The effect of self-esteem development programme applied to secondary school students on self-esteem and peer bullying victimization: A randomized controlled trial

BACKGROUND

Self-esteem and peer bullying, which affect the academic success and psychological development of secondary school students, are increasingly becoming a serious problem.

AIM

This study was conducted to examine the effect of the Self-Esteem Development Programme applied to secondary school students on self-esteem and peer bullying victimization.

METHODS

This randomized controlled trial was conducted with 66 students (intervention = 33, control = 33) studying in the 6th grade at a secondary school. Personal Information Form, Rosenberg Self-Esteem Scale and Peer Bullying Identification Scale Adolescent Form were used to collect the data. The intervention group received 8 sessions of Self-Esteem Development Programme in the form of one session per week of 45-60 min; the control group continued their routine education programme.

RESULTS

In the study, after the Self-Esteem Development Programme, the mean self-esteem score of the intervention group increased and the mean peer bullying score decreased, and the difference between the groups was found to be statistically significant (p < 0.05).

CONCLUSION

In conclusion, it can be stated that the Self-Esteem Programme is an effective psychiatric nursing intervention in increasing self-esteem and reducing peer bullying.

IMPLICATIONS FOR PRACTICES

Students with low self-esteem are at risk of exposure to peer bullying. This study provides significant evidence for improving the self-esteem and reducing peer bullying among students who are at risk due to low self-esteem and peer bullying. The results of this study demonstrate that the Self-Esteem Development Programme can be utilized to enhance self-esteem and reduce exposure to peer bullying among students.

CLINICALTRIALS ID

NCT04737374.

Perspectives of adult patients with mental health disorders on the relationship with nurses: a focus group study

BACKGROUND

The relationship between the nurse and the patient with mental health disorder is crucial to the recovery process. Thus, patients with mental health disorders should be active subjects in this relationship by having autonomy and self-determination.

METHODS

This study aimed to explore the perspectives of adult patients with mental health disorders on the relationship with nurses. A qualitative, descriptive, and exploratory study was conducted in March 2023, using focus group meetings in an association to support patients with severe mental health disorders in the Northern region of Portugal. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). A total of 8 patients participated in the study. Two focus group meetings were conducted. The inductive method was used, and content analysis of the transcripts was performed. The QDA Miner Lite 4.0 and Microsoft Excel were used for content analysis.

RESULTS

Participants considered the relationship with nurses important for their recovery and expected nurses to provide support and help, being able to identify their needs, thus personalising their care. Attitudinal and communication aspects were also considered crucial for establishing a solid, trusting, and meaningful relationship.

CONCLUSION

According to the findings nursing care is expected to focus on the patient, his/her preferences, expectations, and the uniqueness of each individual. The results of this study may be useful for the reflection and improvement of nurses in their relational and communication skills and the driving force for nursing students' awareness of the perspective of the relationship with patients with mental health disorder and its relevance.

Innovations in teaching during the COVID-19 pandemic: comparisons of the impacts of different teaching approaches in psychiatric nursing on undergraduate nursing students

BACKGROUND

Psychiatric nursing education was significantly impacted during the COVID-19 pandemic, and innovative teaching can be challenging. This study aims to compare the effectiveness of four approaches to psychiatric nursing education in the context of the pandemic.

METHODS

A quasi-experimental design was adopted. Students were subjected to different teaching designs: face-to-face teaching (Class A in 2021), blended teaching with flipped classroom using roleplay (Class B in 2021), live broadcast teaching (Class A in 2022), and online blended teaching with flipped classroom using case studies (Class B in 2022). Multivariable logistic regression was used to analyse the outcomes in terms of academic performance and course workload.

RESULTS

The number of valid data points was 270. The results indicated that compared with Class A in 2021, the two classes in 2022 achieved significantly higher academic performance scores, and Class B in 2021 exhibited a significantly lower workload. Compared with Class A in 2022, Class B in 2021 exhibited a significantly lower workload. Compared with Class B in 2022, Class B in 2021 exhibited a significantly lower workload and achieved lower academic performance scores.

CONCLUSION

This study demonstrated that innovative teaching designs for psychiatric nursing offer advantages with regard to either facilitating academic performance or optimizing learners' task loads. Furthermore, blended learning is a promising teaching approach in the context of the COVID-19 pandemic. Future teaching initiatives could adopt student-centred constructive learning designs and ensure feasible teaching.

Development and Pilot Testing of a Nurse Care Manager Role in Coordinated Specialty Care for Early Psychosis

Coordinated specialty care (CSC) improves mental health and functional outcomes among individuals with first-episode psychosis but lacks a standardized approach to addressing chronic disease risk. The authors used community-based participatory intervention mapping with nine CSC teams to implement a nurse care manager role for the team in order to identify and address chronic disease risk factors. The role was piloted at one CSC site to explore its feasibility and acceptability. The nurse care manager role was highly acceptable to clients, team members, and leadership. More than one-quarter of the nurse's time was spent on nonbillable activities, and lack of a clear plan for financial sustainability was the primary barrier to implementation.

Developing entrustable professional activities to enhance application of an aggression prevention protocol

AIM

The research aim of this study was to seek feedback from prevention of aggression training experts about the suitability of Entrustable Professional Activities (EPAs) as an assessment tool for an Aggression Prevention Protocol. The protocol was designed to structure intervention to prevent aggression and reduce the use of restrictive practices following risk assessment using a validated instrument (the Dynamic Appraisal of Situational Aggression).

BACKGROUND

Preventing aggression and limiting the use of restrictive practices are key priorities for inpatient mental health services. Assessing clinical activities using a competence framework has limitations, particularly when determining complex interventions. EPAs could provide a suitable method for assessing complex clinical activities like de-escalation and limit setting, which comprise some of the interventions in the Aggression Prevention Protocol. EPAs are new to forensic mental health nursing; therefore, feedback was sought regarding the utility of EPAs to assess aggression prevention interventions.

METHODS

Data were collected via focus groups including 11 aggression prevention experts from Australia and New Zealand. A thematic analysis, comparative analysis and a Strength, Weakness, Opportunity and Threats analysis was conducted.

