The Influence of Emotional Intelligence on Psychiatric Nurses' Care Behavior, and the Chain Mediating Role of Compassion Fatigue and Perception of Management

PURPOSE

To investigate psychiatric nurses' emotional intelligence and its effect on care behavior, while also examining the mediating effect of compassion fatigue and perception of management.

METHOD

This cross-sectional study was conducted in several specialized psychiatric hospitals with 360 psychiatric nurses. Self-report surveys were administered, which included the Caring Factor Survey-Caring of Manager, Caring Behaviors Inventory, Compassion Fatigue Short Scale, and Wong Law Emotional Intelligence Scale. Data were analyzed using descriptive, correlation, and path analyses.

RESULTS

Mean score for care behavior was 4.78 (SD = 0.83), which was at a moderate level. Compassion fatigue exhibited negative correlations with other variables. Results of mediation effect analysis showed that emotional intelligence directly predicted care behavior (p < 0.001). Emotional intelligence also indirectly affected care behavior through the mediating roles of perception of management and compassion fatigue, and affected care behavior through the chain mediation effect of perception of management and compassion fatigue.

CONCLUSION

Nurse managers should pay attention to the influence of emotional intelligence on care behavior and improve care behavior by strengthening leadership and alleviating compassion fatigue. [Journal of Psychiatric Nursing and Mental Health Services, 63(2), 35-43.].

Exploring Nurses' Perceptions of Nursing Presence in the Mental Health Setting

BACKGROUND

Nursing presence is a core relational phenomenon in nursing. It is the process of devoting attention to being with and connecting with another, requisite to providing quality, holistic, person-centered care. Presence has been incorporated in the newly revised scope and standards of nursing, as an intervention. There is a paucity of research on the experience of nurses practicing in mental health settings who employ presence to provide unique, relational care.

AIMS

The aim of this research is to understand the lived experience of nurses providing nursing care and engaging with presence in the mental health setting.

METHODS

The tenets of hermeneutic phenomenology proposed by Heidegger and Gadamer were used to guide this inquiry. Twelve nurses practicing mental health were interviewed on Zoom using a semistructured interview guide and the interview time ranged from 45 min to 1 hr. Data were analyzed using the interpretative phenomenological analysis (IPA) process outlined by Smith et al.

RESULTS

Four themes are identified: A powerful intervention which fuels healing, Building the bridge, Transcending barriers, and Preserving the well.

CONCLUSIONS

Nursing presence is implicated as essential to improving the quality of holistic health care, positively impacting patients and nurses. These findings may influence nursing leaders, educators, and administrators to incorporate nursing presence in nursing curricula, develop policies respecting presence, and alter the culture of the health care environment.

The Nursing Practice Environment and Patients' Satisfaction with Nursing Care in a Hospital Context

Nursing, being a profession in health, aims to improve the quality of the response to patients' demands, which have repercussions on the attitudes, behaviors and performance of nurses.

BACKGROUND

The aim of the study was to evaluate the relationships among the nursing practice environment, nurse-patient interactions and patients' satisfaction with nursing care in a hospital context.

METHODS

The study applied a descriptive analysis. Based on the initial exploration of the data, we decided to perform a simple linear regression of the dimensions of the scales.

RESULTS

The latent variables and interactions between the different dimensions of the three constructs (the nursing practice environment (PES-NWI), nurse-patient interactions (NPIS-22-PT) and patients' satisfaction in the hospital context (SAPSNC-18)) were submitted to confirmatory analysis. The model was statistically significant, with a good fit with the data (χ2/gl = 128.6/41 (0.000); GFI = 0.900; AGFI = 0.831; TLI = 0.910; CFI = 0.907; RMSEA = 0.102).

CONCLUSIONS

The study showed favorable rates of overall satisfaction on the part of patients, such as the nurses' skills in dealing with their illness/health situation, ability to solve problems in a timely manner, responsiveness to patients' needs and technical competence.

Validating Psychometric Properties of a Revised Patient Version of the Combined Assessment of Psychiatric Environments (CAPE)

BACKGROUND

Measuring patient experience is an essential challenge in the inpatient behavioral health population.

AIM

This initiative analyzed the psychometric properties of a revised version of the patient Combined Assessment of Psychiatric Environments (p-CAPE-R) survey.

