The first clinical practice experiences of psychiatric nursing students: A phenomenological study

Innovative Approaches to Mental Health Education: Standardized Patients and Tag Team Simulation

BACKGROUND

Nursing students often feel unprepared to care for patients with psychiatric diagnoses and alcohol use disorder (AUD), leading to low confidence, with fear and stigma impacting care. Simulation offers a way to build these skills.

PURPOSE

This project assessed the effectiveness of standardized patients and tag team simulation in increasing nursing students' exposure and confidence managing mental healthcare and AUD.

METHODS

A mixed-method pre-post design evaluated student confidence and skills. Students worked in pairs, "tagging" the next pair to continue care. Outcomes measured included the Mental Health Clinical Confidence Scale and student reflections on their simulation experience.

RESULTS

Significant improvements were found in empathy (p = 0.021), assisting with living skills (p = 0.002), and conducting suicide risk assessments (p = 0.002). Reflections emphasized communication, empathy, and self-reflection as essential to confidence.

CONCLUSIONS

Simulation enhances confidence and skills. Research should continue to examine standardized patients and tag team methods in mental health training.

Mental Health of Nursing Students: A Bibliometric Review Based on CiteSpace Visual Analysis

Background: The mental health of nursing students directly affects their future performance, quality of patient care, and personal development. Therefore, an in-depth understanding of research in this area can assist in implementing effective measures to improve the mental health of nursing students. Aim: This study used bibliometric analyses to identify and analyze articles, authors, journals, and research institutes investigating nursing students' mental health in terms of thematic structure and topic evolution, aiming to provide direction and guidance for future research. Methods: In this retrospective bibliometric analysis, data were downloaded from the Web of Science Core Collection on August 15, 2024. Subsequently, CiteSpace software was employed to analyze the annual number of publications and citations, explore relationships between authors, institutions, countries, and keywords, and summarize research hotspots and frontiers in the field of nursing students' mental health. Results: Articles published from database inception to August 15, 2024, were screened, leading to the retrieval of 3803 relevant articles. The United States of America was the leading country in terms of research output on the mental health of nursing students, with 982 (25.79%) published articles, while the United States Department of Health and Human Services provided the most funding. Furthermore, Happell, B was the most productive author in this field, with 80 published papers. Lastly, Nurse Education Today was the most prolific journal in nursing education. Conclusion: The main recent research trends include the psychological profile of nursing students, intervention strategies for improving the mental health of nursing students, and the influence of educational methods, clinical experience, and humanistic care on the mental health of nursing students. These trends imply that researchers should develop targeted training programs, apply information technology, and implement personalized teaching to enhance the psychological resilience of the nursing student population. Moreover, higher education institutions should provide nursing students with more comprehensive and effective mental health support by maintaining mental health files, strengthening mental health education, providing psychological counseling services, and establishing social support systems.

Inclusivity in Practice Education: The Views and Experiences of Nurse Educators Supporting Nursing Students With Mental Health Needs in Mental Health Clinical Placements

AIM

This study aimed to explore the perspectives and experiences of Nursing Practice Supervisors and Assessors, referred to as Nurse Educators, regarding their support for students with mental health needs during mental health clinical placements.

DESIGN

A qualitative survey design was employed to delve into Nurse Educators' views and experiences at two Mental Health Trusts in the Southeast of England, UK.

METHODS

Data were collected using Google Forms to create an anonymous online questionnaire. Thirty-five Nurse Educators, comprising Practice Supervisors and Practice Assessors from two National Health Trusts, providing placements for two universities in the Southeast of England, responded to the survey. Thematic analysis was conducted to interpret the responses.

RESULTS

Factors which facilitated and inhibited Nurse Educators efforts to supporting students' mental health needs during placements were identified. They encompassed personal, professional, and procedural issues which were intricately intertwined to support students with mental health needs. While most Nurse Educators expressed a willingness to support students with mental health needs, challenges regarding the reasonableness of adjustments and their impact on Nurse Educators' practice were widely reported. Recommendations include a review of learning arrangements, guidelines, and policies for students with mental health needs in clinical placements, as well as tailored training of students' inclusive needs for Nurse Educators. No patient or public contribution.

Learning and achieving basic mental health competence in placement studies with the support of a tool: A qualitative study of student nurses' experiences

Background

Learning basic mental health care competence is often challenging for the bachelor of science student nurses, and many lack basic mental health care competence to ensure safe and confident mental health care practice. Mental health assessment is an integrated part of this competence.

Objective

The objective of this study was to explore and describe in depth how student nurses experience learning and achieving basic mental health competence while on mental health placement with the support of a learning tool.

Design

An explorative and descriptive qualitative design was conducted to gain insight on how student nurses experienced learning basic mental health competence when on placement.

Setting

A diversity of mental health placement settings in which student nurses were involved with patient care or welfare were approached; general psychiatric wards (n = 2), psychiatric ward for elderly people (n = 1), community mental health in-patient facilities (n = 2) and unconventional placements in the community (n = 9). Unconventional placements are a diversity of non-clinical service contexts.

Participants

The participants comprised student nurses in their 3rd and final year while on mental health placement. Potential participants received information from course coordinators, the online learning platform, and from teachers in plenary. Using purposive sampling, 14 student nurses were recruited.