RESULTS

Three themes were interpreted from the data: 1) Frameworks such as the APP are needed to work towards elimination of restrictive practices; 2) APP-EPAs afford an opportunity to set the standard for practice; and 3) 'who watches the watchers', were identified by the experts as well as areas to enhance EPAs prior to introduction into practice.

CONCLUSIONS

EPAs address a practice-gap and offer a framework to assist movement towards elimination of restrictive practices, while prompting best-practice, self-reflection and practice improvement guidance.

New registered nurse and registered psychiatric nurse graduates' transition-to-practice amid the pandemic: An art-based grounded theory study

BACKGROUND

According to the Transition Shock theory, new Registered Nurses face formidable obstacles within their first year of practice. However, little is known about the experience of new Registered Psychiatric Nurses entering the workforce.

OBJECTIVES

The aim was to explore how new graduates from nursing and psychiatric nursing experience their transition into the workplace that included identifying mediating factors that assist or challenge these entry-level professionals within their transition.

DESIGN

Constructivist grounded theory methodology developed by Charmaz was utilized to explore the first-year transition period using art-based methods.

PARTICIPANTS AND SETTING

A total of 13 new graduates practicing as Registered Nurses and Registered Psychiatric Nurse in a western Canadian province were recruited to participate in the study. Three art-based workshops occurred at four, eight, and 12-months starting in the fall of 2020 through the Spring of 2021 during the novel coronavirus pandemic with subsequent member checks in the Spring of 2022.

METHODS

A total of 38 interview and focus group data were collected. Art-based activities included sand tray and figurine object exercises, collaging, reflective and thematic writing, as well as group concept mapping. Through co-creation of knowledge using Charmaz's methodology, participants selected the major themes throughout their first year of transition with guided researcher facilitation. Data were analyzed using the constant comparative method of analysis for each workshop drawing on the art creations, discussion, and narrative reflective writing pieces generated by participants.

RESULTS

Participants were in a basic psychosocial process of growing personal and professional self. Through co-construction of knowledge with the participants, three substantive interconnected categories were identified: (1) Being thrown into the fire; (2) Adjusting and adapting to the team environment; and (3) Nurturing self and others.

CONCLUSIONS

The findings revealed many recommendations for employers hiring new graduates and nursing education programs preparing graduates for the practice arena.

The application and effect of predictive nursing in the prevention of accidental events during operations for SMI patients

OBJECTIVE

To explore the status and influencing factors of job burnout among psychiatric nurses and provide a reference for hospital managers to carry out occupational and psychological interventions.

METHODS

Between September 2021 and September 2022, the psychiatric nurses in Wuhan Wudong Hospital (Wuhan Second Psychiatric Hospital) were selected as research participants using convenience sampling. The Chinese version of the nursing burnout scale was used to investigate the psychiatric nurses in the hospital, and a multiple linear regression analysis was performed on the factors affecting job burnout.

RESULTS

Among the 121 psychiatric nurses, 57.85 % had no or only mild job burnout, 36.36 % had mild to moderate job burnout and 5.79 % had severe job burnout. The one-way analysis of variance indicated that there were statistical differences in the scores in terms of marital status, educational background, working years, income, work departments and shifts (p < 0.05). The multiple linear regression analysis indicated that the main influencing factors of job burnout were working years and work department (p < 0.05).

CONCLUSION

The detection rate of nurses' job burnout in the featured psychiatric hospital was 42.10 %. The main influencing factors of job burnout were working years and work department, and targeted intervention can be carried out according to these two factors.

Effectiveness of the positive discipline program applied to parents of preschool children: A randomized-controlled trial

BACKGROUND

Although the Positive Discipline Program is used extensively internationally, there are very few evidence-based studies on it. This study aims to examine the experimental results of the Positive Discipline Program.

METHOD

This randomized-controlled study had the following types of groups: intervention, active control, and non-contact control. The study sample consisted of 72 parents with children aged between 3 and 6 years. The intervention group participated in an eight-session online Positive Discipline Program, the active control group participated in an eight-session online free interaction program, and the non-contact control group received no intervention.

RESULTS

Parents in the intervention group demonstrated an increase in cooperation with their children after the training and during the follow-up period. In the intervention group, parents' oppressive and authoritarian attitudes decreased after the training and during the follow-up period; spouses' democratic attitudes increased after the training and their overprotective attitudes decreased in the follow-up period. Parent-child communication and unhindered listening increased in the intervention and active control groups. The problem-solving skills of the intervention group increased after the training and during the follow-up period, and sensitivity increased in the follow-up period.

CONCLUSION

As one of the few experimental studies implementing the Positive Discipline Program, this study revealed the strengths of the program as well as culture-specific aspects that need to be improved. Further, this program was effective in improving parents' relationships with their children, attitudes, and problem-solving skills, and it provided evidence for the program's positive contributions to raising a child.

IMPLICATIONS FOR PRACTICE

The Positive Discipline Program can guide parents in solving the developmental and school-related problems of preschool children as well as school and adolescence children.

Incorporating social justice learning into competency-based graduate nursing: A discussion of integrating pedagogies

BACKGROUND

The impact of social inequity on the collective health of a society is well documented and, despite decades of research, the problem persists on a global scale. Nurse practitioners are competent to treat the downstream health effects of social inequity, but nursing students may lack the structural awareness to accurately target primary prevention efforts.

OBJECTIVE

The authors discuss faculty preparation and pedagogical considerations when incorporating social justice learning into a graduate and post-graduate psychiatric nurse practitioner course.

DESIGN/METHODS

Guided by Walter's Emancipatory Nursing Praxis model, several pedagogical strategies were developed to enhance graduate nursing students' awareness of oppressive and unjust realities in the healthcare setting.

CONCLUSION

Emancipatory pedagogical strategies in competency-based graduate nursing education can enhance the transformative social learning essential for the development of health equity praxis.

Effectiveness of a nursing board games in psychiatric nursing course for undergraduate nursing students: An experimental design

AIM

To examine the effectiveness of a psychiatric nursing board game in an undergraduate psychiatric nursing course.

