71 results
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2. Using the Nominal Group Technique to determine a nursing framework for a forensic mental health service: A discussion paper.
- Author
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Maguire, Tessa, Garvey, Loretta, Ryan, Jo, Olasoji, Michael, and Willets, Georgina
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CONSENSUS (Social sciences) , *PSYCHIATRIC nursing , *DISCUSSION , *CORRECTIONAL institutions , *MINORITIES , *CONCEPTUAL structures , *FORENSIC nursing , *NURSING research , *DECISION making in clinical medicine , *FORENSIC psychiatry , *THEMATIC analysis , *GROUP process , *MENTAL health services , *DELPHI method - Abstract
The Nominal Group Technique is a method used to explore issues, generate ideas, and reach consensus on a topic. The Nominal Group Technique includes individual and group work and is designed to ensure participants have the same opportunity to engage and provide their opinions. While the technique has been used for around six decades to assist groups, in industry, and government organizations to examine issues and make decisions, this technique has received limited attention in nursing research, particularly in mental health. This discussion paper describes the use of a modified Nominal Group Technique for a study designed to determine a nursing decision‐making framework for a state‐wide forensic mental health service. Modifications were made to the traditional technique, to enable participants to make an informed and collective decision about a suitable framework for the novice to expert nurses, across secure inpatient, prison, and community forensic mental health settings. The Nominal Group Technique generated rich data and offered a structured approach to the process. We argue that the Nominal Group Technique offers an exciting and interactive method for nursing research and can increase opportunity for minority group members to participate. This technique also offers a time efficient way to engage busy clinical nurses to participate in research, with the advantage of members knowing the decision on the day of the group. Consideration, however, needs to be given to the duration and effect on participant concentration, and if not actively managed by facilitators, the possible emergence of group dynamics affecting individuals' decisions. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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3. Nurse Experiences of Caring for Medically Compromised Adolescents With Eating Disorders in General Hospital Environments: A Scoping Review.
- Author
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Gamlath, Inuri, Buchanan‐Hagen, Sally, Alexander, Louise, and Searby, Adam
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EATING disorders in adolescence , *MENTAL health services , *EATING disorders , *PSYCHIATRIC hospitals , *BODY weight , *PSYCHIATRIC nursing - Abstract
ABSTRACT Eating disorders encompass a spectrum of mental health conditions that are characterised by a preoccupation with eating, exercise, body weight or shape. The trajectory of eating disorders can result in hospitalisation for medical complications, such as electrolyte imbalance, extremely low weight and other medical issues that require urgent inpatient attention. Typically, care for adolescents with medically compromised eating disorders occurs in general medical settings, with most care provided by nurses who may or may not have the training and experience to provide quality care for this complex mental health condition. The aim of this scoping review is to examine literature surrounding the experience of nurses caring for adolescents admitted to general medical wards (non‐mental health settings) with medically compromised eating disorders. We used Arksey and O'Malley's (2005) five‐step scoping review process to conduct this review. A systematic search of the literature located 476 relevant papers, and after screening, 10 were included in the final review. Most included papers were qualitative in methodology, with one using a mixed‐methods design. The papers examined in this scoping review found common themes among nurses who were providing care for adolescents with medically compromised eating disorders being cared for in medical wards (non‐mental health settings): a lack of preparation to care for individuals with eating disorders, a high emotional and psychological toll on nurses providing care and a degree of stigma towards adolescents with eating disorders, including a belief that eating disorders were a ‘choice.’ This review indicates that to provide quality and safe care for adolescents with eating disorders admitted to general medical wards, nurses require specialised training. In addition, the care of adolescents with medically compromised eating disorders requires the support of trained mental health nurses, especially where nurses on general medical wards are novice or have limited mental health training. We recommend further research into support structures to prevent burnout and turnover that is prevalent when providing care to individuals with eating disorders. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Young People Transitioning From Child and Adolescent to Adult Mental Health Services: A Qualitative Systematic Review.
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Rosina, Robyn, McMaster, Rose, Lovecchio, Victoria, and Wu, Chiung‐Jung
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ECOLOGICAL systems theory , *MENTAL health services , *YOUNG adults , *LIFE change events , *TRANSITION to adulthood , *CHILD mental health services - Abstract
ABSTRACT To critically synthesise the literature on the lived experience of young adults about their transition to adult mental health services including the perspectives of key people in their world: parents, carers and clinicians. Young people within child and adolescent mental health services are usually required to transition to adult mental health services at the age of 18, despite evidence showing cognitive and emotional development impacted by childhood trauma, illness and adverse life events. This qualitative systematic review searched relevant electronic databases, policy documents, grey literature and theses examining original qualitative peer‐reviewed studies published from 2009 to 2022 in English. The process utilised the PRISMA guidelines and the quality of papers assessed by the JBI critical appraisal tool. Nine papers met the criteria for inclusion in the review. The results indicate that qualitative research listening to the voices of young people transitioning to adult mental health services is a rarity. Even fewer papers examine the perspectives of key people in their lives: this review has critically synthesised the literature on the lived experience of young adults about their transition to adult mental health services including the perspectives of key people in their world: parents, carers and clinicians. The main themes identified include: age 18 is not a helpful trigger to transition; young people want more individualised planning; parents want more involvement and clinicians open up about a challenging nexus with adult mental health services. [ABSTRACT FROM AUTHOR]
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- 2024
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5. The Extended Social Network‐Oriented Support Model for Intimate Partner Violence Survivors.
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Davies, Ryan L., Rice, Kylie, and Rock, Adam J.
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INTIMATE partner violence , *SOCIAL support , *SOCIAL boundaries , *SOCIAL networks , *PREPAREDNESS - Abstract
ABSTRACT Intimate partner violence (IPV) transcends cultural, social and economic boundaries, affecting countless individuals globally. Recovery for IPV survivors is supported by their social networks, yet the readiness of these networks is often poorly understood. This perspective paper proposes an extension to existing network‐oriented IPV support models by integrating a focus on the readiness and well‐being of informal supporters towards the goal of enhancing IPV survivor recovery through effective networks. This paper presents the extended social network‐oriented support model, incorporating the Informal Supporter Readiness Inventory. This tool assesses the readiness of informal supporters, incorporating factors, such as normative and individual beliefs about IPV, and context‐specific factors, to enable identification and targeted assistance where needed. Additionally, the proposed model emphasises the importance of supporting the well‐being of informal supporters, who frequently endure elevated levels of stress, anxiety and depression. By integrating these elements, the extended social network‐oriented support model is designed to help professional supporters foster resilient and sustainable support networks for IPV survivors, with potential applicability across various healthcare disciplines. The extended model underscores the necessity of assessing and fostering both the readiness and well‐being of informal supporters to enhance the recovery journey for IPV survivors. [ABSTRACT FROM AUTHOR]
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- 2024
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6. The Memoir of a Ghost: The Invisible Plight of Mental Health Nurse Education in the United Kingdom Following the Nursing and Midwifery Council's Move Towards Genericism.
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Warrender, Dan
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MENTAL health education , *NURSING education , *COOPERATIVE education , *PSYCHIATRY education , *EDUCATIONAL standards , *PSYCHIATRIC nursing - Abstract
ABSTRACT The aim of this paper is to identify barriers to quality mental health nurse education in the United Kingdom and show these through the sharing of personal experiences of working as a mental health nurse academic. Since the Nursing and Midwifery Council introduced their ‘future nurse’ education standards in 2018, mental health content for mental health nurses has been argued to have been marginalised. The sense of a diluted mental health nurse education was supported by an open letter, signed by over 100 mental health nurses, with representation across 33 universities. Nonetheless, the approach taken by the NMC has been defended. Meanwhile, mental health nurse academics all over the United Kingdom are having varying experiences, some of incredible discomfort and invalidation. The movement ‘mental health deserves better’ arose through many of these mental health nurses feeling they had no representation or channel to voice their concerns. This is a personal position paper which outlines barriers to autonomy for mental health nurse academics, and shares personal opinion on experiences which have impacted the ability to deliver a depth of knowledge, skill and critical thinking to students, impacting the quality of new mental health nurse graduates. The issue is discussed using contemporary literature to support lines of argument, which are augmented by personal experiences of working in nurse education. There are complex interconnected issues within nurse education which can hinder the autonomy of mental health nursing to decide its own future. This paper recounts a personal journey. Often we cannot understand the failings of a system until we try to navigate it from the inside. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Barriers and Enablers for Adolescents Accessing Substance‐Use Treatment: A Systematic Review and Narrative Synthesis.
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James, Philip D., Nash, Michael, and Comiskey, Catherine M.
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YOUNG adults , *PSYCHIATRIC nursing , *HEALTH services accessibility , *TEENAGERS , *SUBSTANCE abuse - Abstract
ABSTRACT Substance use is a persistent concern for adolescents in many countries due to the significant negative impact on mental, physical and social outcomes. US research indicates that while 4.1% of 12–17‐year‐olds require treatment, <10% of those who require it access it. This paper summarises the literature available on the barriers and enablers to those under 18s attending substance use treatment to inform policy and practice. Using a systematic approach, we searched six databases for studies which reported barriers and enablers to those aged 18 and under accessing substance use treatment. Thirty‐two papers met the inclusion criteria and we present the findings using a narrative synthesis. Only one paper identified explored this topic in Europe. Barriers and enablers are presented across four themes: (1) individual factors, (2) societal factors, (3) Gateway Providers and (4) treatment service factors. Mental health nurses, especially those working with young people, should be aware that adolescents are unlikely to perceive their substance use as problematic and rely on adults to access treatment. Access appears more difficult for females and socially marginalised youth. Various professionals direct young people towards treatment, but clear protocols are needed to encourage them to intervene, which could be an opportunity for nurses to be innovative and lead in this area. Services perceived as adolescent‐specific, youth‐friendly and flexible encourage attendance while the cost of treatment, including time off work and transport, function as barriers. [ABSTRACT FROM AUTHOR]
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- 2024
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8. The shame of sexual violence towards women in rural areas.