Methods

Individual semi-structured interviews were conducted online and in person at two campuses of one university in Norway between August 2020 and December 2021. The interviews were transcribed and thematically analysed as described by Braun and Clarke.

Results

Students expressed insecurity in a new clinical context. They engaged in new learning situations and realized the diversity of nursing practice. Unconventional placements were described as challenging contexts for learning basic mental health care competence.

Conclusions

This qualitative study provided insight into how student nurses experience learning mental health assessment, and gaining relational, communicative, and ethical competence while on placement. Students revealed their insecurities and challenges in learning in a new context. Awareness of clinical learning opportunities on placement when preparing student nurses to learn basic mental health competence may help improve their confidence.

Are pediatric practicum experiences a beneficial component of registered nurse education programs? Nursing students and new graduates weigh in: A qualitative descriptive research study

BACKGROUND

In Canada, the British Columbia College of Nurses and Midwives requires baccalaureate registered nurse education programs to deliver a generalist curriculum meeting entry-level competencies. To fulfill this requirement, nursing programs ensure the provision of practice opportunities for hands-on experience with patients of all ages through practicum. Current literature suggests the limited availability of clinical placement opportunities in pediatric settings. This may reduce the opportunity for nursing students to become acquainted with the unique needs of infants, children, and adolescents as part of their nursing education.

AIM

This study aimed to explore students' and new graduates' experiences of acute and community pediatric clinical practicum as part of their British Columbia nursing education program.

SETTINGS, PARTICIPANTS, AND METHODS

This study utilized a qualitative descriptive approach. Fifteen online semi-structured interviews were conducted with thirteen undergraduate nursing students and two recent graduates. Participants in this study were distributed across the province of British Columbia, representing the North, the Interior, and the Lower Mainland. Data were analyzed using thematic analysis.

RESULTS

The key themes of relational practice and exposure to lived experiences (and their related subthemes) are explored in detail. Both themes encapsulate the importance that nursing students ascribe to the pediatric practicum experience as part of their nursing education.

CONCLUSION

The result of this study deduced that the pediatric practicum experience provided nursing students with learning opportunities they may not get elsewhere such as: building relationships with children, adolescents, and their families within the context of care and developing awareness of the lived experiences of health and illness with each patient encounters. This unique perspective of nursing students may prove valuable for the planning and delivery of clinical learning in nursing education programs.

Challenges Faced by University of Limpopo Learner Nurses during Psychiatry Clinical Exposure: A Qualitative Study

Clinical exposure of learner nurses to psychiatric hospitals is a requirement by the South African Nursing Council. Clinical experience helps learner nurses build cognitive and affective skills, cultural acculturation, and professional identity. The clinical placement also aids nursing learner nurses in making decisions regarding future career paths. The goal of psychiatric nursing practice is to enhance mental and physical health and improve the patient's quality of life and rehabilitation. A qualitative research approach was followed, and a descriptive, explorative, and contextual design was used in this study to explore the challenges faced by University of Limpopo learner nurses during psychiatry clinical exposure. The population included learner nurses from level two to level four who registered for psychiatric nursing science practice. Convenience sampling was adopted. Semi-structured interviews were used to collect data, and the data were analyzed using the Tesch open coding method. Measures to ensure trustworthiness were adhered to, and ethical considerations were observed. The findings of this study indicated that learner nurses go through challenges and discomfort in the form of mental health care users, clinical environment matters, and the attitude of clinical staff in the hospital. Proper preparation of the learner nurses and clinical areas can assist in reducing the challenges that learner nurses go through.

Health-related behaviors and symptoms of anxiety and depression in Spanish nursing students: an observational study

Background

Symptoms of anxiety and depression are prevalent among young adults and are a significant public health issue. College students are at a higher risk of experiencing poor mental health than other young people due to several factors, including moving away from home, financial pressures, heavy workload, poor time management skills, competitivity, new processes of socialization and insufficient coping mechanisms, among others. In addition, nursing students' mental and physical health may also be affected by unhealthy lifestyle habits and health-related behaviors.

Aim

To determine the prevalence of symptoms of depression and anxiety, and the association between these symptoms and health-related behaviors, in a population of Spanish student nurses.

Methods

Cross-sectional study on a sample of 339 nursing students. We used the Hospital Anxiety and Depression Scale, the International Physical Activity Questionnaire-Short form, the Spanish Healthy Eating Index and an "ad hoc" questionnaire for sociodemographic variables. The association between psychological symptoms and health-related behaviors was analyzed through binary logistic regression models.

Results

The prevalence of symptoms of depression and anxiety was 3.8% and 24.5%, respectively. Negative health-related behaviors were frequent, namely tobacco and alcohol consumption, suboptimal physical activity and diet. Moderate physical activity was associated with a lower probability of experiencing depressive symptoms. Symptoms of anxiety were related to a low level of physical activity, an unhealthy diet and alcohol consumption ≥2 times a week.

Conclusion

Student nurses could benefit from the implementation of both physical and mental health promotion initiatives.

Exploring the experience of undergraduate nursing students following placement at psychiatric units in China: A phenomenological study

AIM

To explore undergraduate nursing students' experiences of psychiatric placements.

