97 results
Search Results
2. 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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3. '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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4. 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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5. 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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6. 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
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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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7. 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]
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- 2024
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8. 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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9. 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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10. 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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11. 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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12. 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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13. 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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14. 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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15. 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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16. 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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17. 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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18. Considerations for peer research and implications for mental health professionals: learning from research on food insecurity and severe mental illness.
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McGeechan, Grant J., Moore, Hannah, Le Sauvage, Nikita, Smith, Jo, and Giles, Emma L.
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Accessible Summary What is known on the subject What the paper adds to existing knowledge What are the implications for practice Introduction Aim Thesis Implications for Practice Peer research methodologies and methods are increasingly used in research, particularly to benefit from lived experiences. The experiences of peer researchers with severe mental illness are less common, including the impact on them of conducting peer‐led research. This paper shares the experience of peer research and suggests in the context of food insecurity, that it is not well understood by some healthcare professionals. Implications include considerations around trauma‐informed care and the need for screening for food insecurity in mental healthcare settings. Research implications include providing training for peer research and needing to consider longevity of peer researcher relationships. Food insecurity means that a person does not have access to sufficient nutritious food for normal growth and health. This can lead to health problems such as obesity, heart disease, diabetes and other long term chronic health conditions. People living with a severe mental illness are more likely to experience food insecurity than people without a severe mental illness.The aim of this paper is to present a lived experience narrative of two peer researchers. Peer researchers conducted interviews with adults with severe mental illness from Northern England as part of a funded research project. These interviews discussed experiences of food insecurity and strategies to tackle it and were conducted between March and December 2022.The following paper does not discuss the results of the interviews themselves. Rather the narrative begins with an overview of peer research, before sharing the experiences of the two peer researchers in undertaking this project.This includes healthcare professionals understanding food insecurity, what it is and what it is not, thinking about trauma‐informed care, and screening for food insecurity. Peer research implications centre on adequate support and training, considerations to longevity of peer research relationships and reducing unnecessary research burden for peer researchers. [ABSTRACT FROM AUTHOR]
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- 2024
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19. Care giving and receiving for people with complex emotional needs within a crisis resolution/home treatment setting: A qualitative evidence synthesis.
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Haslam, Michael, Lamph, Gary, Jones, Emma, and Wright, Karen
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Accessible Summary What is known on the subject? What this paper adds to existing knowledge? What are the implications for practice? Background Objective Method Findings Discussion Conclusions The term ‘complex emotional needs’ (CEN) is used here to describe people with difficulties and needs that are often associated with the diagnostic label of ‘personality disorder’. People with CEN might use out of hours services such as emergency departments and Crisis Resolution/Home Treatment (CRHT) teams more often when experiencing a mental health crisis. Very little is understood about the experiences of both those receiving, and those delivering care, for people with CEN within CRHT settings. There are differences between priorities for those delivering and those receiving care within CRHT settings. CRHT staff members are likely to focus more upon those aspects of their role relating to risk issues. managing resources, anxieties and the expectations of others. Service users, meanwhile, focus upon the caring relationship, wanting staff to listen to them, and to feel supported and reassured. In the papers reviewed, service users experiencing CEN did not always feel ‘listened to’ or ‘taken seriously’ especially in relation to risk issues and decision‐making. Relating the findings to mental health nursing and CEN within the context of CRHT, to better understand the person experiencing a mental health crisis, mental health nurses need to focus more upon the person and when making decisions around their care and must be aware of the potential for power imbalances. Collaborative ‘sense‐making’ in relation to a person's risk behaviours may help. A growing body of qualitative evidence focusing upon the experiences of care within Crisis Resolution/Home Treatment (CRHT) is emerging; however, a firm evidence base regarding both the giving and receiving of care for those with complex emotional needs (CEN) in this context is yet to be established.A qualitative evidence synthesis was used to develop a comprehensive understanding of how crisis care for people with CEN is experienced by both those giving and receiving care, within the context of CRHT.Findings from 19 research papers considering both clinician and service users' experiential accounts of CRHT were synthesised using meta‐ethnography.Both the giving and receiving of care within a CRHT context was experienced across four related meta‐themes: ‘contextual’, ‘functional’, ‘relational’ and ‘decisional’.Service user accounts focused upon relational aspects, highlighting a significance to their experience of care. Meanwhile, clinicians focused more upon contextual issues linked to the management of organisational anxieties and resources. For those with CEN, a clinician's focus upon risk alone highlighted power differentials in the caring relationship.There is a need for nurses to connect with the experience of the person in crisis, ensuring a better balance between contextual issues and relational working. [ABSTRACT FROM AUTHOR]
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- 2024
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20. Inpatient staff experiences of providing treatment for males with a diagnosis of borderline personality disorder: A thematic analysis.
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Davies, Meghan, Pipkin, Alastair, and Lega, Claudia
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Accessible Summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Introduction Aim Method Results Discussion Implications for Practice We know that there are similar rates of borderline personality disorder (BPD) diagnosed in both men and women; however, some research suggests that BPD is diagnosed later and less frequently in men. Some research suggests that males diagnosed with BPD present differently to women, but not much is known about how this influences the care men receive in inpatient mental health hospitals. This paper is the first to specifically ask inpatient staff about men diagnosed with BPD, and to hear about their perceptions and experiences. It identified that some staff do not feel as knowledgeable in identifying and treating BPD in men compared to women. Some staff talked about how emotional difficulties like BPD are often not the first thought when men present with distress compared to women. Staff also talked about needing a safe, open and transparent working culture to be able to ask questions and to be questioned on their own assumptions, biases or lack of training. This paper suggests that inpatient staff may hold some assumptions about men and their emotions, such as assuming that they are less likely to struggle with emotional difficulties like BPD. Staff anxieties about risk management may influence how they perceive and care for men in inpatient wards. The findings suggest that male‐specific training in identifying and treating BPD should be provided for staff on inpatient wards, to improve knowledge and confidence. Research highlights discrepancies in recognition of borderline personality disorder (BPD) in men, despite similar rates of prevalence across genders.To investigate inpatient mental health professionals' experiences of delivering treatment for males with a diagnosis of BPD.Six mental health professionals working within adult acute inpatient wards completed a semi‐structured interview. All participants were members of the nursing team. Thematic analysis was used to analyse the data.Five themes were identified: Gender Differences, Stereotyping, Facilitators to Care Delivery, Barriers to Care Delivery and Ways to Improve Care. Participants talked of a lack of awareness and understanding of BPD in males impacting both diagnosis and treatment in an acute inpatient setting.There may be factors ranging from gender stereotypes, limited knowledge and understanding of gender differences in presentations, and personal/organisational cultures influencing the formulation and treatment of males with a diagnosis of BPD in inpatient settings.The findings suggest that gender stereotypes such as masculine norms may influence how male patients' emotional difficulties are understood and managed, and that additional training in male‐specific issues to improve knowledge and care provision. This research will support inpatient staff, service leads and clinical educators to identify ways to adapt care provision for men. [ABSTRACT FROM AUTHOR]
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- 2024
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21. Embedding the service user voice to co‐produce UK mental health nurse education—A lived experience narrative.
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O'Brien, Sam and Davenport, Caroline
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Accessible Summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Introduction Aim Methods Thesis Implications for Practice Co‐production aims to value service user voices and is increasingly used in healthcare. Less is known about how co‐production in nursing education is experienced by service users. This paper shares the experience of one service user who teaches student nurses in a UK university. For the first author, the paper highlights that co‐producing nurse education has been valuable and rewarding for both a service user and students. Co‐production has the potential to benefit student nurses, including challenging their perceptions of ‘difficult’ patients. To achieve this, teaching sessions must be equally produced and delivered. By employing and including service users, universities have the potential to improve experiences for students and service users alike. Co‐production is increasingly used in health care but there is less attention to a co‐produced mental health nurse education.This article sought to explore the co‐production experiences of a service user who teaches mental health nurses, alongside the benefits of this to nurse education.The article is a lived experience narrative co‐written with a nursing lecturer.Co‐produced mental health nurse education challenges students' perceptions towards self‐harm and encourages empathy and understanding of service user distress.Co‐production has many benefits to nurse education including a positive student experience, and validation of the service user experience to support meaningful recovery. [ABSTRACT FROM AUTHOR]
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- 2024
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22. Mentalizing capacities of mental health nurses: A systematic PRISMA review.
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Free, Gieke, Swildens, Wilma, Knapen, Saskia, Beekman, Aartjan, and van Meijel, Berno
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ONLINE information services ,PSYCHOLOGY information storage & retrieval systems ,MEDICAL databases ,CINAHL database ,PSYCHOLOGICAL burnout ,OCCUPATIONAL roles ,NURSES' attitudes ,EVALUATION of human services programs ,ATTITUDES of medical personnel ,PROFESSIONAL employee training ,SYSTEMATIC reviews ,MENTAL health ,NURSE-patient relationships ,PSYCHIATRIC nurses ,CLINICAL competence ,DESCRIPTIVE statistics ,MEDLINE ,PSYCHOTHERAPY ,MENTAL health services - Abstract
Accessible Summary: What is known on the subject?: Mentalizing is the capacity to understand both one's own and other people's behaviour in terms of mental states, such as, for example, desires, feelings and beliefs.The mentalizing capacities of healthcare professionals help to establish effective therapeutic relationships and, in turn, lead to better patient outcomes. What this paper adds to existing knowledge?: The personal factors positively associated with the mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. There is limited evidence that training programmes can improve mentalizing capacities.Although the mentalization field is gaining importance and research is expanding, the implications for mental health nursing have not been previously reviewed. Mental health nurses are underrepresented in research on the mentalizing capacities of healthcare professionals. This is significant given that mental health nurses work closest to patients and thus are more often confronted with patients' behaviour compared to other health care professionals, and constitute a large part of the workforce in mental healthcare for patients with mental illness. What are the implications for practice?: Given the importance of mentalizing capacity of both the patient and the nurse for a constructive working relationship, it is important that mental health nurses are trained in the basic principles of mentalization. Mental health nurses should be able to recognize situations where patients' lack of ability to mentalize creates difficulties in the interaction. They should also be able to recognize their own difficulties with mentalizing and be sensitive to the communicative implications this may have. Introduction: Mentalizing capacities of clinicians help to build effective therapeutic relationships and lead to better patient outcomes. Few studies have focused on factors associated with clinicians' mentalizing capacities and the intervention strategies to improve them. Aim: Present a systematic review of empirical studies on factors associated with healthcare professionals' mentalizing capacities and the effectiveness of intervention programmes designed to improve these capacities. Method: Following PRISMA‐guidelines, a systematic literature search was conducted in PubMed, PsycINFO, Cochrane Library and CINAHL. Results: Out of a systematic search with 1537 hits, 22 studies were included. Personal factors positively associated with mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. Evidence that training programmes improve mentalizing capacities is limited. Discussion: Mental health nurses are underrepresented in research on mentalizing capacities of healthcare professionals and training programs to improve these capacities are practically absent. Implications for Practice: For mental health nurses, training in basic mentalizing theory and skills will improve their capacities in building effective working relationships with patients. [ABSTRACT FROM AUTHOR]
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- 2024
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23. Could artificial intelligence write mental health nursing care plans?