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Jones, Rikki, Usher, Kim, Rice, Kylie, Morley, Louise, and Durkin, Joanne
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WOUNDS & injuries , *POST-traumatic stress disorder , *SEX crimes , *MENTAL health , *MEDICAL personnel , *RURAL health , *EMOTIONS , *FAMILIES , *COMMUNITIES , *RURAL conditions , *GUILT (Psychology) , *EMBARRASSMENT , *SHAME , *WOMEN'S health , *SOCIAL support , *SOCIAL control , *SOCIAL stigma - Abstract
This perspective paper presents a discussion around the issues of sexual violence (SV) in rural and remote areas and the associated discourses of shame. The authors propose that shame of SV adds additional trauma to survivors, further impacting survivors' mental health which may be exacerbated in rural areas. Shame is a complex emotion that can result in increased feelings of guilt, humiliation, and embarrassment. Shame has been identified as an underlying risk factor and a mechanism for post‐assault mental health problems. We propose it can be particularly pronounced for women subjected to sexual assault in rural or remote areas. This paper will explore the link between SV and shame, explain how shame attached to SV may be used as an informal social control mechanism for women, particularly in rural and remote areas, and discuss the role of health practitioners, particularly mental health nurses, who play a key role in supporting people impacted by SV. SV is an insidious social phenomenon that can have profound consequences for individuals, families, and communities. Addressing shame and stigma is a crucial component of supporting survivors of SV in rural and remote areas. There is a need for targeted community‐led interventions and responsive support services to address the complex and multifaceted issues contributing to SV in rural and remote communities. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Revisiting Alcohol Consumption Among Nurses After the COVID‐19 Pandemic: A Qualitative Descriptive Study.
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Searby, Adam, Burr, Dianna, and Alexander, Louise
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ABSTRACT The COVID‐19 pandemic continues to cause nurses stress and trauma, with alcohol potentially being used to manage this stress. Prior studies of nurses' alcohol consumption during the COVID‐19 pandemic have shown increases in alcohol consumption to manage stress associated with the pandemic. The aim of this paper is to explore perceptions of alcohol consumption and stress among nurses, particularly since the declared end of the COVID‐19 pandemic. We used semi‐structured interviews with Australian nurses (n = 55), using a qualitative‐descriptive study design, conducted between October 2023 and January 2024. Data were analysed using structural coding and reported in accordance with CORE‐Q guidelines. Four key themes emerged from the data: (1) Alcohol consumption in response to ongoing role stress, (2) Alcohol consumption in response to incidents, (3) The lasting impact of the COVID‐19 pandemic and (4) Do nurses feel comfortable seeking help for alcohol use? High‐risk alcohol consumption has persisted beyond the end of the COVID‐19 pandemic to manage the stress associated with clinical environments. Alcohol was also used in response to incidents, and the ongoing trauma and impact of the pandemic was described as a significant source of stress and anxiety. Not all nurses in our study felt comfortable seeking help for alcohol use, with participants describing concern for their nursing registration if they self‐reported their alcohol consumption. Participants reported stronger links between stressful working environments and increased alcohol consumption. Nurses in our study do not feel safe seeking help or self‐reporting alcohol consumption for fear of the regulatory body instituting sanctions that lead to loss or suspension of their registration. These factors require urgent attention to ensure workforce wellbeing and sustainability. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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10. Why Are We Not Asking About Suicidal Mental Imagery?
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Carey, Marie, Keogh, Brian, and Doyle, Louise
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MENTAL health services , *SUICIDE risk assessment , *PSYCHOMETRICS , *CAREER development , *MENTAL imagery , *SUICIDE statistics , *PSYCHIATRIC nursing , *SUICIDE risk factors , *SUICIDAL behavior in youth - Abstract
The article discusses the importance of assessing suicidal mental imagery in addition to verbal expressions and cognitive patterns when evaluating suicide risk. Suicidal mental imagery consists of vivid, self-generated visualizations that can influence an individual's emotional state and increase the risk of suicide. The authors emphasize the need for clinicians to incorporate questions about suicidal mental imagery into routine assessments to provide more comprehensive care and improve outcomes for individuals experiencing suicidal distress. The paper also suggests practical ways for clinicians to inquire about and address suicidal mental imagery during assessments and treatment. [Extracted from the article]
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- 2024
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11. Clinical Risk Management in Mental Health Services: 10 Principles for Best Practice.
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Doyle, Michael, Grundy, Andrew, McGleenan, Katherine, Nash, Michael, and Deering, Kris
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MENTAL health services , *LITERATURE reviews , *PSYCHIATRIC nursing , *QUALITY of service , *BEST practices - Abstract
ABSTRACT Risk assessment and management are a fundamental part of clinical practice globally within mental health services. In the United Kingdom (UK), the evidence to support the effectiveness of structured risk assessment and management remains limited, although the perception remains that structured management frameworks are effective in reducing risk in mental health care. Despite the importance of risk management within mental health services, the most recent UK wide guidance was published in 2009, while international guidance for the assessing and management of service user risks also appears sparse. This perspective paper reports on a consultation and co‐production project to provide up‐to‐date best practice principles in clinical risk management to enhance the consistency, quality and safety of mental health practice in the UK mental health services, and for mental health services in other English speaking countries. A three‐stage approach was used including literature review, referral to mental health experts for review and final evaluation and sign off by users of mental health services as experts by experience. Ten principles for best practice were confirmed as a benchmark for practice and are offered as a benchmark to improve the quality and safety of mental health practice. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Barriers and Facilitators to Mental Health Service Integration: A Scoping Review.
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Searby, Adam, Burr, Dianna, Carolin, Renae, and Hutchinson, Alison
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MENTAL health services , *PRIMARY health care , *MEDICAL personnel , *DISEASE management , *PEOPLE with mental illness , *PSYCHIATRIC nursing - Abstract
ABSTRACT Mental health service integration currently has no consensus definition and exists in a variety of settings, including primary care, addiction treatment and chronic disease management, and mental health nurses have often experienced efforts at service integration with varying degrees of success. The intent of mental health service integration is to enable collaboration between mental health services and other healthcare providers to improve service access and the care provided to individuals with mental health issues or mental illness. This scoping review aimed to explore service integration between mental health services and with a specific focus on those evaluated in peer‐reviewed, primary literature, to determine facilitators and barriers to service integration. Using the Arksey and O'Malley's framework for scoping reviews, we located 3148 studies, with screening narrowing final papers for inclusion to 18. Facilitators to service integration included clinician education, adequate resourcing and an interdisciplinary approach, while barriers included staff factors such as a reluctance to work with individuals with mental illness, consumer level barriers such as poor mental health literacy, ‘territorialism’ among staff and organisational climate. Research indicates that service integration is an effective means to detect and treat mental health issues in settings that do not traditionally provide mental health care, lowering the costs of providing healthcare and providing improved care for mental health needs; however, there are several barriers to be addressed to achieve full implementation of integration models. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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13. Harm Reduction as a Form of ‘Wrap‐Around’ Care: The Nursing Role.
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Abram, Marissa D., Jugdoyal, Adrian, Seabra, Paolo, Murphy‐Parker, Dana, and Searby, Adam
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MENTAL health services , *HARM reduction , *HEALTH facilities , *TREATMENT of addictions , *HEALTH services accessibility , *DRUG abuse treatment - Abstract
ABSTRACT In addiction treatment, harm reduction is a philosophy that aims to reduce the harms from ongoing alcohol and other drug use. Although abstinence may be the ‘gold standard’ in reducing harm from ongoing alcohol and other drug use, harm reduction recognises that abstinence may not be achievable for certain individuals. Accordingly, harm reduction is used to enable medical or mental health treatment for individuals who continue to use alcohol and other drugs, providing a form of care which meets individuals where they present to healthcare facilities. Harm reduction accepts ongoing alcohol and other drug use, while providing a traditionally marginalised cohort of individuals access to healthcare services. In this perspective paper, we argue that the role of nurses in promoting and utilising harm reduction as part of their regular practice is essential to both reducing harm from alcohol and other drug use, engaging individuals who use alcohol and other drugs in healthcare services, and providing a means to accept individuals as they are to build trust and rapport for engagement in addiction treatment when they are ready, and at their own pace. Nurses, by virtue of their role and number in the healthcare landscape (approximately 28 million globally), are ideally placed to implement harm reduction in their practice to achieve better outcomes for individuals who use alcohol and other drugs. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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14. Sir Henry Parkes and the Relationships That Enabled Nightingale Nursing to Advance Mental Healthcare in Nineteenth Century Australia.
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Raeburn, Toby, McDonald, Paul, Schapiro, Sophie, and O'Reilly, Rebecca
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MENTAL health services , *HISTORICAL source material , *HOSPITAL personnel , *NINETEENTH century , *NURSES , *PSYCHIATRIC nursing - Abstract
ABSTRACT This position paper explores famous colonial Australian politician Sir Henry Parkes use of relationships to reform colonial Australian mental healthcare by facilitating the integration of Nightingale‐trained nurses into hospitals for the insane in the late nineteenth century. A review of historical sources including primary documents reveals that Parkes exhibited astute political skill by developing relationships with influential healthcare leaders such as Florence Nightingale, Lucy Osburn and Dr. Frederic Norton Manning. As Parkes cultivated friendships with such people, he was able to sow seeds for the deployment of Nightingale nurses including two members from the original group of six nurses sent by Nightingale to Australia in 1868, as well as three nurses trained under their supervision (probationers) into hospitals for the insane. This historical account provides evidence that enables current‐day nurses to understand ways in which events of the past have contributed to the development of present‐day mental health services and systems. Parkes' legacy also encourages contemporary nurses who are interested in change to consider the importance of forging diverse strategic relationships to bring their own visions into reality. [ABSTRACT FROM AUTHOR]
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- 2024
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15. Exploring the Stepped Care Model in Delivering Primary Mental Health Services—A Scoping Review.
