517 results
Search Results
2. The use of Open Dialogue in Trauma Informed Care services for mental health consumers and their family networks: A scoping review.
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Maude, Phil, James, Russell, and Searby, Adam
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FAMILY psychotherapy ,MENTAL health services ,PATIENTS ,SELF-efficacy ,MEDICAL care ,CINAHL database ,HEALTH ,FAMILIES ,TREATMENT effectiveness ,INFORMATION resources ,EMOTIONAL trauma ,PATIENT-centered care ,SYSTEMATIC reviews ,MEDLINE ,THEMATIC analysis ,COMMUNICATION ,LITERATURE reviews ,ONLINE information services ,PSYCHOSES ,HEALTH education ,PSYCHOLOGY information storage & retrieval systems ,EVALUATION - Abstract
Accessible Summary: What is known on the subject?: Open Dialogue was developed in Finland in the 1980s by clinical psychologist, Jaakko Seikkula. It is a development of family therapy, recognises previous trauma and has proven to be very effective in situations of acute mental illness, and in particular psychosis.Trauma Informed Care is a practice based on the understanding of and responsiveness to the impact of trauma. When people have experienced trauma, they may have difficulties in their everyday life and experience negative physical health outcomes as well as the risk of developing mental ill health.Open Dialogue is aligned to mental health care which aims to be trauma‐informed, person‐centred and rights‐based. Examples exist of the use of both approaches for service delivery with limited evaluation. What the paper adds to existing knowledge?: To our knowledge, no formal evaluation has been made of the use of open dialogue as a Trauma Informed therapy approach to support individuals and their family networks.Although both approaches recognise the impact of trauma on individuals, no study has explored the effectiveness of this treatment combination for use by mental health nurses.This review is timely as it provides insights into contemporary services that are trauma informed and have used Open Dialogue to extend therapy work with individuals and their family/networks.This scoping review was able to determine whether recommendations for clinical practice and training in Open Dialogue with Trauma Informed Care approaches could be identified. What are the implications for practice?: This review provided a broad overview on the current types of trauma‐informed care services incorporating Open Dialogue approaches into their practice.The literature, though sparce, identifies that Trauma Informed Care recognises multiple origins for mental ill health. Open dialogue has an affinity with the common values of mental health nurses. As combined therapies, they are demonstrating usefulness in engaging families and people in their journey towards recovery.Rigid adherence to Open Dialogue focus and delivery as well as training practices could be revised to make them more open to what people and their families wish to discuss. The person with mental ill health and previous trauma should be able to direct the narrative. Trauma Informed Practice principles could be adapted to improve consumer satisfaction with Open Dialogue approaches. Introduction: A large proportion of people who access mental health services have a lived experienced of trauma and are more likely to have a history of complex trauma. Open Dialogue and Trauma Informed Care practices identify previous trauma as a factor related to later psychosis. This scoping review has identified similarities and contrasts in how an Open Dialogue and Trauma Informed Care approach have been combined to complement one another for clinical work with people presenting with psychosis and previous trauma. Aim: We aimed to answer the following research question in this scoping review: What is known of the combined use of Open Dialogue and Trauma Informed Care practice when working with consumers and their family networks? As such, the purpose of this paper was to explore the application to practice and identify if any training existed and been evaluated. Method: This scoping review was based on the Arksey and O'Malley's framework. A comprehensive search was performed across five electronic databases. Grey literature was also searched through Psyche Info and Google Scholar for books, Dissertation and Theses, alongside hand searching of the reference of the studies. Articles searched was from January 2013 to January 2023. Results: Five distinct themes were identified from the literature: (1) Linking open dialogue with trauma, (2) Response to treatment, (3) Empowerment and information sharing, (4) Interpretation by clinical services, (5) Staff training outcomes. Discussion: Some tentative recommendations for practice recognised the individuals' unique story and perspective, suggested that trauma is an important concept to assess. Services practising as Trauma Informed Services that have incorporated an Open Dialogue approach have mixed experiences. The use of Open Dialogue may have some benefits for family work and exploring consumer narratives while building a network of support. However, consumers identified similar frustrations with service delivery as with the family therapy literature. For example, it was difficult to bring family members together and difficult to discuss previous traumatic events in front of family. People experiencing training in Open Dialogue reported it taking a slow pace and not what they were familiar with. Implications for Practice: Open Dialogue can facilitate engagement of consumers and their family networks and greater recognition of the peer workforce to promote collaboration in therapy is needed. Future research should also focus on evaluating the effectiveness of such services and comparing their outcomes across regions. [ABSTRACT FROM AUTHOR]
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- 2024
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3. An exploration of loneliness experienced by people living with mental illness and the impact on their recovery journey: An integrative review.
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Caple, Vanessa, Maude, Phil, Walter, Ruby, and Ross, Alistair
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CINAHL database ,PSYCHOLOGY information storage & retrieval systems ,PSYCHOTHERAPY patients ,CONVALESCENCE ,SYSTEMATIC reviews ,SCHIZOPHRENIA ,PSYCHOSES ,EXPERIENCE ,PATIENTS' attitudes ,PSYCHOSOCIAL factors ,LONELINESS ,QUALITY of life ,MEDLINE ,MENTAL illness - Abstract
Accessible Summary: What is known on the subject?: There is evidence that social isolation and loneliness is more prevalent in people living with mental illness than in the general population.People living with mental illness frequently experience stigma, discrimination, rejection, repeated psychiatric admissions, low self‐esteem, low self‐efficacy, and increased symptoms of paranoia, depression, and anxiety.There is evidence of common interventions that can be used to improve loneliness and social isolation such as psychosocial skills training and cognitive group therapy. What the paper adds to existing knowledge?: This paper offers a comprehensive assessment of the evidence between mental illness, loneliness, and recovery.The results suggest that people living with mental illness experience elevated levels of social isolation and loneliness leading to poor recovery and quality of life.Social deprivation, social integration and romantic loneliness are related to loneliness, poor recovery, and reduced quality of life.A sense of belonging, ability to trust and hope are important aspects of improved loneliness, quality of life and recovery. What are the implications for practice?: The existing culture in mental health nursing practice needs to be examined to address loneliness in people living with mental illness and its impact on recovery.Existing tools to research loneliness do not consider dimensions in loneliness experience as reflected in the literature.Practice needs to demonstrate an integrated approach to recovery, optimal service delivery and augmentation of evidence‐based clinical practice to improve individual's loneliness, social circumstances, and relationships.Practice needs to demonstrate nursing knowledge in caring for people living with mental illness experiencing loneliness.Further longitudinal research is required to clearly understand the relationship between loneliness, mental illness, and recovery. Introduction: To our knowledge, there are no previous reviews on the impact of loneliness experienced by people aged 18–65, who are living with mental illness and their recovery experience. Aim/Question: To explore the experience and impact of loneliness in people living with mental illness during recovery. Method: An integrative review. Results: A total of 17 papers met the inclusion criteria. The search was conducted using four electronic databases: MEDLINE, CINAHL, Scopus and PsycINFO. Across these 17 papers, participants were most commonly, diagnosed with schizophrenia or psychotic disorders and recruited from community mental health services. Discussion: The review revealed loneliness to be substantial in people living with mental illness and that loneliness affected their recovery, and their quality of life. The review identified many factors that contribute to loneliness including unemployment, financial strain, social deprivation, group housing, internalized stigma and mental illness symptoms. Individual factors such as social/community integration and social network size as well as an inability to trust, a sense of not belonging, hopelessness and lack of romance were also evident. Interventions targeting social functioning skills and social connectedness were found to improve social isolation and loneliness. Implications for Practice: It is vital for mental health nursing practice to employ an approach integrating physical health as well as social recovery needs, optimal service delivery and augmentation of evidence‐based clinical practice to improve loneliness, recovery, and quality of life. [ABSTRACT FROM AUTHOR]
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- 2023
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4. RETRACTED: Reduced self‐harm on acute mental health wards following the implementation of a vision‐based patient monitoring system: Evidence from five NHS trusts.
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Kekic, Maria, Rose, Adam, Baker, Cameron, and Bayley, Daniel
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Accessible Summary: What is known on the subject?: Inpatient mental health settings pose unique challenges for patient safety, in part because psychiatric disorders are well‐known risk factors for self‐harm and suicide.Ward staff follow protocols to try and keep patients safe including carrying out in‐person safety checks, usually every 15 min, but patients unfortunately still find opportunities to harm themselves.A vision‐based patient monitoring system (VBPMS) is a contact‐free technology that can help mental health nurses to monitor patients in hospital more effectively. For example, the tool alerts staff to situations where a patient might need assistance, like when they spend a long period of time in their ensuite bathroom.Research has shown that the VBPMS can support staff to prevent safety incidents from occurring and a recent study found a decrease in self‐harm after the tool was implemented at one NHS mental health trust. What does the paper add to existing knowledge?: This paper presents data from five NHS mental health trusts and suggests that the VBPMS can consistently help staff to prevent self‐harm on acute mental health wards. What are the implications for practice?: Managing self‐harm behaviours is a challenge for mental health nursing staff. Standard safety protocols are not effective enough – staff need new ways to monitor patients.In general hospitals, technology is used every day to support care. This research shows that the VBPMS can be used to improve patient safety in mental health hospitals. Introduction: Self‐harm is sadly relatively common in mental health inpatient settings, and the effectiveness and appropriateness of strategies used to prevent it have long been disputed. The use of vision‐based patient monitoring systems (VBPMS) has been shown to improve various safety outcomes. Their potential to support staff in preventing inpatient self‐harm warrants further exploration. Aim: This research investigated whether implementing a VBPMS—as an adjunct to existing clinical practice—within acute inpatient services at five NHS England mental health trusts led to reductions in self‐harm. Method: Five quasi‐experimental studies assessed the number of bedroom self‐harm incidents, across 12 adult wards, before and 5–12 months after a VBPMS was deployed. Percentage changes were calculated. Four studies used control groups and were included in a fixed‐effect meta‐analysis. Results: In the meta‐analysis, a significant inverse‐weighted average relative risk percentage change of −38.9% was recorded. For the study with no control groups, reductions in self‐harm were seen across all wards (range: −9.1% to −29.8%). Discussion: This research demonstrates that VBPMS can support clinicians to create safer ward environments by preventing incidents of self‐harm from occurring. Implications for Practice: The results provide preliminary support for wider rollout of the technology on acute mental health wards. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Experiences of consumers, carers and clinicians during borderline personality disorder presentations to the emergency department—An integrative review.
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Miller, Joseph, Nguyen, Elle, Lam, Amanda Yu Hui, Brann, Peter, Innes, Stanley, Buntine, Paul, Broadbear, Jillian, and Hope, Judy
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MEDICAL information storage & retrieval systems ,CONSUMER attitudes ,CINAHL database ,HOSPITAL emergency services ,DESCRIPTIVE statistics ,BORDERLINE personality disorder ,PROFESSIONS ,SYSTEMATIC reviews ,MEDLINE ,ATTITUDES of medical personnel ,CAREGIVER attitudes ,PSYCHOLOGY information storage & retrieval systems ,SOCIAL stigma - Abstract
Introduction: People with a borderline personality disorder (BPD) diagnosis or symptoms may experience emotional crises which necessitate use of the emergency department (ED). No existing reviews focus specifically on experiences of consumersa, carersb and clinicians in relation to ED presentations by people diagnosed with BPD. Aim/Question: The aim of this study was to synthesise knowledge on consumer, carer and clinician experiences of BPD in the ED. Method: An integrative review methodology was chosen as it best captures the complexity of varied perspectives and emergent phenomena from diverse literature sources. EMBASE, CINAHL, PsycInfo and Medline were searched for papers published before 16 February 2022. Results: Nine papers met the inclusion criteria (five qualitative, one quantitative, one mixed methods and two letters to the editor). Key themes were barriers to timely and adequate care, and stigmatising attitudes and practices towards people diagnosed with BPD. Negative attitudes were perceived to perpetuate harmful outcomes and further ED visits. Discussion: Predominantly negative ED experiences were expressed by clinicians, consumers and carers. Further work is needed in ED models of care and staff education to improve the experience of care for consumers, carers and clinicians alike. Implications for Practice: Opportunities for change will exist through co‐designed innovation, education, advocacy and leadership. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Mothers' and birthing parents' experiences with 1‐day cognitive behavioural therapy‐based workshops for postpartum depression: A descriptive qualitative study.
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Varambally, Meghna, Layton, Haley, Jack, Susan M., and Van Lieshout, Ryan J.
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WORLD Wide Web ,EDINBURGH Postnatal Depression Scale ,RESEARCH funding ,QUALITATIVE research ,COMPUTER software ,CONTENT analysis ,STATISTICAL sampling ,QUESTIONNAIRES ,ATTITUDES of mothers ,POSTPARTUM depression ,INTERNET ,TREATMENT effectiveness ,PSYCHOLOGICAL adaptation ,PSYCHOEDUCATION ,BEHAVIOR ,EMOTIONS ,ADULT education workshops ,RESEARCH methodology ,ABILITY ,SOCIAL skills ,COGNITIVE therapy ,SOCIAL support ,PATIENT satisfaction ,APPLICATION software ,DATA analysis software ,AFFECT (Psychology) ,LEARNING strategies ,CHILD care ,TRAINING ,PATIENTS' attitudes ,THOUGHT & thinking ,PATIENT participation - Abstract
Accessible Summary: What Is Known about the Subject?: One in five mothers and birthing parents are affected by postpartum depression (PPD), yet only a small proportion of those with PPD receive treatment.Given cost and accessibility barriers to treatment, brief therapies (e.g. 1 day) could help address PPD on a large scale, though understanding participants' unique experiences with this novel treatment will help guide its refinement and use. What this Paper Adds to Existing Knowledge?: This paper describes the experiences, perspectives and satisfaction of participants who attended a 1‐day workshop for PPD.Participants appreciate being taught practical techniques and the receipt of social support from facilitators and other attendees in the group setting, while some recommended further 'booster sessions' to enhance effectiveness. What Are the Implications for Practice?: One‐day CBT‐based workshops may be an effective, low‐intensity treatment option that provides helpful skills and builds social networks for individuals with PPD.Additional post‐workshop booster sessions may enhance participant satisfaction with this new treatment by providing a reinforcement of their learning and an opportunity to re‐connect with other birthing parents. Introduction: Postpartum depression (PPD) affects up to one in five mothers and birthing parents. Understanding their perceptions of therapeutic interventions is key to their effectiveness and scalability. Aim: The aim of the study was to understand participants' experiences attending an in‐person or online 1‐day cognitive behavioural therapy (CBT)‐based workshop for PPD and compare their experiences participating in either modality. Method: This descriptive qualitative study was embedded in two separate randomized controlled trials evaluating the effectiveness of 1‐day CBT‐based workshops for PPD delivered in‐person or online. Responses were provided by 94 in‐person and 95 online participants about their experiences. Content analysis was used to code and categorize the data. Results: Participants appreciated learning skills to improve PPD symptoms and joining a community of individuals with shared experiences. Integrating practical coping techniques after the workshop was reported to be most useful, though some wanted additional post‐workshop support. Online participants identified additional barriers to workshop engagement. Discussion: Participants who attended either workshop found them to be valuable and effective. Participants valued psychoeducation, social connections and applying practical CBT techniques. Implications for Practice: One‐day CBT‐based workshops may be an accessible treatment option for individuals with PPD, providing new skills and social support, though some prefer to receive additional post‐workshop support. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Clinical teaching practices in maternal mental health care: An integrated review.
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Hussein, Chrissie Rashidi, Baluwa, Masumbuko, and Bvumbwe, Thokozani
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MATERNAL health services ,MENTAL health services ,INTERPROFESSIONAL relations ,GREY literature ,MIDWIVES ,HEALTH occupations students ,UNDERGRADUATES ,EDUCATIONAL outcomes ,TEACHING methods ,MIDWIFERY education ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,THEMATIC analysis ,CLINICAL competence ,LABOR demand ,CLINICAL education ,ONLINE information services ,PROFESSIONAL standards ,PSYCHIATRIC nursing ,NURSE educators - Abstract
Accessible Summary: What is known about the topic?: Mental health‐related problems in pregnancy are now becoming a global health concern. However, most studies have reported that midwives are unable to assess and support maternal mothers due to poor preservice education. The findings of these studies needed to be explored further from the available literature to address the gap. What does the paper add to existing knowledge?: The paper has identified maternal mental health core competencies and innovative clinical teaching strategies that nurse educators can utilize when supporting students theoretically and during clinical practice so that students should be adequately prepared for maternal mental health practice.Challenges and recommendations for clinical teaching were also identified. However, there are still gaps in the literature related to the effectiveness of teaching strategies to promote competence acquisition in maternal mental health. What are the implications for education?: The study results can be used by nurse educators to develop effective clinical teaching practices in maternal mental health care. The findings can be used in the development of best clinical teaching guidelines for maternal or perinatal mental health to be used by nurse educators for the undergraduate midwifery training programmes. Introduction: Maternal mental health problems are commonly experienced by women; however, they are usually not adequately recognized and treated by midwives in Malawi. Evidence suggests poor preservice education by nursing colleges which affects the development of essential maternal mental health competencies. Aim: The aim of the study was to review existing evidence on clinical teaching practices by nurse educators in teaching student midwives maternal mental health care. Method: Integrative review method was used, and various databases were searched. Out of 1768 articles, 27 research articles met the inclusion criteria. The critical appraisal skills programme checklist tools were used to assess data quality. Thematic analysis was done by comparing, grouping and integrating data. Results: Six themes emerged, namely: core maternal mental health competencies, professional regulation, interactive teaching strategies, collaborative partnerships, capacity building and shortage of resources. Discussion: Clinical teaching is an important aspect of midwifery education. Utilizing student‐centred teaching approaches helps students acquire competencies in maternal mental health care. Further research is required to identify the effectiveness of the clinical teaching methods. The Implication to Practice: The study results can assist nurse educators to provide comprehensive clinical teaching practices in maternal mental health care which will aid in the development of maternal mental health competencies among student midwives. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Staff perspectives of emergency department pathways for people attending in suicidal crisis: A qualitative study.