BACKGROUND

Didactic teaching fails to assist students in deepening their understanding of abstract concepts in psychiatric nursing. The game-based learning of professional courses can address the demands of digital-age students, which may improve their learning outcomes.

DESIGN

A parallel two-arm experimental design was adopted in a nursing college in southern Taiwan.

METHODS

The participants were fourth-year students enroled in a college nursing programme in southern Taiwan. Simple random sampling was used to divide the class into intervention and control groups. The former participated in an eight-week game-based intervention course, while the latter continued to receive traditional instruction. In addition to collecting the students' demographic data, three structural questionnaires were developed to examine the variation in students' nursing knowledge and attitudes toward psychiatric nursing, as well as their learning satisfaction before and after the intervention.

RESULTS

There were a total of 106 participants, with 53 in each group. After the intervention, the two groups were significantly different in terms of their psychiatric nursing knowledge, attitudes and self-reported learning satisfaction. The intervention group's scores were significantly higher than those of the control group across all three dimensions. This suggests the positive effects of the board game intervention on students' learning outcomes.

CONCLUSION

The research outcome can be applied in formative and undergraduate nursing education in teaching psychiatric nursing globally. The game-based learning materials developed can be used to train psychiatric nursing teachers. Future studies should recruit a larger sample and increase the follow-up time for assessing students' learning outcomes, as well as examine the similarities and differences in the learning outcomes of students from different educational systems.

Development and Validation of Clinical Schedule for Primary Care Psychiatric Nursing (CSP-N) for Primary Care Nurses

Introduction

As per the World Health Organization's mental health report for 2022, nearly a billion people have mental health issues, and 82% of them are in low and middle-income countries where mental health services are largely absent. For the successful integration of mental health into primary health care, proper training and education of primary care professionals are mandatory. Primary care nurses are in an excellent position to screen, identify, dual collaboration for treatment planning/referral, and follow-up of persons with mental illness (PMI), but they often lack the confidence and competence to tackle mental health problems. The study aimed to develop and validate the clinical schedule for primary care psychiatric nursing (CSP-N).

Materials and Methods

It is conducted in two phases: the development and validation phases. An extensive literature search has been conducted, and the ten themes derived from the two-focused group discussions and three-direct one-to-one interviews and input from mental health experts were used to design the CSP-N. The CSP-N was checked for content validity by a panel of 17 experts using the item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI).

Results

The draft version 1 of the CSP-N showed high content validity for individual items (I-CVI range: 0.82 to 1.00) and high overall content validity (S-CVI = 0.95), and suggestions from the experts were incorporated. The CSP-N was developed in four modules. The single-measure two-way mixed absolute agreement ICC value was calculated (for 32 subjects) for the reliability test, and the ICC value was 0.97 with a 95% CI (0.94, 0.99).

Conclusions

Using an iterative approach, the development and validation of the CSP-N demonstrated high I-CVI and S-CVI for screening and identification, dual collaboration for the treatment plan, referral, and follow-up of a person with mental illness by the nurses in the community.

Content analysis of suicide prevention web pages from perspective of preventive psychiatric approaches

Suicide is a serious public health problem; however, suicides are preventable with evidence-based and often low-cost interventions. This study analyzes the online content of suicide prevention and helps websites in the context of preventive psychiatry. The universe and sample of the research consisted of 147 web pages whose links can be found on the most widely used international social media platforms and websites dedicated to suicide prevention. To conduct the content analysis, the crisis hotline guide prepared by the World Health Organization for suicide prevention and the guide prepared for media professionals were used in the data collection form created by the researchers. The majority of the websites were of European origin and were prepared by mental health and suicide prevention associations for suicide prevention and crisis intervention. Telephone helplines were the most common means of communicating with consultants via the web page. On the basis of the research findings, suggestions were generated regarding the scope, content, and sustainability of web pages for crisis intervention and suicide prevention prepared at the national and international levels.

Sexual needs of people with schizophrenia: a descriptive phenomenological study

BACKGROUND

Sexual health is one of the main areas of health and basic human rights which has been paid less attention in schizophrenia. Most studies have focused on sexual dysfunction rather than the sexual needs of people with schizophrenia. This study explores the sexual needs of people with schizophrenia and identify factors hindering sexual activities.

METHODS

We carried out a qualitative study using a descriptive phenomenological approach. Data were collected at a psychiatric hospital in China. In total, 20 patients with schizophrenia were recruited through purposive sampling. Face to face semi-structured in-depth interviews were conducted with them. Interview recordings were transcribed by the research team, and transcripts were analyzed by two independent coders with Colaizzi's descriptive analysis framework by using NVivo 11 software. The consolidated criteria for reporting qualitative research checklist was used for reporting.

RESULTS

The data analysis revealed 10 subthemes categorized into 3 macro themes: (1) multiple barriers hinder sexual activity; (2) significance of sex; and (3) conditions for fulfilling sexual needs.

CONCLUSION

A poor sexual quality of life may be found in patients with schizophrenia. Furthermore, people with schizophrenia did not lose interest in maintaining an active sex life. Mental health services should address this issue in three areas: sexual knowledge, sexual space, and sexual objects.

Emergency Removal of Supervision Requirements for Psychiatric Mental Health Nurse Practitioners: A Mixed-Methods Survey

OBJECTIVE

Physician supervision of nurse practitioners (NPs) was temporarily waived in Massachusetts in response to a state of emergency due to the COVID-19 pandemic. The authors examined the impact of the scope-of-practice changes and pandemic-related demands on psychiatric mental health NPs (PMHNPs) during the state's first COVID-19 surge.

METHODS

A mixed-methods Web-based survey was conducted in May and June of 2020. Fisher's exact test was used to compare associations across certification types, and inductive content analysis was applied to open-ended responses.

