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Lagging coverage for mental health services among children and adolescents through home and community-based Medicaid waivers 通过家庭和社区医疗补助豁免,儿童和青少年的心理健康服务覆盖面滞后
IF 1.5 Q2 Nursing Pub Date : 2022-09-08 DOI: 10.1111/jcap.12392
Jessica Keim-Malpass PhD, RN, Leeza Constantoulakis PhD, RN, Emily K. Shaw MSN, CPNP-BC, Lisa C. Letzkus PhD, RN, CPNP-AC

Problem

Many states cover mental health home and community-based services (HCBS) for youth through 1915(c) Medicaid HCBS waivers that allow states to waive certain Medicaid eligibility criteria and define high-risk populations based on age, medical condition(s), and disability status. We sought to evaluate how States are covering children and adolescents with mental health needs through 1915(c) waivers compared to other youth waiver populations.

Methods

Data elements were extracted from Medicaid 1915(c) approved waivers applications for all included waivers targeting any pediatric age range through October 31, 2018. Normalization criteria were developed and an aggregate overall coverage score and level of funding per person per waiver were calculated for each waiver.

Findings

One hundred and forty-two waivers across 45 states were included in this analysis. Even though there was uniformity in the Medicaid applications, there was great heterogeneity in how waiver eligibility, transition plans, services covered, and wait lists were defined across group classifications. Those with mental health needs (termed serious emotional disturbance) represented 5% of waivers with the least annual funding per person per waiver.

Conclusions

We recommend greater links between public policy, infrastructure, health care providers, and a family-centered approach to extend coverage and scope of services for children and adolescents with mental health needs.

到1915年,许多州为青少年提供心理健康家庭和社区服务(HCBS) (c)医疗补助HCBS豁免,允许各州放弃某些医疗补助资格标准,并根据年龄、医疗状况和残疾状况定义高风险人群。我们试图评估与其他青少年豁免人群相比,各国在1915年(c)豁免期间是如何覆盖有心理健康需求的儿童和青少年的。方法从Medicaid 1915(c)批准的豁免申请中提取数据元素,包括截至2018年10月31日的所有儿童年龄段的豁免申请。制定了标准化标准,并计算了每次豁免的总覆盖范围得分和每个人每次豁免的供资水平。这项分析包括了45个州的142个豁免。尽管在医疗补助申请中存在一致性,但在豁免资格、过渡计划、服务覆盖范围和等待名单的定义上存在很大的差异。有精神健康需要(称为严重情绪障碍)的人占豁免人数的5%,每人每年获得的资助最少。我们建议加强公共政策、基础设施、卫生保健提供者和以家庭为中心的方法之间的联系,以扩大有心理健康需求的儿童和青少年的服务覆盖范围和范围。
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引用次数: 1
Understanding the Turkish adolescents' weight perception: A cross-sectional study 了解土耳其青少年的体重感知:一项横断面研究
IF 1.5 Q2 Nursing Pub Date : 2022-08-19 DOI: 10.1111/jcap.12389
Figen I. Esenay PhD, RN, Tufan A. Sezer PhD, RN

Problem

Adolescence is regarded as a period in which adolescents go through a number of physical changes in appearance and a transition from childhood to adulthood. Throughout this transitional period, adolescents become more concerned with their size and weight. The aim of this study was to determine the self-perceived weights status of adolescents 11–19 years old.

Methods

A cross-sectional study was conducted with a sample of 1459 students, aged 11–19 years, in Turkey. Anthropometric measurements of weight and height were measured with appropriate tools and adolescents' self-perception of weight status was assessed by the Figure Rating Scale.

Findings

Nearly half of the adolescents had misperceptions about their weight status (49.6%). There was a significant association between body mass index (BMI) z-score categories and weight status misperception. Overall, the weight status misperception was more common among the girls than boys.

Conclusion

Misperception of weight status in adolescent should take into account the following: development of intervention programs aimed at screening weight and weight perception, empowering young people to have accurate weight status perception, and raising awareness of the issue in school health professionals.