BACKGROUND

Placement is an important learning phase for undergraduate nursing students and the placement experiences may affect their career choices. However, nursing students' experiences of psychiatric placements have not been fully explored in China.

DESIGN

This study adopted a descriptive, phenomenological design.

METHODS

After psychiatric placement, a semi-structured interview was conducted in June 2022 among 22 final-year undergraduate nursing students using purposive sampling. The data were analysed using Colaizzi's seven-step analysis method.

RESULTS

Five themes were identified: i) destigmatising mental illness; ⅱ) beneficial communication; ⅲ) gaining confidence; iv) disappointment and sadness; and v) fear and discomfort.

CONCLUSION

Nursing students experienced various positive experiences and negative emotions during their psychiatric placement. Further research should explore and validate appropriate educational strategies to optimise students' placement experiences to increase their career interest in psychiatric nursing.

How to prepare nursing students for mental health clinical engagement: a qualitative study

BACKGROUND

Since clinical experience is challenging, identifying the factors influencing the learning process and acquiring clinical competence in mental departments is essential. Limited studies have investigated students' concerns regarding attending this clinical setting and how they are mentally and academically prepared.

AIM/QUESTION

Explaining the various aspects of nursing students' preparation to attend the mental clinical environment.

METHODS

This qualitative study was conducted on bachelorette nursing students and college professors using in-depth, semi-structured interviews. Inductive content analysis was used for data analysis, and Lincoln and Guba's criteria were used for the rigor of the data.

RESULTS

The participants' viewpoints regarding how to prepare nursing students to enter mental clinical settings can be summarized in 4 categories: "understanding the students' concerns" "understanding the students' expectations" "the necessity of the students' mental preparation" and "preparing the scientific materials needed to attend in a mental ward".

CONCLUSION

Nursing students have fears and worries about entering mental departments and have expectations of themselves and their instructors. To help students deal with these concerns, psychological and educational preparations should be provided, among which the role of new educational technologies can be mentioned.

Psychological distress in nursing students: relationship with screen time, diet and physical activity

OBJECTIVE

to determine the prevalence of anxiety and depression symptoms, as well as their association with screen time, diet and physical activity, in a cohort comprised by nursing students.

METHOD

a descriptive and cross-sectional study conducted with a sample of 648 Nursing students. The instruments used were the Hospital Anxiety and Depression Scale, the short version of the International Physical Activity Questionnaire and the Spanish Healthy Eating Index (Índice de Alimentación Saludable Español, IASE). Different multiple linear regression models were performed to analyze the association between anxiety/depression symptoms and screen time, diet and physical activity.

RESULTS

the prevalence values for anxiety and depression symptoms were 24.1% and 3.7%, respectively. Prolonged screen times (>6 hours a day), low levels of physical activity and inadequate diet were independently and significantly associated with deeper psychological symptoms.

CONCLUSION

Nursing students' mental health might benefit from the implementation of initiatives promoting healthy lifestyles.

Psychological distress in nursing students: relationship with screen time, diet and physical activity

OBJECTIVE

to determine the prevalence of anxiety and depression symptoms, as well as their association with screen time, diet and physical activity, in a cohort comprised by nursing students.

METHOD

a descriptive and cross-sectional study conducted with a sample of 648 Nursing students. The instruments used were the Hospital Anxiety and Depression Scale, the short version of the International Physical Activity Questionnaire and the Spanish Healthy Eating Index (Índice de Alimentación Saludable Español, IASE). Different multiple linear regression models were performed to analyze the association between anxiety/depression symptoms and screen time, diet and physical activity.

RESULTS

the prevalence values for anxiety and depression symptoms were 24.1% and 3.7%, respectively. Prolonged screen times (>6 hours a day), low levels of physical activity and inadequate diet were independently and significantly associated with deeper psychological symptoms.

CONCLUSION

Nursing students' mental health might benefit from the implementation of initiatives promoting healthy lifestyles.

Consumer Involvement in Psychiatric Nursing Education: An Analysis of South Korean Students' Experiences

This study examined the experiences of South Korean nursing students in a psychiatric nursing class with consumer involvement. Data on 98 nursing students were collected in June 2021 and analysed using content analysis of participants' journals. Our qualitative study design adheres to the COREQ checklist for qualitative studies. Four main categories and subcategories were identified: (1) reflection, (2) learning, (3) preparation for the future, and (4) requirements. The findings demonstrated that applying consumer involvement to psychiatric nursing education is an innovative and effective strategy to correct negative prejudices among nursing students against people with mental illness.

Exploring Nursing Undergraduates' Experiences with a Redesigned Blended Learning Course: A Descriptive Qualitative Study

AIM

To explore the experience of nursing undergraduates with a blended course, that was redesigned using the Community of Inquiry framework.

DESIGN

The Obstetrics and Gynaecology Nursing Course was redesigned using blended learning pedagogy, which starts from the creation of teaching presence, plays the intermediary role of social presence and aims at realizing cognitive presence.

METHODS

After the course completion, we conducted a qualitative descriptive study and collected data using focus group interviews and field notes.

RESULTS

The findings comprised three main themes including role promotion, passive and selective learning and recommendations. Teachers and peers reportedly played the supervisors, facilitators and coordinators in learning promotion. Some students experienced difficulties in adapting to the blended learning environment due to passive learning habits, character flaws and academic pressure. However, a majority of them supported the application of the model.