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McCarthy, Molly, McIntyre, Jason, Nathan, Rajan, Ashworth, Emma, and Saini, Pooja
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MEDICAL protocols ,SUICIDAL ideation ,QUALITATIVE research ,PSYCHOLOGICAL burnout ,INTERVIEWING ,HOSPITAL emergency services ,CRISIS intervention (Mental health services) ,THEMATIC analysis ,WORKING hours ,JOB satisfaction ,ATTITUDES of medical personnel ,RESEARCH methodology - Abstract
Accessible Summary: What is known on the subject?: Emergency departments (ED) are key settings to support and manage suicidal crisis; thus, ED staff are often the first point of contact for people in suicidal crisis. Despite this, some ED staff receive little training and/or education on how to best support such patients. What the paper adds to existing knowledge: Previous research focuses on one staffing role (e.g. triage nurses) whereas this paper includes staff working across the ED pathway. Administrative staff have often been excluded from research, despite representing a key part of the clinical pathway and being a person's initial contact with the ED.Overall findings demonstrate that staff experience a lack of confidence, training and burnout due to regularly supporting people in suicidal crisis. Staff also perceive there to be a negative ED culture, which often leads to poor attitudes towards suicidal crisis. The main challenges reported are an increase in working pressures, unavailability of resources and staff retention.Findings build upon previous research to highlight key challenges different staff face along the clinical pathway and the implications this can have on a patient's journey and follow‐up care provided. What are the implications for practice?: Findings are of particular importance and relevance to ED managers, and more broadly NHS England. Negative ED culture, poor staff attitudes and confidence can have a detrimental impact on both staff health and wellbeing, as well as a patient's journey throughout the ED, resulting in repeat presentations and absconding as appropriate support is not received.Policymakers need to consider staff burnout and lack of resources in mental health care strategies, and training programmes should be developed to improve culture and confidence among ED staff and managers to improve care for people attending EDs in suicidal crisis. Introduction: Emergency departments (EDs) are often the first point of contact for people in suicidal crisis. Yet, previous work has tended to focus on only one type of staffing role, failing to account for different staff perspectives along the clinical pathway. Aims: To explore and synthesise the perspectives of ED administrative (i.e. receptionists), medical (triage nurses) and mental health staff (liaison psychiatrists) working with people presenting in suicidal crisis. Method: Qualitative study guided by thematic analysis of semi‐structured interviews with 23 ED staff across six EDs in Cheshire and Merseyside, England. Results: Findings demonstrate that staff experience a lack of confidence, training and burnout due to regularly supporting people in suicidal crisis. The main challenges reported are an increase in working pressures, unavailability of resources and staff retention. Discussion: Staff felt unequipped to deal with suicide‐related presentations. Organisational support is perceived to be lacking, with increased staffing pressures and poor service availability. This lack of support was linked to job dissatisfaction. Implications for Practice: Findings are of particular relevance to individual EDs and NHS England. Addressing the challenges staff are reporting can have positive implications for staff wellbeing, as well as a patient's experience and journey throughout the ED. [ABSTRACT FROM AUTHOR]
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- 2024
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9. 'It is not a mannequin disease': A lived experience narrative of living with bulimia nervosa.
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Öcalan, Sinem, Kovancı, Mustafa Sabri, and Hiçdurmaz, Duygu
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BULIMIA treatment ,PSYCHIATRIC nursing ,OCCUPATIONAL roles ,SOCIAL support ,COGNITION ,EXPERIENCE ,BULIMIA ,HEALTH behavior ,NURSES ,EATING disorders ,BODY image ,HEALTH promotion - Abstract
Accessible Summary: What is known on the subject?: Bulimia nervosa is characterized by recurrent episodes of binge eating, inappropriate compensatory behaviours to prevent weight gain and excessive mental preoccupation with body weight and shape. What the paper adds to existing knowledge?: In this paper, the feelings, thoughts and experiences of an individual with bulimia nervosa are explained, and the positive and negative effects of their experiences during the treatment process are emphasized.This paper offers advice to patients, relatives and healthcare professionals in recognizing and treating bulimia nervosa. What are the implications for practice?: Mental health nurses should organize training, seminars and conferences to raise awareness of society against bulimia nervosa, which is defined as a mannequin disease and therefore creates a positive perception.Mental health nurses, an essential part of the health system, should raise awareness of individuals and families about recognizing, monitoring and supporting the early symptoms of bulimia nervosa. Introduction: Bulimia nervosa is one of the areas where mental health professionals have difficulties due to its nature and course. It is important to understand the factors related to this problem in‐depth to discover the dynamics unique to the individual that causes the difficulty, identify new perspectives on these dynamics and identify alternative behaviours, stop stubborn binge‐eating attacks and prevent relapse. Aim: It is aimed to provide an in‐depth insight into the nature, course and treatment processes of bulimia nervosa through the narrative of the lived experience of an individual living with this problem. Implication for Practice: The perception of beauty seriously impacts the onset and later course of bulimia nervosa and draws attention to the fact that mental health professionals and media workers have important duties to change the concept of beauty equals being skinny, created in society and the media. Quality of perceived social support is very important in preventing, treating and rehabilitating bulimia nervosa. Adopting a more objective approach, which will prevent the positive or negative stigmatization of the disease in explaining bulimia nervosa to the public, should be adopted. [ABSTRACT FROM AUTHOR]
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- 2024
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10. An account of loneliness while living with an eating disorder.
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Grech, Paulann, Azzopardi, Andrew, and Borg, Sarah
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WELL-being ,SOCIAL participation ,CONVALESCENCE ,SOCIAL media ,MENTAL health ,EXPERIENCE ,SOCIAL isolation ,LONELINESS ,MENTAL depression ,EMOTIONS ,EATING disorders - Abstract
Accessible Summary: What is known on the subject?: Severe and prolonged loneliness is known to be detrimental to mental well‐being. Eating disorders and loneliness are linked to each other with loneliness often acting as a barrier during the recovery journey. What this paper adds to existing knowledge?: This paper explores the experience of loneliness while recovering from an eating disorder, as framed within the context of childrearing and challenging family dynamics. While loneliness has negative connotations, it may act as a 'companion' to the person experiencing it. What are the implications for practice?: The first visible need is that for public figures to raise awareness of loneliness and mental well‐being. Another emerging issue is the need to re‐think automatic negative assumptions associated with loneliness. Importantly, professionals and caregivers have to consider the co‐morbidity of loneliness and mental illness. Links between loneliness and unhealthy family dynamics also need to be assessed when providing support. [ABSTRACT FROM AUTHOR]
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- 2024
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11. Mental health service users' experiences of telehealth interventions facilitated during the COVID‐19 pandemic and their relevance to nursing: An integrative review.
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Bright, Ann‐Marie and Doody, Owen
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CINAHL database ,PSYCHOLOGY information storage & retrieval systems ,MEDICAL databases ,NURSING ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,PATIENTS' attitudes ,NURSING practice ,DESCRIPTIVE statistics ,DATA analysis software ,MEDLINE ,COVID-19 pandemic ,TELEMEDICINE ,MENTAL health services - Abstract
Accessible summary: What this paper adds to existing knowledge?: Service users report telehealth interventions to be useful in terms of access and convenience however, a preference for face‐to‐face interventions remains.Nurses are using telehealth interventions in clinical practice however, further research is necessary in this area as the evidence of their involvement is limited. What are the implications for practice?: This paper highlights the use of telehealth interventions should augment rather than replace face‐to‐face care provision. Introduction: The Covid‐19 pandemic saw the swift implementation of physical and social distancing that impacted the way in which mental health services were facilitated. Consequently, telehealth/e‐health interventions are increasing in use. Aim: This integrative review aims to explore existing literature regarding mental health service users' experiences of telehealth interventions facilitated through the COVID‐19 pandemic, to determine the visibility of nursing involvement in the facilitation of telehealth interventions and to use these experiences to inform nursing practice. Method: A methodical search of eight (n = 8) academic databases was undertaken using CINAHL, SCOPUS, EMBASE, PsycINFO, Web of Science, Cochrane, MEDLINE and Academic Search Complete between January 2020 and January 2022. Results: A total of 5133 papers were screened by title and abstract of which (n = 77) progressed for full‐text screening. Five (n = 5) papers met the inclusion criteria for this review and results were mapped onto the four meta‐paradigms of nursing: person; where the findings discuss the acceptability of telehealth interventions; environment; where the findings highlight barriers and facilitators to the use of telehealth interventions; health; where the findings discuss staff time and logistical issues relating to telehealth interventions and nursing; where the findings centre around the therapeutic relationship. Discussion: This review highlights there is a paucity of direct evidence relating to nursing involvement in the facilitation of telehealth interventions. However, there are benefits to the use of telehealth interventions that include increased access to services, less perceived stigma and increased engagement which are relevant to nursing practice. A lack of individual contact and concerns relating to infrastructure indicates a fondness for face‐to‐face interventions remains high. Implications for Practice: There is a need for further research on the role of the nurse in the facilitation of telehealth interventions, specific interventions used and outcomes of such interventions. [ABSTRACT FROM AUTHOR]
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- 2023
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12. A voice of experience: Positive and negative experiences of mental health from a service user's/lived experience perspective.
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Gray, Benjamin
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PSYCHIATRIC diagnosis ,MENTAL illness drug therapy ,PSYCHIATRIC nursing ,SOCIAL support ,CAREGIVERS ,MEDICAL care ,EXPERIENCE ,PATIENTS' attitudes ,DISEASE relapse ,QUALITY assurance ,LEGAL procedure ,MENTAL health services ,PSYCHIATRIC treatment ,CONTROL (Psychology) ,ANTIPSYCHOTIC agents ,SUPPORTED employment - Abstract
Accessible Summary: What is known on the subject?: People with mental health problems are often left behind, forgotten and excludedLittle is known or written from a service user perspective about experiences of psychiatry, mental health nursing, Mental Health Tribunals and alternative approaches (such as counselling, peer support, psychological and recovery approaches, cognitive behavioural therapy—CBT and creative/art/music/drama/horticultural/dance therapies). What the paper adds to existing knowledge?: This paper aims to remedy this gap in knowledgeIt focuses on positive and negative experiences of psychiatry, Mental Health Tribunals and alternative treatments from a service user's perspective. What are the implications for practice?: The paper makes several recommendations. In brief, (1) psychiatrists need to listen more attentively rather than being focused on signs of psychosis; (2) de‐escalation techniques (for example, talking calmly with the patient) should be used by nurses before physical restraint; (3) psychiatry should be less biomedical. Nurses and social care professionals deserve better training, time for and practice in alternative and more therapeutic forms of care; (4) carers need to be more involved; (5) there need to be better, more democratic, more open processes of law; (6) voluntary work and supported employment schemes should be run by health and social services for people who want to work and want to have a vocational life. This paper aims to describe the lived experience of mental illness, coercive treatment by psychiatry and mental health nursing, and the problematic case and bias of Mental Health Tribunals. It then looks at more positive experiences of alternative approaches and makes recommendations for improving mental health services and people's experiences of them. [ABSTRACT FROM AUTHOR]
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- 2023
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13. Analysis of changes in the national mental health nursing workforce in England, 2011–2021.
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Brimblecombe, Neil
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PSYCHIATRIC nursing ,OCCUPATIONAL roles ,NURSING ,LABOR supply ,NATIONAL health services ,NURSES ,DRUG prescribing ,DESCRIPTIVE statistics ,EMPLOYMENT ,RESEARCH funding ,NURSE practitioners ,ADVANCED practice registered nurses - Abstract
Accessible Summary: What is known on the subject?: Nurses work in mental health services around the world, constituting the largest professional group.Nurses have been identified as being potentially able to carry out a much wider range of functions than are typically allowed in practice, when provided with suitable training.There are long‐term concerns regarding shortages of mental health nurses in England and many other countries.Workforce data is rarely subject to analysis in peer‐reviewed journals. What the paper adds to existing knowledge?: This paper provides a case study of the workforce patterns of a national mental health nurse (MHN) workforce overtime allowing comparison with other countries and specialities.MHN numbers reduced from 2011 to 2017, then increased to near the 2011 level by 2021, not meeting ambitious national plans for increasing numbers.The mental health nursing proportion of the total NHS nursing workforce decreased through this period.Advanced practice roles and skills are widely, but unevenly, distributed and are provided by a small proportion of nurses.The proportion of nurses working in community settings has increased to constitute more than half of all nurses for the first time.The ratio of support workers to nurses increased in inpatient settings and will continue to change. What are the implications for practice?: Historical challenges in recruiting MHNs suggest that future plans to expand the profession are overly optimistic.To support the development of advanced practice roles and new skill sets, clearer research evidence of impact is required and clearer national guidance regarding best practice models.Good workforce data are essential to inform good workforce planning. Introduction: Data regarding changes in characteristics of the MHN workforce is commonly cited in governmental publications, but is rarely analysed in peer‐reviewed journals, despite ongoing concerns regarding high vacancy rates within mental health services. Aim: The aim of the study was to characterize changes in the MHN workforce, implementation of new nursing roles/skills and alignment with national policy. Method: Analysis of nationally published workforce data, peer‐reviewed publications and governmental policy/planning documents. Results: Nurse numbers declined from 2011 to 2017, subsequently returning to near 2011 levels, but remaining below national targets. Nurses in community settings increased to constitute more than half of all nurses, whilst inpatient numbers declined, although more slowly than bed numbers. The ratio between nurses and support workers changed due to more support workers in inpatient settings. New advanced skills and roles for nurses have increased, but are unevenly distributed, constituting a small proportion of the total workforce. Implications for Practice: This paper provides a case study against which comparisons may be made with the nursing workforce in other countries and specialities. Even clear policy commitment to nursing growth may not deliver planned changes in numbers and introducing new roles may have uneven impact, especially in the absence of a robust evidence base. [ABSTRACT FROM AUTHOR]
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- 2023
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14. Perspectives of service users and carers with lived experience of a diagnosis of personality disorder: A qualitative study.
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Balmer, Anna, Sambrook, Laura, Roks, Hana, Ashley‐Mudie, Peter, Tait, Jackie, Bu, Christopher, McIntyre, Jason C., Shetty, Amrith, Nathan, Rajan, and Saini, Pooja
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PERSONALITY disorder diagnosis ,PERSONALITY disorder treatment ,PERSONALITY disorders ,RECOGNITION (Psychology) ,PSYCHOLOGICAL burnout ,PROFESSIONS ,HEALTH services accessibility ,ATTITUDES of medical personnel ,RESEARCH methodology ,CONVALESCENCE ,MEDICAL personnel ,INTERVIEWING ,SOCIAL stigma ,MEDICAL care ,PATIENT-centered care ,LABOR demand ,HEALTH service areas ,EXPERIENCE ,QUALITATIVE research ,COMPASSION ,PSYCHOSOCIAL factors ,DIALECTICAL behavior therapy ,RESEARCH funding ,THEMATIC analysis ,DECISION making in clinical medicine ,MEDICAL needs assessment ,EARLY medical intervention ,MENTAL health services ,PSYCHIATRIC treatment - Abstract
Accessible Summary: What the paper adds to existing knowledge?: Personality disorder is a serious mental health condition affecting up to 52% of psychiatric outpatients and 70% of inpatients and forensic patients. People with a diagnosis of personality disorder have higher morbidity and mortality than those without.Service users and carers reported a lack of training for staff in the management of individuals with a diagnosis of personality disorder, particularly with regard to self‐harm and suicidal behaviours.Staff burnout creates barriers to compassionate person‐centred care for individuals with a diagnosis of personality disorder as staff struggled to accommodate the nature of the presentation when under significant emotional, psychological and professional strain caused by understaffing and lack of support. What are the implications for practice?: This paper adds new knowledge by informing services of ways to improve care provision from the perspectives of both carers and service users.A more holistic and less medicalised approach to the treatment of problems associated with a diagnosis of a personality disorder should be adopted, and personality disorder training introduced for all healthcare practitioners, to improve patient outcomes. Introduction: There is limited understanding of the experience of people with complex mental health (CMH) needs, including those with a diagnosis of personality disorder (PD) and carers of those individuals. Little is known about carers of those in inpatient forensic settings, yet it has been identified that they may have additional needs when compared to general carers. Research highlights that community carer support services were perceived as inadequate and out‐of‐area placements were described as putting an added strain on ability to support loved ones. Understanding PD within a population of people with CMH needs and how a diagnosis described as PD impacts on care and treatment experience is vital to providing high‐quality care. Aim: To evaluate the care experience of service users and carers with lived experience of a diagnosis of PD and out‐of‐area placements. Method: Semi‐structured interviews were conducted with six service users and four carers to explore the experiences and perspectives of people with a diagnosis of PD. Interviews were audio recorded and thematically analysed. Results: Four interrelated themes were developed; Influence of a diagnosis of PD on Staff, Early and Appropriate Intervention, Recognition of the Individual and Training and Knowledge of people with a diagnosis of PD. Discussion: Anti‐stigma interventions for staff, research on care provision and structural changes to services including more evidence‐based therapy for individuals with a diagnosis of PD may help reduce disparate treatment and improve prognosis for recovery. Implications for Practice: This paper informs services of ways to improve care provision from the perspective of carers and service users. A more holistic and less medicalised approach to the treatment of problems associated with diagnoses of PD should be adopted, and PD training for all healthcare practitioners to improve patient outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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15. Positive mental health, depression and burnout in healthcare workers during the second wave of COVID‐19 pandemic.
