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Accessible Summary: What is known on the subject?: Mental health nursing is generally viewed as the least attractive career choice among nursing students. What the paper adds to existing knowledge?: Studying in the generic nursing program influence higher desire for a career in mental health nursing.Nursing students who have prior experience working in mental health and have provided care to psychiatric patients are more inclined to express a desire to pursue a career in this field What are the implications for practice?: Nursing students enrolled in the generic program, who have previous work experience in mental health or experience caring for a person with a mental illness, and who have a lower level of stigmatizing attitudes, may constitute the future workforce in mental health nursing. Introduction: Mental health nursing is often perceived as an unattractive career choice among nursing students, and it remains unclear whether the type of nursing program influences this view. Aim: This cross‐sectional study aimed to explore the association between stigmatizing attitudes in nursing students and their desire for a career in mental health nursing, comparing students in generic and accelerated programs. Method: A total of 220 nursing students from generic and accelerated programs in North‐Center Israel participated in this cross‐sectional study, completing a questionnaire on stigmatizing attitudes and their interest in a mental health nursing career. Results: Nursing students displayed a generally low desire for mental health nursing, influenced by factors such as enrollment in the generic program, previous mental health work experience and stigmatizing attitudes. Discussion: Students in the generic program, with lower stigmatizing attitudes and prior mental health experience, exhibited a higher inclination towards mental health nursing. Implications for Practice: Prospective mental health nursing professionals may be identified in the generic program, particularly those with prior mental health experience and lower stigmatizing attitudes. Additional studies are required to confirm and broaden their applicability to other contexts. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recovery‐oriented services have been shown to promote recovery in people with mental illness; their implementation is important for current psychiatric practice and is being considered by many professional institutions.The Japanese government released the policy 'A Vision for Reform of Mental Health and Medical Welfare' (Ministry of Health, Labour and Welfare, 2004; https://www.mhlw.go.jp/topics/2004/09/dl/tp0902‐1a.pdf), aiming to update public consciousness, reorganize the mental healthcare welfare system and strengthen the foundation of mental healthcare to promote a basic policy focusing on the transition 'from hospital to community life'. What the paper adds to existing knowledge?: This is the first study to clarify recovery‐oriented attitudes among psychiatric nursing directors and related factors in Japan. It shows an association between recovery‐oriented attitudes and hospital size. What are the implications for practice?: A relationship exists between the recovery knowledge and recovery‐oriented attitudes of psychiatric nursing directors. It may thus be valuable for directors to see and hear about the experiences of patients living in the community during their recovery process. As hospital size and organizational climate may hinder the successful implementation of recovery‐oriented practices, these factors must be considered when introducing such practices.Further research is needed on the relationship between psychiatric nursing directors' recovery‐oriented attitudes and practices. Moreover, to develop intervention studies that uncover success factors for enhancing recovery‐oriented attitudes, organizational factors that enable recovery‐oriented practices must be further investigated. Introduction: Recovery‐oriented practices in mental health services have become a global priority. Despite their proven effectiveness, Japanese hospitals have not widely implemented such practices. Aim: This study clarified psychiatric nursing directors' recovery‐oriented attitudes and factors regarding promoting recovery‐oriented practices to identify methods for developing these practices in Japan. Method: This cross‐sectional study used a questionnaire survey with 250 nursing directors from 1287 Japanese psychiatric hospitals. Multivariable regression analysis assessed how socio‐demographic variables and Recovery Knowledge Inventory (RKI) scores affected Recovery Attitudes Questionnaire (RAQ‐7) scores. Results: The analysis revealed that more clinical and managerial experience was associated with more negative recovery‐oriented attitudes. High RKI scores, knowledge of strength, hospital size and outpatient work experience were associated with more positive recovery‐oriented attitudes. Discussion: Implementing recovery practices requires consideration of knowledge and experience in recovery and hospital size alongside recovery training based on a hospital's organizational structure. Although the low response rate could influence the study's generalisability, it could also indicate low interest in recovery‐oriented practices among professionals. Implications for Practice: Acquiring more knowledge and experience regarding recovery promotes recovery‐oriented attitudes among nursing directors. An appropriate organizational culture and consideration of hospital size are required when introducing such recovery practices. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Restraining and secluding health consumers for safety reasons continue to be used in psychiatric inpatient facilities even though they have no therapeutic value and have negative effects on consumers, families and staff.Six Core Strategies (6CS) for reducing seclusion and restraint have been developed to address this problem but there are very few effectiveness studies in inpatient adolescent psychiatric facilities. What the paper adds to existing knowledge: We used a mixed methods approach to evaluate the implementation of 6CS in an adolescent psychiatric facility. The implementation was successful. It eliminated the use of seclusion, substantially reduced the use of restraints and significantly reduced staff absenteeism.Using thematic analysis on feedback surveys, we identified five dominant themes that described consumers' and carers' experiences during their stay at the facility: communication, service delivery, flexibility, consistency and internal feeling states. What are the implications for practice: This study provides support for the feasibility of a comprehensive and broad‐based intervention program such as 6CS to reduce seclusion and restraint practices in inpatient mental health facilities.This study also demonstrates the value of using surveys to gather consumer and carer feedback and improve outcomes for service users. Introduction: Seclusion and restraint practices are routinely used in psychiatric facilities but are controversial for ethical, legal and safety reasons, and can cause significant harm to consumers, staff and organisations. Six Core Strategies (6CS) for reducing seclusion and restraint were developed to address this problem but very few studies have examined their effectiveness in adolescent settings. Aim/Question: To evaluate the implementation of 6CS in an adolescent inpatient psychiatric facility. Method: We retrieved archival data from an acute adolescent psychiatric ward that implemented the 6CS. Using a mixed methods approach, we evaluated outcomes on the use of seclusion and restraint, nursing staff sick leave and feedback surveys. Results: Findings showed an elimination of seclusion, and a significant reduction in restraint use and staff absenteeism in the 12 months after project implementation. Thematic analysis of feedback survey responses identified communication, service delivery, flexibility, consistency and internal feeling states as dominant themes in consumers' and carers' experience on the unit. Discussion: The 6CS is feasible and may be effective in reducing seclusion and restraint, which in turn may have a positive impact on staff wellbeing. Implications for Practice: Implementation of the 6CS with executive support, combined with staff and programmatic changes at a local level is recommended. [ABSTRACT FROM AUTHOR]

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]