Psychiatric care and education understood from a student perspective: Enhancing competences empowering personal and social recovery

BACKGROUND

During the last decades, a recovery-based approach has called for a change in mental health care services. Several programmes have been presented, and the need to develop student and professional competences in education and clinical practice has been documented.

AIM

The aim of this study was to explore how psychiatric care is understood seen from a student perspective (nursing students, masters nurses and a master in applied philosophy) with focus on their personal competences and the educational interventions empowering processes for users' personal and social recovery.

METHOD

A qualitative design with a phenomenological-hermeneutic approach based on the French philosopher Paul Ricoeur's theory of interpretation. Data were collected through semi-structured interviews.

FINDINGS

All interviewees expressed that both theoretically and clinically students did not experience a recovery-oriented approach empowering users' personal and social recovery process. On the contrary, they experienced that both education and practice were dominated by a biomedical approach providing clinical recovery. However, several students were aware of their need of developing personal and relational competences to be able to support the users' personal and social recovery journey. The students expressed that there is a need for educational processes targeting personal competences in 'becoming a professional' supporting 'presentness and awareness' and thereby the development of relational abilities and the courage to engage. The results relate to two nursing schools and two universities.

CONCLUSION

A biomedical approach dominates and makes it difficult to develop students' personal competences during education in practice and theory vital to the development of personal and social recovery-oriented practices. It is recommended that educators-in practice and in school-accentuate presentness, awareness and creativity as crucial relational capabilities and incorporate this in their teaching and supervision method, supporting the education and formation of the students' (and teachers' and supervisors') personal development processes.

Nursing students' beliefs about mental health, interest in work, and job tendencies

PURPOSE

To explore nursing students' mental health educational level, mental illness beliefs, and interest in working in mental health.

DESIGN AND METHODS

Descriptive research conducted with 173 nursing students which convenience sampled. The questionnaire was composed of mental illness beliefs, interest in working in mental health, and tendency to work in nursing areas.

FINDINGS

Main finding demonstarted perception of dangerous from mental illness related to low interest in working in mental health regarding all nursing students.

PRACTICE IMPLICATIONS

There is a necessity to discuss mental health beliefs within theoretical and practical learning as it may eventually can contribute to the quality of care and improve the image of mental healthcare.

Strategies Used to Teach Professional Boundaries Psychiatric Nursing Education

Issues in understanding professional boundaries have been reported amongst student psychiatric nurses. Nursing students are at risk of crossing and violating professional boundaries as they are inexperienced in maintaining therapeutic relationships. Despite these challenges, there was a lack of literature regarding boundary instruction in psychiatric nursing education. Interpretative description was applied as method to answer: What strategies do psychiatric nurse educators utilize to teach professional boundaries to undergraduate students? Eleven educators and nine psychiatric nurses were interviewed. Data was analyzed using an inductive approach. Eight participants also attended a focus group to help refine analysis. Boundary instruction strategies included sharing stories, reflective activities, discussion in clinical settings, role modeling, and role play. Boundary instruction should be incorporated into psychiatric nursing curriculum in a deliberate manner to ensure students are exposed to the topic in meaningful ways throughout their academic career.

Attitude of Iranian medical specialty trainees toward providing health care services to patients with mental disorders

Introduction

The stigma of mental illness has a negative impact on the diagnosis and treatment of these disorders. Considering the high prevalence of mental illness, the attitude of medical specialists toward mental disorders, who are front liners in diagnosing and treating these patients, is critical. Therefore, we examined the attitude of Iranian medical specialty trainees toward providing health care services for patients with mental illness.

Methods

We included 143 residents in the fields that have the most interactions with patients with mental disorders, including internal medicine, surgery, neurology, cardiovascular diseases, and psychiatry. A demographic checklist, as well as the opening minds scale for health care providers stigma assessment questionnaire, was provided, which measures five dimensions of improvement, social responsibility, social distance, exposure, and other (such as risk) in health care providers toward delivering the healthcare services to patients with mental disorders.

Results

The mean score of stigma for mental illness in medical specialty trainees was 61.36 ± 4.83 out of 100. Psychiatric residents have the least stigmatizing attitude (58.38 ± 3.54), and internal medicine and cardiology residents have the highest score, respectively, (62.96 ± 6.05, 62.45 ± 3.80). As for comparing subscales between specialties, only the social responsibility subscale showed a significant difference, with psychiatry having less stigma toward social responsibility (12.93 ± 2.01) than cardiology (15.09 ± 1.50) trainees.

Conclusion

The attitude of medical specialty trainees toward providing health care services for patients with mental illness is not uniform; internal medicine and cardiology residents have more stigmatizing attitude, while psychiatric residents have less stigmatizing attitude. It seems that not every contact could be useful in making a better attitude toward mental illness, but it needs preconditions, like a structured contact that leads to positive outcomes. Anti-stigma interventions are needed to improve the attitude of medical specialty trainees toward providing health care services to patients with mental illness.