RESULTS

The survey response rate was 41% (N=389 of 958), consisting of 26 PMHNPs and 363 other NPs. Compared with other NPs, PMHNPs were significantly more likely to work in a telehealth setting (42% vs. 11%, p<0.001), to spend more time working during the initial surge (50% vs. 26%, p<0.05), and to believe that the waiver improved clinical work (52% vs. 25%, p<0.01). Content analysis of PMHNPs' open-ended responses identified four themes: the supervision waiver reduced burden on PMHNPs, collaboration and mentorship models persisted, the pandemic exacerbated the already high demand for psychiatric care, and telehealth helped meet the high demand for such care.

CONCLUSIONS

PMHNPs may be more sensitive to the scope-of-practice changes and telehealth expansion than other NPs because of the constraints of the psychiatrist shortage and high relative uptake of telehealth in psychiatric care. The interactions of workforce supply, telehealth expansion, and scope-of-practice laws are important to consider in the development of policies to improve access to mental health care.

Self-Reported Experience of Abuse During the Life Course Among Men Seeking General Psychiatric or Addiction Care-A Prevalence Study in a Swedish Context

A prevalence study was conducted using the NorVold Abuse Questionnaire for men (m-NorAQ) to estimate the prevalence of self-reported experience of life-course abuse and to identify the perpetrators of the abuse. This among men seeking general psychiatric and addiction care in a Swedish context. In total, 210 men completed the questionnaire, and were included in the study. The total prevalence of life-course abuse (i.e., any emotional, physical or sexual abuse during the life course) was 75% (n = 157). The results of this study indicate the importance of identifying experiences of life-course abuse among men in general psychiatric and addiction care settings.

The relationship between beliefs toward mental illnesses, empathic tendency and social distancing in university students

This study was conducted to determine the level of beliefs toward mental illnesses in university students and to examine its relationship with empathic tendency and social distance level. This descriptive and relational study was conducted at the Faculty of Health Sciences and Faculty of Nursing of a state university in Turkey. The sample of the study consisted of 678 students studying in the 4th grade of these faculties. Personal Information Form, the Beliefs Toward Mental Illness Scale (BMI), the Empathic Tendency Scale (ETS), and the Social Distance Scale (SDI) were used to collect data. It was determined that there was a high level of negative relationship between the students' mean BMI score and the age variable and the empathic tendency and social distance mean scores. It was seen that the mean Empathic Tendecy Scale and Social Distance Scale scores accounted for 86.6 % of the change in the mean BMI score (Adjusted R2 = 0.826). The mean BMI score of the students was found to be below the medium level. On the other hand, it was found that empathic tendency and social distance mean scores were above the medium level and had an effect on the mean BMI score. Psychosocial factors that are effective in the emergence of negative beliefs about mental illnesses in students should be investigated and studies should be carried out to increase awareness about negative beliefs.

The effect of solution-focused approach on anger management and violent behavior in adolescents: A randomized controlled trial

BACKGROUND

This study was carried out to evaluate the effect of a solution-focused approach on anger management and violent behavior in adolescents.

METHOD

The study was an experimental and randomized controlled trial including pre-test and post-test measurements and control group. The sample of experimental (n = 24) and control groups (n = 24) of the study consisted of 48 students. A 7-session program of anger management and prevention of violent behavior based on a solution focused approach was applied to the experimental group.

RESULTS

There were no statistically significant differences between trait anger, anger in, anger out, anger control sub-dimensions and VTS scores of the experimental and control groups before the intervention (p > 0.05). In post-test and follow-up test, trait anger (23.32 ± 2.83) (21.10 ± 3.51), anger-out (14.95 ± 4.16) (15.50 ± 3.49) and the mean scores of VTS (30.77 ± 4.01) (32.80 ± 4.53) of the individuals in the experimental group were significantly lower, whereas their mean score of anger control (24.86 ± 3.62) (23.65 ± 4.44) were significantly higher than the control group.

CONCLUSION

Solution-oriented approach programs should be used by psychiatric nurses to provide anger management and reduce violence tendencies in adolescents.

Effects of the family support and psychoeducation program based on the Calgary Family Intervention Model on the coping, psychological distress and psychological resilience levels of the family caregivers of chronic psychiatric patients

AIMS

This study was aimed at investigating the effects of family support and psychoeducation program based on Calgary Family Intervention Model on coping, psychological distress and psychological resilience levels of families of chronic psychiatric patients.

METHODS

The sample of this quasi-experimental study consisted of the caregivers of chronic psychiatric patients who were admitted to the adult psychiatry inpatient and outpatient unit of a university hospital and the caregivers of chronic psychiatric patients registered with the Schizophrenia Solidarity Association. Nonparametric analysis was used in the analysis of the data.

RESULTS

It was found that there was a significant decrease between the mean distress scores the caregivers participating in the Calgary Family Intervention-Based Family Support and Psychoeducation Program obtained from the measurements before, right after, and 3 and 6 months after the intervention (p < 0.05). There was no statistically significant difference between the coping scores and psychological resilience scores the caregivers obtained from the measurements before, right after, and 3 and 6 months after the intervention (p > 0.05).

CONCLUSION

It was concluded that the family support and psychoeducation program based on the Calgary Family Intervention Model applied to family members giving care to individuals with chronic mental illnesses had positive effects on the general health status of the caregivers.

The effect of two simulations on students' knowledge and skills regarding physical health problems of psychiatric patients: A mixed-method study

BACKGROUND

Simulation-based training can help nursing students improve their mental and physical healthcare knowledge and skills.

OBJECTIVES

This study focused on two different simulation modalities and investigated whether they helped nursing students acquire knowledge and develop skills necessary to address the physical health problems of people with mental disorders.

DESIGN

This is a mixed-method study.

SETTINGS

This study was conducted in Turkey.

PARTICIPANTS

The sample consisted of 61 students divided into two experimental groups and one control group.

METHODS

One experimental group participated in a clinical simulation scenario involving a standardized patient modality, while the other participated in a hybrid simulation modality (standardized patient and high-fidelity model simulator). The control group participated in conventional training. The researchers evaluate the effect of the modalities and conventional training on clinical practice one month after the interventions. Focus group interviews were conducted with all participants one month after the evaluation. Knowledge test was administered to all participants before the intervention, after the intervention, at the third and sixth months after the intervention.