Accessible Summary: What is known on the subject?: Because the definition of spirituality is complex and has cultural and individual dimensions, it is important to be receptive to individual differences in the perception of spirituality during clinical practice of mental health nurses.Although enhancing spiritual care is beneficial to patients diagnosed with mental illnesses, the extrinsic (e.g., education) and intrinsic factors that would affect nurses' attitudes towards spiritual care have not been investigated.Notwithstanding the known impact of certain intrinsic factors (e.g., personality‐related) of mental health nurses on their coping strategies as well as their emotional and mental health, the link to their spiritual care attitudes has received little attention. What this paper adds to existing knowledge?: This paper is the first to identify the beneficial impacts of extrinsic factors including postgraduate education, working experience, participation in palliative care education programmes, and spiritual care experience on spiritual care attitudes among mental health nurses.Certain intrinsic factors, including those personality‐related such as "Extraversion," "Openness/Intellect," "Conscientiousness," and "Agreeableness," were also associated with higher awareness of providing spiritual care among mental health nurses. What are the implications for practice?: The finding of an association of certain intrinsic factors with more positive attitudes towards spiritual care could encourage further studies to explore possible links between these factors and attitudes of spiritual care.Those less aware of the patients' spiritual needs may benefit through participating in relevant education and on‐the‐job training programmes that involves actual practice and collaboration in a multidisciplinary team. Introduction: Although enhancing spiritual care can facilitate the communication of mental health nurses with patients diagnosed with mental illnesses, extrinsic and intrinsic factors that may influence their spiritual care attitudes remain unclear. Aim: To conduct a questionnaire‐based survey on mental health nurses from eight hospitals. Method: A total of 239 psychiatric nurses were assessed based on (1) "big‐five Mini‐Markers" questionnaire and (2) spiritual care attitudes scale on three components (i.e., core values, growth, and nursing) to investigate the associations of spiritual care attitudes with social/occupational characteristics and personality. Results: A positive attitude was significantly associated with working experience, higher educational level, previous participation in palliative care education programmes, spiritual care experience, and personality factors including "Extraversion," "Openness/Intellect," "Conscientiousness," and "Agreeableness." Discussion: Despite demonstrating impacts of intrinsic factors (e.g., personality) on mental health nurses' spiritual care attitudes, other modifiable extrinsic factors (e.g., education) were important in enhancing their awareness towards spiritual care. Implications for Practice: Our findings encourage further studies to explore possible links between intrinsic factors and attitudes of mental health nurses towards spiritual care as well as suggest benefits of continuing education and on‐the‐job training that involves actual practice and collaboration in a multidisciplinary team to provide spiritual care. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Self‐management comprises five core skills: "Problem Solving, Decision‐Making, Resource Utilization, Forming a Patient/Healthcare Provider Partnership and Taking Action."Effective self‐management among patients diagnosed with anxiety can reduce the number of relapses and improve treatment outcomes.Knowledge of the impact of the family atmosphere, well‐being and illness symptoms on self‐management in patients diagnosed with anxiety disorders is limited. What does the paper add to the existing knowledge?: This is the first study in China to explore whether family atmosphere and well‐being of patients diagnosed with anxiety disorders affects self‐management.This paper adds to the list of factors influencing self‐management among patients diagnosed with anxiety disorders.SAS scores are a major factor influencing self‐management among patients diagnosed with anxiety disorders.The subjective well‐being of patients diagnosed with anxiety disorders can influence their self‐management behaviour.Patients who experienced family harmony had significantly higher self‐management scores than those who experienced family disharmony. What are the implications for practice?: Nurses should encourage patients diagnosed with anxiety disorders to manage their condition while receiving treatment at home.Nurses should focus on patients diagnosed with anxiety disorders who have significant anxiety symptoms and low well‐being.Nurses should emphasize the importance of the home environment in family self‐management and affirm that a good home environment promotes patient self‐management. Introduction: Better self‐management can improve treatment outcomes and reduce the number of relapses for patients diagnosed with anxiety disorders. However, the impact of well‐being and the home environment on self‐management among patients diagnosed with anxiety disorders is unclear in China. Aim: This study sought to determine the impact of the home environment, well‐being and illness symptoms on self‐management during home treatment for patients diagnosed with anxiety disorders. Method: This cross‐sectional study was conducted with patients diagnosed with anxiety disorders. Data were collected with SAS, Self‐Management Scale for People with Anxiety Disorders and Index of Well‐being. Frequency, percentage, analysis of variance, Kruskal–Wallis and multiple linear regression analyses were used. Results: Home environment (p <.001), self‐perceived quality of life (p =.015), well‐being index (p =.002) and SAS total score (p =.033) had a major impact on self‐management in patients diagnosed with anxiety disorders (n = 245). Discussion: Family disharmony, poor self‐perceived quality of life, high SAS scores and low levels of well‐being were significant influences on self‐management among people diagnosed with anxiety disorders. Implications for Practice: Nurses should focus on the self‐management of patients diagnosed with significant anxiety symptoms and low well‐being and value the importance of the home environment in facilitating self‐management among patients diagnosed with anxiety disorders. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Police and ambulance staff are increasingly asked to help people experiencing mental health crises, but they often feel under‐prepared.The single frontline service approach is time‐intensive and risks a coercive pathway to care.The emergency department is the default location for transfers by police or ambulance involving a person involved in a mental health crisis, despite being viewed as suboptimal. What the paper adds to existing knowledge: Police and ambulance staff struggled keeping up with the mental health demand, reporting inadequate mental health training, little enjoyment and negative experiences when trying to access help from other services.Most mental health staff had adequate mental health training and enjoyed their work, but many experienced difficulties getting help from other services.Police and ambulance staff found it hard to work with mental health services. What are the implications for practice: The combination of limited training, poor interagency referral processes, and difficulties accessing support from mental health services means that when police and ambulance services attend mental health crises alone, distress may be heightened and prolonged. Enhanced mental health training for first responders and more streamlined referral processes may improve process and outcomes.Mental health nurses have key skills that could be utilized in assisting police and ambulance staff who attend 911 emergency mental health calls.New models such as co‐response teams, whereby police, mental health clinicians and ambulance staff respond conjointly should be trialled and evaluated. Introduction: First responders are increasingly called to assist people experiencing mental health crises but little research exists canvassing multi‐agency perspectives of such work. Aim/Question: To understand the views of police officers, ambulance and mental health staff attending mental health or suicide‐related crises in Aotearoa New Zealand and to discover how they experience current models of cross‐agency collaboration. Methods: A descriptive cross‐sectional survey involving mixed methods. Quantitative data were analysed using descriptive statistics and free text by content analysis. Results: Participants included 57 police officers, 29 paramedics and 33 mental health professionals. Mental health staff felt adequately trained, but only 36% described good processes for accessing inter‐agency support. Police and ambulance staff felt undertrained and unprepared. Accessing mental health expertise was considered difficult by 89% of police and 62% of ambulance staff. Discussion: Frontline services struggle managing mental health‐related 911 emergencies. Current models are not working well. Miscommunication, dissatisfaction and distrust exist between police, ambulance and mental health services. Conclusion: The single‐agency frontline response may be detrimental to service users in crisis and under‐utilizes the skills of mental health staff. New ways of inter‐agency cooperation are required, such as co‐located police, ambulance and mental health nurses responding in partnership. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Prior research has demonstrated that childhood trauma can increase adolescents' suicidal ideation, and perceived stress plays a mediating role in the relationship between childhood trauma and adolescents' suicidal ideation. Character strengths, which are trait‐like positive personality characteristics, have also been found to be closely related to decreased stress and suicidal ideation. However, it is unclear whether character strengths act as a transfer mechanism that links childhood traumatic experiences with perceived stress and eventually suicidal ideation. What the paper adds to existing knowledge?: This study found that character strengths and perceived stress serially mediated the association between childhood trauma and suicidal ideation. Specifically, childhood trauma was associated with inferior character strengths, and the impaired character strengths further triggered high perceived stress, which was finally linked to a heightened risk of suicidal ideation. This study provided important theoretical implications for preventing suicidal risk among adolescents who are exposed to traumatic events during childhood. What are the implications for practice?: This study highlighted the roles of character strengths and perceived stress in the relationship between childhood traumatic experiences and suicidal ideation, which provided suggestions for designing nursing interventions to reduce adolescents' suicidal ideation, especially for those with traumatic childhood experiences. In addition to family nursing, school‐based regular monitoring and interventions of character strengths and perceived stress are necessary. Aim: This study sought to examine the mediating effects of character strengths and perceived stress on the relationship between childhood trauma and suicidal ideation among adolescents. Methods: A cross‐sectional survey was conducted on a sample of 1069 Chinese adolescents. The Chinese versions of the Suicidal Ideation Scale, Childhood Trauma Questionnaire, Perceived Stress Scale and Character Scale for Adolescents were used to assess adolescents' suicidal ideation, childhood trauma, perceived stress and character strengths. Results: The findings showed that childhood trauma influenced suicidal ideation directly and indirectly via perceived stress. Moreover, character strengths and perceived stress serially mediated the association between childhood trauma and suicidal ideation, implying that childhood trauma was associated with inferior character strengths, and the impaired character strengths further triggered high perceived stress, which was finally linked to a heightened risk of suicidal ideation. Conclusions: This study highlighted the joint contribution of childhood trauma, character strengths and perceived stress to suicidal ideation, providing theoretical and practical implications to guide mental health nurses to reduce the suicide risk among adolescents. Implications for Practice: These findings highlighted the importance of developing character strengths and stress‐coping strategies. Family nursing and school‐based regular monitoring and interventions of character strengths and perceived stress are necessary among adolescents who exposed to a high level of childhood trauma experiences to reduce their suicidal ideation and foster mental health. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recurrence is common in patients diagnosed with major depressive disorder (MDD). Psychological resilience has been shown to be a protective factor against recurrence of depression. It has important clinical nursing significance to analyse the influencing factors of psychological resilience in major depressive disorder in remission (MDDR) patients. What the paper adds to existing knowledge?: There are few previous studies on the influencing factors of psychological resilience in patients diagnosed with MDDR. We found the education levels, personal monthly income, social support, well‐being and self‐efficacy were influencing factors of psychological resilience in patients diagnosed with MDDR. What are the implications for practice?: According to the factors affecting the psychological resilience of patients diagnosed with MDDR, targeted clinical nursing is helpful to prevent the recurrence of depression. Nurses should strengthen the nursing of patients with <12 years of education, and patients with personal monthly income less than 5000 RMB. In addition, nurses should cultivate patients' awareness of social support and identity, cultivate their ability to strive for social support, cultivate interpersonal skills and positive emotional experience to improve subjective well‐being and carry out self‐efficacy training to improve psychological resilience by enhancing patients' internal protective factors. Aim: Psychological resilience is closely related to recurrence of depression. There are few previous studies on the influencing factors of psychological resilience in patients diagnosed with major depressive disorder in remission (MDDR). Here, we investigated the current status of resilience in patients diagnosed with MDDR and its influencing factors. Methods: A descriptive cross‐sectional study was conducted from June 2019 to April 2021. One hundred and forty‐two patients diagnosed with MDDR were recruited from the Department of Psychiatry and Psychology of the General Hospital of Northern Theater Command. Demographic information, social support, well‐being, self‐efficacy and psychological resilience were collected using self‐reported questionnaires. Results: The psychological resilience of MDDR patients was lower than that of the healthy Chinese adults in China. Multiple logistic regression analysis showed that education, personal monthly income, social support, well‐being and self‐efficacy were associated with psychological resilience. Receiver operating characteristic (ROC) curve analysis further confirmed that social support, well‐being and self‐efficacy were associated with psychological resilience. Conclusion: The psychological resilience of MDDR patients was lower than that of the general population in China. The education levels, personal monthly income, social support, well‐being and self‐efficacy were influencing factors of psychological resilience. Implications for Practice: According to the factors affecting the psychological resilience of patients diagnosed with MDDR, targeted clinical nursing is helpful to prevent the recurrence of depression. [ABSTRACT FROM AUTHOR]

