Working with Families Affected by Mental Distress: Stakeholders' Perceptions of Mental Health Nurses Educational Needs

Factors associated with attitudes of mental health nurses towards the importance of families in mental health nursing care

Family involvement in mental healthcare is a key ingredient in the recovery of patients with mental illness. Research on the attitudes of mental health nurses regarding family involvement in mental healthcare remains limited. This study aimed to examine factors that affect the attitudes of mental health nurses towards the importance of family involvement in mental health nursing care. A descriptive, correlational study with a cross-sectional design was conducted with 162 mental health nurses at two psychiatric hospitals in Taiwan. Descriptive statistics, independent t-tests, one-way analysis of variance, and stepwise multiple linear regression analyses were applied to analyse data. Mental health nurses generally demonstrated positive attitudes towards incorporating families into nursing care. Older age, more clinical experiences in mental healthcare, and workplace (such as working in chronic psychiatric inpatient wards) were found to be key factors for mental health nurses' attitudes. Particularly, greater competence in working with families and job satisfaction were the most significant factors associated with positive attitudes of mental health nurses towards involving families as important in nursing care. Insight into correlates of mental health nurses' attitudes towards the importance of focusing on families in care is pivotal for targeted interventions to improve nurses' attitudes towards families and, thus, implement family engagement in mental healthcare practices.

Attitudes towards family involvement in nursing care among psychiatric nurses in Hong Kong: A cross-sectional descriptive study

WHAT IS KNOWN ON THE SUBJECT?: Family-involved interventions can result in better outcomes than traditional mental health care for both service users and their families. Nurses' attitudes towards family involvement can affect family participation in care. Earlier studies on psychiatric nurses' attitudes towards family involvement in care report ambiguous findings. Hong Kong's unique integrated cultures may influence Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The majority of psychiatric nurses had positive views on family involvement in care in Hong Kong. Four variables (i.e. gender, clinical experience, nature of working unit and family nursing training) of psychiatric nurses are associated with their attitudes towards family involvement in care in Hong Kong. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Policy makers should develop strategies to increase psychiatric nurses' awareness of the importance of family involvement in patient care. Nurse educators help to design family nursing training to enhance psychiatric nurses' competence in collaborating with families of people suffering from mental disorders.

ABSTRACT

INTRODUCTION: In Hong Kong, involving the family in nursing care is still optional and mainly depends on nurses' attitudes and the willingness of the family. Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care may be influenced by the unique integrated Eastern and Western cultures, however earlier studies report ambiguous findings.

AIMS

This study aimed to assess Hong Kong psychiatric registered nurses' attitudes towards family involvement in care and its associated factors.

METHODS

This study is a cross-sectional descriptive online survey with convenience sampling based on the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) instrument.

RESULTS

Most of the psychiatric nurses had supportive attitudes towards family involvement in care. Females with more clinical experience, working in a rehabilitation-related unit and having attended a family nursing education course were associated with positive attitudes towards family involvement in care.

DISCUSSION

The supportive attitude of psychiatric nurses may be explained by the shift of mental health nursing care from hospital care to community care in recent decades.

IMPLICATIONS FOR PRACTICE

Mental health nurse education and training in Hong Kong could place more emphasis on building family work skills, particularly for newly qualified nurses and those working in acute inpatient settings.

Mental health service engagement with family and carers: what practices are fundamental?

BACKGROUND

Substantial and important benefits flow to all stakeholders, including the service user, when mental health services meaningfully engage with carers and family members. Government policies around the world clearly supports inclusiveness however health service engagement with family and carers remains sporadic, possibly because how best to engage is unclear. A synthesis of currently used surveys, relevant research and audit tools indicates seven core ways that families and carers might be engaged by health services. This study sought to confirm, from the perspective of family and carers, the importance of these seven health service engagement practices.

METHODS

In a mixed method online survey, 134 family members and carers were asked what they received and what they wanted from mental health services. Participants also quantified the importance of each of the seven core practices on a 0-100 point likert scale.

RESULTS

Almost 250 verbatim responses were deductively matched against the seven themes, with additional unaligned responses inductively categorised. The findings triangulate with multiple diverse literatures to confirm seven fundamental engagement practices that carers and family want from health services. Conceptually, the seven practices are represented by two broad overarching practice themes of (i) meeting the needs of the family member and (ii) addressing the needs of the service user.