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Woodnutt, Samuel, Allen, Chris, Snowden, Jasmine, Flynn, Matt, Hall, Simon, Libberton, Paula, and Purvis, Francesca
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PSYCHIATRIC nursing ,OCCUPATIONAL roles ,MEDICAL quality control ,PRIVACY ,AUTHORS ,NURSING ,EMPATHY ,DATA security failures ,NURSING care plans ,WORK ,ARTIFICIAL intelligence ,SELF-injurious behavior ,MEDICAL software ,PARADIGMS (Social sciences) ,MEDICAL errors ,EXPERIENTIAL learning ,DIALECTICAL behavior therapy ,NURSES ,MEDICAL ethics ,WRITTEN communication ,COMMUNITY mental health personnel ,THERAPEUTIC alliance ,NURSING diagnosis ,NURSING interventions - Abstract
Accessible Summary: What is Known on the Subject?: Artificial intelligence (AI) is freely available, responds to very basic text input (such as a question) and can now create a wide range of outputs, communicating in many languages or art forms. AI platforms like OpenAI's ChatGPT can now create passages of text that could be used to create plans of care for people with mental health needs. As such, AI output can be difficult to distinguish from human‐output, and there is a risk that its use could go unnoticed. What this Paper Adds to Existing Knowledge?: Whilst it is known that AI can produce text or pass pre‐registration health‐profession exams, it is not known if AI can produce meaningful results for care delivery.We asked ChatGPT basic questions about a fictitious person who presents with self‐harm and then evaluated the quality of the output. We found that the output could look reasonable to laypersons but there were significant errors and ethical issues. There are potential harms to people in care if AI is used without an expert correcting or removing these errors. What are the Implications for Practice?: We suggest that there is a risk that AI use could cause harm if it was used in direct care delivery. There is a lack of policy and research to safeguard people receiving care ‐ and this needs to be in place before AI should be used in this way. Key aspects of the role of a mental health nurse are relational and AI use may diminish mental health nurses' ability to provide safe care in its current form.Many aspects of mental health recovery are linked to relationships and social engagement, however AI is not able to provide this and may push the people who are in most need of help further away from services that assist recovery. Background: Artificial intelligence (AI) is being increasingly used and discussed in care contexts. ChatGPT has gained significant attention in popular and scientific literature although how ChatGPT can be used in care‐delivery is not yet known. Aims: To use artificial intelligence (ChatGPT) to create a mental health nursing care plan and evaluate the quality of the output against the authors' clinical experience and existing guidance. Materials & Methods: Basic text commands were input into ChatGPT about a fictitious person called 'Emily' who presents with self‐injurious behaviour. The output from ChatGPT was then evaluated against the authors' clinical experience and current (national) care guidance. Results: ChatGPT was able to provide a care plan that incorporated some principles of dialectical behaviour therapy, but the output had significant errors and limitations and thus there is a reasonable likelihood of harm if used in this way. Discussion: AI use is increasing in direct‐care contexts through the use of chatbots or other means. However, AI can inhibit clinician to care‐recipient engagement, 'recycle' existing stigma, and introduce error, which may thus diminish the ability for care to uphold personhood and therefore lead to significant avoidable harms. Conclusion: Use of AI in this context should be avoided until a point where policy and guidance can safeguard the wellbeing of care recipients and the sophistication of AI output has increased. Given ChatGPT's ability to provide superficially reasonable outputs there is a risk that errors may go unnoticed and thus increase the likelihood of patient harms. Further research evaluating AI output is needed to consider how AI may be used safely in care delivery. [ABSTRACT FROM AUTHOR]
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- 2024
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24. The nurse faculty role: A lived experience of mentoring nurses while coping with anxiety during the COVID‐19 pandemic.
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Orth, Stephanie J. and Evanson, Tracy A.
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OCCUPATIONAL roles ,PSYCHOLOGICAL burnout ,WORK ,SELF-perception ,MOTIVATION (Psychology) ,YOGA ,COLLEGE teacher attitudes ,MENTORING ,RECREATION ,MENTAL health ,EXPERIENCE ,HOPE ,REINFORCEMENT (Psychology) ,PSYCHOSOCIAL factors ,EDUCATORS ,EXPERIENTIAL learning ,INTERPROFESSIONAL relations ,PROFESSIONAL identity ,SECONDARY traumatic stress ,NURSING school faculty ,PSYCHOLOGICAL adaptation ,ANXIETY ,COVID-19 pandemic ,REFLECTION (Philosophy) - Abstract
Accessible Summary: What is known on the subject?: Anxiety is common in women, nurses and nurse educators and can negatively impact overall mental well‐being and work–life satisfaction.Anxiety increased during the COVID‐19 pandemic.Hope is a personal resource that can be employed to help cope with anxiety.Professional identity, 'our why', is important to recognize and revisit as a way to add value to daily work in anxious times. What this paper adds to existing knowledge?: Compassion fatigue has contributed to burnout and turnover of nurses and nursing faculty.Knowing our 'why' helps understand the motivation in our work.Using hope as a personal resource, and sharing my lived experience, could be useful to other nursing faculty struggling with anxiety. What are the implications for mental health nursing?: There is a need for mental health resources within healthcare and education systems to support nurses and nurse educators not only during the COVID‐19 pandemic but through future healthcare crises.Support programmes and interventions need to be developed to sustain and retain both nurses and nursing faculty. Background: Providing patient care and nurse education in today's healthcare environment is high‐stress, often resulting in high‐anxiety among both nurses and nurse educators. The impact of the COVID‐19 pandemic on nurse faculty is largely unexplored. Aims: The aim was to share the experience of living and work working with anxiety in the nurse faculty role during the COVID‐19 pandemic. Materials & Methods: This is a lived experience narrative of one nurse faculty member. Results: Through daily purposeful self‐motivation and reflection, yoga, and brief outdoor respites, the author was able to strengthen professional identity, to see value in her work and to activate the personal resource of hope (Nursing Management, 52, 2021, 56; Journal of Occupational and Organizational Psychology, 93, 2020, 187). Discussion: 'Nursing faculty are essential to the profession' and likely experienced 'emotional exhaustion' during the pandemic (Nursing Education Perspectives, 42, 2021, 8) in their efforts to buoy students. It needs to be acknowledged that nursing faculty can experience anxiety, secondary trauma (International Journal of Environmental Research and Public Health, 17, 2020, 8358) and compassion fatigue, through listening to students' experiences and offering reinforcement during chaotic times. Conclusion: Little is known about what nursing faculty experienced as they attempted to support students (Nursing Education Perspectives, 42, 2021, 285). It is hoped that by sharing this lived experience, nurses and nurse faculty will understand how employing hope as a personal resource and re‐engaging with their professional identity will help them cope with the significant stresses that future healthcare pandemics or disasters may bring. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Solving the shortage of psychiatric – mental health nurses in acute inpatient care settings.
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Frawley, Timmy and Culhane, Aisling
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MEDICAL quality control ,OCCUPATIONAL roles ,HEALTH facilities ,LEADERSHIP ,HEALTH facility administration ,PROFESSIONAL employee training ,NURSE supply & demand ,LABOR supply ,NURSING practice ,PSYCHIATRIC nurses ,CRITICAL care medicine ,NURSES ,MENTAL health services - Abstract
Introduction: This debate essay proposes possible remedies to the shortage of nurses in acute inpatient mental health settings and draws inspiration from a Journal of Psychiatric and Mental Health Nursing editorial, Glascott and McKeown (2022, 29, 767). Aim: The aim is to stimulate debate within the profession. The art and science of nursing continues to develop but staffing shortages in key areas undermine practice, leadership, academic and policy efforts to improve the quality of care for people attending services. Method: This is a debate essay which draws on the authors' experience and presents ideas based on extant literature. Results: Organisational, professional and wider societal challenges are explored. Practice‐based solutions as well as recommendations for improving the terms and conditions of employment of nurses are made. Opportunities which may empower the nursing profession are promulgated. Discussion: It is intended that this paper will provoke further discourse and may reflect the 'call to action' advocated by Glascott and McKeown (Journal of Psychiatric and Mental Health Nursing, 2022, 29, 767). Implications for Practice: While the focus is on acute inpatient mental health nursing, the ideas presented may have an application to wider nursing groups or a wider cadre of public sector workers. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Non‐pharmacological interventions for people living with young‐onset dementia and their carers: A scoping review focussing on the support of participants' needs.