What is known on the subject?: Public shaming, especially by consumers of healthcare, is getting worse and has become a specific case of bullyingDespite extensive research on physical and verbal violence directed towards mental health workers, the issue of social shaming and bullying by patients or relatives has not been sufficiently researched What the paper adds to existing knowledge: Mental healthcare workers are exposed to the threat of social shaming and bullying on a regular almost weekly basisAbusive behaviours by patients are associated with professional burnout, decreases in professional functioning and even a tendency to leave the workplace among mental health workers What are the implications for practice?: The stability and strength of the therapeutic alliance between healthcare giver and psychiatric patient are critical to the success of the treatmentThere is a need to develop a dedicated organizational policy for the prevention, early detection, intervention and support for teams exposed to social shaming and bullyingAn emphatic response, and effective intervention in a case of social shaming may improve professional functioning and reduce burnout and intention to leave. Introduction: Social shaming can impair caregivers' performance. The prevalence of shaming experienced by mental health workers and the relationships to their function or burnout is unknown. Aim: To examine the associations between exposure to social shaming and bullying by patients, the risk appraisal of negative impact of this behaviour, burnout, professional functioning and intention to leave among mental health workers. Method: In this cross‐sectional study, 122 workers from a psychiatric hospital completed a questionnaire. Results: Participants reported exposure to social shaming and bullying by patients on a regular basis. Shaming and bullying were significantly associated with lower professional functioning and higher intention to leave, while burnout may at least partially mediate the association between these variables. Conclusions: The phenomenon of shaming and bullying of mental health workers by patients is common and is associated with lower functioning and higher burnout, which have a negative impact on the patient‐caregiver interaction. Implications for Practice: There is a need to establish a policy for early detection of shaming of mental health workers in order to prevent burnout or intention to leave. Evidence based interventions, such as the Safewards model, accompanied by assessment of their effectiveness, may help in this effort. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Mental healthcare requires acceptance of suicide and flexible attitudes especially in relation to caring for people who have suicidal thoughts or who have attempted suicide. Nurse education programmes for student nurses can shape positively the attitudes of individual participants, yet limited research exists on what nursing students' attitudes currently are towards people who are suicidal. What this paper adds to existing knowledge?: This paper adds to the developing international comparative work that is providing a greater understanding of cultural perceptions of suicide amongst students. This paper along with existing literature highlights a potential relationship between certain religious belief systems and their potential to be protective against suicide. At the same time, such religious belief is more likely to be associated with more judgmental attitude towards suicidal behaviour. This paper using a validated research tool, devised by a research psychologist, scored for the first time, individual student attitudes towards caring for people that are suicidal, whilst establishing the overall differences between the two countries from which the data are collected. What are the implications for practice?: This paper offers potential explanations for differences in nursing students' attitudes between the UK and Turkey. Disparities under discussion include gender, type of education, culture and religion. This is an important discussion in the consideration of nurse education worldwide. It is recognized that students may come from a variety of different backgrounds, with varying personal and social attitudes to begin with; yet, there exists the potential to positively influence overall attitudes towards service users whilst learners are still within a training programme, consisting of education and practice experiences. The merits of a specialist mental health nurse training programme and its potential to impact more favourably on students attitudes deserve more attention and research. Abstract: Introduction: Suicide is a major public health issue internationally, and the impact of positive or negative attitudes amongst the mental health professional workforce warrants scrutiny. The study aimed to examine English and Turkish nursing students' attitudes towards people with suicidal behaviour. Method: This cross‐cultural study reports on attitudes of 240 nursing students towards suicide in Turkey and 82 nursing students in the UK. A reliable and valid 24 item “Attitudes towards Suicide Scale” and “Social Reactions to Suicidal Persons Scale” were used to measure attitudes. Results: The UK nursing students were found to display more accepting attitudes to suicide, and scored higher on acceptability of suicide, seeing suicide as a solution and open reporting and discussion of suicide subscales than their Turkish counterparts. Turkish nursing students scored higher on punishment after death and hiding suicidal behaviour subscales than the UK students. Turkish nursing students scored significantly higher on deterring subscale of reactions to a suicidal peer scale than the UK nursing students. Implications for practice: It is vital for nurse students to develop positive acceptance of suicide through education, reflection and clinical supervision to be more therapeutic towards suicidal patients. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Patient and public involvement (PPI) is recognized as an increasingly important feature of healthcare research, education and public policy.In mental health, PPI is increasingly seen as evidence of the further democratization of services, which started with de‐institutionalization in the 1960s and the recovery movement in the 1990s.While much is known about learning enablers and learning gains on generic community‐based training programmes, less is known about PPI‐specific programmes in mental health. What this paper adds to existing knowledge?: Participants at a national training programme to support the engagement of service users, their families and carers in mental health services identified training topics of greatest importance to them and reported on what they learnt and what helped their learning.Patient and public involvement training initiatives aimed at supporting the engagement of service users, their families and carers should emphasize individual needs and local contexts.Training programmes should not make artificial or actual distinctions between the programme participants who are health professionals and those who are non‐professionals, such as service users.To our knowledge, this PPI initiative is the first time a national health service provider has sought to develop an engagement structure in mental health on a state‐wide basis. What are the implications for practice?: Participants in training programmes designed to support patient and public involvement believe that such programmes should include understanding how conflict is resolved, how committees work effectively and how to develop interpersonal and facilitation skills.Training programmes in mental health involving both professional and non‐professional participants requires all the participants to work together in particular at commissioning and design stages to achieve their desired outcome.The evaluation of the training programme to support the roll‐out of this initiative offers lessons to others who may wish to pursue similar structures in other jurisdictions. Introduction: The Irish national mental health service provider commissioned a national training programme to support a patient and public involvement (PPI) initiative in mental health services. The programme evaluation afforded an opportunity to describe the learning gains and learning enablers and the factors that support PPI in mental health. Aim: We aimed to evaluate a PPI training programme across nine regional administrative units in a national mental health service. Methods: We conducted a participant exit survey, using the Student Assessment of Learning Gains (SALG) instrument. We analysed the survey responses using SPSS version 24 software and applied directed content analysis to the narrative comments provided in open‐ended questions. Results: A total of 54 participants returned the completed questionnaire, yielding a response rate of 60%. The overall mean SALG score yielded was 3.97 (SD 0.66; range 1–5), indicating that participants reported very good to excellent gains in their learning from the programme. Participants who offered narrative comments indicated an overall positive experience but suggested that all stakeholders should work together to co‐produce the training. Discussion: All the stakeholders in a PPI training initiative to support the engagement of service users, their families and carers in mental health should work together to achieve their desired outcome. This requires co‐production in the design, delivery and evaluation of the training initiative, and co‐production can impact at both individual and local levels. Implications for Practice: PPI training initiatives in mental health should retain a focus on understanding conflict resolution, committee effectiveness, interpersonal and facilitation skills. Ensuring a shared understanding of key concepts, such as co‐production, is a necessary prerequisite at the co‐commissioning, co‐design, co‐planning, co‐delivery and co‐assessment stages of programme development, as is the need to avoid artificial or actual distinctions between health professionals and those who are non‐professionals, such as service users. Relevance statement: Mental health engagement and PPI are key principles underpinning modern mental health services and may increasingly impact on wider health service provision including policy and research imperatives. This paper discusses the evaluation of a PPI training programme and offers practical insights as to how such initiatives can be improved. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The importance of and interest in nurses' attitudes towards and subjective experience with workplace violence in clinical settings is increasing.The prevalence of patient‐perpetrated violence against Korean nurses in hospital settings is highly prevalent.Only few instruments are available to measure the nurses' perception of patient aggression in Korea. What the paper adds to existing knowledge?: This is the first study to assess the linguistic and psychometric reliability and validity of an instrument that evaluates the attitude of Korean nursing staff towards patient‐perpetrated workplace violence. What are the implications for practice?: This valid and reliable instrument could be used to assess and monitor the nurses' attitudes towards aggressive tendencies in the workplace.The results could contribute to the development of relevant interventions for coping with violence by patients towards nursing staff and the implementation of practical training to cultivate healthy perceptions towards patients to foster therapeutic nurse–patient relationships. Introduction: Despite the high prevalence of patient‐perpetrated violence against Korean nurses globally, reliable and valid measures of patient aggression are lacking in Korean. Aim: We translated the 12‐item Perception of Aggression Scale (POAS) into Korean and psychometrically assessed its utility in measuring nurses' attitudes towards aggression. Methods: The 12‐item Korean POAS was obtained through forward–backward translation and cognitive debriefing. It was administered online to 319 nurses (mean age = 32.64 years; females = 96.2%), of which 206 completed it again after two weeks. Confirmatory factor analysis validated the 3‐factor structure as hypothesized in the original version. The intra‐class correlation coefficient was used to assess the test–retest reliability. Results: The originally hypothesized 3‐factor structure showed a good fit. The 3 dimensions: aggression as a dysfunctional or undesirable phenomenon, aggression as a functional or comprehensible phenomenon, and aggression as a protective measure had internal consistencies of 0.74, 0.86 and 0.90 and corresponding ICCs of 0.70, 0.86 and 0.90, respectively. Discussion: The 12‐item Korean POAS is a valid and reliable scale that might aid investigating nurses' attitudes towards patient aggression. Implications for practice: The 12‐item Korean POAS can help Korean nurses adopt protective behaviours and develop interventions to cope with aggression. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject: If women suffer from postpartum psychosis, treatment in a specialist facility like a psychiatric mother–baby unit is recommended and should focus on the maternal health, mother–baby outcomes and the care for the next of kin.The role of mental health nurses on a mother–baby unit is essential but challenging, given the complex problems and care needs of the patient, the baby and family members.To date, very little evidence about effective nursing interventions for patients with postpartum psychosis is available. What this paper adds to existing knowledge: This paper systematically describes nursing interventions and their rationale for patients with postpartum psychosis admitted to a specialized mother–baby unit.Given the limited scientific evidence for effective nursing interventions for patients with postpartum psychosis, knowledge was obtained from a best‐practice setting (i.e., a specialized mother–baby unit), thus providing a basis for the systematic development of nursing interventions to be tested on effectiveness in future studies. Implications for mental health nursing: Mental health nurses play an essential role in the multidisciplinary treatment team in providing information on the patient's personal functioning and her ability to take care for the baby, in order to determine the appropriate amount of guidance and protection, in order to prevent harm and promote recovery.To provide integrated and personalized nursing care, mental health nurses should tailor their interventions to the needs of the patient, the baby and the next of kin, adapted to the successive stages of treatment. Introduction: Postpartum psychosis is one of the severest psychiatric disorders to occur in the postpartum period. If it requires a woman's admission, a psychiatric mother–baby unit is recommended, where care will focus on the mother's health, the mother–baby dyad and their next of kin. To date, few studies have examined nursing interventions for patients with postpartum psychosis. Aim: Identifying nursing interventions used at a psychiatric mother–baby unit, when a patient is hospitalized with postpartum psychosis. Method: A qualitative design using thematic analysis. Data were collected using semi‐structured interviews (N = 13) with expert nurses working at such a unit. Results: The analysis identified three themes: (a) treatment of the mental disorder, which involves interventions to improve the mother's mental and physical well‐being; (b) care for the mother–baby dyad, which involves interventions intended to promote safe interactions between mother and baby; and (c) care for the partner, which involves interventions to improve the partner's well‐being. Discussion: Overall, within each of these themes, nurses described the urgency to tailor interventions to the needs of the patient, baby and partner. Implications to practice: Our comprehensive description of interventions can be used for the improvement of nursing care for patients hospitalized with postpartum psychosis. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on this subject?: The physical health of people with serious mental illness (SMI) is an issue of growing concern in New Zealand and internationally.Metabolic syndrome is prevalent among people with severe mental illness and increases the likelihood of developing cardiovascular disease and diabetes.No previous international research has investigated rates of metabolic monitoring in specialist mental health services and in primary care. What this paper adds to existing knowledge?: Rates of metabolic monitoring are low in this specialist mental health service and in primary care.Primary care nurses are positive in their views of their role in providing care for people with mental illness, and would value further education in this area. What are the implications for practice?: Services need to consider ways in which nurses can be supported to improve rates of metabolic monitoring.Guidelines may have a role to play in improved monitoring but need service‐level support in order to be effective. Introduction: People with serious mental illness experience significant disparities in their physical health compared with the general population. One indicator of health impairment is metabolic syndrome, which increases the likelihood of developing cardiovascular disease and diabetes. No international studies have reported both primary care and mental health nurses' rates of metabolic monitoring among people with serious mental illness, and no New Zealand studies have investigated rates of metabolic monitoring. Aim: To evaluate metabolic monitoring practices within one of New Zealand's 20 district health board regions. Method: An audit of clinical records in primary care (n = 46) and secondary care (n = 47) settings and a survey of practice nurses were conducted. A survey was sent to 127 practice nurses with a response rate of 19% (n = 24). Data were analysed using descriptive statistics. Results: Rates of metabolic monitoring were low in both services. Survey participants expressed positive views towards physical health monitoring and confidence in relating to mental health consumers. Rates of treatment of metabolic abnormalities were low, and communication between primary and secondary services was limited. Conclusion: Despite existence of guidelines and protocols, metabolic monitoring rates in both primary and secondary health services are low. Incorporating metabolic monitoring systems into service delivery, supported by appropriate tools and resourcing, is essential to achieve better clinical outcomes for people experiencing mental illness. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: This paper addresses an identified gap in the international literatures related to physical health care of young people with first episode psychosis. Previous studies indicate that nurses’ skills, knowledge and attitudes influence physical health outcomes for service users. The educational preparation of nurses influences their physical health care nursing practices. Nurses who have a high level of skills, knowledge and positive attitudes towards the provision of physical health care are more likely to initiate this care to young people experiencing first episode psychosis Young people experiencing first episode psychosis are more likely to have physical health comorbidities and less likely to receive treatment for them than young people in the general population. What does this study add to existing knowledge?: Psychiatric/mental health educated nurses are more likely to provide routine physical health care, for example checking that service users have a general practitioner for health care follow‐ups, while comprehensive/generalist educated nurses also consider the young person's more complex physical health care needs such as smoking cessation and sexual health. The length of nurses’ employment in mental health did not have any significant influence on their physical health care practices to young people. What are the implications for practice?: Nurses working in the mental health setting provide physical health care to young people experiencing first episode psychosis, so it is important to determine if their educational preparation affects their physical health care practices. Provision of professional education opportunities and resources will enable nurses to improve their knowledge, skills and increase their awareness of the importance of providing comprehensive physical health care to young people experiencing first episode psychosis. Education providers need to emphasize the importance of providing physical health care to young people as part of mental health content in undergraduate nursing curricula. Abstract: Background: Registered nurses working in the area of mental health complete either a psychiatric/mental health or comprehensive/generalist nursing program, and their education preparation influences their physical health care nursing practices. The differences in educational preparation may be a contributory factor to nurses’ delivery of physical health care to young people experiencing first episode psychosis. This paper addresses an identified gap in nursing practices related to physical health care of young mental health service users. Aim: To examine the relationship between the educational preparation of nurses and attitudes, confidence level, perceived barriers and physical health care nursing practices. Method: A cross‐sectional survey was conducted in 2015 with 207 nurses using the modified Physical Health Attitude Scale for Mental Health Nurses (PHASe). Results: Comprehensive/generalist prepared nurses were more likely to provide education on heart disease prevention and sexual health and support young people to stop cigarette smoking than psychiatric/mental health nurses. However, as the length of service progresses, the propensity for psychiatric/mental health nurses to be involve in smoking cessation increases. Implication for practice: It is important to identify how nurses’ educational preparation affects their nursing practices so as to address the gaps in their physical health literacy. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Pre‐ and postmenopausal women (PPW) experience changes in physical, psychological and social health. South‐East Asia's female suicide rate is the highest compared with other countries, and the suicide rate of PPW in these countries continues to increase.The most influential factor in Asian women's suicidal ideation is family conflict; specifically, if PPW in South Korea cannot express their anger, it results in a culture‐bound syndrome called "Hwa‐Byung." However, there is a lack of research on Asian PPW. What the paper adds to existing knowledge?: This study found differences in individual‐ and community‐level factors affecting suicidal ideation between pre‐ and postmenopausal women.Individual factors that commonly affected suicidal ideation were experiencing violence, stress and depression. Individual factors that affected the suicidal ideation of premenopausal women more than postmenopausal women were religious beliefs, alcohol use and chronic disease.Community level factors affecting suicidal ideation were locational depression and locational counselling for stress in premenopausal women and locational counselling for depression in postmenopausal women. What are the implications for practice?: Mental health nurses could help prevent suicide by developing and applying community‐based programmes for PPW, considering the specific socio‐economic and cultural context and characteristics of Asian women.Mental health nurses could help PPW participate in programmes by preparing various interventions such as case management, personal counselling, physical activity, home‐based mental health services, cognitive behavioural therapy and digital interventions for self‐management.Mental health nurses need to prepare various methods such as online, offline, individual and group methods to work effectively in any social situation. Introduction: Pre‐ and postmenopausal women (PPW) experience physical and psychological changes with hormonal changes. Among Asian middle‐aged women, family and culture affect suicidal ideation, and the suicide rate among this population is increasing. There are few existing research on suicidal ideation among Asian PPW. Aim: We examined individual‐ and community‐level factors that predict suicidal ideation among PPW. Method: Large‐scale panel data from 5,154 South Korean PPW aged 35–64 years were used in a series of multilevel logistic regression analyses to examine factors associated with suicidal ideation at individual and community levels. Results: Among premenopausal women, religious beliefs, alcohol use, chronic disease, experience of violence, stress and depression were individual‐level factors. Locational depression and locational counselling for stress were community‐level factors. Among postmenopausal women, experience of violence, stress, depression and perceived health status were individual level factors, and locational counselling for depression was a community level factor. Discussion: Suicidal ideation among PPW is affected by both individual and community level factors. Nurses must comprehensively determine what risk factors affect suicidal ideation through various intervention methods—including online, offline, individual and group methods—while considering socio‐economic situations. Implications for Practice: Mental health nurses should provide targeted biopsychosocial interventions targeting psychosocial and physical problems and promoting the use of community resources to reduce PPW's suicidal ideation. [ABSTRACT FROM AUTHOR]