METHODS

The p-CAPE was revised to encompass the interdisciplinary treatment team and implemented on five inpatient psychiatric units at an academic medical center. A psychometric analysis was performed on the p-CAPE-R.

RESULTS

Analysis of factor loadings with a large sample (n = 786) revealed a more coherent item structure under the "staff competency and engagement" and "treatment effectiveness" domains than presented in the original instrument development research.

CONCLUSIONS

Although the p-CAPE-R reflects a more useful and psychometrically sound instrument than the original p-CAPE, further analysis and revision to reflect the entire interdisciplinary team is warranted.

The impact of mindfulness training on supportive communication, emotional intelligence, and human caring among nursing students

PURPOSE

This study was aimed to investigate the impact of mindfulness training on supportive communication and human caring ability among nursing students.

DESIGN AND METHODS

Sixty nursing students were randomly divided into the mindfulness group who accepted 8-week mindfulness training and the control group who attended two 2-h lectures about mindfulness in 8 weeks. All of them completed the Supporting Communication Scale (SCS), Emotional Intelligence Scale (EIS), and Caring Ability Inventory (CAI) before training (T1), after it (T2), and at 3-month follow-up (T3).

FINDINGS

The mindfulness group showed higher scores on SCS, EIS, and CAI than the control group at both T2 and T3, and improvements in emotional intelligence partially mediated the training effects on supportive communication.

PRACTICE IMPLICATIONS

Mindfulness training could be applied to improve the abilities of communication and human caring during nursing education.

Service User and Carer Views and Expectations of Mental Health Nurses: A Systematic Review

Service users' views and expectations of mental health nurses in a UK context were previously reviewed in 2008. The aim of this systematic review is to extend previous research by reviewing international research and work published after the original review. Five databases were searched for studies of any design, published since 2008, that addressed service user and carer views and expectations of mental health nurses. Two reviewers independently completed title and abstract, full-text screening and data extraction. A narrative synthesis was undertaken. We included 49 studies. Most included studies (n = 39, 80%) were qualitative. The importance of the therapeutic relationship and service users being supported in their personal recovery by mental health nurses were core themes identified across included studies. Service users frequently expressed concern about the quality of the therapeutic relationship and indicated that nurses lacked time to spend with them. Carers reported that their concerns were not taken seriously and were often excluded from the care of their relatives. Our critical appraisal identified important sources of bias in included studies. The findings of our review are broadly consistent with previous reviews however the importance of adopting a recovery approach has emerged as a new focus.

Magnitude of patient satisfaction and its associated factors at the outpatient psychiatry service of Dilla university referral hospital, Southern Ethiopia, Dilla, 2020

Background

Patient satisfaction is a subjective attitudinal response of a client to a health institution’s services and a pillar of quality assurance. Patients who are happy with their treatment are much more likely to stick with it, improve quickly, and function normally. Satisfied patients are more compliant, improve faster, and are more functional. However, there haven’t been enough studies conducted across the country, and none have been conducted in this study area. As a result, the purpose of the study was to estimate the size of patient satisfaction and associated determinants at Dilla University Referral Hospital’s psychiatry unit in Dilla, 2020.

Methods

This was a hospital-based cross-sectional study design utilized using a simple random sampling technique. To assess patient satisfaction, we used the 24-item Mental Health Service Satisfaction Scale which was a validated tool in Ethiopia. The link between the outcome and the independent variable was determined using linear regression analysis (P< 0.05).

Result

This study enrolled 409 respondents with a response rate of 97%. The overall mean percentage score of patient satisfaction was 55.4% (95% CI (48.4%– 59.2%). Having bipolar disorder diagnosis [β = -2.93, 95% CI (-4.33, -1.96), p = .000], distance from the hospital [β = -2.34), 95% CI (-3.765, -1.735), P = .001], waiting time [β = -2.19, 95% CI (-3.49, -1.10), p = .000], monthly income (2.95, 95% CI (1.65, 5.23) and Urban residence (β = 1.43, 95% CI (1.03–3.43), p = 0.01) were variables significantly associated with perceived patient satisfaction.

Conclusions and recommendations

In this study, more than half of the respondents scored above the mean percentage score of patient satisfaction. The amount of time spent in the waiting area and the distance traveled to the hospital were identified as variables that could be improved by working with different stakeholders.