CONCLUSION

Policy, clinical practice, training and future research might encompass the seven core practices along with consideration of the intertwined relationship of family, carers and the service user suggested by the two broader concepts.

PhotoVoice: An Ideal Methodology for Use within Recovery-Oriented Mental Health Research

At the heart of recovery-orientated mental health care and the Patient and Public Involvement (PPI) movement, is the inclusion of experts by experience as collaborators on mental health research projects. However, embedding Public and Patient Involvement (PPI) can be challenging in academic institutions that have long-standing researcher-as-expert structures in place. PhotoVoice is a collaborative, participant-centric community-based methodology that has potential to overcome some of the challenges encountered within Public and Patient Involvement (PPI). This discursive paper describes what PhotoVoice is, why it was developed, it's application in research and its alignment to recovery principles. Thereby arguing that PhotoVoice is an ideal methodology for use within recovery-orientated research.

Nurses' attitudes facing the family involvment in caring for people with mental disorder

OBJECTIVE

To characterize the attitudes of Primary Health Care nurses, regarding the involvement of the family in the care for people with Mental Disorder.

METHODS

Correlational study with 257 nurses from the city of São Paulo. The scale "Importance of Families in Nursing Care- Nurses' Attitudes" was used. For the analysis, descriptive and inferential statistics were used.

RESULTS

The scale scores were high, with a mean value of 82.1 (SD=8.4) favorable to the families' involvement, and are related to being a nurse in the Family Health Strategy (p<0.001), having received education/training in family nursing (p<0.005), the workload of 40 hours/week (p<0.005), working in the West, East and Center Regions (p<0.005).

CONCLUSION

Most nurses have positive attitudes towards the involvement of families, a relevant indicator for their inclusion in the health-mental care process.

Outcomes of Consumer Involvement in Mental Health Nursing Education: An Integrative Review

This integrative review analyzed the research on consumer involvement in mental health nursing education in the last decade. We aimed to derive the main contents, methods, and outcomes of education using consumer involvement for mental health nursing students. We searched six electronic databases using English and Korean search terms; two authors independently reviewed the 14 studies that met the selection criteria. Studies on the topic were concentrated in Australia and some European countries; most of them used a qualitative design. The main education subject was recovery, and consumers tended to actively participate in education planning. Moreover, students’ perceptions about education using consumer involvement and people with mental health problems changed positively, as well as their experiences of participating in mental health nursing education. There is a lack of interest in the topic in Asian countries, including Korea. Thus, future studies in Asian countries are needed to conduct qualitative and in-depth explorations of students’ experiences regarding an educational intervention that uses consumer involvement as a tool rigorously designed for mental health nursing education. Consumer involvement can be an innovative strategy to produce high-quality mental health nurses by minimizing the gap between theory and practice in the undergraduate program.

"Waiting in the Wings"-Next-of-Kin's Experiences of Lifestyle Interventions for People with Schizophrenia

People with schizophrenia have an increased risk of experiencing physical ill health and thus risk premature death. It is important to gain knowledge about the next-of-kin's experiences of lifestyle interventions in order to increase the understanding of the development of health promotion. This study aimed to describe the experiences of next-of-kin of lifestyle interventions for people with schizophrenia. Ten next-of-kin to people diagnosed with schizophrenia were interviewed and content analysis was used to analyze the data. Three categories emerged in the analysis: Low prioritization of physical health, Patients' needs for motivational support and Next-of-kin's' limited and distant participation. Mental health nurses need a holistic view of human beings and to include the patients' physical health and the role of the family in their responsibilities. Further studies are needed that focus on the views of the next-of-kin and the staff from the mental health services about the care and support needs for promoting physical health in this patient group.

Importance of families in nursing care for people with mental disorders: attitudes of Portuguese and Brazilian nurses

OBJECTIVE

To characterize and compare the attitudes of nurses working in primary healthcare on the importance of involving the families of people with mental disorders in nursing care.

METHOD

A cross-sectional study carried out in the cities of Porto (Portugal) and São Paulo (Brazil). Data was collected in 2018 using the "The Importance of Families in Nursing Care - Nurses' Attitudes" scale.