Accessible summary This paper examines the usage of psychological therapies by mental health nurses. The paper presents the findings from a questionnaire survey of 528 practising mental health nurses in Australia. Key findings include: Mental health nurses believe employing psychological therapies such as cognitive behaviour therapy in their practice will improve therapeutic outcomes for consumers., Mental health nurses overwhelmingly want to employ psychological therapies in their practice., They think mental health nursing and hospital and community health management is too focussed on medical treatment and risk management, which means that their nursing practice is dominated by the administration of medication, excessive documentation, and patient observation., They identify barriers preventing them from practising psychological therapies. These include lack of confidence, low nurse morale, no support from other nurses, low staffing levels, lack of training opportunities, and inadequate support from nursing management., Abstract This paper reports on a research project which examines the feasibility of mental health nurses employing psychological therapies in the nursing care of people with severe mental illness. Attitudes towards current usage and factors influencing the adoption of psychological therapies are investigated. The paper addresses the gap in the Australian nursing literature regarding the therapeutic role of mental health nurses ( MHN)s in relation to the use of evidence-based psychological therapies. This paper presents the findings from an online questionnaire survey of 528 practising MHNs in Australia. The findings demonstrate enthusiastic support among nurses towards employing psychological therapies, with 93% of respondents indicating they would like to use psychological therapies in their current practice. Correspondingly, there is strong demand for education and training in applying psychological therapies. A number of barriers to implementing psychological therapies are identified. It is noted that place of employment is a significant factor, with mental health nurses working in the public sector more likely to state institutional barriers are restricting their therapeutic potential and preventing them from implementing psychological therapies. [ABSTRACT FROM AUTHOR]

