Ukamaka Oruche
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Dr. Ukamaka Oruche’s interdisciplinary intervention program supports parents and caregivers of adolescents with disruptive behavior disorders (DBD). Adolescents with DBD, characterized by ongoing patterns of antisocial and defiant behaviors, have lower educational achievement, greater involvement with the criminal justice system, and lower rates of stable, long-term placement in the child welfare system than adolescents without DBD.
These adolescents have complex treatment regimens that require active parent involvement with child service and mental health systems. Parents describe feeling stressed, disrespected, and blamed for their adolescents’ behavior problems. These negative experiences leave parents feeling disengaged from care and less likely to follow recommended treatment, which can contribute to poor adolescent outcomes.
Low-income urban parents, particularly African Americans, are at greater risk for aversive interactions with professionals because of socio-economic disadvantage. Dr. Oruche developed the theoretical-based Family Management Efficacy intervention to address the stress parents and caregivers experience in caring for their adolescents with DBD.
Her intervention research is designed to strengthen family member’s perceived self-efficacy to manage interactions both within the family and with child service system professionals. Research products include a standardized treatment manual, a facilitator guide, parent workbooks, and fidelity checklists.
Dr. Oruche’s work to support parents and caregivers of adolescents with DBD is another example of how IUPUI faculty are TRANSLATING RESEARCH INTO PRACTICE.
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Item Executive summary: Indiana Schools of Nursing substance abuse education(2022) Oruche, Ukamaka M.; Adams, Nicole; Xu, Jiayun; Crowder, Sharron; Cangany, Martha; Bracale, Jolene; Ofner, Susan; Fulton, Janet S.Item Preparing Nurse Practitioner Students to Recognize Health Inequities and Global Health Issues(2022-07-24) Oruche, Ukamaka M.; Moorman, Meg; deRose, Barbara; Berlanga King, Gloria; Antisdel, J'AndraThis is a quality improvement project to enhance the preparation of advanced practice or master's level nursing students training for workplace readiness to serve ALL patients and advance health equity locally and globally.Item Educational QUality-improvement in APRN Learning: Reducing Health Inequities for ALL Program (EQUAL-ALL Program)(2020-03-03) Oruche, Ukamaka M.We proposed a quality improvement project focused on MSN students to ensure they are well prepared to contribute with all diverse patient populations from both the United States and beyond. Specific aims are to assess MSN students’ learning needs and develop and implement a training program to increase MSN students’ knowledge and skills for working with different others.Item Integrating the “Cultural Health Capital” Module Throughout the PMHNP Program to Promote Students’ Abilities to Reduce Health & Health Care Disparities(Indiana University, 2020) Oruche, Ukamaka M.; Hone, Augustina; Henline, S.Item The Role and Practice of Clinical Nurse Specialist in Nigeria(Springer, 2021) Obichi, Chidiebele Constance; Anieche, John Emenike; Osuala, Eunice Ogonna; Oruche, Ukamaka M.; Fulton, Janet S.; Holly, Vincent W.Although the clinical nurse specialist was recognized as an expert practitioner in the United States for 50 years, there is an absence of a framework for the clinical nurse specialist role in Nigeria. There are three pathways through which the federal government, state government, and private sector provide specialist education and training for nurses in Nigeria. Nurses who have received graduate education should practice to the full extent of their education and training. Also, nurses who have their practice expanded in the treatment of communicable diseases and reproductive, maternal, newborn, and childcare should be appropriately recognized. This chapter explores challenges to developing the clinical specialist nurse role in Nigeria and the extent to which the clinical nurse specialist role is evolving in Nigeria through specialist education and training for nurses. Regardless of the pathway, setting, or specialty, Nigerian nurses may have achieved many clinical nurse specialist core competencies without a formal master’s education. Hence, Nigeria is long overdue for the development, recognition, and legal inclusion of the clinical nurse specialist role and practice in the career structure of nurses at all levels of the Nigerian health system.Item Individualized approach to primary prevention of substance use disorder: age-related risks(Springer, 2020-08-14) Afuseh, Eric; Pike, Caitlin; Oruche, Ukamaka M.; University LibraryBackground The misuse of legal and illegal substances has led to an increase in substance use disorder (SUD) in the United States. Although primary prevention strategies