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Mareya, Shingai, Watts, Mimmie Claudine, Zhao, Lin, and Olasoji, Michael
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MENTAL health services , *MEDICAL care , *RANDOMIZED controlled trials , *SUBJECT headings , *PEOPLE with mental illness - Abstract
ABSTRACT The stepped care model (SCM) is a patient‐centred approach to mental health care, offering a range of services from least to most intensive, tailored to individual needs. This scoping review examines the adoption, effectiveness, challenges and implications associated with applying SCM within primary mental health service delivery. Evidence from global sources suggests the model is viable, effective and useful. This review explores the literature available, clarifies fundamental concepts and identifies existing knowledge gaps. The literature search included CINAHL, MEDLINE, PsycINFO, Scopus, the Federation University library, Google and Google Scholar databases. A systematic keyword‐based search using terms like “stepped care model,” “mental health,” and “primary care”; and a combination of keywords and subject headings, were used. The search strategy was refined by considering factors such as relevance, publication date, objectives and outcomes. This strategy yielded 20 papers compiled in this review. They include randomised controlled trials and cross‐sectional studies. The review supports SCM adoption in primary mental health care but acknowledges the need for further research. Key inclusions of the review include cost‐effectiveness, diverse diagnoses, efficacy and the model's structural configuration. Clear treatment details, delivery methods, intervention durations and chronological sequences are essential. This systematic approach enhances generalisability across different SCM models and areas, strengthening reliable inferences. In summary, the SCM holds promise for enhancing mental health service delivery. However, there is a need to further examine the factors that determine its effectiveness and understand the different ways in which SCM is implemented. Such inquiry forms the foundation for implementing and advancing mental health care services in Australia and internationally. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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16. Measurement of Psychological Resilience to Support Therapy Interventions for Clients in the Clinical Mental Healthcare Setting: A Scoping Review.
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Margetts, Judye L., Hazelton, Michael, Santangelo, Peter, Yorke, Janelle, and Wilson, Rhonda L.
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MENTAL health services , *PSYCHOMETRICS , *PSYCHOLOGICAL research , *MENTAL depression , *DEVELOPMENTAL psychology - Abstract
ABSTRACT Waves of psychological research over 50 years have resulted in the development of scales to measure psychological resilience. Multiple psychological resilience definitions and factors have emerged during this time, making its measurement complex. The overall aim of the review was to identify and describe developments in the measurement of psychological resilience in the clinical mental healthcare setting. Specific objectives included (1) consideration of the validity and reliability of psychological resilience scales, (2) the effectiveness of the scales in clinical mental healthcare settings and (3) to identify the scope that resilience factors are addressed in the included scales. It provides a timely update regarding psychological resilience measurement tools and considers further developments that may be required. Between 2011 and 2024, databases were searched, and English‐language, peer‐reviewed papers with full text were extracted. Eligible studies were those reporting validated existing resilience measures or the outcomes of new measures for use in clinical mental healthcare settings. Seventeen studies met the inclusion criteria. The review demonstrated that psychological resilience measures require further development, particularly focusing on the utility of measurement tools in clinical mental healthcare settings. In this review, we highlight an existing gap in resilience measurement and underscore the need for a new measure of psychological resilience that can effectively assess individuals' subjective experience of their psychological resilience in clinical mental healthcare settings. The currently available psychological resilience measures included in this review do not directly reflect all the factors that might impact a client's depression or anxiety and warrant further research. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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17. Lived experience allyship in mental health services: Recommendations for improved uptake of allyship roles in support of peer workforces.
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Reeves, Verity, Loughhead, Mark, Teague, Courtney, Halpin, Matthew Anthony, and Procter, Nicholas
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Inclusion of service users in the design and delivery of mental health services is clearly articulated throughout Australian mental health action plans and stated as an expectation within contemporary mental health policy. International and local Australian research demonstrates benefits for the inclusion of lived experience workers in service users' recovery journey; however, persistent challenges and barriers limit their effective integration into transdisciplinary mental health service teams. Non‐lived experience workers who actively advocate and champion the inclusion of lived experience or peer workers, known as allies, are acknowledged and recognised as enablers for effective integration of peer workers to service teams. In this discursive paper, authors present recommendations for further development of allyship roles within leadership positions of mental health organisations in Australia. Leaders are in a position to influence the allocation of resources, redress power inequalities and facilitate opportunities for the inclusion of lived experience expertise across all levels of mental health organisations. This paper makes recommendations for areas of learning and unlearning ingrained bias and assumptions which may be detrimental to integration of lived experience workforces and hinder movement toward greater adoption of recovery‐orientated service delivery. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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18. Mental Health Crisis: An Evolutionary Concept Analysis.
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Hudson, Emilie, Pariseau‐Legault, Pierre, Cassivi, Christine, Chouinard, Chad, and Goulet, Marie‐Hélène
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CRISIS intervention (Mental health services) , *CAREGIVERS , *PSYCHIATRIC nursing , *MEDICAL personnel , *ACTIVITIES of daily living - Abstract
ABSTRACT The term ‘mental health crisis’ is a widely used concept in clinical practice and research, appearing prominently in mental health literature across healthcare and social science disciplines. Within these contexts, the term is frequently either left undefined or defined rather narrowly, confined to clinical observations or guidelines targeted at healthcare providers and negating the multifaceted nature of crisis as described by those with lived experience. Therefore, the aim of this paper is to explore the characteristics of and provide a conceptual definition for the concept of ‘mental health crisis’. Rodgers' method of evolutionary concept analysis was employed and 34 articles, ranging from 1994 to 2021 and a variety of disciplines, were analysed. The results highlighted the contrast between clinically oriented surrogate terms and related concepts and those used by individuals with lived crisis experience. Antecedents of crisis included underlying vulnerabilities, relational dysfunction, collapse of life structure and struggles with activities of daily living. The concept's attributes encompassed the temporality of crisis, signs and symptoms of crisis, functional decline and crisis in family and caregivers. Finally, the consequences comprised looking inward for help, looking outward for help, and opportunities and dangers. This concept analysis serves as a foundational step in understanding ‘mental health crisis’ and its various dimensions, facilitating more nuanced discussions and interventions in the realm of mental healthcare. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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19. Diagnostic Overshadowing of Chronic Hepatitis C in People With Mental Health Conditions Who Inject Drugs: A Scoping Review.
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Preston, Regan, Christmass, Michael, Lim, Eric, McGough, Shirley, and Heslop, Karen
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CHRONIC hepatitis C , *MEDICATION errors , *DIAGNOSTIC errors , *CINAHL database , *MEDICAL screening , *HEPATITIS C - Abstract
ABSTRACT Diagnostic overshadowing refers to a phenomenon whereby people with mental health conditions encounter inadequate or delayed medical attention and misdiagnosis. This occurs when physical symptoms are mistakenly attributed to their mental health condition. This paper presents a scoping review focusing on direct causes and background factors of diagnostic overshadowing in the context of hepatitis C infection in people who inject drugs and have concurrent mental health conditions. Despite significant strides in hepatitis C treatment with direct‐acting antiviral drugs, the complex interplay of mental health conditions and physical symptoms necessitates a nuanced approach for accurate diagnosis and effective screening. This review was conducted using Joanna Briggs Institute's methodology for scoping reviews. The databases searched included Medline, Embase, PsycInfo, Global Health, CINAHL and Scopus. This review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR). The search strategies identified 1995 records. Overall, 166 studies were excluded. Forty‐two (42) studies met the inclusion criteria. Three (n = 3) studies represented direct causes, and 39 (n = 39) with background factors related to diagnostic overshadowing. Studies highlighted six key themes encompassing diagnostic overshadowing, with communication barriers, stigma and knowledge deficiencies being the most prominent. Recognising and addressing diagnostic overshadowing in chronic hepatitis C will lead to increased screening, diagnosis and timely administration of life‐saving antiviral therapy, resulting in profound enhancements in well‐being and health outcomes. Moreover, this proactive approach will play a pivotal role in advancing the global effort towards eliminating hepatitis C by 2030. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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20. Nurses' experiences of racism in mental health settings through patient and family interactions: A systematic review.
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Wijayaratnam, Anuson, Kozlowska, Olga, Krayem, Amani, Kaur, Satinder, Ayres, Helen, Smith, Rebecca, Paterson, Jane, Moghabghab, Rola, and Henshall, Cathy
- Subjects
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PREVENTION of racism , *NURSING education , *PREVENTION of violence in the workplace , *NURSE-patient relationships , *PATIENTS' families , *NURSES , *FORENSIC nursing , *MENTAL health services , *MEDICAL personnel , *DIVERSITY & inclusion policies , *CINAHL database , *WORK environment , *NURSING , *EVALUATION of medical care , *RACISM , *PSYCHIATRIC nurses , *SYSTEMATIC reviews , *MEDLINE , *COMMUNICATION , *NURSES' attitudes , *PSYCHOLOGY information storage & retrieval systems , *MEDICAL incident reports - Abstract
Nursing staff engage readily with patients and associates in mental health/forensic inpatient settings. These settings are known to have instances of workplace violence directed towards staff and such violence includes racism. Racism is a form of workplace violence that must be better understood and supported within this complex setting. Completing a systematic review to coalesce preexisting research and suggested interventions can be beneficial to supporting nurses. Systematic review following PRISMA guidelines. CINAHL, PsycInfo, Medline, British Nursing Database and Web of Science databases were searched. Reviewers screened the papers for inclusion (29 articles out of 7146 were selected for inclusion) and completed the quality appraisal using the Mixed Methods Appraisal Tool. Subsequently, data extraction was completed, and findings were summarised through narrative synthesis. The way racism was conceptualised impacted how data was collected, reported and interpreted; racism was silenced or exposed depending on how studies were undertaken. If exposed, evidence indicates racism is a problem but is not always acknowledged or acted upon. Some evidence determined racism led to negative work‐related outcomes. The literature provided limited examples of interventions. These included changing education/orientation for staff, openly discussing racist events and better planning for patients among colleagues and management. Increasing diversity within the workforce requires more research exploring and addressing issues related to racism towards nurses. Narratives of racism being normalised and embedded in mental health/forensic settings need to be challenged. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
- View/download PDF
21. Survey of staff experiences of potential stigma during the COVID19 pandemic.
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Higgins, Niall, Jones, Lee, Hutton, Tara, Dart, Nathan, Fawcett, Lisa, and Muir‐Cochrane, Eimear
- Subjects
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WORK , *CROSS-sectional method , *SELF-efficacy , *CRONBACH'S alpha , *SOCIAL alienation , *WORK environment , *STATISTICAL sampling , *DESCRIPTIVE statistics , *SURVEYS , *ATTITUDES of medical personnel , *URBAN hospitals , *RESEARCH , *JOB descriptions , *FACTOR analysis , *MENTAL health personnel , *DATA analysis software , *SOCIODEMOGRAPHIC factors , *COVID-19 pandemic , *PSYCHOSOCIAL factors , *HEALTH facility employees , *EXPERIENTIAL learning , *SOCIAL stigma , *SOCIAL isolation , *INTER-observer reliability , *DISCRIMINANT analysis , *EMPLOYMENT , *WELL-being , *EMPLOYEES' workload ,RESEARCH evaluation - Abstract
The impact of COVID‐19 on everyone's lives has been significant. However, there is also another factor related to the well‐being of healthcare workers (HCWs) and that is how they are perceived by the general public. The aim of this study is to provide insight into the scope of this potential problem and describe how HCWs perceive community views and if this influences provision of patient care. A paper‐based survey was conducted within mental health wards and community services as well as medical and surgical wards of a large metropolitan hospital in Queensland. Exploratory Factor Analysis was used to explore the dimensionality of the HCW stigma scale from the staff survey. Confirmatory Factor Analysis was used to assess validity and reliability. A total of 545 staff (67.9% nursing, 6.6% medical, 14.7% Allied Health and 10.8% Administrative) completed the survey between June and July 2020. Exploratory Factor Analysis showed that five factors explained 55% of the variance and represent factors of (i) Alienation, (ii) Social isolation, (iii) Perceived workplace harmony, (iv) Perceived job demands, (v) Clinical self‐efficacy. The survey displayed high internal reliability and discriminant validity was observed for all subscales. Australian HCW's reported feeling well supported at work and appreciated by society in general during the pandemic, possibly because Australian healthcare services were better prepared than those countries that first experienced COVID‐19. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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22. Dealing With a Stressful Extra Duty: The Intrapersonal Conflict Experiences of Nurses Caring for Survivors of Suicide Attempts on Medical–Surgical Wards.