RESULTS AND CONCLUSION

The clinical simulation was statistically effective for students' skill development about physical health problems of psychiatric patients. Also, in the qualitative findings, the clinical simulation increased the knowledge level of the students and improved their physical health assessment skills. Standardized patient simulation and hybrid simulation modalities should be used to help nursing students develop their assessment skills regarding the physical health problems of psychiatric patients.

The patient-authored medical record: A narrative path to a new tool in psychiatric nursing

This paper describes preliminary research from Japan on developing a new tool for psychiatric nurses, the patient-authored medical record, a "prescription" written in ordinary language by the patient with the assistance of a nurse. The nurse asks the patient how to improve their illness and she types up the patient's story on site in the form of a first-person narrative. The patient checks it for accuracy before taking a copy home. Ten Japanese patients participated in this field-oriented ethnographic study, and the analysis of the qualitative data strongly suggested that the approach had therapeutic effects on each patient. This narrative-based prescription could be used as a tool, specifically by psychiatric nurses, in many cultures, and it is our hope that it contributes to their professional identity.

Short-stay crisis units for mental health patients on crisis care pathways: systematic review and meta-analysis

BACKGROUND

Internationally, an increasing proportion of emergency department visits are mental health related. Concurrently, psychiatric wards are often occupied above capacity. Healthcare providers have introduced short-stay, hospital-based crisis units offering a therapeutic space for stabilisation, assessment and appropriate referral. Research lags behind roll-out, and a review of the evidence is urgently needed to inform policy and further introduction of similar units.

AIMS

This systematic review aims to evaluate the effectiveness of short-stay, hospital-based mental health crisis units.

METHOD

We searched EMBASE, Medline, CINAHL and PsycINFO up to March 2021. All designs incorporating a control or comparison group were eligible for inclusion, and all effect estimates with a comparison group were extracted and combined meta-analytically where appropriate. We assessed study risk of bias with Risk of Bias in Non-Randomized Studies - of Interventions and Risk of Bias in Randomized Trials.

RESULTS

Data from twelve studies across six countries (Australia, Belgium, Canada, The Netherlands, UK and USA) and 67 505 participants were included. Data indicated that units delivered benefits on many outcomes. Units could reduce psychiatric holds (42% after intervention compared with 49.8% before intervention; difference = 7.8%; P < 0.0001) and increase out-patient follow-up care (χ² = 37.42, d.f. = 1; P < 0.001). Meta-analysis indicated a significant reduction in length of emergency department stay (by 164.24 min; 95% CI -261.24 to -67.23 min; P < 0.001) and number of in-patient admissions (odds ratio 0.55, 95% CI 0.43-0.68; P < 0.001).

CONCLUSIONS

Short-stay mental health crisis units are effective for reducing emergency department wait times and in-patient admissions. Further research should investigate the impact of units on patient experience, and clinical and social outcomes.

Effect of emotional awareness skills training on emotional awareness and communication skills in patients with schizophrenia: A Randomized Controlled Trial

PURPOSE

This study was conducted to examine the effect of emotional awareness skills training on emotional awareness and communication skills in patients with schizophrenia.

METHODS

This randomized controlled trial was conducted with 44 patients with schizophrenia (22 in the intervention group and 22 in the control group) registered at a community mental health center. The personal information form, Toronto Alexithymia Scale (TAS-20), and communication skills scale-adult form were used to collect patient data. The emotional awareness skills training was implemented once a week for 8 weeks.

RESULTS

After the training, the mean scores of the "Difficulty Identifying Feelings" and "Difficulty Describing Feelings" subscales of TAS-20 decreased and the mean scores of the communication skills scale-adult form increased in the intervention group; the difference between the groups was statistically significant. While there was no difference between the groups in the initial measurements, a significant difference was found between the mean scores of "Difficulty Identifying Feelings" and "Difficulty Describing Feelings" in the intervention group and a significant difference was found in both groups between the subscales of "Basic Skills and Personal (Self) Expression", "Willingness to Communicate", "Caring Communication" and "Active Listening and Non-Verbal Communication" and the total mean score after the intervention.

CONCLUSION

Based on the study results, it can be concluded that emotional awareness skills training is an effective psychiatric nursing intervention that improves emotional awareness and communication skills. NCT05038927.

The experiences of parents as caregivers of adolescents with mental illnesses, the impact of the crisis and the admission to a day hospital

AIM

The aim of this study was to analyze the caregiving experience of parents whose adolescent children with a mental illness require admission to a day treatment hospital for mental health services.

METHOD

The study used qualitative interpretative research methods. A total of 18 parents participated in the semi-structured interviews. Data were then transcribed and analyzed in accordance with established methods for the analysis of inductive thematic data.

RESULTS

Seven themes were identified: questioning an unseen disease, abnormal behavior, a long road, truancy and loss of parental authority, internalized stigma on admission, regaining the meaning of life and an uncertain future.

DISCUSSION

The experience of the parents was analyzed and various emotional, psychological and interpersonal barriers were found that influenced the help-seeking for the adolescent's treatment.

IMPLICATIONS FOR PRACTICE

Nursing interventions should be based on detecting barriers and validating the experience of parents with mentally ill adolescents.

How may cultural and political ideals cause moral distress in acute psychiatry? A qualitative study

BACKGROUND

There is growing public criticism of the use of restraints or coercion. Demands for strengthened patient participation and prevention of coercive measures in mental health care has become a priority for care professionals, researchers, and policymakers in Norway, as in many other countries. We have studied in what ways this current ideal of reducing the use of restraints or coercion and attempting to practice in a least restrictive manner may raise morals issues and create experiences of moral distress in nurses working in acute psychiatric contexts.

METHODS

Qualitative interview study, individual and focus group interviews, with altogether 30 nurses working in acute psychiatric wards in two mental health hospitals in Norway. Interviews were recorded and transcribed. A thematic analytic approach was chosen.

