NRP 730, Final DNP Practicum Readiness Form Essay
Efficacy of Mindfulness-Based Stress Reduction (MBSR) in Alleviating Anxiety Levels among Adult Psychiatric Patients at Desai Medical Group: An 8-10 Week Intervention Study.
Issue Identified by Decision Makers
During discussions with the decision-makers at Desai Medical Group, a pressing issue that received significant attention was the growing anxiety levels among their adult psychiatric patients. As a result, treatment durations have been prolonged, there has been an increase in medication usage, and some patients have even had to be readmitted. This strains healthcare resources and potentially jeopardizes patient well-being. As a result of these worries, there is a significant desire to investigate evidence-based non-pharmacological therapies that might be implemented into the present treatment strategy. We specifically discussed the advantages of incorporating mindfulness-based stress reduction programs into their current framework because of their encouraging outcomes in related healthcare settings. The decision-makers hoped that addressing this specific concern through our proposed project would improve patient outcomes and align with the institution’s commitment to holistic care.
Translation Science Model: Bench-to-bedside model
Anxiety disorders are highly prevalent mental health conditions that significantly impact individuals worldwide, causing considerable distress and impairment (Penninx et al., 2021). Currently, conventional treatments at medical facilities like Desai Medical Group primarily rely on pharmacological interventions. While effective, these medications may come with side effects and might not address the comprehensive needs of patients in totality (Garakani et al., 2020). Additionally, certain anti-anxiety drugs’ limitations and adverse effects are increasingly recognized. Henceforth arises the necessity for evidence-based complementary approaches that can be integrated into existing treatment protocols. Numerous studies indicate that mindfulness-based stress reduction holds promise as an intervention for reducing anxiety symptoms, thus offering a viable alternative or adjunctive strategy to explore further (Fumero et al., 2020).
Need for change
Globally, anxiety disorders significantly burden millions of individuals worldwide (Yang et al., 2021). As the most prevalent mental health disorder, traditional therapeutic interventions have some benefits but can often fall short of providing long-term relief from anxiety symptoms (Garakani et al., 2020). There is growing concern at Desai Medical Group and other medical institutions regarding patients who continue to experience persistent anxiety symptoms despite being on medication. To address this challenge comprehensively, evidence-based interventions like Mindfulness-Based Stress Reduction offer a more holistic approach to patient care (Maddock & Blair, 2021). This approach focuses on incorporating mind-body techniques for managing anxiety and has gained support from recent research findings (Goldberg et al., 2020: Liu et al., 2021). By integrating MBSR into our therapeutic protocol at Desai Medical Group, we aim to enhance patient outcomes by reducing medication dependence while equipping individuals with practical tools for managing their symptoms.
The Purpose of the Proposed Project
The purpose of the proposed DNP project is to evaluate the efficacy of implementing a mindfulness-based stress reduction program in reducing anxiety levels among adult psychiatric patients at Desai Medical Group over an 8-10-week period, compared to traditional therapeutic interventions. This initiative provides evidence-based suggestions for incorporating holistic techniques, such as mindfulness, into traditional care paradigms to improve patient outcomes and well-being.
For adult psychiatric patients at Desai Medical Group, does the implementation of a mindfulness-based stress reduction program, compared to current practice, impact anxiety levels in 8-10 weeks?
The DNP project focuses on adult psychiatric patients at Desai Medical Group dealing with clinical anxiety. To ensure that the study produces meaningful outcomes within the given timeframe, it is anticipated to have a sample size of around 100 participants. This number has been determined based on the average number of adult psychiatric patients visiting Desai Medical Group and strikes a balance between achieving statistically significant results and practical feasibility.
- Participants must be adults between the ages of 18 and 65
- Individuals are diagnosed with anxiety disorder by a licensed psychiatrist or psychologist.
- Patients have actively sought treatment at Desai Medical Group for at least one month.
- Voluntary enrollment in the mindfulness-based stress reduction program is required.