- Author
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Lyu, Xiao‐Chen, Chen, Cheng, Lee, Li‐Hung, Akkadechanunt, Thitinut, Yang, Cheng‐I, and Tao, Xiu‐Bin
- Subjects
- *
MEDICAL-surgical nurses , *ATTEMPTED suicide , *NURSES , *PATIENTS , *SUICIDE statistics , *PSYCHOLOGICAL stress - Abstract
ABSTRACT Nurses are the frontline professionals caring for patients who have attempted suicide. When clinical nurses learn from medical records or nursing handover, or are proactively informed by patients or family members, that the patients they are caring for have suicidal tendencies, they often experience pressure and face challenges. However, little attention has been given to the experiences of the nurses caring for patients with suicidal intent on medical and surgical wards. We aimed to address this knowledge gap. The purpose of this study was to explore medical and surgical nurses' experiences, especially the internal conflicts they might experience while caring for patients who have a history of attempted suicide. A qualitative descriptive design and semi‐structured interviews were used in this study. Twenty‐three nurses were recruited and interviewed individually. Data were analysed by qualitative content analysis. The focus of this paper is to examine the emergent theme of intrapersonal conflict experienced by the participants. Nurses' experiences can be clustered into two themes: (1) Pity and annoyance and (2) Hard work does not necessarily pay off. Intrapersonal conflict was identified by participants as considerable fear and anxiety about the possibility of a patient's suicide, as well as a mixture of pity for and annoyance with the patients. Nurses feel sorry for such patients, but they are also annoyed by the extra work required to prevent suicide attempts in the ward. Additionally, having limited time and ability, they see that their hard work does not necessarily pay off and may sometimes lead to punishment. Our findings raise serious concerns about the adequacy of the knowledge of the nurses, their competence and their difficulties in caring for such patients. In addition, there is a need to provide them with appropriate on‐the‐job education and immediate emotional support relevant to caring for survivors of suicide attempts. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
23. The mental health and substance use treatment experiences of racially and ethnically minoritised women who have experienced sexual violence.
- Author
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Spaducci, Gilda, Oram, Sian, Thiara, Ravi, Robson, Debbie, Peeren, Siofra, Gibbs, Annie, and Trevillion, Kylee
- Subjects
- *
SUBSTANCE abuse treatment , *MENTAL illness treatment , *MEDICAL information storage & retrieval systems , *WOUNDS & injuries , *SEX crimes , *MENTAL health , *MENTAL health services , *RESEARCH funding , *CINAHL database , *PSYCHOLOGY of women , *DESCRIPTIVE statistics , *RACE , *SYSTEMATIC reviews , *MEDLINE , *RACISM , *MINORITIES , *TREATMENT programs , *DATA analysis software , *PATIENTS' attitudes , *PSYCHOLOGY information storage & retrieval systems - Abstract
The mental health and substance use treatment experiences of racially and ethnically minoritised women who have experienced sexual violence is not well understood. To address this we conducted a systematic review and meta‐synthesis of qualitative studies. Our search strategy included electronic searches of 18 databases and grey literature, citation tracking and reference list screening. Studies were eligible if they presented qualitative data from racially and/or ethnically minoritised women or girls, who had experienced sexual violence at any age and described their experiences of receiving treatment from statutory mental health and/or substance use services. Studies were analysed using meta‐ethnography. Fourteen papers based on 12 individual studies were included. Analysis developed three main themes: (1) understanding minoritised women holistically, (2) processing the trauma and beginning the healing and (3) the need for social connectedness and empowering relationships. For minoritised women to benefit from treatment, mental health and substance use services need to challenge the dynamics of the multiple traumas minoritised women experience. Knowledge and understanding of the racial trauma minoritised women experience is limited and many are subjected to further harm from racist practices occurring in some treatment services. Offering culturally safe, trauma‐informed care which promotes anti‐racist practices may help improve mental health and substance use service responses to minoritised women who have experienced sexual violence. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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24. Mental health deserves better: Resisting the dilution of specialist pre‐registration mental health nurse education in the United Kingdom.
- Author
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Warrender, Dan, Connell, Chris, Jones, Emma, Monteux, Sebastian, Colwell, Lucy, Laker, Caroline, and Cromar‐Hayes, Maxine
- Subjects
- *
PSYCHIATRIC nursing , *MEDICAL quality control , *PROFESSIONAL ethics , *NURSES' attitudes , *NURSING , *MENTAL health , *COLLEGE teacher attitudes , *MEDICAL care , *RACE , *CONFLICT (Psychology) , *PSYCHIATRIC nurses , *CLINICAL competence , *NURSING students , *NEEDS assessment , *RECORDING & registration - Abstract
This article aims to draw attention to increasing genericism in nurse education in the United Kingdom, which sees less specialist mental health education for mental health nursing students and offers opposition to such direction. In 2018, the Nursing and Midwifery Council produced the 'Future Nurse' standards which directed changes to pre‐registration nurse education. This led to dissatisfaction from many mental health nurses, specifically regarding reduced mental health content for students studying mental health nursing. Concerns have been raised through public forum and evolved into a grassroots national movement 'Mental Health Deserves Better' (#MHDeservesBetter). This is a position paper which presents the perspective of many mental health nurse academics working at universities within the United Kingdom. Mental health nurse academics collaborated to develop ideas and articulate arguments and perspectives which present a strong position on the requirement for specialist pre‐registration mental health nurse education. The key themes explored are; a conflict of ideologies in nursing, no parity of esteem, physical health care needs to be contextualized, the unique nature of mental health nursing, ethical tensions and values conflict, implications for practice, necessary improvements overlooked and the dangers of honesty and academic 'freedom'. The paper concludes by asserting a strong position on the need for a change of direction away from genericism and calls on mental health nurses to rise from the ashes to advocate for a quality education necessary to ensure quality care delivery. The quality of mental health care provided by mental health nurses has many influences, yet the foundation offered through pre‐registration education is one of the most valuable. If the education of mental health nurses does not attend to the distinct and unique role of the mental health nurse, standards of mental health care may diminish without assertive action from mental health nurses and allies. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
25. Psilocybin‐assisted psychotherapy for treatment‐resistant depression: Which psychotherapy?
- Author
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Crowe, Marie, Manuel, Jenni, Carlyle, Dave, and Lacey, Cameron
- Subjects
- *
ANTIDEPRESSANTS , *BRIEF psychotherapy , *INTERPERSONAL psychotherapy , *SOCIAL support , *DRUG resistance , *TREATMENT effectiveness , *MENTAL depression , *PSYCHOTHERAPY , *HALLUCINOGENIC drugs , *COGNITIVE therapy - Abstract
This perspective paper explores the choice of psychotherapy for psilocybin‐assisted psychotherapy for treatment‐resistant depression. There is evidence to support the use of some psychotherapies in treating 'treatment‐resistant' depression, and emerging evidence for the efficacy of psilocybin. The next step which is the focus of this paper is to identify psychotherapies that are both effective and congruent with the psilocybin experience. The evidence for the efficacy of the psychotherapies is drawn from a Cochrane review and the analysis of their congruence with the psilocybin experience is drawn from a qualitative meta‐synthesis of the experience of psilocybin. The paper will examine whether three one‐to‐one psychotherapies identified as effective in the treatment of treatment‐resistant depression are compatible with the psilocybin experience. Each psychotherapy will be examined in relation to its congruence with the qualitative evidence that suggests the choice of psychotherapy needs to give priority to the subjective experience, facilitate emotional processing, support connectedness with others, acceptance of the self as emotional and support change based on the person's insights into their relationships with others and the world in which they live. We conclude that interpersonal psychotherapy and intensive short‐term dynamic psychotherapy align with that experience, although others are currently being trialled. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
26. Experiencing restraint: A dialogic narrative inquiry from a service user perspective.
- Author
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Cusack, Pauline, McAndrew, Sue, Duckworth, Jean, Cusack, Frank, and McKeown, Michael
- Subjects
- *
INTERVIEWING , *MENTAL health , *PATIENTS' attitudes , *RESTRAINT of patients , *SOUND recordings , *MENTAL health services , *PSYCHOLOGICAL distress - Abstract
In recent decades concerns about violence and programs for the minimization of physical restraint, amongst other restrictive practices, have proliferated within mental health policy and practice. Whilst nurses are often called upon when violence occurs within mental health care settings, they often find themselves having the conflicting roles of caring and controlling. Within such situations it is service users, who are experts by experience, who perhaps can offer more meaningful insight into being restrained and thus provide a more appropriate approach in dealing with mental distress. This paper presents the findings of a narrative study of individuals' experiences of physical restraint within the mental health care system. In total 11 mental health service users, who had experienced physical restraint, were interviewed. Frank's (2010, Letting stories breathe: a socio‐narratology) guiding questions were used to undertake a dialogical narrative analysis of each story. For the purpose of this paper, four of the 11 stories are presented as these are representative of Frank's 'quest narrative'. However, whilst studies from the service user perspective regarding restraint are scarce, findings are discussed in relation to the grand narrative of restraint. The dialogical relationship between individual stories and the dominant grand narrative implies that the former has the capacity to shape and review the latter within mental health care. Adding to the growing body of evidence of restraint from service users' perspectives could enable nurses to provide more appropriate and meaningful mental health care in times of mental distress. [238]. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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27. Film as a pedagogical tool for climate change and mental health nursing education.