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Ruini, Chiara, Pira, Giorgio Li, Cordella, Erika, and Vescovelli, Francesca
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MENTAL health personnel , *MEDICAL personnel , *PEER counseling , *PSYCHOLOGICAL distress , *PSYCHOLOGICAL burnout , *PSYCHIATRIC nursing - Abstract
Accessible Summary What is known on the subject? What this paper adds to existing knowledge? What are the implications for practice? Introduction Aims Methods Results Discussion Implication for Practice In the past 2 years, the COVID‐19 pandemic had a robust negative impact on the mental health of healthcare providers, with increasing rates of depression, anxiety, acute stress and burnout. Healthcare workers experiencing poor mental health are reluctant to seek help and treatment because they are afraid of being stigmatized and excluded by their colleagues and employers. During the pandemic positive emotions, resilience and psychological well‐being buffered distress and burnout in healthcare workers. This paper describes positive mental health, depression, anxiety and burnout in healthcare workers during the second wave of the pandemic. Forty‐eight per cent of healthcare workers were flourishing (high levels of positive emotions and well‐being), 10% languishing (absence of well‐being and positivity). Flourishing individuals reported lower levels of depression, anxiety and burnout. These findings documented a relevant number of resilient healthcare workers, who restored/maintained their well‐being also under stressful conditions. Vulnerable healthcare workers were less than 20%, and they reported severe anxiety, depression and burnout. No differences emerged between languishing and moderate mental health groups in their levels of anxiety, depression and burnout. The condition of flourishing is the only one that provides protection from depression and anxiety and burnout, while moderate mental health does not differ substantially from the languishing state. The study confirms the importance of maintaining and/or promoting the well‐being of healthcare workers. Interventions for promoting positive mental health of vulnerable workers are needed. Mental health nurses can have the skills and expertise for evaluating early symptoms of psychological distress and for implementing interventions for promoting and restoring well‐being. These interventions may include informational campaign (i.e. preparing and distributing pamphlets and guidelines) and emotional support programmes (psychoeducation and training, mental health support team, peer support and counselling) that can be delivered also via digital platforms. Few studies focused on healthcare workers' positive mental health (i.e. high levels of psychological well‐being) and its association with anxiety, depression and burnout in the second wave of the pandemic.To evaluate the protective role of well‐being in buffering burnout and psychological distress.We evaluated 173 Italian healthcare workers with indicators of psychological distress (Depression Anxiety Stress Scales [DASS]‐21), burnout (Copenhagen Burnout Inventory [CBI]) and positive mental health (Mental Health Continuum) and we cross‐classified them according to their levels of mental health (flourishing, languishing and moderate mental health) and their levels of anxiety, depression and burnout.Forty‐eight per cent of health workers were classified as flourishing, 10% as languishing and 42% as moderate mental health. Flourishing individuals presented lower scores on DASS and CBI scales, whereas no differences emerged between languishing and moderate mental health groups. More than 80% of health workers with clinically significant symptoms of anxiety, depression and risk of burnout were classified as not flourishing.This investigation documented the presence of flourishing mental health in almost half of the sample of Italian healthcare workers. However, those with moderate or languishing mental health manifested higher levels of anxiety, depression and higher risks of burnout.The study confirms the importance of maintaining and/or promoting the well‐being of this population, with a crucial role of mental health nurses who can easily approach other healthcare workers and provide them informational (training, guidelines) and emotional support programmes (psychoeducation, mental health support team, peer support and counselling) when facing adverse working conditions. [ABSTRACT FROM AUTHOR]
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- 2024
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16. Digital cognitive behavioural therapy for patients with insomnia and depression: A systematic review and meta‐analysis.
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Bai, Nan, Cao, Juling, Zhang, Huiyue, Liu, Xin, and Yin, Min
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INSOMNIA treatment ,DIGITAL technology ,MEDICAL information storage & retrieval systems ,MENTAL health ,MEDICAL technology ,TREATMENT effectiveness ,SEVERITY of illness index ,DESCRIPTIVE statistics ,META-analysis ,NURSING interventions ,SYSTEMATIC reviews ,MEDLINE ,MEDICAL databases ,COGNITIVE therapy ,ONLINE information services ,SLEEP quality ,MENTAL depression ,PSYCHOLOGY information storage & retrieval systems ,BEHAVIOR therapy ,SLEEP disorders - Abstract
Accessible Summary: What is known on the subject: Sleep problems are common among those with depression, and there is increasing evidence that sleep problems should be addressed during treatment simultaneously rather than treating depression alone.The first‐line treatment for insomnia is cognitive behavioural therapy for insomnia (CBT‐I), due to a lack of well‐trained therapists and patient time constraints (travelling, work), CBT‐I has not been popularized.The development of digital cognitive behavioural therapy for insomnia (dCBT‐I) is making the treatment more accessible. What this paper adds to existing knowledge: Interventions for dCBT‐I were significantly better than other control conditions in both reducing insomnia and improving depression in patients with depression and insomnia comorbidities.The effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention and therapist‐involved dCBT‐I has less shedding than self‐help. What are the implications for practice: It's important for mental health practitioners to realize that insomnia in depressed people needs to be treated.Future trials may explore the effectiveness of therapist‐guided dCBT‐I in depressed populations and analyse the cost‐effectiveness of this treatment. Aim: The aim of the study was to systematically identify and synthesize the evidence for the effectiveness of digital cognitive behavioural therapy in insomnia with comorbid depression. Design: Systematic review and metaanalysis. Methods: A search was conducted on five English and four non‐English databases from the inception of the databases to November 2023. This review adhered to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta‐analysis Statement 2020 and the included studies were evaluated using version 2 of the Cochrane risk of bias tool. This review examined sleep‐related outcomes, including insomnia severity and sleep diaries, along with psychological outcomes, such as depression. We conducted a meta‐analysis of each outcome using a random effects model. Heterogeneity was assessed by the I2 statistic. Results: A total of seven articles with 1864 participants were included in this review. The results showed that the digital cognitive behavioural therapy group demonstrated a statistically significant amelioration in the severity of insomnia symptoms, as well as a reduction in depressive symptomatology compared with the control groups. The post‐intervention effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention. Conclusions: Digital cognitive behavioural therapy for insomnia application in patients with depression and insomnia was demonstrated to be effective, less time‐consuming and more accessible. Relevance to Clinical Practice: We may consider incorporating nurses into treatment plans and conducting nurse‐led interventions in specific programs. In the future, nurses may be able to provide exclusive digital behavioural therapy for insomnia to patients with depression to achieve greater effectiveness. [ABSTRACT FROM AUTHOR]
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- 2024
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17. Experiences of general home visiting nurses regarding patients with suicidal ideation in Japan: Results from semi‐structured interviews.
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Chijiiwa, Tomoko and Ishimura, Kayoko
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NURSING education ,NURSES ,HOME nursing ,NURSE-patient relationships ,RISK assessment ,COMMUNICATIVE competence ,SUICIDAL ideation ,QUALITATIVE research ,RESEARCH funding ,INTERVIEWING ,CONTINUUM of care ,EXPERIENCE ,ISOLATION (Hospital care) ,SUICIDE prevention ,PSYCHIATRIC nurses ,NURSE liaisons ,THEMATIC analysis ,NURSES' attitudes ,RESEARCH methodology ,RESEARCH ,INFORMED consent (Medical law) ,PSYCHIATRIC nursing - Abstract
Accessible Summary: What is known on the subject?: The leading reason for suicide attempts in Japan is health problems, among which depression is the most common, followed by physical illnesses.Patients with physical illness and suicide ideation are not rare among patients receiving home‐based care.General home visiting nurses (GHVNs) without knowledge, skills or experience in psychiatric care are required to provide care for patients with physical illness who are at risk of suicide in Japan. What this paper adds to existing knowledge?: More detailed understanding of GHVNs' experiences and perspectives on working with suicidal patients in home care.This study enriches our understanding of how suicide prevention strategies should be developed for GHVNs. What are the implications for practice?: Focusing education on therapeutic communication skills and meanings with relationships with patients is required by GHVNs.Training for suicide risk assessment and guidelines appropriate to GHVNs' situation is crucial.Establishing a liaison service system with a multidisciplinary team, including psychiatric home‐visiting nurses, is necessary for home healthcare to achieve continuity of care. Introduction: In Japan, even a general home visiting nurse (GHVN) lacking psychiatric experience and training can provide home nursing care to patients at risk of suicide. Little attention is given to nursing care for suicide by GHVNs who care for patients with physical illness. However, these patients with suicidal ideation for home care are surprisingly common. Aim/Question: We explored the experiences of GHVNs who cared for patients with suicidal ideation and focused on the nurses' perceptions and interactions. Method: We conducted semi‐structured interviews with 15 GHVNs. We discussed the nurses' experiences caring for patients with suicidal ideation, their perceptions during these interactions and their response. Results: General home visiting nurses were perplexed upon learning of the patient's suicidal ideation. They interacted with such patients by 'avoiding the core of the matter' while focusing on maintaining a relationship with them. Discussion: Not addressing the patient's suicidal thoughts will not only disable the suicide risk assessment but also lead to patient isolation. Suicide prevention care needs to consider the unique characteristics of home care. Implications for Practice: General home visiting nurses require training in suicide risk assessment and communication skills. Establishing a liaison service, including psychiatric home visiting nurses, is necessary to achieve continuity of care. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Stigma and loneliness among young and middle‐aged stroke survivors: A moderated mediation model of interpersonal sensitivity and resilience.
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Huang, Haitao, Zhang, Liao, Dong, Wanglin, Tu, Ling, Tang, Haishan, Liu, Shejuan, Chen, Hong, Xie, Naze, and Chen, Chaoran
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PSYCHOLOGICAL resilience ,CROSS-sectional method ,PEARSON correlation (Statistics) ,STATISTICAL correlation ,SCALE analysis (Psychology) ,CRONBACH'S alpha ,PROBABILITY theory ,STATISTICAL sampling ,INTERVIEWING ,QUESTIONNAIRES ,LONELINESS ,DESCRIPTIVE statistics ,MATHEMATICAL models ,RESEARCH ,STROKE patients ,INTERPERSONAL relations ,DATA analysis software ,CONFIDENCE intervals ,THEORY ,SOCIODEMOGRAPHIC factors ,SOCIAL stigma ,PSYCHOSOCIAL factors ,SENSITIVITY & specificity (Statistics) ,SOCIAL participation ,REGRESSION analysis ,MIDDLE age ,ADULTS - Abstract
Accessible Summary: What is known about the subject?: Loneliness is common among young and middle‐aged stroke survivors. It not only hinders the recovery of their neurological and physical functions but also increases the risk of stroke recurrence, disability, and even death.Improving the mental health of young and middle‐aged stroke survivors is of utmost importance. However, previous research has not yet investigated the impact of interpersonal sensitivity and resilience on the relationship between stigma and feelings of loneliness. What the paper adds to existing knowledge?: This study confirms that stigma has a positive impact on loneliness among young and middle‐aged stroke survivors.Interpersonal sensitivity partially mediates the relationship between stigma and loneliness, and resilience plays a moderating role in the mediating mechanism. What are the implications for practice?: Mental health nurses can formulate nursing interventions to reduce loneliness of young and middle‐aged stroke survivors with the goals of improving stigma, reducing interpersonal sensitivity and cultivating resilience. Introduction: Previous studies have not explored the impact of interpersonal sensitivity and resilience on the relationship between stigma and loneliness. However, improving the resilience of young and middle‐aged stroke survivors and increasing their social participation is of great significance for reducing patients' loneliness of patients and promoting their physical and mental rehabilitation. Aims: To investigate the influence of stigma, interpersonal sensitivity and resilience on loneliness among young and middle‐aged stroke survivors. Methods: A cross‐sectional design was used to collect data. A total of 330 participants completed measures of stigma, resilience, interpersonal sensitivity and loneliness. The descriptive statistical approach, Pearson's correlation analysis and Hayes' PROCESS Macro Model 4 and 7 in regression analysis were used to analyse the available data. Results: The results revealed that young and middle‐aged stroke survivors' stigma, resilience, interpersonal sensitivity and loneliness were significantly correlated between every two variables, with coefficients ranging between −0.157 and 0.682. Interpersonal sensitivity played a partial mediating role in stigma and loneliness, accounting for 63.27% of the total effect; This process was moderated by resilience. Discussion: Stigma positively predicts participants' loneliness. As a mediating mechanism with moderating, interpersonal sensitivity and resilience further explain how stigma affects loneliness. Implications for Practice: Understanding this mechanism is of guiding significance to reduce loneliness of young and middle‐aged stroke patients and promote their physical and mental rehabilitation. [ABSTRACT FROM AUTHOR]
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- 2024
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19. Psychological provision in acute inpatient settings: An evaluation of indirect input.
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Bennetts, Alison and Southwood, James
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MENTAL illness treatment ,CLINICAL psychology ,PSYCHOLOGISTS ,OCCUPATIONAL roles ,T-test (Statistics) ,HOSPITAL care ,RESEARCH evaluation ,TREATMENT effectiveness ,DESCRIPTIVE statistics ,ATTITUDES of medical personnel ,RESEARCH methodology ,PSYCHIATRIC nursing ,PSYCHIATRIC hospitals ,DATA analysis software - Abstract
Accessible Summary: What is known on the subject?: Psychiatric hospitals have input from a range of professionals, including Clinical Psychologists.Most evidence used to guide what Clinical Psychologists do is based on their work with individuals rather than staff teams.Some evidence shows working with staff teams is important, but most of this is based on interviews rather than measuring the impact using numbers and statistics.The current study aimed to investigate the effectiveness of staff‐level interventions provided by a Psychology team within a psychiatric inpatient setting. What the paper adds to existing knowledge?: Training sessions were effective at increasing staff levels of confidence and understanding in psychological approaches, and the perceived usefulness of the session to their practice.Case discussion sessions were effective at increasing staff levels of understanding a service user, compassion towards the service user, perceived opportunities for change with the service user, their perceived skills to work with the service user and their perception of the usefulness of the session to their practice.Reflective practice sessions were effective at providing a space for learning, sharing ideas and reflecting.Other interventions were highly valued by nursing staff. What are the implications for practice?: Staff‐level interventions are effective and valued by mental health nursing staff and should be considered in allocation of psychology resources.Interventions improved staff psychological thinking which could positively impact service user experience.There is potential for people with lived experience to participate in these interventions, which could facilitate the therapeutic relationship and reduce restrictive practices. Introduction: The role of Psychologists in psychiatric inpatient settings is well established and involves intervention at various levels; however, quantitative exploration of the effectiveness of staff‐level interventions is lacking. Aim: The aim of the study was to examine the effectiveness of a variety of staff‐level interventions provided by a Psychology team within a psychiatric inpatient setting. Methods: The evaluation used a mixed methods approach incorporating pre–post quantitative data and post‐intervention feedback. Additional data were collected via survey. Key Findings: Results indicated all staff‐level interventions were effective in achieving their aims and were highly valued by staff. Qualitative data supported the quantitative findings and showed tentative suggestion of a change to clinical practice. Discussion: Indirect psychology provision was found to significantly impact a range of staff attitudes and was highly valued by the staff team, supporting previous qualitative findings in psychiatric inpatient settings. Further quantitative evidence of the impact of staff‐level interventions should be sought. Implications: Staff‐level interventions are effective and valued by mental health nursing staff and should be considered in allocation of psychology resources. Furthermore, there is potential for people with lived experience to participate in these interventions, which could facilitate the therapeutic relationship and reduce restrictive practices, however this requires future research. [ABSTRACT FROM AUTHOR]
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- 2024
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20. Development of the clinical competency assessment scale in child and adolescent mental health nursing.
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Funakoshi, Akiko, Miyamoto, Yuki, Tsuchiya, Tomoko, and Tsunoda, Aki
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NURSING audit ,COMPETENCY assessment (Law) ,PEDIATRIC nursing ,MULTITRAIT multimethod techniques ,SCALE analysis (Psychology) ,PEARSON correlation (Statistics) ,RESEARCH funding ,STRUCTURAL models ,MEDICAL errors ,T-test (Statistics) ,CRONBACH'S alpha ,RESEARCH methodology evaluation ,INTERVIEWING ,RESEARCH evaluation ,QUESTIONNAIRES ,HOSPITALS ,DESCRIPTIVE statistics ,EXPERIMENTAL design ,PSYCHIATRIC nurses ,RESEARCH methodology ,PSYCHOMETRICS ,STATISTICAL reliability ,STATISTICS ,INTRACLASS correlation ,NATIONAL competency-based educational tests ,PSYCHIATRIC nursing ,FACTOR analysis ,DATA analysis software - Abstract
Accessible Summary: What is known on the subject?: Children and adolescents' mental health problems, such as autism spectrum disorder, anxiety disorder and attention‐deficit hyperactivity disorder, are a global public health concern, and nurses require advanced expertise and skills to properly care for this population.There is a gap between the required competencies and the actual skills and knowledge of CAMHN practitioners. Previous studies suggest that educational interventions for nurses are necessary to enhance the quality of care for children and adolescents with mental health problems. However, the corresponding evaluation indicators have not been verified, making it difficult to determine the most effective methods. What this paper adds to existing knowledge?: The present study developed the two‐factor (direct care for children and their family members and approach to the care environment) Clinical Competency Assessment Scale in Child and Adolescent Mental Health Nursing (CCAS‐CAMHN).We demonstrated that the assessment scale was reliable and valid, based on its adequate internal consistency and temporal stability, the acceptable range of its model‐fit indexes, and its good concurrent and divergent validity. What are the implications for practice?: The newly developed scale is useful for assessing nurses' competency and could help them identify their difficulties in CAMHN.The scale could contribute to the development of effective educational interventions to enhance the quality of care for children and adolescents with mental health problems. Introduction: Caring for children and adolescents with mental health problems, such as autism spectrum disorder, anxiety disorder and attention‐deficit hyperactivity disorder, requires expertise and skills. A quantitative clinical competency measurement tool in child and adolescent mental health nursing (CAMHN) is needed to evaluate the indicators of advanced expertise. Aim: The aim of this study was to develop a clinical competency assessment scale in CAMHN and evaluate its psychometric properties. Method: Scale items were derived from previous studies and adjusted based on cognitive interviews with five CAMHN experts. In total, 505 nurses in CAMHN from 29 hospitals in Japan participated in the self‐administered survey. The scale's construct validity, criterion‐related validity, internal consistency and test–retest reliability were assessed. Results: A two‐factor (direct care for children and their family members and approach to the care environment) scale was constructed. A secondary structural model showed that a two‐factor model fits best. The total score was significantly and positively correlated with excellence in nursing practice, amount of clinical experience and mental status. The overall scale exhibited good validity and reliability. Discussion: The scale is reliable and valid for assessing CAMHN clinical competency. Implications for Practice: The scale is useful for assessing nurses' competency and evaluating educational interventions' effectiveness for nurses. [ABSTRACT FROM AUTHOR]
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- 2024
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21. Parenting and family life experiences of mothers diagnosed with schizophrenia within Chinese cultural context.
