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Jay EK, Moxham L, Roberts M, Yousiph T, Robson G, Lewer K, Patterson C. Contributing to 'a sense of purpose' - Evaluating consumer recovery progress after attending a therapeutic-recreation intervention programme: A quantitative analysis. Int J Soc Psychiatry 2024:207640241242024. [PMID: 38605480 DOI: 10.1177/00207640241242024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
INTRODUCTION The recommended objective for mental health plans and policies is the adoption of recovery approaches to mental healthcare. Mental health recovery is no longer defined by symptom resolution but as a journey towards a meaningful life from the consumer's own perspective. Recovery approaches focus on consumers' strengths, feelings of well-being and the achievement of personal goals. Designing recovery-oriented interventions is crucial for supporting people in their personal recovery journey. AIM This study sought to evaluate how attending a recovery-oriented intervention impacts the recovery of attending people living with serious mental illness. METHODS A quasi-experimental approach was utilised to examine changes in self-reported recovery progress in a purposive sample of consumers living with enduring mental illness (N = 105). Recovery progress was evaluated via the Recovery Assessment Scale - Domains and Stages (RAS-DS). Data were collected at entry and exit to a therapeutic recreation programme grounded in principles of recovery-oriented care and social contact theory. Pre-post scores were analysed via a repeated-measures multivariate analysis of variance (RM-MANOVA) per the four RAS-DS recovery domains. RESULTS After attending the therapeutic recreation programme, consumer recovery scores significantly increased in the functional, personal, and social recovery RAS-DS domains as measured by 'Doing Things I Value', 'Looking Forward', and 'Connecting and Belonging' (respectively). No changes were observed to consumers' clinical recovery progress, as assessed via the recovery domain 'Mastering my Illness'. CONCLUSION The results of this study demonstrate that therapeutic recreation camps can provide a recovery-based approach to mental healthcare, with positive effects on the three areas of: a purposeful life; connection and belonging; and optimism and hope. Recovery Camp has been previously identified by the Productivity Commission as having potential person-centred recovery benefits for mental health consumers. The results of this study now establish these benefits as evidence based and can be used to guide mental health practice and policy for the implementation of therapeutic recreation camps for mental health recovery.
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Affiliation(s)
- Elissa-Kate Jay
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | - Lorna Moxham
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | - Michelle Roberts
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | - Taylor Yousiph
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | - Georgia Robson
- Faculty of the Arts, Social Science & Humanities, University of Wollongong, NSW, Australia
| | - Kelly Lewer
- Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
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Moxham L, Tapsell A, Perlman D, Al Mutair A, Al-Sagarat AY, Alsaraireh FA, Chung MH, Jose TT, Kuo SY, Liu MF, Nayak AK, Shamsan A, Sudhakar C, Tsai HT, Velayudhan B, Yang CY, Roberts MM, Yeh PM, Patterson C. Nursing students' attitudes towards mental illness: A multi-national comparison. J Psychiatr Ment Health Nurs 2024. [PMID: 38532682 DOI: 10.1111/jpm.13048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024]
Abstract
Accessible Summary What is known on the subject Health professionals, including nurses, are shown to have stigmatizing attitudes towards mental illness. For nursing students who are in their formative years of professional development, mental illness stigma can severely impact the care they provide. Little research has investigated multi-national comparisons of nursing students' attitudes towards mental illness. What this paper adds to existing knowledge This study shows that between countries, there were substantial differences amongst nursing students in stigmatizing attitudes towards mental illness. Cultural perspectives may explain some of these differences. What are the implications for practice Regardless of location, stigmatizing attitudes are present at varying levels. Each nation can take steps to reduce these by acknowledging the presence of stigmatizing attitudes amongst nurses, educating nurses regarding the negative impacts of stigma on patient outcomes, and decrease stigmatizing attitudes by facilitating opportunities for nurses (particularly student nurses) to have direct contact with people with lived experiences of mental illness. ABSTRACT INTRODUCTION: Stigmatizing attitudes perpetuated by nursing professionals are a pervasive problem for people experiencing mental health issues. This global issue has detrimental consequences; inhibiting one's life chances and help-seeking behaviours. To date, few studies have compared nursing students' attitudes towards mental illness from a multi-national perspective. AIM To compare undergraduate nursing students' attitudes towards mental illness across six countries: Australia, India, Jordan, Saudi Arabia, Taiwan and USA. METHOD In a cross-sectional design, data were collected from undergraduate nursing students (N = 426) using the Social Distance Scale. A one-way analysis of variance was used to compare differences between countries. RESULTS Nursing students' attitudes to mental illness differed between countries. Social Distance Scores were highest amongst nursing students from Jordan and Saudi Arabia. Students from Taiwan and India possessed moderate stigma scores. Social Distance Scores from the USA and Australia were lowest. DISCUSSION Clear differences in stigmatizing attitudes emerged between countries; these are discussed in relation to possible cultural influences. IMPLICATIONS FOR PRACTICE It is suggested that educating nurses, combined with direct contact with people with lived experiences of mental illness, can reduce stigmatizing attitudes regardless of country, location or educational institution.
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Affiliation(s)
- Lorna Moxham
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Amy Tapsell
- University of Sydney Business School, University of Sydney, Sydney, New South Wales, Australia
| | - Dana Perlman
- School of Education, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Abbas Al Mutair
- Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
- College of Health Sciences, University of Sharjah, University City - Sharjah, Sharjah, United Arab Emirates
| | - Ahmad Yahya Al-Sagarat
- Community and Mental Health Nursing Department, Faculty of Nursing, Mutah University, AL-Karak, Jordan
| | - Faris A Alsaraireh
- Community and Mental Health Nursing Department, Faculty of Nursing, Mutah University, AL-Karak, Jordan
| | - Min-Huey Chung
- College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Tessy Treesa Jose
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, India
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Megan F Liu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Asha K Nayak
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, India
| | - Abbas Shamsan
- Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Christopher Sudhakar
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, India
| | - Hsiu-Ting Tsai
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Binil Velayudhan
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, India
| | - Chyn-Yng Yang
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Michelle M Roberts
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Pi-Ming Yeh
- College of Nursing, East Tennessee State University, Johnson City, Tennessee, USA
| | - Christopher Patterson
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Happell B, Gordon S, Hurley J, Foster K, Hazelton M, Lakeman R, Moxham L, Warner T. It takes it out of the textbook: Benefits of and barriers to expert by experience involvement in pre-registration mental health nursing education. J Psychiatr Ment Health Nurs 2024. [PMID: 38509738 DOI: 10.1111/jpm.13042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/22/2023] [Accepted: 02/27/2024] [Indexed: 03/22/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Service user involvement in mental health nursing education is beneficial in terms of attitudinal change to reduce stigma, clinical skill development and enhancing understandings of recovery-oriented practice. Service users as experts by experience have not been embedded within pre-registration nursing programs. Consequently, they remain limited in number, ad hoc and frequently tokenistic. Nurse academics responsible for the design and delivery of pre-registration mental health nursing curricula have a potentially important role in facilitating expert by experience involvement in mental health nursing education. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE Nurse academics teaching mental health nursing have generally favourable views about the importance of expert by experience involvement. Nurse academics experience significant barriers in supporting the implementation of academic positions for experts by experience, particularly in obtaining funding. The experts by experience could contribute to mental health nursing education does not appear to be clearly understood by nurse academics. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health services aspire to adopt a recovery-oriented approach to practice. Involving experts by experience in mental health nursing education can facilitate increased understanding and appreciation of recovery-oriented practice. Nurse academics could play an important role in supporting the implementation of experts by experience positions in nursing academia. To do so, they require an understanding of the benefits of EBE involvement in academia and the barriers that can be encountered when attempting to facilitate the implementation of such positions. Experts by experience contribute unique expertise, essential to the development of quality mental health services. Conveying this expertise through the educating the future nursing workforce in mental health is essential. ABSTRACT INTRODUCTION: Involving service users in mental health nursing education is ad hoc and minimal, despite growing evidence of its benefits. Insights and experiences of nurse academics teaching mental health to pre-registration students have been underrepresented in the research to date. AIM To seek insights and experiences of nurse academics involved in designing and delivering pre-registration mental health nursing education in Australian universities regarding involving service users in mental health nursing education. METHODS A descriptive qualitative study involving 19 nurse academics from 13 Australian universities, involved in pre-registration mental health nursing education. Data were analysed thematically. RESULTS Participants reported minimal service user involvement. Most sought an increase and identified barriers. Data analysis resulted in five identified themes: (1) value-rich, (2) resource-poor, (3) imperfect processes, (4) 'part, but not all' and (5) unrecognised worth. CONCLUSIONS Increasing meaningful involvement of service-users in mental health nursing education requires support and investment from multiple stakeholders. Nurse academics are crucial stakeholders in understanding the unique expertise service users bring. IMPLICATIONS FOR PRACTICE Service users being central to all aspects of mental health services requires their active participation in the education of health professionals. Nurse academics have an important role in realising this goal.
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Affiliation(s)
- Brenda Happell
- Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
| | - Sarah Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington South, Wellington, New Zealand
| | - John Hurley
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Mike Hazelton
- School of Nursing and Midwifery, College of Medicine, Health and Well-being, University of Newcastle, Callaghan, New South Wales, Australia
- School of Nursing and Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
| | - Richard Lakeman
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Health and Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Terri Warner
- ANU Medical School, Australian National University, Acton, New South Wales, Australia
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Lakeman R, Foster K, Happell B, Hazelton M, Moxham L, Hurley J. Informing the development of a fit-for-purpose mental health nursing curriculum: A survey of mental health nurse academics in Australia. Int J Ment Health Nurs 2024; 33:93-103. [PMID: 37705299 DOI: 10.1111/inm.13226] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/30/2023] [Accepted: 09/03/2023] [Indexed: 09/15/2023]
Abstract
Inadequate mental health nursing content in pre-registration nursing curricula has been the topic of debate and concern since the introduction of comprehensive nursing education in Australia. Government-initiated inquiries and the efforts of mental health professional organizations and leaders have not successfully addressed this problem. The aim of the current study was to garner the perspectives and experiences of mental health nurse academics regarding the adequacy of mental health content in producing graduates able to work effectively in mental health settings and identify barriers and enablers to implementing and sustaining sufficient mental health content in pre-registration programs. A survey was distributed to mental health academics in Australian universities offering pre-registration nursing degrees. In total, 44 complete responses were included in the analysis. The results demonstrated the following: Most participants considered the current mental health content, theory and clinical hours insufficient to prepare graduates for practice in mental health settings. They reported a scarcity of tenured mental health nurse academics to deliver content effectively. Most participants were dissatisfied with the comprehensive approach to nurse education and preferred a double degree (nursing and mental health nursing), or a direct entry mental health nursing program. These findings provide further evidence for the current crisis in mental health nursing education and highlight the need for urgent action. People accessing health services have the right to receive high-quality care from appropriately qualified nurses. The inadequacy of mental health content in these programs effectively denies vulnerable people the standard of care and treatment they should be entitled to.
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Affiliation(s)
- Richard Lakeman
- Faculty of Health, Southern Cross University & School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Kim Foster
- Australian Catholic University, Melbourne, Victoria, Australia
| | - Brenda Happell
- Faculty of Health, Southern Cross University, School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Mike Hazelton
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Lorna Moxham
- University of Wollongong, Wollongong, New South Wales, Australia
| | - John Hurley
- Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
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Patterson C, Roberts M, Yousiph T, Robson G, Lewer K, Jay EK, Moxham L. Connection and recovery in the COVID-19 age: An analysis of changes in goal-setting throughout the pandemic by consumers living with enduring mental illness. Int J Ment Health Nurs 2024; 33:166-174. [PMID: 37743556 DOI: 10.1111/inm.13232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/09/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023]
Abstract
Goal-setting is a tool that empowers consumer recovery. Though the pandemic has affected consumer goal-setting, the nature and extent of this impact have not been examined in a recovery setting. The aim of this study is to assess whether the recovery goals of individuals with serious mental illness changed in association with the COVID-19 pandemic. In this mixed-methods design, data were collected from a purposeful sample of consumers (nTOTAL = 355) aged 19-67 years (MAGE = 44.56, SD = 13.05) attending Recovery Camp, a 5-day therapeutic-recreation programme for individuals living with severe mental illness (e.g., PTSD, schizophrenia). Consumer-set goals were examined across 5 programmes prior to March 2020 (nPRE = 126) and 11 following (nPOST = 229). Goals were set on day one, with attainment self-scored on day five. Chi-squared goodness-of-fit tests compared goal proportions per domain; tests of independence assessed changes in goals pre- and post-pandemic. Six goal domains were identified: Approach-Based Recovery, Avoidance-based Recovery, Novel Physical Activities, Relationships, Health, and Recreation/Relaxation. Irrespective of the pandemic, goal attainment was consistently high across all programmes (86.56%). Approach-based Recovery goals were predominant pre-pandemic, but were significantly reduced post-pandemic (p = 0.040). Goals related to Relationships and Novel Physical Activities took precedence throughout the pandemic. Post-COVID-19, consumer recovery goals reveal increased desire for connection, novelty-seeking, and positive behavioural change.