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Kim, Iktae, Yang, Yoosun, Cheon, Hongjin, Kim, Jiyeon, and Song, Jun‐Ah
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TREATMENT of dementia ,ONLINE information services ,CINAHL database ,CAREGIVERS ,SOCIAL support ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,PSYCHOEDUCATION ,DEMENTIA patients ,COGNITIVE rehabilitation ,AUTONOMY (Psychology) ,QUALITY assurance ,DESCRIPTIVE statistics ,RESEARCH funding ,NEEDS assessment ,LITERATURE reviews ,MEDLINE ,PSYCHOTHERAPY - Abstract
Accessible Summary: What is known on the subject?: Young‐onset dementia (YOD) refers to a phenomenon in which dementia symptoms appear under age 65. Diagnosing YOD is difficult and its progression is fast. Furthermore, it limits the socio‐economic careers of people living with YOD, regardless of their needs.People living with YOD and their carers have unstable occupational status and their dependents also have to face a high burden of care. They claim that existing social support for dementia is limited to the elderly and is not suitable for them. What the paper adds to existing knowledge?: The characteristics of non‐pharmacological intervention studies for people living with YOD and/or their carers so far, and an analysis of the needs supported via the applied interventions.A theoretical basis and direction for the interventions to be studied in the future. What are the implications for practice?: Research and intervention development should focus more on the needs of people living with YOD. In addition, it is necessary to understand and reflect on carers who directly care for people living with YOD.A multidisciplinary programme that supports wide area of the needs should be developed. Introduction: Young‐onset dementia (YOD) is a highly influential disease that exerts force on the normal life of those who still have to continue social life. Research has been lacking in spite of its seriousness, which accounts for about 9% of all dementia cases. Aim: This study aimed to examine non‐pharmacological interventions for people living with YOD and/or their carers, and to analyse how those interventions support their needs. Method: A scoping review methodology was utilized to search the studies examining interventions for people living with YOD and/or their carers, and in English or Korean. The information was extracted, summarized and analysed in CANE categories. Results: Sixteen studies were included in the review. Five types of interventions were drawn. 'Memory' was the most covered part of the needs by the interventions. Discussion: This study found that interventions currently do not match the needs of people living with YOD and their carers. Multidisciplinary research would be eligible to cover the subjects' wide range of the needs as much as possible. Implications for Practice: We suggest the development of a specialized needs assessment tool and specialized interventions for people living with young‐onset dementia and their carers. [ABSTRACT FROM AUTHOR]
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- 2024
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27. I am the psychiatric patient and the psychiatric patient is me: Retelling a lived experience narrative of professional sexual misconduct.
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Wiggins, Morgan
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Accessible Summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Professional sexual misconduct is the name given to the phenomenon of healthcare providers crossing sexual boundaries with their patients. It is comprised of a range of behaviors from comments to unwanted touching and even rape. The exact incidence is unknown, but estimates have been made. These abuses are thought to be underreported. The applicable reporting processes are problematic. Trauma‐informed care presupposes knowledge of various types of trauma, and this is one type. Traua‐informed care places emphasis on healthcare systems and healthcare providers' avoidance of retraumatizing patients who disclose any type of trauma, including sexual violence. This paper adds one narrative experience of a sexual assault perpetrated by the writer's colleague psychiatrist. It can be viewed as a cautionary tale about horizontal violence against nurses. This narrative discusses how one traumatic event can mushroom into chronic traumatic sequelae when disclosure re‐traumatizes. Increased knowledge of this type of sexual violence may help those who have suffered it. As psychiatry is among the healthcare fields who regularly screen patients for trauma, it is imperative that the psychiatric workforce gain familiarity with trauma‐informed responses to avoid re‐traumatizing patients who disclose sexual violence. [ABSTRACT FROM AUTHOR]
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- 2024
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28. When the wounds heal but the soul bleeds—A lived experience narrative.
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Anonymous
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Accessible Summary What is known on the subject? What this paper adds to existing knowledge? What are the implications for mental health nursing? This paper acknowledges the profound and lasting impact of childhood abuse on substance use and homelessness. It underscores the inherent value and humanity of every individual, regardless of their struggles. That a comprehensive approach to mental health care, encompassing medication, therapy and a secure environment, is imperative. Early intervention and recognising individuals who suffer in silence are paramount. Mental health nurses must have the courage to ask uncomfortable questions and truly hear the unspoken words. Mental health nurses should never underestimate the power of simply being present with someone during their darkest moments. This simple act can wield significant influence. [ABSTRACT FROM AUTHOR]
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- 2024
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29. Unmet care needs in psychiatric healthcare context: A systematized literature review.
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Kohanová, Dominika, Zrubcová, Dana, Bartoníčková, Daniela, and Solgajová, Andrea
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LITERATURE reviews , *PSYCHIATRIC nursing , *MEDICAL personnel , *PATIENT satisfaction , *NURSES as patients , *NURSE administrators - Abstract
Accessible summary What Is Known on the Subject What the Paper Adds to Existing Knowledge What Are the Implications for Practice Introduction Aim Methods Results Discussion Implication for Practice Missed, rationed or unfinished nursing care represents a global problem that jeopardizes the provision of quality and safe care. This phenomenon is frequently observed in adult, paediatric and child healthcare facilities and various care units. The findings of this review contribute valuable information to inform evidence‐based practices, foster organizational improvements and ultimately optimize the overall quality of care in psychiatric healthcare settings. In addition, the review illuminates the far‐reaching consequences of care on both patient and nurse outcomes, emphasizing the urgent need for tailored strategies to mitigate these effects. Based on the synthesis of the literature, a thorough and continuous assessment of patient care needs in the physical, psychological and social domains is needed, primarily utilizing standardized instruments designed for psychiatric settings to ensure a comprehensive understanding of unmet needs. Based on identified unmet needs, nurses should develop individualized care plans and tailor interventions to address them. In addition, nurse managers must adopt and implement regular monitoring mechanisms to track the prevalence of unmet care needs and at the same time establish reporting systems that capture the proportion of unmet needs, allowing timely interventions and adjustments to care delivery. Lastly, nurse managers must not only emphasize the importance of ethical care practices and dignity‐focused interventions but also educate healthcare providers, especially nurses, on the potential threats to patient dignity arising from unmet care needs. Despite frequent observations of unmet care needs in acute care adult settings, there are a limited number of studies that focus on investigating this phenomenon in the psychiatric setting.To synthesize the existing empirical research on unmet care needs in psychiatric healthcare settings.The search was carried out in August 2023 in four scientific databases, PubMed, ProQuest, Web of Science and OVID Nursing, based on their institutional availability. The search produced 1129 studies. The search and retrieval process reflected the recommendations of the Preferred Reporting Items for systematic reviews and meta‐analyses.This review included 14 studies investigating unmet care needs in the psychiatric healthcare setting. Unmet care needs included three domains: physical, psychological and social. The analysis of the factors revealed factors related to the characteristics of the organization, nurse and patient.The classification of unmet needs provides a comprehensive understanding of the various challenges facing people in psychiatric healthcare settings.Identified factors that influence the occurrence of unmet care needs will help prevent the occurrence of unmet care needs and timely assessment. The resolution of needs helps to achieve patient and nurse outcomes, increase the quality of care provided and patient satisfaction in a psychiatric healthcare setting. [ABSTRACT FROM AUTHOR]
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- 2024
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30. Nursing in the digital age: The role of nursing in addressing cyberbullying and adolescents mental health.
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Amin, Shaimaa Mohamed, Mohamed, Marwa Ahmed El‐Sayed, Metwally El‐Sayed, Mona, and El‐Ashry, Ayman Mohamed
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- *
PSYCHIATRIC nursing , *DIGITAL technology , *CYBERBULLYING , *MENTAL health , *POOR families , *ADOLESCENT health - Abstract
Accessible Summary The Relevance of Our Study to Mental Health Nursing What is known on the subject? What this paper adds to existing knowledge? What are the implications for practice? Summary Statement of Implications for Practice What Does This Research Add to Existing Knowledge of Cyberbullying Among Adolescents? What are the Implications of This New Knowledge for Nursing Care with Adolescents? How Could the Findings Influence Policy, Practice, Research, or Education? Background Methods Results Conclusion Patient or Public Contribution Implications for Nursing Practice The study's findings are crucial for mental health nursing, as they highlight the significant impact of cyberbullying on adolescents' mental health in Egypt. By establishing a clear link between cyberbullying, family income, and mental health issues such as anxiety, stress, and depression, the research underscores the need for targeted interventions and support systems. Mental health nurses can utilize this information to develop effective prevention and treatment strategies, advocate for policy changes, and educate families and communities. Addressing cyberbullying and its effects can lead to improved mental health outcomes, demonstrating the critical role of mental health nursing in supporting affected adolescents. This study brings attention to the widespread occurrence of cyberbullying among adolescents in Egypt and its substantial impact on their mental health. The research indicates that cyberbullying, along with family income, collectively explains more than 60% of the variation in mental health. These results underscore the importance of developing strategies to address cyberbullying and taking socioeconomic factors into account when addressing mental health issues in adolescents. School nurses should be knowledgeable about the prevalence and effects of cyberbullying on the mental well‐being of teenagers. They need to be equipped to recognize signs of cyberbullying and associated mental health issues, such as anxiety, depression, and stress. Educating adolescents, parents, and school staff about the dangers of cyberbullying and prevention methods is a crucial role that school nurses can play. This may involve teaching safe internet usage, promoting open communication about online experiences, and encouraging positive online behaviour. When evaluating mental health needs and planning care for adolescents, school nurses should consider their economic status. They should advocate for resources and assistance for low‐income families to help alleviate the impact of financial stress on mental health. It is important to introduce policies that provide financial support to families with lower incomes, as the research has shown a strong connection between a family's monthly income and its members' mental well‐being. Educational institutions, including schools, should introduce programs to prevent bullying, with a specific focus on cyberbullying. It would be beneficial for researchers to explore the effectiveness of various interventions in reducing cyberbullying and improving mental health outcomes. It is crucial to integrate education on cyberbullying into school curricula in order to raise awareness about this issue and to teach students how to respond if they or someone they know becomes a victim of cyberbullying. Educating parents and teachers about the indicators of cyberbullying and its potential impact on mental health is important so that they can offer support to adolescents who are experiencing cyberbullying. Further research is needed to address other covariates that could impact cyberbullying, such as addictive personality traits, impulsive seeking behaviours, and parenting styles. Cyberbullying, a significant concern in today's digital age, has a profound impact on teenagers' mental health, leading to stress, depression, anxiety, low self‐esteem, and, in severe cases, suicidal ideation. This study aimed to explore the effects of cyberbullying on adolescents' mental health.The study employed a cross‐sectional descriptive research design conducted at five public secondary schools in El‐Beheira governorate, Egypt. A total of 500 students were selected through a multistage sampling technique, yielding a response rate of 96%. The instruments used for data collection were the European Cyberbullying Intervention Project Questionnaire and the Depression Anxiety Stress Scale‐21.The findings revealed that 27.4% and 32.0% of respondents reported high levels of victimization and cyberaggression, respectively. Furthermore, 72.2%, 44%, and 52.6% of students exhibited severe to extremely severe levels of anxiety, stress, and depression, respectively. The study also found that cyberbullying and family monthly income accounted for 61.6% of the variance in stress, anxiety, and depressive symptoms (adjusted R2 = .614).The study concludes that cyberbullying is a prevalent issue among adolescents in Egypt, with a majority of students experiencing moderate to high levels of cybervictimization and aggression. This leads to varying degrees of anxiety, stress, and depression. The study also established a significant relationship between cyberbullying and mental health issues among adolescents. Moreover, both cyberbullying and family monthly income were found to significantly influence mental health, with higher levels of cyberbullying and lower income associated with increased stress, anxiety, and depressive symptoms.No Patient or Public Contribution.It is important for nurses working with adolescents to have an understanding of how common cyberbullying is and how it can affect mental health. They should receive training to be able to recognize signs of cyberbullying and mental health issues, such as anxiety, depression, and stress. Nurses can teach adolescents, parents, and school staff about its dangers and ways to prevent cyberbullying. This may involve educating adolescents on safe internet practices, promoting open communication about online experiences, and encouraging positive online behaviour. Lastly, considering the strong connection between income and mental health, nurses should also take into account the socioeconomic status of adolescents when assessing their mental health needs and planning care. They should work to secure resources and support for low‐income families to help alleviate the impact of financial stress on mental health. Additionally, further research is needed to address other covariates that could impact cyberbullying, such as addictive personality traits, impulsive seeking behaviours, and parenting styles. [ABSTRACT FROM AUTHOR]
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- 2024
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31. The role of psychological formulation in inpatient settings in supporting staff empathy and therapeutic optimism for adults diagnosed with borderline personality disorder: A pre‐ and post‐vignette study.
