Veterans' experiences with and perspectives on insomnia treatment: A qualitative study.

Qualitative interviews were conducted with veterans to understand their experiences and perceptions about insomnia and its treatment, with a focus on cognitive-behavioral therapy for insomnia (CBT-I) and brief behavioral treatment for insomnia (BBTI). There is a lack of knowledge about veterans' understanding of this prevalent disorder, yet their experiences and perceptions can influence treatment delivery and treatment outcomes. The Department of Veterans Affairs (VA) can improve insomnia care by considering and responding to this valuable information from veteran stakeholders.

The Future of Nursing Education: Multidisciplinary Community-Engaged Research for Undergraduate Nursing Students.

Background: Undergraduate nursing students with research experience are more likely to pursue graduate education. Community-engaged research mentoring facilitates not only this process but also student engagement in topics such as cultural relevance and community partnerships.

Method: Two cohorts of undergraduate students participated in a novel yearlong multidisciplinary mentored research experience based in a predominantly Black community.

Wise Women's Provision of Maternal-Child Health Information and Support for Urban, African American Women.

The United States is experiencing a maternal-child health (MCH) crisis including racial inequalities in mortality. This study explored the roles of lay experts who provide information and support to women of childbearing age (i.e.

Mental health treatment preferences and challenges of living with multimorbidity from the veteran perspective.

Objective: To explore middle-aged and older veterans' current disease-management practices, mental health treatment preferences, and challenges of living with multiple chronic health conditions (i.e., multimorbidity).

Racial Differences in Veterans' Satisfaction With Addiction Treatment Services.

Objectives: Racial minorities experience lower rates of alcohol treatment completion than whites. Treatment satisfaction is an important factor in alcohol treatment retention, yet few studies have explored the satisfaction of racial minorities while in treatment. This study examined racial differences in addiction treatment satisfaction and explored factors that might mediate or moderate racial differences in satisfaction.

Telepsychiatry in the assessment and treatment of schizophrenia.

Background: Telehealth technology has become more available to providers as a means of treating chronic diseases. Consideration of the applicability of telehealth technology in the treatment of schizophrenia calls for a review of the evidence base in light of the special needs and challenges in the treatment of this population. Our aims are to assess the types and nature of distant interventions for patients with schizophrenia, either telephone-based, internet-based or video-based telehealth systems.

Factor structure and risk factors for the health status of homeless veterans.

Homeless veterans have numerous health problems that have been previously characterized as falling into four major subgroups; addiction, psychosis, vascular disorders, and generalized medical and psychiatric illness. Comorbid conditions are common, often involving a combination of psychiatric and medical disorders. Using data from the same survey of homeless veterans that was used to establish these subgroups with cluster analysis, the present study examined the structure of these subgroup patterns through the use of factor analysis.

Comorbidity between psychiatric and general medical disorders in homeless veterans.

Homeless veterans have numerous co-occurring medical and behavioral health problems. Identification of common patterns of comorbid conditions may help providers to determine severity of medical conditions and triage health care more effectively. In this study we identify such patterns of comorbid medical and psychiatric disorders using cluster analysis and we evaluate relationships between these patterns and sociodemographic factors.

Veterans' decision-making preferences and perceived involvement in care for chronic heart failure.

Background: Patients with heart failure require a great deal of information about their disease, but it is also important to know about their preferences for involvement in medical decision making and about factors that may influence their preferences so that patients' needs, values, and preferences can be met by clinicians.

Objectives: We assessed patients' preferred role and perceived level of involvement in medical decision making and tested the effects of patients' age and role preference on perceived involvement in medical decision making.

Methods: We conducted a telephone survey of 90 adults being treated for heart failure by a Veterans Affairs primary care provider or cardiologist.

"They diagnosed bad heart": a qualitative exploration of patients' knowledge about and experiences with heart failure.

Background: Patient education is central to the management of individuals with heart failure; therefore, it is important to know what these patients understand and experience both clinically and personally.

Objectives: This study qualitatively explored patients' knowledge regarding a heart failure diagnosis, their understanding of their cardiac care providers' treatment recommendations, and their views concerning the impact of heart failure on their daily lives and prognosis.

Methods: A qualitative study was conducted whereby data were collected through 25 telephone interviews with adults being followed for heart failure at a Veterans Affairs medical center.

Racial differences in expectations of joint replacement surgery outcomes.

Objective: Prior studies have indicated racial differences in patients' expectations for joint replacement surgery outcomes. The goal of this study was to measure these differences using a well-validated survey instrument and to determine if the differences could be explained by racial variation in disease severity, socioeconomic factors, literacy, or trust.

Methods: Detailed demographic, clinical, psychological, and social data were collected from 909 male patients (450 African American, 459 white) ages 50-79 years with moderate or severe osteoarthritis (OA) of the hip or knee receiving primary care at 2 veterans affairs medical centers.

Polypharmacy and health beliefs in older outpatients.

Background: Polypharmacy is a significant problem among older adults. Patient-related characteristics and beliefs have not been the focus of prior research in this area, which has primarily evaluated the effects of patients' health status and health care system factors.

Objective: The goal of this research was to determine the prevalence and predictors of unnecessary drug use in older veteran outpatients, with a focus on patient-related factors and health beliefs.

Arthritis-specific health beliefs related to aging among older male patients with knee and/or hip osteoarthritis.

Background: Disease-specific beliefs may impact patients' perceptions of the efficacy of various treatment options, thus, it is important to understand these beliefs. We examined the relationship between patients' demographic characteristics and arthritis-specific beliefs related to aging.

Methods: We performed a cross-sectional survey of 591 elderly primary care patients, who had symptomatic osteoarthritis (OA) of the knee and/or hip, at the Louis Stokes VA Medical Center in Cleveland, Ohio.

African American veterans' experiences with mobile geriatric care.

To explore perspectives concerning use of a mobile geriatrics unit (MGU) by underserved populations in low-income urban neighborhoods, we recruited 18 elderly African American patients and engaged them in in-depth semistructured interviews. Using grounded theory techniques of constant comparative analysis, we found that most patients learned about the MGU from community members and initially visited it to determine whether it would be worth using in the future. In describing their MGU experiences, patients tended to focus on three main factors: quality of care, accessibility of services, and ambience of the care setting.