RESULTS

While nurses sense a strong expectation to minimise the use of restraints/coercion, patients on acute psychiatric wards are being increasingly ill with a greater tendency to violence. This creates moral doubt and dilemmas regarding how much nurses should endure on their own and their patients' behalf and may expose patients and healthcare personnel to greater risk of violence. Nurses worry that new legislation and ideals may prevent acutely mentally ill and vulnerable patients from receiving the treatment they need as well as their ability to create a psychological safe climate on the ward. Furthermore, persuading the patient to stay on the ward can cause guilt and uneasiness. Inadequate resources function as external constraints that may frustrate nurses from realising the treatment ideals set before them.

CONCLUSIONS

Mental health nurses working in acute psychiatric care are involved in a complex interplay between political and professional ideals to reduce the use of coercion while being responsible for the safety of both patients and staff as well as creating a therapeutic atmosphere. External constraints like inadequate resources may furthermore hinder the healthcare workers/nurses from realising the treatment ideals set before them. Caught in the middle nurses may experience moral distress that may lead to physical discomfort, uneasiness and feelings of guilt, shame, and defeat. Pressure on nurses and care providers to reduce or eliminate the use of coercion and reduction of health care spending are incompatible demands.

The effect of a solution-oriented therapy on the depression levels and the perceived social support of depressive patients

BACKGROUND

This study was executed to evaluate the effect of the solution-oriented therapy programme on the depression levels and the perceived social support of depressive patients METHOD: The study was designed as a randomized controlled trial with a pre-test and post-test control group and repeated measures. The Solution-Oriented Therapy Programme was implemented in a total of 6 to 10 sessions with the patients of experimental group.

RESULTS

There were no statistically significant differences between the mean BDI and PSSI scores of the experimental and control groups before the programme. At one week after the programme (29.89 ± 4.15) and after 3 months (31.71 ± 3.72), the mean of the BDI grades of the individuals in the experimental group were significantly lower than was that of the individuals in the control group. In the study group, the mean PSSI scores significantly increased at one week after programme (50.79 ± 10.81) and decreased (46.61 ± 10.37) at after 3 months.

CONCLUSION

The execution of Solution-Oriented Therapy Programme with the depressive patients should be done by the psychiatric nurses within the scope of the services that psychiatric care units serve.

A critical analysis of the Tidal Model of Mental Health Recovery

The purpose of this paper is to critically analyze the Tidal Model of Mental Health Recovery. This examination consolidates the existing knowledge used in developing and implementing this model in order to add clarity and explores how its theory relates to practice, research, and educational activities. This paper follows Chinn and Kramer's theory analysis framework, which includes the following criteria: clarity, simplicity, generalizability, importance, and accessibility. While the Tidal Model theory meets the criterion of clarity, simplicity is impeded due to the complexity of its concepts. That being said, Barker's theory is applicable across different psychiatric nursing settings because it is general and accessible. To enhance simplicity and make this a more actionable mid-range theory, an illustration is offered to demonstrate how the theory could be utilized and empiricized with a potential population of women who use substances. It is concluded that the Tidal Model appeals not only to mental health practice, but as the literature indicates, it also supports everyone who needs shelter where they feel safe at some point in their lives.

Personal recovery and its challenges in forensic mental health: systematic review and thematic synthesis of the qualitative literature

BACKGROUND

There has been a call for a framework to guide recovery-oriented practices in forensic mental health services.

AIMS

This study aims to examine personal recovery and its challenges in forensic mental health settings in relation to the established framework for personal recovery in mental illness: connectedness, hope, identity, meaning and empowerment (CHIME).

METHOD

This study is an updated and expanded systematic review and thematic synthesis of the qualitative literature. A systematic search of six electronic databases (Web of Science, Medline, PsycINFO, CINAHL, EMBASE and SocIndex) was carried out in January 2019, using the terms [Recover*] AND [Forensic OR Secure] AND [Patient* OR Offend* OR Service User*]. Only studies that included service user's own perceptions and were published from 2014 onward were included in the review. Data were examined with thematic synthesis and subsequently analysed in relation to the CHIME framework.

RESULTS

Twenty-one studies were included in the review. Findings suggest that some adjustments to the original CHIME framework are needed for it to be more relevant to forensic populations, and that an additional recovery process regarding feeling safe and being secure (safety and security) could be added to CHIME, providing the CHIME-Secure framework (CHIME-S). Specific challenges and barriers for forensic recovery were identified and found to represent the opposite of the recovery processes defined by CHIME (e.g. hopelessness).

CONCLUSIONS

We present the CHIME-S as a framework for the personal recovery processes of forensic mental health service users. The CHIME-S may guide the recovery-oriented work of forensic mental health services.

The Effect of Death Anxiety on Psychosocial Adjustment in Individual With Chronic Obstructive Pulmonary Disease

Objectives:

This study was carried out in a descriptive manner to determine the effect of death anxiety on psychosocial adjustment in patients with chronic obstructive pulmonary disease (COPD).

Materials and Methods:

The study was carried out on 150 inpatients and outpatients who were being treated at the thoracic diseases department of a state hospital during January 1– April 20, 2016. Personal information form, death anxiety scale (DAS) and psychosocial adjustment to illness scale-self report (PAIS-SR) were used for data acquisition. The data were analysed through IBM Statistical Package for the Social Sciences 22 software.

Results:

The DAS score average of the patients was determined as 6.96 ± 3.45, PAIS-SR total score average was determined as 67.54 ± 14.96. A positive and statistically significant relationship was determined between the death anxiety of the patients and their psychosocial adjustments (P < 0.05).

Conclusion:

It can be concluded as a result of the study that the death anxieties of COPD patients are at a moderate level, that their psychosocial adjustments to the disease are at a bad level and that their psychosocial adjustments to the illness and to life are disrupted with increasing death anxiety. Psychiatry nurses can contribute to increasing the psychosocial adjustment to the illness of the patient by helping the patient and his/her family in adjusting to the changes in their life styles, preventing non-beneficial adjustments, developing the coping skills of the patient and his/her family and accordingly making the necessary planning.

Building psychiatric advanced practice student nurse competency to conduct comprehensive diagnostic interviews using two types of online simulation methods

BACKGROUND

Through innovative use of established technologies, online nursing programs can provide psychiatric mental health nurse practitioner (PMHNP) students with robust virtual experiences for learning professional competencies, including those involving psychomotor and affective domains.