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Watkin, Felicity, Scott, Helen, and Richards, Ruth
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BORDERLINE personality disorder , *EMPATHY , *MENTAL health personnel , *OPTIMISM , *PERSPECTIVE taking , *COMMUNITY mental health services - Abstract
Accessible summary What is known on the subject? What the paper adds to existing knowledge? Objectives Method Results Conclusion Psychological formulation brings together a service user story and expertise, with psychological knowledge, research, and practitioners clinical experience to make sense of a service users' presentation (thinking about their difficulties but also strengths). Evidence into the effectiveness of formulation is largely anecdotal, qualitative, or small scale. Although this is very valuable research, there is not a lot of research which quantitatively evidences the role of formulation for service users or services. Quantitative evidence that does exist is also conflicting. Considering how widely psychological formulation is used, and the governing guidelines that recognize this as a core competency for psychological practitioners, it is important to continue to add to the evidence base. Psychological formulation can increase staff empathy and hope. This could help service users to feel more understood and hopeful. Formulation; however, did not impact feelings of personal distress in staff. This research may suggest a need for the two distinct processes (i.e. team formulation and reflective practice) to support all components of empathy within inpatient services. Psychological formulation could support the provision of psychologically informed care within inpatient services, of which promotes effective care delivery. National Health Service (NHS) values, such as empathy and therapeutic optimism, are integral when supporting service users with complex mental health presentations. There is some evidence to suggest that psychological formulation can increase empathy and optimism in healthcare professionals. This study, therefore, aimed to investigate whether a psychological formulation of a hypothetical service user with a complex presentation, typically labelled with a diagnosis of borderline personality disorder (BPD), increased empathy and therapeutic optimism in professionals working in mental health inpatient services.Sixty‐six mental health professionals working in NHS inpatient services took part in a pre‐ and post‐vignette study. Participants were asked to read a case vignette about a hypothetical service user, with a diagnostic label of BPD, and complete questionnaires capturing levels of empathy and therapeutic optimism. Participants were then randomized into two conditions and either asked to read the same information again (control condition) or read a psychological formulation based on the same hypothetical service user (intervention condition). The findings were analysed using a series of ANCOVAs/ANCOHETs.Two constructs of empathy (i.e. perspective taking and empathic concern), and therapeutic optimism significantly increased following exposure to the psychological formulation when compared to the control group condition.This study warrants further replication. These initial findings; however, indicate that psychological formulation can significantly increase the ability to perspective take, display empathic concern, and hold therapeutic optimism towards service users with a presentation associated with a diagnosis of BPD. [ABSTRACT FROM AUTHOR]
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- 2024
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32. Experiences of restrictive interventions in psychiatric health care from the perspectives of patients and health care professionals: Meta‐synthesis of qualitative evidence.
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Kim, Jiu and Nam, Soo‐Hyun
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MEDICAL personnel as patients , *MEDICAL personnel , *PATIENTS' attitudes , *MENTAL health services , *PSYCHIATRIC nursing , *NURSE-patient ratio , *MEDICAL care , *OPPRESSION - Abstract
Accessible Summary What Is Known on the Subject What the Paper Adds to Existing Knowledge What Are the Implications for Practice Introduction Methods Findings Discussion Conclusion Following their experience, patients with physical restraints often experienced traumatic sensations. The experiences of healthcare professionals' (HCPs') are primarily concerned with moral distress or conflicts between loyalty to the treatment and oppression of the patient's freedom when implementing RIs. Improving the competency of HCPs can help establish therapeutic relationships rooted in compassionate care and facilitate appropriate assessments to determine whether and how often RIs are necessary. Furthermore, fostering an environment that guarantees patient safety and dignity, assuring a sufficient staffing ratio, and providing opportunities to share RI experiences can help improve the quality of care and build safe environments for RIs. Effective interaction between HCPs and patients, thorough patient assessment, and compassionate patient care may improve competency of HCPs intervene RIs procedures. Creating a safe therapeutic environment, including improvements to structural environments, increasing the staff‐to‐patient ratio, establishing organizational policies that guarantee staff debriefing, provide emotional support, provide appropriate training programs to HCPs to their coping skills during RIs also reduce the use of RIs and improve the quality of mental health care. Restrictive interventions (RIs) are used in psychiatric inpatient units for ensuring safety. However, few studies have comprehensively reviewed physical restraint and seclusion experiences from the perspectives of both patients and healthcare professionals' (HCPs'). This study aims to gain an in‐depth understanding of the RI experiences of mental health inpatients and HCPs.A meta‐synthesis was undertaken of qualitative studies exploring the RI experiences. Five electronic databases were searched and additional manual searches were performed for studies published within the last decade. Twelve articles were included, and a thematic analysis was conducted. The Critical Appraisal Skills Program (CASP) checklist was used to assess data quality.Two main subthemes were identified: ‘Competency of HCPs’ (three subthemes: interaction between patients and HCPs, assessment methods, and care) and ‘systems’ (three subthemes: environment, protocols with training, and debriefing), including both positive and negative experiences.The Competency of HCPs and the ward environment are critical factors related to patients' unmet needs. Effective interactions between HCPs and patients, thorough patient assessments, and compassionate patient care are important elements of RI implementation.An environment that guarantees safety and care with dignity, sufficient staffing ratios, and opportunities to share RI experiences may improve quality of care and create safe environments for RIs. [ABSTRACT FROM AUTHOR]
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- 2024
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33. Attitudes and behaviours of mental health professionals in the care of transgender people: A qualitative study.
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Cutillas‐Fernández, M. Asunción, Jiménez‐Ruiz, Ismael, Herrera‐Giménez, María, and Jiménez‐Barbero, Jose Antonio
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MENTAL health services , *TRANSGENDER people , *GENDER nonconformity , *HEALTH behavior , *PROFESSIONALISM , *MENTAL health personnel - Abstract
Accessible Summary What is known on the subject? What the paper adds to existing knowledge? What Are the implications for practice? Introduction Aim Method Results Discussion/Implications for Practice Mental health professionals' beliefs about transgender individuals vary, often influenced by stereotypes. There's recognition of healthcare needs, but limited knowledge impacts decision‐making. Stereotypes persist regarding why transgender individuals seek mental health care. Professionals' attitudes show both positive support and negative, discriminatory views. Lack of training and knowledge gaps hinder effective care for transgender individuals. Pathologising attitudes exist, associating gender diversity with mental health conditions. Addressing training gaps is crucial for equitable care for transgender individuals. Challenging stereotypes and beliefs is necessary to reduce stigma and improve understanding. Enhancing knowledge and evidence‐based tools will ensure safe and equal healthcare access. Transgender people face against significant barriers in accessing mental health services due to, among other reasons, discrimination and a lack of expertise among professionals.To explore the beliefs and attitudes of professionals in the mental health network of the region of Murcia towards transgender people, focusing on aspects such as knowledge, perceptions, and prejudices about gender identity.We carried out a qualitative study involving 14 participants, conducting semi‐structured interviews based on prior knowledge of the topic. We asked the professionals about their experiences and challenges in their clinical interaction with transgender users and followed an inductive‐deductive process to analyse the data.Two main themes were identified from the interviews, which were sub‐categorised into different sub‐themes: (a) beliefs about transgender people: underlying factors and origins of gender diversity, health needs, and stereotypes about the demand for health care; (b) attitudes and behaviours of professionals towards transgender people: pathologization and attitudes towards decision‐making.Our findings suggest that mental health professionals tend to oversimplify the factors underlying gender diversity and hold certain stereotypical beliefs about these users that oversimplify the complexity of their experiences. [ABSTRACT FROM AUTHOR]
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- 2024
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34. Individual factors as predictors of secondary traumatic stress and burnout in forensic inpatient staff.
