Nurses' experiences of encountering patients with mental illness in prehospital emergency care - a qualitative interview study

The effects of workplace violence and work-to- family conflict on job engagement of nurses: A multilevel longitudinal research

BackgroundWorkplace violence in hospitals has been a longstanding concern, and in recent years, it has been on the rise. This research specifically examines this issue as it pertains to nurses. The violence they encounter and the work-family conflict (WFC) resulting from the difficulties in their work environment both play roles in diminishing their work engagement.ObjectiveThe aim of this study is to reveal the impact of workplace violence (WV) and WFC on the work engagement (WE) of nurses by conducting a longitudinal research design.MethodsConvenience sampling was used. The study includes 52 nurses working in a private hospital in the province of Kocaeli. Participants were required to fill out daily-level surveys at the conclusion of each workday for continuous period of 5 days. A daily short form of Utrecht Employment Engagement Scale (UWES), daily Work to Family Conflict Scale developed by Netemeyer, Boles & McMurrian in 1996, and Workplace Violence Scale was developed by Chen et al. in 2004 were used to form questionnarie. Cronbach's alpha score for scales across 5 consecutive days ranged from .70 to 0.76. All scales were accepted as reliable.ResultCorrelation results showed that WV and WFC had a significant relation with WE. It is also seen that there is a positive association between WV and WFC. WV and WFC are supported to negatively affect WE of nursesConclusionHealth care institutions should develop practices that will reduce workplace violence and eliminate the causes of workplace violence.

Competence required while caring for people living with mental illness in the ambulance care setting: a Delphi study

BACKGROUND

People living with mental illness form a significant component of individuals presenting to emergency care services. Ambulance care embraces the care and treatment given to people of all ages who have suffered a sudden illness or injury and is carried out twenty-four-seven, regardless of setting and organizational belonging.

AIM

The aim was to explore ambulance clinicians' competence requirements in caring for people living with mental illness.

METHOD

The study had a deductive and explorative design. A Delphi method was adopted using a group of experienced individuals recruited from the emergency care chain and non-governmental organizations (N = 15). An initial open-ended questionnaire was distributed covering three questions about; (1) knowledge, (2) skills and (3) attitudes that ambulance clinicians need to care for people living with mental illness. The informants' answers were analysed using a manifest content analysis ending up in statements designed into a questionnaire that was sent out digitally in two rounds.

RESULTS

The 57 statements that reached consensus could be categorised as referring to knowledge (n = 26), skills (n = 13) and attitude (n = 18).

CONCLUSION

Ambulance clinicians are expected to manage a range of incidents involving people living with mental illness, demanding knowledge of mental illness and the skills of mental health assessment, to ensure ambulance clinicians have the ability and non-judgmental attitude to make appropriate decisions within a caring encounter.

Skills for communicating effectively with people who have mental health issues

Nurses have an important role in providing high-quality care to meet the needs of diverse populations, including people with mental health issues. Developing rapport is essential for engaging with service users and promoting a person-centred approach in the context of mental health care. However, in practice this may not always come naturally to all nurses. In this article, the author discusses several evidence-based methods for effective communication with people who have mental health issues, such as making a good introduction, active listening, using open questions, using silence and being aware of body language. The author also explains how nurses can communicate compassionately, demonstrate cultural sensitivity and develop trust within a therapeutic relationship, thereby enabling them to effectively explore service users' thoughts, feelings and needs.

Navigating oneself through the eyes of the other - meanings of encountering ambulance clinicians while being in a suicidal process

PURPOSE

The suicidal process contains both observable and non-observable phases, and patients have described the process as characterized by loneliness and darkness. Ambulance clinicians encounter patients in all phases of the suicidal process but little is known on what meaning this encounter has to the patients. The aim of this study was to elucidate meanings of encountering ambulance clinicians while being in a suicidal process.

METHODS

Data were collected through fifteen individual interviews with eight participants who had lived experiences of encountering ambulance clinicians. Inductive design using phenomenological hermeneutical approach was used.

FINDINGS

Patients are impacted by the clinicians, both in how they find their value in the situation, but also in expected trajectory. Three themes; 'Being impacted by representatives of society', 'Being unsure of one´s own value' and 'Regaining hope in moments of togetherness' generated the main theme ´Navigating oneself through the eyes of the other´.

CONCLUSION

The way ambulance clinicians communicate impacts how patients navigate themselves in the ambivalence about living or dying, and the encounter either consolidate a feeling of being a burden, or instil hope of an endurable life. Through conversation, clinicians could support the patients in taking the first steps in the journey of recovery.

The effect of acceptance and commitment therapy on work-related rumination and job fatigue of medical emergency and accident management center staff: an experimental study

BACKGROUND

Working in accident management centers and medical emergencies makes employees face psychological tensions and leads to a decrease in their work quality and endangering the lives of patients. Therefore, any solution to reduce their tension will be valuable. This study was conducted to investigate the effect of acceptance and commitment-based therapy (ACT) on work-related rumination and job fatigue among the employees of the Emergency and Medical Accident Management Center of Alborz Province, Iran.

