Agitation is not only a frequent and disturbing behavior for many patients with dementia, but it also troubles their caregivers and families. Many serious problems and side effects are associated with the use of medications to treat agitation; therefore, alternative approaches to treating agitation must be assessed. The current article presents results from a quality improvement pilot project that examined the usefulness of a specially designed, multisensory room intervention for geriatric psychiatric inpatients with mild to moderate agitation. Thirty-two visits to the sensory room were made by 13 inpatients with dementia. A significant decrease occurred in the Pittsburgh Agitation Scale (PAS) total scores over time from pre-room to post-room intervention, as well as 1-hour post-room intervention (F = 95.3, p < 0.001). Significant effects were found for all PAS subscales (i.e., aberrant vocalizations, motor agitation, and resistance to care), with the exception of the aggression subscale. The multisensory room intervention was effective in decreasing some symptoms of agitation in the geriatric psychiatric patient, thus contributing to positive patient, family, and nursing outcomes.

Uncontrolled anger is a contributing force in the three leading causes of adolescent death: homicide, suicide, and injuries. Anger may be one of the early warning signs which could lead to violent behavior. The purpose of this study was to examine the relationship between anger experience and expression with the potential correlates of life events, perceived social support, self-esteem, optimism, drug use, anxiety, and depressive symptoms in rural adolescents. The participants (n=193) were aged 14 to 17 years old in ninth through eleventh grades enrolled at three rural Western Pennsylvania public high schools. Participants completed nine questionnaires. Negative life events, anxiety, drug use, and depressive symptoms had significant positive correlations with anger. In addition, anger was found to have significant negative correlations with the adolescents' perceived family support, self-esteem, and optimism. With this knowledge, health promotion programs conducted by pediatric nurses can target anxiety, drug use, and depressive symptoms while bolstering family support, self-esteem, and optimism to promote anger management in adolescent health care. KeywordsAdolescents; Anger; Mental health; Rural Uncontrolled anger is a contributing force in the three leading causes of adolescent death: homicide, suicide, and injuries (Centers for Disease Control and Prevention [CDC], 2006). Address correspondence to Kirsti Hetager Stark, Project Director, Clinical Specialist, University of Pittsburgh School of Nursing, 415 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261. kms87@pitt.edu. Publisher's Disclaimer: Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf This article maybe used for research, teaching and private study purposes. Any substantial or systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.This article is not subject to US Copyright law. Anger may be one of the early warning signs which may lead to this violent behavior. Anger that is expressed frequently and intensely in response to minor irritants may signal potential violent behavior (Dwyer et al., 1998 (USDHHS, 2007). In particular, rural adolescents face additional disparities related to the compounding stresses of geographic isolation, lack of specialized services, and poverty. Although the actions of angry youth, from school shootings to dating violence, have peppered the media in recent years, few studi...

The group modality is a viable holistic treatment consideration for the elderly, given the steady increase in the elderly population, the presence of various psychiatric and/or medical conditions in this cohort, and cost concerns. The holistic nurse and group leader share similar role definitions of being a facilitator in the healing process. They embrace the concept that the person and group are greater than the sum of the parts. Using a group modality can increase the number of people served by one nurse, thereby making it cost-effective. Incorporating the holistic mind-body-spirit approach addresses the Healthy People 2010 goal of increasing the quality of life. Tips on conducting groups with the elderly are reviewed, including types of groups, setting, goals, composition, duration, and frequency. Theme-centered groups are discussed from a holistic perspective. Yalom's 11 therapeutic factors that account for group functions are explained, along with other group concepts that reflect holistic nursing concepts.

An anxiety disorder affects 13 out of every 100 children. The purpose of this paper is to determine if there are differences in self-reported anxiety between male and female rural adolescents. One hundred and ninety three students aged 14-17 years in three western Pennsylvania rural high schools, USA, were surveyed. The majority of participants were Caucasian (86.5%, n = 167), female (53.4%, n = 103), and aged 15.57 (SD = .93). Females' mean self-reported anxiety score was higher than the males' score (p < 0.0001). The females' mean score was 25.09 (SD = 13.83) (score ≥ 25 may indicate the need for further evaluation for the presence of a potential anxiety disorder) while the males' mean score (n = 90) was 16.88 (SD = 10.81). Of interest, all the five factors (specific types of anxiety) scores were significantly different between males and females at p < .05. Evidenced based implications for the mental health nurse's practice will be discussed. Anxiety screening is promoted to identify youth that may need mental health treatment and referrals, especially rural and female youth.

Anger could be an early warning signal of violent behavior. Early peer education health promotion in relation to anger management could help children before uncontrolled anger becomes a problem in adolescence and adulthood. Peer education has been identified as a viable intervention strategy worldwide with various prevention programs for youth. The purpose of this article is to describe an anger management program (Teaching Kids to Cope with Anger, TKC-A 4th-8th graders) co-led by high school peer educators in an urban school district's summer school enhancement program. A program of five modules will be described. This paper discusses the peer educator implementation and recommendations for future implementation.