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Chapman, Katrina Jade, Scott, Helen, and Rydon‐Grange, Michelle
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SECONDARY traumatic stress , *ACCEPTANCE & commitment therapy , *ADAPTABILITY (Personality) , *DISEASE risk factors , *PSYCHOLOGICAL burnout , *FORENSIC nursing - Abstract
Accessible Summary What is known on the subject What the paper adds to existing knowledge What are the implications for practice Introduction Aims Method Results Discussion Implication for Practice Secondary traumatic stress (STS) is the indirect traumatisation of a person through the stress of helping or knowing about other's trauma. Burnout is gradual exhaustion in response to long‐term work‐related stress. Both have negative psychological, physiological and/or organisational consequences; however, the existing research in forensic health care professionals (FHCPs) is limited. One study explored STS in FCHPs and found that lower psychological flexibility (ability to adapt) was a predictor of greater STS. Existing research on burnout in FHCPs suggests that individual differences, such as the ways in which we cope (talking to people vs. using substances), may predict burnout levels. Prevalence findings add to the recent evidence base, which also found moderate levels of burnout. However, this study is the first to find high levels of secondary traumatic stress in FHCPs. Similar to existing literature, the study's findings suggest that FHCP's with lower levels of psychological flexibility and more maladaptive coping strategies may experience greater STS and burnout symptoms, while staff who use more adaptive coping strategies may experience less burn‐out. Unexpectedly, staff who reported a more anxious attachment style were burnt‐out; however, there are limitations to this finding. Policies and practices in forensic settings should reflect the risk of STS and burnout. Practices or interventions should enhance adaptive coping strategies and psychological flexibility, such as Resilience Enhancement Programmes or Acceptance and Commitment Therapy (ACT). Secondary traumatic stress (STS) and burnout literature in inpatient forensic health care professionals (FHCPs) is limited, despite the psychological, physiological and organisational consequences.This study aimed to further this limited evidence base, investigating predictors of STS and burnout in FHCPs.98 healthcare professionals working in two UK forensic inpatient settings completed measures assessing: burnout, STS, psychological flexibility, coping style, attachment style and a demographic questionnaire recording length of service and the sex of staff.Results indicated high STS and moderate burnout levels. The main predictors of STS and burnout were poorer psychological flexibility and greater maladaptive coping styles, whereas lower burnout was predicted by greater adaptive coping styles and an anxious attachment style.This study has contributed towards a limited evidence base and indicates poorer psychological flexibility and greater maladaptive coping may be risk factors for STS and burnout in FHCPs, whereas greater maladaptive coping may be a protective factor.The findings suggest that interventions such as Acceptance and Commitment Therapy (ACT) and coping skills interventions, may offer protective benefits to inpatient forensic healthcare professionals. [ABSTRACT FROM AUTHOR]
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- 2024
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35. Evaluation of a novel co‐designed and co‐delivered training package to de‐escalate violence and aggression in UK acute inpatient, PICU and forensic mental health settings.
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Grundy, Andrew C., Papastravrou Brooks, Cat, Johnston, Isobel, Cree, Lindsey, Callaghan, Patrick, and Price, Owen
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MENTAL health personnel , *MENTAL health , *COMMUNITY mental health personnel , *TRAUMA-informed care , *AGGRESSION (Psychology) , *VIOLENCE - Abstract
Accessible Summary What is known on the subject? What does this paper add to existing knowledge? What are the implications for practice? Background Aim Methods Results Discussion Implications for Practice Relevance Statement Clinical guidelines and staff training recommend using de‐escalation over restrictive practices, such as restraint and seclusion Evidence suggests that restrictive practices continue to be used frequently despite training This suggests a lack of impact of existing staff de‐escalation training. The features of de‐escalation training that are acceptable to staff and perceived to be impactful A co‐designed and co‐delivered training session on a trauma‐informed approach to de‐escalation on mental health wards was acceptable and perceived to be impactful Those attending training particularly valued how lived experience was incorporated into the training content and co‐delivery The organizational and team context may need more consideration in adapting the training. De‐escalation training that adopts a trauma‐informed approach and considers the context of ward environments is acceptable to staff Co‐delivery models of training to tackle restrictive practice can be acceptable and impactful Further research will show how clinically effective this training is in improving outcomes for service users in ward contexts. Evidence suggests a discrepancy between recommended and routine practice in de‐escalation in mental health settings, suggesting a lack of impact of existing training.To investigate the acceptability and perceived impact of a co‐designed/delivered training intervention on a trauma‐informed approach to de‐escalation on mental health wards.Trainees were invited to complete the Training Acceptability Rating Scale (TARS) post‐training. Responses to the quantitative items were summarized using descriptive statistics, and open‐text responses were coded using content analysis.Of 214 trainees, 211 completed the TARS. The trainees rated the training favourably (median overall TARS = 55/63), as acceptable (median 33/36) and impactful (median 23/27). There were five qualitative themes: modules of interest; multiple perspectives; modes of delivery; moulding to context; and modifying other elements.The EDITION training was found to be acceptable and impactful, with trainees particularly valuing the co‐delivery model. Trainees suggested several ways in which the training could be improved, particularly around the need for further moulding of the intervention to the specific ward contexts/teams.We recommend co‐designing and co‐delivering staff training to mental health professionals that tackles restrictive practices.This research is relevant to lived experience practitioners who want to be involved in training mental health professionals around restrictive practices, demonstrating the value and importance of their voice. It is relevant to current providers of de‐escalation training, and to staff receiving training, outlining a novel, but acceptable and impactful, form of training on a key area of mental health practice. It is relevant to anyone with an interest in reducing restrictive practice via co‐delivered training. [ABSTRACT FROM AUTHOR]
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- 2024
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36. Effective provider communication for personal agency in mental health recovery: A cross‐sectional study on Japanese users' perspectives.
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Okumura, Satoshi and Katsuki, Fujika
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PSYCHIATRIC nursing , *COMMUNITY mental health services , *MENTAL health services , *MENTAL health , *PEOPLE with mental illness , *PATIENT-professional relations , *MULTIPLE regression analysis - Abstract
Accessible summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Introduction Aim Method Results Discussion Implications for Practice Recovery‐oriented practices in community‐based mental health services are of increasing importance. The recovery journey of individuals with mental illness starts with a sense of agency, and a therapeutic relationship with the providers who support them is a prerequisite. In Japan, the construction of community‐based integrated care systems for individuals with mental illness is positioned as a priority health issue, with communication with familiar individuals being particularly important for recovery in Japanese and Asian cultures. This study is the first to examine effective communication factors for personal agency in the recovery of individuals with mental illness, focusing on addressing uncertainty about treatment choices and dissatisfaction with decision‐making, and considering the user's personal recovery journey. In recovery‐oriented practice, it is important to prioritize addressing the emotional aspects of decision‐making alongside the mental illness condition, supporting users' self‐determination in their unique recovery journeys. The findings emphasized the need to actively engage with users' perspectives and emotions, emphasize shared life planning, and foster a therapeutic relationship based on partnership. Providers should approach dialogue as carefully as medication prescriptions, prioritizing the establishment of an effective therapeutic relationship with the user. These characteristics are essential for developing a strong therapeutic relationship and effectively facilitating users' recovery. The findings are applicable not only to nurses but to all mental health service providers, contributing to the advancement of recovery‐oriented practice. Recovery‐oriented practice in community‐based mental health services is crucial for individuals with mental illness, with communication with familiar individuals being important for recovery in Japanese and Asian cultures.This study aimed to examine effective communication factors for personal agency in recovery by investigating the association between perceived support provided through communication and personal agency of individuals with mental illness.A cross‐sectional study was conducted among community‐dwelling Japanese mental health service users, assessing subjective agency, decisional conflict, staff support for personal recovery, activation for mental health self‐management, demographic variables and living difficulties. Multiple linear regression analysis identified factors predicting subjective agency, revealing characteristics of effective provider communication for recovery.Data from 222 users were analysed, revealing negative correlations between uncertainty about treatment choices and ineffective decision‐making with higher subjective agency, while staff support for personal recovery positively correlated with higher subjective agency.In recovery‐oriented practice, prioritizing users' emotional experiences during decision‐making and supporting their self‐determination in their unique recovery journeys is crucial.Providers should approach dialogue as carefully as medication prescriptions, prioritizing therapeutic partnerships with users. The findings extend beyond nursing to all mental health service providers, advancing the theory of recovery‐oriented practice. [ABSTRACT FROM AUTHOR]
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- 2024
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37. Stakeholder perspectives on continuous observation in inpatient psychiatric wards.
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Anstee, Lottie, Chifamba, Denford, Loothfaully, Wasim, Suleiman, Suleiman, Shah, Chetan, Littlechild, Brian, and Zia, Asif
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COMMUNITY mental health services , *QUALITY of service , *TRUST , *PATIENT experience , *SEMI-structured interviews , *SOCIAL change , *SERVICES for caregivers - Abstract
Accessible summary What is known on the subject? What this paper adds to existing knowledge? What are the implications for practice? Introduction Aim Method Results Implications for Practice Continuous observation is often used in mental health wards to support the safety of service users, where they will be constantly watched by a member of staff. Evidence suggests that continuous observations may be unhelpful and restrictive, but not enough is known about the practice or the best ways to improve it. This evaluation integrates the perspectives of service users, informal carers and staff to explore current continuous observation experiences and inform future improvements. While previous research highlights the importance of therapeutic engagement, this study additionally emphasizes how the observation procedure could be adapted to individual needs. Continuous observations could be more beneficial if they are therapeutic, proportional to the level of risk and co‐developed with the service user, informal carer and staff. Further training about communication could support staff engagement and the observation process could be formalized to ensure regular collaborative reviews. Continuous observation is a frequently used tool to manage high levels of risk on psychiatric wards. However, there is little previous research on its use in practice.This qualitative service evaluation aims to explore the continuous observation experiences of service users, informal carers and staff in a local NHS Mental Health Trust, informing suggested future improvements to current practice.Five service users, three informal carers and seven healthcare staff completed semi‐structured interviews, which were thematically analysed to create four themes.Positive interaction and engagement in activities were critical for a therapeutic approach to observations, supporting service users and staff to minimize the unproductive behaviours that can arise. Difficulties balancing safety with privacy could suggest the importance of proportionate and tailored observation procedures for each service user. Ensuring the voices of service users and informal carers remain central to decisions regarding care could further improve the observation experience.This study highlights therapeutic, proportionate and co‐produced observations as key characteristics to improve practice. Further training and formalization of the observation process could foster cultural changes towards more long‐term approaches to risk management. [ABSTRACT FROM AUTHOR]
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- 2024
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38. Assessing the impact of long‐acting injectable compared to oral antipsychotic medications on readmission to a state psychiatric hospital.