What is known on the subject?: There is very limited literature on the health of Middle Eastern immigrants in the United States, and the available studies were mostly conducted on small convenient samples in local communities.There is also a need to understand changes in the rates of serious psychological distress (SPD) during the 15 years after 2001, as there were negative effects on Arabs' health since the September 2001 aftermath. What does this paper add to existing knowledge?: The study examined the rates of SPD, the risk of SPD and its associated factors in a national sample of Middle Eastern immigrants in the United States from 2001 to 2015.The study found that serious psychological distress rate was high among Middle Eastern immigrants. Being a female and having obesity were associated with a higher risk of reporting serious psychological distress among this population. What are the implications for practice?: These outcomes necessitate mental health nursing interventions that provide culturally sensitive mental health care to immigrantsFor example, developing community‐based prevention programmes is required to address risk factors of psychological distress and to increase awareness about psychological distress among Middle Eastern immigrants. Introduction: While Middle Eastern immigrants are a fast‐growing population in the United States, there is very limited literature on their mental health. Most of the available studies were conducted on small convenient samples in local communities. Aims: To examine rates of serious psychological distress (SPD) and its associated factors among Middle Eastern immigrants in the United States, compared with US‐born, non‐Hispanic Whites. Methods: Data from the National Health Interview Survey (NHIS) from 2001 to 2015 were analysed. The survey included 1,246 Middle Eastern immigrants and 232,392 US‐born, non‐Hispanic Whites. SPD was measured by the Kessler‐6 psychological distress scale. Survey analysis procedures, sampling weights and variance estimates were conducted. Descriptive statistics and regression analyses were employed to examine differences and factors associated with SPD. Results: SPD rate was the highest among Middle Eastern immigrants (5.99%) between 2006 and 2010. Among Middle Eastern immigrants, being female and obese were significantly associated with a higher risk of SPD. Discussion: Middle Eastern immigrants in the United States suffered high rates of SPD. Gender and obesity were factors associated with SPD risk. Implications: These outcomes indicate the need for mental health nursing interventions that provide culturally sensitive mental health care to immigrants, such as developing community‐based prevention programmes. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Coercive interventions (CI) in emergency psychiatry face increasing criticism, as they can be an emotional, even traumatic event for all persons involved. They are thus considered the last resort.The use of coercive interventions differs widely with regard to type and frequency of measures across different countries and institutions.Individual staff characteristics, such as attitudes towards coercion, may play a vital role in the management of aggression.Little is known about the influence of emotions of staff members on CI, but they are likely to play an important role. What the paper adds to existing knowledge?: Most staff members surveyed had a rather critical view of coercion and considered it a "necessary evil."Staff members with the most work experience had a more critical view of coercion in comparison with less experienced staff. Nurses rated coercion more positively than did psychiatrists or psychologists.Emotions play an important role in decision‐making processes. The current study systematically asked for accompanying emotions during the application of CI and looked for individual differences. A majority of the participants experienced compassion; about half felt helplessness, grief or anxiety. Almost 20% stated that they felt a sense of power. Older staff members more often felt anger or guilt; women felt less power than men did. Nurses felt more desperation than other occupational groups.Staff members consider reflective interventions, such as team supervisions or post‐seclusion/restraint debriefings with the patient, as important. Nevertheless, only half reported that these interventions are carried out routinely.Staff members believe that certain risk factors (including stress, low staffing, a fully occupied ward and the presence of particular staff members) enhance the probability of CI. What are the implications for practice?: To reduce the use of coercive interventions, we recommend that psychiatric teams include highly experienced staff members as work experience has a positive effect on the attitudes towards coercive interventions.Structured post‐seclusion/restraint debriefings and team supervisions are considered helpful by staff members and are relatively easy to implement on acute wards. Enhancing staff members' ability to reflect on their own attitudes, emotions and actions is likely to reduce coercive interventions. Introduction: Little is known about staff attitudes towards coercive interventions (CI) and emotions accompanying these measures. Aim: The current study assessed attitudes, views on reflective interventions and accompanying emotions of different occupational groups towards CI, as well as factors, that increase the probability of CI. Method: Staff members (N = 138) of a large psychiatric hospital in Germany were assessed using the Staff Attitude to Coercion Scale (SACS) and newly developed items assessing staff members' emotions and views on coercion. Results: Experienced staff members were most critical of coercion. Nurses rated coercion significantly more positively than other staff. A majority experienced compassion; about half felt helplessness, grief or anxiety. Almost 20% felt a sense of power. Nurses felt the most desperation. Participants strongly desired reflective measures such as post‐seclusion/restraint debriefings with patients. According to staff members, stress on the wards and low staffing increases the probability of CI. Discussion: The study assessed accompanying emotions during the application of CI. Attitudes towards coercion and emotions are associated with individual staff characteristics (e.g. profession, work experience). Implications: The presence of experienced staff members may help prevent CI. Staff consider reflective interventions helpful in reducing CI. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: AHDs in mental health are fundamental tools in advance care planning processes. It is an important method for involving mental healthcare users in clinical decisions and in providing effective healthcare based around user preferences.AHDs can be applied in situations in which the person may forfeit their legal capacity, according to the Convention on the Rights of Persons with Disabilities.However, the use of AHDs as described above is not yet a reality in Spain. What the paper adds to existing knowledge?: The present study surveys the knowledge and attitudes of mental healthcare providers towards AHDs in clinical practice.Although providers had a moderate–low level of knowledge about AHDs, they presented positive attitudes towards them. What are the implications for practice?: The use of AHDs in mental healthcare practice poses challenges to the Spanish mental healthcare system. Acquiring up‐to‐date data on the knowledge and attitudes of providers towards AHDs allows organizations to address aspects of their service that require reinforcement. This data could also be used by other countries just starting to use AHDs, as an initial step towards supporting the implementation of a multistage intervention process.More in‐depth training for providers would help improve their competence to implement or honour the statements set out in AHDs, the related legal and ethical issues, and liability issues related to their implementation.The Spanish mental healthcare system requires structural changes so that providers can embrace new ways of relating to users and to organize partnerships and a continuity of care centred on user preferences. Introduction: Advance healthcare directives (AHDs) in mental health offer important information regarding service users' preferences. However, whether AHDs are truly understood by providers is questionable. Aim: To survey the knowledge and attitudes of mental health professionals towards AHDs and examine any associations with sociodemographic and occupational variables. Method: We cross‐sectionally surveyed the knowledge and attitudes of 113 mental health professionals by using two validated questionnaires. Results: Participants showed very positive attitudes and high levels of knowledge about the conceptual definition and application of AHDs in clinical practice but their knowledge of the legalities, procedure and registration of AHDs was poor. Working in a community, having a career specializing in mental health or having personally signed an AHD was associated with enhanced knowledge about them. Moreover, female sex or employment as an auxiliary nursing‐care technician was associated with stronger positive attitudes. Discussion: Legal and structural changes will be needed to implement AHDs in Spain and to promote competence among healthcare providers in order to include AHDs in everyday practice. Implications for practice: The Spanish mental healthcare system requires legal and structural changes and must improve healthcare providers' competence in AHDs before they are implemented. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Self-harm is a relatively common occurrence in adolescents; however, there remains a lack of understanding about the motivations behind adolescent self-harm, and this poor understanding can have a negative impact on how mental health professionals respond to young people who self-harm., What does this paper add to existing knowledge? This paper identifies the reasons for self-harm in a community sample of young people and finds that the functions of self-harm differ for different people and that there may be multiple reasons for self-harm., Findings provide support for the affect-regulation model of self-harm which states that young people self-harm to regulate how they are feeling, but provides little support for the interpersonal influence model which proposes that self-harm is an attempt to influence how other people respond to them. , What are the implications for practice? Self-harm for most young people serves at least one specific function and is an indication of distress., There is a requirement for a non-pathologizing response towards young people who self-harm; self-harm should be understood as a meaningful behaviour rather than a symptom of an illness., Mental health nurses need to understand the multiple functions of self-harm. A better understanding of the individualized meaning behind self-harm can positively impact on attitudes towards young people who self-harm and provide for improved mental health service provision., Abstract Introduction Although self-harm is a relatively common occurrence in adolescents, there is a lack of understanding about the motivations behind it. A poor understanding of self-harm contributes to negative perceptions about those who self-harm and a poor healthcare experience. Aim & Methods This study identifies motivations behind self-harm in school-based adolescents using a cross-sectional survey. Motivations behind self-harm were elicited using a scale and open-ended responses. Results Of the 856 adolescents who completed the survey across 11 postprimary schools, 103 reported a history of self-harm. The most commonly endorsed reason for self-harm was to 'get relief from a terrible state of mind' (79%). Open-ended responses were consistent with scale responses with most reporting that they self-harmed to relieve distressing emotions. Discussion Findings provide support for the affect-regulation model of self-harm with support also demonstrated for the self-punishment and antidissociation models. There was little support for the interpersonal influence model suggesting that the commonly held belief that self-harm is attention-seeking is one attributed by others to young people, and not widely reported by young people themselves. Implications for practice Mental health services need to be responsive to the needs of young people who self-harm which requires eliciting and understanding the individual and multiple meanings behind self-harm to best inform treatment options. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Adolescents who partake in one health risk behaviour (HRB) easily adopt other HRBs, simultaneously or subsequently.Multiple HRBs might threaten adolescents' future health in adulthood.Adolescents with psychological problems have higher rates of smoking, alcohol use, early sexual initiation and activity, and illicit substance use compared with others. What does this paper add to existing knowledge?: A considerable number of Korean adolescents with mental health problems were engaged in multiple HRBs. For those with mental health problems, more than half of the Korean adolescents with multiple HRBs tended to use alcohol and cigarettes concurrently.Korean adolescents who felt depressed and had suicidal ideation were more likely to engage in a greater number of HRBs.Substance abuse is the most prevalent problem that is combined with other HRBs among those with depression and suicidal ideation compared to those who exhibited other HRBs. What are the implications for practice?: When mental health nurses working in schools and community centres for mental health identify Korean adolescents with significant depression and suicide ideation levels, they should also assess adolescents' engagement in multiple HRBs.Population‐based campaigns and policy changes that emphasize both psychological health and risky behaviour reduction among adolescents should be provided simultaneously to students and school nurses. Introduction: There is limited understanding about whether poor mental health is associated with certain combinations of multiple health risk behaviours (HRBs) such as smoking, drinking, early sexual activity and substance abuse. Aim: To determine the prevalence of multiple HRBs and to identify associations between poor mental health and multiple HRBs as the number of HRBs increases. Methods: This cross‐sectional study was conducted using the 2016 Korea Youth Risk Behavior Web‐based Survey (N = 65,528). Descriptive statistics and multinomial logistic regression analyses were conducted using the complex sample data. Results: Overall, 28.6% and 13.9% of Korean adolescents were involved in one or multiple HRBs, respectively. Adolescents who were depressed (OR = 1.43–4.47, 95% CI = 1.37–1.49 to 3.23–6.20) and/or who had suicidal ideation (OR = 1.33–3.19, 95% CI = 1.25–1.42 to 2.25–4.51) were more likely to engage in multiple HRBs. Discussion: A considerable numbers of Korean adolescents are engaged in multiple HRBs. When adolescents self‐reported depression and suicidal ideation, they were more likely to engage in a greater number of HRBs than single HRB. Implications for practice: Tailored interventions to decrease multiple HRBs should be designed and provided by considering adolescents' mental health status and needs. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Many carers report feeling unrecognized by professional healthcare teams.Carers often report difficulty accessing mental health services for relatives.Carers who are also mental health professionals may experience role conflict as found for General Practitioners. What this paper adds to existing knowledge?: Carers who are mental health professionals are often not recognized for their professional knowledge and face similar communication barriers as other carers.Difficulties for carers who are mental health professionals are concerned with information sharing, decision‐making and continuity of care. What are the implications for practice?: Opportunity for services to learn from the experiences of mental health professional and carers to develop better communication and shared decision‐making methods for carersCarers who are mental health professionals should be recognized by services for their dual role (and skills).Service development opportunity for training in supporting and engaging carers who are mental health professionals Introduction: Around 60% of carers of relatives with mental health problems report feeling unrecognized by professional health care, and many report a lack of engagement, shared decision‐making and information sharing. There is a paucity of research examining these issues for carers who are also mental health professionals. Aims: This was an exploratory study to (a) explore the extent of this role among health service staff, (b) gather an indication of the issues faced by carers when interacting with the health system and (c) test the feasibility of conducting research. Methods: Mental health professionals in mental health services completed an online survey that assessed the frequency, content and satisfaction of the experiences of carers. Results: The sample comprised 453 mental health professionals (74% female), 52% being carers. Half of carers reported having therapist contact, and 25% were satisfied with the contact. Negative experiences were related to Information, Decision‐making and Continuity of care. Discussion: There was a high frequency of mental health professionals who were carers. The majority were dissatisfied, and this was primarily in relation to communication with services. Implications for practice: Improving information sharing through training of staff and identification of the system barriers is likely to enhance experiences for service users and families. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Research findings indicate the percentage of knowledge‐related errors in medicines management is high, accounting for approximately 75% of all errors, with insufficient knowledge levels one of the most significant contributors of medication errors. Patients should be able to trust nurses to engage therapeutically and actively listen to their needs and concerns, responding using skills that are helpful, providing information that is clear, accurate, meaningful and free from jargon. However, without knowledge of pharmacology, it is impossible for nurses to be able to provide adequate advice. What the paper adds to the existing knowledge?: This study has examined an area that had not yet been systematically examined previously, which draws together previous research findings on mental health nurses' knowledge of adverse events, including side effects and medication errors, related to antipsychotic medication within NHS inpatient settings. What are the implications for practice?: A recent study has found that almost three‐quarters (73%) of patients taking antipsychotic medication reported side effects to some degree. This high number of people experiencing antipsychotic medication side effects is likely to compromise care, especially in situations where nurses have inadequate knowledge of side effects and are unable to provide effective advice to patients.The findings from this study allow the mental health nursing profession an opportunity to reflect on the best means to increase knowledge and increase patient safety awareness and benefits for mental health service users. Introduction: Antipsychotic medications play a significant role in the treatment and recovery of people with several psychiatric disorders. However, research findings indicate mental health nurses are insufficiently knowledgeable about antipsychotic medication side effects. Aim: To assess practising mental health nurses' knowledge of antipsychotic medication side effects using a Multiple‐Choice Questionnaire (MCQ) across National Health Service (NHS) Trusts in England. Hypothesis: Knowledge of antipsychotic medication side effects amongst registered mental health nurses is related to their academic qualification, clinical banding and length of experience. Method: A national survey of registered mental health nurses was carried out using an online questionnaire which was disseminated by Research and Development departments. Results: A total of 504 questionnaires were returned, 245 of which had full data and further analysed. The mean score for the sample was 14.4 and only 21 participants attained a mark of >80%. Implications for Practice: Two out of three of our hypotheses (that length of experience and clinical banding are directly related to knowledge of antipsychotic medication side effects) were supported. Our study found many nurses have a suboptimal working knowledge of antipsychotic medication side effects which has the potential to compromise care. Strategies need to be put in place to enhance pharmacology knowledge. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: A clear association exists between serious mental illness (SMI) and poor physical health.Individuals with SMI have markedly higher risks for mortality and morbidity.Mental health nurses play an important role in enhancing service users' mental and physical well‐being.The attitudes of mental health nurses towards physical health care have been explored in the western part of the world. However, cross‐country differences should be determined to reveal the importance of this global issue. What the paper adds to existing knowledge?: This study adds new data to the literature on the Physical Health Attitude Scale's (PHASe) validity and nurses' attitudes when working in acute mental health services in different cultures.Nurses in acute mental health wards mostly focus on the basic physiological indicators of patients' existing physical health problems, so health promotion practices such as sexual health and eye/dental examinations are neglected for individuals with SMI.Nurses' higher level of confidence about their delivery of physical health care is due to their familiarity with basic nursing practices (e.g. monitoring blood pressure and checking blood glucose levels).Differences that exist between countries in relation to smoking habits are probably due to different regulations. What are the implications for practice?: To improve patients' physical healthcare outcomes, nurses should be provided with additional training and supervision to strengthen their skills and confidence.Nurses' perceived need for additional training reflects the importance of physical health care in mental health settings, in which training could substantially improve patient outcomes.Authors believe that standard protocols must be established in acute psychiatric care to eliminate obstacles to holistic patient care.Training needs of mental health nurses on health promotion practices should be considered by administrators of mental health settings. Introduction: Nurses play an important role in improving the physical health of individuals with serious mental illnesses. The literature on the attitudes of mental health nurses towards physical health care provides a small amount of data. Assessing trends in nurses' attitudes through suitable surveys is important to ensure holistic care. Aim/Question: This study sought to examine the Turkish version of the Physical Health Attitude Scale's (PHASe) validity and reliability and to survey Turkish mental health nurses' attitudes towards physical health care. Method: The sample consisted of 174 nurses working in acute psychiatric wards. Firstly, the psychometric properties of the scale were analysed using factor analysis and measures of internal consistency and reliability. Then, the survey results of the attitudes of mental health nurses towards the physical health of patients with serious mental illnesses were determined using the Physical Health Attitude Scale (PHASe). Results: The translated PHASe functioned best as a 24‐item version and 4‐factor solution that explains 51.3% of the variance. The internal consistency value was 0.83. The respondents' attitudes were generally positive about their role. There was less agreement for the involvement of nurses in practices of health promotion, such as sexual health, eye and/or dental examinations. The nurses surveyed also tended to use smoking for therapeutic purposes. Implications for practice: Mental health nurses' knowledge and attitudes should be enhanced by additional training in the ways of meeting patients' biopsychosocial needs. Obstacles to physical health care can be removed by implementing standard protocols nationwide. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Nurse prescribing allows nurses, after specific training, to prescribe medications under certain conditions. This article describes the third in a series of surveys of mental health services in England to understand how nurse prescribing is being used across the country., While there is research evidence that shows nurse prescribing to be as safe as prescribing by doctors and that service users typically find it at least as acceptable, there is a lack of detailed evidence about current forms of nurse prescribing practice specifically in mental health services., What this paper adds to existing knowledge? The survey found that the number of nurse prescribers has increased over the last few years. Nurse prescribers are increasingly prescribing in a form ('independent prescribing') that makes them independently responsible for prescribing decisions without working to a plan laid out by a doctor. Mental health organisations are increasingly planning in a systematic way how to identify, train and ensure good practice in nurse prescribing., This study demonstrates that growth in numbers of nurse prescribers can take place over an extended time period. The study demonstrates that the exact model of nurse prescribing will influence its applicability in different types of service., What are the implications for practice? Nurse prescribing is becoming increasingly common in mental health services, changing roles for nurses and the experience of services for service users. However, there is great variation between organisations in this regard., Research is needed regarding the outcomes and any risks of independent nurse prescribing specifically in mental health compared to medical prescribing., Abstract Introduction This paper reports the latest in a series of national surveys of nurse prescribing in mental health organizations in England. Aim To describe and understand changes and trends in the use of nurse prescribing nationally. Methods Postal survey to all 53 National Health Service Mental Health Trusts (publicly funded provider organizations); 75% responded ( n = 40). Results Numbers of nurse prescribers (NPs) have grown significantly in the last 6 years, although remain a small percentage of the total Mental Health Nursing workforce. Most NPs are in community services, particularly community mental health teams and drug/alcohol services. Independent prescribing has now become the most common form of NP, replacing supplementary prescribing. Discussion Overall growth in numbers of NPs has continued, but remains marked by large variance in numbers between organizations. The study evidences that the particular form of nurse prescribing will influence its applicability in different clinical settings and that sustained increase over time in NP numbers is feasible at a national level, even with local variation in uptake. Implications for practice Nurse prescribing has become well embedded in many organizations although large-scale adoption may be hindered by the lack of a definitive evidence base as to outcomes compared with those from medical prescribing. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? While smoking rates within the general population in Australia are dropping, 32% of Australians with a mental illness smoke, increasing to 73% among those with severe or chronic mental illness., In Australia and elsewhere, smoking bans within mental health facilities have been implemented., What this paper adds to existing knowledge? We surveyed 98 mental health professionals in Australia to gather information on attitudes toward smoke-free policies in mental health/psychiatric units within Australia., While previous research has sought information on agreement or disagreement with smoking-bans, very little research has been conducted focusing on attitudes held by mental health professionals towards smoke-free policies., This study utilized a mixed-methods approach in which the qualitative data provides a rich source of information to assist in developing programmes or interventions to influence attitudes and therefore change behaviours of mental health professionals., What are the implications for practice? This paper can be useful in providing a better understanding of the theories linking smoking and mental illness, and the common 'myths' which influence attitudes to smoking cessation in clinical populations., Results will influence the development of training and education resources for mental health practitioners, and particularly for nursing staff working within psychiatric facilities, in relation to smoking cessation., Importantly, this issue has implications in the areas of policy planning and development, education relating to smoking behaviour and smoking cessation programmes, together with holistic health care., Abstract Introduction Mental health units in Australia and internationally are increasingly implementing smoke-free policies. Due to the high prevalence of smoking among clinical populations, this has become an important research area. Purpose of study This study explored the attitudes of mental health professionals toward smoke-free policies in mental health units within Australia. Method Using an online survey design, 98 Australian mental health professionals participated in the study. Results Results indicated that only 25.5% agreed with a total smoking ban. Although supporting smoke-free initiatives within the wider community, participants commonly held attitudes that were unsupportive of smoking bans, and indicated beliefs inconsistent with a smoke-free policy for clinical populations. Discussion Results suggest the need for appropriate staff education and training regarding smoking behaviours and risks, and smoking cessation treatments for clinical populations if smoke-free policies are to be successfully implemented. Implications for practice Findings suggest important implications for holistic mental health care, staff education and training, as well as policy, planning and development, particularly in relation to this treatment group, who are likely to have entered a psychiatric unit in crisis. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known about the subject?: Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002 under strict conditions of careful practice. UMS euthanasia occurs fairly rarely in Belgium, but the frequency has increased substantially over the past few years. Although most mental health nurses play an important role and are supportive of euthanasia in general, their role, attitude and knowledge when it comes to UMS euthanasia were unknown until now. What this paper adds to existing knowledge?: Most mental health nurses in Belgium appear to be supportive towards UMS euthanasia and where UMS euthanasia is carried out, mental health nurses are often involved in the preceding decision‐making process. Mental health nurses critically reflect on the interpretation and application of the legal euthanasia criteria as experienced in their daily work with their patients, and identify several problems. After a rather quiet period in Belgium, the public ethical debate regarding UMS euthanasia has recently been reopened and intensified. What are the implications for practice?: Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia. This applies at several levels: legal, healthcare policy, bedside care and education. Specific attention must be paid within the UMS euthanasia process to ensure adequate cooperation between physicians, nurses and patients. There is a need for proper training in: knowledge of psychiatric pathologies and remaining treatment options; communication skills; the legal framework and all its difficulties; transdisciplinary and multicultural approaches; ethical reflection and how nurses handle their own emotions. Abstract: Introduction: Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002, under certain circumstances that govern careful practice. Despite the legal framework, there are specific difficulties and concerns regarding UMS euthanasia. Mental health nurses are often involved in the process, but little is known about their attitudes towards UMS euthanasia, their role and their knowledge. Aim: To determine the attitudes, role and knowledge of mental health nurses regarding UMS euthanasia. Methods: A cross‐sectional survey was performed at a convenience sample of four psychiatric hospitals in Belgium (n = 133) as a pilot study. Self‐administered questionnaires were provided to mental health nurses. Results: Half the nurses in our sample had been involved at least once in the process of UMS euthanasia. A large majority of mental health nurses were supportive of UMS euthanasia. Nurses show differences in attitudes related to the different psychiatric pathologies of the patients, and in whether or not minors are involved. In some cases, they believed that the mental suffering of psychiatric patients can be unbearable and irreversible and that psychiatric patients can be competent to voluntarily request UMS euthanasia. Nurses stated that they have an important role in the UMS euthanasia process, but also demanded more knowledge and clear guidelines to implement the procedure. Discussion: Nurses have a key role regarding UMS euthanasia but face several challenges: the recent process, resistance to a multidisciplinary approach by psychiatrists and an unclear role defined by the legal framework. Nurses do not appear to have a common voice on the topic and the development of clear guidelines appears to be essential. Social recovery can offer a way out of an UMS euthanasia request, but it will not always offer a solution. Implications for Practice: Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia at various levels: bedside practice, healthcare management, education and policy. A form of systematic cooperation between nurses, physicians and patients can contribute to the utmost careful decision‐making process needed in these cases. There is a need for proper training in: knowledge of psychiatric pathologies and remaining treatment options; communication skills; the legal framework and all its difficulties; transdisciplinary and multicultural approaches; ethical reflection and how nurses handle their own emotions. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Psychological distress is a major health concern, and university student populations are at a risk due to high academic, economic and interpersonal demands at this time. While a number of studies have been conducted looking at distress and service uptake amongst university students, there is a lack of comparative information in the student nurse population. Therefore, this study focuses on level of psychological distress and service uptake in student nurses during their training. Student nurses in training are acknowledged as particularly vulnerable to anxiety and depression. Anxiety and depression can interfere with educational achievement and interfere with working relationships, which are an important aspect of clinical practice. What this paper adds to existing knowledge?: This study investigates psychological distress and service uptake in student nurses, in a single study, by measuring the level of distress and comparing this with adult nonpatient norms. The key findings suggest high levels of anxiety and depression and poor uptake of support in student nurses. The main barrier to seeking support was the fear of disclosure about their anxiety and/or depression, and feared impact on their suitability to train as a nurse. What are the implications for practice?: Due to the fear of disclosure and low levels of support seeking, mental health nurses and academics have a key role to play in mental health literacy. It seems reasonable, given the key findings, to suggest that interventions be directed at decreasing anxiety and depression such as mindfulness training and other evidence‐based strategies. It is recommended that psychological distress needs due attention from higher education sector and those health professionals involved in mental health service provision to support evidence‐based strategies that target these issues. Abstract: Introduction: This study adds to the existing international evidence on psychological distress in the student population by focusing on student nurses. It quantitatively assesses psychological distress with comparative norms and investigates service uptake in a single study. Aim: The aim of this study was to investigate the level of psychological distress in students and compare this with population norms and highlight potential facilitators and barriers to help seeking. Methods: This study recruited N = 121 student nurses from one university in a cross‐sectional design. Data were analysed using descriptive statistics, independent t tests and one‐way ANOVAs. Findings: The key findings show high levels of psychological distress, which is above levels seen in the general population. The main barriers to seeking support were fear of disclosure and the perceived impact on their suitability as a student nurse. Discussion: The study highlights that high levels of distress identified in the literature are seen in student nurses and that fear of disclosure may account for some not seeking support. Relevance: The fear of disclosure and low levels of seeking support suggest there is a need for mental health nurses and academics to play a key role in mental health literacy and evidence‐based interventions such as mindfulness to combat these issues. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Many nursing students have inadequate preparation for practice in mental health nursing in the United States and China. The concept of mental illness has different connotations in different cultures. Studies differ from country to country concerning the influence of nursing education on students’ knowledge about and attitudes towards mental disorders. There is a lack of cross‐cultural research that takes a broad perspective to explore how nursing students’ knowledge and beliefs about mental disorders are influenced by the culture within education and healthcare systems. What this paper adds to existing knowledge?: Nursing students in the United States and China shared similar views on a broad range of intervention options including professional help, psychotropic medications and activity interventions for managing depression and schizophrenia. The major difference between the two nursing student groups was that the Chinese students showed more preference to occasional alcohol consumption and specialized therapies including cognitive‐behavioural therapy and electroconvulsive therapy and the US students held less skepticism towards traditional and religious practices as possible treatment options for depression and schizophrenia. What are the implications for practice?: The Chinese nursing students need to be educated about safe alcohol consumption guidelines adopted by the National Health and Family Planning Commission. The US nursing students need to increase their awareness of national practice guidelines for managing mental disorders, particularly with respect to the use of specialized therapies such as cognitive‐behavioural therapy and electroconvulsive therapy. We support professional and psychosocial interventions in caring for patients with mental disorders. Abstract: INTRODUCTION: Nursing students in the United States and China have reported inadequate preparedness for practice in mental health nursing. It is important to investigate nursing students’ mental health literacy levels for a better understanding of their practice readiness in mental health field upon completion of their education. Aim: This study was aimed at developing an understanding of American and Chinese nursing students’ mental health literacy regarding the effectiveness of specific interventions for managing depression and schizophrenia. Method: The “Australian National Mental Health Literacy Survey” was completed by a group of 310 nursing students including 152 Americans and 158 Chinese between April 2016 and April 2017 to compare students’ rated intervention options on two provided vignettes. Results: The two student groups reached consensus on many intervention options. However, the Chinese students showed more preference to occasional alcohol consumption and specialized therapies and the US students held less skepticism towards traditional practices as treatment options for depression and schizophrenia. Discussion and implications for practice: The findings support professional and psychosocial interventions in caring for patients with mental disorders. There is a significant need for specific education on safe alcohol consumption guidelines for Chinese nursing students and clinical practice guidelines for managing mental disorders for American nursing students. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? People admitted to psychiatric facilities have high rates of tobacco use and hospitalizations present an opportunity for patients to have conversations about tobacco use treatment., Clinicians may believe that people with mental illnesses are not interested in quitting or that they do not understand the importance of treatment., Positive attitudes towards tobacco treatment, viewing that participating in treatment is normal care, and feeling that one is quite able to participate in such treatment predicts intentions to participate in treatment, which, in turn, predicts actual participation., What does this paper add to existing knowledge? Psychiatric patients who use tobacco use report poor prior involvement with tobacco treatment., Positive attitudes towards, encouraging opinions of other people about, and having a sense of control over taking part in tobacco treatment increases plans to engage in treatment., Having a sense of control in taking part in tobacco treatment is strongly associated with prior experiences with evidence-based treatment., What are the implications for practice? Because psychiatric hospitalizations are an opportunity for addressing tobacco use and treatment, clinicians should be prepared to support willing patients, especially those with prior substance use histories., Support should include providing them with information regarding tobacco treatment options during their hospital stay and ways that they can continue to receive care after discharge., Clinicians should be promoters of pro-tobacco treatment attitudes and supporting patients' sense of control over participating in treatment during hospitalization., Abstract Introduction Hospitalized tobacco users with mental illnesses ( MI) may face several barriers to stopping smoking. However, motivational factors that affect the intention to engage in tobacco treatment have been shown to predict actual engagement. Aim To use the Theory of Planned Behavior to assess intentions to and prior experiences of engaging in evidence-based tobacco treatment among hospitalized individuals with MI. Method A cross-sectional survey was conducted among 115 patients in a state psychiatric hospital. Multivariate analyses were used to examine associations with the intentions and prior experiences of engaging in tobacco treatment. Results After controlling for demographic and smoking history, attitudes, subjective norms and perceived behavioural control towards engaging in tobacco treatment were significantly associated with intentions towards treatment engagement. Only higher scores on perceived behavioural control and lower education levels were associated with reported prior experiences of tobacco treatment. Discussion The low prior treatment engagement scores, but relatively higher intention to engage scores among participants suggests the need for deliberate support for evidence-based tobacco treatment during psychiatric hospitalizations. Implications for practice Clinician training in tobacco treatment can promote self-efficacy to engage patients while supporting patients' control so that tobacco treatment is an expected component of psychiatric care. [ABSTRACT FROM AUTHOR]