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Ko, Chen Ju, Lee, Shih‐Kai, and Li, Yi‐Cheng
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SCHIZOPHRENIA ,DEHUMANIZATION ,PSYCHOLOGICAL resilience ,RESEARCH funding ,CULTURE ,INTERVIEWING ,PARENTING ,FAMILIES ,ATTITUDES of mothers ,JUDGMENT sampling ,FAMILY relations ,EXPERIENCE ,THEMATIC analysis ,PHENOMENOLOGY - Abstract
Accessible Summary: What is known on the subject?: Parenting experiences are a great challenge but also a meaningful achievement for mothers diagnosed with schizophrenia (MDWSs).Most previous studies focused on the parenting experiences of Chinese mothers diagnosed with depression rather than those diagnosed with schizophrenia, who usually experience psychiatric symptoms. What this paper adds to existing knowledge?: Unlike in Western society, Chinese society is characterised by a family‐centred culture. This study insightfully explores MDWSs' parenting and family life experiences addressing their intrapersonal mindsets, interpersonal connections with family members across generations and extrapersonal roles such as traditional social expectations as a mother, wife and daughter‐in‐law.While Western studies have mainly focused on MDWSs' personal resilience, this study insightfully explored MDWSs' resilient dimensions including their personal, familial and cultural issues within the Chinese society. What are the implications for practice?: This study develops a comprehensive and professional understanding of the parenting experiences and family interactions of MDWSs who struggle to achieve their motherly role and re‐establish connections with intimate family members.The findings highlight the following important considerations when offering family‐based nursing cares: (1) assess power relationships, familial dynamics and cultural influences between MDWSs and their family members; (2) extend family members' involvement, such as parents‐in‐law, while offering psychoeducation to MDWSs and their family members. Introduction: In Chinese culture, raising the next generation is recognised as a crucial family matter involving intergenerational participation. Mothers diagnosed with schizophrenia (MDWSs) usually experience high stress due to psychiatric symptoms, different parenting values across generations and traditional expectations associated with motherly roles. MDWSs need urgent professional assistance. Aim: To explore MDWSs' parenting experiences and family life in Chinese cultural contexts. Method: In‐depth interviews were conducted with 20 MDWSs. Data were analysed using interpretative phenomenological analyses. Results: The superordinate theme was identified as 'You are not a qualified mother'. Three major themes were elicited: experiencing crises in parenting, family life and self‐stability; striving to be a good mother and wife under humiliation; and developing wisdom and courage to move forward. Discussion: A dehumanised attitude of family members in a paternalistic culture was found. While Western society focuses on personal resilience and family‐based nursing care for nuclear families, Chinese society intensively focuses on MDWSs' relationship with nuclear family members as well as extended family members such as parents‐in‐law. Implications for Practice: The results highlighted the significance of culturally sensitive nursing care for MDWSs and family‐centred psychoeducation that clarifies familial dynamics and improves effective communication between MDWSs and their family members. [ABSTRACT FROM AUTHOR]
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- 2024
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22. The impact of storytelling on building resilience in children: A systematic review.
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Ramamurthy, Chandra, Zuo, Peixin, Armstrong, Gregory, and Andriessen, Karl
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PSYCHOLOGICAL resilience ,MEDICAL information storage & retrieval systems ,RESEARCH funding ,MENTAL health ,CINAHL database ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,STORYTELLING ,DATA analysis software ,ONLINE information services ,PSYCHOLOGY information storage & retrieval systems ,ERIC (Information retrieval system) - Abstract
Accessible Summary: What is known on the subject?: Storytelling is an effective tool for communication, is universally comprehensible and transcends linguistic barriers, adapting to cultures easily.Storytelling has a strong influence on children and has been used for knowledge retention and for developing imagination, creativity and prosocial behaviours. What this paper adds to existing knowledge?: The systematic review offers essential insights into the effects of storytelling interventions on the development of resilience in children.It indicates the various forms of storytelling interventions implemented and also the specific measures of resilience employed in the studies.The review has demonstrated that storytelling plays a crucial role in the development of protective factors in children including resilience. What are the implications for practice?: Psychiatric and mental health nurses working in community, hospital or mental health units play an important role in mental health interventions, particularly when it comes to children and young adults.Employing storytelling techniques can help psychiatric and mental health nurses provide timely and consistent support to children while helping them explore support systems, mechanisms and coping strategies helping build resilience.This holds particular importance for low‐ and middle‐income countries where limited resources pose challenges in providing adequate support for mental health programmes for children. Methods such as storytelling are simple and adaptable to the specific challenges faced in the mental health setting. Introduction: Resilience is a crucial aspect of mental health and coping that enables individuals to effectively recover from challenges. Fostering resilience in children becomes a significant objective. Storytelling is known to positively affect resilience, providing opportunities to share and develop narratives that help make sense of difficult experiences, find meaning in them, and building beliefs around our capacity to adapt well to challenging experiences. Aim: The aim of this review is to synthesize peer‐reviewed studies on the impact of storytelling interventions in developing resilience in children. Method: The review adhered to the updated PRISMA 2020 guidelines and was registered with PROSPERO (CRD42022365474). We conducted searches in 12 databases with search strings comprising of concepts regarding storytelling, resilience and children. Results: The review included 11 studies published between 2012 and 2022. The narrative synthesis of the studies indicates that storytelling interventions enhanced psychological resilience in children. Discussion: Storytelling‐based interventions in school settings with participatory approaches using cultural stories, and positive psychology‐based interventions were effective and feasible. Implications for Practice: This review has scope for informing future interventions with children, especially those who live in marginalized communities in low‐ and middle‐income countries (LMICs). [ABSTRACT FROM AUTHOR]
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- 2024
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23. Understanding the experience of stigma in care homes: A qualitative case study in northeast Thailand.
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Tosangwarn, Suhathai, Clissett, Philip, and Blake, Holly
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MENTAL depression risk factors ,ELDER care ,NURSING home patients ,QUALITATIVE research ,PSYCHOLOGICAL distress ,RESEARCH funding ,CULTURE ,POSITIVE psychology ,JUDGMENT sampling ,PSYCHOLOGICAL adaptation ,EXPERIENCE ,ATTITUDE (Psychology) ,THEMATIC analysis ,CASE studies ,FAMILY support ,SOCIAL support ,RESIDENTIAL care ,SOCIAL stigma ,MENTAL depression ,PSYCHOSOCIAL factors ,OLD age - Abstract
Accessible summary: What is known on the subject?: Stigma associated with care homes has been found to influence residents' lives, and it is a known risk factor for depression among older adults worldwide.Older residents in Asia and particularly, in Thai care homes commonly experience stigma due to being strongly influenced by a traditional cultural paradigm of filial piety.The understanding of how residents perceive and experience the stigma associated with residing in care homes, as well as its link to the development of depression, remains very limited. What does the paper add to existing knowledge?: This research explains the dynamics of the process of the stigma associated with living care homes among Thai older residents.This research highlights the various ways in which stigma impacts residents, their families and care home staff.This study identifies mitigating stigma factors, including social support, coping strategies (karma, mindfulness and religious devotions) and activities that may mitigate perceived stigma associated with care home residency. What are the implications for practice?: There is a compelling need to improve the well‐being of older people living in care homes and to combat the cultural stigma associated with living in care homes through promoting positive attitudes and educational interventions in society, communities and care homes themselves and involving residents' families in the planning and delivery of care for residents. We advocate that the government promotes security and sustainable life for all Thai older adults. Introduction: Stigma associated with living in care homes is a known risk factor for depression among care home residents in Asia, including Thailand. However, little is understood about how such stigma is experienced among residents and care home staff. Aims: To examine older adults' perceptions of stigma and to understand how stigma associated with living in care homes causes or exacerbates depressive symptoms. Methods: A qualitative case study approach was used to gain an in‐depth view of stigma, from two public care homes in northeast Thailand. Data were collected by in‐depth interviews with 50 participants (30 older residents and 20 care home staff), and non‐participant observation was conducted over 1 month. Thematic analysis was used to analyse the data. Results: The study identified three major themes of stigma, comprising the causes of stigma, reactions toward stigma, and mitigating factors. Discussion: Negative beliefs about care homes and residents, contribute to stigma. Residents exhibited negative emotions and behaviours, including depressive symptoms. Residents reported using particular coping strategies that helped them cope with their perceptions of stigma. Implications for Practice: Future research should focus on strategies or research to combat stigma in order to prevent depression and reduce perceptions of stigma. [ABSTRACT FROM AUTHOR]
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- 2024
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24. A Nominal Group Technique to finalise Safewards Secure model and interventions for forensic mental health services.
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Maguire, Tessa, Harrison, Maicee, Ryan, Jo, Lang, Ryan, and McKenna, Brian
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PREVENTION of violence in the workplace ,CONSENSUS (Social sciences) ,NURSES ,FORENSIC nursing ,BEHAVIOR disorders ,MENTAL health services ,PATIENT safety ,HUMAN services programs ,MEDICAL personnel ,INTERPROFESSIONAL relations ,VIOLENCE against medical personnel ,FORENSIC psychiatry ,RESTRAINT of patients ,WORK experience (Employment) ,REFLECTION (Philosophy) ,JUDGMENT sampling ,THEMATIC analysis ,PSYCHIATRIC nurses ,EXPERIENCE ,MATHEMATICAL models ,PATIENT-professional relations ,PSYCHIATRIC hospitals ,THEORY ,EXPERTISE ,PSYCHIATRIC nursing ,INDUSTRIAL safety ,GROUP process - Abstract
Accessible Summary: What is known on the subject?: Safewards was developed for acute mental health units, and while could be effective in forensic mental health services, there are some gaps in the model for such services, where factors including offending behaviour and longer term care can have an influence. What this paper adds to existing knowledge?: The importance of acknowledging and addressing responses related to offending behaviour in forensic mental health settings, while also understanding the vulnerability of the consumer group and responsibilities to the maintenance of professional boundaries.Enhancing collaboration with consumers/families/carers/supporters is important in a forensic mental health setting, and an important element of Safewards Secure. What are the implications for practice?: This study completes the development of Safewards Secure, designed to foster collaboration, address issues pertinent to forensic mental health settings to enhance implementation and acceptance of the model and reduce conflict and containment. Introduction: Safewards is a model developed for acute mental health settings designed to reduce conflict and containment; however, it requires adaptation to forensic mental health settings. Aim: To develop the Safewards Secure model, a model to assist forensic mental health services to reduce conflict and containment. Method: A literature review was conducted to elicit possible modifiers and adjustments to the interventions. A Nominal Group Technique was then used to engage forensic mental health experts who had experience implementing Safewards (n = 12) to seek feedback about the suggestions and reach consensus on the Safewards Secure model and interventions. Data were thematically analysed. Results: Experts reached consensus on all suggestions, however, did recommend minor additions and modifications. Two themes were also interpreted: Safewards Secure is just as much for staff as it is for consumers, and the proposed additions encourage more meaningful staff to consumer collaboration. Discussion: This study identified key challenges experienced by nurses working in forensic mental health settings, however, these challenges were not seen as insurmountable. The Safewards Secure model offers prompts and suggestions to encourage reflection, collaboration and a humanistic approach to care in forensic mental health settings. Implications for Practice: Addressing reactions to offending behaviour and encouraging more collaboration might assist in ensuring a more person‐centred approach to forensic mental health nursing care. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Factors influencing the recovery‐oriented attitudes of nursing directors in psychiatric hospitals: A cross‐sectional study in Japan.
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Matsui, Yoko, Kataoka, Mika, and Tanimura, Susumu
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PSYCHIATRIC nursing ,CROSS-sectional method ,INTERDISCIPLINARY education ,HOSPITAL utilization ,INTERPROFESSIONAL relations ,HOSPITAL building design & construction ,REHABILITATION of people with mental illness ,MULTIPLE regression analysis ,SEX distribution ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,AGE distribution ,WORK experience (Employment) ,NURSING ,SURVEYS ,PSYCHIATRIC hospitals ,DATA analysis software ,LENGTH of stay in hospitals ,CONFIDENCE intervals ,EDUCATIONAL attainment - Abstract
Accessible Summary: What is known on the subject?: Recovery‐oriented services have been shown to promote recovery in people with mental illness; their implementation is important for current psychiatric practice and is being considered by many professional institutions.The Japanese government released the policy 'A Vision for Reform of Mental Health and Medical Welfare' (Ministry of Health, Labour and Welfare, 2004; https://www.mhlw.go.jp/topics/2004/09/dl/tp0902‐1a.pdf), aiming to update public consciousness, reorganize the mental healthcare welfare system and strengthen the foundation of mental healthcare to promote a basic policy focusing on the transition 'from hospital to community life'. What the paper adds to existing knowledge?: This is the first study to clarify recovery‐oriented attitudes among psychiatric nursing directors and related factors in Japan. It shows an association between recovery‐oriented attitudes and hospital size. What are the implications for practice?: A relationship exists between the recovery knowledge and recovery‐oriented attitudes of psychiatric nursing directors. It may thus be valuable for directors to see and hear about the experiences of patients living in the community during their recovery process. As hospital size and organizational climate may hinder the successful implementation of recovery‐oriented practices, these factors must be considered when introducing such practices.Further research is needed on the relationship between psychiatric nursing directors' recovery‐oriented attitudes and practices. Moreover, to develop intervention studies that uncover success factors for enhancing recovery‐oriented attitudes, organizational factors that enable recovery‐oriented practices must be further investigated. Introduction: Recovery‐oriented practices in mental health services have become a global priority. Despite their proven effectiveness, Japanese hospitals have not widely implemented such practices. Aim: This study clarified psychiatric nursing directors' recovery‐oriented attitudes and factors regarding promoting recovery‐oriented practices to identify methods for developing these practices in Japan. Method: This cross‐sectional study used a questionnaire survey with 250 nursing directors from 1287 Japanese psychiatric hospitals. Multivariable regression analysis assessed how socio‐demographic variables and Recovery Knowledge Inventory (RKI) scores affected Recovery Attitudes Questionnaire (RAQ‐7) scores. Results: The analysis revealed that more clinical and managerial experience was associated with more negative recovery‐oriented attitudes. High RKI scores, knowledge of strength, hospital size and outpatient work experience were associated with more positive recovery‐oriented attitudes. Discussion: Implementing recovery practices requires consideration of knowledge and experience in recovery and hospital size alongside recovery training based on a hospital's organizational structure. Although the low response rate could influence the study's generalisability, it could also indicate low interest in recovery‐oriented practices among professionals. Implications for Practice: Acquiring more knowledge and experience regarding recovery promotes recovery‐oriented attitudes among nursing directors. An appropriate organizational culture and consideration of hospital size are required when introducing such recovery practices. [ABSTRACT FROM AUTHOR]
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- 2024
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26. 'On the slope of an erupting volcano': A qualitative study on the workplace violence experiences of psychiatric nurses.
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Küçük Öztürk, Gülhan, Başer, Eylül, and Engin, Esra
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WORK ,QUALITATIVE research ,SELF-efficacy ,INTERVIEWING ,CONTENT analysis ,VIOLENCE in the workplace ,JUDGMENT sampling ,PSYCHIATRIC nurses ,THEMATIC analysis ,NURSES' attitudes ,RESEARCH methodology ,GROUNDED theory ,EXPERIENTIAL learning - Abstract
Accessible Summary: What is known on the subject?: Workplace violence is common in healthcare.Workplace violence remains a complex and serious occupational hazard in healthcare. What this paper adds to existing knowledge?: Since there is no study examining detailed explanations of experiences and perspectives of workplace violence among psychiatric nurses, this study will act as a guide for psychiatric nurses.This study provides information about how psychiatric nurses evaluate the concept of workplace violence from their perspective, what it means to them and the effects of workplace violence. What are the implications for practice?: Considering the effects of workplace violence, a preventive, systematic and holistic approach should be used in psychiatry and community mental health centres.Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Introduction: Workplace violence is common in healthcare and remains a complex and serious occupational hazard. Aim: This research was conducted to assess the workplace violence experiences and perspectives of psychiatric nurses. Method: This study was a qualitative study conducted using a grounded theory approach method. The study was conducted between November 2022 and January 2023. The purposeful sampling method was used, and 11 psychiatric nurses were interviewed. Data were collected with an information form and a semi‐structured interview form. The data were analysed using content analysis, and themes were created. Findings: The ages of the psychiatric nurses ranged from 38 to 57 years. Themes and sub‐themes related to the workplace violence experiences and perspectives of psychiatric nurses included the way of violence (rising tension, eruption of the volcano, unintentional violence and turning to ash) and empowerment (ash cloud and ring of fire). Conclusion: Psychiatric nurses stated that they were exposed to verbal and physical violence for many reasons, that this situation seriously affected their physical, mental and social health and that in addition to the devastating effects of violence, they became stronger by developing various skills to protect against violence. Implications for Practice: Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Strategies can be developed to include psychiatric nurses in occupational health nursing courses. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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27. Caregiving and receiving experiences in UK community mental health services during COVID‐19 pandemic restrictions: A qualitative, co‐produced study.
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McKeown, Jane, Short, Valentina, Newbronner, Elizabeth, Wildbore, Ellie, and Black, Carrie‐Ann
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RESEARCH funding ,QUALITATIVE research ,MEDICAL care ,INTERVIEWING ,STATISTICAL sampling ,PATIENT care ,STAY-at-home orders ,PSYCHIATRIC nurses ,THEMATIC analysis ,NURSES' attitudes ,RESEARCH methodology ,CONVALESCENCE ,DATA analysis software ,SOCIAL support ,COVID-19 pandemic ,PATIENTS' attitudes - Abstract
Accessible Summary: What is known on the subject?: At the outset of the COVID‐19 pandemic, little was known about ways of delivering registered nurse practice within CMHTs under restrictions associated with a global pandemic.Emerging research focused on broad healthcare staff wellbeing during the pandemic. Qualitative research explored the overall response of COVID‐19 on people with existing health needs or remote working more specifically.Over the past 2 years studies have emerged detailing experiences but no studies have used qualitative research to understand community mental health nurses and service users experience of services. What the paper adds to existing knowledge?: This co‐produced qualitative study is the first to explore the changes to CMHT care from the experience of service users and nurses later in the COVID‐19 pandemic.The study questions whether recovery‐based approaches are possible in a hybrid way of working.The findings identify challenges for nurses' well‐being and work–life boundaries when working from home.The study adds to historical professional narratives of mental health nursing. What are the implications for practice: While hybrid approaches developed in response to COVID‐19 restrictions may offer more choice these approaches need further co‐produced evaluation on the impact of recovery‐focused care and therapeutic relationships.Mental health nurses need to review how future hybrid working continues to impact nurses' mental health and emotional safety.Nurses and service users need to raise awareness within society and policy on the impact that COVID‐19 had on people with existing mental health conditions. Introduction: Community Mental Health Team responses to COVID‐19 included fundamental service delivery adaptations. Aim/Question: Our co‐produced study sought to understand which service delivery changes experienced by service users and registered nurses were helpful or unhelpful to caregiving and receiving. Method: Qualitative semi‐structured interviews were undertaken with 10 service users and 13 registered nurses from 3 NHS England sites. Co‐produced throughout, people with lived experience of mental health services and nurses wishing to improve their research experience undertook interviews following training. Data were analysed thematically. Findings: Care radically changed from in‐person to large phone or video contact. This reportedly altered therapeutic relationship building and raised questions about whether recovery‐focused care was possible. Hybrid working was viewed as helpful but raised challenges for nurse wellbeing. Discussion: Changes to care delivery challenged the fundamentals of recovery‐focused interventions and therapeutic relationships. Service users and nurses well‐being consequently suffered. The impact of the pandemic on people with existing mental health conditions was poorly acknowledged in the media. Implications for Practice: Recovery‐focused interventions and relationship building need evaluating in the light of ongoing hybrid working. Teams need to consider the well‐being of nurses engaged in complex service‐user interactions from home. [ABSTRACT FROM AUTHOR]
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- 2024
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28. Reducing seclusion and restraint in an acute adolescent psychiatric ward: A feasibility study.