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Okoli, Chizimuzo T. C., Abufarsakh, Bassema, Wang, Tianyi, Makowski, Andrew, and Cooley, Andrew
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PSYCHIATRIC nursing , *ANTIPSYCHOTIC agents , *ORAL medication , *PSYCHIATRIC hospitals , *PATIENT readmissions , *SCHIZOPHRENIA - Abstract
Accessible Summary What is known on the subject What the paper adds to existing knowledge What are the implications for practice Introduction Aim Method Results Discussion Implications for Practice People living with schizophrenia spectrum disorder (SSD) have a higher death rate which is caused, in part, by poorer adherence to treatment as compared to those with other mental illnesses. Using long‐acting injectable antipsychotic (LAI) medications can improve medication adherence and reduce hospitalizations for people living with SSD but are often underutilized. As compared to oral antipsychotic medications provided to patients with SSD at discharge from a psychiatric hospitalization, being provided with an LAI antipsychotic medication may reduce subsequent rehospitalization. Specifically, patients discharged on an atypical or second‐generation LAI medication are less likely to be readmitted to the hospital when compared to those discharged on a typical first‐generation oral medication. Because LAI antipsychotic medications are often underutilized as treatment options, the study findings suggest that this modality may be considered for patients with SSD when being discharged from a psychiatric hospitalization. Ideally, psychiatric‐mental health nurses can educate patients about indications, benefits, and risks of using atypical or second‐generation LAI antipsychotic medications during hospitalization and at discharge prevent the risk for future rehospitalizations. People living with schizophrenia spectrum disorder (SSD) have poorer medication adherence compared to those with other mental illnesses. Long‐acting injectable antipsychotic (LAI) medication use is associated with greater adherence, reduced re‐hospitalizations, and improved recovery outcomes when compared to oral formulations.To compare LAI antipsychotic medication use versus oral formulations on readmission to an inpatient hospital.Medical records (N = 707) from a state psychiatric hospital in the southern region of the United States were reviewed. Controlling for demographic variables, logistic regression analyses were used to examine LAI compared to oral formulations on readmission.Compared to patients discharged with oral antipsychotic medications, those with LAIs had a lower proportion of readmission rates in 6‐month and 1‐year periods, but not 30‐day or 2‐year periods. When controlling for demographic variables, those discharged with an atypical LAI had significantly lower odds of being readmitted within the 24‐year period compared to those discharged on a typical oral antipsychotic.Compared to orals, LAIs do not increase and may mitigate readmissions to psychiatric hospitalization.Psychiatric‐mental health nurses and other professionals may recommend LAIs when indicated for those with SSD. [ABSTRACT FROM AUTHOR]
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- 2024
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39. A systematic review and thematic synthesis of inpatient nursing staff experiences of working with high‐risk patient behaviours.
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Richardson Velmans, Samuel, Joseph, Christiana, Wood, Lisa, and Billings, Jo
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WORK ,MEDICAL information storage & retrieval systems ,RISK-taking behavior ,MENTAL health services ,GREY literature ,ECOLOGY ,PSYCHOLOGICAL burnout ,HOSPITAL nursing staff ,CINAHL database ,SYSTEMATIC reviews ,MEDLINE ,ETHICAL decision making ,AGGRESSION (Psychology) ,SELF-mutilation ,MEDICAL records ,ACQUISITION of data ,SUICIDE ,PSYCHOLOGICAL stress ,SOCIAL support ,EXPERIENTIAL learning ,PATIENTS' attitudes ,PSYCHOLOGY information storage & retrieval systems - Abstract
Introduction: Nursing staff are frequently exposed to high‐risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. Aim: The aim of the study was to examine nursing staff experiences of high‐risk behaviours in inpatient mental health settings. Methods: Four electronic databases (CINAHL, Medline, PsycINFO, EMBASE) were searched. The protocol for this review was prospectively registered in PROSPERO (Ref: CRD42022334739). A meta‐synthesis of nursing staff's experiences of high‐risk behaviours in inpatient mental health settings was conducted. Results: We identified 30 eligible studies. Six themes were constructed from the meta‐synthesis: the social contract of care; the function of risk behaviours; the expectation of risk; risk as a relational concept; navigating contradictions in care; the aftermath. Discussion: Nursing staff conceptualize risk as a meaningful behaviour shaped by patient, staff and environmental factors. Managing risk is an ethical dilemma for nursing staff and they require more training and support in ethical risk decision‐making. Implications for Practice: Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours. Relevance Statement: Nursing staff are frequently exposed to high‐risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. This systematic review offers insights into how high‐risk behaviours are experienced by nursing staff and makes recommendations about how to improve the understanding and management of them. Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours. [ABSTRACT FROM AUTHOR]
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- 2024
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40. Handling conflict situations in psychosis inpatient care: Nursing staff experiences of the Interactive Approach model.
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Arturén, Hanna, Zetherström, Jenny, Sjöström, Nils, Abrams, Daniel, and Johansson, Lena
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Accessible Summary What is known on the subject? What this paper adds to existing knowledge? What are the implications for practice? Introduction Aim/Question Method Results Discussion Implications for Practice In inpatient wards, there is a risk that conflicts occur when nursing staff interact with psychotic patients. The Interactive Approach (IA) model is an action‐based model, used in psychiatric settings, to manage conflict situations. The IA model can be used to improve communication between nursing staff and patients in numerous critical situations. Using a structured risk scale to evaluate a conflict can be an effective way to guide action and sort out the different aspects of communication between nursing staff and psychotic patients. The clarity of an action‐based model will help sort out which interventions are most likely to succeed in each conflict situation. The IA model highlights the importance of understanding and strengthening the patient's perspective, being flexible for each individual patient, and providing the patient with clear information about the situation. The Interactive Approach (IA) model is a structured management tool used to improve communication between caregivers and patients in psychiatric care settings.To examine the nursing staff's experiences of the IA model. How do they use the interventions in conflict situations with psychotic patients?A sample of nursing staff (n = 11) was recruited from three psychosis inpatient care units. Semi‐structured questions covered staff experiences of working with the problem‐solving interventions in the IA model. Transcribed data were analysed by qualitative content analysis.Three categories were defined: (1) ‘To apply a flexible approach' describes how staff tried to adapt to each patient and situation; (2) ‘Try to understand the person's inner world’ describes the importance of active listening and exploring the patient's concerns; and (3) ‘To communicate clearly’ relates to experiences of clear communication and the setting up of boundaries.The risk scale and training in communication skills helped the interaction between staff and patients in conflict situations. Different interventions were used with a focus on maintaining patient alliance.The findings highlight the importance of educational efforts and practical training, to prevent violence and the use of coercive measures. [ABSTRACT FROM AUTHOR]
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- 2024
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41. Teaching psychiatric nursing with films during the COVID‐19 pandemic: A qualitative study.
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Arkan, Burcu and Bostanlı, Aylin
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Accessible summary What is known on the subject What the paper adds to existing knowledge What are the implications for practice Introduction Aim/Question Method Results Discussion Implication for Practice Interactive learning environments are known to be among the most effective methods used in education. Some of the interactive methods used in psychiatric nursing education are simulations, group discussions, case studies and video and film presentations. In psychiatric nursing education, cinematic films are among the online methods used. It is known that films used in psychiatric nursing education are useful for understanding mental disorders, the nurse–patient relationship, the roles of the nurse and the therapeutic environment. The COVID‐19 pandemic deeply affected nursing education, and the difficulties faced gave rise to many new perspectives. After this period, it is of prime importance to update the nursing curriculum and develop new strategies in clinical practice. Teaching with films can help students to understand people's feelings, make sense of them and empathize. This method can have an emotional impact on student nurses and take learning to a deeper level beyond simple theoretical understanding. The findings of the study suggest that teaching through film is an effective method that can be used practically in psychiatric nursing education. Standardizing these practices may be an effective strategy for developing students' professional identity as nurses. This study is focused on undergraduate students, but has implications for nurses in continuing education and professional development of nurses in developing a positive perspective towards psychiatric patients, increasing self‐awareness and reducing prejudices. The COVID‐19 pandemic affected many areas of life and had a negative effect on education.This study investigated the impacts of using film as a method of education in students who were taking Psychiatric Nursing class during the COVID‐19 pandemic, examining how this method contributed to theoretical and clinical practices of the students, their personal development and their viewpoint on psychiatric patients.This study adopted a qualitative research design. The study data were collected from 15 nursing students in June 2022. Interviews were conducted, audiotaped and transcribed verbatim.The method of education via film made contributions such as better theoretical understanding of the subjects taught, acquisition of analytical thinking skills and greater awareness of professional nursing skills and care practices. The students developed their professional perspectives, and their motivation increased.Using film is effective and practical when used in psychiatric nursing education. Standardizing these practices may be an effective strategy for developing students' sense of their identity as professional nurses.This study relates directly to undergraduate students and also has implications for nurses undergoing continuing education and professional development. [ABSTRACT FROM AUTHOR]
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- 2024
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42. Mental health patients' preferences regarding restrictive interventions: An integrative review.
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Lindekilde, Camilla Rosendal, Pedersen, Martin Locht, Birkeland, Søren Fryd, Hvidhjelm, Jacob, Baker, John, and Gildberg, Frederik Alkier
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Accessible summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Introduction Aim Method Results Discussion Implications for Practice The use of restrictive interventions is described as a violation of patients' rights and autonomy. It must only be used as a last resort to manage dangerous behaviour, to prevent or reduce the risk of mental health patients harming themselves or others. International mental health policy and legislation agree that when restrictive interventions are applied, the least restrictive alternative should be chosen. The results are ambiguous, as to which restrictive intervention is preferred over others, but there are tendencies towards the majority preferring observation, with mechanical restraint being the least preferred. To make the experience less intrusive and restrictive, certain factors are preferred, such as a more pleasant and humane seclusion room environment, staff communicating during the application and staff of same gender applying the intervention. When applying restrictive interventions, mental health professionals should consider environment, communication and duration factors that influence patient preferences, such as the opportunity to keep some personal items in the seclusion room, or, when using restraint, to communicate the reason and explain what is going to happen. More research is needed to clarify patients' preferences regarding restrictive interventions and their views on which are the least restrictive. Preferably, agreement is needed on standard measures, and global use of the same definition of restrictive interventions. The use of restrictive interventions is a violation of patients' rights that causes physical and psychological harm and which is a well‐known challenge globally. Mental health law and legislative principles and experts agree that when restrictive interventions are applied, the least restrictive alternative should be used. However, there is no consensus on what is the least restrictive alternative, especially from the patient perspective.To investigate the literature on mental health patients' preferences regarding restrictive interventions applied during admission to a psychiatric hospital.An integrative review informed by the PRISMA statement and thematic analysis were undertaken.There were tendencies towards patients preferring observation and, for the majority, mechanical restraint was the least preferred restrictive intervention. Factors such as environment, communication and duration were found to influence patients' preferences.There is a lack of agreement on how best to measure patients' preferences and this complicates the choice of the least restrictive alternative. Nonetheless, our findings show that staff should consider environment, communication and duration when applying restrictive interventions.More research on restrictive interventions and the least restrictive alternative is warranted, but agreement is needed on standard measures, and a standard global definition of restrictive interventions. [ABSTRACT FROM AUTHOR]
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- 2024
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43. A comparative study of old versus novel psychoactive substances on craving, perceived stigma and suicidal risk among rural‐dwelling patients with substance abuse.