Nursing Student Experiences with the Mental Health Population: A Scoping Review of Qualitative and Quantitative Evidence

Nursing students must increasingly deliver quality care to the psychiatric mental health population during their educational experiences and as graduate nurses. This review examines experiences and adds practical knowledge on the development of teaching strategies for nursing programs, supporting nurse educators, future new nurses, and nurse leaders in psychiatric mental health nursing. Fourteen studies from the CINAHL, PsycInfo, Medline, PubMed, and Web of Science databases were included. Two themes emerged: mental health nursing modality experiences and student perspectives. Rigorous scientific studies are needed highlighting the influence and effectiveness of psychiatric-behavioral and mental health nursing clinical education.

The clinical practice experience in psychiatric clinic of nursing students and career intention in China: A qualitative study

BACKGROUND

Nursing students face a lot of complicated situations and problems when they participate in psychiatric clinical practice for the first time. However, the nursing students' internship experience and career intention in psychiatry have not been well described in China.

PURPOSE

This study aims to explore the experience and career intention of Chinese nursing undergraduates during their first psychiatric internship.

METHOD

This is a qualitative design using phenomenological approach. Data were collected through a case-study, semi-structured, two face-to-face in-depth interviews (N = 13) with third-year nursing students from a university in China on their first clinical internship in a psychiatric department. We followed the consolidated criteria for reporting qualitative research (COREQ) checklist.

RESULTS

Four themes were identified: negative stereotype perceptions about mental illness, professional maturation, personal development, attitude towards psychiatric patients and career choice.

CONCLUSIONS

The experience of nursing students in psychiatric clinical practice was constantly changing. This study indicated that nursing students went through a continuous development process of psychiatric care professional maturation and personal development. However, psychiatric nursing was not an ideal career choice of nursing students. This study provides guidance for educators to optimize the internship experience and take comprehensive measures to improve the professional attractiveness and professional identity of psychiatric nursing.

'Working as a Real Nurse': Nursing Students' Experiences of a Clinical Education Ward in Psychiatric Care

Although the concept of clinical education wards has shown encouraging outcomes regarding nursing students' satisfaction with clinical placements in somatic care, the existing research in a psychiatric context is sparse. This study aims to explore nursing students' experience during clinical education at a psychiatric clinical education ward. A qualitive descriptive study with content analysis, using interviews with 16 bachelor's degree nursing students was conducted. The results indicated that an enriched and adapted learning environment focusing on psychiatric nursing with peer learning supported independence and progression into the future nursing role.

What Do Nursing Students Tell Us About Their Communication With People With Mental Illness? A Qualitative Study

BACKGROUND

Communication with individuals with mental disorder (IMDs) may often be a nonlinear, complex, and variable situation. In general, the first contact of nurses with IMDs occurs during training rotations at a psychiatric clinic. Psychiatric nursing students' initial communication experiences with IMDs may be critical to their thinking of psychiatric nursing as a career.

AIM

To determine the communication experiences of psychiatric nursing students with IMDs.

METHOD

A qualitative interview study was conducted with psychiatric nursing students studying at a nursing faculty in the east of Turkey in 2019 who completed the clinical practice. Semistructured interviews were conducted by an independent researcher. The data were analyzed using content analysis with an inductive approach.

RESULTS

In this study, maximum effort was made for data saturation criteria, and data saturation was achieved with 26 students. As a result of the data analysis, four main themes and 11 categories were developed. The main themes were as follows: (1) restrictions caused by psychological barriers, (2) restrictions caused by thinking and perceptions, (3) restrictions caused by personal and behavioral barriers, and (4) effective communication and therapeutic environment.

CONCLUSIONS

In this study, although it is seen that nursing students encounter many communication barriers with IMDs, it is an important development that they implement approaches to provide effective therapeutic communication. The results show the importance of effective nurse-patient communication skills as the first step in improving the clinical practice of nurses in psychiatry clinics.

The relationship between psychiatric nurses' spiritual care practices, perceptions and their competency

PURPOSE

The research aimed to examine the relationship between psychiatric nurses' spiritual care practices, perceptions and competencies.

METHODS

This study was conducted as a descriptive -correlational study. The population of the study consisted of the nurses working at Manisa Mental Health Hospital (N =134). It was intended to contact the whole of the population, and so there was no selection process. Thus, the study sample consisted of 128 nurses, who accepted to participate in the research. Spirituality Spiritual Care Rating Scale used to determine nurses' perceptions spirituality and spiritual care. Spiritual Care Competence Scale was used to evaluate the nurses' spiritual care competence.

RESULTS

Spirituality and Spiritual Care Rating Scale of psychiatric nurses item score mean was 3.93 ± 0.49, the Spiritual Care Competence Scale of psychiatric nurses item score mean was 3.54 ± 0.63. There was no significant relationship between two scales (p > 0.05). As a result of multiple regression analysis, psychiatric nurses' which accounts for only 20.1% of spirituality and spiritual care perceptions of feel incompetent about spiritual care.

CONCLUSION

Psychiatric nurses' perceptions of spiritual and spiritual care were high, but their competence was at a moderete level. There was no a correlation between nurses' perceptions and competencies of spiritual care.

The effect of a peer education program on nursing students' beliefs toward mental illnesses and their career choices

PURPOSE

The aim of this study was to investigate the effect of a peer education program on nursing students' beliefs toward mental illnesses and their career choices. DESIGN AND METHODS: This one-group quasi-experimental study was conducted with 95 undergraduate nursing students.