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Lee‐Aube, Angel, Vakili, Alexandra, Padhi, Ashwini, Joseph, Sumithira, Norcott, Julie, and Yap, Keong
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SAFETY ,SICK leave ,PSYCHOTHERAPY patients ,SCALE analysis (Psychology) ,CURRICULUM ,HUMAN services programs ,JOB absenteeism ,CRONBACH'S alpha ,HOSPITAL nursing staff ,PILOT projects ,CHILD psychiatry ,MEDICAL care ,VIOLENCE against medical personnel ,SCIENTIFIC observation ,PARAMETERS (Statistics) ,SECLUSION of psychiatric hospital patients ,RESTRAINT of patients ,DESCRIPTIVE statistics ,MANN Whitney U Test ,THEMATIC analysis ,SURVEYS ,SELF-mutilation ,MATHEMATICAL statistics ,RESEARCH methodology ,COMMUNICATION ,PSYCHIATRIC hospitals ,PSYCHOLOGY of caregivers ,DATA analysis software ,PSYCHOSOCIAL factors ,WELL-being ,NONPARAMETRIC statistics - Abstract
Accessible Summary: What is known on the subject: Restraining and secluding health consumers for safety reasons continue to be used in psychiatric inpatient facilities even though they have no therapeutic value and have negative effects on consumers, families and staff.Six Core Strategies (6CS) for reducing seclusion and restraint have been developed to address this problem but there are very few effectiveness studies in inpatient adolescent psychiatric facilities. What the paper adds to existing knowledge: We used a mixed methods approach to evaluate the implementation of 6CS in an adolescent psychiatric facility. The implementation was successful. It eliminated the use of seclusion, substantially reduced the use of restraints and significantly reduced staff absenteeism.Using thematic analysis on feedback surveys, we identified five dominant themes that described consumers' and carers' experiences during their stay at the facility: communication, service delivery, flexibility, consistency and internal feeling states. What are the implications for practice: This study provides support for the feasibility of a comprehensive and broad‐based intervention program such as 6CS to reduce seclusion and restraint practices in inpatient mental health facilities.This study also demonstrates the value of using surveys to gather consumer and carer feedback and improve outcomes for service users. Introduction: Seclusion and restraint practices are routinely used in psychiatric facilities but are controversial for ethical, legal and safety reasons, and can cause significant harm to consumers, staff and organisations. Six Core Strategies (6CS) for reducing seclusion and restraint were developed to address this problem but very few studies have examined their effectiveness in adolescent settings. Aim/Question: To evaluate the implementation of 6CS in an adolescent inpatient psychiatric facility. Method: We retrieved archival data from an acute adolescent psychiatric ward that implemented the 6CS. Using a mixed methods approach, we evaluated outcomes on the use of seclusion and restraint, nursing staff sick leave and feedback surveys. Results: Findings showed an elimination of seclusion, and a significant reduction in restraint use and staff absenteeism in the 12 months after project implementation. Thematic analysis of feedback survey responses identified communication, service delivery, flexibility, consistency and internal feeling states as dominant themes in consumers' and carers' experience on the unit. Discussion: The 6CS is feasible and may be effective in reducing seclusion and restraint, which in turn may have a positive impact on staff wellbeing. Implications for Practice: Implementation of the 6CS with executive support, combined with staff and programmatic changes at a local level is recommended. [ABSTRACT FROM AUTHOR]
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- 2024
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29. Breaking the cycle: Exploring the relationship of metacognition beliefs, obsessive‐compulsive symptoms, and psychosocial performance among individuals diagnosed with schizophrenia.
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Taha, Samah Mohamed, El‐Sayed, Mona Metwally, Khedr, Mahmoud Abdelwahab, El‐Ashry, Ayman Mohamed, Aboeldahab, Mostafa, Sonbol, Hassan Mohammed, and Abd‐Elhay, Eman Sameh
- Subjects
- *
PSYCHIATRIC nursing , *PEOPLE with schizophrenia , *PSYCHOSOCIAL functioning , *BEHAVIOR therapy , *MEDICAL personnel , *METACOGNITIVE therapy - Abstract
Accessible Summary The Relevance to Mental Health Nursing Background Design Tools Results Conclusion This research paper explores the intricate relationship between metacognitive dysfunctional beliefs, obsessive‐compulsive symptoms, and psychosocial performance in patients diagnosed with schizophrenia. Understanding these dynamics can help mental health nurses identify and address each patient's needs more effectively. It can guide them in devising personalized care plans that not only manage the symptoms but also improve the underlying mechanism that exacerbates the psychotic symptoms and social functioning and the overall quality of life. Moreover, the findings of this research can contribute to developing training programs for mental health nurses, equipping them with the necessary skills and knowledge to provide optimal care.
What the paper adds to existing knowledge? •This study provides empirical evidence of the significant positive correlation between OCS and metacognitive dimensions in individuals with schizophrenia. •It highlights the role of certain demographic factors, such as younger age and single marital status, in increasing the likelihood of elevated OCS. •It underscores the inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning. •It identifies age and metacognitive scores as crucial predictors of psychosocial functioning across various domains.What are the implications for practice? •The findings suggest that therapeutic nursing interventions for individuals diagnosed with schizophrenia should address metacognitive dysfunctional beliefs to improve overall functioning and well‐being. •Clinicians, including psychiatrists and psychiatric nurses, should consider the patient's age, marital status, and metacognitive scores when assessing the risk of elevated OCS and devising treatment plans. •The study emphasizes the need for comprehensive psychiatric nursing assessment, including metacognitive dysfunction and OCS evaluation.What are the implications for future research? •Future research could explore the causal relationships between metacognitive dysfunctional beliefs, OCS, and psychosocial functioning in schizophrenia. •Longitudinal studies could provide insights into the progression of these relationships over time and the impact of therapeutic interventions. •Further research could also investigate the effectiveness of specific therapeutic strategies such as Metacognitive Therapy (MCT), Schema Therapy (ST), Cognitive Enhancement Therapy (CET), and Cognitive Behaviour Therapy (CBT) to address this population's metacognitive dysfunctional beliefs.What the paper adds to existing knowledge? •This study provides empirical evidence of the significant positive correlation between OCS and metacognitive dimensions in individuals with schizophrenia. •It highlights the role of certain demographic factors, such as younger age and single marital status, in increasing the likelihood of elevated OCS. •It underscores the inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning. •It identifies age and metacognitive scores as crucial predictors of psychosocial functioning across various domains. This study provides empirical evidence of the significant positive correlation between OCS and metacognitive dimensions in individuals with schizophrenia.It highlights the role of certain demographic factors, such as younger age and single marital status, in increasing the likelihood of elevated OCS.It underscores the inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning.It identifies age and metacognitive scores as crucial predictors of psychosocial functioning across various domains.What are the implications for practice? •The findings suggest that therapeutic nursing interventions for individuals diagnosed with schizophrenia should address metacognitive dysfunctional beliefs to improve overall functioning and well‐being. •Clinicians, including psychiatrists and psychiatric nurses, should consider the patient's age, marital status, and metacognitive scores when assessing the risk of elevated OCS and devising treatment plans. •The study emphasizes the need for comprehensive psychiatric nursing assessment, including metacognitive dysfunction and OCS evaluation. The findings suggest that therapeutic nursing interventions for individuals diagnosed with schizophrenia should address metacognitive dysfunctional beliefs to improve overall functioning and well‐being.Clinicians, including psychiatrists and psychiatric nurses, should consider the patient's age, marital status, and metacognitive scores when assessing the risk of elevated OCS and devising treatment plans.The study emphasizes the need for comprehensive psychiatric nursing assessment, including metacognitive dysfunction and OCS evaluation.What are the implications for future research? •Future research could explore the causal relationships between metacognitive dysfunctional beliefs, OCS, and psychosocial functioning in schizophrenia. •Longitudinal studies could provide insights into the progression of these relationships over time and the impact of therapeutic interventions. •Further research could also investigate the effectiveness of specific therapeutic strategies such as Metacognitive Therapy (MCT), Schema Therapy (ST), Cognitive Enhancement Therapy (CET), and Cognitive Behaviour Therapy (CBT) to address this population's metacognitive dysfunctional beliefs. Future research could explore the causal relationships between metacognitive dysfunctional beliefs, OCS, and psychosocial functioning in schizophrenia.Longitudinal studies could provide insights into the progression of these relationships over time and the impact of therapeutic interventions.Further research could also investigate the effectiveness of specific therapeutic strategies such as Metacognitive Therapy (MCT), Schema Therapy (ST), Cognitive Enhancement Therapy (CET), and Cognitive Behaviour Therapy (CBT) to address this population's metacognitive dysfunctional beliefs.Schizophrenia is a chronic mental health disorder that significantly impacts an individual's cognitive, emotional and social functioning. Recent research has highlighted the role of metacognitive beliefs and obsessive‐compulsive symptoms (OCS) in the psychosocial performance of individuals diagnosed with schizophrenia. Understanding these relationships could provide valuable insights for developing more effective nursing interventions. This study aimed to investigate the relationship between metacognitive beliefs, OCS and psychosocial performance among individuals diagnosed with schizophrenia.A cross‐sectional survey was conducted involving 174 purposively selected participants diagnosed with schizophrenia.The Meta‐Cognitions Questionnaire‐30, Young Adult Self‐Report Scale for OCS and Specific Level of Functioning Scale were used to gather the necessary data.The study found a significant positive correlation between OCS and metacognitive dimensions. Age was a significant predictor with an Oddis Ratio of 2.471. The metacognitive dysfunction was a highly significant predictor in univariate and multivariate analyses, with Oddis Ratios of 1.087 and 1.106, respectively. The study also discovered that higher levels of metacognitive dysfunctional beliefs were associated with lower levels of psychosocial functioning. Age and the metacognitive dysfunction score were significant predictors of psychosocial functioning scores, accounting for 26.8% of the variance in these scores.The study reveals a compelling inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning in individuals diagnosed with schizophrenia. It also identifies certain demographic factors, such as younger age, as significant contributors to elevated OCS. Importantly, metacognitive dysfunction emerged as a critical predictor of psychosocial functioning across various domains. These findings underscore the potential of incorporating metacognitive‐focused interventions in the treatment plans for schizophrenia patients. By addressing these cognitive patterns, healthcare professionals can enhance overall functioning and well‐being in individuals diagnosed with schizophrenia. [ABSTRACT FROM AUTHOR]- Published
- 2024
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30. Beyond the symptoms: Exploring attachment styles and reality‐testing among schizophrenia clients from a nursing perspective.
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Helyel, Eman Saad and El‐Sayed, Mona Metwally
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- *
ATTACHMENT behavior , *NURSES' attitudes , *INTERPERSONAL psychotherapy , *MENTAL illness , *SCHIZOPHRENIA - Abstract
Accessible Summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? What are the implications for future research? Introduction Aim Methods Results Discussion Implication for Practice The insecure attachment styles are associated with mental health problems and can influence reality perception, particularly in individuals with schizophrenia. The paper provides empirical evidence for the correlation between insecure attachment styles and reality‐testing impairment in clients with schizophrenia. Higher reality testing impairment scores were observed in specific demographics: males who were unmarried and aged between 40 and 50 years old, as well as those with a duration of illness of less than 5 years. The findings underscore the importance for nurses to understand insecure attachment styles, particularly anxious and avoidant styles, in clients with schizophrenia. Healthcare providers and nurses should understand the psychological dynamics of clients with insecure attachment styles to establish effective therapeutic relationships. A secure, structured and consistent environment is vital to modifying insecure attachment styles and promoting reality orientation. Secure Attachment Style Psycho‐Educational Program, Mentalization, Cognitive Interpersonal Therapy, and Cognitive Analytic Therapy can help reduce reality‐testing impairment. Imply early intervention through educating mothers on fostering secure bonds can potentially prevent future occurrences of schizophrenia. Conducting empirical studies to explore the associations between insecure attachment style, social functioning, and poor service engagement is essential. Research is needed to investigate specific techniques for managing insecure attachment styles, particularly the avoidant ones, and reality testing impairments within the therapeutic setting. Insecure attachment styles are associated with mental health problems and may influence reality perception.This study investigated the link between attachment styles and reality‐testing impairment in individuals with schizophrenia.A cross‐sectional survey with 200 participants diagnosed with schizophrenia assessed their attachment styles (Psychosis Attachment Measure) and reality‐testing abilities (Bell Reality Testing Inventory).A significant positive correlation emerged between insecure attachment and poorer reality testing (r = .394, p < .001). Avoidant attachment was most prevalent (mean scores: 17.01, SD = 3.71), followed by anxious attachment (16.53, SD = 4.20). Reality‐testing impairment manifested across all three domains: uncertainty of perception (7.16, SD = 2.45), reality distortion (3.52, SD = 1.21), and hallucinations/delusions (26.63, SD = 5.83). Interestingly, specific demographics (male, unmarried, 40–50 years old) and those with a duration of illness of less than 5 years had higher mean scores (27.35, SD = 5.61).Insecure attachment styles, notably anxious and avoidant, are dominant among clients with schizophrenia, who also struggle with reality distortion, perceptual uncertainty, and hallucinations/delusions in all three domains.Healthcare providers and nurses should understand the psychological dynamics of clients with insecure attachment styles to establish effective therapeutic relationships. A secure, structured, and consistent environment is vital to modifying insecure attachment styles and promoting reality orientation. Secure Attachment Style Oriented Psycho‐Educational Program, Mentalization, Cognitive Interpersonal Therapy, and Cognitive Analytic Therapy can help reduce reality‐testing impairment. Fostering Maternal and Child Health (MCH) centers on empathizing secure bonds between mothers (and mothers‐to‐be) and their children to promote healthy attachment styles as a preventive measure. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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31. Anti‐stigma initiatives for mental health professionals—A systematic literature review.
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Sreeram, Anju, Cross, Wendy M., and Townsin, Louise
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MENTAL illness ,MENTAL health personnel ,ATTITUDES toward mental illness ,CINAHL database ,PSYCHOLOGY information storage & retrieval systems ,ONLINE information services ,ATTITUDES of medical personnel ,SYSTEMATIC reviews ,SOCIAL stigma ,PSYCHOSOCIAL factors ,DESCRIPTIVE statistics ,MEDLINE - Abstract
Accessible summary: What is known on the subject?: Negative attitudes towards mental illness lead to the formation of stigma. Stigma prevents the recovery of people diagnosed with mental illness.There is evidence of stigmatic attitudes towards mental ill health among mental health professionals.Anti‐stigma initiatives, such as education and training, may be effective in enhancing or maintaining positive attitudes towards mental illness among mental health professionals. What this paper adds to existing knowledge?: Education and training that is designed and delivered around a specific mental health diagnosis or condition appears an appropriate strategy that could benefit mental health professionals to develop a deeper appreciation and understanding of mental ill health and its impacts on individuals.Consumer involvement in the education and training of mental health professionals regarding the stigma of mental illness is recommended; however, this is an under‐explored area of investigation.There is a weak evidence base regarding the long‐term sustainability of effects from anti‐stigma education and training. This should be addressed via further research in future. What are the implications for practices?: Anti‐stigma initiatives can support mental health professionals to develop stigma‐free, recovery‐oriented practices in their work. Further, such initiatives can improve the provision of evidence‐based quality care for the consumers, facilitating their recovery. Introduction: Despite an increasing focus on stigma, evidence shows prejudicial attitudes towards mental illness among mental health professionals still exist. It is suggested that anti‐stigma initiatives can aid in enhancing the attitudes of mental health professionals. However, research on initiatives targeting stigma of mental illness among mental health professionals is limited. Aim: To identify and analyse scientific literature pertaining to the effectiveness of anti‐stigma initiatives regarding mental ill health among mental health professionals. Method: A systematic literature review was performed using the databases MEDLINE, CINAHL, PsycINFO, PubMed, Scopus, Google Search engine and Google Scholar. The papers were limited to English language, published in peer‐reviewed journals with full‐text articles available and published between the years 2008 and 2020 to understand the most recent trends in the attitudes of mental health professionals including nurses. The Population, Intervention, Comparison and Outcome (PICO) strategy was used to identify papers meeting the inclusion criteria. Results: A total of 439 papers were identified. However, papers not meeting the inclusion criteria were excluded from selection. Three appraisers reviewed the selected papers individually using the Joanna Briggs Institute [JBI] critical appraisal tool. Finally, eight unanimously accepted papers were included in the systematic review. Several effective anti‐stigma initiatives were identified through the review, and these had positive impacts on mental health professionals' attitudes towards mental illness, for at least a short period. It was identified that contact‐based interventions are relevant and effective although the involvement of consumers and caregivers in the design and delivery of interventions was not explicitly addressed in detail in studies included in the review. Education strategies tailored for specific mental illness may be more appropriate, rather than approaches that refer to mental illness in general. Conclusions: This review shows the evidence of pessimistic attitudes towards mental illness persists among mental health professionals. Anti‐stigma initiatives identified in the selected papers were effective in changing these attitudes. Future research should be focused on the effectiveness of contact‐based interventions and understanding the longer‐term effects of the interventions among homogeneous groups. Full consideration of the varying level of clinical experience and expertise in mental health should guide the development and implementation of anti‐stigma initiatives in this context. Implications for practice: Anti‐stigma interventions can have a positive impact on mental health professionals' knowledge, attitudes and supportive caring for people diagnosed with mental illness. Such anti‐stigma interventions may meaningfully support stakeholders to address the impact of negative attitudes on the physical and mental health status of people diagnosed with mental illness. With sustained leadership, effort and reinforcement, it is possible to create workplace cultures that prioritize stigma‐free and recovery‐oriented behaviours and practices within mental health services. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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32. The experience of mood disorder and substance use: An integrative review.
