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Few studies have explored how forensic mental health nurses can rebuild the therapeutic relationship following an episode of physical restraint in the acute forensic setting. In this study, we aimed to redress this gap in the literature by exploring with forensic mental health nurses the factors that enable or hinder the rebuilding of the therapeutic relationship following an episode of physical restraint. A qualitative study design was used to capture participants' experiences, views and perceptions of the therapeutic relationship following an episode of physical restraint in the acute forensic setting. Data were collected through individual interviews with forensic mental health nurses (n = 10) working in an acute forensic setting. Interviews were audio recorded, and transcribed verbatim and accounts were analysed using thematic analysis. Four themes were identified: 'Building a Recovery Focused Therapeutic Relationship'; 'Authoritarian Role'; 'Inevitable Imbalance'; 'Rebuilding the Therapeutic Relationship'; plus two sub‐themes 'Facilitators to rebuilding' and 'Barriers to rebuilding'. Findings suggest that an inevitable imbalance exists in building a recovery‐focused therapeutic relationship and at times, is hindered by the authoritarian role of the forensic mental health nurse. Recommendations for changes in clinical practice and in upcoming policies should incorporate a dedicated debrief room and protected time for staff to debrief effectively following restraint. Routine post‐restraint‐focused clinical supervision would also be beneficial to mental health nursing staff. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety are common comorbidities in heart failure (HF) and are associated with adverse outcomes including unplanned hospitalization. However, there is insufficient evidence on the factors associated with depression and anxiety for community patients with HF to inform optimal assessment and treatment in this population. Aim: The aim of this study was to examine the prevalence of and factors associated with depression and anxiety in community-dwelling patients with HF. Methods: A retrospective cohort study of 302 adult patients given a diagnosis of HF referred to United Kingdom's largest specialist cardiac rehabilitation center, from June 2013 to November 2020. Main study outcomes were symptoms of depression using Patient Health Questionnaire-9 and anxiety using the General Anxiety Disorder 7-item scale. Explanatory variables included demographic and clinical characteristics and functional status from the Dartmouth COOP questionnaire: quality of life, pain, level of social activity and daily activities, and being bothered by emotional problems (feelings). Logistic regressions were performed to evaluate the association between demographic and clinical characteristics and depression and anxiety. Results: Of the sample, 26.2% reported depression and 20.2% had anxiety. Higher depression and anxiety were associated with difficulty in performing daily activities (95% confidence interval, 1.11–6.46 and 1.13–8.09, respectively) and being bothered by feelings (95% confidence interval, 4.06–21.77 and 4.25–22.46, respectively). Depression was associated with limitations in social activity (95% confidence interval, 1.06–6.34) and anxiety with distressing pain (95% confidence interval, 1.38–7.23). Conclusion: Findings indicate the importance of psychosocial interventions for patients with HF to minimize and manage depression and anxiety. Patients with HF may benefit from interventions targeted to maintain independence, promote participation in social activities, and optimally manage pain. [ABSTRACT FROM AUTHOR]

Rates of self‐harm among children and adolescents have risen significantly over the past decade and clinical guidelines place children's nurses at the heart of their care. This article reports on the evaluation of 'Our Care Through Our Eyes', an online self‐harm learning programme for children's nurses. A self‐selected, convenience sample of registered children's nurses (n = 42) completed scales pre‐ and postlearning programme that captured their attitudes, beliefs, empathy, anxiety, and confidence. Mean change scores were assessed, and qualitative comments captured postintervention were thematically summarized. There were small improvements in participants' attitudes, empathy and confidence were reported. Anxiety scores increased in a small number of items. Qualitative comments confirmed the value of the online learning programme for improving children's nurses' knowledge and understanding of self‐harm among CYP. Our findings demonstrate that children's nurses agree on the importance of mental health training in self harm, and this could be a catalyst for renewal of both pre‐ and postregistration education including support structures within the National Health Service. This study is the first to explore the feasibility of evaluating 'Our Care Through Our Eyes' delivered using e‐leaning and could be used to inform further investigations. [ABSTRACT FROM AUTHOR]

Problem: Open and responsive safeguarding communications between multiagency professionals who work with children and young people can be critical. Few studies have examined the experience of interprofessional safeguarding communications, and most reports are of social workers. This study explored safeguarding communications from the perspectives of four disciplines. Method: Semistructured interviews were conducted in (London) England with 11 professionals who were purposively sampled for their involvement in safeguarding and child protection work: school nurses (n = 4); teachers (n = 3); general practitioner (n = 1); and social workers (n = 3). Interviews were audio‐recorded, transcribed verbatim, and thematically analyzed. Findings: Five themes emerged from participant data to describe their experiences of safeguarding communications: communication technology; care coordination; professional relationships; information sharing; and, resources. Conclusions: Although participants reported positive experiences they also encountered significant communication challenges in their safeguarding roles. Complex technology could alienate as well as connect professionals, for which some IT system and process improvements were recommended. However, participants also wanted more opportunities for face‐to‐face contact. Their experiences indicate that effective safeguarding communications are best assured by both. [ABSTRACT FROM AUTHOR]