FINDINGS

The peer education program positively affected nursing students' beliefs toward mental illnesses (p < 0.005). It was determined that the students preferred psychiatric nursing more as a career field after the peer education program. PRACTICE IMPLICATIONS: Peer education programs may be a part of the nursing curriculum in combating stigma toward mental illnesses.

[Understanding the lived experiences of undergraduate nursing students during a mental health practicum. An interpretive phenomenological analysis]

In a global context where populations' mental health needs are growing rapidly, recruiting the next generation of nurses to work in these care settings is particularly problematic. Because of their negative views on mental health issues, nursing students reject such a career path. According to the literature, training programs, particularly clinical immersions, are the main way of mitigating the unpopularity of mental health care among this new generation of nurses. Through an interpretive phenomenological analysis of semi-structured interviews conducted with eleven undergraduate nursing students, this research studied their learning experience during a clinical immersion in mental health care. Anchored in Parse's humanbecoming theory, this study explores the meaning that students attribute to such an experience, the experiential negotiation processes of the practicum setting, and the participants' ability to project themselves beyond the learning experience itself. These results raise various issues related to mental health nursing education, such as the importance of having a nursing role model, as well as various influencing factors related to the rejection of a career in mental health care by the next generation, such as the perception that working in these care settings involves an increased risk of aggression.

Locked versus open ward environments and restrictive measures in acute psychiatry in Greece: Nursing students' attitudes and experiences

PURPOSE

To examine student nurses' attitudes and experiences of door policies and restrictive measures in acute psychiatric care.

METHODS

A mixed-method study with 274 third-year students.

RESULTS

Participants' attitudes towards door locking and other containment measures appeared to be more a matter of custom, practice and tradition at particular units. The therapeutic benefits of open doors was the central organizing element in open units experiences while locked doors appeared to be "invisible" when the locked unit was perceived as a caring environment.

PRACTICAL IMPLICATIONS

Exploring student nurses' attitudes towards crucial and debatable aspects of mental health practice contributes in cultivating a critical and analytical attitude towards the service they provide necessary for supporting a recovery mental health model and building a strong professional identity.

Experiences of nursing students during clinical education in mental health clinics: A phenomenological qualitative study

AIM

Nursing students have both positive and negative experiences during clinical education. This study was conducted to identify experiences of nursing students during clinical education in mental health clinics.

DESIGN

This phenomenological qualitative design study was conducted with 4th year undergraduate nursing students from a university in Turkey to identify their experiences specifically in mental health clinics.

METHODS

The data were collected using focus groups interviews with 40 nursing students and assessed with the 7-stage phenomenological analysis method described by Colaizzi.

RESULTS

Three main themes were determined: (i) the need for supportive interventions to cope with negative emotions; (ii) difficulty in translating theoretical knowledge into practice; and (iii) the lack of role model nurses and teaching staff.

CONCLUSIONS

The results of this study indicate that supportive interventions should be given to nursing students before clinical education. Also, the duration of clinical education, the teaching methods to be used and role model nurses and teaching staff effectiveness in clinical education should be planned carefully.

Associations between health behaviors and mental health in Australian nursing students

AIM

Nursing students experience high levels of stress, anxiety and depression. This study examined associations between health behaviors and stress, anxiety and depression in Australian nursing students.

DESIGN

this was a cross-sectional study.

METHODS

Participants completed an online survey providing demographic information and responses to the 21-item Depression Anxiety Stress Scale, Fagerström Test for Nicotine Dependence, short Food Frequency Questionnaire, Alcohol Use Disorders Identification Test, International Physical Activity Questionnaire and Workforce Sitting Questionnaire. Associations were evaluated using multivariate linear regression.

RESULTS

Mild to extremely severe stress (46.6%), anxiety (52.8%) and depression (42.2%) were prevalent. Intake of snack-foods was associated with higher depression (β = 8.66, p < 0.05) and stress (β = 3.92, p = 0.055) scores. More time spent sitting was associated with higher depression (β = 0.48, p < 0.001) and stress (β = 0.28, p < 0.05) scores. Skipping meals correlated with higher stress, anxiety and depression scores.

CONCLUSION

More support must be provided to nursing students to manage psychological distress and mental health during university study.

Nursing students' perceptions on the use of clinical simulation in psychiatric and mental health nursing by means of objective structured clinical examination (OSCE)

BACKGROUND

In view of the rising incidence and prevalence of mental disorders, and the stigma often attached to persons with these pathologies, the question of specific, appropriate training for nursing students is one of great importance. Objective structured clinical examination (OSCE) and clinical simulation may provide a useful means of introducing the student to this environment.

OBJECTIVES

To examine the perceptions and satisfaction of nursing students after their participation in a targeted mental health course in which the main specialist skills were acquired via clinical simulation.

DESIGN

A quantitative, descriptive, transversal study was conducted, in which the participants in a mental health course completed a questionnaire on their satisfaction with the experience.

PARTICIPANTS

The study population consisted of 141 nursing students enrolled in a mental health course and currently in the third year of their Nursing Degree studies at the University of Málaga (Spain).