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Crowe, Marie, Inder, Maree, and Thwaites, Bridgette
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PSYCHOLOGY information storage & retrieval systems ,PSYCHIATRIC nursing ,SUBSTANCE abuse ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,EXPERIENCE ,PATIENTS' attitudes ,ATTITUDES toward illness ,HARM reduction ,AFFECTIVE disorders ,MEDLINE ,THEMATIC analysis ,PSYCHOLOGICAL adaptation - Abstract
Accessible Summary: What is known on the subject?: People with mood disorders often use substances.There are several clinician‐driven hypotheses explaining the relationship. What the paper adds to existing knowledge?: The paper draws together the existing research on the perceptions of those with lived experience of mood disorders on the reasons for using substances.The participants in the studies identified using substances to manage their mood when treatment to manage their mood was not effective or acceptable, and as an escape from trauma and hardship. What are the implications for practice?: Mental health nurses need an understanding of why people with mood disorders may use substances and the impact of this on their treatment.Mental health nurses need to provide trauma‐informed care that emphasizes harm reduction for those who have mood disorders and substance use. Introduction: Substance use is highly prevalent among people with mood disorders. Effective treatment for these people requires a better understanding of the relationship between both mood and substance use from the perspectives of those with lived experience. Question: What are the reasons those with lived experience of mood disorders give for substance use? Method: An integrative review was conducted. The Joanna Briggs Institute suite of critical appraisal tools was used to evaluate the quality of individual studies. Data relevant to the review question were extracted, and the results were synthesized into themes. Results: Eighteen papers met the eligibility criteria. Three themes were identified across the included studies: Managing my mood, More Effective than prescribed medication, and Escape from trauma and hardship. Discussion: This integrative review identified that people with a mood disorder who use substances described choosing to take substances to manage their mood, as an alternative to prescribed medications, and to cope with trauma and social hardships. Implications for Practice: Mental health nurses need to provide care that recognizes why people use substances. They need to understand these reasons to provide a harm reduction and trauma‐informed model of care. Evidence‐based non‐pharmacological interventions for mood disorders need to be available as an alternative to medications or as a supplement. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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33. 'Finding my Hard Hat': Reflections of recovery from a service user and caring professional.
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Kiernan, Gary, Donohue, Gráinne, and Kirwan, Shane
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MENTAL illness drug therapy ,HEALTH services accessibility ,CONVALESCENCE ,PHYSICIAN-patient relations ,HELP-seeking behavior ,CREATIVE ability ,SOCIAL stigma ,PATIENTS' attitudes ,NURSING practice ,SOCIAL worker attitudes ,INTERPERSONAL relations ,MENTAL health services - Abstract
Accessible Summary: What is known on the subject?: Lived experience narratives of recovery can provide an insight and subtlety where academic papers can often fall short.There is a need for people who work in mental health services to address and take care of their own psychosocial needs. What the paper adds to existing knowledge?: This paper provides a unique insight into a care professional's recovery from mental ill health.Looked at through this dual lens of service user and care professional provide the reader with a rich narrative from the perspective of both sides of the caring role. What are the implications for practice?: People who work in caring roles need to be vigilant of their own needs and the impact that the work can have on them.Safety protocol for managing one's own mental health should be a requirement for people within the caring profession. Introduction: This is an account of my experiences becoming unwell and accessing general and mental health services in Ireland. Aim: It is hoped that this lived narrative of my recovery will shed light on accessing mental health services from a dual lens; that of service user and social worker. Method: It traces this experience from initial contact with my general practitioner, to admission to a secure psychiatric ward where recovery slowly began. Results: It is also hoped that reading my experiences of recovery and some of the insights shared will help those in the nursing or social care profession consider how they may be affected by their work. Discussion: It is important to note that this account views my experiences within a neurobiology framework and this might not align to other people's experiences. However, my narrative of help‐seeking is complex and includes multiple points where I uncover insights and encounter different healthcare professionals. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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34. To Hell and Back: A Performer's mental health journey during the COVID‐19 pandemic.
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Grech, Paulann, Chircop, Daniel, and Azzopardi, Andrew
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MENTAL illness risk factors ,PSYCHIATRIC epidemiology ,PSYCHIATRIC nursing ,OCCUPATIONAL roles ,PSYCHOSES ,CONVALESCENCE ,QUALITY of life ,MENTAL depression ,NURSES ,ANXIETY ,COVID-19 pandemic ,MENTAL health services ,REFLECTION (Philosophy) - Abstract
Accessible Summary: What is known on the subject?: The COVID‐19 pandemic has induced a considerable amount of mental health difficulties, ranging from anxiety and depression to psychosis. As services struggle to cope with the demand for support, the effect of such psychological challenges on quality of life remains a major concern. What does the paper add to existing knowledge?: Since the beginning of the COVID‐19 pandemic, a vast amount of research has focused on the physical consequences of the virus. Gradually, studies on the mental health effects related to the pandemic started to emerge, as it became clear that mental health difficulties were as present and as concerning as the physical ones. Whilst such studies commonly explore the prevalence and nature of the presenting mental health challenges, the publication of personal mental health experiences linked to the ongoing situation is lacking. Introducing the human element in literature is an important means of raising awareness on the mental health difficulties that can be triggered by the pandemic. Using public figures such as the individual in this paper is additionally powerful due to the role model effect. What are the implications for practice?: The paper highlights the need for enhanced awareness and monitoring of mental health especially by health professionals who therefore need to receive adequate mental health training. Furthermore, mental health awareness efforts need to be considered as being a part of the role of the psychiatric and mental health nurse who is at a prime position to educate, monitor and support those receiving care. [ABSTRACT FROM AUTHOR]
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- 2023
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35. "Were you wearing underwear?" Stigma and fears around sexual violence: A narrative of stranger rape and considerations for mental health nurses when working with survivors.
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Welfare‐Wilson, Alison and J, Betty
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RAPE & psychology ,DISCLOSURE ,NURSING ,EMPATHY ,JUDGMENT (Psychology) ,PSYCHOTHERAPISTS ,ATTITUDES of medical personnel ,SOCIAL stigma ,FEAR ,EMOTIONAL trauma ,PSYCHOLOGY of nurses ,CRIME victims ,COMPARATIVE studies ,SEX crimes ,NURSES ,DESCRIPTIVE statistics ,PATIENT safety - Abstract
Accessible summary: What is known about the subject?: Although sexual violence is prevalent, incidents of stranger rape remain statistically uncommon.Societal stigma and myths surrounding sexual violence are widespread.An individual's experience in the immediate aftermath and beyond can be shaped by the perception/s of sexual violence which are held and expressed by those they come into contact with. What this paper adds to existing knowledge?: This paper adds to the limited literature base and the population and practical‐knowledge gap around a specific form of sexual violence.This paper also demonstrates the need for reflection and discussion in minimizing blame that can unconsciously be shifted onto survivors in the form of myths and stereotypical views of sexual violence. What are the implications for practice?: Perceptions may be held around sexual violence, and by extension about the survivor, which may impede engagement and the building of trust within a therapeutic relationship.Myths that are synonymous with rape and all forms of sexual violence can be held by professionals, and lead to blame, negative judgement and lack of empathy towards survivors.Given the prevalence of sexual violence, this paper is applicable across all health and social care settings, and in particular mental health nursing professionals who may be more likely to meet people who have experienced sexual trauma. Introduction: This narrative illustrates the lived experience of a specific form of sexual violence (stranger rape) and its resulting implications as experienced by the second author, which is discussed under the following headings: your body as a crime scene, how lived experience compares to the myth of the 'real rape' and the wellbeing and health consequences arising from the experience. [Correction added on 5 September 2022, after first online publication: The preceding paragraph has been corrected in this version.] Aim: In their capacity as mental health nurses, the authors invite readers to consider the spoken, or more likely unheard stories of sexual violence, which are unfortunately commonplace among those who access mental health services. Implications for Practice: For professionals holding the privileged position of hearing these stories, there is a need to be reflective as to how fear, and personal or professionally held myths and stigmatizing views of sexual violence, and by extension views towards the survivor, are carried into therapeutic spaces, and the implications these can have. Practical suggestions as to how to discuss and manage disclosure of sexual violence in the context of trauma informed care are also provided. [ABSTRACT FROM AUTHOR]
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- 2023
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36. The ongoing importance of the routine enquiry into trauma and abuse and trauma‐informed care within mental health trusts in England.
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McNally, Katrina, Ragan, Kathryn, Varese, Filippo, and Lovell, Karina
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HEALTH policy ,ADVERSE childhood experiences ,CHILD abuse ,ACCESS to information ,WOUNDS & injuries ,MENTAL health services - Abstract
Accessibility Summary: What is known on the subject?: A significant number of people with mental health diagnoses have also experienced some form of trauma.In 2008, it was recommended that MHTs in England provide training to MHPs to support them in how to ask their service users about trauma and abuse.It has been identified that staff are not consistently enquiring about trauma and abuse in mental health services. What the paper adds to existing knowledge?: A description of how many MHTs in England are providing training for staff to ensure that they enquire about trauma and abuse.The current gaps in the resources available for mental health practitioners and staff. What are the implications for practice?: Much more work and development of trauma‐informed care and accessibility of training is needed for MHPs working in MHTs.Most MHTs still need to take the first step of implementing training in trauma‐informed care. This should involve ways to ask about trauma and abuse and advice on how to respond to any disclosures made. Introduction: Trauma, abuse and adversities are extremely prevalent for those who access secondary mental health services. Health policy guidance recommends that mental health professionals (MHPs) should routinely enquire about trauma and abuse. Staff training is required to adopt trauma‐informed approaches, as research has identified a clear gap in practice. This study provides a baseline measure of the current provision of trauma‐informed training in English mental health trusts (MHTs). Question: What trauma‐informed training is currently available for MHPs in England? Method: A freedom of information request was submitted to 52 MHTs in England to explore the current training available for MHPs in trauma‐informed care, routine enquiry into abuse and responding to disclosures. Results: The results showed 70% of respondents reported no available training in trauma‐informed care. Discussion: Many MHTs in England do not provide any trauma‐informed training (despite existing recommendations from 2008). Does this contribute to the re‐traumatisation of patients? Implications for Practice: MHTs in England require a responsible and active approach to training MHPs in sensitive routine enquiry into trauma and abuse as a first step to becoming trauma responsive. [ABSTRACT FROM AUTHOR]
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- 2023
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37. Personal recovery associated with deep brain stimulation for treatment‐resistant depression: A constructivist grounded theory study.
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Raffin Bouchal, Donna S., Ferguson, Angela L., Green, Theresa, McAusland, Laina, Kiss, Zelma, and Ramasubbu, Rajamannar
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DEEP brain stimulation ,HUMAN research subjects ,CONVALESCENCE ,GROUNDED theory ,MATHEMATICAL models ,QUALITATIVE research ,INFORMED consent (Medical law) ,MENTAL depression ,THEORY ,FIELD notes (Science) ,DESCRIPTIVE statistics ,RESEARCH funding ,PSYCHOLOGICAL adaptation ,DATA analysis ,COGNITIVE therapy - Abstract
Accessible Summary: What is known on the subject?: Major depressive disorder is the most prevalent of all mental illnesses.10%–20% of patients with depression and 1% of the population overall have treatment‐resistant depression (TRD).DBS is an emerging investigational treatment for TRD with documented clinical efficacy and safety.The framework of the recovery model includes both clinical and personal recovery. Personal recovery is a self‐process in which hope, empowerment and optimism are embraced to overcome the impact of mental illness on one's sense of self.Although clinical and functional outcomes of DBS for TRD have been well documented in the previous studies, personal recovery as an outcome has been explored only in a handful of studies. What this paper adds to existing knowledge?: This is the first qualitative study exploring personal recovery from DBS treatment specific to the target of subcallosal cingulate cortex in patients with TRD. Since the existing literature on personal recovery in DBS studies is limited, the contribution of this paper is crucial to this field.For individuals who responded to deep brain stimulation clinically, neither participants nor family believed it cured their depression, but rather there was a significant decrease in the severity of symptoms of depression. A holistic‐oriented framework (that includes personal recovery) is significant for those individuals with TRD undergoing DBS. Personal and clinical recovery are two different constructs, and individuals may experience one or the other or both.The experience of participants who responded to deep brain stimulation recognized that the recovery from depression is a process of reconstructing self. This process involved a period of adjustment that evoked a deeper self‐awareness, re‐engagement with daily living and newfound gratitude in living. Individuals transitioned from an emotionally driven life to one where future goals were considered. Supportive relationships were instrumental in this process. What are the implications for practice?: A deep brain stimulation intervention for treatment‐resistant depression offered individuals an opportunity for personal recovery where a reconstruction of self occurred.Personal recovery can be considered as an outcome in conjunction with clinical and functional outcomes in future DBS trials for TRD. The relevance of personal recovery in the prevention of relapses needs further investigation.To advocate for care and services that facilitate the process of recovery from depression, it is important to understand the personal dimensions and experience of recovery that may influence the process.To develop recovery‐oriented interventions to help patients and families in recovery post‐deep brain stimulation, further understanding of support and negotiating relationships during this life‐altering experience is needed. Introduction: Multiple trials of antidepressant treatments in patients with depression pose a major challenge to the mental health system. Deep brain stimulation (DBS) is an emerging and promising investigational treatment to reduce depressive symptoms in individuals with treatment‐resistant depression (TRD). The clinical and functional outcomes of DBS for TRD have been well documented in previous studies; however, studies of personal recovery as an outcome of DBS specific to the target of subcallosal cingulate cortex in patients with TRD are limited. Aim: To explore the processes of personal recovery in patients with treatment‐resistant depression following subcallosal cingulate‐deep brain stimulation. Method: Participants were 18 patients with TRD who participated in the subcallosal cingulate (SCC)‐DBS trial and 11 family members. They also participated in add‐on individual cognitive behavioural therapy during the trial. A qualitative constructivist grounded theory approach was used to conceptualize the personal recovery process of patients and families. Results: While every participant and their families' journey were unique following the deep brain stimulation intervention, a theoretical model of Balancing to Establish a Reconstructed Self emerged from the data. The themes underlying the model were (1) Balancing to Establish a Reconstructed Self: A Whole‐Body Experience, (2) The Liminal Space in‐between: Balancing with Cautious Optimism, (3) Hope: Transitioning from Emotion‐Focussed Living to Goal‐Oriented Planning and (4) Support: Negotiating Relationships. Discussion: This is the first study examining recovery from patients' perspectives as an outcome of SCC‐DBS intervention for TRD. The study shows that personal recovery is a gradual and continual process of reconstruction of the self, developing through supportive relationships. Clinical and personal recovery are two distinct constructs, and individuals may experience one or the other or both. Most patients who do respond clinically experience improvement in terms of having optimism and hope. Some patients, however, respond with significant symptom reduction but are not able to achieve personal recovery to experience joy or hope for improved quality of living. Implications for Practice: Strategies for personal recovery for both patients and family need to be considered during and post deep brain stimulation intervention. Nurses working with these patients and families may benefit from education, training and support to assess and engage in conversations about their recovery process. [ABSTRACT FROM AUTHOR]
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- 2023
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38. Accompanying mental health problems at home: Preliminary data from a crisis resolution and home treatment team in Catalonia.
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Vázquez, Iria Domínguez, Tintó, Alba Luque, Arjona, Carmen Hidalgo, Martínez, Mar Bodas, and Díaz, Antoni Corominas
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MENTAL illness treatment ,LENGTH of stay in hospitals ,HOME care services ,RESEARCH methodology ,MENTAL health ,MEDICAL care ,HEALTH outcome assessment ,HEALTH care teams ,CRITICAL care medicine ,DESCRIPTIVE statistics ,HOSPITAL care ,DATA analysis software ,CRISIS intervention (Mental health services) ,MENTAL health services ,CORPORATE culture - Abstract
Accessible Summary: What is known on the subject?: Home treatment teams help people in a mental health crisis to recover. The staff goes to the person's home, avoiding the need to go to the hospital and providing care in the person's environment.The teams have been created in our country in recent years, becoming part of the mental health care network. What this paper adds to existing knowledge?: The paper presents the functioning of a CRHTT, the type of care it provides, and the coordination with the rest of the care network. It also shows the clinical results obtained in the first two years since its creation, supporting the CRHTT's effectiveness in accompanying people with mental health crises and reducing the need for hospital care.The outstanding factors in the team operation were coordination fluidity with referral services (facilitating accessibility), a prolonged care time (about two months), and continuity of care during the CRHTT intervention (the same CRHTT professionals visited the user and the family at home) and upon discharge (CRHTT staff organized joint visits with the professionals who would care for the user and the family after home treatment).The CRHTT followed a person‐centered orientation based on horizontality and dialogue. The CRHTT fostered the inclusion of the family and social network in the treatment and a deep understanding of the crisis considering social determinants. What are the implications for practice?: Flexibility, approach to the person's environment, dialogue, shared decision‐making, and the inclusion of the family and social network in the treatment are central factors in CRHTT functioning. It helps the person regain control over their life and enhance their resources to face possible future crises.Training in crisis management, community mental health and family care, and teamwork (which implies joint home visits and co‐responsibility with the rest of the staff, user, and the family) are relevant for CRHTT professionals. Introduction: Crisis resolution and home treatment teams (CRHTTs) provide intensive home care to people in a mental health crisis, becoming an increasingly widespread alternative to hospital admissions. However, there are wide variations in service delivery, organization, and outcomes, and little literature on how these teams work in clinical practice and different settings. Aim: To share the organizational functioning, the therapeutic approach, and the outcomes obtained in a CRHTT in Catalonia, Spain. Method: A descriptive analysis of the functioning of a home treatment team, the characteristics of the people served, and the clinical results from November 2017 to December 2019 are presented. Results: One hundred and five people were served, with an average stay of 57 days. And 55.24% were women, and the mean age was 41. Most people could overcome the crisis at home, and 5.71% required hospital admission during home care. A statistically significant improvement was observed in the results of the GAF and HoNOS scales at admission and discharge. Discussion: Despite reduced staff, home care was an alternative to hospital admission for most people treated. Implications for Practice: Flexibility, teamwork, and collaboration with the social network are relevant factors when accompanying the recovery process at home. [ABSTRACT FROM AUTHOR]
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- 2023
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39. The psychological well‐being of people in a COVID‐19 supervised quarantine facility: A mixed methods study.
