Exploring the use of body-worn cameras in acute mental health wards: A qualitative interview study with mental health patients and staff

First responders' experiences with major earthquakes in Türkiye: a qualitative study of innovation needs and challenges

BACKGROUND

The response phase is a phase of disaster management that begins when a disaster occurs. The experience of the First Responders who responded in the first days to the 2023 earthquake in Turkey, which killed more than fifty thousand people, is expected to inform and add value to the preparations for subsequent disasters.

METHODS

A qualitative approach was used; focus group interviews were conducted with 15 first responders (8 fire fighters and 7 medical personnel) that responded in the first moments of the devastating Kahramanmaraş and Hatay earthquakes. The interviews conducted in June 2023. A qualitative approach with the thematic analysis method was employed.

RESULTS

Based on the analyses the research six main themes and 13 subthemes were identified. The identified themes were resources, needs, collaboration, innovation, disaster management and challenges. The participants emphasized the need for better communication tools, protective equipment, and technologies such as drones and advanced sensors to enhance disaster response efforts. The findings also highlight the critical role of collaboration between different organizations and the necessity for integrated disaster management practices and applications. The findings obtained from the views of experienced first responders will inspire national and international disaster crisis managers, policy makers and technology providers to develop more effective disaster response methods. Through technological solutions and better training, the safety and effectiveness of first responders can be significantly improved in future disaster scenarios.

CONCLUSIONS

This study fills an important gap in the literature by investigating the innovation needs and challenges faced by first responders during the 2023 earthquakes in Türkiye. In this study, the gap analysis was determined through interviews conducted with teams that responded to the 2023 major Turkey earthquake in the initial hours following the disaster. These findings are of significant value in guiding the improvement of the approaches and development of technological products in the field of disaster management.

Exploring Nurses' and Nursing Students' Attitudes Toward Coercive and Technological Measures in Mental Health: A Conceptual Framework and Study Protocol

BACKGROUND/OBJECTIVES

The use of coercive measures (CMs) and security technologies (STs) in mental healthcare continues to raise ethical and practical concerns, affecting both patient and staff well-being. Mental health nurses (MHNs) and nursing students (NSs) play a key role in the decision-making process regarding these interventions. However, their attitudes, particularly toward STs, remain underexplored in Italy. This study protocol aims to introduce a new conceptual framework and investigate Italian MHNs' and NSs' attitudes toward CMs and STs in mental health settings. Additionally, it will explore the influence of sociodemographic and psychological factors, including stress, anxiety, depression, stigma, and humanization on these attitudes.

METHODS

The research will be conducted in two phases. Phase 1 involves a national survey of a convenience sample of MHNs and NSs to assess their attitudes and related factors. Phase 2 includes qualitative interviews with a purposive sample of MHNs and NSs to explore participants' perspectives on STs in more depth. Quantitative data will be analyzed using descriptive and inferential statistics, while qualitative data will be examined through thematic analysis.

CONCLUSIONS

This study protocol seeks to enhance our understanding of MHNs' and NSs' attitudes toward the use of CMs and STs in mental health settings, identifying key factors influencing these attitudes. The findings aim to inform policy development, education programs, and clinical practices in both the Italian and international panoramas. Additionally, the proposed conceptual framework could guide future research in this field.

The use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings: a systematic review

BACKGROUND

The use of surveillance technologies is becoming increasingly common in inpatient mental health settings, commonly justified as efforts to improve safety and cost-effectiveness. However, their use has been questioned in light of limited research conducted and the sensitivities, ethical concerns and potential harms of surveillance. This systematic review aims to (1) map how surveillance technologies have been employed in inpatient mental health settings, (2) explore how they are experienced by patients, staff and carers and (3) examine evidence regarding their impact.

METHODS

We searched five academic databases (Embase, MEDLINE, PsycInfo, PubMed and Scopus), one grey literature database (HMIC) and two pre-print servers (medRxiv and PsyArXiv) to identify relevant papers published up to 19/09/2024. We also conducted backwards and forwards citation tracking and contacted experts to identify relevant literature. The Mixed Methods Appraisal Tool assessed quality. Data were synthesised narratively.

RESULTS

Thirty-two studies met the inclusion criteria. They reported on CCTV/video monitoring (n = 13), Vision-Based Patient Monitoring and Management (n = 9), body-worn cameras (n = 6), GPS electronic monitoring (n = 2) and wearable sensors (n = 2). Sixteen papers (50.0%) were low quality, five (15.6%) medium quality and eleven (34.4%) high quality. Nine studies (28.1%) declared a conflict of interest. Qualitative findings indicate patient, staff and carer views of surveillance technologies are mixed and complex. Quantitative findings regarding the impact of surveillance on outcomes such as self-harm, violence, aggression, care quality and cost-effectiveness were inconsistent or weak.

CONCLUSIONS

There is currently insufficient evidence to suggest that surveillance technologies in inpatient mental health settings are achieving their intended outcomes, such as improving safety and reducing costs. The studies were generally of low methodological quality, lacked lived experience involvement, and a substantial proportion (28.1%) declared conflicts of interest. Further independent coproduced research is needed to more comprehensively evaluate the impact of surveillance technologies in inpatient settings. If they are to be implemented, all key stakeholders should be engaged in the development of policies, procedures and best practice guidance to regulate their use, prioritising patients' perspectives.