PURPOSE

To describe a virtual simulation teaching methodology using online text-based simulations of patient visits prior to a virtual standardized patient (SP) encounter in an asynchronous online course for PMHNP students.

METHOD

Student learning experiences were framed by the Framework for the 21st Century Learning. Two types of online simulations were employed: (1) four text-based exercises, created with a testing tool in a learning management system, allowed students to practice the critical thinking processes behind diagnostic interviewing, and (2) a telehealth simulation with an SP, where students engaged the patient, conducted a diagnostic interview, and discussed the treatment plan with the patient. Following the telehealth simulation, students completed self-assessments, received individual feedback from the SP and clinical faculty, and discussed experiences in small groups.

RESULTS

Students demonstrated professional competencies and developed self-awareness and self-efficacy through reflection and discussion.

CONCLUSION

This teaching approach can potentially enhance learning and build greater career skills including conducting diagnostic interviews using therapeutic communication skills for patients with stigmatizing mental health conditions.

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

BACKGROUND

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

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Development and validity of the Korea psychiatric triage algorithm

Background

Psychiatric emergencies require timely intervention because of the risk of harm to individuals and society, including others. The aim of the present study was to test the content validity of a psychiatric triage algorithm developed for use in South Korea.

Methods

The initial algorithm was developed through systematic literature review. Its validity was then verified by 10 experts. Based on results of expert validity, the algorithm was modified and the final algorithm was developed.

Results

Its clinical validity was then verified by 37 emergency room nurses who had used triage. Four questions of expert validity results with a CVI of 0.8 or less were revised to reflect expert opinion. The usefulness, adequacy, and convenience of the final modified algorithm was 2.98 ~ 3.53.

Conclusion

After sufficiently validated by follow-up studies, it is expected that the use of psychiatric classification algorithms in emergency room nurses will not only improve the quality of care, but also can improve patient outcomes and experience.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Lifetime neuropsychiatric symptoms in Huntington's disease: Implications for psychiatric nursing

Neuropsychiatric manifestations of Huntington's disease (HD) can present years before motor symptoms. Nurses with specialized training provide superior care for HD patients, but HD exposure in nursing education is limited. Here we aimed to describe the historical neuropsychiatric burden in 50 HD patients and discuss implications for psychiatric nurses. Fifty patients with HD were assessed by a board-certified psychiatrist and completed surveys about symptoms, social history, medication use, and quality of life outcomes. Descriptive statistics were used to summarize patient characteristics, and correlation analyses assessed the relationships between neuropsychiatric symptoms and quality of life outcomes. Most patients (72%) reported a history of neuropsychiatric symptoms prior to their HD diagnosis. Prodromal anger/irritability was most common (52%), though few patients received treatment for this. Anxiety was the most common current symptom (78%), yet 40% of patients had never been prescribed an SSRI. Anxiety was associated with poorer patient-reported quality of life outcomes (p < .01). HD patients in this sample experienced frequent, early-onset neuropsychiatric symptoms. In coming years, psychiatric nurses in community settings will be more likely to encounter gene-positive HD patients before they develop motor symptoms. Psychiatric nurses can address identified gaps through enhanced screening and encouraging early intervention in those at risk.

The Prevalence of Burnout and its Associations with Demographic Correlates and Quality of Life among Psychiatric Nurses in China

This study examined the prevalence of burnout and its association with quality of life (QOL) among psychiatric nurses in China.Ten psychiatric hospitals were included. Burnout and QOL were measured using standardized instruments. Altogether, 1449 nurses completed the assessment. The mean scores of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA) were 11.87 (SD = 6.72), 6.98 (SD = 5.71) and 22.06 (SD = 8.67), respectively. Of the participants, 59.8% (95% CI: 57-62%) experienced burnout; with 23.3% (95% CI: 21-25%) in EE, 14.6% (95% CI: 13-16%) in DP and 45.1% (95% CI: 43-48%) in PA. Psychiatric nurses who reported burnout had lower QOL in social (F _{(1, 1448)} = 86.20, P < 0.001), physical (F _{(1, 1448)} = 170.46, P < 0.001), psychological (F _{(1, 1448)} = 205.63, P < 0.001), and environmental (F _{(1, 1448)} = 120.24, P < 0.001) domains. Multiple logistic regression analysis revealed that alcohol users (P = 0.04; OR = 1.29, 95%CI: 1.01-1.64 in model 1 and P = 0.03; OR = 1.32, 95%CI: 1.04-1.69 in model 2) were significantly more susceptible to burnout, while senior nurses (P = 0.007; OR = 0.70, 95%CI: 0.53-0.91) and nurses with longer work experience (P = 0.02; OR = 0.70, 95%CI: 0.53-0.91) were less likely to develop burnout. Burnout is common in psychiatric nurses in China. In light of its negative impact on health and QOL, there is an urgent need for regular screening as well as effective preventive measures and interventions to reduce burnout within this at-risk occupational group.

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

BACKGROUND

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

OBJECTIVES

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

DESIGN

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

PARTICIPANTS

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

RESULTS

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

CONCLUSIONS

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

Stigmatization and dehumanization perceptions towards psychiatric patients among nurses: A path-analysis approach

BACKGROUND

People with mental illness are stigmatized and dehumanized, which contributes to disorders' maintenance. Dehumanization is associated with abuse/neglect and should thus be evaluated among healthcare workers. We compared nurses' stigmatizing/dehumanizing perceptions of people with psychiatric versus non-psychiatric disorders. We also investigated the impact of social contact's quality/frequency and identified the determinants of dehumanization.

METHODS

French-speaking hospitals and nurses' associations were contacted to disseminate the survey among their employees or members. Three hundred thirty-six nurses reported their perceptions of one among three clinical populations (people with severe alcohol use disorder, schizophrenia, or cardiovascular disease). Nurses' perception of patients was evaluated through stigmatization, dehumanization, quality of contacts, structural discrimination, and evaluation of patients' life, pain, consent, and diagnostic overshadowing. Nurses' well-being was evaluated through their own perception of being dehumanized by superiors and their burnout, depression, anxiety, and stress levels.