RESULTS

The overall satisfaction expressed was more than 8 out of 10 (mean score = 8.43, SD = 1.25) and the students' satisfaction with specific aspects of the procedure exceeded 4 out of 5. The study results show that these nursing students considered the methodology in question to be useful preparation for clinical practice (mean score = 4.78, SD = 0.45), that they appreciated the participation of an expert (mean score = 4.72, SD = 0.60) and that receiving the opinions of their peers about their performance was an enriching part of the experience (mean score = 4.54, SD = 0.64).

CONCLUSIONS

The participants reported a high degree of satisfaction with the OSCE procedure and observed that this method should be implemented more frequently. Debriefing is viewed as a vital contribution to the learning process and to the participants' satisfaction. However, further research is needed to study the impact of stress and anxiety on the acquisition of skills via OSCEs.

'Anyone can have a mental illness': A qualitative inquiry of pre-registration nursing students' experiences of traditional mental health clinical placements

Nurses play a crucial role in mental healthcare provision. Like many countries, Australian nursing students are educated in comprehensive pre-registration programmes which include mental health clinical placements. Placements play a vital role in students' education, providing the opportunity to engage with consumers and develop mental health nursing knowledge and skills. There is limited knowledge of student perspectives on traditional placements in contemporary recovery-oriented mental health services. This interpretive qualitative inquiry aimed to explore nursing students' experience of traditional mental health clinical placement and how it influenced their practice and their understandings of recovery from mental illness. Data were collected from focus groups with n = 31 nursing students in a large metropolitan public mental health service. Thematic analysis resulted in three themes of experience: humanizing people with mental illness; learning about recovery; and shifting perspectives on mental health nursing. Through a positive placement experience where they felt supported and included by staff, students came to see consumers as people rather than diagnoses, developed greater understanding of mental health nursing work and were more likely to consider mental health nursing as a career choice. Peer-support workers were an important influence on students' understandings of recovery and have a key role to play in educating students on placement. Students need to be prepared and supported by university and clinical staff to deal with vicarious trauma that may occur on placement. Mental health placements play a crucial role in attracting students into the field, and it is imperative they remain part of comprehensive pre-registration education.

Peer learning in clinical placements in psychiatry for undergraduate nursing students: preceptors and students' perspective

Aim

To describe the experiences of peer learning in psychiatric inpatient settings during clinical placement of undergraduate nursing students and to highlight the possibility for peer learning in psychiatric outpatient settings.

Design

A qualitative inductive design.

Method

Questionnaires with 14 students and 12 preceptors in inpatient and outpatient care and interviews with one student and one preceptor in outpatient care were analysed with content analysis.

Results

Students and preceptors perceived learning benefits with peer learning. They described how learning increased through exchange of knowledge and how collaboration created security and independence, structured learning activities were appreciated as a learning tool. Incompatibility of students was an issue that could be overcome. Peer learning was perceived to contribute to a secure learning atmosphere, increased self-confidence and to provide a deeper understanding of psychiatric nursing. Peer learning was described as promoting discussion and reflection on practice and preparing nursing students for their future profession.

[The unpopularity of mental health/psychiatry care settings among nursing students: A systematic review]

In every population and country around the world, mental health needs are great and are on the rise. Through their training and their vast field of expertise, nurses are an important lever for addressing the issue of accessibility in these care settings. While the increase in the number of new nursing graduates should have helped this issue, recent data show a sharp increase in the shortage of nurses in these care settings. This systematic review (n=40) using the CINAHL, MEDLINE, PsycArticles, and Scopus databases aims to explore why psychiatric and mental health care settings are unpopular with the next generation of nurses. Guided by Parse's theory, this review identifies three major themes : (1) nursing students' perspectives on mental health issues, (2) the influences of educational interventions on these perspectives, and (3) the factors facilitating and constraining a career in these care settings for new nursing graduates. These results enable a better understanding of what can affect the recruitment of new graduate nurses in mental health/psychiatry, while proposing various levers of intervention to specifically address this issue.

Parenting among mothers exposed to ongoing military conflict in childhood: An exploratory study

Mothers living in areas exposed to ongoing military conflict are at higher risk for psychological difficulties, such as posttraumatic stress disorder, than those not living in such areas. The aim of this two-part exploratory study was twofold. The first aim was to examine differences between mothers who grew up under ongoing military conflict in childhood and mothers who did not grow up in affected areas in terms of their levels of differentiation of self and parental self-efficacy (PSE). The second aim was to identify and describe the parenting experiences of mothers who were exposed to military conflict in childhood. In Part 1 of the study, the sample included 120 mothers (half of whom reported on being exposed to ongoing military conflict in childhood). Findings showed that mothers exposed to ongoing military conflict in childhood reported lower levels of differentiation of self and PSE than their counterparts. In Part 2, 10 mothers who were exposed to ongoing military conflict as children were interviewed about their experience as parents and their PSE. Results indicated that the mothers felt their childhood experiences affected their parenting and PSE negatively, resulting in anxiety, difficulty dealing with stress and sometimes posttraumatic symptoms as well as parental patterns of overprotectiveness, separation anxiety and intergenerational transmission of anxiety. The results highlight the consequences of exposure to ongoing military conflict during childhood on levels of differentiation of self and parenting practices.