Accessible summary What is known about the subject? People with learning disability are more likely than the general population to develop schizophrenia., Personal recovery philosophies are based on positive attitudes and an optimism that recognizes and values people and their strengths and capacity to achieve goals., Little is known from previous studies about the illness perceptions of learning disability practitioners who work with people that experience both a learning disability and schizophrenia., The illness beliefs of learning disability practitioners about schizophrenia may mediate the potential for social exclusion and limit recovery outcomes., What this study/paper adds to existing knowledge? The findings show that the illness beliefs of learning disability practitioners and support workers regarding schizophrenia are pessimistic in terms of the consequences for people with schizophrenia and learning disability and their relatives as well as the chronic course of the illness., What are the implications for clinical practice? This study identifies the nature of LD practitioner perceptions about schizophrenia and provides guidance about how personal recovery philosophies can be applied to the management of LD and schizophrenia., The beliefs of learning disability practitioners and support workers regarding schizophrenia need to be reframed to support better recovery outcomes and social inclusion for this group., The findings from this study can inform the development of training in bio-psycho-social models of schizophrenia, recovery approaches, family/carer interventions, clinical supervision, mentorship and reflection on clinical practice, which could be potentially useful strategies to help facilitate a reframing of beliefs., Abstract Background and purpose of study The prevalence of schizophrenia in people with learning disability is 3-4%. This is the first study to investigate the illness perceptions of learning disability ( LD) practitioners towards people with schizophrenia. Methods Learning disability practitioners ( n = 210) that work with people with LD and schizophrenia completed a modified version of the Illness Perception Questionnaire Schizophrenia Carers Version ( IPQ- SCV). Descriptive and correlational analyses were conducted for all of the IPQ- SCV subscales. Results A significant positive correlation was found between consequences relative and consequences patient (0.495, P < 0.001), and a negative correlation was found between timeline episodic and timeline chronic (−0.243, P < 0.001) subscales. Discussion Consistent with previous evidence found regarding negative staff attitudes to schizophrenia recovery outcomes, course and chronicity, the current investigation has extended and confirmed these observations to staff working with individuals with comorbid schizophrenia and learning disability. Implications for practice This study identifies the nature of LD practitioner perceptions about schizophrenia and contributes to the development of the recovery philosophy in relation to the management of LD and schizophrenia. The findings inform the design of training modules in bio-psycho-social models of schizophrenia, recovery approaches, family intervention, clinical supervision and reflection. These can help LD practitioners to reframe their schizophrenia/ LD illness beliefs. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? The only previous quantitative study that examined nurses' use of assessment tools to identify antipsychotic medication side effects found that about 25% of mental health nurses were using assessment tools., No previous studies have examined factors that influence the manner in which mental health nurses assess antipsychotic medication side effects., What this paper adds to existing knowledge? One-third of the respondents were not aware of any antipsychotic medication side-effect assessment tool, and only one-quarter were currently using an assessment tool., 'Service responsibility' was significantly associated with ongoing use of antipsychotic medication assessment tools, indicating that respondents with more positive attitudes to their service were more likely to continue using antipsychotic medication assessment tools., What are the implications for practice? The low level of awareness and use of antipsychotic medication side-effect assessment tools indicates that nursing educational institutions should incorporate more detail about these tools in course content, and emphasize in particular the benefits that result from the use of these tools in clinical practice., Service processes contributed significantly to the use of antipsychotic medication assessment tools, which indicates that managers need to foster workplace cultures that promote routine use of these tools., Abstract Introduction Limited evidence suggests that only a minority of mental health nurses regularly use standardized assessment tools to assess antipsychotic medication side effects, but the factors that contribute to the non-routine use of these tools remain unknown. Aim To examine Australian mental health nurses' awareness of, and attitudes towards, side-effect assessment tools, and also identify factors the influence the use of these tools. Methods A cross-sectional survey was undertaken through distributing an online questionnaire via email to members of the Australian College of Mental Health Nurses. Completed questionnaires were received from 171 respondents. Linear regression was used to examine the relationship between the 'service responsibility' and 'personal confidence' scale scores, and awareness, previous use and ongoing use of antipsychotic medication assessment tools. Results Only one-quarter of the respondents (26.5%) were currently using an assessment tool. 'Service responsibility' was significantly associated with ongoing use of antipsychotic medication assessment tools ( Β = 3.26; 95% CI 0.83-5.69). 'Personal confidence' did not influence the ongoing use of assessment tools ( Β = −0.05; 95% CI −1.06-1.50). Implications for clinical practice Stakeholders can incorporate 'service responsibility' processes to foster increased use of assessment tools, which may enhance the identification antipsychotic medication side effects and improve the quality of care for service users. [ABSTRACT FROM AUTHOR]