- Demonstrated capacity to provide informed consent.
- Participants with severe cognitive impairments or significant neurological disorders may hinder their ability to engage in mindfulness practices.
- People experiencing acute suicidal thoughts or tendencies.
- Non-fluency in the language
- Patients currently enrolled in another intervention study or program
- The treating psychiatrist or psychologist may exclude patients for specific medical or psychological reasons if they deem them unsuitable candidates for participation.
Explanation of the Intervention
To address the needs of Desai Medical Group and reduce anxiety among adult psychiatric patients, we will implement a structured program called Mindfulness-Based Stress Reduction. MBSR is an evidence-based approach combining mindfulness meditation to decrease stress and enhance psychological well-being.
Week 1 – Project Initiation: Conduct initial meetings with the psychiatric team and other stakeholders at Desai Medical Group and provide an overview of the MBSR program by presenting research on its effectiveness. The pre-intervention anxiety levels of participants will be evaluated using a tool known as General Anxiety Disorder-7. Identify potential participants based on the predetermined criteria.
Weeks 2-3 – Orientation to the MBSR Program: To familiarize participants with the essential elements and goals of the Mindfulness-Based Stress Reduction program. A short practical exercise will also be conducted during this session to provide hands-on experience. Detailed information about weekly schedules, expected levels of engagement, and recommended home practices will also be shared.
Weeks 4-8 – Program Implementation: The core MBSR sessions will occur during this period. Participants will attend a weekly 2-hour session guided by an instructor trained in MBSR. These sessions will involve guided meditation practices, gentle yoga, and group discussions to share experiences. Participants will receive guided meditation audio and recommended readings to support their daily home practice.
Week 9 – Intensive Practice and Feedback: An intensive day-long MBSR retreat will be organized for participants to enhance their mindfulness practice further. Following the retreat, individual feedback sessions will be conducted to gain insights into participants’ experiences and any challenges they may have encountered.
Week 10- Project Wrap-up and Data Collection: Gather post-intervention data using the GAD-7 tool to evaluate any changes in anxiety levels among participants. Participants fill out a feedback form where they can provide insights about their overall experience with the program and its effectiveness from their perspective and offer suggestions for potential enhancements. Subsequently, all collected data will be compiled and organized for subsequent analysis.
The goal of implementing the MBSR program within a relatively short timeframe of 8-10 weeks is ambitious but achievable. This objective can be accomplished effectively through careful planning, adequate resource allocation, and consistent monitoring. However, there are specific challenges and obstacles that one should be prepared for:
- Time Constraints: Given the limited time frame, unexpected delays could disrupt the plan. To mitigate such risks, it is crucial to initiate communication early on and make all necessary arrangements in advance. This includes ensuring that all required resources are readily available and establishing clear participant guidelines.
- Participant Commitment: Participating in an MBSR program demands a significant investment of time from its participants. Inconsistent attendance or dropouts may significantly impact the overall effectiveness of the program. Before commencement, it is essential to clarify these expectations with potential participants so they fully understand what commitment is required from them.
- Limited Availability of Resources: Access to a trained MBSR instructor or suitable spaces for conducting the sessions may be limited. To address this, planning and booking early, partnering with local mindfulness centers, or utilizing online platforms for virtual sessions if necessary is advisable.
- Initial Resistance: Some individuals dealing with mental health issues may not be familiar with MBSR and might have reservations about its unconventional nature. Alleviating concerns can be achieved by offering informational sessions highlighting the benefits of MBSR along with scientific evidence supporting its effectiveness.
To handle such challenges effectively, it is essential to incorporate buffers into the timeline, develop contingency plans in advance, and maintain open lines of communication throughout the process.