Korean Nursing Students' First Experiences of Clinical Practice in Psychiatric Nursing: A Phenomenological Study

Nursing students have a more negative attitude toward psychiatric practice than other practices. In particular, Korean nursing students experience increased pressure during clinical practice in psychiatric nursing due to sociocultural and institutional influences, such as prejudices, fear, and anxiety towards mental illnesses. This study aimed to conduct an investigation on students’ first experiences of clinical practice in psychiatric nursing. Participants were 12 fourth year nursing students in South Korea. The data were collected through semi-structured interviews, and data analysis was done using Colaizzi’s phenomenological method. The students’ experiences of clinical practice in psychiatric nursing could be categorized into emotional fluctuation, burnout, transformation, and growth. The results of this study show that nursing students experienced emotional fluctuation and burnout at the beginning of their clinical practice in psychiatric nursing. At the end of the clinical practice, they experienced transformation and growth. The study suggests that nursing instructors and on-site staff need to interact with nursing students to understand the nature of these first experiences and support them through teaching and field guidance.

Factors associated with the evolution of attitudes towards mental illness in a cohort of nursing students

WHAT IS KNOWN ON THE SUBJECT?: People with mental health difficulties have poorer physical health than the general population. The stigmatizing attitude of health professionals impacts the quality of care for these people. There is a broad background on the effectiveness of activities based on theoretical training, clinical practices or social contact to improve nursing students' attitudes towards people with mental health difficulties. There is an important need to assess whether the benefits identified in the short term are maintained in the longer term. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The positive evolution of attitudes towards mental illness does not last over time. Some students' attitude towards people with a mental health difficulty worsened in the final stage of their training after completing clinical practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is necessary for tutors incorporate an understanding of stigma throughout the degree training and to discuss with the students the emotional aspects experienced during the performance of clinical practices. The design of any anti-stigma intervention must include the factor of "time". ABSTRACT: Introduction The stigma of health professionals is a contributing factor to morbi-mortality among people with mental health difficulties. There is a lack of research on long-term outcomes in nursing students. Objective To identify factors associated with the evolution of stigmatizing attitudes towards mental illness in a cohort of students trained in mental health. Method A prospective observational study of the impact of training in mental health care. Age, gender, stigma, level of previous familiarity with mental illness, self-education by Internet, academic performance and the place where practicums are conducted were evaluated on three occasions over 15 months. Results Academic performance, online consultation and the size or origin of the theoretical group were indicators of better attitudes. The positive evolution of attitudes does not last over time. Discussion Instability over time could be explained by students' experience in the practicum, although the time itself has been identified as a determining factor. Practical implications Further studies should be promoted in academia to assess the content of mental health training and its influence on the evolution of the stigmatizing attitude. It is also necessary to address stigma in small groups, where students with better academic results lead anti-stigma activities.

Individuals With Type 2 Diabetes: An Exploratory Study of Their Experience of Family Relationships and Coping With the Illness

PURPOSE

The purpose of this qualitative study is to explore familial patterns that may be related to type 2 diabetes (T2DM) and to patients' ways of coping with the illness.

METHODS

A purposive sample of 32 Israeli Jewish (n = 12) and Arab (n = 20) individuals with T2DM were recruited from a community population and interviewed about their familial experiences and their illness. Interview data were analyzed using Colaizzi's phenomenological method.

RESULTS

Many participants, particularly from the Arab society, reported familial patterns that suggest fused relationships and emotional cutoff. They described highly close and positive family relationships, on one hand, but demonstrated unwillingness to share their difficulties with their family members, on the other hand. Precipitating stressful or traumatic events and day-to-day stress appeared as leading perceived causes of the illness. Maintaining an appropriate lifestyle, stress reduction, and family support were the main coping strategies with the illness.

CONCLUSIONS

The findings suggest a possible avenue in which fusion with family members and inability to attenuate emotional distress by sharing difficulties with others may contribute to the development of T2DM. Assessment of such family dynamics and ways of coping with stress could lead to more appropriately nuanced treatment for individuals with T2DM and prediabetes.

Undergraduate nursing students' strategies for coping with their first clinical placement: Descriptive survey study

BACKGROUND

Clinical placement is an essential component in academic nursing programs to provide nursing students with an opportunity to apply theoretical knowledge to practice. The first clinical placement can be an extremely stressful experience for some nursing students, which may affect their decision to be a nurse.

OBJECTIVE

The aim of this study was to identify factors and strategies that enable a positive experience of the first clinical placement for first year nursing students.

DESIGN

Mixed methods descriptive survey design.

SETTINGS

The study was conducted in a nursing school at one university in South Australia.

RESPONDENTS

Respondents were all first year undergraduate nursing students at a higher education facility in South Australia.

METHODS

Data collection tool was an online questionnaire including quantitative and qualitative questions. Coping strategies framework informed qualitative analysis.

RESULTS

Respondents identified a range of strategies that had enabled them to positively cope with their first clinical placement experience. Strategies included use of debriefing sessions with their clinical lecturers and seeking-out their friends and family to talk about their first clinical placement experiences. Other strategies included being adequately prepared before the clinical placement, identifying and seeking advice from supportive nursing staff and effective communication between nursing schools and clinical institutions about placement arrangements and expectations.

CONCLUSIONS

It must not be forgotten how stressful first clinical placements are. This experience will leave a lasting impression on students' introduction to the nursing profession. Sharing coping strategies used by nursing students will assist to provide a positive introduction to nursing practice.