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Affiliation(s)
- Christopher Patterson
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Michelle Roberts
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Taylor Yousiph
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Georgia Robson
- Faculty of the Arts, Social Science & Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kelly Lewer
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elissa-Kate Jay
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lorna Moxham
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Chatwiriyaphong R, Moxham L, Bosworth R, Kinghorn G. The experience of healthcare professionals implementing recovery-oriented practice in mental health inpatient units: A qualitative evidence synthesis. J Psychiatr Ment Health Nurs 2023. [PMID: 37807633 DOI: 10.1111/jpm.12985] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 08/23/2023] [Accepted: 09/17/2023] [Indexed: 10/10/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The principles of personal recovery are primarily applied in outpatient and community settings as these settings provide continuity of care and recovery-based community programs supporting consumers' recovery journey. A range of healthcare professionals are involved in the care of people within mental health in-patient units, including nurses, psychiatrists, psychologists, occupational therapists and social workers. The integration of recovery-oriented care in mental health inpatient units may be impaired by a lack of confidence among mental health professionals. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Developing hope and a safe place is an integral part of recovery-oriented practice within mental health inpatient units. Instilling connectedness is a relevant recovery principle; however, there may be greater barriers in mental health settings which traditionally prioritise safety and risk mitigation practices to prevent perceived harmful behaviours. Staff workload and inadequate understanding of recovery concepts present challenges to promoting recovery-oriented care in everyday practice. Using strength-based practice is critical in promoting a safe space for consumers by providing psychosocial interventions and person-centred care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The provision of recovery-oriented practice requires adopting a collaborative approach that places a strong emphasis on the involvement of consumers and their families. Empowering mental health professionals to believe that recovery-oriented practice is possible in mental health inpatient units is crucial. Mental health professionals need to create a safe environment and positive relationships through respect and empathy for consumers and their family members. ABSTRACT: Introduction Recovery-oriented practice underpins an individual's personal recovery. Mental health nurses are required to adopt a recovery-oriented approach. Globally, a paucity of literature exists on mental health professionals' experience of recovery-oriented practice in mental health inpatient units. Aim The aim of this synthesis was to explore the experiences of healthcare professionals regarding recovery-oriented care in mental health inpatient units by appraising and synthesising existing qualitative research. Method Three databases, including MEDLINE, PsycINFO and CINAHL were searched between 2000 and 2021. Data were extracted and synthesised using thematic integrative analysis. The quality of included studies was assessed with the CASP Critical Appraisal Checklist. Results Ten qualitative research projects met the inclusion criteria. Four themes were identified (i) developing a safe and hopeful space, (ii) promoting a healing space, (iii) instilling connectedness and (iv) challenges to realising recovery-oriented care. Discussion Mental healthcare professionals perceived the principles of recovery-oriented care to be positive and include: therapeutic space, holistic care and person-centred care. Nevertheless, findings revealed limited knowledge and uncertainty of the recovery concept to be key barriers that may hinder implementation into practice. Implications for Practice Recovery-oriented practice must underpin consumer and family engagement, treatment choices and continuity of care to facilitate consumer's personal recovery.
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Affiliation(s)
- Rinlita Chatwiriyaphong
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi hospital, Mahidol University, Bangkok, Thailand
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Rebecca Bosworth
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Grant Kinghorn
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Patterson C, Roberts M, Perlman D, Moxham L. The Role of Self-Determined Motivation and the Potential for Pre-registration Student Learning: A Comparative Study within a Mental Health Clinical Placement. Issues Ment Health Nurs 2023:1-6. [PMID: 37418704 DOI: 10.1080/01612840.2023.2222829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
Developing therapeutic relationship skills as well as clinical skill confidence is critical for nursing students. While the nursing literature has examined multiple factors that influence student learning, little is known about the role of student motivation in skill development in non-traditional placement settings. Although therapeutic skills and clinical confidence are vital across a variety of contexts, here we focus on its development in mental health settings. The present study aimed to investigate whether the motivational profiles of nursing students varied with the learning associated with developing (1) a therapeutic relationship in mental health and (2) mental health clinical confidence. We examined students' self-determined motivation and skill development within an immersive, work-integrated learning experience. Undergraduate nursing students (n = 279) engaged in five-day mental health clinical placement, "Recovery Camp," as part of their studies. Data were collected via the Work Task Motivation Scale, Therapeutic Relationship Scale and the Mental Health Clinical Confidence Scale. Students were ranked into either high (top-third), moderate (mid-third) or low (bottom-third) motivation-level groups. These groups were compared for differences in Therapeutic Relationship and Mental Health Clinical Confidence scores. Students higher in motivation reported significantly higher therapeutic relationship skills (Positive Collaboration, p < .001; Emotional Difficulties, p < .01). Increased student motivation was also associated with greater clinical confidence compared to each lower-ranked motivation group (p ≤ .05). Our findings show that student motivation plays a meaningful role in pre-registration learning. Non-traditional learning environments may be uniquely placed to influence student motivation and enhance learning outcomes.
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Affiliation(s)
- Christopher Patterson
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Michelle Roberts
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Dana Perlman
- School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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Twist IL, Moxham L, Tillott S, Fernandez R. Experiences of nurse practitioners working during the COVID-19 pandemic: A metasynthesis of qualitative studies. J Am Assoc Nurse Pract 2023; 35:347-356. [PMID: 37141430 DOI: 10.1097/jxx.0000000000000869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/14/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND The impact of the COVID-19 pandemic forced global changes to how nurses practice. Nurse practitioners adjusted their scope, changed how they delivered their service, and worked with limited resources. For some services, patient access was also compromised. OBJECTIVES To synthesize, combine, and present current evidence on the experiences of nurse practitioners working during the COVID-19 pandemic. DATA SOURCES CINAHL, Embase, and MEDLINE electronic databases were used to perform a structured search strategy. CONCLUSION During the COVID-19 pandemic, health care services had to leverage their workforce skills to accelerate COVID-19 identification, treatment, and care. Nurse practitioners rapidly found themselves at the forefront and were concerned about infecting others. They also identified the need for support and were able to adapt to the changing environment. Nurse practitioners also recognized the impact on their well-being. Having insight into nurse practitioner's experiences during the pandemic is valuable for future health care workforce planning. Understanding how they coped will help with critical preparedness and response actions to other health care crises. IMPLICATIONS FOR PRACTICE Having insight into nurse practitioner's experiences during the pandemic is valuable for future health care workforce planning because, as we know, the nurse practitioner workforce is one of the most rapidly growing professions in primary health care. Any future work in this space will help inform future nurse practitioner education and also help by informing critical preparedness and response actions to future health care crises, whether global or local or clinical or nonclinical.
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Affiliation(s)
- Ida Laura Twist
- Faculty of Science, Medicine, and Health-School of Nursing, University of Wollongong, Australia
| | - Lorna Moxham
- Faculty of Science, Medicine, and Health-School of Nursing, University of Wollongong, Australia
| | - Sarah Tillott
- Faculty of Science, Medicine, and Health-School of Nursing, University of Wollongong, Australia
| | - Ritin Fernandez
- School of Nursing and Midwifery, University of Newcastle, Australia
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Moxham L, Thomas T, Curtis E, Mackay M, Pratt H, Livingstone K. Nursing students' attitudes, behaviour, and knowledge toward smoking cessation: Results from a descriptive survey at a regional university. Nurse Educ Today 2023; 125:105798. [PMID: 36933373 DOI: 10.1016/j.nedt.2023.105798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/01/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Smoking is the largest single cause of lifestyle-related preventable morbidity and mortality. Nurses form the largest cohort of health professionals and are strategically placed to implement smoking cessation interventions. However their capacity is underutilised, particularly in rural and remote areas in countries such as Australia where the incidence of smoking in is higher than average and access to healthcare is limited. One strategy to address the underutilisation of nurses in smoking cessation interventions is to include training in the university/college nursing curriculum. To effectively implement this training, it is vital to have an in-depth knowledge of student nurses' attitudes towards smoking including the role of healthcare professionals in smoking cessation, their smoking behaviour and that of their peers, and knowledge regarding smoking cessation techniques and resources. OBJECTIVES Investigate nursing students' attitudes, behaviour, and knowledge towards smoking cessation, determine the impact of demographics and educational experienced on these, and develop recommendations for future research and educational practice. DESIGN Descriptive survey. PARTICIPANTS Non-probability sample of undergraduate nursing students (n = 247) from a regional Australian university. RESULTS Significantly more participants had tried smoking cigarettes than had not (p = 0.026). There were no significant relationships between gender and smoking (p = 0.169) or e-cigarette use (p = 0.200), but a significant relationship was found between age and smoking status where older participants (48-57 years) were more likely to smoke (p < 0.001). Most participants (70 %) were supportive of public health measures to reduce cigarette smoking but felt that they lacked specific knowledge to assist their patients to cease smoking. CONCLUSIONS Within education there needs to be an emphasis on the central role that nurses play in smoking cessation with a greater focus on training nursing students about smoking cessation strategies and resources. There is also a need to ensure that students know it falls within their duty of care to address smoking cessation with patients.
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Affiliation(s)
- Lorna Moxham
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
| | - Tamsin Thomas
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
| | - Elizabeth Curtis
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
| | - Maria Mackay
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
| | - Helen Pratt
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
| | - Kimberley Livingstone
- University of Wollongong, 2 Northfields Avenue, Keiraville, Wollongong, NSW 2500, Australia.
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Jay EK, Patterson C, Fernandez R, Moxham L. Experiences of recovery among adults with a mental illness using visual art methods: A systematic review. J Psychiatr Ment Health Nurs 2023; 30:361-374. [PMID: 36305611 DOI: 10.1111/jpm.12882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/20/2022] [Accepted: 10/18/2022] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Arts-based research is an established and accepted research approach and systematic reviews have been published on this methodology. There are many possible data collection techniques and study designs within arts-based research, which have been implemented but not yet systematically reviewed. Rationales and challenges for arts-based research have covered participants' experiences of being in arts-based studies in health service research. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The main results of this systematic review are that mental health recovery concepts are effectively communicated by visual arts-based research and participation in these studies is progressive and connecting for mental health consumers. This paper adds new knowledge about participants' experiences specifically in visual arts-based studies, where the participants are mental health consumers. The results are significant because they support visual arts-based research in its development and popularity, both as a research approach and as an empowerment intervention. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The results of this systematic review can enhance the fields of qualitative research methods and mental health nursing. Recommendations for professional development can be advanced from consumers' ideas and experiences of recovery reported in this review. Nurse scientists and consumer researchers can take into consideration visual arts-based data collection techniques for use as research and empowerment interventions with mental health consumer participants. ABSTRACT INTRODUCTION: Art creation has been found to be therapeutic to mental health consumers, making the prospect of art creation's conceivable benefits as a mental health research strategy worthy of consideration. AIM This systematic review aims to explore experiences of recovery among adults with a mental illness using visual art methods. METHOD Following a comprehensive database search, 14 suitable studies were identified. These involved adult participants with a formal mental health diagnosis, or who self-identify as having a mental illness. The studies employed arts-based methodologies with participant-created, visual art as their data. Articles underwent data extraction and quality appraisal with the JBI-QARI (Qualitative Assessment and Review Instrument). RESULTS Results were categorised and further aggregated into two synthesised findings according to Joanna Briggs Institute (JBI) guidelines. The synthesised findings are: (1) Creative artmaking enables the use of visual metaphors which can aid expression of feelings, externalisation of identity, and personal learning, and (2) Interpersonal and self-connectedness through inclusion in community, receiving support when needed, and progressing through loss, are beneficial for mental health recovery. DISCUSSION These findings are comparable to those already existing in the literature, and suggest that visual arts-based research methods are as dependable as other qualitative research methods. Additionally, this systematic review reveals that when conducting research studies, there are benefits for mental health consumer participants when visual arts-based methods are used. IMPLICATIONS FOR PRACTICE A visual arts-based research intervention can be concluded to have the effect of an empowerment intervention, as well as being a credible research method.
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Affiliation(s)
- Elissa-Kate Jay
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Christopher Patterson
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Ritin Fernandez
- Australia Centre for Research in Nursing and Health, St George Hospital, Kogarah, New South Wales, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, New South Wales, Australia
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
- JBI Centre of Excellence, University of Wollongong, Wollongong, New South Wales, Australia
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Borah K, Jose TT, Mysore Nagaraj AK, Moxham L. Suicide prevention program (SPP) in South Asian Countries: A protocol for systematic review. F1000Res 2023; 12:425. [PMID: 37484516 PMCID: PMC10362371 DOI: 10.12688/f1000research.132215.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction: Every year, over 700,000 individuals lose their life by suicide and many individuals attempt suicide. Suicide occurs in all age groups and is the fourth major cause of death among 15-29-year-olds globally in 2019. A suicide prevention program (SPP) is a capacity-building program that helps gatekeepers to identify the risk of suicide. The objective of the review is to determine the effectiveness of SPP on the improvement of knowledge, attitude, and gatekeeper behaviour among gatekeepers in South Asian countries so that the number of suicide cases will be reduced among college students in South Asia countries. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) will be followed in this review. This review will include all interventional studies (controlled and uncontrolled) that provided a suicide prevention program to the gatekeepers as an intervention. The full-text articles will be included from the following databases, Scopus, PubMed (MEDLINE), Cochrane, PsycINFO, Web of Science, and CINAHL, published in peer-reviewed, and indexed journals from the date of inception to 2022. A grey literature search and hand-search of reference lists of the included studies will also be done. A search strategy will be developed using keywords and MeSH terms for each database. Cochrane ROB-2 tool, JBI Critical Appraisal Checklist will be used to evaluate the quality of individual studies. Analysis of the data will be done using narrative synthesis. Conclusions: This review will provide information on knowledge, attitude, and gatekeeper behaviour toward suicide prevention in college students and will be helpful for the prevention of suicide. Therefore, the authors plan to publish the review outcome through a peer-reviewed journal. Registration : The review is registered in PROSPERO (CRD42023387020).