问题青春期被认为是青少年在外表上经历一些身体变化和从童年到成年的过渡时期。在这个过渡时期,青少年更加关注自己的体型和体重。本研究的目的是了解11-19岁青少年的自我感知体重状况。方法对土耳其11-19岁的1459名学生进行横断面研究。用适当的工具测量体重和身高,用身材评定量表评估青少年对体重状况的自我感知。调查结果近一半(49.6%)的青少年对自己的体重状况存在误解。身体质量指数(BMI) z分数类别与体重状态误解之间存在显著关联。总体而言,女孩对体重状况的误解比男孩更普遍。结论青少年体重状态误解应考虑以下因素:制定干预方案,筛选体重和体重认知,增强青少年准确的体重状态认知,提高学校卫生专业人员对这一问题的认识。
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引用次数: 0
Does attention-deficit/hyperactivity disorder increase the risk of minor blunt head trauma in children? 注意力缺陷/多动障碍是否会增加儿童轻微钝性头部创伤的风险?
IF 1.5 Q2 Nursing Pub Date : 2022-08-13 DOI: 10.1111/jcap.12390
Murat Pakyurek MD, Mohamed Badawy MD, Irma T. Ugalde MD, Paul Ishimine MD, Pradip P. Chaudhari MD, Kevan McCarten-Gibbs MD, Ozra Nobari MD, Nathan Kuppermann MD, MPH, James F. Holmes MD, MPH

Problem

It is unclear if attention-deficit hyperactivity disorder (ADHD) increases the risk of head trauma in children.

Methods

We conducted a multicenter prospective observational study of children with minor blunt head trauma. Guardians were queried, and medical records were reviewed as to whether the patient had previously been diagnosed with ADHD. Enrolled patients were categorized based on their mechanism of injury, with a comparison of those with motor vehicle collision (MVC) versus non-MVC mechanisms.

Findings

A total of 3410 (84%) enrolled children had ADHD status available, and 274 (8.0%; 95% confidence interval, CI: 7.1, 9.0%) had been diagnosed with ADHD. The mean age was 9.2 ± 3.5 years and 64% were males. Rates of ADHD for specific mechanisms of injury were: assaults: 23/131 (17.6%; 95% CI 11.5, 25.2%), automobile versus pedestrian 23/173 (13.3%; 95% CI: 8.6, 19.3%), bicycle crashes 26/148 (17.6%; 95% CI: 11.8, 24.7%), falls 107/1651 (6.5%; 95% 5.3, 7.8%), object struck head 31/421 (7.4%; 5.1, 10.3%), motorized vehicle crashes (e.g., motorcycle, motor scooter) 11/148 (7.4%; 3.8, 12.9%), and MVCs 46/704 (6.5%; 95% CI: 4.8, 8.6%).

Conclusion

Children with ADHD appear to be at increased risk of head trauma from certain mechanisms of injury including assaults, auto versus pedestrian, and bicycle crashes but are not at an increased risk for falls.

问题:目前尚不清楚注意力缺陷多动障碍(ADHD)是否会增加儿童头部创伤的风险。方法:我们对轻度钝性头部创伤儿童进行了一项多中心前瞻性观察研究。询问了监护人,并审查了患者之前是否被诊断为多动症的医疗记录。纳入的患者根据其损伤机制进行分类,并将机动车碰撞(MVC)机制与非MVC机制的患者进行比较。研究结果:共有3410名(84%)注册儿童患有多动症,274名(8.0%;95%置信区间,CI:7.1%,9.0%)被诊断为多动症。平均年龄9.2岁 ± 3.5岁,64%为男性。特定损伤机制的多动症发生率为:袭击:23/131(17.6%;95%置信区间11.525.2%),汽车与行人之比23/173(13.3%;95%可信区间8.619.3%),自行车碰撞26/148(17.6%,95%置信区间11.824.7%),跌倒107/1651(6.5%;95%5.37.8%),物体撞击头部31/421(7.4%;5.110.3%),机动车辆碰撞(如摩托车、摩托车)11/148(7.4%,3.812.9%),和MVCs 46/704(6.5%;95%可信区间:4.8,8.6%)。结论:患有多动症的儿童似乎因某些损伤机制而增加了头部创伤的风险,包括袭击、汽车与行人碰撞和自行车碰撞,但跌倒的风险没有增加。
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引用次数: 0
Which factors affect internalized stigmatization in adolescents with mental disorders? 哪些因素影响青少年精神障碍患者的内化污名?
IF 1.5 Q2 Nursing Pub Date : 2022-08-13 DOI: 10.1111/jcap.12391
Gül Dikeç RN, PhD, Öznur Bilaç MD, Cansın Kardelen MD, Şermin Yalın Sapmaz MD, Hasan Kandemir MD

Purpose

The aim of this descriptive study was to determine the factors affecting internalized stigmatization of adolescents with mental disorders.