Purpose: Expert consensus is that people with an intellectual disability are over represented across the criminal justice setting (CJS). Primary research studies have been conducted in police stations and prisons, but little is known about the prevalence of this population in the court setting. The purpose of this paper is to conduct a literature review to find out more about the prevalence of defendants with an intellectual disability in court. Design/methodology/approach: A literature review was conducted using standard systematic review methodology (Julian et al., 2011) and the PRISMA reporting guidelines (Moher et al., 2009). Findings: Two papers met the inclusion criteria and were critically appraised. The papers reported prevalence findings ranging from 10%–20%. Research limitations/implications: Differences in study design, sampling, recruitment and diagnostic criteria affect the ability to make comparisons or synthesise findings. Practical implications: It is important that future primary and secondary research studies standardise operational terms to enable true comparison between studies, systematic reviews and evidence syntheses. Social implications: Defendants with an intellectual disability need to be identified to enable criminal justice professionals to make reasonable adjustments to proceedings and consider diversion and alternative disposal options. This will likely improve outcomes for this population and reduce recidivism. Originality/value: This literature review contributes to the growing evidence base about meeting the criminal justice needs of people with a learning disability and recognition of the increased prevalence across the CJS and specifically within the court setting. [ABSTRACT FROM AUTHOR]

Objectives There is consensus that empowerment is key to recovery from mental health problems, enabling a person to take charge of their life and make informed choices and decisions about their life. However, little is known about the mechanisms through which empowerment affects mental health in young people. The current study involved young people aged 16-29 years and examined empowerment as a potential mediator of the relationship between psychological factors (psychosocial, cognition, coping, and control) and mental health, well-being, and recovery from personal problems. Methods A cross-sectional, Internet-based questionnaire study recruited 423 young people aged between 16 and 29 attending universities in England ( n = 336) and Ireland ( n = 87). Psychological factors, mental well-being, empowerment, and recovery from personal problems were measured using self-report measures. Results Mediation analysis in both the single and one over-arching mediator models revealed that empowerment mediates the relationship between psychological factors (psychosocial, self-efficacy, thinking style, coping, and control) and mental health, well-being, and recovery from general life problems. Conclusions This study demonstrates the importance of empowerment, showing that it mediates the relationship between psychological processes and mental health, well-being, and recovery in young people. Clinical implications for working with young people within mental health services, and facilitating their empowerment are discussed. Practitioner points Empowerment is currently a poorly defined concept. This study demonstrates how empowerment mediates the relationship between psychological processes and mental health, well-being, and recovery in young people., Clinicians working with young people might benefit from a structured means of understanding and assessing the different ways in which individuals manage their thinking styles., Empowerment in young people is influenced by the manner in which clinicians facilitate them in establishing social networks in support of employment, education, family/social relations and to encourage young people to take an assertive role in their own care. [ABSTRACT FROM AUTHOR]

The objective of this study was to develop a substantive grounded theory of staff psychosocial intervention use with residents with dementia in long-stay care. “Becoming a person again” emerged as the core category accounting for staffs’ psychosocial intervention use within long-stay care. Interview data were collected from participants in nine Irish long-stay settings: 14 residents with dementia, 19 staff nurses, one clinical facilitator, seven nurse managers, 21 nursing assistants, and five relatives. Constant comparative method guided the data collection and analysis. The researcher’s theoretical memos, based on unstructured observation, and applicable extant literature were also included as data. By identifying the mutuality of the participants’ experiences, this classic grounded theory explains staff motivation toward psychosocial intervention use within long-stay care. It also explains how institutional factors interact with those personal factors that incline individuals toward psychosocial intervention use. [ABSTRACT FROM AUTHOR]

Evidence suggests that empowerment is central to improving the effectiveness and quality of mental health care. Empowerment includes increased involvement, choice and access to health information for service users. Within the process of empowerment, individuals may better understand their health needs and accordingly improve their prognoses. Despite the widespread use of the term 'empowerment' within mental health, there have been no studies examining how young people with psychosis understand and conceptualize the term empowerment or which factors are conductive to them developing a sense of empowerment. This study aims to qualitatively conceptualize empowerment from the perspective of young people aged 14-18 years experiencing psychosis. Individual interviews were conducted with nine young people with a diagnosis of a psychotic disorder regarding their understanding and experience of empowerment. The interviews were audiotaped, transcribed verbatim and analysed using interpretative phenomenological analysis. Results indicated that young people who have experienced psychosis conceptualized empowerment as being listened to, being understood, taking control and making decisions for themselves. Young people place high importance on experiencing personal empowerment in relation to being users of mental health services and regard being empowered as the most important factor for determining their own recovery. Results also revealed that young people view mental health workers as very variable in their ability and willingness to address and help facilitate empowerment. They also identified daily routine, structure and avoidance of inactivity as additional means of increasing empowerment. The implications for research and practice are discussed. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message The way practitioners interact with young people impacts upon their experience of empowerment., Young people with psychosis equate being listened to with being empowered., Young people with psychosis, especially when hospitalized, want to develop and use their own coping styles., Clinicians who give choices and have a sense of humour are valued by young people with psychosis., Clinicians must consider whose needs are being met when decisions are made for young people with psychosis. [ABSTRACT FROM AUTHOR]