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Affiliation(s)
- Kallabi Borah
- Psychiatric Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - Tessy Treesa Jose
- Psychiatric Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - Anil Kumar Mysore Nagaraj
- Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - Lorna Moxham
- Mental Health Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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Sikhosana N, Whitehead D, Moxham L, Karacsony S, Namasivayam P, Fernandez R. Voice of persons with a life-limiting illness in conversation with healthcare professionals: systematic review and meta-synthesis. BMJ Support Palliat Care 2023:spcare-2022-003855. [PMID: 37197891 DOI: 10.1136/spcare-2022-003855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 04/20/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Healthcare organisations are transforming the way care is delivered to people with a life-limiting illness with an increased focus on recognising the voice of the persons experiencing the illness and putting them in the centre of decision-making. However, the clinical practice remains largely based on the views of healthcare professionals and families or carers of the person with the illness. OBJECTIVES To synthesise the best available evidence on the experience of persons living with a life-limiting illness about expressing their voice during communication with healthcare professionals. DESIGN Systematic review and meta-synthesis. DATA SOURCES CINAHL, Embase, Medline, PsycINFO, ProQuest Dissertations and Theses. REVIEW METHODS A structured search was conducted to identify qualitative studies that reported on the experience of persons living with a life-limiting illness. The methodological quality of included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. The review was undertaken using the JBI and PRISMA guidelines. RESULTS The expression of the voice of persons living with a life-limiting illness is influenced by: (1) the uncertain future surrounding illness trajectory and prognosis; (2) what is known from experience, media, family and friends; (3) emotional and psychological factors and (4) control and personal autonomy. CONCLUSIONS In the early stages of a life-limiting illness, the voice of those experiencing the disease is not always audible. Instead, this voice is potentially present but silent and carried and promoted within healthcare professionals' values of accountability, professionalism, respect, altruism, equality, integrity and morality.
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Affiliation(s)
- Nqobile Sikhosana
- School of Nursing | Faculty of Science, Medicine, and Health, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
| | - Dean Whitehead
- School of Nursing and Midwifery, Federation University Australia, Ballarat, Victoria, Australia
| | - Lorna Moxham
- Graduate Research School, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
| | - Sara Karacsony
- School of Nursing and Midwifery, University of Tasmania College of Health and Medicine, Hobart, Tasmania, Australia
| | - Pathmavathy Namasivayam
- School of Nursing and Midwifery, University of Tasmania College of Health and Medicine, Hobart, Tasmania, Australia
| | - Ritin Fernandez
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia
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Yousiph T, Patterson C, Moxham L. Exploring the benefits and challenges of being a consumer educator in nursing education: A scoping review. J Psychiatr Ment Health Nurs 2023. [PMID: 36734153 DOI: 10.1111/jpm.12909] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/12/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
What is known on the subject The mental health needs of individuals are increasing following the COVID-19 pandemic, with a need to focus on the education of nurses to be equipped to respond. Stigma around mental health still exists for nursing students, with the implementation of mental health education by an individual with lived experience having a known positive effect on stigmatizing attitudes. Research on consumer involvement in nursing education identifies that the consumer role is often varied and casual, with no existing review on the consumer experience. What the paper adds to existing knowledge The study emphasizes the importance of consumer involvement in nursing education. Alongside the literature focussing on the student benefits, this review highlights both the benefits of being an educator, and the challenges of being an educator from the consumer's perspective. IMPLICATIONS FOR PRACTICE: The knowledge around the consumer perspective mapped in this review has the potential to impact and transform education protocols for consumer involvement in education. This can maximize on the meaningful contribution that lived experience has within mental health nursing education. This review enforces the need for an awareness of the challenges consumers face in their role as an educator, and highlights the need for further understanding of how to overcome these challenges. There is also an opportunity to capitalize on the benefits identified by consumers in their role within nursing education and sharing their lived experience. ABSTRACT: Introduction While the mental health needs of populations are increasing, the targeted training of mental health professionals, specifically nurses, is required. Stigma surrounding mental health from nursing students exists, highlighting educational gaps. To address this, the involvement of consumers in undergraduate education has resulted in a positive effect on the stigmatizing attitudes of nursing students. There is still a limited understanding, however, of the consumers experience in this process. Aim To explore the experiences of individuals living with mental illness in educating nursing students. Methods The Joanna Brigg's Institute's (JBI) methodology for scoping reviews was used to search CINAHL, Medline, PsychInfo, Web of Science and Scopus including grey literature. The eligibility criteria for participants included individuals (a) diagnosed with a mental illness; (b) over 18 years of age; and (c) who participated in the educating of nursing students surrounding mental health in any context. Articles were only considered that were in the English language, and no time constraint was enforced during the search strategy for article selection. The search yielded 2640 results, of which 26 articles were included. Results Results found two prominent categories, including both benefits and challenges of being the educator from the consumer perspective. The benefits included: (a) the person behind the diagnosis; (b) reciprocal relationships; (c) positive effects on well-being; (d) unique contribution; and (e) purpose in storytelling. Challenges identified included: (a) vulnerability; (b) voyeuristic; (c) lack of preparation; (d) negative effects on well-being; (e) support; (f) not a real consumer; (g) variation of involvement; and (h) acknowledging consumer perspective. Discussion As consumer-led education for mental health nursing curriculum becomes mandated, amplifying the voice of the consumer in nursing education is crucial. While the benefits and challenges voiced by consumers in their involvement in mental health nursing education have been outlined here, further knowledge focussed on the consumer's experience as an educator outside the classroom setting, and in clinical practicum, alongside consumer involvement in specialized mental health education sessions, could aid in transforming consumer involvement. Implications for practice This review offers an incentive for nurse educators to capitalize on the benefits of educating for consumers to promote a meaningful contribution, while also practicing with an awareness of voiced challenges.
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Affiliation(s)
- Taylor Yousiph
- University of Wollongong, Wollongong, New South Wales, Australia
| | | | - Lorna Moxham
- University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia.,Australian Health Services Research Institute (AHSRI), Wollongong, Australia
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14
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Fernandez R, Green H, Hobbs C, Loveday C, Almasi E, Middleton R, Halcomb EJ, Moxham L. Adaption of the Cancer Information Overload Scale for pandemics and assessment of infodemic levels among nurses and midwives. Int J Nurs Pract 2023; 29:e13055. [PMID: 35373425 PMCID: PMC10078180 DOI: 10.1111/ijn.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/09/2021] [Accepted: 03/06/2022] [Indexed: 02/04/2023]
Abstract
AIM This study was conducted in three phases. Phase 1 aimed to adapt the Cancer Information Overload Scale and conduct content validity testing. Phase 2 aimed to conduct factorial validity testing of the scale. Phase 3 aimed to assess information overload and the sources of information used by nurses and midwives to keep up-to-date about COVID-19. DESIGN A cross-sectional survey of nurses and midwives working in a metropolitan Local Health District in Sydney, Australia, was conducted from May to June 2020. METHODS Adaptation of the Cancer Information Overload Scale and content validity of the modified scale (as the Pandemic Information Overload Scale) was undertaken by an expert panel comprising of senior nurses and researchers. Factorial validity and reliability of the Pandemic Information Overload Scale were evaluated using exploratory factor analyses using one subsample of the data. Using the second subsample of the data, information overload and sources of information used by nurses and midwives to keep up-to-date about COVID-19 were examined. RESULTS The Pandemic Information Overload Scale is a reliable and valid instrument for measuring information overload among nurses during a pandemic. Its internal consistency was high (α = 0.81, M = 3.84). CONCLUSION The 8-item PIO scale is a brief, reliable and psychometrically sound instrument for measuring nurses' and midwives' perceptions of information overload during COVID-19. Mean scores across this study indicated that participants were experiencing above average information overload. Implementing strategies to reduce this overload would optimize clinical decision making and promote patient safety.
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Affiliation(s)
- Ritin Fernandez
- Centre for Research in Nursing and Health, St George Hospital, Kogarah, New South Wales.,Centre for Evidence Based Initiatives in Health Care: A Joanna Briggs Centre of Excellence, Wollongong, New South Wales.,School of Nursing, University of Wollongong, Wollongong, New South Wales
| | - Heidi Green
- Centre for Research in Nursing and Health, St George Hospital, Kogarah, New South Wales.,Centre for Evidence Based Initiatives in Health Care: A Joanna Briggs Centre of Excellence, Wollongong, New South Wales
| | | | - Clare Loveday
- St George Hospital, Kogarah, New South Wales, Australia
| | - Elham Almasi
- Sutherland Hospital, Caringbah, New South Wales, Australia
| | - Rebekkah Middleton
- School of Nursing, University of Wollongong, Wollongong, New South Wales
| | | | - Lorna Moxham
- School of Nursing, University of Wollongong, Wollongong, New South Wales
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15
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Astell-Burt T, Hipp JA, Gatersleben B, Adlakha D, Marselle M, Olcoń K, Pappas E, Kondo M, Booth G, Bacon S, Lem M, Francois M, Halcomb E, Moxham L, Davidson P, Feng X. Need and Interest in Nature Prescriptions to Protect Cardiovascular and Mental Health: A Nationally-Representative Study With Insights for Future Randomised Trials. Heart Lung Circ 2023; 32:114-123. [PMID: 36588036 DOI: 10.1016/j.hlc.2022.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/01/2022] [Accepted: 11/05/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE "Nature prescriptions" are increasingly being adopted by health sectors as an adjunct to standard care to attend to health and social needs. We investigated levels of need and interest in nature prescriptions in adults with cardiovascular diseases, psychological distress and concomitants (e.g. physical inactivity, sedentary behaviour, obesity, loneliness, burn-out). METHODS A nationally-representative survey of 3,319 adults across all states and territories of Australia was completed in February 2021 (response 84.0%). Participants were classified across 15 target groups using validated health indicators and surveyed on (1) time and frequency of visits to green and blue spaces (nature spaces), (2) interest in a nature prescription, and (3) potential confounders (e.g. age, income). Analyses were done using weighted logistic regressions. RESULTS The sample was 50.5% female, 52.0% were aged ≥45 years, 15.2% were living alone and 19.3% were born overseas in non-English-speaking countries. Two-thirds of the sample spent 2 hours or more a week in nature, but these levels were generally lower in target groups (e.g. 57.7% in adults with type 2 diabetes). Most participants (81.9%) were interested in a nature prescription, even among those spending fewer than 2 hours a week in nature (76.4%). For example, 2 hours a week or more in nature was lowest among sedentary adults (36.9%) yet interest in nature prescriptions in this group was still high (74.0%). Lower levels of nature contact in target groups was not explained by differences in access to or preference for local nature spaces. CONCLUSIONS High levels of interest in nature prescriptions amid low levels of nature contact in many target health groups provides impetus for developing randomised trials of interventions that enable people to spend more time in nature. These findings can inform intervention co-design processes with a wide range of community stakeholders, end-users in target health groups, and the health professionals who support them.
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Affiliation(s)
- Thomas Astell-Burt
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia.
| | - J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, Center for Geospatial Analytics, NC State University, Raleigh, NC, USA
| | - Birgitta Gatersleben
- Environmental Psychology Research Group, School of Psychology, University of Surrey, Guildford, UK
| | - Deepti Adlakha
- Department of Landscape Architecture and Environmental Planning, Natural Learning Initiative, College of Design, NC State University, Raleigh, NC, USA
| | - Melissa Marselle
- Environmental Psychology Research Group, School of Psychology, University of Surrey, Guildford, UK
| | - Katarzyna Olcoń
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Evangelos Pappas
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Michelle Kondo
- USDA Forest Service, Northern Research Station, Philadelphia Field Station, Philadelphia, PA, USA
| | - Gillian Booth
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Simon Bacon
- Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Ile-de-Montreal, Montreal, Québec, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - Melissa Lem
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Monique Francois
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Lorna Moxham
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia; School of Nursing, University of Wollongong, Wollongong, NSW, Australia; Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Patricia Davidson
- The Vice-Chancellor's Unit (P.M.D.), University of Wollongong, Wollongong, NSW, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; School of Population Health, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia; The George Institute of Global Health, Sydney, NSW, Australia.