- Author
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Abebe, Natania, Bailey, Elisabeth, and Radu, Raluca
- Subjects
- *
PSYCHIATRIC nursing , *DIVERSITY & inclusion policies , *MOTION pictures , *TEACHING methods , *PROFESSIONAL employee training , *MOTIVATION (Psychology) , *MENTAL health , *NURSING education , *PSYCHIATRIC nurses , *DESPAIR , *TEACHING aids , *NURSING students , *CLIMATE change , *BEHAVIOR modification , *DIFFUSION of innovations - Abstract
The relationship between climate change and worsening mental health is of increasing concern globally. Climate change is ubiquitous, yet marginalized populations bear a disproportionate burden of the physical and mental health impacts, while youth are more likely to report mental health concerns related to climate change than older generations. Mental health nurses will inevitably see these impacts play out in their practice, thus it is important to explore innovative tools for teaching about and responding to the emotional and psychological impacts of climate change. This perspective paper presents an educational project that utilized film and structured reflection to engage with the intersecting topics of planetary and mental health. The authors created a documentary film that presents the relationship between mental health and climate change as well as an accompanying reflective toolkit. Both the film and toolkit were integrated into an undergraduate course about the health impacts of climate change. This paper explores the relevance of climate change to mental health nursing education and practice, describes the process of creating and integrating the film and toolkit into a course and advances the position that film is an innovative way to engage individuals and communities (such as student or community groups) with the emotional and psychological concerns that arise in response to complex challenges of climate change. More research is needed to better understand the mental health impacts of climate change and to explore novel approaches to education and advocacy about this topic. We hope that sharing our project and experiences will inspire additional discussion and research related to these emerging issues that are of great relevance to mental health nursing. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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28. The impact of climate change on country and community and the role of mental health professionals working with Aboriginal communities in recovery and promoting resilience.
- Author
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Upward, K., Usher, K., and Saunders, V.
- Subjects
- *
WELL-being , *OCCUPATIONAL roles , *PSYCHIATRIC nursing , *HEALTH services accessibility , *RURAL health services , *CONVALESCENCE , *MEDICAL personnel , *DIARY (Literary form) , *PSYCHOSOCIAL factors , *PSYCHOLOGY of women , *NATURAL disasters , *ABORIGINAL Australians , *RURAL health , *COMMUNITY mental health personnel , *CLIMATE change , *PSYCHOLOGICAL resilience , *MEDICAL needs assessment - Abstract
This paper emerged from discussions between the authors about our shared and different perspectives of climate change and its impact on the social, emotional, physical, spiritual and cultural wellbeing of Aboriginal Peoples and mental health services in a rural region, heavily impacted in recent years by bushfires and floods. Here we discuss, from the lead authors personal perspective as a Gamilaraay Woman, the experience of Solastalgia as a critical impact of climate change on wellbeing. Specifically, we discuss the relationship of a connection to country from a Gamilaraay, first person perspective through a series of diary entries from the lead author. Authors are researchers from different cultural backgrounds, connected through a medical research futures fund research project, to promote resilience within Aboriginal communities and the health services sector in the New England, North West region. The lead author has cultural connections to some of the communities we work with and our work is informed by these connections. While this paper was written to express an Aboriginal perspective on climate change and wellbeing, it reflects our shared perspectives of how disasters such as bushfires impact the wellbeing of Aboriginal peoples. We also explore the connection between the impact of localised, recurring natural disasters and the increasing demands on mental health services in regional and rural areas and discuss what this means with Aboriginal and non‐Indigenous mental health nurses and researchers working in regional and rural areas where access to mental health services often poses considerable challenges. From our perspective, mental health research and nursing play an important role in walking alongside Aboriginal Peoples as we explore, respond and create resilience to the ever‐present influence that climate change is having on our lives, communities, country and workplaces. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
29. Locked external doors on inpatient mental health units: A scoping review.
- Author
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Searby, Adam, James, Russell, Snipe, Jim, and Maude, Phil
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- *
PSYCHIATRIC nursing , *WORK environment , *CINAHL database , *PSYCHOLOGY information storage & retrieval systems , *HEALTH facilities , *NURSES' attitudes , *MEDICAL information storage & retrieval systems , *CONVALESCENCE , *SYSTEMATIC reviews , *SECURITY systems , *HOSPITAL care , *JOB satisfaction , *DESCRIPTIVE statistics , *LITERATURE reviews , *AGGRESSION (Psychology) , *MEDLINE , *MENTAL health services - Abstract
The principles of least restrictive care and recovery‐focused practice are promoted as contemporary practice in the care of individuals with mental ill health, underpinning legislation concerning mental health and illness in many jurisdictions worldwide. Inpatient mental health units with locked doors are incompatible with this style of care and throwback to a time where care for mental illness was primarily custodial. The aim of this scoping review is to determine whether evidence exists for locking mental health unit doors, whether this practice is compatible with recovery‐focused care and to determine whether door locking has changed since a review conducted by Van Der Merwe et al. (Journal of Psychiatric and Mental Health Nursing, 16, 2009, 293) found that door locking was not the preferred practice in the management of acute mental health units. We used Arksey and O'Malley's (International Journal of Social Research Methodology: Theory and Practice, 8, 2005, 19) framework for scoping reviews, with our initial search locating 1377 studies, with screening narrowing final papers for inclusion to 20. Methodologies for papers included 12 using quantitative methodology, 5 qualitative and 3 that used mixed methods designs. Poor evidence was found for door locking to mitigate risks such as absconding, aggression or illicit substance importation. Furthermore, locked doors had a detrimental impact on the therapeutic relationship, nurse job satisfaction and intention to leave the profession. This scoping review indicates that research is urgently needed to address a mental healthcare culture where door locking is an entrenched practice. Studies of alternative approaches to risk management are required to ensure inpatient mental health units are truly least‐restrictive, therapeutic environments. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
30. Consumer involvement and guiding frameworks in mental healthcare: An integrative literature review.
- Author
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Ahlstrand, Anita, Mishina, Kaisa, Elomaa‐Krapu, Minna, and Joronen, Katja
- Abstract
Perspectives of healthcare have, in past decades, focused more on active citizenship, human rights and empowerment. Healthcare consumer involvement as a concept is still unstructured and consumers have no apparent opportunities to participate in their care processes. The focus is often on the expertise of professionals, even if mental health consumers are willing to become involved and have sufficient decisional capacity. The aim of this integrative literature review was to construct an understanding of consumer perceptions and guiding frameworks of consumer involvement. There was no previous synthesis of mental health consumer perceptions combined with guiding frameworks. An integrative review methodology was employed, following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. The quality of the 18 studies included was analysed with the Whittemore and Knafl approach. By following Braun and Clarke's guidelines, an inductive thematic analysis was conducted to collate the themes from the selected papers. Mental health consumers' perceptions of involvement included expectations of person‐centred care, such as respect, dignity, equal interaction, supportive environments and being part of a community. This research did not find any single established framework to give clear guidelines for consumer involvement in mental healthcare, but similar determinants describing various frameworks were uncovered. This review also shows how the terminology has changed throughout the years. The perceptions of mental health consumers need to be considered to enable the implementation of person‐centredness from guidelines through to practice. Paying more attention to the education of professional mental health caregivers and the involvement of mental health consumers in their care provides better opportunities to co‐develop successful mental health services and recovery processes. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
31. The weather as a determinant of farmer's mental health: A dependent, interacting, cumulative and escalating model (DICE) of the effects of extreme weather events.
- Author
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Rice, Kylie and Usher, Kim J.
- Abstract
This perspective paper presents a conceptual, theoretical framework of the weather as a determinant of mental health for farmers. This model proposes that the effects of extreme weather events have interacting and cumulative effects for farmers, who are dependent on the land. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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32. Effectiveness of nonpharmacological multi‐component intervention on depressive symptoms in patients with mild cognitive impairment and dementia: A systematic review and meta‐analysis.
- Author
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Cai, Mingjin, Bai, Dingxi, Hou, Dongjiang, You, Qian, Wang, Wei, Lu, Xianying, and Gao, Jing
- Subjects
- *
PSYCHOTHERAPY , *MEDICAL information storage & retrieval systems , *MILD cognitive impairment , *CINAHL database , *TREATMENT effectiveness , *META-analysis , *DESCRIPTIVE statistics , *SYSTEMATIC reviews , *MEDLINE , *MEDICAL databases , *DEMENTIA , *ONLINE information services , *DATA analysis software , *CONFIDENCE intervals , *COMPARATIVE studies , *MENTAL depression , *PSYCHOLOGY information storage & retrieval systems , *PHYSICAL activity - Abstract
Patients with mild cognitive impairment (MCI) and dementia are more prone to depression than people without MCI or dementia. Some studies have found nonpharmacological multi‐component intervention to be more effective than single‐component intervention in improving the condition of patients with MCI and dementia; however, their effect on depressive symptoms is still inconsistent. Therefore, it is necessary to explore the effectiveness of nonpharmacological multi‐component intervention in improving depressive symptoms in patients with MCI and dementia. This review retrieved papers from PubMed, Embase, Cochrane Library, CINAHL, PsycINFO and CNKI. The retrieval time limit was set from 1 January 1990 to 25 November 2022. The PRISMA 2020 guideline was used to report the included studies. The result showed that nonpharmacological multi‐component intervention could improve depressive symptoms in patients with MCI and dementia. Among them, nonpharmacological multi‐component intervention with a duration of <6 months, physical and cognitive activities, or other activities had significant effects. However, each study differed in terms of specific measures, duration and frequency of intervention methods. Accordingly, more randomized controlled trials with larger samples are required to discover the best scheme for nonpharmacological multi‐component intervention. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
33. Everyday ordinariness, neglected but important for mental health nurses' therapeutic relationships: An initial exploration for applying Daniel Kahneman's two systems of thinking.