Data Collection Plan
A pre-test and post-test design will be employed to evaluate the impact of the Mindfulness-Based Stress Reduction program on anxiety levels in adult psychiatric patients at Desai Medical Group. The primary objective is to measure the change in anxiety levels experienced by adult psychiatric patients after participating in an 8-10 week MBSR program. For this study, we will use the Generalized Anxiety Disorder 7 scale as our assessment tool. The GAD-7 has been validated and widely used for screening and assessing generalized anxiety disorder severity (Lee & Kim, 2019). The GAD-7 has demonstrated psychometric solid properties, including good reliability and validity across multiple domains such as criterion, construct, factorial, and procedural validity (Sapra et al., 2020). The initial assessment will provide baseline data regarding your current level of anxiety. After completing the 8-10 week MBSR program, participants will be asked to complete the GAD-7 scale again. This assessment will enable us to assess whether there has been a noteworthy decrease in their anxiety levels after participating in the MBSR intervention.
|Measurable Outcome(s) as identified in the PICOT question||Data collection process pre- and post-intervention|
|Reduction in anxiety levels of psychiatric patients||Pre-intervention: Participants will complete the Generalized Anxiety Disorder 7 (GAD-7) scale to establish baseline data on their anxiety levels.
Post-intervention: After the 8-10 week MBSR program concludes, participants will again be administered the GAD-7 scale to evaluate any changes in their anxiety levels.
Data Analysis Plan
Paired sample t-tests will be utilized for data analysis.
Fumero, A., Peñate, W., Oyanadel, C., & Porter, B. (2020). The effectiveness of mindfulness-based interventions on anxiety disorders. A systematic meta-review. European Journal of Investigation in Health, Psychology and Education, 10(3), 704–719. https://doi.org/10.3390/ejihpe10030052
Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: Current and emerging treatment options. Frontiers in Psychiatry, 11(595584). https://doi.org/10.3389/fpsyt.2020.595584
Goldberg, S. B., Riordan, K. M., Sun, S., Kearney, D. J., & Simpson, T. L. (2020). Efficacy and acceptability of mindfulness-based interventions for military veterans: A systematic review and meta-analysis. Journal of Psychosomatic Research, 138, 110232. https://doi.org/10.1016/j.jpsychores.2020.110232
Johannsen, M., Nissen, E. R., Lundorff, M., & O’Toole, M. S. (2022). Mediators of acceptance and mindfulness-based therapies for anxiety and depression: A systematic review and meta-analysis. Clinical Psychology Review, 94, 102156. https://doi.org/10.1016/j.cpr.2022.102156
Lee, B., & Kim, Y. E. (2019). The psychometric properties of the generalized anxiety disorder scale (GAD-7) among Korean university students. Psychiatry and Clinical Psychopharmacology, 1–8. https://doi.org/10.1080/24750573.2019.169132
Liu, X., Yi, P., Ma, L., Liu, W., Deng, W., Yang, X., Liang, M., Luo, J., Li, N., & Li, X. (2021). Mindfulness-based interventions for social anxiety disorder: A systematic review and meta-analysis. Psychiatry Research, 300, 113935. https://doi.org/10.1016/j.psychres.2021.113935
Maddock, A., & Blair, C. (2021). How do mindfulness-based programmes improve anxiety, depression and psychological distress? A systematic review. Current Psychology. https://doi.org/10.1007/s12144-021-02082-y
Penninx, B. W., Pine, D. S., Holmes, E. A., & Reif, A. (2021). Anxiety disorders. The Lancet, 397(10277), 914–927. https://doi.org/10.1016/s0140-6736(21)00359-7
Sapra, A., Bhandari, P., Sharma, S., Chanpura, T., & Lopp, L. (2020). Using generalized anxiety disorder-2 (GAD-2) and GAD-7 in a primary care setting. Cureus, 12(5). https://doi.org/10.7759/cureus.8224
Yang, X., Fang, Y., Chen, H., Zhang, T., Yin, X., Man, J., Yang, L., & Lu, M. (2021). Global, regional and national burden of anxiety disorders from 1990 to 2019: Results from the global burden of disease study 2019. Epidemiology and Psychiatric Sciences, 30(36). https://doi.org/10.1017/s204579602100027
The purpose of this assignment is to complete the DNP Practicum Readiness Form in preparation for the practicum courses. The Practicum Readiness Form must be completed entirely because the information will be needed to write the project plan, complete the institutional review board application, and implement the DNP practice change project.
