Search

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]

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]

Background: Recent policy and service provision recommends a woman-centred approach to maternity care. Midwife-led models of care are seen as one important strategy for enhancing women's choice; a core element of woman-centred care. In the Republic of Ireland, an obstetric consultant-led, midwife-managed service model currently predominates and there is limited exploration of the concept of women centred care from the perspectives of those directly involved; that is, women, midwives, general practitioners and obstetricians. This study considers women's and clinicians' views, experiences and perspectives of woman-centred maternity care in Ireland.Methods: A descriptive qualitative design. Participants (n = 31) were purposively sampled from two geographically distinct maternity units. Interviews were face-to-face or over the telephone, one-to-one or focus groups. A thematic analysis of the interview data was performed.Results: Five major themes representing women's and clinicians' views, experiences and perspectives of women-centred care emerged from the data. These were Protecting Normality, Education and Decision Making, Continuity, Empowerment for Women-Centred Care and Building Capacity for Women-Centred Care. Within these major themes, sub-themes emerged that reflect key elements of women-centred care. These were respect, partnership in decision making, information sharing, educational impact, continuity of service, staff continuity and availability, genuine choice, promoting women's autonomy, individualized care, staff competency and practice organization.Conclusion: Women centred-care, as perceived by participants in this study, is not routinely provided in Ireland and women subscribe to the dominant culture that views safety as paramount. Women-centred care can best be facilitated through continuity of carer and in particular through midwife led models of care; however, there is potential to provide women-centred care within existing labour wards in terms of consistency of care, education of women, common approaches to care across professions and women's choice. To achieve this, however, future research is required to better understand the role of midwife-led care within existing labour ward settings. While a positive view of women-centred care was found; there is still a difference in approach and imbalance of power between the professions. More research is required to consider how these differences impact care provision and how they might be overcome. [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]