Method

The study data were collected in a university hospital between August 1, 2020 and July 30, 2021 (n = 123), using a Personal information form and the Internalized Stigmatization of Mental Illness-Adolescent Form (ISMI-AF).

Results

Gender and the number of hospitalizations were determined to be independent variables with explanatory power in the ISMI-AF, and in the model created with these variables, it was determined that these variables explained 18% of the change in the total points of the ISMI-AF.

Conclusions

It could be recommended that psychosocial programs are developed with the aim of decreasing internalized stigmatization and increasing the psychological resilience of adolescents.

目的本研究旨在探讨影响青少年精神障碍内化污名化的因素。方法研究数据于2020年8月1日至2021年7月30日在某大学医院收集(n = 123),使用个人信息表和精神疾病内化污名化-青少年表格(ISMI-AF)。结果性别和住院次数被确定为ISMI-AF中具有解释力的独立变量,并且在用这些变量创建的模型中,确定这些变量解释了ISMI-AF总分变化的18%。结论建议开展心理社会项目,减少青少年的内化污名化,提高青少年的心理弹性。
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引用次数: 1
The use of social media among high school students and its relationship with the perception of loneliness: A pilot study 高中生社交媒体的使用及其与孤独感的关系:一项初步研究
IF 1.5 Q2 Nursing Pub Date : 2022-08-06 DOI: 10.1111/jcap.12388
Yeter Kitiş, Büşra Dağci MSC, Neslihan Köse MSC, Çiğdem Geniş MSC

Background

Physical, psychological, and social impairments are becoming more common in the world due to internet use and excessive use.

Purpose

This study was conducted to determine the relationship between social media addiction (SMA) and the perception of loneliness in the high school period when peer influence is important.

Methodology

This cross-sectional study was conducted with a total of 988 students studying at four high schools in Ankara, the capital city of Turkey, in the fall semester of 2019-2020. The research data were collected using Introductory Information Form, Social Media Addiction Scale (SMAS), and UCLA Loneliness Scale.

Results

According to the findings, 67.2% of the students had different degrees of SMA. It was found that 7.8% of the students had a high or very high degree of addiction. Loneliness levels of the students were found to be high (UCLA mean 62.78). A strong negative correlation (p < 0.01) was found between loneliness and all the subscales of the SMAS except the busyness subscale.

Conclusions

The findings demonstrate the social media addiction and the perception of loneliness in high school students are related at a level that cannot be ignored. Future research should evaluate social media addiction and loneliness together with other psychological markers.

由于互联网的使用和过度使用,身体、心理和社会障碍在世界上变得越来越普遍。目的本研究旨在探讨社交媒体成瘾(SMA)与高中孤独感之间的关系。这项横断面研究是在2019-2020年秋季学期对土耳其首都安卡拉四所高中的988名学生进行的。研究数据采用介绍信息表、社交媒体成瘾量表(SMAS)和UCLA孤独量表收集。结果67.2%的学生存在不同程度的SMA。结果发现,7.8%的学生有较高或非常高的成瘾程度。学生的孤独感水平很高(UCLA平均62.78)。孤独感与SMAS各分量表均呈显著负相关(p < 0.01)。结论社交媒体成瘾与高中生孤独感存在不可忽视的相关关系。未来的研究应该将社交媒体成瘾和孤独感与其他心理指标一起评估。
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引用次数: 1
Fostering better outcomes for youth of parents with opioid use disorder 为患有阿片类药物使用障碍的青少年父母提供更好的结果
IF 1.5 Q2 Nursing Pub Date : 2022-07-30 DOI: 10.1111/jcap.12387
Brandy M. Mechling PhD, RN, PMHCNS-BC
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引用次数: 0
Psychoeducational interventions to promote adolescents' mental health literacy in schools: Identifying theory for the development of a complex intervention 促进学校青少年心理健康素养的心理教育干预:复杂干预发展的识别理论
IF 1.5 Q2 Nursing Pub Date : 2022-06-24 DOI: 10.1111/jcap.12386
Tânia M. M. Morgado PhD, Luís M. J. Loureiro PhD, Maria A. M. Rebelo Botelho PhD

Topic

The concept of mental health literacy (MHL) was defined as the knowledge and beliefs about mental disorders that help in their recognition, management, or prevention. The complexity of interventions to promote adolescents' MHL requires that they be investigated through a process of development, feasibility/piloting, evaluation, and implementation, according to Medical Research Council (MRC) Framework.