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Eweida, Rasha Salah, Abdelwahab Khedr, Mahmoud, and Hussein, Rasha Mohamed
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Accessible Summary What is known on the subject? What the paper adds to existing knowledge? What are the implications for practice? Introduction Aim Method Discussion Implication for Practice According to recent estimates, 10.4% of adults are patients with substance abuse, which is almost double the global rate. Rural areas are typically marginalized, compounded by a lack of access to mental health care, creating a startling disparity in suffering from drug use issues among rural cohorts. Drawing on data from a descriptive comparative design would provide a distinctive picture related to the similarities and/or differences in relation to craving and how it affects perceived stigma and suicidal risk among patients using old versus novel psychoactive substances. Substance abuse is a leading public health concern that forces nurses to encompass it into their agendas to tackle this looming problem. Addiction rehabilitation services are frequently run by nurses. They are well‐versed in supporting patients during their journey to recovery and enabling them to adjust to a new lifestyle. Substance use disorder is a leading public health concern that currently, nations regulatory agencies are grappled with. The noticeable difference in the chemical structures between old and novel psychoactive substances can result in significant clinical complications among patients with substance abuse.The study aims to compare substance craving, perceived stigma and suicidal risk among patients addicted to old and novel psychoactive substances (NPS).A descriptive comparative design was adopted on a sample of 105 patients with substance use who completed The Penn Alcohol Craving Scale (PACS), The Perceived Stigma of Addiction Scale (PSAS) and Suicide Probability Scale (SPS).Most participants were male, with 89.5% in the old addictive substance group and 93.8% in the new addictive substance group. A statistically significant difference in the NPS groups' perceptions of stigma (23.4 ± 5.3) compared to the old addictive substance group (20.6 ± 4.2), (t = 3.037, p = .003).Participants in the new substance group report more suicidal ideation, negative self‐evaluation and hostility than those in the old substance group. Policies and practices should be tailored to the type of drug used and potential risk factors to avoid suicide among patients with substance abuse. [ABSTRACT FROM AUTHOR]
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- 2024
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44. Pregnancy in the shadow of psychosis: Navigating first‐time motherhood with increased likelihood of postpartum psychosis and postnatal depression.
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Walsh, Alison
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Accessible Summary What is known on the subject? What does this paper add to existing knowledge? What are the implications for practice? Introduction Aim Methods Findings Discussion New parents who have previously experienced psychosis outside and/or following childbirth have an increased likelihood of experiencing an episode during the postpartum period. The decision to try to conceive can be agonising. Receiving care from a specialist perinatal community mental health team can improve outcomes. This article offers a first‐person insight into the steps the author took to minimise the impact of an episode of postpartum psychosis and/or postnatal depression whilst navigating new motherhood. This lived experience narrative aligns with the evidence base that demonstrates specialist perinatal community mental health services improve outcomes. It highlights the importance of maternity care providers asking about mental health history to identify any previous episodes or family history and offering referral to a specialist perinatal mental health service if available. Postpartum psychosis is a life‐changing but treatable condition that usually occurs in the first few days to weeks after childbirth affecting 1–2 in 1000 pregnancies. Those who have experienced psychosis before, either as a single episode, related or unrelated to childbirth or as part of a long‐term mental health condition have a higher likelihood of experiencing an episode in the postnatal period.In this lived experience narrative the author shares personal experience of planning and navigating pregnancy with a higher likelihood of experiencing postpartum psychosis and postnatal depression around this major life transition due to previous episodes.The author utilises a first‐person approach to share and reflect on her lived experience.The author shares her experience of receiving care and some of the steps she took to try to manage the impact of pregnancy and birth on her mental health during this major life transition. She describes how care from a specialist perinatal community mental health team and peer support contributed significantly to her family's well‐being.Specialist perinatal community mental health services can improve outcomes for those with a higher likelihood of experiencing postpartum psychosis and postnatal depression by facilitating planning and mitigating some of the risks that could lead to relapse in the perinatal period. [ABSTRACT FROM AUTHOR]
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- 2024
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45. Spiritual care for clients with mental illness from an Islamic background: Nursing students' perspectives.
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Alyahya, Norah M. and Alenezi, Shahad
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Accessible Summary What is known on the subject? What the paper adds to existing knowledge What are the implications for practice? Introduction Aim Method Results Discussion Implications for practice Spirituality is an important aspect for clients with mental illness. Spirituality is essential to holistic care in mental health nursing. Nurses found an apparent disconnection between the theory and practice of spiritual care. Nurses acknowledged that attitudes that allocate blame towards clients with mental illness have the most negative impact on clients' spiritual wellbeing. The conflicting worldviews between spiritual healing and a biomedical approach impact the provision of care as relationships among the mental health team are disrupted. The non‐assessment of the client's spirituality hindered nurses from providing spiritual care. Language differences between nurses and clients impede nurses from providing spiritual care. The use of spiritual therapy as an element of nursing care works if clients and nurses are both aware of the importance of spirituality. Nursing staff must also be aware of several issues that may make it difficult for nurses to provide such therapy, including specific symptoms of mental illness. Nurses can apply spiritual care effectively when they have significant spirituality. Nurses with good competency in mental health nursing skills are more likely to provide efficient spiritual care as part of holistic care. Spiritual care is essential to clients with mental illness.To explore mental health nursing students' perspectives on spirituality and spiritual care and how this impacts clients with mental illness in an Islamic context (Saudi Arabia).Thematic analysis is used to analyse data from two focus groups of mental health nursing students (one comprising eight, the other six).Six themes emerged: factors affecting spirituality in mental illness, the impact of mental illness on spirituality, the use of spiritual healing in mental illness, nurses' use of spiritual healing; challenges in providing spiritual care and recommendations for improving spiritual care.Clients being blamed for having mental illness by health professionals and the community harmed their spirituality. The religious support of peers was a practical approach to spiritual therapy, asserted as a beneficial element of nursing care. However, nurses found providing such therapy challenging because of the language barrier and the lack of any assessment of clients' spirituality. It was also challenging when dealing with specific symptoms of mental illness.The study asserts that spiritual therapy in nursing care will work if the client knows its importance. Nurses who have significant spirituality can apply it effectively. [ABSTRACT FROM AUTHOR]
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- 2024
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46. Nursing students' attitudes towards mental illness: A multi‐national comparison.
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Moxham, Lorna, Tapsell, Amy, Perlman, Dana, Al Mutair, Abbas, AL‐Sagarat, Ahmad Yahya, Alsaraireh, Faris A., Chung, Min‐Huey, Jose, Tessy Treesa, Kuo, Shu‐Yu, Liu, Megan F., Nayak, Asha K., Shamsan, Abbas, Sudhakar, Christopher, Tsai, Hsiu‐Ting, Velayudhan, Binil, Yang, Chyn‐Yng, Roberts, Michelle M., Yeh, Pi‐Ming, and Patterson, Christopher
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Introduction Aim Method Results Discussion Implications for Practice Accessible Summary What is known on the subject Health professionals, including nurses, are shown to have stigmatizing attitudes towards mental illness. For nursing students who are in their formative years of professional development, mental illness stigma can severely impact the care they provide. Little research has investigated multi‐national comparisons of nursing students' attitudes towards mental illness. What this paper adds to existing knowledge This study shows that between countries, there were substantial differences amongst nursing students in stigmatizing attitudes towards mental illness. Cultural perspectives may explain some of these differences. What are the implications for practice Regardless of location, stigmatizing attitudes are present at varying levels. Each nation can take steps to reduce these by acknowledging the presence of stigmatizing attitudes amongst nurses, educating nurses regarding the negative impacts of stigma on patient outcomes, and decrease stigmatizing attitudes by facilitating opportunities for nurses (particularly student nurses) to have direct contact with people with lived experiences of mental illness. Health professionals, including nurses, are shown to have stigmatizing attitudes towards mental illness. For nursing students who are in their formative years of professional development, mental illness stigma can severely impact the care they provide. Little research has investigated multi‐national comparisons of nursing students' attitudes towards mental illness. This study shows that between countries, there were substantial differences amongst nursing students in stigmatizing attitudes towards mental illness. Cultural perspectives may explain some of these differences. Regardless of location, stigmatizing attitudes are present at varying levels. Each nation can take steps to reduce these by acknowledging the presence of stigmatizing attitudes amongst nurses, educating nurses regarding the negative impacts of stigma on patient outcomes, and decrease stigmatizing attitudes by facilitating opportunities for nurses (particularly student nurses) to have direct contact with people with lived experiences of mental illness. Stigmatizing attitudes perpetuated by nursing professionals are a pervasive problem for people experiencing mental health issues. This global issue has detrimental consequences; inhibiting one's life chances and help‐seeking behaviours. To date, few studies have compared nursing students' attitudes towards mental illness from a multi‐national perspective.To compare undergraduate nursing students' attitudes towards mental illness across six countries: Australia, India, Jordan, Saudi Arabia, Taiwan and USA.In a cross‐sectional design, data were collected from undergraduate nursing students (N = 426) using the Social Distance Scale. A one‐way analysis of variance was used to compare differences between countries.Nursing students' attitudes to mental illness differed between countries. Social Distance Scores were highest amongst nursing students from Jordan and Saudi Arabia. Students from Taiwan and India possessed moderate stigma scores. Social Distance Scores from the USA and Australia were lowest.Clear differences in stigmatizing attitudes emerged between countries; these are discussed in relation to possible cultural influences.It is suggested that educating nurses, combined with direct contact with people with lived experiences of mental illness, can reduce stigmatizing attitudes regardless of country, location or educational institution. [ABSTRACT FROM AUTHOR]
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- 2024
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47. Using Delphi method to address factors contributing to aggressive behaviour in mental health settings.