METHODS

This study is an experimental research with intervention and control groups conducted between January 16, 2019, and July 8, 2019. Sixty-four employees were selected based on the entry criteria and randomly assigned to two groups. People in the intervention group participated in 8 sessions of 2-hour therapy based on acceptance and commitment. Questionnaires for demographic information, work-related rumination, and occupational recovery/exhaustion were used to collect data. The intervention was conducted with univariate and multivariate covariance analysis.

RESULTS

The findings showed that the average job fatigue reached 16.78[Formula: see text] 11.44 from 37.06 ± 16.70 in the pre-test with a decrease of 20.28 points. Also, the average of all rumination dimensions related to work decreased in the post-test. The findings showed that the effectiveness of treatment based on acceptance and commitment therapy was confirmed on job fatigue and all its components and all dimensions of work-related rumination (p < 0.05). The partial eta square index was greater than 0.14 in all cases and showed the significant effectiveness of the intervention on all components of work-related rumination and job fatigue.

CONCLUSION

Treatment based on acceptance and commitment reduced rumination and job fatigue. It is recommended to practice this intervention to improve personnel's mental health and the quality of services provided to patients.

CLINICAL TRIAL NUMBER

Not applicable.

Exploration of Nursing Care for Individuals With Bipolar Disorder in a Manic Episode: A Qualitative Study

BACKGROUND

Bipolar disorder is a mental illness that is chronic and has frequent relapses.

OBJECTIVES

The purpose of the research was to study the nursing care of patients with bipolar disorder in the mania phase.

METHODS

A qualitative study was employed in this study. The sample consisted of 10 nurses working in psychiatric clinics and data were collected through semi-structured interviews. Thematic analysis was applied for analysing the data.

RESULTS

Of the 10 participants, 70% were female and 30% were male. The mean age was 48.7 years. All participants were registered nurses and most of them held a Master of Science degree. Their work experience ranged from 10 to 30 years. Three main themes emerged when analysing the data obtained from the interviews with the nurses, those themes were a) Echoes of Vigilance: Navigating the journey, b) Amidst the Tempest: Attending to the Patients' Complex Needs, and c) Restoring Balance: The Nurturing Hands of Bipolar Nursing Care, each of which could be divided into several sub-themes.

CONCLUSIONS

 Nursing care plays an important role in symptom improvement and disease control by providing patient support, managing pharmacotherapy, preventing suicidality, and educating patients about the disease and self-management strategies.

Nursing students' metaphors of first clinical experiences of encountering patients with mental disorders

BACKGROUND

Psychiatric wards are one of the most stressful medical centers. Apprenticeship in mental health can cause feelings of stress and anxiety among nursing students. Investigating nursing students' beliefs about mental illnesses is very important to improve nursing education. The present study aimed to identify nursing students' metaphors for their first clinical experiences of encountering patients with mental disorders.

METHODS

This descriptive qualitative study was conducted on 18 undergraduate nursing students studying in two nursing colleges at Guilan University of Medical Sciences, in the north of Iran, in 2022. The data were collected through semi-structured interviews and analyzed using Critical Metaphor Analysis by the MAXQDA 2007 software.

RESULTS

The analysis of nursing students' metaphors led to the emergence of 36 metaphors and 5 categories. These categories were "experience of dealing with a mental patient is similar to fear mixed with excitement", " patient is similar to an errant human", " psychiatric hospital is similar to a prison", "nurse is similar to a prison guard", and "clinical instructor is similar to a supporter, sympathetic and knowledgeable friend".

CONCLUSIONS

The results showed their negative attitude towards the psychiatric hospital and health care providers. It is suggested that the findings of this study be taken into consideration in the planning of clinical education of nursing students.

Meeting the Needs of Older Adults with Mental Ill-Health in Non-Psychiatric Care Settings: Self-Rated Confidence in Helping and its Co-Variates within a Multiprofessional Study Sample

In this paper we sought to explore health and social care professionals' self-rated confidence in helping older adults with mental ill-health in non-psychiatric care settings. A cross-sectional survey study was performed exploring the participants' (n = 480) confidence in helping. Confidence in helping was analyzed together with background characteristics and selected explanatory variables, such as the workplace and work experience of the participants, their personal experiences of and attitudes to mental ill-health, as well as their knowledge in mental ill-health among older adults, by means of descriptive statistics and logistic regression analysis. We found that approximately half (55%) of the participants were confident in helping older adults with mental ill-health. The odds ratios for being confident in helping were significantly associated to the workplace of the professionals, professionals' attitude to and experience of mental ill-health, and knowledge of mental health among older adults. To increase confidence in helping older adults with mental ill-health, we recommend confidence-building interventions, for example, educational programs, through which knowledge of mental health among older adults is increased and negative attitudes are challenged, especially within the context of specialist somatic healthcare.