Accessible summary What is known about the subject? Loneliness among people diagnosed with schizophrenia is a serious problem. Recent studies have focused on the loneliness; however, no study has examined the relationships between loneliness and both individual and environmental factors comprehensively., What this paper adds to existing knowledge? The main results indicated that the community-dwelling people diagnosed with schizophrenia in Japan as well as in other countries experienced higher levels of loneliness. Both individual and environmental factors were related to loneliness. Increasing the self-efficacy for community life and self-esteem of individual factors, and not being socially isolated and increasing community integration of environmental factors would improve their loneliness., What are the implications for practice? Health practitioners, in particular, public health nurses in mental health care, should work to develop a partnership with people diagnosed with schizophrenia, their family members, friends and other community-dwelling people in order to decrease and prevent loneliness. For individuals diagnosed with schizophrenia, interventions by cooperating with community resources and using the technique of nurses to assist them with continuous community activity could be useful. For environmental interventions, population approach such as developing daily programmes which family members can participate in, and cooperating with educational institutions and community events could have a positive effects., Abstract Introduction Loneliness among people diagnosed with schizophrenia living in communities can decrease quality of life and may contribute to suicide. Aim The aim of this study was to examine the levels of loneliness among Japanese people diagnosed with schizophrenia and to identify individual and environmental factors related to their loneliness. Method A cross-sectional survey was conducted with 264 people diagnosed with schizophrenia who use local activity support centres in urban areas. The self-administered questionnaires included questions on loneliness, demographic characteristics, individual factors including self-efficacy for community life and self-esteem, and environmental factors including social isolation, community integration and service use. Results The study results indicated that people diagnosed with schizophrenia in Japan experience higher levels of loneliness, corroborating results from other countries. Multiple regression analysis showed that a lower level of self-efficacy for community life, self-esteem, community integration and social isolation predicted a higher level of loneliness, accounting for 55.3% of variance. Implications for Practice Public health nurses in mental health care in Japan can work with individuals diagnosed with schizophrenia and communities using the technique to assist them with continuous activity and cooperating with community resources and educational institutions in order to decrease and prevent loneliness. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Stigma related to mental illnesses is a great burden on societies globally. Factors associated with nurses' attitudes towards people with mental illness in health-care settings are discrepant., Stigmatized attitudes among staff members towards patients with mental illness have widely been studied in various specialized health care contexts, but less often in primary health-care settings., What this paper adds to the existing knowledge? Nurses' attitudes towards people with mental illness in general were positive in primary care health settings. Younger nurses expressed feeling afraid of mentally ill patients., They not only lacked a feeling of safety around these patients but were also often of the opinion that people with mental illness should be segregated from the general population., What are the implications for practice? Systematic and continuous mental health on-the-job training for primary care nurses is recommended to strengthen the positive attitudes of young nurses towards patients., Young nurses especially should be prevented from developing stigmatized attitudes towards patients with mental problems and to ensure a skilled workforce for the future in this demanding area of health care., Abstract Introduction Despite the development of mental health services in many countries, nurses working in different health care specialties may still have concerns and negative attitudes towards people with mental illness. Aim To describe nurses' attitudes towards people with mental illness and examine factors associated with their attitudes in primary care health centres. Method The data were collected from nursing staff ( N = 264, response rate 84%) in 15 primary care health centres in two Finnish cities (spring 2014) with a self-report questionnaire (Attribution Questionnaire-27, Corrigan 2003) and analysed by descriptive statistics and multiway covariance analysis. Results Nurses' attitudes towards people with mental illness were generally positive. The nurses mostly reported willingness to help and feelings of concern and sympathy towards these patients. However, younger nurses or those without additional mental health training expressed a fear of patients. Discussion Special attention should be paid to nursing education and on-the-job training to prevent young nurses from developing stigmatized attitudes towards patients. Implications for practice Higher confidence in nursing staff could ensure a skilled work force in areas of mental health in the future, prevent young nurses from developing a fear of patients at work and support positive attitudes towards patients with mental problems. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Nurses play an important role in monitoring and supporting patients and their relatives at the end of life., To date, there is a lack of recent empirical research on the experiences of psychiatric nurses in providing palliative care to psychiatric patients who suffer from life-threatening physical co-morbidity., The limited literature available indicates that palliative care for psychiatric patients needs to be improved., What this paper adds to existing knowledge? This explorative study is unique in offering an insight into current palliative care practice for psychiatric patients and showed that one in three nurses working in Dutch mental health facilities is involved in palliative care provision., Important elements of palliative care, i.e.: care domains, multidisciplinary approach, early recognition and family care are recognized by nurses. Moreover, in palliative care for psychiatric patients there is more attention for psychosocial and spiritual care compared to palliative care for patients without psychiatric disorders., Patient characteristics and little attention for palliative care within mental health facilities were found to hamper timely and adequate palliative care provision by nurses., What are the implications for research and practice? Educating psychiatric nurses about palliative care and close collaboration between physical and mental health care are crucial to address the palliative care needs of this vulnerable patient group., Since mental health care is increasingly provided ambulatory, the development of palliative care for psychiatric patients outside mental health facilities should be closely monitored., Abstract Introduction Recent empirical research on palliative care for psychiatric patients is lacking. Aim The aim of this study was to explore nurses' experiences with and identify barriers to providing palliative care to psychiatric patients in Dutch mental health facilities. Methods Mixed-methods; 137 nurses working in Dutch mental health facilities completed a survey. Nine participated in in-depth interviews. Results Thirty-six percent of nurses had experience with providing palliative care to psychiatric patients with physical co-morbidity in the past 2 years. Of all patients, 63% received physical care before death, 46% psychosocial care and 33% spiritual care. In 91% of all cases, care was provided by multidisciplinary teams. Patient characteristics and little attention to palliative care were barriers for timely and adequate palliative care. Discussion In palliative care for psychiatric patients, there is more attention for psychosocial and spiritual care compared to palliative care for patients without psychiatric disorders. Yet there are barriers to adequate palliative care provision. Implications for practice Educating psychiatric nurses about palliative care and close collaboration between physical and mental health care are crucial to address the palliative care needs of psychiatric patients. Since mental health care is increasingly provided ambulatory, palliative care for psychiatric patients outside mental health facilities should be closely monitored. [ABSTRACT FROM AUTHOR]

Accessible summary Negative attitudes towards people with mental illness exist across all nations and cultures. People with mental illness experience the most discrimination from health professionals. This impacts negatively on the illness experience and results in poorer outcomes. The social and political climate and the culture of countries are strong determinants of tolerance and stigma of people with mental illness. The country in which a nurse practices is the most influential factor in predicting their attitudes to mental illness., In Jamaica, the most common response to mental illness is fear of dangerousness; however, in recent years, there has been some improvement in tolerance and attitudes. There are no studies that have explored whether these attitudes are held by nursing students., This paper provides baseline evidence that some student nurses in Jamaica hold negative attitudes towards mental illness, particularly, a perception that people with mental illness are dangerous., Negative attitudes and staff criticism is known to be associated with poorer patient functioning and overall outcomes. Fewer nurses view mental health nursing as a possible career choice., Abstract There is longstanding evidence of nurses demonstrating negative attitudes towards people with mental illness. Student nurses' fear or discomfort with mentally ill patients results in poorer outcomes for patients and students' dissatisfaction with their experience of mental health nursing. There is evidence of negative attitudes towards mental illness in the Jamaican society; however, no studies have explored whether these attitudes are held by nursing students. The aim of the study was to examine the attitudes of nursing students towards mental illness. A questionnaire survey was conducted with a convenience sample of 143 third-year nursing students who were enrolled in a baccalaureate programme. Data were collected using the Attitudes Towards Acute Mental Health Scale ( ATAMHS). A response rate of 71% was achieved for the survey. The findings indicated that the student nurses held an overall negative attitude towards mental illness, with a general perception that mentally ill people are dangerous. The student nurses were divided in their opinions in a number of areas, suggesting a possible conflict of opinions. Negative attitudes towards mental illness impact client outcomes and the career choices made by nurses. This study provides baseline data within the Jamaican context that adds to the evidence on nursing students' attitude to mental illness. Further research is needed to explore whether nursing education and clinical experience enables student nurses in Jamaica to develop a more positive attitude towards mental illness and mental health nursing and whether cultural factors contribute to negative attitudes. [ABSTRACT FROM AUTHOR]

Accessible summary Borderline personality disorder (BPD) is a complex and challenging mental health condition for the person and family carers who support them., This paper reports on the results of a survey of 121 family carers of people diagnosed with BPD about their experiences of being carers, their attempts to seek help for the person diagnosed with BPD and their own carer needs. It provides the first detailed account across these domains., Family carers of people diagnosed with BPD experience significant exclusion and discrimination when attempting to interact with generalist health and mental health services. Further education for all health professionals is indicated, particularly general practitioners who likely come into contact with BPD carers. All health professionals need to improve their skills and attitudes in working with people diagnosed with BPD, and also their skills and attitudes in working with BPD carers. Carers of people diagnosed with BPD may need specialist carer support that addresses their distinct information, education and support needs., Abstract There is limited understanding of the experience of family carers of people diagnosed with borderline personality disorder ( BPD). This study aimed to explore their experiences of being carers, their attempts to seek help for the person diagnosed with BPD and their own carer needs. An invitation to participate in an online survey was distributed to carers across multiple consumer and carer organizations and mental health services, by the Private Mental Health Consumer Carer Network ( Australia) in 2011. Responses from 121 carers showed that they experience significant challenges and discrimination when attempting to engage with and seek support from health services. Comparison with consumers' experiences (reported elsewhere) showed that these carers have a clear understanding of the discrimination faced by people with this diagnosis, largely because they also experience exclusion and discrimination. Community carer support services were perceived as inadequate. General practitioners were an important source of support; however, they and other service providers need more education and training to support attitudinal change to address discrimination, recognize carers' needs and provide more effective support. This study provides the first detailed account of BPD carers' experiences across a broad range of support needs and interactions with community support and health services. [ABSTRACT FROM AUTHOR]

