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Item Implementation of standardized trauma and resiliency screening in a youth therapeutic residential setting: a quality-improvement project(Montana State University - Bozeman, College of Nursing, 2021) Bugni, Katherine Tabije; Chairperson, Graduate Committee: Sandra Benavides-VaelloThe purpose of this DNP project was to establish standardized trauma and resiliency screening for patients within the youth therapeutic residential setting. A lack of standardized screening and documentation of trauma exposure and resiliency factors was identified internally by the organization. The establishment of routine screening for traumatic experiences provides valuable data, which will inform and be incorporated into the patient's treatment plan. Additionally, routine screening of the patient's resiliency measures complements the trauma information that was collected. This information is important as resiliency plays a critical role in countering the downward trajectory that is set by a child's experience of trauma. Resilience can act as a safeguard from the negative outcomes that are linked with experiencing early trauma. The major objectives for this project were (1) for staff to implement trauma screening and (2) resiliency screening with youth in a therapeutic setting. Not only does the trauma score provide key information about the patient, but it can also guide treatment and serves to establish a baseline for the continued tracking of trauma and resiliency experiences. Additionally, continued data tracking beyond discharge is a requirement of the recent Family First Prevention Services Act of 2018. This project's aim was for participants to utilize the organization's electronic health record to collect and house the screening data. At a later date, the information can be utilized for advocacy of funding, vitals tracking, and for future quality-improvement processes. The results include that staff obtained screenings for 100% of the organization's residential population, with screenings for trauma (ACEs) and resiliency (CYRM-R), incorporating the new process into routine practice within the short PDSA cycle. The results of staff success in incorporating the new screening process for trauma and resiliency with youth residents during weekly routine visits indicate that this practice change is not only achievable, but can be applied during already established weekly visit time between existing trained staff and the patients within the two communities' residential therapeutic group homes.Item The relationship between exercise and resilience in people with multiple sclerosis(Montana State University - Bozeman, College of Nursing, 2014) Chandler, Nyla Sue; Chairperson, Graduate Committee: Kathleen SchachmanMultiple sclerosis (MS) is an autoimmune disease, in which a person's own white blood cells to attack the fatty protective layer called myelin around nerves in the brain and spinal cord resulting in demyelinization and nerve damage. MS is typically diagnosed between the ages of 20 and 40 years old. The impact and damage is highly variable from one person to the next. Women are affected more often than men. Exercise is a pattern of physical activity and movement. Resilience is the ability to cope with change or misfortune, a fluid quality that acts to modify individual responses to risk. The purpose of this study was to examine the relationship between exercise and resilience in people with MS. A correlational study was used to determine if a relationship exists between exercise and resilience in a convenience sample, consisting of 74 MS patients at a neuroscience center. The hypothesis that there was a positive relationship between exercise and resilience in persons with MS was not borne out in this population. r= 0.094 indicating that there was no relationship between exercise and resilience in persons with MS. Characteristics that may have contributed to the lower GLTEQ scores and the higher RS scores include that the sample was older, substantially unemployed, had suffered the impact of the disease for many years, and may have been living at a lower income level from those who more recently were diagnosed with MS. The convenience sample was somewhat homogeneous, and was missing younger persons who were in earlier stage of the disease. Recommended areas for future study and emphasis include; Targeting prevention from initial diagnosis instead of waiting until an MS patient has already suffered many negative outcomes. Studying a more active, fit subpopulation of MS patients may indicate a positive correlation between resilience and fitness, and therefore underscore the need for more structured, rigorous, aerobic exercise programs that would maintain and lead to fitness for those with MS.Item Educating U.S. Army Reserve soldiers on resiliency(Montana State University - Bozeman, College of Nursing, 2012) Lewis-Richardson, Charlene Ann; Chairperson, Graduate Committee: Kathleen SchachmanResiliency is defined as a set of processes that enable good outcomes in spite of serious threats. It is the ability to persist in the face of challenges and to bounce back from adversity. US Army Reserve soldiers need to be trained on resiliency to provide them with tools to cope with stress and deal with adverse events. PTSD has increased by 40% since the beginning of the Global War on Terrorism. Resiliency training will be a proactive step to assist in minimizing the occurrence of PTSD. The purpose of this professional project was to present an educational program to US Army Reserve soldiers in Montana. Education includes the definition of PTSD, the risk factors for PTSD and practical hands-on exercises for developing resiliency skills. The project consisted of a 11-question knowledge pre-test regarding PTSD, a 45-minute educational presentation on resiliency and a 5-question post-presentation questionnaire disbursed to the 75 US Army Reserve soldier participants. It occurred at Fort Harrison in Helena, MT. The educational intervention was based on Nola Pender's Health Promotion Model and grounded in principles of adult learning. The results of the project revealed the soldiers strongly agreed that the objectives of resiliency training and education were helpful. The soldiers felt they could take the information presented in the educational project and utilize it in their US Army Reserve life and their civilian careers and family relationships. The U.S. Army exists to protect this country. Our soldiers, family members, and Army civilians have never failed to answer our nation's call during a time of need. The Army needs to recognize they need to do more to prepare the forces for the psychological demands that come with fighting a protracted, decades-long conflict. Resiliency training will do that!