- Author
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Deveau, Roy
- Subjects
- *
NEUROSCIENCES , *PSYCHIATRIC nursing , *THERAPEUTIC alliance , *THOUGHT & thinking - Abstract
Mental health nurses undertake difficult and complex roles. Therapeutic relationships and engagement between mental health nurses and people experiencing severe mental ill‐health provide the core purpose and rationale for such mental health care. These relationships are influenced by factors outside of frontline mental health nurses control. They are difficult to define or describe with clarity, have limited 'quantitative' evidence of effectiveness and are frequently not experienced as therapeutic. This paper presents some initial ideas regarding 'everyday ordinariness' using psychologist Daniel Kahneman's two systems of thinking as a focus for understanding and potentially improving mental health nurse practice, and therapeutic relationships and engagement. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
34. The problem with resilience.
- Author
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Fisher, Jane and Jones, Emma
- Subjects
- *
IATROGENIC diseases , *EXPERIENCE , *MENTAL health services , *PSYCHOLOGICAL resilience - Abstract
The term 'resilience' has become a fashionable buzzword infiltrating mental health services globally. This latest ad nauseam has become both an irritation and insult to service users and mental health professionals alike. We argue resilience is a flawed Western theory of suffering aligned with neoliberal ideology. It is a double‐edged sword indiscriminately yielded at both service users and staff. This paper examines the origins and evolution of resilience, and how mental health services have morphed resilience into a meaningless slogan, causing iatrogenic harm. We call for mental health professionals to consider their use of language and the intended or unintentional meaning behind their choice of words. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
35. Analysis of a nursing survey: Reasons for compromised quality of care in inpatient mental health wards.
- Author
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Thompson, Elissa, Senek, Michela, and Ryan, Tony
- Subjects
- *
MENTAL health service laws , *COMPETENCY assessment (Law) , *PSYCHIATRIC nursing , *MEDICAL quality control , *WORK experience (Employment) , *WORK environment , *INDUSTRIAL safety , *NURSES' attitudes , *ETHICS , *RESEARCH methodology , *CROSS-sectional method , *SELF-evaluation , *MOTIVATION (Psychology) , *MIDWIFERY , *LEADERSHIP , *EVIDENCE gaps , *FEAR , *TREATMENT effectiveness , *SURVEYS , *LABOR supply , *COMPARATIVE studies , *COMMUNICATION , *EMPLOYMENT , *HOSPITAL nursing staff , *DESCRIPTIVE statistics , *RESEARCH funding , *THEMATIC analysis , *SHAME , *CIVIL rights , *SUPERVISION of employees , *MENTAL health services , *PERSONNEL management , *PSYCHOLOGICAL distress - Abstract
Current evidence suggests understaffing is related to poor quality and missed care in a global context, but this relationship is complex. There is also a research gap for quality in mental health care in the United Kingdom that includes a wider set of patient outcomes. This paper aims to investigate RMN's perception of quality of care on their last shift, their self‐reported reasons for compromised care and potential impact on patient outcomes. A mixed methods approach, we used descriptive statistics to create a framework within which to qualitatively analyse data from the 2017 Royal College of Nursing (RCN) employment survey to consider the complex relationship between understaffing and care quality. We established three themes: 'Understaffing', 'Professional Code Expectations and Moral Distress' and 'Management'. In line with the current evidence; lack of resources and understaffing were consistently present throughout. Nurses also felt pressure from the Nursing and Midwifery Council (NMC) code of conduct which in turn instilled shame and fear for their registration when they were unable to achieve the standards expected. This was further exacerbated by poor management and supervision; leading nurses to reflect on poor outcomes for patients which compromised not only legal rights but safety of patients and staff alike. We conclude that focusing on staffing numbers alone is unlikely to improve care quality. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
36. An analysis of the barriers and enablers to implementing the Safewards model within inpatient mental health services.
- Author
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Knauf, Sarah Anne, O'Brien, Anthony John, and Kirkman, Allison Margaret
- Subjects
- *
PSYCHIATRIC nursing , *CINAHL database , *PSYCHOLOGY information storage & retrieval systems , *ONLINE information services , *MEDICAL databases , *HEALTH services accessibility , *NURSING , *SYSTEMATIC reviews , *ATTITUDES of medical personnel , *HUMAN services programs , *JOB involvement , *PATIENTS' attitudes , *HEALTH literacy , *HOSPITAL care , *RESEARCH funding , *CONTENT analysis , *RISK management in business , *MEDLINE , *MENTAL health services , *PSYCHIATRIC hospitals , *PATIENT safety - Abstract
Mental health inpatient units can provide a sanctuary for people to recover from mental illness. To support a therapeutic environment, the safety and well‐being of service users and staff need protection through reduced conflict and containment rates. The Safewards model identifies 10 interventions to prevent conflict and containment. This paper aims to present barriers and enablers to implementing Safewards by analysing current literature on the Safewards model. It will also compare the Safewards model to New Zealand's Six Core Strategies. In a systematic search of 12 electronic databases following the PRISMA flow chart, 22 primary studies were included in this analysis. JBI tools were used for quality appraisal and deductive content analysis was used to organize and interpret data. Four categories were identified: (a) designing the Safewards interventions and implementation; (b) staff participation and perception of Safewards; (c) healthcare system influences on Safewards implementation; (d) service user participation and perception of Safewards. To support successful Safewards implementation in future practice, this review recommends that Safewards implementation is enabled through robust design of the Safewards interventions and implementation methods; staff participation and positive perception of the Safewards model; a resourced healthcare system that prioritizes Safewards implementation; service user awareness and participation in Safewards interventions. Interactionist perspectives may support the implementation of Safewards. This analysis is limited by research settings mostly being inpatient adult services and inadequate capturing of the service user voice. An ongoing review of barriers and enablers is important for supporting future Safewards implementation. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
37. Utilization and effects of security technologies in mental health: A scoping review.
- Author
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Anastasi, Giuliano and Bambi, Stefano
- Subjects
- *
ONLINE information services , *CINAHL database , *PSYCHOLOGY information storage & retrieval systems , *PSYCHIATRIC nursing , *MEDICAL information storage & retrieval systems , *SYSTEMATIC reviews , *MENTAL health , *VIOLENCE , *SECURITY systems , *WEARABLE technology , *QUANTITATIVE research , *MEDICAL care , *SURVEYS , *QUALITATIVE research , *TECHNOLOGY , *LITERATURE reviews , *MEDLINE , *PATIENT safety - Abstract
Violence in healthcare is an urgent and increasing issue. Mental health settings are particularly affected, with severe negative impacts on staff, patients, and organizations. Security technologies could help maintain and improve safety in this field. However, knowledge of their utilization and effectiveness in mental health is lacking. A scoping review was conducted using the methodology recommended by the Joanna Briggs Institute to map research on the utilization and effects of security technologies in mental health, identify how research is currently performed, and highlight gaps in the existing knowledge. Literature search for peer‐reviewed publications was performed on PubMed, CINAHL, PsycInfo, Embase, and Scopus. Following the screening process and the eligibility criteria, 22 articles were included in this review. The publication range was 2002–2020, many studies were surveys, and European countries were the most investigated, especially the United Kingdom. Overall, the use of 10 different technologies was reported 46 times. The most represented category was alarms, followed by video cameras, other technologies (such as wearable sensors), and metal detectors. More than half of the included papers reported positive effects of these measures on safety. This review indicates that several security technologies are available in mental health settings, with encouraging positive safety outcomes for both patients and healthcare professionals, especially nurses. However, research on the topic is still emerging, with a limited number of sources and a few high‐quality designed studies. Therefore, future research should focus on producing evidence on the availability and effectiveness of these measures in mental health settings across countries. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
38. Medical decision‐making for adolescents with depression: A bibliometric study and visualization analysis via CiteSpace.
- Author
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Hua, Nan, Tan, Xiangmin, He, Yuqing, Sun, Mei, and Wang, Xiuhua
- Subjects
- *
THERAPEUTICS , *BIBLIOGRAPHIC databases , *ATTITUDE (Psychology) , *BIBLIOMETRICS , *HELP-seeking behavior , *CITATION analysis , *PATIENTS' attitudes , *PARENTING , *FAMILY roles , *PRIMARY health care , *DECISION making , *MENTAL depression , *RESEARCH funding , *HEALTH , *VISUALIZATION , *ADOLESCENCE - Abstract
This study focussed on evaluating the status of recent research on medical decision‐making for adolescents with depression and identifying research hotspots and frontiers via CiteSpace. We extracted studies that were concerned with medical decision‐making for adolescents with depression from the Web of Science Core Collection (WoSCC), covering the period from 1 January 1999 to 20 September 2022. We used CiteSpace to generate online maps of worldwide cooperation among countries, institutions, and authors. Hotspots and frontiers were systematically summarized. A total of 368 papers related to medical decision‐making for adolescents with depression were obtained from WoSCC. The most prolific author was Nick Midgley (seven papers). The United States and University College London were the leading country and institution in this research area, with 177 and 17 papers, respectively. Countries, institutions, and authors all actively collaborated. Main recent research trends include the preference or attitude towards medical treatment in adolescents with depression; approaches for adolescents with depression to seeking medical help; and the key role of parent, family, and primary care in medical decision‐making for adolescents. Thus, further attention should be paid to determining how to promote the role of parents, families, and primary care in the decision‐making process and create appropriate online help‐seeking tools and decision aids to facilitate shared decision‐making in the future. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
39. Psychiatry and/or recovery: a critical analysis.
- Author
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Crowe, Marie
- Subjects
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PSYCHIATRY , *PSYCHIATRIC nursing , *CONVALESCENCE , *DISCOURSE analysis - Abstract
This perspective paper aims to present a personal viewpoint on the impact of psychiatric discourse on the principles of recovery in mental health care. Mental health services espouse these principles, yet psychiatric discourse remains the dominant model. A critical analysis will examine how psychiatry maintains this dominance. The aim is to examine how psychiatric discourse constructs both the nature of mental distress and its treatment, and how it maintains its power as the dominant authority and its relationship to recovery principles. The paper concludes that psychiatric discourse is the antithesis of recovery principles and that its authority is perpetuated through co‐opting a medical explanatory model, claiming expertise in the ability to predict social risk, and maintaining a tightly controlled echo chamber. A way forward involves the dismantling of the hierarchical service delivery model based on psychiatric discourse and replacing it with a more horizontal service delivery model in which the lived experience of mental distress is central. Regular audit of services needs to prioritize recovery principles. The implications for mental health nursing are considered. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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40. The effectiveness of ūloa as a model supporting Tongan people experiencing mental distress.