Background: Medication self‐management (MSM) is considered an important aspect of pharmacotherapy and plays an essential role in the treatment of various illnesses. To date, research into the willingness and attitude of psychiatric healthcare providers toward MSM in patients diagnosed with schizophrenia or bipolar disorders during hospitalization is lacking. Aim: The aim of this study was to identify healthcare providers' willingness to MSM and assess their attitude, conditions, benefits, and ability toward it during hospitalization. Methods: A multicenter, quantitative cross‐sectional observational design was used to study psychiatric healthcare providers' attitude to MSM during hospitalization in patients diagnosed with schizophrenia or bipolar disorders. Results: In this study, 173 healthcare providers, of which 147 were nurses and 26 psychiatrists, participated. During hospitalization, 86% of the healthcare providers were willing to MSM. Regularly evaluating patients' ability regarding MSM during hospitalization was seen as an important condition (94%). Psychiatrists were significantly less convinced that MSM during hospitalization has a positive impact on adherence when compared to nurses (respectively 54% vs. 77%, p =.009). Discussion: Most healthcare providers indicated that they were willing to MSM in patients diagnosed with schizophrenia or bipolar disorders during hospitalization under specific conditions. [ABSTRACT FROM AUTHOR]

Accessible summary What is known about the subject? The Advancing Recovery in Ireland ( ARI) project (Health Service Executive, 2012) promotes recovery-orientated services. A previous study of Irish mental health practitioners (Cleary & Dowling ) identified the need to improve knowledge and attitudes towards recovery., To facilitate implementation of ARI and monitor progress, this study provided a 'benchmark' of current knowledge and attitudes to recovery., What this study adds to existing knowledge? The study provides important baseline information on recovery knowledge and attitudes which can be used to assess the impact of the ARI Project. It also provides valuable information that can be compared to recovery approaches employed in other countries., Despite the increased emphasis on recovery in Ireland, knowledge and attitudes of health care practitioners towards recovery remain relatively unchanged between 2007 and 2013., Working in dual settings, being a non-nurse, and training was associated with better RKI scores. Training appears to be the strongest factor in predicting better recovery knowledge., The findings suggest that knowledge levels and attitude changes following education may not be sustained over time and ongoing training may be required., What are the implications for practice? There is considerable scope to improve recovery knowledge. Key recommendations include the need for more recovery training, evaluate whether training translates into clinical practice, using 'Recovery Champions', introducing peer support workers and developing local policies and protocols to support recovery practice., Abstract Introduction A study of Irish mental health practitioners (Cleary & Dowling ) identified the need to improve knowledge and attitudes towards recovery. This led to the Advancing Recovery in Ireland Project ( ARI) which promoted recovery-orientated services and a need to 'benchmark' progress. There is little evidence regarding the types of educational interventions that maintain positive recovery knowledge and attitudes in providers. Aim The study assessed current knowledge and attitudes to recovery. Methods The methodology of Cleary & Dowling () was replicated. A survey was administered to practitioners (n = 337) using the adapted Recovery Knowledge Inventory ( RKI) (Cleary & Dowling ). Results No significant differences were found in recovery scores compared to Cleary & Dowling () or by level of experience. Working in dual settings, being a non-nurse, and training was associated with better recovery scores. Significantly more respondents had received training in recovery (40% versus 23%) compared to Cleary & Dowling (). Training appears to be the strongest factor predicting better recovery knowledge. Conclusions There is considerable scope to improve recovery knowledge. Key recommendations include the need for more recovery training, using 'Recovery Champions', introducing peer support workers and developing local policies and protocols to support recovery working. [ABSTRACT FROM AUTHOR]

Accessible summary Emerging adults, or those between ages 18 and 25, are at increased risk for mental health problems as they transition into adult roles and relationships. These risks are magnified when a parent has suffered with depression during that emerging adult's upbringing., Studies examining children of depressed parents tend to focus on samples under the age of 18 when children have yet to develop abstract thinking (e.g. improved reasoning skills, greater understanding of life experiences) and have had less time to reflect on their own experience., It has been difficult to decipher the most important elements experienced by these children and the impact on emerging adult outcomes and most studies lack theory guiding the work. Some evidence suggests that they encounter a form of loss., This study is unique in that the retrospective experience of emerging adults who grew up with a depressed parent was examined using variables based on propositions from Ambiguous Loss Theory and the impact on current psychosocial well-being., Abstract A parent who is depressed is physically present, but may be psychologically absent, or different to their children. Changes in the parent-child relationship, feelings of loss, and increased stress can occur for the child. These factors can impair psychosocial well-being throughout the child's upbringing, and the effects might impact that child the most in their transition to adulthood. The aim of this exploratory study was to examine factors experienced while growing up with a depressed parent that might contribute to the current psychosocial well-being of emerging adults (individuals between the ages of 18 and 25) using ambiguous loss theory as a theoretical lens. A cross-sectional, correlational design with multiple regression analysis was used to examine relationships between emerging adults' ( n = 120) perceptions of retrospective duration and understanding of parent's depression, caregiving, stress, social support, hope, and boundary ambiguity and current psychosocial well-being. Experiencing hope, stress, and then the length of parent's depression during their upbringing were the most predictive variables for emerging adult psychosocial well-being. Findings from this study will help mental health professionals better understand factors contributing to outcomes for this population. The knowledge to be gained is important for developing or refining age and developmentally appropriate interventions aimed at improving outcomes of adult children of depressed parents. [ABSTRACT FROM AUTHOR]

Accessible summary The Attitudes Toward Acute Mental Health scale (ATAMHS) was translated into Korean with attention to linguistic and content equivalence. Nine items were eliminated from the Korean version because of low correlations with the overall scale due to differences in clinical nursing environments and culture between South Korea and English-speaking countries., The results of this study showed that the Korean version of the ATAMHS (ATAMHS-K) is a reliable and valid scale for measuring attitudes toward mental illness in nurses and nursing students in an acute mental care setting., Factor analysis of the 24-item ATAMHS-K revealed three factors: (1) professional perspective; (2) semantic differentials; and (3) positive attitudes. The final analysis revealed that the three factors accounted for 39.5% of the variance. In addition, the ATAMHS-K was shown to have strong concurrent validity due to its strong positive correlations with the Community Attitudes Toward the Mentally Ill - Korean version (CAMI-K) scale., This study was the first attempt to adapt the ATAMHS for use in South Korea and to validate it with Korean nurses and nursing students., Abstract The purpose of this study was to adapt the Attitudes Toward Acute Mental Health Scale ( ATAMHS) into the Korean language and culture and then to determine the reliability and validity of it by administering it to a sample of Korean nursing students and nurses. We conducted a psychometric evaluation that included a two-step item analysis (analysis and reanalysis), exploratory factor analysis and concurrent validity. The ATAMHS was translated into Korean by bilingual nurses. Then, 429 participants (224 undergraduate nursing students and 205 nurses, all with psychiatric experience) completed the translated version of the ATAMHS. The item analysis revealed that nine items correlated poorly with the rest; thus, they were deleted from the scale. The final Korean version of the scale, which we refer to as the Korean version of the ATAMHS ( ATAMHS- K), contains 24 items. The ATAMHS- K showed good internal consistency. Exploratory factor analysis revealed three factors (professional perspective, semantic differentials and positive attitudes) that explained 39.5% of the variance. The ATAMHS- K had strong correlations with the Korean version of the Community Attitudes towards the Mentally Ill Scale, thus confirming the concurrent validity. Therefore, the ATAMHS- K demonstrated acceptable psychometric properties as a measure of attitudes toward acute mental health in Korean nursing students and nurses. [ABSTRACT FROM AUTHOR]

Accessible summary The study aimed to examine the occurrence and type of mental illness stigma that exists in the Greek culture., One hundred and eleven individuals who viewed themselves as belonging to the Greek culture completed a questionnaire that measured different types of stigma and their level. These people lived in either England or Greece., Overall, the Greek people sampled in our survey were found to possess medium-high level of authoritarian attitudes (the view that people with mental illness are inferior) and a moderate level of social restrictiveness (the view that they should be restricted and carefully controlled in society). The results also found a high 'benevolence' score, which indicates that they are also sympathetic to people with mental illness. Greeks educated in England (instead of Greece), who were more religious, who had less knowledge about mental illness and less personal experience of mental illness were most likely to hold stigmatizing attitudes., The results - which support previous research - show that Greek people are sympathetic towards the mentally ill but nevertheless feel the need for them to be closely controlled in society. This means that more work is needed to help minimize negative attitudes among Greek people., Abstract Mental illness stigma negatively affects the lives of individuals with mental health disorders. Studies have indicated that the type and degree of stigma significantly varies across cultures. This study aimed to add to this body of knowledge by examining the prevalence and the type of mental illness stigma among individuals who identified themselves as Greek. It also examined the influence of a range of potential within-culture stigma moderating factors, including levels of previous experience with mental illness and mental illness knowledge. A cross-sectional quantitative design was employed, and 111 participants living in England and Greece were sampled through the snowball sampling technique. Stigma prevalence was measured using the ' Community Attitudes to Mental Illness' questionnaire. The findings revealed that participants showed a high degree of sympathy for people with mental illness but also considered them to be inferior and of a lower social class, and needing strict societal control. Higher stigma was significantly associated with being educated in England (instead of Greece), higher religiosity, lower knowledge levels and lower levels personal experience of mental illness. Targeted antistigma campaigns specifically tailored for the Greek culture are required in order to help reduce stigmatizing attitudes. [ABSTRACT FROM AUTHOR]

Accessible summary It is stressful to be ill. People need nurses who help them emotionally while caring for their physical problems. The undergraduate psychiatric course is a good place to begin this learning. A pre and post survey asked 67 baccalaureate student nurses what they learned from their first clinical psychiatric nursing course. Specifically, the authors wanted to know whether working with people with mental illness would help students learn how to help people with emotional stress., The students developed skills in listening and communication and progressed through steps essential to the development of empathy: breaking down stigma and prejudicial judgments, developing skills of self-reflection, allowing people to impact them and feeling what it would be like if they were the patient, and recognizing what they had learned thereby making the learning conscious. With these new skills, students remarked on the life-changing experiences they had with these patients. Many commented on their intention to integrate these skills and understandings into their nursing practice with all patients., These study findings are important for three reasons: (1) recognition of the importance of the first psychiatric course in helping students develop empathy; (2) encouraging research to focus on faculty efforts to help students integrate these practices into other areas of nursing; and (3) recognition that empathy is a learned process., Abstract Psychiatric nursing teaches students how to engage and communicate with patients who have severe emotional distress. Nurses need this knowledge as the majority of patients encountered in hospitals are distressed. This study explores the impact of a psychiatric clinical course in helping students learn to relate to distressed patients. The study used a mixed research methodology to survey 67 baccalaureate students about their experiences in the placement portion of the psychiatric nursing course. The pre-clinical questions focused on students' anticipation regarding individuals with mental illness and how the clinical experience would affect them as nurses and as individuals. The post-clinical questions asked how the clinical experience affected them. The students stated that their time with patients had changed them. Ninety-nine per cent were no longer frightened of the patients. Students realized the patients were distressed and were glad to help them. This work sensitized them to the individual rather than the generic patient. It initiated a process in self-awareness, in sensitivity to the feelings of another person and in communication skills. These are steps in the development of an empathetic presence. The students recognized the need for these skills in all nursing. The authors recommend strategies to assist students in developing an empathetic presence. [ABSTRACT FROM AUTHOR]

Accessible summary [ABSTRACT FROM AUTHOR]