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Green H, Fernandez R, Moxham L, MacPhail C. Social capital and wellbeing among Australian adults' during the COVID-19 pandemic: a qualitative study. BMC Public Health 2022; 22:2406. [PMID: 36550458 PMCID: PMC9772589 DOI: 10.1186/s12889-022-14896-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND COVID-19 has created global disruption, with governments across the world taking rapid action to limit the spread of the virus. Physical distancing and lockdowns abruptly changed living conditions for many, posing specific challenges of social isolation and lack of connectedness due to being physically and socially isolated from family and friends. Social capital is the bonding of individuals within a society that facilitates and shapes social interactions. The aim of this study was to qualitatively explore the impact that existing social capital has on Australians' experience of lockdowns during the COVID-19 pandemic and the effect this has had on their wellbeing and quality of life. METHODS Participants from various socioeconomic areas within Australia were purposively selected to participate in semi-structured interviews conducted via videoconferencing or telephone. Inductive thematic analysis of the data was undertaken. RESULTS A total of 20 participants were interviewed ranging in age from 21 to 65 years, including 50% (n = 10) females, 40% (n = 8) males, 5% (n = 1) non-binary and 5% (n = 1) transgender. Three main themes emerged from the analysis of the data: No person is an island; Social engagement; and Loneliness and isolation. Individuals who resided in low socioeconomic areas, those who lived alone and had reduced social support expressed feelings of poorer wellbeing. CONCLUSIONS This study describes the lived-experiences of the influence of the COVID-19 pandemic on Australians' social capital and wellbeing. The findings highlight the need for interventions to increase social support, social cohesion, and social connectedness, especially among Australians from low socioeconomic areas, to enhance their overall wellbeing.
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Affiliation(s)
- Heidi Green
- grid.416398.10000 0004 0417 5393Centre for Research in Nursing and Health, St George Hospital, Kogarah, NSW Australia ,grid.1007.60000 0004 0486 528XCentre for Evidence Based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XSchool of Health and Society, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XIllawarra Health and Medical Research, University of Wollongong, Wollongong, NSW Australia
| | - Ritin Fernandez
- grid.416398.10000 0004 0417 5393Centre for Research in Nursing and Health, St George Hospital, Kogarah, NSW Australia ,grid.1007.60000 0004 0486 528XCentre for Evidence Based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XIllawarra Health and Medical Research, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XSchool of Nursing, University of Wollongong, Wollongong, NSW Australia
| | - Lorna Moxham
- grid.1007.60000 0004 0486 528XCentre for Evidence Based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XIllawarra Health and Medical Research, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XSchool of Nursing, University of Wollongong, Wollongong, NSW Australia
| | - Catherine MacPhail
- grid.1007.60000 0004 0486 528XSchool of Health and Society, University of Wollongong, Wollongong, NSW Australia
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McInnes S, Halcomb E, Ashley C, Kean A, Moxham L, Patterson C. An integrative review of primary health care nurses' mental health knowledge gaps and learning needs. Collegian 2022; 29:540-548. [PMID: 35043041 PMCID: PMC8758997 DOI: 10.1016/j.colegn.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/05/2022]
Abstract
Background The global COVID-19 pandemic has escalated the prevalence of mental illness in the community. While specialist mental health nurses have advanced training and skills in mental health care, supporting mental health is a key role for all nurses. As front-line health care professionals, primary health care (PHC) nurses need to be prepared and confident in managing mental health issues. Aim To critically analyse and synthesise international literature about the knowledge gaps and learning needs of PHC nurses in providing mental health care. Design and methods An integrative review. The quality of papers was assessed using the Mixed Methods Appraisal Tool. Data were extracted into a summary table and analysed using narrative analysis. Data sources CINAHL, Ovid MEDLINE, Web of Science and EBSCO electronic databases were searched between 1999 and 2019. Papers were included if they reported original research which explored mental health education/training of nurses working in PHC. Findings Of the 652 papers identified, 13 met the inclusion criteria. Four themes were identified: preparedness; addressing knowledge gaps, education programs, and facilitators and barriers. Discussion Despite increasing integration of physical and mental health management in PHC, there is limited evidence relating to knowledge gaps and skills development of PHC nurses or their preparedness to provide mental health care. Conclusion Findings from this review, together with the global increase in mental illness in communities arising from COVID-19, highlight the need for PHC nurses to identify their mental health learning needs and engage in education to prepare them to meet rising service demands.
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Affiliation(s)
- Susan McInnes
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, & Illawarra Health and Medical Research Institute, Northfields Ave Wollongong NSW 2522, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, & Illawarra Health and Medical Research Institute, Northfields Ave Wollongong NSW 2522, Australia
| | - Christine Ashley
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, & Illawarra Health and Medical Research Institute, Northfields Ave Wollongong NSW 2522, Australia
| | - Ashley Kean
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, & Illawarra Health and Medical Research Institute, Northfields Ave Wollongong NSW 2522, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, & Illawarra Health and Medical Research Institute, Northfields Ave Wollongong NSW 2522, Australia
| | - Chris Patterson
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, & Illawarra Health and Medical Research Institute, Northfields Ave Wollongong NSW 2522, Australia
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Halcomb E, McInnes S, Patterson C, Moxham L, Bird S. Australian general practice nurse involvement in mental health: A descriptive survey. Collegian 2022. [DOI: 10.1016/j.colegn.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Moxham L, Fernandez R, Lord H, Halcomb E, Middleton R. Life during lockdown: coping strategies used by preregistration nursing students during COVID-19. Nurse Educ Pract 2022; 63:103388. [PMID: 35816921 PMCID: PMC9222489 DOI: 10.1016/j.nepr.2022.103388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 05/04/2021] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
Aim To explore the coping strategies used by Australian preregistration nursing students during the COVID-19 pandemic ‘lockdown’ period. Background COVID-19 has had a significant impact on preregistration nursing students, both physically and psychologically. As campuses closed and online learning commenced, clinical placement access was reduced, with heightened concern about personal and family safety. As such, nursing students were forced to adopt coping strategies to manage their self and the environment. Design A descriptive qualitative study. Methods One hundred and fifty-five preregistration nursing students enrolled at a regional Australian university completed a self-administered online survey. Results Overwhelmingly, student responses revealed that staying connected was the key coping strategy to ensure emotional and mental health wellbeing. Heightened vigilance in infection control measures was also evident, personally and for others. Routines, including exercise, facilitated physical and mental wellbeing. Overall, coping strategies identified by nursing students demonstrated applied resilience during the isolation period. Conclusions Understanding the adaptive coping strategies used by nursing students can enable nurse academics to understand how to best provide support. This study emphasises the importance of recognising that not all students are able to adapt and ‘cope’ without supports in place. Future studies should investigate the longer-term impact of COVID-19 within the broader preregistration nursing experience and how this might impact nursing students’ future careers.
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Affiliation(s)
- Lorna Moxham
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia; Illawarra Health and Medical Research Institute, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Ritin Fernandez
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia; Centre for Research in Nursing and Health, St George Hospital, South Street, Kogarah NSW 2217, Australia; Illawarra Health and Medical Research Institute, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Heidi Lord
- Centre for Research in Nursing and Health, St George Hospital, South Street, Kogarah NSW 2217, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia; Illawarra Health and Medical Research Institute, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
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Perlman D, Moxham L, Patterson C, Tapsell A, Keough E. The influence of a self-determination theory grounded clinical placement on nursing student's therapeutic relationship skills: A pre-test/post-test study. Int J Ment Health Nurs 2022; 31:305-312. [PMID: 34820992 DOI: 10.1111/inm.12957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022]
Abstract
For undergraduate nursing students, an integral mode of learning is their clinical placements. Learning within the clinical setting is influenced by factors such as the facilitators, peers, unit, or department the student is placed on. What is not known is the role of a social context that is grounded in Self-Determination Theory and how this influences the development of therapeutic relationship skills among undergraduate nursing students. The aim of this study was to examine the role of autonomy support in the professional learning of undergraduate nursing students. This study employed a two-group pre-test and post-test design, with undergraduate nursing students placed in either an autonomy-supportive group or a comparison group in an Australian context. Therapeutic relationship skills were assessed at the beginning and end of their compulsory mental health clinical placement. Participants were 210 (n = 210) Australian undergraduate nursing students. Using a tertile split, 140 students were placed into one of two groups based on their perception of autonomy support at the post-test time point. Pre- and post-test therapeutic relationship data were collected for both groups. A repeated measures analysis of variance was used to examine whether engagement in different clinical placements would illicit significant differences in therapeutic relationship skills. Undergraduate nursing students who were engaged in the autonomy-supportive setting had significantly higher scores associated with the therapeutic relationship subscales: Positive Collaboration and Positive Clinical Input. The importance of the social context is underscored, which is strongly influenced by the educational leader, typically referred to as a nurse facilitator.
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Affiliation(s)
- Dana Perlman
- School of Education: Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lorna Moxham
- School of Education: Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Christopher Patterson
- School of Nursing: Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Amy Tapsell
- Global Challenges Program, Research and Innovation Division, University of Wollongong, Wollongong, New South Wales, Australia
| | - Emily Keough
- School of Psychology: Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
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Hobbs C, Moxham L, Green H, Almasi E, Middleton R, Halcomb E, Fernandez R. It’s just not that easy! Challenges faced by nurses and midwives in the work environment in adhering to social distancing during COVID-19. AUST J ADV NURS 2022. [DOI: 10.37464/2020.391.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Burns S, Tapsell A, Perlman D, Patterson C, Moxham L. Stigma in the media: Investigating journalism students attitudes towards mental illness. Int J Ment Health Nurs 2022; 31:104-110. [PMID: 34628715 DOI: 10.1111/inm.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/28/2021] [Indexed: 11/30/2022]
Abstract
Given the profound role that media play in public opinion, there exists an ongoing necessity to understand the portrayal of mental illness by journalists. There is a plethora of studies that have examined how mental illness is portrayed in the media, but few studies have sought to understand what journalist opinions about mental illness are, and none could be found regarding journalism students' opinions. This study aimed to bridge this gap by examining journalism student's attitudes towards mental illness using the Social Distance Scale (SDS). This study adheres to STROBE guidelines for cross-sectional studies. One hundred and seventy-two undergraduate journalism students (n = 172) completed the SDS with findings suggesting that students had moderate stigmatizing attitudes, with varying degrees of stigma present depending on the social context. Positively framed reporting and constructive media coverage surrounding mental illness may be improved by shared communication and education with health professionals who specialize in mental health: mental health nurses.
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Affiliation(s)
- Shawn Burns
- School of the Arts, English & Media, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Amy Tapsell
- Public Health Unit, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Dana Perlman
- School of Education, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Christopher Patterson
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, IHMRI, AHSRI, Wollongong, New South Wales, Australia
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Middleton R, Loveday C, Hobbs C, Almasi E, Moxham L, Green H, Halcomb E, Fernandez R. The COVID-19 pandemic - A focus on nurse managers' mental health, coping behaviours and organisational commitment. Collegian 2021; 28:703-708. [PMID: 34744479 PMCID: PMC8556582 DOI: 10.1016/j.colegn.2021.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/22/2021] [Accepted: 10/19/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The emergence of COVID-19 has substantially impacted frontline health care workers, including nurse managers. To date, no studies have been conducted to examine the impact COVID-19 has had on Nurse Managers' mental health, coping strategies and organisational commitment. AIM To investigate the mental health, coping behaviours, and organisational commitment among Nurse Managers during the COVID-19 pandemic. METHODS Cross-sectional study involving 59 Nursing Managers from one Local Health District in Sydney Australia during the first wave of the COVID-19 pandemic. Data were collected relating to demographics, anxiety, coping strategies and organisational commitment. RESULTS Overall, approximately three quarters of the Nurse Managers had high anxiety scores. Managers who had worked longer as a nurse had higher scores for adaptive coping strategies and 41% of Nurse Managers considered leaving their jobs. CONCLUSIONS Strategies to minimise anxiety and enable coping as part of organisational disaster, emergency or crisis planning for Nurse Managers may result in decreased anxiety and stress levels, increased use of adaptive coping strategies and lower intent to leave the organisation and the nursing profession.
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Affiliation(s)
- Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Clare Loveday
- St. George Hospital, Gray St, Kogarah NSW 2217, Australia
| | - Cassandra Hobbs
- Sutherland Hospital, Kingsway & Kareena Rd, Caringbah NSW 2229, Australia
| | - Elham Almasi
- Sutherland Hospital, Kingsway & Kareena Rd, Caringbah NSW 2229, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Heidi Green
- St. George Hospital, Gray St, Kogarah NSW 2217, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- St. George Hospital, Gray St, Kogarah NSW 2217, Australia
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Alomari A, Hunt L, Lord H, Halcomb E, Fernandez R, Middleton R, Moxham L. Understanding the support needs of Australian nursing students during COVID-19: a cross-sectional study. Contemp Nurse 2021; 57:258-268. [PMID: 34689721 DOI: 10.1080/10376178.2021.1997147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: COVID-19 has caused significant disruption. This has been particularly evident within the university student population where their traditional ways of learning were abruptly reorganised and support structures removed.Objective: This paper aims to explore undergraduate student nurses' perceptions of the support required from the university during COVID-19 using the Achievement Goal Theory framework.Design: Data were collected via an online survey of undergraduate student nurses from an Australian university. This paper is reporting the data from a single open-ended item asking participants about their support needs from the University. Data were analysed using thematic analysis.Results: Of the 178 students who responded 206 individual statements were provided about the support they would like from the university. Four primary themes emerged, Support beyond academia, Academic support, Online learning readiness and Clinical practice units and clinical placement. The students identified that their needs during this pandemic include financial needs, social isolation, needs for more communication and unpreparedness for online teaching.Conclusion: Several factors were identified by participants about the additional support required from the university during COVID-19. Understanding and addressing these factors have the potential to improve student support during COVID-19 and support students in future crises.Impact statement: Understanding what support students perceive they require from the university during significant disruption will assist in future crisis management planning.
