#1

 Long-term cognitive, psychological, and physical impairments linked to intensive care treatment over time are referred to as the symptom complex of post-intensive care syndrome (PICS). About 60 percent of survivors are impacted (Beutel et al., 2025). The research design for this article is a qualitative, semi-structured interview study conducted by performing in-depth interviews to learn more about their experiences with psychological stress after intensive care unit treatment. Participants were selected from the intervention group of the PICTURE trial. There was a total of 10 participants in this study, patients who ranged in age from 18 to 85 years of age who had spent two years in critical care with mechanical ventilation and severe organ failure. Two of the 10 individuals invited for the interview had to be turned down (one because of time limits and one because of a lack of collaboration). I believe the sample size of this study was perfect because they could focus on the in-depth interviews with each of them. The research methods do fit the purpose of the study because the PICTURE project is a multicenter study financed by the DFG that was carried out between 2017 and 2024. By including general practitioners, this study seeks to enhance the care environment for patients who have post-ICU PTSD. In three 45-minute sessions, general practitioners (GPs) provide a brief trauma-focused intervention based on Narrative Exposure Therapy (NET) to patients who meet the inclusion criteria for mild to moderate stress. The data collection and analysis were appropriate because a balanced distribution of gender, age, educational background, dwelling size, and admission diagnosis served as the basis for the selection. The planned three NET sessions had already been sent to each respondent. Digital recordings of semi-structured guided telephone interviews were made. A protocol was developed for every interview. Deductive reasoning was used to build the interview guide. The study’s findings about the relationship between the severity of memories of the intensive care unit stay and the development of mental health served as the foundation for the theoretical framework. Yes, the phenomenon was identified when the results were revealed. A brief, easily accessible psychological intervention in the primary care setting is extremely valuable because patients who have been in an intensive care unit (ICU) frequently experience significant psychological stress due to the traumatic nature of their stay, including feelings of helplessness, pain, inability to communicate, sleep disturbances, and confusion, which can last even after discharge. As a critical care nurse, I believe this study’s results can help nurses be more vigilant about the patients’ feelings after discharge, and hospitals should offer therapy. 

#2

Perceptions on the Implementation of a School Nurse

The study implemented qualitative descriptive research to examine what stakeholders thought about establishing a school nursing pilot program in the Canary Islands. This research design allowed researchers to collect diverse input and firsthand accounts about the program’s implementation. The study participants came from groups of school nurses, teachers, parents, and students who joined the pilot program. This qualitative research needed 25 participants who helped reach data saturation and yielded valuable and detailed insights. The research focused on groups and semi-structured interviews to study how program stakeholders think and feel about their implementation experience. It gathered information from interviews from focus groups and used thematic analysis to process the data. This method helps researchers find patterns and themes in qualitative data while providing a structured way to understand how study participants think and feel. The study focused on understanding how various school members evaluated and felt about this nursing initiative. The research showed how the program affected student health while uncovering implementation difficulties and why stakeholder cooperation matters. Research findings demonstrate that stakeholders think the program makes students healthier and improves their wellbeing. The research found both benefits and struggles from stakeholders’ viewpoints including resource constraints and ineffective team communication. The research team highlighted the need to maintain consistent support and learning opportunities for school nurses. School nursing programs prove effective at boosting student health if stakeholders provide sufficient support. These conclusions can be used to launch additional programs which can fix challenges in resource distribution and working relationships among partners.

• Explain the controversy that surrounds dissociative disorders.
• Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.
• Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
• Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.

References x 4

• Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer. 
  • Chapter 11, “Dissociative Disorders”

PICK ONE BELOW 

1. Jim is a 69-year-old male who comes in today complaining of dyspnea on exertion, and you have noted that he has gained about 25 pounds since his last visit 7 months ago. He tells you that he is not sleeping at night because of a constant cough, and he thinks he has a cold because he is coughing up pink frothy “spit”. He is extremely fatigued because of his lack of sleep.  Your examination reveals bilateral 3+ pitting edema with his lower extremities being cool to the touch, distended abdomen, hepatomegaly, hacking cough, and S3 with a gallop. Jim had a myocardial infarction (MI) 15 years ago, and his currently on medication for hypertension.
2. Matthew is a 52-year-old truck driver who is seeing you today for his physical. He states that he has been in his usual state of health but missed his physical for the past few years.  His BP is 165/90, HR 90, Height is 6’2, and Weight is 204. Total Cholesterol 244, HDL 32 LDL 166 Triglycerides 344 A1C 6.8.
3. Jennifer is an 84-year-old who recently returned from London with her husband. She comes to your clinic as a walk-in from the airport because she does not feel well. She has felt shaky, a little short of breath, and slightly light-headed for the past 2 to 3 hours. She did not take her Norvasc or Lisinopril this morning because she didn’t feel well. She presents to you slightly diaphoretic. Her BP is 90/50, HR is 155, and RR 20. She is alert and oriented.