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A new assessment scheme--the Short-Term Assessment of Risk and Treatability (START)-- presents a workable method for assessing risks to self and others encountered in mentally and personality disordered clients. This study aimed to demonstrate (a) prevalence and severity of risk behaviors measured by the START, (b) psychometric properties of START, (c) similarities and differences in START scores across different mental health professionals, and (d) concurrent validity of START with diverse negative outcomes. Treatment team members completed the 20-item, dynamically focused START for 137 forensic psychiatric inpatients. Prevalence and severity of START risk domains were measured for 51 patients detained in the hospital for 1 year. Results revealed high rates of generally low-level adverse events. With some exceptions, START scores were meaningfully associated with outcomes measured by a modified Overt Aggression Scale. (Contains 8 notes and 7 tables.)

Introduction: Self‐management support for schizophrenia has become expected practice leaving organisations to find ways for feasible implementation. Self‐management support involves a foundational cultural shift for traditional disease‐based services, new ways of clients‐providers working together, coupled with delivering a portfolio of tools and techniques. A new model of self‐management support embedded into traditional case management services, called SET for Health (Self‐management Engaging Together for Health), was designed and tailored to make such services meaningfully accessible to clients of a tertiary care centre. This paper describes the proof of concept demonstration efforts, the successes/challenges, and initial organisational changes. Method: An integrated knowledge translation approach was selected as a means to foster organisational change grounded in users' daily realities. Piloting the model in two community case management programmes, we asked two questions: Can a model of self‐management support be embedded in existing case management and delivered within routine specialised mental health services? What organisational changes support implementation? Results: Fifty‐one clients were enroled. Indicators of feasible delivery included 72.5% completion of self‐management plans in a diverse sample, exceeding the 44% set minimum; and an attrition rate of 21.6%, less than 51% set maximum. Through an iterative evaluation process, the innovation evolved to a targeted hybrid approach revolving around client goals and a core set of co‐created reference tools, supplemental tools and resources. Operationalisation by use of tools was implemented to create spaces for client‐provider collaborations. Monitoring of organisational changes identified realignment of practices. Changes were made to procedures and operations to further spread and sustain the model. Conclusion: This study demonstrated how self‐management support can be implemented, within existing resources, for routine delivery of specialised services for individuals living with schizophrenia. The model holds promise as a hybrid option for supporting clients to manage their own health and wellness. [ABSTRACT FROM AUTHOR]

Introduction: This article describes the planning and development of a novel self‐management support protocol, self‐management engaging together (SET) for Health, purposefully designed and embedded within traditional case management services to be accessible to people living with schizophrenia and comorbidities. Drawing on established self‐management principles, SET for Health was codesigned by researchers, healthcare providers and clients, to create a practical and meaningful intervention to support the target group to manage their own health and wellness. Decision making is described behind tailoring the self‐management innovation to meet the needs of an at risk, disadvantaged group served by tertiary, public health care in Canada. Method: This integrated knowledge translation (IKT) study used a descriptive approach to document the process of planning and operationalizing the SET for Health intervention as a part of routine care in two community‐based teams providing predominantly schizophrenia services. Diffusion of innovations literature informed planning. The setting was strategically prepared for organizational change. A situational assessment and theoretical frameworks identified contextual elements to be addressed. Existing established self‐management approaches for mental illness were appraised. Results: When a review of established approaches revealed incongruence with the aims and context of service delivery, common essential elements were distilled. To facilitate collaborative client–provider self‐management conversations and self‐management learning opportunities, core components were operationalized by the use of tailored interactive tools. The materials coproduced by clients and providers offered joint reference tools, foundational for capacity‐building and recognition of progress. Conclusion: Planning and developing a model of self‐management support for integration into traditional schizophrenia case management services required attention to the complex social ecological nature of the treatment approach and the workplace context. Demonstration of proof of concept is described in a separate paper. [ABSTRACT FROM AUTHOR]

PROBLEM. People with mental illness are twice as likely to smoke than people without a mental illness. METHODS. Data were collected through interviews with individuals who smoke and have been [...]

PROBLEM. To identify factors influencing movement of nurse-patient dyads from Peplau's orientation phase to the working phase of the nurse-client relationship in a tertiary care psychiatric setting. METHODS. Ten nurse-client [...]

Clients' perceptions of continuous support during the transition from hospital to the community have been understudied. The present study evaluated clients' perceptions of the benefits and potential adjustments to the implementation of a transitional discharge model (TDM), an intervention for community integration of clients with mental health issues. A focused ethnography methodology was used to investigate the effectiveness of the TDM. Data were collected using two sets of focus groups which involved 87 clients with mental illness seeking care from nine hospitals across the Province of Ontario, Canada. One focus group was conducted at six months and another at the one‐year time point of the study. Data analysis followed a four‐step ethnographic approach proposed by Leininger (1985) for thematic analysis in qualitative research. Four main themes emerged: (i) clients' perceived benefits of the TDM. These came in the form of reassurance about transitioning from hospitalization to community, reduced feelings of isolation, and enhanced continuity of care and recovery, (ii) TDM for community integration; clients believed that the intervention offered suitable friendships, was a tool for social connectedness, and helped to reduce stigma, (iii) encountered challenges, which included issues with trust, perceiving peer supporters as intruders, issues with communication, and initial fears about discharge and (4) suggestions for improving the TDM, such as, more in‐person interactions, formalizing the TDM and raising awareness about community resources. The TDM implementation may facilitate the transition from hospital to the community by offering social support that enhances recovery. [ABSTRACT FROM AUTHOR]

Research has demonstrated the benefits of mental healthcare interventions that ensure a safe transition of clients throughout the discharge and community integration process. This paper reports on qualitative data from focus groups with health professionals collected as part of a larger a mixed method study designed to examine the effectiveness and sustainability of implementing the transitional discharge model. Data collection involved two sets of focus groups, which were held at six months and one‐year post‐implementation. There were 216 health professional participants from nine (9) hospitals across the Province of Ontario, Canada. Data analysis used a four‐step ethnographic framework by Leininger (1985) to identify descriptors and recurrent and major themes. The study identified four major themes, including healthcare professionals' roles and positive experiences in implementing the transitional discharge model; perceived benefits of the model; challenges to implementing the model; and suggestions for sustaining the model's implementation. Healthcare professionals felt that the implementation of the transitional discharge model has the potential for increasing their awareness of the process of clients' integration, serving as a framework for discharge planning, and reducing hospital readmissions. The study findings may provide healthcare providers with information on pragmatic ways to plan clients' discharge, to bridge the gap between hospital and community care, and to positively impact client health outcomes. [ABSTRACT FROM AUTHOR]

The Health Education and Learning for The Handicapped (HEALTH) program provides sex education to developmentally handicapped persons through group discussion, role-playing, films, and other visual aids. The one-hour group sessions, given over 12-14 weeks with 6-12 participants, discuss body parts, acceptable social behavior, assertiveness, birth control, and sexually transmitted diseases. (Author/VW)

Recommends the use of poster presentation as a vehicle for communicating nursing research. Responsibilities of the agency hosting the conference; Responsibilities of the presenter; Areas to consider in poster presentation.

Although nurses are expected to incorporate research findings into their practice and be accountable for their actions, they often lack support to carry out these professional responsibilities. Below, how a service agency facilitated the linkage between nursing research and practice at a Canadian hospital. [ABSTRACT FROM AUTHOR]

Probes into the confusion in the definition of primary nursing and primary care in the U.S. Advent of the term primary nursing; Medical definition of primary health care and primary nursing; Differences and similarities between the two concepts; Disadvantages of the misinterpretation of the two terms.