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Affiliation(s)
- Albara Alomari
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | - Leanne Hunt
- School of Nursing and Midwifery, Western Sydney University, Penrith South, Australia
| | - Heidi Lord
- Clinical Nurse Consultant, Centre for Research in Nursing and Health, Kogarah, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, Australia
| | - Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, Australia
| | | | - Lorna Moxham
- Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, Australia
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Middleton R, Fernandez R, Moxham L, Tapsell A, Halcomb E, Lord H, Alomari A, Hunt L. Generational differences in psychological wellbeing and preventative behaviours among nursing students during COVID-19: a cross-sectional study. Contemp Nurse 2021; 57:213-223. [PMID: 34591737 DOI: 10.1080/10376178.2021.1987941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Many nursing programmes have had to swiftly move online in response to COVID-19. Nursing students are often a heterogenous group that traverses generational boundaries. Exploring generational differences may assist in developing support systems for specific groups. This study sought to examine psychological wellbeing and preventative behaviours among nursing students from the iGeneration in comparison to older generations. METHOD A prospective cross-sectional study was undertaken using a convenience sample of pre-registration nursing students studying at two Australian Universities, one regional and one metropolitan. About 631 pre-registration nursing students completed an online survey. RESULTS An independent samples t-test revealed that students from the iGeneration possess higher anxiety compared to nursing students from older generations (p = .000). Compared to iGeneration participants, older generation participants had significantly higher scores for knowledge of COVID-19 (p = .015). iGeneration participants utilised social media to source information about COVID-19 far more than older generations (p = .008). iGeneration participants were significantly more concerned than older generations about the impact of COVID-19 on completing their clinical placement (p = .014). Older generations tended to have higher academic preventative behaviours, with significant mean scores for not attending university if they or others they knew had symptoms of COVID-19. CONCLUSION Given the differences between generation groups with regard to psychological wellbeing, knowledge about COVID-19, and concerns about studying in an altered study environment, strategies should be targeted to generational groups. Anxiety negatively impacts the quality of life, educational performance and clinical practice and is experienced more frequently in the iGeneration. Therefore it is crucial for nursing educators to reflect on how they engage this generation in the online space to provide support, stability and a sense of connection. This will contribute towards ensuring a well-prepared future nursing workforce who may encounter other pandemics and isolating events. IMPACT STATEMENT Compared with other generations, iGeneration students have a greater likelihood to experience mental health issues, isolation and insecurity. Nursing leaders and educators must be sensitive to such intergenerational differences, to ensure they are developing a skilled and productive workforce.
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Affiliation(s)
- Rebekkah Middleton
- School of Nursing, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, Australia
| | - Ritin Fernandez
- School of Nursing, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, Australia.,St George Hospital, Sydney, Australia
| | - Lorna Moxham
- School of Nursing, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, Australia.,Global Challenges Program, Research and Innovation Division, University of Wollongong, Wollongong, Australia
| | - Amy Tapsell
- Public Health Unit, Illawarra Shoalhaven Local Health District, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, Australia
| | | | - Albara Alomari
- School of Nursing and Midwifery, Western Sydney University, Liverpool, Australia
| | - Leanne Hunt
- School of Nursing and Midwifery, Western Sydney University, Liverpool, Australia
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Fernandez R, Sikhosana N, Green H, Halcomb EJ, Middleton R, Alananzeh I, Trakis S, Moxham L. Anxiety and depression among healthcare workers during the COVID-19 pandemic: a systematic umbrella review of the global evidence. BMJ Open 2021; 11:e054528. [PMID: 34548373 PMCID: PMC8458002 DOI: 10.1136/bmjopen-2021-054528] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To summarise the evidence relating to the prevalence of anxiety and depression among healthcare workers (HCWs) during the COVID-19 pandemic. DESIGN An umbrella review of systematic reviews was undertaken using the Joanna Briggs Institute (JBI) methods. DATA SOURCES The Cochrane database of systematic reviews, JBI Evidence Synthesis, MEDLINE, Web of Science, PsycINFO, Embase and CINAHL were searched in March 2021 for reviews published in English. ELIGIBILITY CRITERIA Systematic reviews reporting the prevalence of anxiety and depression among HCWs during the COVID-19 pandemic. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed using the JBI critical appraisal tool for systematic reviews, and the degree of overlap in primary studies was calculated. RESULTS Ten systematic reviews (100 unique studies), including 169 157 HCWs from 35 countries were included. The prevalence of anxiety among all HCWs ranged from 22.2% (95% CI 21.3% to 23.1%) to 33.0% (95% CI 31.9% to 34.1%). The prevalence of anxiety among physicians (n=5820) was reported to be between 17% and 19.8% and for nurses (n=14 938) between 22.8% and 27%. The prevalence of depression among all HCWs ranged from 17.9% (95% CI 17.1% to 18.8%) to 36% (95% CI 34.9% to 37.1%). The prevalence of depression among physicians (n=643) and nurses (n=8063) was reported to be 40.4% and 28%, respectively. CONCLUSIONS There is wide variation evident in the presence of anxiety and depression among HCWs. In particular, the prevalence of depression among physicians was high. Strategies to reduce the incidence of anxiety and depression are urgently required. PROSPERO REGISTRATION NUMBER CRD42021238960.
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Affiliation(s)
- Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Centre for Evidence based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, New South Wales, Australia
| | - Nqobile Sikhosana
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Centre for Evidence based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, New South Wales, Australia
| | - Heidi Green
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Centre for Evidence based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elizabeth J Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales, Australia
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales, Australia
| | - Ibrahim Alananzeh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Stamatia Trakis
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
| | - L Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Centre for Evidence based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales, Australia
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Jay EK, Moxham L, Patterson C. Using an arts-based approach to explore the building of social capital at a therapeutic recreation camp. Int J Ment Health Nurs 2021; 30:1001-1009. [PMID: 33904636 DOI: 10.1111/inm.12856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2021] [Indexed: 11/26/2022]
Abstract
Therapeutic recreation is beneficial for people with and without disabilities, promoting an empowered, connected, and joyful life. The present study aimed to analyse canvas art created on a therapeutic recreation programme called Recovery Camp, to discover what they reveal about the shared experiences which have occurred. This study utilized an arts-based research method and thematic analysis to discover what participants have communicated via their artwork from ten camps between 2018 and 2019. This study adheres to the COREQ guidelines for qualitative studies. Reflexive thematic analysis produced subthemes which informed three main themes and an identified core meaning of Social Capital. The three main themes were Togetherness and teamwork, Positivity, and Gratitude for Recovery Camp. Based on these findings, canvas art has revealed that shared experiences during a therapeutic recreation camp were positive and connecting. Social capital was created and bridged at Recovery Camp through teamwork and prosocial attitudes. Gratitude has also been disclosed by participants for their shared positive experience.
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Affiliation(s)
- Elissa-Kate Jay
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Lorna Moxham
- Australian Health Services Research Institute, University of Wollongong, Innovation Campus, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW, Australia
| | - Christopher Patterson
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW, Australia
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Affiliation(s)
- Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia.,Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah, NSW 2217, Australia
| | - Heidi Lord
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia.,Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah, NSW 2217, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia.,Illawarra Health & Medical Research Institute, Keiraville, Australia
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia.,Illawarra Health & Medical Research Institute, Keiraville, Australia
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Picton C, Fernandez R, Moxham L, Patterson CF. Experiences of outdoor nature-based therapeutic recreation programs for persons with a mental illness: a qualitative systematic review. JBI Evid Synth 2021; 18:1820-1869. [PMID: 32813402 DOI: 10.11124/jbisrir-d-19-00263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this review was to identify, appraise, and synthesize the best available evidence related to participation in outdoor nature-based therapeutic recreation programs for adults with a mental illness living in the community. INTRODUCTION Therapeutic recreation is posited to be beneficial for persons living with a mental illness. Research evidence indicates that therapeutic recreation programs can foster mental health recovery. It is important to understand the effectiveness of this from the perspective of persons living with mental illness how outdoor nature-based therapeutic recreation programs are meaningful and helpful for recovery. INCLUSION CRITERIA This review considered studies that collected qualitative data on the experiences and perspectives of adults with a mental illness regarding their participation in outdoor nature-based therapeutic recreation programs. METHODS The databases PsycINFO, CINAHL, MEDLINE, Scopus, and Informit, as well as unpublished sources in gray literature (Google Scholar, OpenGrey), were searched and reference lists were checked to locate any additional studies. Studies published in English were considered, with a date range from inception to 2019. Three reviewers independently assessed the methodological quality of the studies that met the inclusion criteria using the JBI critical appraisal approach for qualitative research. Data were extracted by one reviewer using the standardized qualitative extraction tool and checked for accuracy by three other reviewers. The qualitative research findings were pooled using JBI methodology. The JBI process of meta-aggregation was used to identify categories and synthesized findings, and a level of confidence was assigned to both synthesized findings. RESULTS Eighteen papers met the inclusion criteria and were included in the data extraction phase. A total of 84 findings were extracted and aggregated into six categories based on similarity of meaning and two synthesized findings. The methodological quality of the studies varied, and the overall level of confidence of the synthesized findings was determined to be moderate. CONCLUSIONS This review identified that persons living with mental illness perceive outdoor nature-based therapeutic recreation as enjoyable and that therapeutic recreation makes a positive contribution to mental health. Congruent with the literature, therapeutic recreation offers a socially inclusive and psychologically safe environment. The intentionally structured social milieu enhances the formation of social relationships and meaningful connections for persons with mental illness. Elements linked with psychological well-being, such as intrinsic motivation, overcoming perceived challenges, and finding purpose and meaning, are enhanced through participation in therapeutic recreation in outdoor nature-based settings. Increased levels of physical activity, greater self-esteem, and enhanced sense of identity were some of the perceived positive changes. This review provides important insights into the subjective needs of persons with mental illness who undertake therapeutic recreation in outdoor nature-based settings. The qualitative findings can inform health care providers, or those interested in therapeutic recreation programming, to use alongside quantitative evidence of effectiveness to design nature-based therapeutic recreation activities that are meaningful for persons with mental illness. Limitations of the research were that papers published in languages other than English were not searched, and papers not located may have influenced the findings of this review.
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Affiliation(s)
- Caroline Picton
- School of Nursing, University of Wollongong, Wollongong, Australia.,Centre for Evidence Based Initiatives in Health Care: A JBI Centre of Excellence
| | - Ritin Fernandez
- School of Nursing, University of Wollongong, Wollongong, Australia.,Centre for Evidence Based Initiatives in Health Care: A JBI Centre of Excellence
| | - Lorna Moxham
- School of Nursing, University of Wollongong, Wollongong, Australia.,Global Challenges Program, University of Wollongong, Wollongong, Australia
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Cutler NA, Sim J, Halcomb E, Stephens M, Moxham L. Understanding how personhood impacts consumers' feelings of safety in acute mental health units: a qualitative study. Int J Ment Health Nurs 2021; 30:479-486. [PMID: 33179361 DOI: 10.1111/inm.12809] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/08/2020] [Accepted: 10/14/2020] [Indexed: 12/26/2022]
Abstract
Being admitted to an acute mental health unit can lead to feelings of shame, and loss of personhood for some consumers. Promoting safety for consumers is a function of acute mental health units. This paper explores how consumers' personhood influences their perception and experience of safety in acute mental health units. Semi-structured interviews were conducted with 15 participants who had previously been admitted to an acute mental health unit. Thematic analysis was used to analyse the data. Participants perceived safety as being intrinsically linked to their personhood. When participants' innate worth was affirmed in their interactions with staff, participants felt safe. Three subthemes were identified: 'Seen as an equal', 'Being respected', and 'Able to make choices'. These findings can be used to inform nursing practices that enhance consumers' sense of personhood and, in so doing, promote consumers' safety and recovery in acute mental health units.