have been successfully used to target chronic physical diseases, these strategies have been less effective with SUD, given misconceptions of SUD, shortages in behavioral health professionals, and the population-based focus on specific substances. A developmental approach to the identification and primary prevention of SUD that does not fully rely upon behavioral health workers is needed. The purpose of this paper was to examine age related risk factors for developing SUD and present a novel individualized approach to SUD prevention. Methods A literature search was conducted to identify risk factors for SUD among children, young adults, adults, and older adults. We searched CINAHL, PsycINFO, and PubMed between the years 1989–2019, and extracted data, analyzing similarities and differences in risk factors across life stages. Broader categories emerged that were used to group the risk factors. Results More than 370 articles were found. Across all age groups, risk factors included adverse childhood experiences, trauma, chronic health diseases, environmental factors, family history, social determinants, and grief and loss. Despite the similarities, the contextual factors and life challenges associated with these risks varied according to the various life stages. We proposed an approach to primary prevention of SUD based on risk factors for developing the disease according to different age groups. This approach emphasizes screening, education, and empowerment (SEE), wherein individuals are screened for risk factors according to their age group, and screening results are used to customize interventions in the form of education and empowerment. Given that trained persons, including non-healthcare providers, close to the at-risk individual could conduct the screening and then educate and mentor the individual according to the risk level, the number of people who develop SUD could decrease. Conclusions The risk factors for developing SUD vary across the various life stages, which suggests that individualized approaches that do not overtax behavioral healthcare workers are needed. Using SEE may foster early identification and individualized prevention of SUD.Item Activation in persons with mental health disorders: An integrative review(Wiley, 2021-07-26) Keen, Alyson; Lu, Yvonne; Oruche, Ukamaka M.; Mazurenko, Olena; Burke Draucker, Claire; School of NursingWHAT IS KNOWN ON THE SUBJECT?: Evidence indicates a strong relationship between patient activation (i.e. confidence, knowledge and skills to self-manage health) and positive health behaviours and outcomes in a variety of clinical populations. Because persons with mental health disorders experience significant disease burden but often underutilize mental health treatment or experience poor treatment outcomes, they would likely benefit from increases in activation. No systematic reviews have been conducted to summarize and synthesize research on patient activation in persons with mental health disorders. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: To our knowledge, this is the first comprehensive review to identify factors associated with activation and interventions that have shown to be effective in persons with mental health disorders. This integrative review indicates that better health status, less depression, positive health attitudes and behaviours, and higher quality therapeutic relationships may be associated with higher levels of activation in persons with mental health disorders. This review also indicates that a variety of interventions, most notably educational programs, are effective in increasing levels of patient activation in persons with mental health disorders. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric mental health nurses and other clinicians should consider routine assessment of patient activation to inform individualized treatment plans for their clients. Clinicians should aim to form high-quality therapeutic relationships with clients as a way to promote higher levels of activation. Interventions that have been found to be effective in improving activation could be offered in a variety of mental health settings. ABSTRACT: Introduction Patient activation is understanding one's role in the healthcare process and having confidence, knowledge, and skills to self-manage one's health and health care. Researchers have begun to investigate patient activation in persons with mental health disorders, but no systematic reviews have been conducted to summarize and synthesize this research. For psychiatric mental health nurses and other clinicians to develop strategies to increase patient activation in this population, more information is needed about factors associated with activation and interventions that increase activation. Review Questions (1) What factors are associated with levels of activation in persons diagnosed with mental health disorders? (2) What interventions have shown to be effective at increasing