Successful completion of this form is required to enroll in NR711.
Revise your DNP Practicum Readiness Form using the faculty feedback from the Week 3 draft assignment. Check each line of the document to be sure all revisions are completed.
Complete all pages entirely with sufficient detail, paying attention to the following:
If some information does not apply, such as the mentor information, enter Not Applicable. Be sure to answer the questions at the bottom of the page with the check-boxes.
Answer all questions and sub-questions. If a sub-question is not completed, the form is considered incomplete.
Enter complete APA references for 5 contemporary research articles (< 5 years old).
A minimum of 2 articles should be related to your practice problem.
A minimum of 3 articles related to your evidence-based intervention.
The form is considered incomplete with less than 2 articles for the practice problem and 3 articles supporting the evidence-based intervention.
Explain the steps in your intervention implementation plan in detail so that the reader can implement the same intervention by following your plan’s exact steps.
Examine the feasibility of implementing your project in 8-12 weeks.
Analyze the barriers you anticipate and the strategies to overcome or mitigate the barriers.
Explain your data collection plan and process fully so that the reader can replicate the data collection process exactly.
State the outcome(s) you will measure and the data collection process pre-implementation and process post-implementation.
Explain your data analysis plan and the statistical tests you will use to evaluate the outcome data. Importantly, you must complete the two questions with check-boxes at the bottom of the page.
The final submission of this assignment is a pass/fail assignment. If the form is completed entirely, all points will be awarded. If a question or sub-question is left unanswered, zero (0) points will be assigned.
This assignment enables the student to meet the following program outcomes:
Integrates scientific underpinnings into everyday clinical practice. (POs 3, 5)
Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
Uses analytic methods to translate critically appraised research and other evidence into clinical scholarship for innovative practice improvements. (POs 3, 5)
Appraises current information systems and technologies to improve health care. (POs 6, 7)
Analyzes health care policies to advocate for equitable health care and social justice to all populations and those at risk due to social determinants of health. (POs 2, 9)
Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)
Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (POs 1, 4)
This assignment enables the student to meet the following course outcomes:
Prioritize and apply ethical considerationsâ€¯and theories relevant to translation science. (PCs 1, 3, 8; POs 3, 4, 5)â€¯ â€¯
Apply clinical scholarship methodologies for designing, developing, implementing, and evaluating quality improvements and the translation of evidence-based practice, to improve healthcare outcomes at the micro, meso, or macrosystem level. (PCs 1, 3, 5; POs 3, 5, 9)â€¯
Appraise and synthesize the highest level of evidence available to improve the quality, cost-effectiveness, and healthcare outcomes of diverse populations. (PCs 1, 2, 3, 4, 6, 8; POs 4, 5, 6, 8)â€¯
By 11:59 p.m. MT on Sunday
Late Assignment Policy applies
Week 5 Assignment Grading Rubric
Week 5 Assignment Grading Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
1. Complete page 1 entirely with sufficient detail.
2. Complete page 2 entirely with sufficient detail.
3. Complete page 3 entirely with sufficient detail.
4. Complete page 4 entirely with sufficient detail.
5. Complete all revisions faculty requested in the Week 3 Assignment draft.
6. If a question or sub-question is left unanswered, zero ( 0 ) points will be assigned.
The form is completed entirely. There are no unanswered questions and Not Applicable is entered appropriately. All questions are answered in sufficient detail. All revisions from the Week 3 draft are completed.
The form is not completed entirely with unanswered questions, and/or the answers are superficial without the required detail, and/or some revisions from the Week 3 draft were not completed.
Total Points: 250