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Affiliation(s)
- Natalie Ann Cutler
- School of Nursing, University of Wollongong, Illawarra Health & Medical Research Institute, Wollongong, New South Wales, Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong, Illawarra Health & Medical Research Institute, Wollongong, New South Wales, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Illawarra Health & Medical Research Institute, Wollongong, New South Wales, Australia
| | - Moira Stephens
- School of Nursing, University of Wollongong, Illawarra Health & Medical Research Institute, Wollongong, New South Wales, Australia
| | - Lorna Moxham
- School of Nursing, University of Wollongong, Illawarra Health & Medical Research Institute, Wollongong, New South Wales, Australia
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Cutler NA, Halcomb E, Sim J, Stephens M, Moxham L. How does the environment influence consumers' perceptions of safety in acute mental health units? A qualitative study. J Clin Nurs 2021; 30:765-772. [PMID: 33348440 DOI: 10.1111/jocn.15614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/26/2020] [Accepted: 12/13/2020] [Indexed: 12/28/2022]
Abstract
AIMS AND OBJECTIVES To explore how the physical and social environment of acute mental health units influences consumers' perception and experience of safety. BACKGROUND Acute mental health units are places in which consumers should feel safe. Not all consumers, however, feel safe in this environment. Little is known about what contributes to consumers' feelings of safety in this setting. DESIGN The study used a qualitative descriptive design, influenced by naturalistic enquiry. Data were analysed using thematic analysis and are reported according to the COREQ checklist. METHODS Fifteen people who had experienced admission to an acute mental health unit were individually interviewed. RESULTS Having a supportive environment enhanced consumers' perception and experience of safety. A supportive environment was experienced when consumers had privacy, felt safe from other consumers and had meaningful activities to participate in within the acute mental health unit. In contrast, having their privacy breached by other consumers made participants feel unsafe. Many participants were fearful of other consumers, and felt unsafe and unable to protect themselves. Lack of meaningful activities led to boredom and contributed to consumers feeling unsafe. CONCLUSIONS Personal spaces should address consumers' privacy needs without compromising staff access. Staff presence enhances consumers' feelings of safety, but this need can be heightened when consumers are unable to alert staff when they feel unsafe. Meaningful activities link consumers to their lives outside of the hospital and can enhance recovery. RELEVANCE TO CLINICAL PRACTICE Understanding how the acute unit environment is perceived by consumers can assist nurses and managers to promote feelings of safety among consumers. Feeling safe can, in turn, optimise recovery.
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Affiliation(s)
- Natalie Ann Cutler
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health & Medical Research Institute, Wollongong, NSW, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health & Medical Research Institute, Wollongong, NSW, Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health & Medical Research Institute, Wollongong, NSW, Australia
| | - Moira Stephens
- Illawarra Health & Medical Research Institute, Wollongong, NSW, Australia
| | - Lorna Moxham
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health & Medical Research Institute, Wollongong, NSW, Australia
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Patterson C, Perlman D, Moxham L, Sudhakar C, Nayak AK, Velayudhan B, Jose TT, Tapsell A. Australian and Indian nursing students' skills and attitudes surrounding mental illness: Preparing for a transnational nursing education collaboration. Nurse Educ Pract 2020; 50:102909. [PMID: 33285402 DOI: 10.1016/j.nepr.2020.102909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/11/2020] [Accepted: 10/27/2020] [Indexed: 11/17/2022]
Abstract
Cultural competence is a viewed as a necessary set of skills within nursing, and there is a need for student support in this area. This is particularly important in mental health care, with two skills considered crucial for providing quality care: therapeutic relationship skills and positive attitudes. With the objective of initiating an educational collaboration between two educational institutions, this study examined Australian and Indian undergraduate nursing student's perceived therapeutic relationship skills and stigma attitudes associated with mental illness. Participants were five hundred and fifty-five (n = 555) undergraduate nursing students from two different universities in Indian and Australia. The modified version of the Scale To Assess Therapeutic Relationship (STAR-C) and the Social Distance Scale (SDS) were both used to examine student's perceived therapeutic relationship skills and stigma attitudes. Australian nursing students indicated lower levels of stigma with lower levels of self-reported therapeutic relationships skills, as compared with the Indian nursing student cohort. However, Indian nursing students indicated higher levels of stigma with higher self-reported therapeutic relationship skills. The results of this study may reflect cultural differences and meanings attached to mental illness.
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Affiliation(s)
- Christopher Patterson
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong Northfields Avenue, NSW, 2522, Australia.
| | - Dana Perlman
- School of Education, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Lorna Moxham
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Christopher Sudhakar
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, 576104, India
| | - Asha K Nayak
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, 576104, India
| | - Binil Velayudhan
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, 576104, India
| | - Tessy Treesa Jose
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Karnataka, 576104, India
| | - Amy Tapsell
- Global Challenges Program, Research and Innovation Division, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
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Fernandez R, Lord H, Halcomb E, Moxham L, Middleton R, Alananzeh I, Ellwood L. Implications for COVID-19: A systematic review of nurses' experiences of working in acute care hospital settings during a respiratory pandemic. Int J Nurs Stud 2020; 111:103637. [PMID: 32919358 PMCID: PMC7206441 DOI: 10.1016/j.ijnurstu.2020.103637] [Citation(s) in RCA: 368] [Impact Index Per Article: 92.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pandemics and epidemics are public health emergencies that can result in substantial deaths and socio-economic disruption. Nurses play a key role in the public health response to such crises, delivering direct patient care and reducing the risk of exposure to the infectious disease. The experience of providing nursing care in this context has the potential to have significant short and long term consequences for individual nurses, society and the nursing profession. OBJECTIVES To synthesize and present the best available evidence on the experiences of nurses working in acute hospital settings during a pandemic. DESIGN This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. DATA SOURCES A structured search using CINAHL, MEDLINE, EMBASE, PubMed, Google Scholar, Cochrane Library, MedNar, ProQuest and Index to Theses was conducted. REVIEW METHODS All studies describing nurses' experiences were included regardless of methodology. Themes and narrative statements were extracted from included papers using the SUMARI data extraction tool from Joanna Briggs Institute. RESULTS Thirteen qualitative studies were included in the review. The experiences of 348 nurses generated a total of 116 findings, which formed seven categories based on similarity of meaning. Three synthesized findings were generated from the categories: (i) Supportive nursing teams providing quality care; (ii) Acknowledging the physical and emotional impact; and (iii) Responsiveness of systematised organizational reaction. CONCLUSIONS Nurses are pivotal to the health care response to infectious disease pandemics and epidemics. This systematic review emphasises that nurses' require Governments, policy makers and nursing groups to actively engage in supporting nurses, both during and following a pandemic or epidemic. Without this, nurses are likely to experience substantial psychological issues that can lead to burnout and loss from the nursing workforce.
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Affiliation(s)
- Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia; Center for Evidence Based Initiatives in Health Care: A JBI Center of Excellence, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Heidi Lord
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia; Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia; Center for Evidence Based Initiatives in Health Care: A JBI Center of Excellence, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Ibrahim Alananzeh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong NSW 2522, Australia.
| | - Laura Ellwood
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, South Street, Kogarah NSW 2217, Australia.
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Broadbent M, Moxham L, Dwyer T. Understanding nurses perspectives of acuity in the process of emergency mental health triage: a qualitative study. Contemp Nurse 2020; 56:280-295. [PMID: 33086935 DOI: 10.1080/10376178.2020.1841014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Post deinstitutionalisation, mental health mainstreaming has led to substantial increases in presentations to Emergency Departments (EDs). The assessment process requires the ED triage nurse to undertake a rapid client assessment, assign a clinically appropriate triage score, and then refer the client to a mental health clinician. The initial assessment is important, and a number of factors influence the process of triage, referral and response including an understanding of mental health presentation acuity. Aim: To understand the factors that influence the ED triage assessment, referral and clinical response of clients with a mental illness. Methods: An ethnographic methodology underpinned the research design. ED triage nurses and mental health triage nurses who worked in a regional hospital provided insights through interviews and observations. The study was also informed by institutional policies and procedures regarding triage. Transcribed in-depth interviews, field notes and memos were analysed using an inductive thematic process. Findings: Mental health triage nurses and ED triage nurses concur that triage is an important part of the assessing process for a person who presents to the ED with a mental health problem. Timely and clinically accurate assessment, followed by referral and response is strongly influenced by the user knowledge of the mental health triage scale, and comprehension of mental health acuity. The conflicting understandings between the two professional nursing groups, called professionally cultured orientations, further impact this process. Conclusion: Professionally cultured orientation to mental health triage and acuity comprehension influence the process of emergency mental health triage and therefore may affect optimal client outcomes. Further research into ED triage design, ED triage education, and a shared understanding of acuity is called for.
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Affiliation(s)
- Marc Broadbent
- School of Nursing, Midwifery & Paramedicine, University of the Sunshine Coast, ML 40 Locked Bag 4, Maroochydore DC, QLD 4558, Australia
| | - Lorna Moxham
- School of Nursing, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia
| | - Trudy Dwyer
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Building 18 Bruce Hwy, Rockhampton, QLD, 4702, Australia
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35
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Picton C, Fernandez R, Moxham L, Patterson C. Experiences of outdoor nature-based therapeutic recreation programs for persons with a mental illness: a qualitative systematic review protocol. ACTA ACUST UNITED AC 2020; 17:2517-2524. [PMID: 31290796 DOI: 10.11124/jbisrir-d-19-00046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to identify, appraise and synthesize the best available qualitative evidence on participation in outdoor therapeutic recreation programs for adults with a mental illness living in the community. INTRODUCTION Therapeutic recreation is posited to be beneficial for persons living with a mental illness. Research indicates that therapeutic recreation programs can foster mental health recovery. It is necessary to understand how nature-based therapeutic recreation programs are beneficial from the perspective of persons living with mental illness. INCLUSION CRITERIA The review will consider studies that have collected qualitative data on the experiences and perspectives of adults with a mental illness of their participation in nature-based therapeutic recreation programs. METHODS The databases PsycINFO, CINAHL, MEDLINE, Scopus and Informit and unpublished sources in gray literature databases (Google) will be searched and reference lists will be checked to locate any additional studies. Studies published in English will be considered with no date limit. Two reviewers will independently assess the methodological quality of the studies which meet the inclusion criteria using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research. Data will be extracted by one reviewer using the standardized qualitative extraction tool and checked for accuracy by a second reviewer. The qualitative research findings will be pooled using JBI methodology. The JBI process of meta-aggregation will be used to identify categories and synthesized findings.
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Affiliation(s)
- Caroline Picton
- School of Nursing, University of Wollongong, Wollongong, Australia.,Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Institute Centre of Excellence
| | - Ritin Fernandez
- School of Nursing, University of Wollongong, Wollongong, Australia.,Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Institute Centre of Excellence
| | - Lorna Moxham
- School of Nursing, University of Wollongong, Wollongong, Australia.,Global Challenges, University of Wollongong, Wollongong, Australia
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36
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Lord H, Loveday C, Moxham L, Fernandez R. Effective communication is key to intensive care nurses' willingness to provide nursing care amidst the COVID-19 pandemic. Intensive Crit Care Nurs 2020; 62:102946. [PMID: 33139165 PMCID: PMC7528824 DOI: 10.1016/j.iccn.2020.102946] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/03/2020] [Accepted: 09/06/2020] [Indexed: 01/08/2023]
Abstract
Background The COVID-19 pandemic posed and continues to pose challenges for health care systems globally, particularly to Intensive Care Units (ICU). At the forefront of the ICU are highly trained nurses with a professional obligation to care for patients with COVID-19 despite the potential to become infected. The aim of this study was to explore ICU nurses’ willingness to care during the COVID-19 pandemic. Methods A prospective cross-sectional study to explore ICU nurses’ willingness to provide care during the COVID-19 pandemic was undertaken between 25 March and 3 April 2020 at a large principal and referral teaching hospital in Sydney, NSW Australia. Results A total of 83 ICU nurses completed the survey. Approximately 60% reported receiving sufficient information from managers regarding COVID-19 and about caring for a patient with COVID-19. Ninety percent of nurses were concerned about spreading COVID-19 to their family. Sixty one percent of the nurses indicated that they were willing to care for patients with COVID-19. Receiving timely communication from managers was the only predictor of willingness to care among ICU nurses. Conclusions Effective communication is a vital component during a public health emergency in order to promote nurses’ willingness to care for patients in the ICU.