levels of activation in persons diagnosed with mental health disorders? Method A 5-stage integrative review as described by Whittemore & Knafl. Results Twenty-nine articles were included in the review. Ten provided correlations between activation and other factors, and 20 examined the effects of interventions on activation. Some studies revealed significant correlations between a variety of health and treatment-related factors, and others revealed that some interventions, most notably educational programs, were shown to increase activation. Discussion The findings of this comprehensive review can inform psychiatric mental health nurses and other clinicians in developing strategies to increase activation in the patients with whom they work. More research is needed to provide a deeper understanding of the role of activation in the recovery and treatment of persons with mental health disorders. Implications for Practice Psychiatric nurses and other clinicians should assess for patient activation and incorporate strategies to increase levels of activation in patients in their practice. Positive therapeutic relationships likely enhance activation in persons with mental health disorders.Item A Review of Nursing Position Statements on Racism Following the Murder of George Floyd and Other Black Americans(Association of Nurses in AIDS Care (Wolters Kluwer), 2021-07) Knopf, Amelia; Budhwani, Henna; Logie, Carmen H.; Oruche, Ukamaka M.; Wyatt, Erin; Burke Draucker, Claire; School of NursingNational outrage over the killings of George Floyd and other Black Americans in the United States prompted public outcry against police brutality and racism in law enforcement and drew national attention to systemic racism as a public health crisis. In response, during the summer of 2020 many health organizations issued position statements in response to the murders. This article examines such statements issued by 3 prominent nursing organizations and 18 schools of nursing. Thematic analysis revealed six themes in the statements of the professional organizations, and a content analysis revealed that the statements of the schools of nursing were generally aligned with these themes. Such position statements can provide a viable approach to the public commitment to anti-racist reforms, but it is unclear if such statements can promote meaningful and measurable change.Item Perceptions of the barriers, facilitators, outcomes, and helpfulness of strategies to implement screening, brief intervention, and referral to treatment in acute care(Springer Nature, 2021-04-23) Keen, Alyson; Thoele, Kelli; Oruche, Ukamaka M.; Newhouse, Robin; School of NursingBackground Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a clinical intervention used to address alcohol and illicit drug use. SBIRT use has resulted in positive health and social outcomes; however, SBIRT implementation remains low. Research on implementing interventions, such as SBIRT, lacks information about challenges and successes related to implementation. The Expert Recommendations for Implementing Change (ERIC) provides a framework to guide comprehension, clarity, and relevance of strategies available for implementation research. This framework was applied to qualitative feedback gathered from site coordinators (SCs) leading SBIRT implementation. The purpose of this study was to describe the SCs’ experiences pertaining to SBIRT implementation across a health system. Methods Within the context of a larger parent study, a semi-structured interview guide was used to capture 14 SCs’ perceptions of the barriers, facilitators, and outcomes pertaining to SBIRT implementation. Qualitative data were analyzed using standard content analytic procedures. A follow-up survey was developed based on 14 strategies identified from qualitative data and was administered electronically to determine the SC’s perceptions of the most helpful implementation strategies on a scale of 1 (least helpful) to 5 (most helpful). Results All 14 invited SCs participated in the SBIRT implementation interview, and 11 of 14 (79%) responded to the follow-up survey. Within the categories of barriers, facilitators, and outcomes, 25 subthemes emerged. The most helpful implementation strategies were reexamining the implementation (M = 4.38; n = 8), providing ongoing consultation (M = 4.13; n = 8), auditing and providing feedback (M = 4.1; n = 10), developing education materials (M = 4.1; n = 10), identifying and preparing champions (M = 4; n = 7), and tailoring strategies (M = 4; n = 7). Conclusion SCs who led implementation efforts within a large healthcare system identified several barriers and facilitators to the implementation of SBIRT. Additionally, they identified clinician-related outcomes associated with SBIRT implementation into practice as well as strategies that were helpful in the implementation process. This information can inform the implementation of SBIRT and other interventions in acute care settings.