Evidence Based Nursing Research

This document discusses the proposed solution of providing mindfulness based cognitive therapy to military veterans with mental health issues such as depression and PTSD. It explores the effectiveness of this intervention and the potential barriers to its implementation. The expected outcomes and methods to achieve them are also discussed.

Running head: EVIDENCE BASED NURSING RESEARCH
Evidence based nursing research
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Proposed solution
a) In response to the prevalence of mental health issues like depression and post traumatic
stress disorder (PTSD) in military veterans, the proposed solution is to provide 10 week
mindfulness based cognitive therapy to the population at risk. This solution has been
targeted particularly because mindfulness technique has the potential to address both
suicide ideation as well as depressive symptoms. Another reason behind choosing this
intervention is that it is consistent with current evidence too which shows the efficacy of
the solution in promoting mental health of military veterans. Kline et al. (2016) gave the
evidence regarding the efficacy of mindfulness based cognitive therapy in reducing risk
of suicide and improving quality of life for military veterans and their family. A literature
review by Boyd, Lanius and McKinnon (2018) gave evidence regarding the effectiveness
of mindfulness based treatment as a promising adjunctive approach for people with
PTSD. The reason behind this is that mindfulness target specific features of PTSD
particularly shame, avoidance, guilt, hyperarousal and emotional numbing. Hence,
mindfulness works to reduce ruminative tendencies and promote people’s capacity for
attention control and reduction in negative behaviours.
b) Although the review of research literature shows the potential of the mindfulness based
therapy in addressing depressive symptom in military veterans, however the intervention
is unrealistic to be implemented in the health and counselling department of the military
unit because of lack of staffs to deliver the therapy. Another barrier to the application of
the intervention is that although the existing staffs at the selected unit lack training to
deliver the intervention. Hence, to make the solution feasible in the target setting, first
strategy would be to incur additional expense to recruit staffs with knowledge and

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experience in delivering cognitive based therapy or implement an extensive training
session where mental health staffs can be trained regarding the way to deliver the therapy
in the target setting. This is essential to ensure that all resource needed for advanced
practice is present at the setting (DeNisco & Barker, 2015).
Organization culture:
The chosen intervention is consistent with the organization culture because the military
unit has an internal focus to maintain high quality care and optimal health of military personnel.
Hence, as the mindfulness based therapy is likely to improve mental health, reduce risk of social
isolation and reduce risk of suicide ideation, the intervention is consistent with the organization’s
vision of providing high quality care. As the chosen organization is a military unit and the
organizers are flexible to changes in infrastructure based on need, there is a high probability of
successful uptake of the intervention. If appropriate evidence or data regarding the problem of
depression or PTSD among military veterans are provided, there is a probability that the
organization can readily accept the intervention.
Expected outcome:
The expected outcome of the project is as follows:
 Reduction in symptoms of depression and PTSD
 Reduction in suicide ideation and rate of suicide among military veterans
 Improvement in quality of life of military veterans
Method to achieve outcome:
The above outcomes will be achieved by taking the following steps:

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1. Firstly, military veterans with symptom of depression and suicide ideation will be taken
in the study
2. All the sample group will be provided 10 weeks of mindfulness based therapy
3. The reduction in symptom of depression will be evaluated by the use of Beck’s
Depression Inventory which is a validated and consistent tool to identify severity of
symptoms in client
4. The rate of reduction in suicidal events and improvement in suicide ideation behaviour
will be evaluated
At this point, it is possible that military veterans might also have other health problems like
cognitive disorder and multiple diseases which might contribute to mental health issues. As this
can act as confounding factors, the strategies is to first screen people by means of DSM-IV
criteria for mental disorder and then provide the 10 week session c
Outcome impact:
If expected outcome is achieved for the military veterans, it is likely to enhance
professional expertise of client as they can focus on task and concentrate more when they do not
struggle with negative emotions like depression. It would also lead to quality care improvement
for the military unit because earlier the unit had no special treatment or therapy to treat people
with depression and PTSD (Polusny et al., 2015). However, implementation of training and
infrastructure for PTSD is likely to improve the quality care provision.
Conclusion:
To conclude, the paper gave an insight into the effectiveness of the proposed solution of
mindfulness based therapy for military veterans with depression and suicide ideation. The

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common theme that makes the solution consistent with other research includes reduction in
suicide risk, quality of life improvement, decreasing ruminant thoughts and addressing core
features related to PTSD. Hence, as the intervention targets the thinking pattern of people and
helps them to achieve a sense of control, it is likely to promote mental health of military
veterans.

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References:
Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2018). Mindfulness-based treatments for
posttraumatic stress disorder: a review of the treatment literature and neurobiological
evidence. Journal of Psychiatry & Neuroscience.
DeNisco, S. M., & Barker, A. M. (2015). Advanced practice nursing: Essential knowledge for
the profession. Jones & Bartlett Publishers.
Kline, A., Chesin, M., Latorre, M., Miller, R., Hill, L. S., Shcherbakov, A., ... & Interian, A.
(2016). Rationale and study design of a trial of mindfulness-based cognitive therapy for
preventing suicidal behavior (MBCT-S) in military veterans. Contemporary clinical
trials, 50, 245-252.
Polusny, M. A., Erbes, C. R., Thuras, P., Moran, A., Lamberty, G. J., Collins, R. C., ... & Lim,
K. O. (2015). Mindfulness-based stress reduction for posttraumatic stress disorder among
veterans: a randomized clinical trial. Jama, 314(5), 456-465.