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Affiliation(s)
- Heidi Lord
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, Kogarah, NSW, Australia; Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, NSW, Australia.
| | - Clare Loveday
- Intensive Care Services, St George Hospital, Kogarah, NSW, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, Building 41, University of Wollongong, NSW, Australia
| | - Ritin Fernandez
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, Kogarah, NSW, Australia; Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, NSW, Australia; School of Nursing, Faculty of Science, Medicine and Health, Building 41, University of Wollongong, NSW, Australia
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37
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Cutler NA, Sim J, Halcomb E, Moxham L, Stephens M. Nurses' influence on consumers' experience of safety in acute mental health units: A qualitative study. J Clin Nurs 2020; 29:4379-4386. [DOI: 10.1111/jocn.15480] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Natalie Ann Cutler
- School of Nursing University of Wollongong Northfields Ave Wollongong NSW 2522 Australia
- Illawarra Health and Medical Research Institute University of Wollongong Wollongong NSW Australia
| | - Jenny Sim
- School of Nursing University of Wollongong Northfields Ave Wollongong NSW 2522 Australia
- Illawarra Health and Medical Research Institute University of Wollongong Wollongong NSW Australia
| | - Elizabeth Halcomb
- School of Nursing University of Wollongong Northfields Ave Wollongong NSW 2522 Australia
- Illawarra Health and Medical Research Institute University of Wollongong Wollongong NSW Australia
| | - Lorna Moxham
- School of Nursing University of Wollongong Northfields Ave Wollongong NSW 2522 Australia
- Illawarra Health and Medical Research Institute University of Wollongong Wollongong NSW Australia
| | - Moira Stephens
- School of Nursing University of Wollongong Northfields Ave Wollongong NSW 2522 Australia
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Geia L, Baird K, Bail K, Barclay L, Bennett J, Best O, Birks M, Blackley L, Blackman R, Bonner A, Bryant AO R, Buzzacott C, Campbell S, Catling C, Chamberlain C, Cox L, Cross W, Cruickshank M, Cummins A, Dahlen H, Daly J, Darbyshire P, Davidson P, Denney-Wilson E, De Souza R, Doyle K, Drummond A, Duff J, Duffield C, Dunning T, East L, Elliott D, Elmir R, Fergie OAM D, Ferguson C, Fernandez R, Flower AM D, Foureur M, Fowler C, Fry M, Gorman E, Grant J, Gray J, Halcomb E, Hart B, Hartz D, Hazelton M, Heaton L, Hickman L, Homer AO CSE, Hungerford C, Hutton A, Jackson AO D, Johnson A, Kelly MA, Kitson A, Knight S, Levett-Jones T, Lindsay D, Lovett R, Luck L, Molloy L, Manias E, Mannix J, Marriott AMR, Martin M, Massey D, McCloughen A, McGough S, McGrath L, Mills J, Mitchell BG, Mohamed J, Montayre J, Moroney T, Moyle W, Moxham L, Northam OAM H, Nowlan S, O'Brien AP, Ogunsiji O, Paterson C, Pennington K, Peters K, Phillips J, Power T, Procter N, Ramjan L, Ramsay N, Rasmussen B, Rihari-Thomas J, Rind B, Robinson M, Roche M, Sainsbury K, Salamonson Y, Sherwood J, Shields L, Sim J, Skinner I, Smallwood G, Smallwood R, Stewart L, Taylor S, Usher AM K, Virdun C, Wannell J, Ward R, West C, West R, Wilkes L, Williams R, Wilson R, Wynaden D, Wynne R. A unified call to action from Australian nursing and midwifery leaders: ensuring that Black lives matter. Contemp Nurse 2020; 56:297-308. [DOI: 10.1080/10376178.2020.1809107] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- L. Geia
- James Cook University, Townsville, QLD, Australia
| | - K. Baird
- University of Technology Sydney, Sydney, NSW, Australia
| | - K. Bail
- University of Canberra, Canberra, ACT, Australia
| | - L. Barclay
- University of Sydney, Sydney, NSW, Australia
| | - J. Bennett
- University of Newcastle, Callaghan, NSW, Australia
| | - O. Best
- University of Southern Queensland, Darling Heights, QLD, Australia
| | - M. Birks
- James Cook University, Townsville, QLD, Australia
| | - L. Blackley
- Queensland Health, Joyce Palmer Health Service, Palm Island, QLD, Australia
| | - R. Blackman
- Gidgee Healing Mt Isa, Mount Isa, QLD, Australia
| | - A. Bonner
- Griffith University, Brisbane, QLD, Australia
| | - R. Bryant AO
- Rosemary Bryant Foundation, South Australia, Australia
| | - C. Buzzacott
- Rhodanthe Lipsett Indigenous Midwifery Charitable Fund, Caringbah, NSW, Australia
| | - S. Campbell
- Charles Darwin University, Darwin, NT, Australia
| | - C. Catling
- University of Technology Sydney, Sydney, NSW, Australia
| | | | - L. Cox
- Queensland University of Technology, Brisbane, QLD, Australia
| | - W. Cross
- Federation University, Ballarat, VIC, Australia
| | - M. Cruickshank
- University of Technology Sydney, Sydney, NSW, Australia
- Sydney Children’s Hospital Network, Sydney, NSW, Australia
| | - A. Cummins
- University of Technology Sydney, Sydney, NSW, Australia
| | - H. Dahlen
- Western Sydney University, Sydney, NSW, Australia
| | - J. Daly
- University of Sydney, Sydney, NSW, Australia
| | - P. Darbyshire
- Philip Darbyshire Consulting, Highbury, South Australia, Australia
| | - P. Davidson
- University of Technology Sydney, Sydney, NSW, Australia
- Western Sydney University, Sydney, NSW, Australia
- John Hopkins University, Baltimore, USA
| | | | | | - K. Doyle
- Western Sydney University, Sydney, NSW, Australia
| | - A. Drummond
- Queensland University of Technology, Brisbane, QLD, Australia
| | - J. Duff
- Queensland University of Technology, Brisbane, QLD, Australia
| | - C. Duffield
- University of Technology Sydney, Sydney, NSW, Australia
- Edith Cowan University, Perth, Western Australia, Australia
| | - T. Dunning
- Deakin University, Melbourne, VIC, Australia
| | - L. East
- University of New England, Armidale, NSW, Australia
| | - D. Elliott
- University of Technology Sydney, Sydney, NSW, Australia
| | - R. Elmir
- Western Sydney University, Sydney, NSW, Australia
| | - D. Fergie OAM
- Australian Catholic University, Fitzroy, VIC, Australia
| | - C. Ferguson
- Western Sydney University, Sydney, NSW, Australia
| | - R. Fernandez
- University of Wollongong, Keiraville, NSW, Australia
| | | | - M. Foureur
- University of Newcastle, Callaghan, NSW, Australia
| | - C. Fowler
- University of Technology Sydney, Sydney, NSW, Australia
| | - M. Fry
- University of Technology Sydney, Sydney, NSW, Australia
| | - E. Gorman
- New South Wales Health, Sydney, NSW, Australia
| | - J. Grant
- Charles Sturt University, Dubbo, NSW, Australia
| | - J. Gray
- University of Technology Sydney, Sydney, NSW, Australia
| | - E. Halcomb
- University of Wollongong, Keiraville, NSW, Australia
| | - B. Hart
- University of Notre Dame, Darlinghurst, NSW, Australia
| | - D. Hartz
- Charles Darwin University, Darwin, NT, Australia
| | - M. Hazelton
- University of Newcastle, Callaghan, NSW, Australia
| | - L. Heaton
- Western Sydney University, Sydney, NSW, Australia
| | - L. Hickman
- University of Technology Sydney, Sydney, NSW, Australia
- Contemporary Nurse Journal
| | | | | | - A. Hutton
- University of Newcastle, Callaghan, NSW, Australia
| | - D. Jackson AO
- University of Technology Sydney, Sydney, NSW, Australia
| | - A. Johnson
- University of Newcastle, Callaghan, NSW, Australia
| | - M. A. Kelly
- Sydney Children’s Hospital Network, Sydney, NSW, Australia
| | - A. Kitson
- Western Sydney University, Sydney, NSW, Australia
| | - S. Knight
- James Cook University, Townsville, QLD, Australia
| | | | - D. Lindsay
- James Cook University, Townsville, QLD, Australia
| | - R. Lovett
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - L. Luck
- Western Sydney University, Sydney, NSW, Australia
| | - L. Molloy
- University of Wollongong, Keiraville, NSW, Australia
| | - E. Manias
- Deakin University, Melbourne, VIC, Australia
| | - J. Mannix
- Western Sydney University, Sydney, NSW, Australia
| | | | - M. Martin
- Queensland Aboriginal and Islander Health Council, Brisbane, QLD, Australia
| | - D. Massey
- Southern Cross University, Gold Coast Campus, QLD, Australia
| | | | - S. McGough
- Curtin University, Perth, Western Australia, Australia
| | - L. McGrath
- Aboriginal Medical Service Redfern, Sydney, NSW, Australia
| | - J. Mills
- La Trobe University, Melbourne, VIC, Australia
| | | | - J. Mohamed
- Lowitja Institute, Melbourne, VIC, Australia
| | - J. Montayre
- Western Sydney University, Sydney, NSW, Australia
| | - T. Moroney
- University of Wollongong, Keiraville, NSW, Australia
| | - W. Moyle
- Griffith University, Brisbane, QLD, Australia
| | - L. Moxham
- University of Wollongong, Keiraville, NSW, Australia
| | | | - S. Nowlan
- Queensland Health, Joyce Palmer Health Service, Palm Island, QLD, Australia
| | | | - O. Ogunsiji
- Western Sydney University, Sydney, NSW, Australia
| | - C. Paterson
- University of Canberra, Canberra, ACT, Australia
| | - K. Pennington
- Flinders University, Adelaide, South Australia, Australia
| | - K. Peters
- Western Sydney University, Sydney, NSW, Australia
| | - J. Phillips
- University of Technology Sydney, Sydney, NSW, Australia
| | - T. Power
- University of Technology Sydney, Sydney, NSW, Australia
| | - N. Procter
- University of South Australia, Adelaide, South Australia, Australia
| | - L. Ramjan
- Western Sydney University, Sydney, NSW, Australia
| | - N. Ramsay
- Queensland Health, Joyce Palmer Health Service, Palm Island, QLD, Australia
| | | | | | - B. Rind
- Aboriginal Health Unit Mt Druitt Hospital, Sydney, NSW, Australia
| | - M. Robinson
- Murdoch University, Perth, Western Australia, Australia
| | - M. Roche
- University of Technology Sydney, Sydney, NSW, Australia
| | - K. Sainsbury
- University of Canberra, Canberra, ACT, Australia
| | | | - J. Sherwood
- Charles Sturt University, Dubbo, NSW, Australia
| | - L. Shields
- University of Queensland, Brisbane, QLD, Australia
| | - J. Sim
- University of Wollongong, Keiraville, NSW, Australia
| | - I. Skinner
- James Cook University, Townsville, QLD, Australia
| | - G. Smallwood
- James Cook University, Townsville, QLD, Australia
| | - R. Smallwood
- University of Newcastle, Callaghan, NSW, Australia
- University of New England, Armidale, NSW, Australia
| | - L. Stewart
- James Cook University, Townsville, QLD, Australia
| | - S. Taylor
- Top End Health, Northern Territory, Darwin, NT, Australia
| | - K. Usher AM
- University of Technology Sydney, Sydney, NSW, Australia
- University of New England, Armidale, NSW, Australia
| | - C. Virdun
- University of Technology Sydney, Sydney, NSW, Australia
| | - J. Wannell
- Melbourne Poche Centre for Indigenous Health, Melbourne, VIC, Australia
| | - R. Ward
- University of Southern Queensland, Darling Heights, QLD, Australia
| | - C. West
- James Cook University, Townsville, QLD, Australia
| | - R. West
- Griffith University, Brisbane, QLD, Australia
| | - L. Wilkes
- Western Sydney University, Sydney, NSW, Australia
| | - R. Williams
- Charles Darwin University, Darwin, NT, Australia
| | - R. Wilson
- University of Newcastle, Callaghan, NSW, Australia
- University of New England, Armidale, NSW, Australia
| | - D. Wynaden
- Curtin University, Perth, Western Australia, Australia
| | - R. Wynne
- Western Sydney University, Sydney, NSW, Australia
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Fernandez R, Ham-Baloyi WT, Al Mutair A, Lapkin S, Moxham L, Tapsell A. Similarities and differences in well-being between Australian, Saudi Arabian and South African pre-registration nursing students. Collegian 2020. [DOI: 10.1016/j.colegn.2019.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Douglas JA, Bourgeois S, Moxham L. Early career registered nurses: How they stay. Collegian 2020. [DOI: 10.1016/j.colegn.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Anderson C, Moxham L, Broadbent M. Recognition for registered nurses supporting students on clinical placement: a grounded theory study. AUST J ADV NURS 2020. [DOI: 10.37464/2020.373.98] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: This study examined registered nurses’ perspectives of being supportive of nursing students and providing them with learning opportunities when on clinical placements. Background: In Australia, as part of their three-year Bachelors degree, undergraduate nursing students undertake a minimum of 800 hours of clinical placement. During these clinical placement hours, nursing students are supervised by registered nurses who are required to be supportive of the students and provide them with learning opportunities. Study design and methods: This study used a grounded theory approach. In this qualitative study there were fifteen registered nurse participants. Thirteen participants were female participants and two were male. Participants were individually interviewed. Transcripts from these in–depth interviews were analysed using constant comparative analysis. Results: The major category, an added extra, emerged from this study. An added extra is about registered nurses’ perception that having a student is an added extra to their daily duties. The major category an added extra is informed by three emergent themes. The first theme was time, the second theme was workload and the third theme was wanting recognition. Discussion: Registered nurses perceived that their workloads tend not to be taken into consideration when they have nursing students. The literature suggests that nursing students often miss out on learning opportunities when they are on clinical placement because registered nurses do not have additional time to effectively support students’ clinical learning. Conclusion: Participants in this study believed being supportive of nursing students and providing them with learning opportunities was an added extra to their daily nursing duties. Findings revealed registered nurses want to be recognised for the extra time and effort they dedicate to students’ learning.