What are the core competencies of a mental health nurse? A concept mapping study involving five stakeholder groups

Mental health nurses aim to provide high-quality care that is safe and person-centred. Service users require individualized care, responsive to their preferences, needs, and values. The views of service users, mental health nurses, nurse academics, psychiatrists, and nurse managers about the core competencies of mental health nurses have not been explored. Our study aimed to describe and contrast the views of multiple stakeholder groups on the core competencies of mental health nurses. Concept mapping is a six-step mixed-methods study design that combines qualitative data with principal component analysis to produce a two-dimensional concept map. Forty-eight people participated in the study from five stakeholder groups that included service users and clinicians. The final concept map had eight clusters: assessment and management of risk; understanding recovery principles; person- and family-centred care; good communication skills; knowledge about mental disorders and treatment; evaluating research and promoting physical health; a sense of humour; and physical and psychological interventions. There were important differences in how service users and health professionals ranked the relative importance of the clusters. Service users reported the understanding recovery principles cluster as the most important, whilst health professionals ranked the assessment and management of risk group the most important. There may be a disconnect between what service users and other stakeholders perceive to be the core competencies of mental health nurses. There is a need for more research to examine the differing perspectives of service users and health professionals on the core competencies of mental health nurses.

Developing and validating the nursing presence scale for hospitalized patients

Aim

We developed and psychometrically tested the Nursing Presence Scale.

Background

Nursing presence is a foundation for professional nursing practice; therefore, it is critical to measure this concept.

Introduction

This instrument development study was designed to generate an itemized scale and psychometric testing using a sample of Iranian patients.

Methods

Based on both a concept development and literature review, and finally face and content validity 44-item draft scale was generated. During November 2018–2019, 774 patients were surveyed. Exploratory and confirmatory factor analyses were used to evaluate the scale’s construct validity; concurrent and predictive reliability of the nursing presence scale were also evaluated. We also examine the weighting to scale items.

Results

The analyses yielded a 36-item, 4-factor scale that adequately fit the data. Cronbach’s alpha coefficient for the whole instrument was 0.94. The intra class correlation coefficient was 0.91. Nursing Presence Scale scores were positively correlated with Revised Humane Caring Scale and predicted 25% of missed nursing care.

Conclusion

This 36-item has good reliability and validity, making it useful for measuring the current condition of nursing presence.

Implications for Nursing and Health Policy

Measuring the frequency of nursing presence allows for data-driven planning and upgrading the inpatient care services.

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

BACKGROUND

Nurses working in prehospital emergency care (PEC) encounter patients with all types of health conditions. Increasingly, they are encountering patients suffering from mental illness and this trend reflects the worldwide increase in mental illness. There is very little current knowledge of encounters between nurses and patients with mental illness in 'PEC', especially from the nurses' perspectives.

AIM

The aim of the study is to investigate nurses' experiences of encountering patients with mental illness in 'PEC'.

METHODS

The participants were recruited in a region in southeast Sweden (that covers approximately 5600 km2 and has 300,000 inhabitants). In total, 17 nurses consented to participate. The participants were asked to narrate their individual experience of encountering patients with mental illness. The interviews were transcribed verbatim, then analysed with qualitative content analysis.

RESULTS

The result is presented in terms of three themes and eight sub-themes. The main themes are 'Lacking trust in the patient and one's own abilities', 'Being under internal and external influences' and 'Moving towards a genuine nurse-patient relationship'.

CONCLUSION

The results show that nurses strive to lay the foundation for a trusting relationship. Simultaneously nurses encountering is characterized by a mistrust and it is influenced by pre-understanding and emotions when they take care for patients. The findings could be used to develop nurses' readiness and capability to encounter patients with mental illness and to respond appropriately to the patients somatic and mental care needs.

Psychiatric inpatients' view of the therapeutic environment: A Turkish interview study

PURPOSE

The aim of the study was to determine the feelings, thoughts, and experiences of inpatients in a psychiatric clinic about the therapeutic environment of the clinic.

DESIGN AND METHODS

The data were collected in interviews using the phenomenological method and interpreted using Strauss and Corbin's approach to qualitative data analysis.