Improving the Accuracy of mmWave Radar for Ethical Patient Monitoring in Mental Health Settings

Monitoring patient safety in high-risk mental health environments is a challenge for clinical staff. There has been a recent increase in the adoption of contactless sensing solutions for remote patient monitoring. mmWave radar is a technology that has high potential in this field due it its low cost and protection of privacy; however, it is prone to multipath reflections and other sources of environmental noise. This paper discusses some of the challenges in mmWave remote sensing applications for patient safety in mental health wards. In line with these challenges, we propose a novel low-data solution to mitigate the impact of multipath reflections and other sources of noise in mmWave sensing. Our solution uses an unscented Kalman filter for target tracking over time and analyses features of movement to determine whether targets are human or not. We chose a commercial off-the-shelf radar and compared the accuracy and reliability of sensor measurements before and after applying our solution. Our results show a marked decrease in false positives and false negatives during human target tracking, as well as an improvement in spatial location detection in a two-dimensional space. These improvements demonstrate how a simple low-data solution can improve existing mmWave sensors, making them more suitable for patient safety solutions in high-risk environments.

Exploring the use of body worn cameras in acute mental health wards: a mixed-method evaluation of a pilot intervention

BACKGROUND

Body worn cameras (BWC) are mobile audio and video capture devices that can be secured to clothing allowing the wearer to record some of what they see and hear. This technology is being introduced in a range of healthcare settings as part of larger violence reduction strategies aimed at reducing incidents of aggression and violence on inpatient wards, however limited evidence exists to understand if this technology achieves such goals.

AIM

This study aimed to evaluate the implementation of BWCs on two inpatient mental health wards, including the impact on incidents, the acceptability to staff and patients, the sustainability of the resource use and ability to manage the use of BWCs on these wards.

METHODS

The study used a mixed-methods design comparing quantitative measures including ward activity and routinely collected incident data at three time-points before during and after the pilot implementation of BWCs on one acute ward and one psychiatric intensive care unit, alongside pre and post pilot qualitative interviews with patients and staff, analysed using a framework based on the Consolidated Framework for Implementation Research.

RESULTS

Results showed no clear relationship between the use of BWCs and rates or severity of incidents on either ward, with limited impact of using BWCs on levels of incidents. Qualitative findings noted mixed perceptions about the use of BWCs and highlighted the complexity of implementing such technology as a violence reduction method within a busy healthcare setting Furthermore, the qualitative data collected during this pilot period highlighted the potential systemic and contextual factors such as low staffing that may impact on the incident data presented.

CONCLUSION

This study sheds light on the complexities of using such BWCs as a tool for 'maximising safety' on mental health settings. The findings suggest that BWCs have a limited impact on levels of incidents on wards, something that is likely to be largely influenced by the process of implementation as well as a range of contextual factors. As a result, it is likely that while BWCs may see successes in one hospital site this is not guaranteed for another site as such factors will have a considerable impact on efficacy, acceptability, and feasibility.

Implementation of Body Worn Camera: Practical and Ethical Considerations

Body-worn cameras are increasingly being used as a violence prevention tool in inpatient mental health wards. However, there remains a limited understanding of this technology from an implementation perspective, such as protocols and best practice guidance if cameras are to be used in these settings. This study explores the perspectives of patients, mental health staff, and senior management to understand the practical and ethical issues related to the implementation of body-worn cameras. Semi-structured interviews (n = 64) with 24 patients, 25 staff from acute wards, six Mental Health Nursing Directors, and 9 community-based patients were conducted. Interviews were analysed using reflexive thematic analysis. Ethical approval was granted by the Health Research Authority. Findings from this study show that the implementation of BWC in healthcare settings requires careful consideration. The perspectives of patients and staff demonstrate the complex reality of implementation alongside the consideration of practical and ethical issues around implementation that are essential to ensures that wards recognise the need to assess their capacity to use the cameras in a way that is fair and consistent for all involved. The findings further highlight wider questions around power and autonomy in mental health care.

Medical Response to the February 6, 2023, Earthquakes in Hatay: Challenges Faced in the Deadliest Disaster in the History of Türkiye

OBJECTIVE

The Kahramanmaraş earthquakes struck the north-eastern part of Türkiye and Syria on February 6, 2023. It is well known that timely coordination and provision of emergency medical care in the field is particularly important to save lives after earthquakes. This study aimed to identify the challenges faced by medical responders on the ground.

METHODS

This exploratory-descriptive qualitative study was conducted in Hatay, the province most affected by the earthquakes. Data were collected through in-depth semi-structured interviews and field observations, and then analyzed using thematic analysis approach.

RESULTS

The study was carried out with 15 first responders from the medical profession. The study revealed 9 themes of challenges faced by medical responders: providing safety and security, human resources management, meeting personal needs, recording data, communication, patient transport, burial procedures, psychological acumen, and logistical problems. Some problems were resolved after 72 h and some continued until day 7.

CONCLUSIONS

Inadequate organization of volunteer health workers, communication breakdowns, and logistical problems are some of the main challenges. To address these issues, satellite phones and radio systems can be promoted, as well as disaster-resilient logistical planning and better coordination of volunteers.