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Eweida, Rasha and Ibrahim, Nashwa
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Accessible summary What Is Known about the Subject? What the Paper Adds to Existing Knowledge What Are the Implications for Mental Health Nursing Practice? Introduction Aim Methods Results Discussion Implications for Mental Health Nurses Nurses' perspectives and consensus on the possible key factors contributing to aggression at inpatient units can be summarized into patients' related factors, staff related factors and environment related factors. Results of the possible factors contributing to aggression at inpatient units reflect the complicated nature of this problem. Perspectives of nurses as frontline mental health professionals on factors contributing to aggression as one of the psychiatric emergencies were considered through an iterative process. This approach gave nurses an opportunity to revisit their own views in each round to provide an in‐depth reflection in the light of the contribution of others. Nursing curricula should focus on nurses' communication skills and emotion regulation training. An open dialogue between nurses and people with mental health issues should be initiated to discuss the possible key factors contributing to aggressive behaviour at inpatient units from both standpoints. Mental health nurses' turnover at inpatient settings could be targeted through the design and implementation of aggression prevention protocols Aggression at inpatient units is a universal problem leading to hazardous outcomes.To generate group consensus about factors contributing to aggressive behaviour among patients with mental health issues at inpatient units.Nurses working at inpatient psychiatric departments were approached, and purposive sampling was employed to implement Delphi technique. A total of three Delphi rounds were conducted online. The average percent of majority opinions method was followed to measure consensus in which questions with a cut‐off rate below 69.7% were included in the next round.Twenty‐one nurse experts with different skills participated in this study. Consensus increased among nurse experts across rounds for the following items: Patients' misinterpretation of the attitude of the healthcare providers, severity of mental health issues, attitude and communication style of the healthcare providers, nurses limited emotional regulation capacity and the inadequate staff–patient ratio in psychiatric wards.The complicated nature of aggressive behaviour displayed by people with mental health issues is reflected on the results of the current study; patients' related factors, staff related factors and environment related factors constitute interacting facets for this issue.Nurse scientists could use insights derived from this study to design studies aiming at assessment and management of aggression at inpatient units guided by implementation science frameworks. Additionally, open dialogues between nurses and people with mental health issues could be initiated about factors contributing to aggression at inpatient units. Mental health nursing training should focus on nurses' communication and emotion regulation skills. [ABSTRACT FROM AUTHOR]
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- 2024
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48. It takes it out of the textbook: Benefits of and barriers to expert by experience involvement in pre‐registration mental health nursing education.
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Happell, Brenda, Gordon, Sarah, Hurley, John, Foster, Kim, Hazelton, Mike, Lakeman, Richard, Moxham, Lorna, and Warner, Terri
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Accessible summary What Is Known on the Subject? What this Paper Adds to Existing Knowledge What Are the Implications for Practice? Introduction Aim Methods Results Conclusions Implications for Practice Service user involvement in mental health nursing education is beneficial in terms of attitudinal change to reduce stigma, clinical skill development and enhancing understandings of recovery‐oriented practice. Service users as experts by experience have not been embedded within pre‐registration nursing programs. Consequently, they remain limited in number, ad hoc and frequently tokenistic. Nurse academics responsible for the design and delivery of pre‐registration mental health nursing curricula have a potentially important role in facilitating expert by experience involvement in mental health nursing education. Nurse academics teaching mental health nursing have generally favourable views about the importance of expert by experience involvement. Nurse academics experience significant barriers in supporting the implementation of academic positions for experts by experience, particularly in obtaining funding. The experts by experience could contribute to mental health nursing education does not appear to be clearly understood by nurse academics. Mental health services aspire to adopt a recovery‐oriented approach to practice. Involving experts by experience in mental health nursing education can facilitate increased understanding and appreciation of recovery‐oriented practice. Nurse academics could play an important role in supporting the implementation of experts by experience positions in nursing academia. To do so, they require an understanding of the benefits of EBE involvement in academia and the barriers that can be encountered when attempting to facilitate the implementation of such positions. Experts by experience contribute unique expertise, essential to the development of quality mental health services. Conveying this expertise through the educating the future nursing workforce in mental health is essential. Involving service users in mental health nursing education is ad hoc and minimal, despite growing evidence of its benefits. Insights and experiences of nurse academics teaching mental health to pre‐registration students have been underrepresented in the research to date.To seek insights and experiences of nurse academics involved in designing and delivering pre‐registration mental health nursing education in Australian universities regarding involving service users in mental health nursing education.A descriptive qualitative study involving 19 nurse academics from 13 Australian universities, involved in pre‐registration mental health nursing education. Data were analysed thematically.Participants reported minimal service user involvement. Most sought an increase and identified barriers. Data analysis resulted in five identified themes: (1) value‐rich, (2) resource‐poor, (3) imperfect processes, (4) ‘part, but not all’ and (5) unrecognised worth.Increasing meaningful involvement of service‐users in mental health nursing education requires support and investment from multiple stakeholders. Nurse academics are crucial stakeholders in understanding the unique expertise service users bring.Service users being central to all aspects of mental health services requires their active participation in the education of health professionals. Nurse academics have an important role in realising this goal. [ABSTRACT FROM AUTHOR]
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- 2024
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49. Longitudinal association of social isolation and loneliness with physical function among in‐patients living with schizophrenia.
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Chen, Li‐Jung, Steptoe, Andrew, Chien, I‐Chia, and Ku, Po‐Wen
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What is Known on the Subject? What This Paper Adds to Existing Knowledge? What are the Implications for Practice? Introduction Aim Methods Results Discussion Implications for Practice People living with schizophrenia have reduced physical function and are more likely to experience loneliness than those without condition. Low physical function is associated with greater loneliness in people with psychosis. However, it is unclear whether social isolation and loneliness contribute to impaired physical function in this population. Loneliness is linked to an increased risk of physical function impairment among older individuals, but research on patients living with schizophrenia is limited. This study is the first to evaluate the longitudinal association of social isolation and loneliness with physical function among inpatients living with schizophrenia. It showed that more than one third of the participants experienced a decline in physical function over a 2‐year period. Loneliness, rather than social isolation, was associated with an increase in physical function impairment over 2 years among inpatients living with schizophrenia. Healthcare professionals should recognize loneliness as a potential risk factor for impaired physical function among inpatients diagnosed with schizophrenia. It is recommended that people living with schizophrenia are assessed for loneliness and that interventions are offered to alleviate their feelings of loneliness. Implementing interventions to reduce loneliness may help improve physical function and overall quality of life for individuals living with schizophrenia. Patients living with schizophrenia often experience low physical function, which is associated with negative health outcomes. Therefore, investigating the risk factors for physical function is crucial in this population.This study examined the longitudinal association of social isolation and loneliness with physical function among inpatients living with schizophrenia.Physical function was assessed using measures of activities daily living (ADL), instrumental activities daily living (IADL) and the combination scores of ADL/IADL. Social isolation was indexed with five types of social connection and loneliness was measured using UCLA Loneliness Scale.Social isolation was not associated with the measures of physical function over 2 years. Loneliness exhibited an association with IADL and ADL/IADL at follow‐up, after adjustment for baseline levels of the outcomes. These associations remained when both social isolation and loneliness were simultaneously entered into the model.Loneliness, rather than social isolation, was associated with increased physical function impairment over 2 years among inpatients living with schizophrenia.Healthcare professionals should consider loneliness as a potential risk factor for impaired physical function. It would be beneficial to assess patients for loneliness and implement interventions to reduce feelings of loneliness. [ABSTRACT FROM AUTHOR]
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- 2024
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50. Reliability testing of the Health of the Nation Outcome Scales 2018.
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Painter, Jon and James, Mick
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Accessible Summary What is known on the subject What the paper adds to existing knowledge What are the implications for practice Introduction Aims Method Results Implications for practice The Health of the Nation Outcome Scales (HoNOS) is a widely used clinical measure designed to rate and monitor the outcomes of service users accessing specialist mental healthcare. Since its development (in 1996), numerous research studies have confirmed the HoNOS captures the aspects of care that it purports to (validity), and that clinicians' ratings are consistent both over time, and between different raters (reliability). In 2018, the HoNOS was reviewed with updates made to some terminology and other revisions intended to remove ambiguity in the guidance for raters. However, although the new version (HoNOS 2018) was accompanied by a recommendation that its validity and reliability be re‐tested this was not undertaken. To our knowledge, this is the first study to re‐assess the updated tool's reliability by measuring the level of agreement between different raters. Our findings confirm that there is an acceptable level of consistency between student mental health nurses that have been trained to use the (new) HoNOS 2018. The HoNOS is nationally mandated for use by all specialist mental healthcare providers in the UK. Our findings provide some assurance that, with appropriate update training and monitoring of organisational‐level data sets, the original HoNOS glossary can safely be replaced with the HoNOS 2018 to ensure more contemporary routine outcome measurement can occur. The Health of the Nation Outcome Scales (HoNOS) is a well‐established clinician rated outcome measure for use in mental health services. Following an international review, an updated version (HoNOS 2018) was published with a recommendation that its psychometric properties be re‐tested prior to widespread implementation. To date, only one such study has been published.To test the inter‐rater agreement levels for HoNOS 2018.Third‐year student mental health nurses received training to complete the HoNOS 2018. Following this timetabled session, they were each invited to independently rate two, randomly selected, videos of (simulated) patient interviews. The resulting data were then analysed to calculate the tool's internal consistency and inter‐rater agreement levels.The 55 participants provided 106 ratings from four vignettes. Cronbach's alphas and McDonalds omegas confirmed the revised tool's internal consistency was acceptable. Average measure intraclass correlation coefficients for the four patient vignettes indicated excellent reliability.This study provides initial assurance that the HoNOS 2018 is a reliable clinician rated outcome measure suitable for use in routine clinical practice by relatively inexperienced mental health practitioners with limited training. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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