FINDINGS

As a result of the data analysis, four themes, "Activities," "Physical Environment," "Personnel," and "Rules" were determined, and each with a number of related subthemes.

PRACTICE IMPLICATIONS

The therapeutic environment is a dynamic space that can be modified according to the needs of the patients. Psychiatric nurses will benefit from responding to the feedback from patients by providing, for example, more activities or additional psychotherapeutic interventions.

Rather a Competent Practitioner than a Compassionate Healer: Patients' Satisfaction with Interactions in Psychiatric Inpatient Care

Interactions with staff are important aspects in patients' experiences of psychiatric inpatient care (PIC). This study aimed to evaluate patients' satisfaction with their interactions with PIC staff and whether sociodemographic factors, depression and anxiety symptoms were associated with their perceptions of these interactions. In this cross-sectional study, we collected data from 84 patients receiving inpatient care in three psychiatric settings in Sweden. The patients' perceptions of interactions with staff and self-reported degrees of depression and anxiety were evaluated through questionnaires. Overall, patients were satisfied with the patient-staff interaction. However, significantly higher scores were related to staffs' practical competence than to their compassion. Older patients reported significantly more satisfaction than younger patients with their most recent meeting with staff. Tailored nursing interventions may improve staff's compassionate capacity. Further research in larger samples is needed to improve our understanding of the factors associated with how patients perceive their interactions with staff.

Correlates of Patient Satisfaction in Psychiatric Inpatient Care: A Survey Study from a Tertiary Hospital in Turkey

In the current study, a questionnaire to evaluate satisfaction levels and related factors upon discharge was completed by 100 patients receiving care for mental illness in a tertiary care hospital in Turkey. The relationships among sociodemographic variables, nonpharmacological interventions, and participants' views about the treatment course and quality of care they received were investigated. Overall satisfaction levels of participants were good. Older participants reported more positive opinions. Involuntary hospitalization, use of restraints/seclusion, or electroconvulsive therapy did not change overall satisfaction. Participants who were hospitalized for the first time were more afraid of other patients, which may imply that this population needs special care from the treatment team. Spending an adequate amount of time and providing necessary information about their treatment plan impact patients' treatment experience positively. [Journal of Psychosocial Nursing and Mental Health Services, 59(4), 38-47.].

Experiences of acute care by persons with mental health problems: An integrative literature review

WHAT IS KNOWN ON THE SUBJECT?: Understanding experiences of acute care by persons with mental health problems is vital for improving these experiences through the development of different parts of the care delivery and its facilities. Literature has extensively addressed experiences of persons with mental health problems in acute care settings. Yet, there is a paucity of studies that aggregate and organize these findings in presenting development-oriented solutions for the improvements of these experiences. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Acute care can be understood through patients' experiences of structure (such as setting, staff and resources); process (such as communication and interpersonal relations); and outcome (such as satisfaction and post-discharge well-being and health) and suggests improvements in these domains. The paper illuminates that previous literature has mainly captured negative experiences of acute care by persons with mental health problems, and suggests diverting the focus to the best practices and to seek inspiration from other fields of research. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Attending to the improvement and development of different parts of the acute care might be an important step in improving experiences of persons with mental health problems. For example, improving resource allocation systems and facilities, emphasizing professionalism in encounters with these patients and systematically assessing patient satisfaction during and after visits are important areas that require attention. ABSTRACT: Aim The provision of acute care to persons with mental health problems is challenging due to difficulties in encountering this group and the vulnerability of these persons. Understanding this group's experiences with acute care is thus an important endeavour. The purpose of this review was to critically and systematically identify and assess previous research on experiences of acute care by persons with mental health problems, guided by Donabedian's structure-process-outcome framework (Prospero ID: CRD42019116652). Method and results An integrative literature review was performed, resulting in the identification of 43 studies. The search was conducted using five electronic databases: Web of Science Core, PubMed, MEDLINE, CINAHL and PsycINFO. Discussion The review revealed that patients experienced structure components such as setting, staff and resources in a predominantly negative way. A predominately negative picture also emerged of the process components, where, for example, communication and interpersonal relations were represented by negative experiences, with limited positive experiences reported. The outcome components, related to patients' satisfaction and their well-being after discharge, were also predominantly experienced negatively. Implications for practice Using Donabedian's framework of structure, process and outcome allowed us to systematize the literature reviewed, to identify the research gaps and to suggest ways forward for the field's development.