Purpose

This article aimed to identify the theory that supports the development of a psychoeducational intervention to promote adolescents' MHL in schools, possibly to be developed by mental health and psychiatric nurses.

Sources Used

Journal articles, books, reports, and regulations.

Conclusions

This theory allows us to design a psychoeducational intervention to promote adolescents' MHL in schools and supports the subsequent phases of the MRC Framework.

心理健康素养(MHL)的概念被定义为对精神障碍的认识、管理或预防的知识和信念。根据医学研究理事会(MRC)框架,促进青少年MHL的干预措施的复杂性要求通过发展、可行性/试点、评估和实施的过程对其进行调查。目的本研究旨在探讨心理教育干预的理论支持,以促进学校青少年的MHL,可能由心理健康和精神科护士开发。期刊文章、书籍、报告和法规。该理论允许我们设计一种心理教育干预来促进青少年在学校的MHL,并支持MRC框架的后续阶段。
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引用次数: 1
Determining the relationship between loneliness and depression in adolescents during the COVID-19 pandemic: A cross-sectional survey 确定COVID - 19大流行期间青少年孤独感和抑郁之间的关系:一项横断面调查
IF 1.5 Q2 Nursing Pub Date : 2022-05-30 DOI: 10.1111/jcap.12384
Kübra Kayaoğlu PhD, BSN, Mehmet Başcıllar PhD, LL.B., MSW

Purpose

The aim of the present study is to determine the relationship between loneliness and depression felt by adolescents during the COVID-19 pandemic.

Design and Methods

The study sample consisted of 423 adolescents who volunteered to participate in the study. All participants had internet access and the cognitive ability to express themselves. The participants filled out the Google Documents form that included the “Socio-demographic Data Form,” “Children's Depression Inventory,” and “Short-form UCLA Loneliness Scale” to collect data.

Findings

It was determined that the depression inventory total mean score of the adolescents participating in the study was 55.15 ± 2.88 (high) and the loneliness scale total mean score was 16.43 ± 4.93 (medium). A statistically positive high correlation was found between the depression total mean scores and the loneliness total mean scores of the adolescents (p < 0.05). As the loneliness levels of the adolescents increased, their depression levels increased.

Practice Implications

Adolescents were more likely to experience mental disorders such as loneliness and depression during and after the pandemic. Governments should focus on the mental health of adolescents in the management of COVID-19. Clinical services should plan and implement prevention activities, support programs, and services to replace early diagnosis and intervention.

摘要目的本研究的目的是确定青少年在2019冠状病毒病大流行期间感到的孤独和抑郁之间的关系。设计和方法研究样本包括423名自愿参与研究的青少年。所有参与者都有互联网接入和表达自己的认知能力。参与者填写了谷歌文档表,其中包括“社会人口统计数据表”、“儿童抑郁量表”和“加州大学洛杉矶分校短期孤独感量表”来收集数据。研究结果确定,参与研究的青少年的抑郁清单总分为55.15 ± 2.88(高),孤独感量表总分为16.43 ± 4.93(中等)。青少年抑郁总平均分与孤独总平均分呈正相关(p < 0.05)。随着青少年孤独感水平的增加,他们的抑郁水平也增加。实践意义在疫情期间和之后,青少年更有可能经历孤独和抑郁等精神障碍。政府在应对新冠肺炎时应关注青少年的心理健康。临床服务应计划和实施预防活动、支持计划和服务,以取代早期诊断和干预。
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引用次数: 5
The associations of cognitive distortions with internet addiction and internet activities in adolescents: A cross-sectional study 认知扭曲与青少年网络成瘾和网络活动的关系:一项横断面研究
IF 1.5 Q2 Nursing Pub Date : 2022-05-30 DOI: 10.1111/jcap.12385
Arif Özparlak RN, MSN, Dudu Karakaya RN, PhD

Purpose

This study examined difference in the levels of internet addiction across internet activities, and the associations of cognitive distortions with internet addiction and internet activities.

Methods

This is a cross-sectional study involving 638 adolescents. Data were collected using a personal information form, the Internet Addiction Scale and The Children's Negative Cognitive Error Questionnaire. Data were analyzed using SPSSv23 and descriptive methods, independent samples t-test, linear regression, logistic regression were performed.