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Vaka, Sione, Hamer, Helen Paris, and Mesui‐Henry, Anau
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CULTURE , *COMMUNITY life , *SPIRITUALITY , *MEDICAL care , *PSYCHOLOGY , *INTERVIEWING , *FISHING , *PSYCHOSOCIAL factors , *CONCEPTUAL models , *INDIGENOUS peoples , *JUDGMENT sampling , *THEMATIC analysis , *PSYCHOLOGICAL distress , *MENTAL health services - Abstract
This article is based on a larger research project, which investigates the effectiveness of a culturally appropriate model, namely ūloa, when working with Tongan people. Ūloa is a communal method of fishing in Tonga, which includes all members of the community. A previous paper described the three phases of ūloa: presenting the concept to health providers and community groups; phase two amended the model based on phase one. This paper reports on phase three and findings related to the increased awareness of ūloa model within the mental health services and to raise awareness of how to work with Pacific people and adjust the health service to suit the needs of this population to test its effectiveness. Using reflexive thematic analysis, results highlighted a number of patterns both across the groups, described as napanapangamālie (harmony, balance), ngāue fakataha (working together/oneness), and toutai (fisher). These findings continue to support that the conventional biomedical approach employed in the mental health services overlooks elements of Tongan constructions of mental illness and the intersections between Tongan and biopsychosocial themes. Care that is based only on the 'medicine' rather than bringing the spiritual aspect into care planning (fake leaves) will not serve the needs of the Tongan community. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
41. Nurses' clinical decision‐making in the use of rapid tranquillization in adult mental health inpatient settings: An integrative review.
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Pedersen, Martin Locht, Gildberg, Frederik Alkier, Laulund, Ronni, Jørgensen, Kim, and Tingleff, Ellen Boldrup
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PSYCHIATRIC nursing , *ONLINE information services , *CINAHL database , *PSYCHOLOGY information storage & retrieval systems , *MEDICAL information storage & retrieval systems , *SYSTEMATIC reviews , *MENTAL health , *COMPARATIVE studies , *DESCRIPTIVE statistics , *DECISION making in clinical medicine , *MEDLINE , *TRANQUILIZING drugs , *ADULTS - Abstract
Rapid tranquillization is a restrictive practice that remains widely used in mental health inpatient settings worldwide. Nurses are the professionals most likely to administer rapid tranquillization in mental health settings. To improve mental health practices, an enhanced understanding of their clinical decision‐making when using rapid tranquillization is, therefore, important. The aim was to synthesize and analyse the research literature on nurses' clinical decision‐making in the use of rapid tranquillization in adult mental health inpatient settings. An integrative review was conducted using the methodological framework described by Whittemore and Knafl. A systematic search was conducted independently by two authors in APA PsycINFO, CINAHL Complete, Embase, PubMed and Scopus. Additional searches for grey literature were conducted in Google, OpenGrey and selected websites, and in the reference lists of included studies. Papers were critically appraised using the Mixed Methods Appraisal Tool, and the analysis was guided by manifest content analysis. Eleven studies were included in this review, of which nine were qualitative and two were quantitative. Based on the analysis, four categories were generated: (I) becoming aware of situational changes and considering alternatives, (II) negotiating voluntary medication, (III) administering rapid tranquillization and (IV) being on the other side. Evidence suggests that nurses' clinical decision‐making in the use of rapid tranquillization involved a complex timeline with various impact points and embedded factors that continuously influenced and/or were associated with nurses' clinical decision‐making. However, the topic has received scant scholarly attention, and further research may help to characterize the complexities involved and improve mental health practice. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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42. Safewards: An integrative review of the literature within inpatient and forensic mental health units.
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Mullen, Antony, Browne, Graeme, Hamilton, Bridget, Skinner, Stephanie, and Happell, Brenda
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CINAHL database , *PSYCHOLOGY information storage & retrieval systems , *HOSPITAL patients , *EVALUATION of human services programs , *INDUSTRIAL safety , *MEDICAL information storage & retrieval systems , *CONVALESCENCE , *SYSTEMATIC reviews , *MENTAL health , *MEDICAL care , *HUMAN services programs , *RESTRAINT of patients , *FORENSIC psychiatry , *MEDLINE , *PSYCHIATRIC hospitals , *CONSUMERS , *PATIENT safety - Abstract
Mental health inpatient units are complex and challenging environments for care and treatment. Two imperatives in these settings are to minimize restrictive practices such as seclusion and restraint and to provide recovery‐oriented care. Safewards is a model and a set of ten interventions aiming to improve safety by understanding the relationship between conflict and containment as a means of reducing restrictive practices. To date, the research into Safewards has largely focused on its impact on measures of restrictive practices with limited exploration of consumer perspectives. There is a need to review the current knowledge and understanding around Safewards and its impact on consumer safety. This paper describes a mixed‐methods integrative literature review of Safewards within inpatient and forensic mental health units. The aim of this review was to synthesize the current knowledge and understanding about Safewards in terms of its implementation, acceptability, effectiveness and how it meets the needs of consumers. A systematic database search using Medline, CINAHL, Embase and PsychInfo databases was followed by screening and data extraction of findings from 19 articles. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of empirical articles, and the Johanna Brigg's Institute (JBI's) Narrative, Opinion, Text‐Assessment and Review Instrument (NOTARI) was used to undertake a critical appraisal of discussion articles. A constant comparative approach was taken to analysing the data and six key categories were identified: training, implementation strategy, staff acceptability, fidelity, effectiveness and consumer perspectives. The success of implementing Safewards was variously determined by a measured reduction of restrictive practices and conflict events, high fidelity and staff acceptability. The results highlighted that Safewards can be effective in reducing containment and conflict within inpatient mental health and forensic mental health units, although this outcome varied across the literature. This review also revealed the limitations of fidelity measures and the importance of involving staff in the implementation. A major gap in the literature to date is the lack of consumer perspectives on the Safewards model, with only two papers to date focusing on the consumers point of view. This is an important area that requires more research to align the Safewards model with the consumer experience and improved recovery orientation. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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43. Implementation of the Nurse Practitioner as Most Responsible Provider model of care in a Specialised Mental Health setting in Canada.
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Kipping, Sarah, Riahi, Sanaz, Velji, Karima, Lau, Emily, Pritchard, Cindy, and Earle, Julie
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NURSING , *MATHEMATICAL models , *NURSING specialties , *HEALTH facility administration , *HUMAN services programs , *CONCEPTUAL structures , *THEORY , *GROUP decision making , *INTERPROFESSIONAL relations , *MENTAL health services , *CORPORATE culture - Abstract
Globally, mental health systems have failed to adequately respond to the growing demands of mental health services resulting in a disparity between the need and provision of treatment. Paucity of mental health care providers contributes to the aforementioned disparity. This can be addressed by engaging Nurse Practitioners (NPs) in an integrated model within healthcare teams. This paper describes the implementation of NPs as Most Responsible Provider (MRP) care of model in a specialised mental health hospital in Ontario, Canada. Guided by the participatory, evidence‐based, patient‐focused process for advanced practise nursing (APN) role development, implementation, and evaluation (PEPPA) framework, authors developed a model of care and implemented the first seven steps of the PEPPA framework – (a) define the population and describe the current model of care, (b) identify stakeholders, (c) determine the need for a new model of care (d) identify priority areas and goals of improvement, (e) define the new model of care, and (f) plan and implement the NP as MRP model of care. Within these steps, different strategies were implemented: (a) revising policies and procedures (b) harmonising reporting structures, (c) developing and implementing a collaborative practise structure for NPs, (d) standardised and transparent compensation (e) performance standards and monitoring (f) Self‐Assessment Competency frameworks, education, and development opportunities. This paper contributes to the state of the knowledge by implementing NPs as MRP model of care in a specialised mental health care setting in Ontario, Canada; and advocates the need for incorporating mental health programmes within the Ontario nursing curriculum. [ABSTRACT FROM AUTHOR]
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- 2022
- Full Text
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44. Utilizing the mental health nursing workforce: A scoping review of mental health nursing clinical roles and identities.
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Hurley, John, Lakeman, Richard, Linsley, Paul, Ramsay, Mike, and Mckenna‐Lawson, Stephen
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PSYCHIATRIC nursing , *OCCUPATIONAL roles , *CINAHL database , *PSYCHOLOGY information storage & retrieval systems , *ONLINE information services , *MEDICAL databases , *SYSTEMATIC reviews , *LABOR supply , *NURSES , *PROFESSIONAL identity , *PROFESSIONAL competence , *LITERATURE reviews , *MEDLINE , *PSYCHOTHERAPY , *PATIENT safety - Abstract
Despite rising international needs for mental health practitioners, the mental health nursing workforce is underutilized. This is in part due to limited understandings of their roles, identities, and capabilities. This paper aimed to collate and synthesize published research on the clinical roles of mental health nurses in order to systematically clarify their professional identity and potential. We searched for eligible studies, published between 2001 and 2021, in five electronic databases. Abstracts of retrieved studies were independently screened against exclusion and inclusion criteria (primarily that studies reported on the outcomes associated with mental health nursing roles). Decisions of whether to include studies were through researcher consensus guided by the criteria. The search yielded 324 records, of which 47 were included. Retained papers primarily focused on three themes related to mental health nursing clinical roles and capabilities. Technical roles included those associated with psychotherapy, consumer safety, and diagnosis. Non‐technical roles and capabilities were also described. These included emotional intelligence, advanced communication, and reduction of power differentials. Thirdly, the retained papers reported the generative contexts that influenced clinical roles. These included prolonged proximity with consumers with tensions between therapeutic and custodial roles. The results of this scoping review suggest the mental health nurses (MHNs) have a wide scope of technical skills which they employ in clinical practice. These roles are informed by a distinctive cluster of non‐technical capabilities to promote the well‐being of service users. They are an adaptable and underutilized component of the mental health workforce in a context of escalating unmet needs for expert mental health care. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