Exploration of the factors related to self-efficacy among psychiatric nurses

The average length of hospital stay in the psychiatric ward is longer, and the risk of patient-to-nurse violence is higher than that in other departments. Therefore, psychiatric nurses' work environment may differ from that of other nurses. The factors related to psychiatric nurses' self-efficacy may also differ from those of general workers or other nurses. Mental health care that considers the characteristics of psychiatric nurses requires exploration of self-efficacy unique to psychiatric nurses. This cross-sectional study aimed to explore the distinct factors related to psychiatric nurses' self-efficacy. The developed 24 items related to improvement in self-efficacy and 25 items related to decrease in self-efficacy were examined. The Generalized Self-Efficacy Scale was used to measure the validity of the factors. To extract the factors of self-efficacy, data from 132 nurses and assistant nurses who provided informed consent were analyzed, and the reliability and validity of the factors were calculated. The factors associated with improvement in self-efficacy were "Positive reactions by patients," "Ability to positively change nurse-patient relationship," and "Practicability of appropriate nursing." The factors associated with decrease in self-efficacy were "Uncertainty in psychiatric nursing" and "Nurses' role loss." The Cronbach's α for all factors exceeded .70. Of the five factors, four had significant weak-to-moderate correlations with the Japanese version of the Generalized Self-Efficacy Scale; therefore, the validity was quantitatively confirmed with four factors. Interventions based on these four factors may improve psychiatric nurses' self-efficacy. Additionally, it is possible that this tool assesses the unique facets of self-efficacy rather than psychiatric nurses' general self-efficacy. Interventions to improve psychiatric nurses' self-efficacy based on the characteristics of psychiatry are needed.

Encounters with Persons Who Frequently Use Psychiatric Emergency Services: Healthcare Professionals' Views

Encounters and interactions between healthcare professionals and patients are central in healthcare services and delivery. Encountering persons who frequently use psychiatric emergency services (PES), a complex patient group in a complex context, may be particularly challenging for healthcare professionals. The aim of the study was to explore healthcare professionals’ experiences of such encounters. Data were collected via individual interviews (N = 19) and a focus group interview with healthcare professionals consisting of psychiatric nurses, assistant nurses, and physicians. The data were analyzed with qualitative content analysis. This study focused on the latent content of the interview data to gain a rich understanding of the professionals’ experiences of the encounters. Two themes were identified: “Nurturing the encounter with oneself and colleagues for continuous, professional improvement” and “Striving for a meaningful connection with the patient”. The professionals experienced their encounters with persons who frequently use PES as caring, professional, and humane processes. Prerequisites to those encounters were knowing and understanding oneself, having self-acceptance and self-compassion, and working within person-centered cultures and care environments.

The association of nurse caring behaviours on missed nursing care, adverse patient events and perceived quality of care: A cross-sectional study

AIM

This study evaluated the role of nurse caring in predicting missed nursing care, adverse patient events and the quality of nursing care.

BACKGROUND

Missed nursing care is an issue essential in health care, as it is associated with adverse patient events. While studies have previously examined factors that result in missed nursing care activities and adverse events, the role of nurse caring itself in this context has not yet been explored.

METHODS

A cross-sectional research design was adopted, employing a convenience sample of 549 registered nurses from six hospitals in the Philippines identified between October 2018 and January 2019. Four self-report scales were used in this study as follows: the caring behaviour inventory, the missed nursing care scale, the adverse patient events scale and a single-item scale to measure the quality of nursing care.

RESULTS

Comforting or talking with patients and changing patients' positioning in bed were the most frequently missed care tasks, while patient/family complaints and patient/family verbal abuse were the most frequently reported adverse events. Nurse caring strongly predicted the quality of care, missed nursing care and patient adverse events.

CONCLUSION

Fostering caring behaviours among nurses has a profound effect on nurses' decision to omit or provide nursing care as well as on reducing adverse events and promoting quality nursing care.

IMPLICATIONS FOR NURSING MANAGEMENT

The adoption of strategies to improve caring behaviours among nurses is critically important to prevent or reduce the occurrence of errors and adverse events.