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Goman C, Patterson C, Moxham L, Harada T, Tapsell A. Alternative mental health clinical placements: Knowledge transfer and benefits for nursing practice outside mental healthcare settings. J Clin Nurs 2020; 29:3236-3245. [PMID: 32447818 DOI: 10.1111/jocn.15336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/24/2020] [Accepted: 05/09/2020] [Indexed: 11/30/2022]
Abstract
AIM AND OBJECTIVES To explore whether nursing student's experiences at Recovery Camp have impacted their current nursing practices. BACKGROUND Recently, there has been a move towards more holistic models of nursing care, which seek to break down barriers of stigmatisation and embrace the tenets of self-determination, to acknowledge people with lived experiences of mental illness and their ability to manage their recovery. In that regard, future health professionals such as nursing students will need to be educated in a manner that recognises the importance of lived experience. In this paper, we propose that Recovery Camp, an alternative clinical placement setting model, enhances clinical practice in multiple domains and is beneficial for both nursing practitioners and people with lived experiences of mental illness, as well as offering an effective nontraditional alternative to conventional clinical placement opportunities. METHODS This study employed a phenomenological research design, involving individual semi-structured telephone interviews. The Standards for Reporting Qualitative Research (SRQR) checklist was adhered to. RESULTS Three main themes were identified from the analysis: (a) engagement, (b) understanding mental health and (c) holistic care. "I definitely look at people with mental health conditions in a different light." At Recovery Camp, participants felt that they had greater opportunities for engagement with people with lived experiences, and through this engagement, their preconceptions of mental illness began to change. CONCLUSIONS Recovery Camp may have facilitated the transfer of knowledge that is more person-centred among nursing students, consequently impacting their current nursing practices. RELEVANCE TO CLINICAL PRACTICE Nurses should be equipped with mental health skills regardless of their career trajectory. While Recovery Camp represents a promising approach to facilitate knowledge transfer, further investigation will be required to determine which other factors are instrumental. This approach may have wider implications for nursing education.
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Affiliation(s)
- Caitlin Goman
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | | | - Lorna Moxham
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Theresa Harada
- School of School of Geography and Sustainable Communities, University of Wollongong, Wollongong, NSW, Australia
| | - Amy Tapsell
- Global Challenges Program, University of Wollongong, Wollongong, NSW, Australia
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Perlman D, Patterson C, Moxham L, Burns S. Examining mental health clinical placement quality using a self-determination theory approach. Nurse Educ Today 2020; 87:104346. [PMID: 32058882 DOI: 10.1016/j.nedt.2020.104346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/20/2019] [Accepted: 01/12/2020] [Indexed: 06/10/2023]
Abstract
Nursing clinical placements provide a unique opportunity for students to develop and hone the skills and knowledge that will be used upon graduation in their future professional practice. There is an on-going inquiry into elements that may facilitate better leaning outcomes in a variety of teaching and learning settings, including clinical experiences. Using a Self-Determination Theory approach, this study examined whether undergraduate nursing students would benefit from immersion in an autonomy-supportive clinical setting. Using a two-group pre and post-test design, students were classified into either an autonomy-supportive or comparison clinical placement cohort and measured on their learning using the Mental Health Clinical Placement Survey. Results of a repeated measures multivariate analysis of variance indicated a significant difference on some of the measures of learning housed within the Mental Health Clinical Placement Survey with students in the autonomy-supportive group reporting higher scores at the post-test time point. Findings support the value that teaching and learning in an autonomy-supportive setting has, on the skills and educational development of students.
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Affiliation(s)
- Dana Perlman
- School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Australia.
| | - Christopher Patterson
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Northfields Ave, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Northfields Ave, Australia
| | - Shawn Burns
- School of the Arts, English & Media, Faculty of Law, Humanities and the Arts, University of Wollongong, Northfields Ave, Australia
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Tapsell A, Martin KM, Moxham L, Burns S, Perlman D, Patterson C. Expert by Experience Involvement in Mental Health Research: Developing a Wellbeing Brochure for People with Lived Experiences of Mental Illness. Issues Ment Health Nurs 2020; 41:194-200. [PMID: 31916868 DOI: 10.1080/01612840.2019.1663566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This is a process paper that describes the development of a wellbeing brochure, shared between university researchers, a consumer research advocate, and fully informed by people who are living with mental illness (experts by experience). The purpose of this brochure was to provide strategies for maintaining wellbeing for EBEs, after attending a psychosocial intervention. Brochure development was guided by a mixed-methods research design, using a survey and focus group. The findings illustrate five key themes in EBEs strategies for maintaining wellbeing: good sleep hygiene, regular physical activity, maintaining a healthy lifestyle, relaxation techniques and social support. This process paper demonstrates how collaborating with experts by experience represents a valuable approach for developing mental health research and resources.
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Affiliation(s)
- Amy Tapsell
- Global Challenges Program, Research and Innovation Division, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kellie M Martin
- Consumer Research Advocate, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Shawn Burns
- School of the Arts, English & Media, Faculty of Law, Humanities and the Arts, University of Wollongong, Wollongong, New South Wales, Australia
| | - Dana Perlman
- School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Christopher Patterson
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Lim HJ, Moxham L, Patterson C, Perlman D, Lopez V, Goh YS. Students' mental health clinical placements, clinical confidence and stigma surrounding mental illness: A correlational study. Nurse Educ Today 2020; 84:104219. [PMID: 31731222 DOI: 10.1016/j.nedt.2019.104219] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/13/2019] [Indexed: 06/10/2023]
Abstract
Theory and clinical practicum in mental health are an important component for students in most nursing curriculum. Some studies have shown that knowledge and confidence in caring for people with mental illness improve after mental health clinical placements while others had contrasting results. Our study examined the relationship between clinical placement, confidence and stigma surrounding mental illness. We undertook a cross-sectional, descriptive correlational study in a sample of 144 undergraduate nursing students in Singapore who had completed their theoretical and clinical practicum in mental health using the Clinical Placement Survey Clinical Confidence Scale and Social Distance Scale. Descriptive, correlations and multiple regression were used to analyse the data. The results showed the mean scores for the social distance scale, clinical confidence scale and clinical placement survey were 19.92 out of 35, 49.29 out of 80 and 103.43 out of 154 respectively. Attitudes toward clinical placement experiences were significantly correlated with both stigmatising attitudes and clinical confidence of which, intentions of working in mental health settings were specifically significantly associated with stigmatising attitudes and attitudes toward clinical placement experiences, with emphasis on greater sense of preparedness, lesser perceived anxiety and greater preference for a future career in mental health nursing. This study highlighted the need to improve current mental health clinical placements to better build nursing students' confidence in caring for mentally ill patients. The interest toward specialising in mental health nursing is still lacking in nursing undergraduate students despite mental health clinical placements.
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Affiliation(s)
- Hui Jing Lim
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
| | - Lorna Moxham
- Faculty of Science, Medicine and Health, Wollongong University, Northfields Ave, Gwynneville, NSW 2500, Australia.
| | - Christopher Patterson
- Faculty of Science, Medicine and Health, Wollongong University, Northfields Ave, Gwynneville, NSW 2500, Australia.
| | - Dana Perlman
- Faculty of Social Sciences, Wollongong University, Northfields Ave, Gwynneville, NSW 2500, Australia.
| | - Violeta Lopez
- College of Nursing, Hubei University of Medicine, China.
| | - Yong Shian Goh
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
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Patterson C, Perlman D, Moxham L, Burns S. Do Help-Seeking Behaviors Influence the Recovery of People With Mental Illness? J Psychosoc Nurs Ment Health Serv 2019; 57:33-38. [PMID: 31566704 DOI: 10.3928/02793695-20190920-03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/13/2019] [Indexed: 11/20/2022]
Abstract
Personal recovery is a primary focus for health care professionals and people with mental illness, with current research focused on understanding the concepts and factors that facilitate a positive recovery journey. A person's ability to seek help is an area that has demonstrated promise. Although there is a wealth of literature that exists on the barriers to someone seeking help, there is little empirical evidence to demonstrate the connection between help-seeking behaviors and personal recovery for people with mental illness. The current study used quantitative measures to examine whether help-seeking behaviors would facilitate personal recovery. One hundred twenty people with mental illness completed two valid and reliable surveys that measured help-seeking behaviors and personal recovery. Using multiple linear regression analysis, results revealed that help-seeking behaviors significantly influenced the personal recovery of participants. Understanding the constructs that facilitate a positive personal recovery journey for a person with mental illness may be viewed as a critical area of inquiry. These results allow for future inquiry into the connection between intention and behavior, as there has been an identified disparity between the need for assistance and use of services. [Journal of Psychosocial Nursing and Mental Health Services, 57(12), 33-38.].
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Perlman D, Taylor E, Moxham L, Patterson C. Nursing students' self-determination: the influence on stigmatizing attitude within clinical placement settings. Int J Ment Health Nurs 2019; 28:706-711. [PMID: 30693635 DOI: 10.1111/inm.12572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2018] [Indexed: 11/28/2022]
Abstract
The training of future health professionals is a complex and dynamic endeavour, whereby students engage in a variety of experiences and learning activities. Skills developed through classes are applied and further developed within authentic settings, such as clinical placements. While there is a wealth of literature that has examined the influence of clinical placements, less inquiry has examined whether the personal traits and/or characteristics of students play a role in their professional learning and development. Specifically, a key trait that has been viewed as influencing the education and growth of people, yet has received little focus in the nursing literature, is self-determination. Therefore, the purpose of this study was to examine whether students' self-determination influences their level of professional learning, as measured by their stigmatizing attitudes, within a clinical placement. Participants were undergraduate nursing students classified as either high or low in their self-determination and engaged in a compulsory 80-hour mental health clinical placement. Data were collected using a battery of surveys to assess their self-determination towards their work and stigmatizing attitude towards people with mental illness. Using a two-group pre test and post test design, statistical analysis revealed a significant difference whereby students with high self-determination towards work possessed less stigmatizing attitudes after completing their clinical placement. Results from this study provide empirical evidence that personality elements such as self-determination and motivation towards work can play a role in the education of future professionals.
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Affiliation(s)
- Dana Perlman
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Ellie Taylor
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Lorna Moxham
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Chris Patterson
- University of Wollongong, Wollongong, New South Wales, Australia
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Perlman D, Moxham L, Patterson C, Cregan A. Stigmatization Behavior of Pre-Registration Nurses: Do the Self-Determined Psychological Needs Influence This? Issues Ment Health Nurs 2019; 40:342-346. [PMID: 30742545 DOI: 10.1080/01612840.2018.1534913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background/problem: Stigma and stigmatization are important concepts in the area of mental health and illness. Nursing and nurse education are continuously examining ways to understand and address the stigma toward people with a lived experience of mental illness. While the negative influence of stigma is understood, the variables that influence these behaviors are emerging. An area may provide insight into aspects that influence stigmatization of pre-registration nurses is motivation. Previous research has illustrated that individual motivation can significantly predict and influence work-related behaviors and actions across a range of work settings. Therefore, the purpose of this study was to examine the predictive influence that the motivational needs, as espoused by Self-Determination Theory, play in the stigmatization of pre-registration nurse toward people with a lived experience of mental illness. Approach: A total of 168 pre-registration nurses completed two surveys that measured support for their psychological needs and their stigmatization of people with a lived experience of mental illness. Outcomes/conclusions: Using a regression analysis, some psychological needs significantly influenced the stigmatization of pre-registration nurses. Results illustrate the potential importance of psychological needs in the training of the future nursing workforce.
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Affiliation(s)
- Dana Perlman
- a School of Education, University of Wollongong , New South Wales , Australia
| | - Lorna Moxham
- b School of Nursing , University of Wollongong , New South Wales , Australia
| | - Chris Patterson
- b School of Nursing , University of Wollongong , New South Wales , Australia
| | - Anita Cregan
- a School of Education, University of Wollongong , New South Wales , Australia
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Halcomb EJ, McInnes S, Patterson C, Moxham L. Nurse-delivered interventions for mental health in primary care: a systematic review of randomized controlled trials. Fam Pract 2019; 36:64-71. [PMID: 30364968 DOI: 10.1093/fampra/cmy101] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Mental health issues are increasingly prevalent within the community. Many people experiencing mental health issues have established relationships with primary care providers, including general practice nurses (GPNs). With the recent growth of general practice nursing, it is timely to explore the evidence for GPNs to provide mental health interventions for adults with mental illness within their scope of practice. OBJECTIVE To synthesize the evidence about nurse-delivered interventions in primary care for adults with mental illness. METHODS A systematic review of randomized control trials (RCTs) retrieved from the CINAHL, Ovid MEDLINE and EBSCO electronic databases between 1998 and 2017. RESULTS Nine randomized controlled trials were identified, which reported nurse-delivered interventions in primary care for the management of mental health in adults with mental illness. The heterogeneity of interventions and outcomes made comparison of studies difficult. Seven studies demonstrated significant improvement in at least one outcome following the intervention. In some studies, these improvements were sustained well beyond the intervention. Additionally, consumers were satisfied with the interventions and the role of the GPN. CONCLUSION There is currently limited evidence of the impact of nurse-delivered interventions in primary care for adults with mental illness. Given the significant improvements in symptoms and the acceptability of interventions seen in included studies, there is a need for further robust research exploring the role of the GPN both individually and within the multidisciplinary team. Such research will enable stronger conclusions to be drawn about the impact of nurse-delivered interventions in primary care for adults with mental illness.
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Affiliation(s)
| | - Susan McInnes
- School of Nursing, University of Wollongong, Wollongong, Australia
| | | | - Lorna Moxham
- School of Nursing, University of Wollongong, Wollongong, Australia
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Moxham L. MINDing the mental health of older Australians. Australas J Ageing 2018; 37:243-244. [PMID: 30506818 DOI: 10.1111/ajag.12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Lorna Moxham
- Mental Health Nursing: Science Medicine and Health, and Living Well Longer, Global Challenges Program, University of Wollongong, Wollongong, New South Wales, Australia
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