45. Towards online delivery of Dialectical Behaviour Therapy: A scoping review.
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Lakeman, Richard, King, Peter, Hurley, John, Tranter, Richard, Leggett, Andrew, Campbell, Katrina, and Herrera, Claudia
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- *
WELL-being , *PILOT projects , *BORDERLINE personality disorder , *SYSTEMATIC reviews , *INTERNET , *SELF-evaluation , *MEDICAL care , *TREATMENT effectiveness , *DIALECTICAL behavior therapy , *QUESTIONNAIRES , *LITERATURE reviews , *EMOTION regulation , *SOCIAL distancing , *COVID-19 pandemic , *TELEMEDICINE , *MENTAL health services - Abstract
Dialectical Behaviour Therapy (DBT) programmes are often the only available treatment for people diagnosed with borderline personality disorder and were rapidly converted to online delivery during the COVID‐19 pandemic. Limited research exists surrounding how the major elements of DBT are delivered in an online environment. This scoping review considered the operationalization of online delivery of DBT and its effectiveness. EBSCO host databases were searched using free text. Of 127 papers, 11 studies from 2010 to 2021 investigating online DBT for any clinical population were included in the review. A narrative synthesis of papers selected was undertaken. Seven articles reported results from five clinical trials (n = 437). Most adaptations mirrored face‐to‐face programmes although there was considerable variation in how therapy was facilitated. Attendance was reported to be greater online with comparable clinical improvements to face‐to‐face for those who remained in therapy. Additional challenges included managing risk, therapist preparedness and technology difficulties. Online delivery of DBT programmes is feasible and may be more accessible, acceptable and as safe and effective as face‐to‐face delivery. However, mirroring face to face delivery in an online environment may not be the most effective and efficient way to adapt DBT to online provision. Research is needed to identify areas which require further adaptation. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
46. How we say what we do and why it is important: An idiosyncratic analysis of mental health nursing identity on social media.
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PSYCHIATRIC nursing , *SOCIAL media , *ATTITUDE (Psychology) , *GROUP identity , *QUALITATIVE research , *PHENOMENOLOGY , *NURSES , *DESCRIPTIVE statistics , *DATA analysis software - Abstract
This paper is the culmination of a qualitative research project into mental health nursing (MHN) identity via exploration of a social media campaign organized in 2018 by the UK Mental Health Nurses Association. Through engagement with this campaign and a multimethod approach, this paper proposes a new and novel heuristic framework for exploring MHN identity holistically, through what is termed the 6Ps of MHN identity. The 6Ps – encompassing the professional, personal, practical, proximal, philosophical, and political aspects of identity – were previously shared with members of the MHN research community at both the 2019 and 2020 proceedings of the International Mental Health Nursing Research Conference. To examine the identity expressed in the social media campaign, all contributions by nurses were amalgamated into one 'text' for analysis. When this text was examined, the focus was the particular language used by MHNs. This granular analysis concentrated on word choice, form, and frequency as the constituent aspects of meaning. Even when it was necessary to examine larger grammatical units, the key nouns – grammatical objects and subjects – were the primary focus of analysis. Following this, the author – a mental health nurse themselves – applied their personal understanding of the field of practice to the text to arrive at an understanding of its contents. This approach is the first in the field of MHN identity research to examine the profession's identity as expressed by members on social media, as well as the linguistic form of that expression. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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47. Elimination of restrictive interventions: Is it achievable under the current mental healthcare landscape?
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Snipe, Jim and Searby, Adam
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MENTAL illness prevention , *PSYCHIATRIC nursing , *HEALTH policy , *REPORT writing , *BUILT environment , *LABOR supply , *RESTRAINT of patients , *PATIENT education , *GOAL (Psychology) - Abstract
The 2021 release of the report from the Royal Commission into Victoria's Mental Health System suggested 65 recommendations to improve a mental healthcare system that was described as "broken". Several of these recommendations relate to the use of restrictive interventions, such as restraint (both physical and mechanical) and seclusion. These interventions continue to be used in Victorian inpatient mental health facilities today, often in response to aggression and violence towards staff, visitors, family and other consumers. Several health services have committed to the substantial reduction or elimination of the use of restrictive interventions. In this perspective paper, we argue that significant investment is required to achieve this goal. Pressure on mental health nursing staff to cease using restrictive interventions without viable alternatives to de‐escalation, restrictions in the built environment, workforce constraints and a lack of education provided early in nursing careers need to be addressed before we can achieve the elimination of restrictive interventions. We recommend that substantial investment in mental health inpatient units, the mental health nursing workforce, and a systemic shift in the role of the mental health nurse are required to attain sustained reduction and potential elimination of restrictive interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
48. Exploring the effectiveness of a regional nurse practitioner led, long‐acting injectable buprenorphine‐based model of care for opioid use disorder.
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Strike, Teresa, D'Angelo‐Kemp, Dante, and Searby, Adam
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DRUG addiction , *NARCOTICS , *NEEDLE exchange programs , *PSYCHIATRIC nursing , *AUDITING , *STATISTICS , *INJECTIONS , *EVALUATION of human services programs , *NURSE administrators , *BUPRENORPHINE , *RURAL conditions , *AMBULANCES , *DRUG overdose , *RETROSPECTIVE studies , *REGRESSION analysis , *OUTPATIENT medical care management , *PEARSON correlation (Statistics) , *CONTROLLED release preparations , *COMMUNITY mental health personnel , *STATISTICAL models , *DATA analysis , *DATA analysis software , *PAIN management , *OPIOID abuse , *HEROIN - Abstract
The introduction of long‐acting injectable buprenorphine preparations for opioid use disorder has been widely heralded as a breakthrough treatment, with several studies indicating positive results when using these medications. In many locations, nurse practitioners prescribe, administer, and monitor long‐acting injectable preparations. The objective of this paper is to explore whether a reduction in dispensed needles and syringes is attributable to increased nurse practitioner prescribing of LAIB. We used a retrospective audit of needles dispensed through the health service needle and syringe program vending machine, and individuals treated with long‐acting injectable buprenorphine by the nurse practitioner led model. In addition, we examined potential factors that may influence changes in the number of needles dispensed. Linear regression found that each individual with opioid dependence treated with long‐acting injectable buprenorphine was associated with 90 fewer needles dispensed each month (p < 0.001). The nurse practitioner led model of care for individuals with opioid dependence appears to have influenced the number of needles dispensed at the needle and syringe program. Although all confounding factors could not be discounted entirely, such as substance availability, affordability, and individuals obtaining injecting equipment elsewhere, our research indicates that a nurse practitioner led model of treating individuals with opioid use disorder influenced needle and syringe dispensing in the study setting. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
49. Staff perceptions of the quality of care delivered in a New Zealand mental health and addiction service: Findings from a qualitative study.
- Author
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Craik, Brooke, Derrett, Sarah, Wyeth, Emma H., Green, Mel, and Cox, Adell
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MENTAL illness treatment , *MEDICAL quality control , *ATTITUDES of medical personnel , *HEALTH of indigenous peoples , *CROSS-sectional method , *RESEARCH methodology , *QUANTITATIVE research , *QUALITATIVE research , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *RESEARCH funding , *HEALTH equity , *DATA analysis software , *PSYCHIATRIC hospitals , *COMPULSIVE behavior , *MEDICAL specialties & specialists - Abstract
In New Zealand, people receiving care from specialist mental health and addiction services experience poorer health outcomes compared to the general population. Māori (Indigenous) specialist mental health and addiction service users experience disproportionate inequities. This study aims to: (1) Describe and understand mental health staff perspectives on the quality of care delivered to specialist mental health and addiction service users in their service – including specifically for Māori; and (2) Identify areas staff report as opportunities for quality improvement. In 2020, Southern District Health Board (now Te Whatu Ora – Southern) mental health staff were invited to participate in a cross‐sectional study assessing their perceptions of a range of service aspects. This paper presents quantitative and qualitative analyses about quality of care. Among the 319 staff who completed the questionnaire; 272 provided quality‐of‐care responses. Among these, 78% reported the quality of care delivered to service users as 'good' or 'excellent'; only 60% reported this for Māori service users. Participants identified individual, service and broader system level factors influencing the quality of care delivered to service users, including factors specific for Māori. This study has identified, for what appears to be the first time, empirical and concerning differences in staff ratings of the quality of care delivered to Māori and SMHAS users overall. Findings highlight the need for institutional and managerial prioritization of hauora Māori, and incorporating tikanga Māori and Te Tiriti into practice. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
50. Barriers and facilitators to becoming an alcohol and other drug nurse practitioner in Australia: A mixed methods study.
- Author
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Searby, Adam, Burr, Dianna, Blums, Colleen, Harrison, Jason, and Smyth, Darren
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OCCUPATIONAL roles , *WORK environment , *OCCUPATIONAL achievement , *ALCOHOLISM , *SUBSTANCE abuse , *NURSES' attitudes , *SOCIAL support , *RESEARCH methodology , *MOTIVATION (Psychology) , *INTERVIEWING , *LABOR supply , *NURSING career counseling , *CONCEPTUAL structures , *NURSING practice , *MEDICATION therapy management , *PSYCHIATRIC nurses , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *NURSES , *DRUG prescribing , *JUDGMENT sampling , *THEMATIC analysis , *DATA analysis software - Abstract
Alcohol and other drug (AOD) nurse practitioners have an advanced scope of practice that allows them to diagnose, prescribe pharmacological treatments for alcohol and other substance use disorders, and monitor physical and mental health. The Behaviour Change Wheel (BCW) is used to understand barriers and facilitators to implementation by applying three conditions of behaviour change (capability, opportunity, and motivation—the COM‐B framework). The aim of this paper is to describe the current AOD nurse practitioner workforce, and to explore barriers and facilitators to AOD nurse practitioner uptake in Australia. A mixed method approach was used in this study: a survey to determine the current state of the AOD nurse practitioner workforce (n = 41) and qualitative interviews with 14 participants to determine barriers to endorsement and ongoing work as a nurse practitioner. Interview transcripts were analysed using thematic analysis and mapped to the COM‐B framework. The AOD nurse practitioner is a highly specialized provider of holistic care to people who use alcohol and other drugs, with AOD nurse practitioners performing advanced roles such as prescribing and medication management. However, there are several barriers to the further uptake of AOD nurse practitioners in Australia, including varied organizational support, a lack of support for the higher study required to become a nurse practitioner and a lack of available positions. Arguably, nurse practitioners are key to addressing prescriber shortages inherent in AOD treatment settings. In addition, they are equipped to provide true holistic care. We recommend that barriers are addressed to expand the AOD nurse practitioner workforce in Australia. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
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