Findings

The prevalence of internet addiction in adolescents was found to be 16.9%. The internet addiction scores of adolescents who use the internet for online gaming, visiting pornographic sites, using and chatting on social media, and aimless browsing are higher. Catastrophizing, personalization, and selective abstraction cognitive distortions explain internet addiction variance at a level of 17.5%. Selective abstraction predicts online gaming and aimless browsing, personalization predicts pornographic site visiting, and catastrophization predicts doing homework on the internet.

Conclusion

Online gaming, visiting pornographic sites, using and chatting on social media and internet aimless browsing are distinctive of internet addiction. Internet addiction and various internet activities are associated with cognitive distortions. Mental health nurses should help adolescents to become aware of their cognitive distortions and to produce more functional thoughts.

目的本研究考察了网络活动中网络成瘾水平的差异,以及认知扭曲与网络成瘾和网络活动的关系。方法这是一项涉及638名青少年的横断面研究。使用个人信息表、网络成瘾量表和儿童负性认知错误问卷收集数据。数据分析采用SPSSv23和描述性方法,进行独立样本t检验、线性回归、逻辑回归。调查结果青少年网络成瘾的患病率为16.9%。使用互联网进行网络游戏、访问色情网站、在社交媒体上使用和聊天以及无目的浏览的青少年的网络成瘾得分较高。灾难化、个性化和选择性抽象认知扭曲解释了17.5%的网络成瘾差异。选择性抽象预测在线游戏和无目标浏览,个性化预测色情网站访问,灾难化预测在互联网上做作业。结论网络游戏、访问色情网站、在社交媒体上使用和聊天以及无目的浏览是网络成瘾的特征。网络成瘾和各种网络活动与认知扭曲有关。心理健康护士应该帮助青少年意识到他们的认知扭曲,并产生更多的功能性思维。
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引用次数: 2
The associations of cognitive distortions with internet addiction and internet activities in adolescents: A cross-sectional study. 青少年网络成瘾和网络活动对认知扭曲的影响:一项横断面研究。
IF 1.5 Q2 Nursing Pub Date : 2022-05-30 DOI: 10.1111/jcap.12385
Arif Özparlak, Dudu Karakaya
PURPOSEThis study examined difference in the levels of internet addiction across internet activities, and the associations of cognitive distortions with internet addiction and internet activities.METHODSThis is a cross-sectional study involving 638 adolescents. Data were collected using a personal information form, the Internet Addiction Scale and The Children's Negative Cognitive Error Questionnaire. Data were analyzed using SPSSv23 and descriptive methods, independent samples t-test, linear regression, logistic regression were performed.FINDINGSThe prevalence of internet addiction in adolescents was found to be 16.9%. The internet addiction scores of adolescents who use the internet for online gaming, visiting pornographic sites, using and chatting on social media, and aimless browsing are higher. Catastrophizing, personalization, and selective abstraction cognitive distortions explain internet addiction variance at a level of 17.5%. Selective abstraction predicts online gaming and aimless browsing, personalization predicts pornographic site visiting, and catastrophization predicts doing homework on the internet.CONCLUSIONOnline gaming, visiting pornographic sites, using and chatting on social media and internet aimless browsing are distinctive of internet addiction. Internet addiction and various internet activities are associated with cognitive distortions. Mental health nurses should help adolescents to become aware of their cognitive distortions and to produce more functional thoughts.
目的:研究网络成瘾水平在网络活动中的差异,以及认知扭曲与网络成瘾和网络活动的关系。方法对638名青少年进行横断面研究。数据收集采用个人信息表、网络成瘾量表和儿童消极认知错误问卷。采用SPSSv23和描述性方法对数据进行分析,并进行独立样本t检验、线性回归、logistic回归。发现青少年网瘾患病率为16.9%。上网玩网络游戏、浏览色情网站、在社交媒体上使用和聊天以及漫无目的浏览的青少年的网络成瘾分数更高。灾变、个性化和选择性抽象的认知扭曲在17.5%的水平上解释了网络成瘾的差异。选择性抽象预测在线游戏和漫无目的的浏览,个性化预测访问色情网站,灾难化预测在互联网上做作业。结论网络游戏、浏览色情网站、使用社交媒体聊天、无目的浏览是网络成瘾的特征。网络成瘾和各种网络活动与认知扭曲有关。心理健康护士应该帮助青少年意识到他们的认知扭曲,并产生更多的功能思想。
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引用次数: 2
期刊
Journal of Child and Adolescent Psychiatric Nursing
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