RESULTS

There were 250 Portuguese and 250 Brazilian nurses who participated. The total average score on the scale was 86.0 in Portugal and 82.1 in Brazil (with a maximum possible of 104). The variables which influence a more favorable attitude towards the involvement of families in nursing care in the Portuguese context are academic qualifications and age, while in Brazil they are training on Family Nursing and the weekly workload.

CONCLUSION

Participants in both countries have a positive attitude towards families, which constitutes a first step towards their integration in nursing care and also enables advances in mental health politics.

Factors Associated With Primary Family Caregivers' Perceptions on Quality of Family-Centered Care in Mental Health Practice

PURPOSE

This study aimed to examine the quality of family-centered care perceived by primary family caregivers and its influencing factors in mental healthcare practice.

DESIGN

A cross-sectional, correlational study.

METHODS

A convenience sample of 121 mental health nurses and 164 primary family caregivers of patients with schizophrenia was recruited from acute psychiatric wards and chronic psychiatric rehabilitation wards in three psychiatric hospitals in Taiwan. Structured questionnaires for mental health nurses were designed to examine nurses' attitudes toward schizophrenia and the importance of families in nursing care. Primary family caregivers were assessed to determine their perceptions of quality of family-centered care. At least one primary family caregiver of patients was matched to a nurse who took major responsibility for the patient during the hospitalization. Data were analyzed with descriptive statistics, Pearson's product-moment correlations, independent t-test, one-way analysis of variance, and stepwise regression analyses.

RESULTS

Quality of family-centered care perceived by primary family caregivers regarding the provision of general and specific information, as compared to enabling and partnership, coordinated and comprehensive care, and respectful and supportive care, was relatively inadequate. Younger and more educated primary family caregivers, having relatives with schizophrenia in acute wards, less supportive nurses' attitudes toward schizophrenia, and the importance of family in nursing care were correlated with poor primary family caregivers' perceptions of quality of family-centered care. Nurses' supportive attitudes toward schizophrenia and chronic psychiatric rehabilitation wards where patients received care were key factors in determining better quality of family-centered care.

CONCLUSIONS

Findings provide a platform for the development of effective continuing education and training programs to equip mental health nurses with supportive attitudes toward mental illness and an integration of the family in nursing care, which will ultimately improve mental health care for families experiencing mental health problems.

CLINICAL RELEVANCE

Efforts in professional training to address stigma and encourage a family-centered approach into recovery-oriented practice for practicing mental healthcare providers, including mental health nurses, are recommended.

Importance of families in care of individuals with mental disorders: nurses' attitudes

Abstract Objectives: To characterize the attitudes of nurses working in primary health care on the importance of involving families in nursing care to the person with mental disorder. Method: A cross - sectional descriptive study with a quantitative approach performed with 328 nurses who work in primary health care in Porto, Portugal. Families Importance in Nursing Care - Nurses Attitudes (FINC-NA) scale was applied. Results: Scale scores were elevated, mean value was 85.9 (Maximum possible 104). The significant correlations were with the variables: academic qualifications (p = 0.001), specialization (p = 0.002) and professional activity context (p = 0.001). Conclusion and implications for practice: Nurses demonstrate a high degree of agreement about the importance of families in nursing care to the person with mental disorder. Positive attitudes of nurses regarding the importance of involving families in care are fundamental to enhance the quality of care in the presence of mental disorder.

Advancing the knowledge, skills and attitudes of mental health nurses working with families and caregivers: A critical review of the literature

Involving and supporting the family members and caregivers of people with mental illness is essential to high-quality mental health services. However, literature suggests that there is a lack of engagement between family members and mental health nurses (MHNs). Lack of knowledge among MHNs is often cited as one of the main reasons for this lack of engagement. The aim of this review was to explore the knowledge, skills and attitudes that are required by MHNs to enable to them to work more effectively with families affected by mental illness. A literature based critical review was used to access and review 35 papers in order to extract concepts that could inform the design of eLearning materials to assist MHNs advance their knowledge in this area. Two overarching themes were identified; 'Mental health problems and the family' and 'Working with the family'. From these themes, the knowledge, skills and attitudes required to work more effectively with families are described. The findings from this review provide a descriptive account of the knowledge skills and attitudes that are required for effective family work. In addition, the review provides an empirical foundation for education programmes in the area.