TO REPLY TO EACH COMMENT WITH APA, CITATION AND REFERENCE ABOVE 2013.

Post 1

Introduction

According to week two, it is clear that the assessment tools used in psychotherapy have two primary purposes. The first purpose is to measure the illness and diagnose clients while the second purpose is to evaluate a client’s response to treatment. There are different types of assessment tools, but in this discussion, I have selected Patient Stress Questionnaire.

The psychometric properties of the Patient Stress Questionnaire as the selected assessment tool

Patient Stress Questionnaire refers to the tool employed in primary care settings to help in screening for the behavioral health symptoms.  The instrument was adapted from the PHQ-9, AUDIT, GAD-7, and PC-PTSD.  Patient Stress Questionnaire is made up of a list of items that efficiently help in identifying the potential behavioral health problems. The tool is a 24-item behavioral health screening tool which is composed of a collection of twelve (12) separate “ultra-brief” screening tools to offer a preliminary mental health and addiction diagnosis. The PHQ-9 is made up of 9 items which represent the criterion symptoms for DSM 5 major depressive disorder. These have questions related to how much sign has bothered the client based on the scale such as  “not at all,” “nearly every day,” and  “several days”. The GAD-7 is made up of seven items with the response similar to PHQ-9 and scored as a continuous variable from 0 to 21 (Kroenke et al. 2016).

When it is appropriate to use Patient Stress Questionnaire

The tool is used when the client is suspected to have depression and anxiety. Several well-validated measures can be used to assess depression and anxiety as separate domains (Flückiger et al 2016), but the advantage of Patient Stress Questionnaire is that it is a measure that offers a single composite score for both the depression and anxiety (Kroenke et al. 2016). The tool is used in assessing depressive symptoms among patients having conditions such as aphasia. The tool is applicable for measuring perceived stress (Laures-Gore et al. 2017).

Furthermore, theoretical and empiric evidence of overarching psychological construct that compromise of distinct but related dimensions of anxiety and depression. Therefore, the intercorrelation between depression and anxiety makes Patient Stress Questionnaire attractive as it provides a composite score.

Based on the efficacy of Patient Stress Questionnaire in evaluating psychopharmacologic medications, psychopharmacological medications aim to manage behavior, stabilize mood, or to treat psychiatric disorders and their associated symptoms. On the other hand, Patient Stress Questionnaire is used to screen for these behavioral health symptoms and therefore, can be used to determine whether the symptoms are reducing or not based on the psychopharmacological medications. The tool can be used to  self-report symptoms and to identify  persistent symptoms of anxiety disorders and even monitor the treatment in clinical practice (Rose & Devine, 2014).

References

Kroenke, K., Wu, J., Yu, Z., Bair, M. J., Kean, J., Stump, T., & Monahan, P. O. (January 01, 2016). Patient Health Questionnaire Anxiety and Depression Scale: Initial Validation in Three Clinical Trials. Psychosomatic Medicine, 78, 6.

Laures-Gore, J. S., Farina, M., Moore, E., & Russell, S. (January 01, 2017). Stress and depression scales in aphasia: Relation between the aphasia depression rating scale, stroke aphasia depression questionnaire-10, and the perceived stress scale. Topics in Stroke Rehabilitation, 24, 2, 114-118.

Rose, M., & Devine, J. (January 01, 2014). Assessment of patient-reported symptoms of anxiety. Dialogues in Clinical Neuroscience, 16, 2, 197-211.

Flückiger, C., Forrer, L., Schnider, B., Bättig, I., Bodenmann, G., & Zinbarg, R. E. (January 01, 2016). A Single-blinded, Randomized Clinical Trial of How to Implement an Evidence-based Treatment for Generalized Anxiety Disorder [IMPLEMENT] — Effects of Three Different Strategies of Impleme

Post 2

psychometric properties of the Screening, brief intervention, and referral to treatment (SBIRT) tool