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Mitchell, David, Bressington, Daniel, Esler, Danielle, Straube, Kylie, Noel‐Gough, Laura, Vermeulen, Lisa, and Stephens, Dianne
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WELL-being ,STATISTICS ,COVID-19 ,SCIENTIFIC observation ,CONFIDENCE intervals ,ANALYSIS of variance ,QUARANTINE ,RESEARCH methodology ,CROSS-sectional method ,COMMUNITY health services ,INTERVIEWING ,PSYCHOLOGICAL tests ,T-test (Statistics) ,DESCRIPTIVE statistics ,DATA analysis software ,DATA analysis ,THEMATIC analysis ,PSYCHOLOGICAL distress - Abstract
Accessible summary: What is known on the subject?: Supervised Quarantine has been shown to impact the psychological well‐being of those in quarantine both during the COVID‐19 pandemic and in previous pandemics.There are few studies regarding the psychological impact of supervised quarantine for the purpose of COVID‐19 mitigation.There is little research regarding the psychological well‐being of professionals maintaining quarantine, despite the fact they risk potential psychological distress. What the paper adds to existing knowledge?: This paper addresses the paucity of knowledge regarding the psychological well‐being of those undergoing quarantine in a purpose‐built facility.The quarantined study population involved uniquely domestic arrivals and also professionals maintaining quarantine.Lack of control, isolation and miscommunication were perceived as challenging mental well‐being. What are the implications for practice?: Although psychological distress in Domestic arrivals appeared low, there are still identifiable stresses on mental well‐being.Mental health workers need to be cognizant that point entry to COVID‐19 quarantine (Domestic vs. International as well as specific regions) may influence risk of psychological distress.Mental Health nurses supporting those in quarantine should afford quarantined individuals a degree of choice, establish regular clear communication and consider how to establish peer support mechanisms within the quarantine environment. Introduction: Supervised quarantine may compromise psychological well‐being. There is equivocal evidence regarding psychological distress in compulsory supervised quarantine facilities. Aims: To evaluate the mental well‐being of people undergoing and working in a supervised COVID‐19 quarantine facility. Method: Mixed methodology was used, including a cross‐sectional analysis of psychological distress (DASS‐21) and individual semi‐structured interviews (10 professionals maintaining quarantine and 10 quarantined persons). Results: Overall levels of psychological distress were low. Those quarantining from Victoria had significantly lower depression scores compared to all other departure points. Qualitative analysis identified distress being linked to a lack of control, isolation and miscommunication. Discussion: Quarantine was associated with low levels of psychological distress. This was lower in people travelling from Victoria, a state where there were higher rates of infections and restrictions. Interviews showed that psychological distress was conceptualized as being associated with supervised quarantine, but participants recognized the overall importance of quarantine. Implications for Practice: Mental health professionals supporting quarantined people should consider original departure points may predict levels of psychological distress. Implementing ways of gaining control through affording choice, improving communication channels and establishing peer support networks within quarantine settings may help maintain mental well‐being. [ABSTRACT FROM AUTHOR]
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- 2023
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40. Grounding co‐writing: An analysis of the theoretical basis of a new approach in mental health care.
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Faccio, Elena, Pocobello, Raffaella, Vitelli, Roberto, and Stanghellini, Giovanni
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PHYSICIAN-patient relations ,MENTAL health ,PHENOMENOLOGY ,ETHNOLOGY research ,VALUE-based healthcare ,PATIENTS' attitudes ,MENTAL illness ,MENTAL health services ,PSYCHOTHERAPY - Abstract
This contribution aims to highlight the theoretical and epistemological premises of the co‐writing experience, a practice where a clinician and a patient are mutually engaged in jointly or collaboratively writing a narrative related to the patient's experience. Unlike a typical set of therapeutic techniques, co‐writing is based on sharing perspectives and meanings about the experience of crisis, recovery, and the therapeutic process. The paper identifies and briefly describes four non‐clinical epistemological paradigms on which it is grounded: ethnography, values‐based practice, narrative care, and phenomenology. Although they differ in several ways, at the same time, they seem to share some common features that the paper investigates and comments. For clinicians, nurses, researchers and Mental Health Service managers, attention to the users and to the improvement of their active roles represents not only a strategy for the empowerment of results, but also the access door to a different perspective which relies on a renewed conceptualization of the mental disease nature that may lead to overcoming the epistemic asymmetry between the 'expert' and the 'other' in favor of intersubjective dialogue. [ABSTRACT FROM AUTHOR]
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- 2023
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41. Seclusion within the first 24 h following admission into inpatient mental health services and associations with referral pathways, recent service contact and HoNOS ratings.
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Lai, Jennifer, Jury, Angela, Tuason, Charito, Basabas, Maria Carmela, Swanson, Caro, Weir‐Smith, Kerry, Wharakura, Mary‐Kaye, Taurua, Tui, Garrett, Nick, and McKenna, Brian
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MENTAL health services ,PSYCHOLOGICAL distress ,RESEARCH funding ,HOSPITAL care ,SEX distribution ,PACIFIC Islanders ,CULTURE ,SCIENTIFIC observation ,LOGISTIC regression analysis ,SECLUSION of psychiatric hospital patients ,RETROSPECTIVE studies ,AGE distribution ,POPULATION geography ,DESCRIPTIVE statistics ,MULTIVARIATE analysis ,RACE ,ODDS ratio ,STATISTICS ,POLICE ,CRIMINAL justice system ,CONFIDENCE intervals ,MEDICAL referrals ,SENSITIVITY & specificity (Statistics) - Abstract
Accessible Summary: What is known on the subject?: Seclusion is a harmful and traumatising intervention for people accessing mental health services.People who are subject to seclusion in inpatient mental health services often first experience this within the first 24 h following admission.There is limited research examining how recent contact with services impacts the likelihood of seclusion when people are admitted to inpatient services. What the paper adds to existing knowledge?: Males, Māori and Pasifika experience higher rates of seclusion within the first 24 h following inpatient admission.People perceived by clinicians as overactive, aggressive, disruptive or agitated are seven times more likely to be secluded within the first 24 h.People referred from police or justice services are three times more likely to be secluded within the first 24 h.People who had frequent contact with community mental health services prior to inpatient admission were less likely to be secluded. What are the implications for practice?: The first 24 h of inpatient admission is a critical focus for eliminating the use of seclusion. Initial interactions with people recently admitted should focus on nurturing relationships and reducing distress.Mental health staff should consider the person's cultural needs, referral pathway, recent service contact and baseline ratings on the Health of the Nation Outcomes Scales (HoNOS) when working proactively to prevent the use of seclusion in the first 24 h following admission.Strengthening the focus on nurturing relationships, cultural understanding and non‐coercive de‐escalation approaches requires leadership support and strategic workforce development. Introduction: People who experience seclusion in inpatient mental health services often do so within the first 24 h following admission. There is limited research examining the potential contributing factors, particularly recent contact with services. Aim/Question: To identify factors associated with seclusion within the first 24 h following admission into acute inpatient mental health services. Method: A retrospective analysis was undertaken using routinely collected data from Aotearoa New Zealand mental health services. Results: A higher likelihood of seclusion within the first 24 h following admission was associated with: males, Māori, Pasifika, referrals from police/justice services, inpatient transfers, recent contact with crisis assessment teams and clinician perceptions of aggression, problematic substance use, cognitive problems and hallucinations or delusions. Recent contact with community mental health services was associated with a lower likelihood. Discussion: People's cultural needs, referral pathway, recent service contact and HoNOS scores should be considered when working to prevent the use of seclusion in the first 24 h following admission. Implications for Practice: The first 24 h following inpatient admission is a critical period for preventing the use of seclusion. Nurturing relationships, cultural understanding and use of non‐coercive de‐escalation approaches can support better outcomes for people recently admitted. [ABSTRACT FROM AUTHOR]
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- 2024
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42. Diabetes self‐care behaviours among people diagnosed with serious mental illness: A cross‐sectional correlational study.
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Tzeng, Wen‐Chii, Tai, Yueh‐Ming, Feng, Hsin‐Pei, Lin, Chia‐Huei, and Chang, Yue‐Cune
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DIABETES prevention ,HEALTH self-care ,HEALTH literacy ,CROSS-sectional method ,STATISTICAL correlation ,FOOT care ,SELF-efficacy ,T-test (Statistics) ,EXERCISE ,RESEARCH funding ,MULTIPLE regression analysis ,STATISTICAL sampling ,DESCRIPTIVE statistics ,AGE distribution ,HEALTH behavior ,RESEARCH ,MEDICAL records ,ACQUISITION of data ,ONE-way analysis of variance ,STATISTICS ,DATA analysis software ,COMORBIDITY ,DIET ,BLOOD sugar monitoring - Abstract
Accessible Summary: What is known on the subject?: People diagnosed with serious mental illness have a high risk of diabetes and are more likely to develop type 2 diabetes at ages below 60 years.Effective diabetes self‐care behaviours among people diagnosed with serious mental illness can improve glycaemic control and reduce vascular complications.Few studies have investigated diabetes self‐care behaviours and their associations with health literacy and self‐efficacy in people diagnosed with serious mental illness. What the paper adds to existing knowledge?: Diabetes self‐care behaviours in people diagnosed with serious mental illness were suboptimal; the least frequently performed self‐care activities were self‐monitoring of blood glucose.Factors associated with diabetes self‐care behaviours are gender, age, communicative and critical health literacy and self‐efficacy.Self‐efficacy is the strongest predictor of self‐care behaviours among people diagnosed with comorbid serious mental illness and type 2 diabetes. What are the implications of practice?: Mental health nurses should assess diabetes‐specific health literacy of people diagnosed with serious mental illness to ensure that they possess the knowledge and skills related to diabetes self‐care.When treating young people and those with newly diagnosed type 2 diabetes, nurses should incorporate strategies to minimise their perceptions of diabetes‐related distress and increase their confidence in managing comorbid diabetes. Introduction: People diagnosed with serious mental illness (SMI) experience greater challenges in managing their type 2 diabetes mellitus (T2DM) than do those diagnosed with T2DM alone. Aim: This study investigated diabetes self‐care activities and the factors associated with these activities in people diagnosed with SMI in a hospital setting. Methods: A cross‐sectional correlational study was conducted among 126 people diagnosed with comorbid SMI and T2DM in Taipei, Taiwan, between October 2020 and April 2021. Data were collected using self‐report questionnaires and a chart review. Three‐step hierarchical multiple regression analysis was used to identify factors associated with diabetes self‐care behaviours. Results: Diabetes self‐care behaviours in people diagnosed with SMI were suboptimal overall. Hierarchical multiple regression analyses revealed that age (β = 0.18, p =.037) and self‐efficacy (β = 0.27, p =.004) significantly associated with diabetes self‐care behaviours. Discussion: Self‐efficacy is the strongest predictor of self‐care behaviours among people diagnosed with comorbid SMI and T2DM. Implications for Practice: Mental health professionals should focus on enhancing confidence in managing comorbid diabetes in people diagnosed with comorbid SMI, especially young people and those with newly diagnosed T2DM. [ABSTRACT FROM AUTHOR]
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- 2024
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43. Experiences of clinical staff who work with patients who self‐harm by ligature: An exploratory survey of inpatient mental health service staff.
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Groves, Samantha, Lascelles, Karen, and Hawton, Keith
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WORK ,CROSS-sectional method ,NURSES ,SCALE analysis (Psychology) ,PERSONNEL management ,QUALITATIVE research ,SUICIDAL ideation ,PSYCHOLOGISTS ,RESEARCH funding ,WORK environment ,QUESTIONNAIRES ,HOSPITAL patients ,LIGATURE (Surgery) ,DESCRIPTIVE statistics ,QUANTITATIVE research ,SELF-mutilation ,ALLIED health personnel ,ATTITUDES of medical personnel ,RESEARCH ,CONCEPTUAL structures ,SUICIDE ,SOCIAL support ,EXPERIENTIAL learning ,SOCIAL stigma ,SENSITIVITY & specificity (Statistics) - Abstract
Accessible Summary: What is known on the subject: Self‐harm by ligature is common within inpatient mental healthcare settings and is a dangerous method of self‐harm. Most fatal and non‐fatal suicidal behaviours in inpatient settings are a result of ligature use.There is a lack of research which has explored the experiences of staff members who work within inpatient settings where patients may self‐harm by ligature. What the paper adds to existing knowledge: Key issues related to self‐harm by ligature reported by staff included (1) understaffing increasing risk of ligature incidents, (2) spreading of self‐harm by ligature within inpatient settings and (3) negative attitudes of staff related to patients who self‐harm by ligature.Working with self‐harm by ligature can have negative impacts on staff's personal (e.g. fear of blame) and professional lives (e.g. increased cautiousness). Many staff members currently feel underprepared by training related to working with self‐harm by ligature, and unsupported after responding to a ligature incident. What are the implications for practice: Training about self‐harm by ligature needs to be improved and be accessible for all inpatient mental healthcare staff. Training should be coproduced, and could include practical components, education on potential reasons for self‐harm, and acknowledgement of the emotional impact on staff.Support for staff members who respond to ligature incidents should be available for all staff members who respond to self‐harm by ligature incidents. Stigma associated with accessing support should be challenged, alongside blame cultures within the workplace. Introduction: Self‐harm by ligature is a common form of self‐harm within inpatient mental health services in England, where most suicides within inpatient settings involve hanging or suffocation. However, little research has examined the experiences of staff members working with this method of self‐harm. Aim: We explored the experiences of clinical staff who work with patients who self‐harm by ligature. Method: A staff survey was developed and disseminated to clinical staff working in inpatient settings in England. Quantitative data were analysed using descriptive statistics, and qualitative data using the framework approach. The study was STROBE checklist compliant. Results: 275 staff members participated. Challenges most frequently reported about working with self‐harm by ligature included understaffing (210, 76.6%), spreading of ligature incidents (198, 72.8%) and negative attitudes held by clinical staff towards such patients (185, 68.5%). Participants' responses indicated that this work could have significant impacts on their professional and personal lives. Staff often reported inadequate training and lack of preparedness, alongside insufficient support opportunities following ligature incidents. Discussion: Staff had a diverse range of professional and personal experiences and identified multiple challenges associated with working with patients who have self‐harmed by ligature. Implications for Practice: There is a need to improve accessibility, format and content of training and support for staff working within inpatient settings where patients may self‐harm by ligature. [ABSTRACT FROM AUTHOR]
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- 2024
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44. Developing a research tool to detect iatrogenic adverse events in psychiatric health care by involving service users and health professionals.
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Okkenhaug, Arne, Tritter, Jonathan Q., and Landstad, Bodil J.
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IATROGENIC diseases ,RISK assessment ,CONSENSUS (Social sciences) ,FOCUS groups ,CONTROL (Psychology) ,MEDICAL errors ,PATIENT safety ,RESEARCH funding ,RESEARCH methodology evaluation ,INTERVIEWING ,JUDGMENT sampling ,CONTINUUM of care ,SOUND recordings ,ATTITUDES of medical personnel ,RESEARCH methodology ,PSYCHIATRIC hospitals ,ADVERSE health care events ,PSYCHIATRIC somatic therapies ,PATIENTS' attitudes ,DISEASE risk factors - Abstract
Accessible Summary: What is known on the subject: Most health professionals working in psychiatric care will experience adverse events (AE) such as service user suicide or violence, during their careerNorway lacks measures to capture potential iatrogenic injuries, such as risk assessment measures, to evaluate patient records for AEs in both inpatient and outpatient psychiatric clinics in hospitals What the paper adds to existing knowledge: We have described an approach to the validation of a research tool between different national contexts; a process that went beyond language translationWe have incorporated the understanding of health professionals and service users; to bring together the lifeworld of the patient with the professional definition of AEs, triggers and risk areas of AEs in a psychiatric context. The service users' experiences resulted in modifications to the tool. What are the implications for nurses: Applying the 'Global Trigger Tool—Psychiatry' in Norway and Sweden can help mental health nurses to prevent iatrogenic harm and reduce the occurrence of AEs through the identification of potential triggers.Implementing 'Global Trigger Tool—Psychiatry' might help mental health nurses to improve patient safety in Norway and Sweden. Introduction: There is little consensus on cross‐cultural and cross‐national adaptation of research instruments. Aim/Question: To translate and validate a Swedish research tool (GTT‐P) to detect iatrogenic adverse events in psychiatric health care by involving service users and health professionals in the process. Method: The GTT‐P, designed to identify events in patient records that were triggers for adverse events, was translated to Norwegian using a cross‐cultural adaptation approach. This involved two focus groups with clinical staff, one of which involved service users, and a joint discussion at a Dialogue Conference to generate consensus on the definition of the triggers of potential adverse events identifiable in patient records. Results: We highlight both the differences and commonalities in defining the nature of risks, the adverse events and the triggers of such events. The Dialogue Conference resulted in three modifications of the tool, based on service users' experiences. Service user involvement and co‐production was essential for both the translation and adaptation of the research instrument. Discussion: We have described an approach to the validation of a research tool between different national contexts; a process that went beyond language translation. This approach enables a more nuanced understanding of potential risks within a psychiatric context as it engages differences in the care delivery. Applying the GTT‐P in hospital‐based psychiatric care might help to identify processes that need to be changed in order to promote patient safety and a safer work environment for mental health nurses. Implications for practice: When translating and validating the GTT‐P from Swedish to Norwegian, we have considered the knowledge and experiences of both service users and health professionals. The application of the GTT‐P can promote greater patient safety in hospital settings. [ABSTRACT FROM AUTHOR]
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- 2024
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45. Shared decision‐making in the treatment of adolescents diagnosed with depression: A cross‐sectional survey of mental health professionals in China.
