Mental stress: Unique solutions for unique populations

The common link -- stress -- is the focus of Johns Hopkins University School of Nursing (JHUSON) PhD Candidate Jan Kaminsky and Doctor of Nursing Practice (DNP) student Jemma Ayvazian.

Working with a group of mothers who had participated in a co-residential prison nursery program, Kaminsky surveyed to see if an insecure maternal attachment due to incarceration was associated with harsher child discipline practices and higher levels of maternal depression. In collaboration with her mentor Dr. Mary Byrne, Columbia University School of Nursing, and through Byrne's ongoing study with these mothers, Kaminsky administered a 20-question Conflict Tactics Scale to determine what types of discipline (non-violent, psychological, and physical assault) they had administered over the past 12 months after their release from prison.

Kaminsky learned that while all mothers reported some use of non-violent discipline, the majority used psychological aggression and minor physical assault against their children, and mothers who had faced significant depression were more likely to utilize physical assault.

Kaminsky was encouraged that most mothers had a strong understanding of and desire to break the cycle of incarceration and family instability they once experienced. She felt prison nursery use was a way to help improve the lives of these vulnerable families, while advancing each mothers' attachment model with their children. One mother, referring to her daughter, said, "She was very full of herself…that she knows that she can accomplish anything. And...you know...I've taught her that…that she can do anything she wants to do with her life."

Looking at a very different population, Jemma Ayvazian is using a remote Veteran's Administration facility to identify care components necessary to produce positive outcomes for veterans who sustained Polytrauma/Traumatic Brain Injury (TBI) during the Iraq and Afghanistan wars.

Ayvazian hopes to promote recovery and successful reintegration into the community and decrease the time Polytrauma/TBI veterans spend in the post-acute and chronic phase. She is also considering development of a phone application that will provide free health information through text messages to clinicians, family members, care givers, and the veterans themselves.

Ayvazian remembers her husband's deployment to Iraq in March of 2003. "I saw soldiers coming back from the war zone with multiple problems: I wanted to somehow help…Although it is difficult for me to witness what our veterans and their families go through, helping -- one at a time -- making a meaningful impact on their lives, serving as their advocate, making sure that their voices are heard and their needs are met is the most rewarding experience."