The SBIRT grant program was developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) which provided either brief intervention/treatment or referred to appropriate services for individuals who use alcohol or psychoactive substances, not including tobacco that may not meet criteria for a substance use disorder (Aldridge, Linford, & Bray, 2017).  It begins with a pre-assessment screening which briefly explores substance use.  If a positive pre-screen is evident, the provider should move to the Alcohol use disorders identification test (AUDIT) and/or the Drug abuse screening test (DAST) for more thorough assessment.  If positive brief intervention or treatment is advised (“Clinician Tools – SBIRT for Substance Abuse,” n.d.).  According to Yong, et al. as part of their systematic review, it is unclear whether it is beneficial to utilize brief interventions as part of the SBIRT screened individuals who were not seeking treatment at the time of assessment (2014).  Evaluation of this project indicated that the program was positively correlated with decreased alcohol and/or substance use in this population.  However, it is unclear whether other factors were key (Aldridge et al., 2017).  It was noted however that participants had significantly lower reports of substance use one month after intervention.  However limitations in study design may have impacted the reported results (Aldridge et al., 2017).

Explain when it is appropriate to use SBIRT with clients

Each client should be assessed using a pre-assessment screening tool yearly.  If positive, the client should be assessed using the AUDIT or DAST tools as indicated above (“Clinician Tools – SBIRT for Substance Abuse,” n.d.)

Is the SBIRT tool appropriate to evaluate the efficacy of psychopharmacologic medications

The SBIRT protocol moves to brief intervention or brief treatment as appropriate.  These interventions are focused on psychological treatments 5-60 minutes in length (“Clinician Tools – SBIRT for Substance Abuse,” n.d.)  As such, they would not be involving psychopharmacological substances, at least initially it would not be appropriate for evaluation of medication effectiveness.

References

Aldridge, A., Linford, R., & Bray, J. (2017). Substance use outcomes of patients served by a large US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT). Addiction, 112, 43–53. https://doi.org/10.1111/add.13651

Clinician Tools – SBIRT for Substance Abuse. (n.d.). Retrieved September 5, 2018, from http://www.sbirt.care/tools.aspx

Young, M. M., Stevens, A., Galipeau, J., Pirie, T., Garritty, C., Singh, K., … Moher, D. (2014). Effectiveness of brief interventions as part of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances: a systematic review. Systematic Reviews, 3, 50. https://doi.org/10.1186/2046-4053-3-50

You have just been hired as a new Vice President of quality and safety for a full-service 600-bed government healthcare organization.  Within your first month on the job, the national security threat level has been raised to Imminent, which means there is a credible, specific, and impending terrorist threat against the United States, and your facility may be directly impacted. The Chief Executive Officer has requested an immediate six to eight-page report of your proposal for handling such a situation.

Note: You may create and /or make all necessary assumptions needed for the completion of this assignment.

Write a 6 page paper in which you:

1. Examine the existing procedures related to at least four (4) of the ten (10) essential public health services. Focus on the principal effects that these procedures will have on your hospital during the emergency.
2. Specify the importance of continuing to evaluate patients, as stipulated by the Emergency Medical Treatment and Active Labor Act (EMTALA), during the emergency.
3. Detail three (3) measures that you would use in order to maintain the electronic medical record system during the emergency.
4. Defend your position on the decision to accept health insurance during the emergency as a potential source of income for the facility. Provide support with at least three (3) examples that illustrate your position.
5. Analyze the extent to which this emergency might affect the quality of care provided to the patients and the unimpeded operation of the organization.
6. Use at least three (3) quality references. Note: Wikipedia and other Websites do not qualify as academic resources.

Your assignment must follow these formatting requirements:

• Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
• Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

As a family nurse practitioner you are working in a rural health clinic. You are evaluating a 16-year-old adolescent patient who comes complaining of having a difficulty concentrating in school. On exam you also note that the patient is very thin and frail in appearance and is asking you for diet pills. Explain the following questions in a 2 page Word document:

1. What are some initial areas for concern?

2. What screening tools can help lead you closer to your diagnosis?

3. Describe 1 health promotion strategy you can discuss with the patient.

4. Make a plan of care that addresses the following: possible pharmacological and non-pharmacological (OTC) interventions, labs, follow-up, teaching, and referrals.

Support your work with a minimum of two (2) evidence-based guidelines and/or articles published within 3-5 years.

Reference:

Centers for Disease Control and Prevention. (2013). Youth risk behavior surveillance system (YRBSS). Retrieved from http://www.cdc.gov/healthyyouth/data/yrbs/index.htm