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Tan, Xiangmin, He, Yuqing, Ning, Ni, Peng, Jiayuan, Wiley, James, Fan, Fangxiu, Wang, Jianjian, and Sun, Mei
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DIAGNOSIS of mental depression ,CROSS-sectional method ,PATIENT compliance ,HEALTH services accessibility ,MEDICAL care for teenagers ,PEARSON correlation (Statistics) ,CRONBACH'S alpha ,T-test (Statistics) ,STATISTICAL sampling ,QUESTIONNAIRES ,HEALTH ,HOSPITAL care ,MULTIPLE regression analysis ,DECISION making ,DESCRIPTIVE statistics ,FAMILIES ,INFORMATION resources ,SURVEYS ,ATTITUDES of medical personnel ,PHYSICIAN practice patterns ,PHYSICIAN-patient relations ,STATISTICAL reliability ,ONE-way analysis of variance ,DRUGS ,DATA analysis software ,SOCIODEMOGRAPHIC factors ,MENTAL depression ,ADOLESCENCE - Abstract
Accessible Summary: What is already known?: SDM improves clinical outcomes by increasing attendance and treatment adherence in adolescents diagnosed with depression.SDM could reduce treatment disagreements and enhance consumers' and their families' satisfaction with mental healthcare services.Healthcare professionals are a critical part of SDM. However, MHPs' practices of SDM in the daily management of adolescents diagnosed with depression need to be clarified. What the paper adds to existing knowledge?: From the viewpoints of MHPs, SDM was not extensively applied in the daily management of adolescents diagnosed with depression.MHPs who trust their consumers and have received training related to SDM are more likely to practice SDM in the daily management of adolescents diagnosed with depression.The positive preferences for providing information and family involvement in treatment decision‐making are facilitators; working in closed inpatient mental health wards and open inpatient mental health wards are hindering factors for MHPs' practices of SDM. What are the implications for practice?: MHPs should encourage information sharing with consumers and their family members to help them participate in treatment decision‐making actively.A trusting and friendly therapeutic relationship with consumers should be maintained in the daily management of adolescents diagnosed with depression.SDM‐related training should be encouraged for MHPs to promote widespread SDM. Introduction: Shared decision‐making (SDM) is an ideal model for a therapeutic relationship that can improve health outcomes. Healthcare professionals are a critical part of SDM, and they play an important role in the practices of SDM in the clinical setting. Evidence suggests that adolescents diagnosed with depression can benefit substantially from SDM. However, mental health professionals' (MHPs) practices of SDM for adolescents diagnosed with depression in China are not well‐documented. Aim: This study aimed to investigate the practices of SDM for adolescents diagnosed with depression from the viewpoints of MHPs in China. Method: In this cross‐sectional study, we recruited a total of 581 MHPs by convenience sampling. The Shared Decision‐Making Questionnaire—Physician Version (SDM‐Q‐Doc) was used to evaluate the MHPs' practices of SDM for adolescents diagnosed with depression. Results: The mean SDM‐Q‐Doc was 80.47 (±16.31). Within the six specific decision‐making situations, most MHPs selected non‐SDM (52.7%–71.6%). Substantial numbers of respondents believed that MHPs made the final decision, especially with regard to the development (37%) and adjustment of medication regimens (42%). The practice of SDM was predicted by MHPs' preference for providing information, their trust in consumers, preference for family involvement in treatment decision‐making, working in an outpatient clinic and receiving SDM training (F = 23.582; p =.000; R2 =.198; adjusted R2 =.189). Discussion: Although the MHPs' self‐rated score of SDM‐Q‐Doc was high, SDM was not extensively applied in the daily management of adolescents diagnosed with depression. Thus, SDM needs to be further promoted by enhancing SDM‐related training for MHPs, thereby actively promoting the involvement of families, facilitating the information sharing for consumers and families, and building an active, trusting consumer‐practitioner relationship. Implications for Practice: MHPs should prioritise information sharing with consumers and families, as well as build trusting and friendly therapeutic relationships. Family involvement in treatment decisions should be encouraged when adolescents diagnosed with depression are in need. Actively participating in training related to SDM is also important. Future high‐quality evidence is still needed to explore the facilitators and barriers to SDM practices from a tripartite perspective of MHPs, adolescents diagnosed with depression and their families. [ABSTRACT FROM AUTHOR]
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- 2024
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46. The experience of healthcare professionals implementing recovery‐oriented practice in mental health inpatient units: A qualitative evidence synthesis.
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Chatwiriyaphong, Rinlita, Moxham, Lorna, Bosworth, Rebecca, and Kinghorn, Grant
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HOLISTIC medicine ,PROFESSIONAL practice ,MENTAL health ,PATIENT safety ,CINAHL database ,SYSTEMATIC reviews ,MEDLINE ,PATIENT-centered care ,CONVALESCENCE ,ATTITUDES of medical personnel ,TRUST ,MENTAL health personnel ,PSYCHOSOCIAL factors ,HOSPITAL wards ,PSYCHOLOGY information storage & retrieval systems - Abstract
Accessible Summary: What is known on the subject?: The principles of personal recovery are primarily applied in outpatient and community settings as these settings provide continuity of care and recovery‐based community programs supporting consumers' recovery journey.A range of healthcare professionals are involved in the care of people within mental health in‐patient units, including nurses, psychiatrists, psychologists, occupational therapists and social workers.The integration of recovery‐oriented care in mental health inpatient units may be impaired by a lack of confidence among mental health professionals. What this paper adds to existing knowledge?: Developing hope and a safe place is an integral part of recovery‐oriented practice within mental health inpatient units.Instilling connectedness is a relevant recovery principle; however, there may be greater barriers in mental health settings which traditionally prioritise safety and risk mitigation practices to prevent perceived harmful behaviours.Staff workload and inadequate understanding of recovery concepts present challenges to promoting recovery‐oriented care in everyday practice.Using strength‐based practice is critical in promoting a safe space for consumers by providing psychosocial interventions and person‐centred care. What are the implications for practice?: The provision of recovery‐oriented practice requires adopting a collaborative approach that places a strong emphasis on the involvement of consumers and their families.Empowering mental health professionals to believe that recovery‐oriented practice is possible in mental health inpatient units is crucial.Mental health professionals need to create a safe environment and positive relationships through respect and empathy for consumers and their family members. Introduction: Recovery‐oriented practice underpins an individual's personal recovery. Mental health nurses are required to adopt a recovery‐oriented approach. Globally, a paucity of literature exists on mental health professionals' experience of recovery‐oriented practice in mental health inpatient units. Aim: The aim of this synthesis was to explore the experiences of healthcare professionals regarding recovery‐oriented care in mental health inpatient units by appraising and synthesising existing qualitative research. Method: Three databases, including MEDLINE, PsycINFO and CINAHL were searched between 2000 and 2021. Data were extracted and synthesised using thematic integrative analysis. The quality of included studies was assessed with the CASP Critical Appraisal Checklist. Results: Ten qualitative research projects met the inclusion criteria. Four themes were identified (i) developing a safe and hopeful space, (ii) promoting a healing space, (iii) instilling connectedness and (iv) challenges to realising recovery‐oriented care. Discussion: Mental healthcare professionals perceived the principles of recovery‐oriented care to be positive and include: therapeutic space, holistic care and person‐centred care. Nevertheless, findings revealed limited knowledge and uncertainty of the recovery concept to be key barriers that may hinder implementation into practice. Implications for Practice: Recovery‐oriented practice must underpin consumer and family engagement, treatment choices and continuity of care to facilitate consumer's personal recovery. [ABSTRACT FROM AUTHOR]
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- 2024
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47. Patient perspective on observation methods used in seclusion room in an Irish forensic mental health setting: A qualitative study.
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Shetty, Shobha Rani, Burke, Shauna, Timmons, David, Kennedy, Harry G., Tuohy, Mary, and Terkildsen, Morten Deleuran
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QUALITATIVE research ,RESEARCH funding ,INTERVIEWING ,SCIENTIFIC observation ,SECLUSION of psychiatric hospital patients ,FORENSIC psychology ,RETROSPECTIVE studies ,JUDGMENT sampling ,SOUND recordings ,THEMATIC analysis ,MEDICAL records ,ACQUISITION of data ,RESEARCH methodology ,PHENOMENOLOGY ,PATIENTS' attitudes - Abstract
Accessible Summary: What is known on the subject?: Nurses' observation of patients in seclusion is essential to ensure patient safety.Patient observation in seclusion assists nurses in adhering to the requirements of mental health legislation and hospital policy.Direct observation and video monitoring are widely used in observing patients in seclusion.Coercive practices may cause distress to patient‐staff relations. What the paper adds to existing knowledge?: We add detailed information on specific observation methods in seclusion and compare them from the perspective of patients.Nurses communicating with patients ensures relational contact and that quality care is provided to patients even in the most distressed phase of their illness.Providing prior information to patients on observation methods in seclusion and the need for engaging patients in meaningful activities, while in seclusion are emphasized.Observation via camera and nurses' presence near the seclusion room made patients feel safe and gave a sense of being cared for in seclusion.Pixellating the video camera would give a sense of privacy and dignity. What are the implications for practice?: The overarching goal is to prevent seclusion. However, when seclusion is used as a last resort to manage risk to others, it should be done in ways that recognize the human rights of the patient, in ways that are least harmful, and in ways that recognize and cater to patients' unique needs.A consistent approach to relational contact and communication is essential. A care plan must include patient's preferred approach for interacting while in seclusion to support individualized care provision.Viewing panels (small window on the seclusion door) are important in establishing two‐way communication with the patient. Educating nurses to utilize them correctly helps stimulate relational contact and communication during seclusion to benefit patients.Engaging patients in meaningful activities when in seclusion is essential to keep them connected to the outside world. Depending on the patient's presentation in the seclusion room and their preferences for interactions, reading newspapers, poems, stories, or a book chapter aloud to patients, via the viewing panel could help ensure such connectedness.More focus should be placed on providing communication training to nurses to strengthen their communication skills in caring for individuals in challenging care situations.Patient education is paramount. Providing prior information to patients using a co‐produced information leaflet might reduce their anxiety and make them feel safe in the room.When using cameras in the seclusion room, these should be pixelated to maintain patients' privacy. Introduction: A lack of research investigating the specific role that various observational techniques may have in shaping the therapeutic relations in mental health care during seclusion warranted this study. Aim: The aim of the study was to explore patients' experience of different methods of observation used while the patient was in seclusion. Method: A retrospective phenomenological approach, using semi‐structured interviews, ten patients' experiences of being observed in the seclusion room was investigated. Colaizzi's descriptive phenomenological method was followed to analyse the data. Results: Communicating and engaging patients in meaningful activities can be achieved via the viewing panel. The camera was considered essential in monitoring behaviour and promoting a sense of safety. Pixelating the camera may transform patient view on privacy in seclusion. Discussion: The mental health services must strive to prevent seclusion and every effort should be made to recognise the human rights of the patient. The study reveals numerous advantages when nurses actively engage in patient communication during the process of observation. Implications for Practice: Different observation methods yield different benefits; therefore, staff education in using these methods is paramount. Empowering the patient with prior information on seclusion, engaging them in meaningful activities and proper documentation on patient engagement, supports the provision of individualised care in seclusion. [ABSTRACT FROM AUTHOR]
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- 2024
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48. Outcomes of trauma‐informed care on the psychological health of women experiencing intimate partner violence: A systematic review and meta‐analysis.
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Chu, Yi‐Chin, Wang, Hsiu‐Hung, Chou, Fan‐Hao, Hsu, Yi‐Fen, and Liao, Kuei‐Lin
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ANXIETY treatment ,TREATMENT of post-traumatic stress disorder ,PSYCHOLOGY of abused women ,EVALUATION of medical care ,CINAHL database ,MEDICAL databases ,PSYCHOLOGY information storage & retrieval systems ,META-analysis ,MEDICAL information storage & retrieval systems ,CONFIDENCE intervals ,SYSTEMATIC reviews ,MENTAL health ,INTIMATE partner violence ,MENTAL depression ,DESCRIPTIVE statistics ,MEDLINE ,DATA analysis software ,STATISTICAL models ,PSYCHIATRIC treatment ,PSYCHOTHERAPY - Abstract
Accessible Summary: What is known on the subject?: Women are more likely to experience intimate partner violence (IPV) than men; 19.2%–69.0% of women have experienced IPV, and the percentage is increasing.Survivors of IPV suffer from physical, psychological, social and reproductive health problems and numerous adverse health consequences such as post‐traumatic stress disorder, depression and anxiety. These are considered IPV comorbidities, especially among women. What the paper adds to existing knowledge?: This study reviews and reinforces existing scientific knowledge regarding the application of trauma‐informed care (TIC), including intervention content or type, frequency, duration of session and length.This study focused on the effects of TIC. Furthermore, it examines short‐term (3 months) and medium‐term (6 months) outcome effects, which are more significant for clinical practice. What are the implications for practice?: Development of a standardized protocol to address specific needs for TIC in IPV care settings.Among multidisciplinary teams, nurses are the ideal professionals to support women experiencing IPV. They can understand their traumatic experiences better, improve their therapeutic relationships and engage patients in collaborative care. Introduction: Post‐traumatic stress disorder (PTSD), depression and anxiety are considered intimate partner violence (IPV) comorbidities, especially among women. Trauma‐informed care (TIC) is the most common element of IPV care. Aim: This study analysed the short‐term (3 months) and medium‐term (6 months) outcomes of TIC on PTSD, depression and anxiety in women experiencing IPV. Method: The Preferred Items for Systematic Reviews and Meta‐Analysis guidelines were followed, and databases were searched from their inception to September 2022. Results: Thirteen randomized controlled trials included 850 women randomly assigned to the TIC and usual care groups. Overall, TIC showed a superior psychological health‐improving effect. Depression and anxiety significantly improved after treatment and at three and 6 months. No difference was observed in PTSD between the two groups at 3 and 6 months. Discussion: The growing evidence demonstrates that the lack of IPV intervention effects reported by reviews may be due to the attributes of PTSD, heterogeneity of TIC intervention design and components of TIC. Therefore, its clinical efficacy remains inconclusive. Implications for Practice: We analysed studies by stratifying intervention frequencies of once or twice a week. Regardless of the intervention frequency, length and design, PTSD decreased immediately after the TIC intervention. However, a significant difference in depression was observed after a TIC intervention of above 9 weeks. [ABSTRACT FROM AUTHOR]
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- 2024
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49. The levels and related factors of posttraumatic growth among nurses: A systematic review and meta‐analysis.
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Wang, Jinfeng, Luo, Zhipeng, Liao, Xinqi, Zeng, Yanli, Zhou, Jing, Liu, Minyan, Yao, Yue, Tian, Jie, and Luo, Wanting
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MEDICAL information storage & retrieval systems ,RESEARCH funding ,CINAHL database ,POSTTRAUMATIC growth ,META-analysis ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,ONLINE information services ,CONFIDENCE intervals ,PSYCHOLOGY of nurses ,PSYCHOLOGY information storage & retrieval systems ,COVID-19 pandemic ,HOSPITAL wards ,REGRESSION analysis - Abstract
Accessible Summary: What is known on the subject?: Nurses often encounter traumatic events in their clinical practice.Trauma can have both negative effects, such as post‐traumatic stress disorder and positive effects, such as growth and positive emotions.Posttraumatic growth is beneficial for nurses, as it contributes to positive mental health outcomes and increases life satisfaction. What the paper adds to existing knowledge?: Our study confirms that nurses commonly experience posttraumatic growth after being exposed to traumatic events, and the level of growth is moderate.We have identified individual, work‐related, and social and organizational factors that may influence the occurrence of posttraumatic growth among nurses. What are the implications for practice?: Our findings provide valuable insights for interventions aimed at promoting posttraumatic growth among nurses. It is crucial to consider individual factors, work‐related factors, and social and organizational factors when designing these interventions. By addressing these factors, healthcare professionals can support nurses in coping with trauma and facilitate their posttraumatic growth. Introduction: While the negative effects of trauma on nurses have been well‐documented, it is equally important to focus on ways to promote posttraumatic growth (PTG) among nurses. Aim: This study aims to explore the levels and related factors of PTG among nurses. Method: A comprehensive search was conducted across nine databases up to 26 December 2022. The pooled mean score for PTG was calculated and presented with a 95% confidence interval. Subgroup and meta‐regression analyses were performed to identify potential moderators of PTG among nurses. Results: A total of 55 studies, involving 35,621 nurses from 11 countries and regions, were included in this review. The pooled scores of the PTG indicated that nurses experienced a moderate level of PTG (55.69, 95% CI: 50.67–60.72). Discussion: Nurses commonly experience PTG following exposure to traumatic events, with a moderate level of PTG. Our systematic review highlights the potential determinants of PTG among nurses, including individual, work‐related, and social and organizational factors. Implications for Practice: Targeting these factors in interventions can provide nurses with the necessary resources and support to effectively cope with stress and trauma, and potentially facilitate PTG. [ABSTRACT FROM AUTHOR]
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- 2024
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50. Factors that influence Asian American college students use of mental health services: A systematic mixed studies review.
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Nguyen, Nina, Kim, BoRam, and Aronowitz, Teri
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CINAHL database ,PSYCHOLOGY information storage & retrieval systems ,ONLINE information services ,ATTITUDES toward mental illness ,CULTURE ,RACISM ,PSYCHOLOGY of college students ,MINORITIES ,SYSTEMATIC reviews ,ACCULTURATION ,ATTITUDE (Psychology) ,INTERGENERATIONAL relations ,ASIAN Americans ,HELP-seeking behavior ,SOCIAL stigma ,GROUP identity ,RESEARCH funding ,MEDLINE ,THEMATIC analysis ,MENTAL health services ,ERIC (Information retrieval system) - Abstract
Accessible Summary: What is known on the subject?: Only 8.6% Asian Americans (AAs) report seeking mental health services compared to nearly 18% of the general population.There is a stigma against seeking mental health services among AAs.Mental illness is thought to be caused by a lack of harmony of emotions or evil spirits leading to delay in treatment among AAs. What the paper adds to existing knowledge?: Asian students are hesitant to use mental health services because they are balancing their desire to be part of the two cultures.Concepts used to define culture were found to have overlapping aspects of how researchers operationally define them, and few studies examined a combination of these concepts as a means of examining interactions between the concepts.AA emerging adults feel pressure through personal stigma from elders to 'save face' by keeping their problems to themselves or within the family to maintain a positive reputation for the family. What are the implications for practice?: The overlap of conceptual definitions to understand cultural beliefs and values affecting measurement have complicated the interpretation of the research.Future research should include a multidimensional operationalization of culture that includes acculturation, ethnic identity, personal stigma and their effect on mental health help‐seeking attitudes.Differences between South Asian and East Asian philosophical and cultural perspectives could influence access to mental health services; therefore, future studies should consider sampling that would allow for comparison of the groups.Understanding the factors that influence mental health help‐seeking behaviours can determine intervention strategies to improve AA emerging adult mental health. Introduction: Only 8.6% of Asian Americans (AA) sought mental health services compared to 18% of United States population. AA college students report higher levels of mental health concerns compared to White students. Aim: The purpose of this systematic review was to identify the factors that influence AA students' mental health help‐seeking behaviours. Method: Employing a data‐based convergent synthesis design. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the sample. Inclusion criteria were peer‐reviewed studies published in English, focused on AA college students' mental health seeking attitudes in United States. Results: The final sample was forty‐four studies. Four themes emerged: acculturation, ethnic identity, racism and stigma. There were discrepant findings regarding how acculturation affects mental health help‐seeking attitudes. Several studies included more than one theme in their analyses. The different concepts included across studies make it difficult to compare the findings. Discussion: There is some overlap between acculturation and ethnic identity that could affect the analysis in studies where both concepts are included. Personal stigma negatively influences mental health help‐seeking attitudes. Implications for Practice: Defining culture to include acculturation, ethnic identity, personal stigma can help in understanding their effect on mental health help‐seeking attitudes. [ABSTRACT FROM AUTHOR]
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- 2024
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