure. A mixed media toolkit was provided to help healthcare providers develop and implement site-specific, sustainable strategies to enhance the level of cultural competency to address the needs of culturally diverse students seeking mental health services. Results: The quality improvement pilot project started with a sample size N=4 and ended with N=3. Pre-training IAPCC-HCP© composite scores for each participant (N=4) ranged from 74- 91, indicating each participant was Culturally Competent at baseline. The post-training IAPCCHCP© composite scores for each participant (N=3) ranged from 74-91, indicating each participant maintained the level of Culturally Competent upon completion of the training session. Two participants showed an increase in composite score upon completion of training when compared to baseline. Participants assessed the quality improvement intervention process as being effective and sustainable. Conclusion: Due to the small sample size and attrition rate of 25%, results from this quality improvement pilot project provide limited information about the improvement conducted in this setting, but highlighted provider willingness to improve knowledge and skills. Needed is further opportunity to replicate the process in other settings and on a larger scale.Item Competence to Stand Trial: Restoring Competence in an Inpatient Forensic Hospital Setting(Washburn University, 2024-04-09)The following is a de-identified case study that describes how competency restoration treatment, psychiatric treatment, and assessments were used to assist Competency to Stand Trial restoration with a patient who has intellectual and psychiatric disabilities, in a state funded and forensic-focused in-patient residential hospital facility. Jack was a 20-year-old White male whose main struggles were with anger and impulsivity. His primary diagnoses were Attention Deficit/Hyperactivity Disorder, and Intellectual Disability. He has a secondary diagnosis of Other Specified Personality Disorder, and a differential diagnosis of Autism Spectrum Disorder. He was recommended by the unit psychologist for individual competency restoration treatment in addition to the group sessions he was assigned to as part of his more comprehensive treatment. Jack was assessed with an initial interview covering psychosocial history and mental status. Formal assessment instruments used included the Emotional Problems Scales (EPS), the Conners’ Adult ADHD Rating Scales (CAARS), and the Competence Assessment for Standing Trial for Defendants with Mental Retardation (CAST*MR). Individual competency restoration treatment sessions were based on and/or accessed from materials included in the Florida State Hospital CompKit manual (Florida State Hospital, 2011), and supplemented with available Mindfulness materials to increase coping skills and decrease impulsive behaviors. Included in this document is a transcript of a mock competency to stand trial evaluation that was the final session for Jack and designed to demonstrate his overall improvement as a result of the individual competency to stand trial treatment.
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