RESULTS

Nurses stigmatized and dehumanized people with a psychiatric disorder more than people without a psychiatric disorder. Nurses dehumanized patients more if they felt dehumanized by their hierarchical superiors and less if they had qualitative contacts with patients.

CONCLUSIONS

Stigmatization and dehumanization are widespread among nurses in psychiatry, which advocates for less stigmatizing practices in healthcare settings. We propose concrete perspectives to reduce stigma/dehumanization among nurses.

Hospital-wide SARS-CoV-2 antibody screening of staff in a university psychiatric centre in Belgium

In this first serosurvey among psychiatric healthcare providers, only 3.2% of a sample of 431 staff members of a Belgian University Psychiatric Centre, screened 3-17 June 2020, had SARS-CoV-2 immunoglobulin G antibodies, which is considerably lower compared with both the general population and other healthcare workers in Belgium. The low seroprevalence was unexpected, given the limited availability of personal protective equipment and the high amount of COVID-19 symptoms reported by staff members. Importantly, exposure at home predicted the presence of antibodies, but exposure at work did not. Measures to prevent transmission from staff to patients are warranted in psychiatric facilities.

Innovations in virtual education for clinical and simulation learning

The global impact of COVID-19 forced nursing education to provide an alternative for scheduled clinical experiences during the Spring and Fall of 2020. Many programs selected the pre-packaged, web-based solutions at the onset of the pandemic due to the uncertainty and recommendation of social distancing. Clinical and simulation faculty began to look for educational alternatives to provide meaningful learning experiences that more closely replicated clinical learning because students expressed displeasure with the asynchronous web-based options. This article outlines how an innovative partnership between clinical faculty, simulation faculty, and the Theatre Department modified an in-person simulation activity designed for groups of two students into a web-based "clinical" experience that included the assigned clinical faculty, eight nursing students, and one simulated patient. This active learning strategy was able to meet the course objectives, required little additional resources, and most importantly, underwent positive evaluation by the weary, screen-based learners.

Perceived barriers to providing spiritual care among psychiatric mental health nurses

BACKGROUND

Although nurses typically view spiritual care as important, it is provided infrequently.

OBJECTIVES

This research investigated psychiatric mental health nurses' perceived barriers to providing spiritual care, and how these barriers were associated with frequency of spiritual care and demographic factors.

METHODS

This cross-sectional correlational study of 159 psychiatric mental health nurses used questionnaires to measure frequency of spiritual care and barriers to spiritual care.

RESULTS

The most frequent barriers to providing spiritual care were lack of education and fear of exacerbating psychiatric symptoms. Psychiatric mental health nurses provided spiritual care infrequently.

CONCLUSIONS

Nurses need education about providing spiritual care to those with psychiatric mental health needs.

A biopsychosocial interpretation of the Neuropsychiatric Inventory - Nursing Home assessment: reconceptualising psychiatric symptom attributions

BACKGROUND

The Neuropsychiatric Inventory (NPI) is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric symptoms is important since the treatment and management of symptoms relies on this understanding.

AIMS

This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in Neuropsychiatric Inventory-Nursing Home (NPI-NH) interviews.

METHOD

The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n = 651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n = 3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with orientation and memory; expressions of need; poor care and communication; or understandable reactions).

RESULTS

Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (such as poor care and communication).

CONCLUSIONS

The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively.

The Mental Health Recovery Model and Its Importance for Colombian Nursing

The article aims to describe the Mental Health Recovery Model, the Tidal Model in Mental Health Recovery and their relevance to implementation within the practice of Colombian nursing. Some concepts about mental health recovery and the theoretical model proposed by Phil Barker are presented in the text, analysing these with the challenges of the nursing professional to improve mental health care, taking into account the current context of care practice. The principles proposed with the Recovery model help to focus care on the person and not on the symptomatology of the illness, understanding that the person has different dimensions which make it possible for him/her to explore his/her own path to recovery. We can conclude that, through the theory, we can develop interventions and nursing activities that contribute to improving the quality of life of people who have been diagnosed with a mental illness, modifying the traditional healthcare models.

Tasks and activities of Advanced Practice Nurses in the psychiatric and mental health care context: A systematic review and thematic analysis

BACKGROUND

To adequately describe the advanced psychiatric nursing roles and to distinguish them from the other roles of psychiatric and general nursing care, it is necessary to explore the concrete tasks and activities and the scope of practice of Psychiatric Mental Health Advanced Practice Nurses (APN).

OBJECTIVE

to extract, summarize and systematize the tasks and activities of the Psychiatric Mental Health APN from the international scientific literature.

DESIGN

systematic literature review reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement and checklist.

METHODS

The database search was performed using CINAHL, PubMed/Medline, Cochrane Library and Google/Google Scholar databases. Literature sources in English and German, which reported tasks and activities of the Psychiatric Mental Health APNs were included in the analysis. No time restrictions were defined. Roles such as Community Mental Health Nurses and Public Mental Health Nurses were excluded from the analysis. Data were extracted by independent reviewers for qualitative thematic analysis.

RESULTS

An extensive body of international literature on Psychiatric Mental Health APN sub-roles could be identified through a systematic literature search. Through our synthesis the main tasks and activities of Psychiatric Mental Health APNs could be identified and described. Altogether 46 items (practice dimensions) could be identified from the 20 sources and finally systematically summarized into six themes or "practice domains": (1) direct (clinical) nursing and care practice, (2) care coordination and case management, (3) psychosocial health promotion and prevention, (4) consulting, education and coaching, (5) leadership and public relations, and (6) research and practice development.

CONCLUSIONS

The results of this review provide a thorough outline of the tasks and activities of the Psychiatric Mental Health APN. Thus, the results reported here form the basis for a further differentiation of the tasks and activities of the Psychiatric Mental Health APNs from the basic nursing activities as well as tasks and activities of the generalist APNs. In this context, however, an attempt should be made to increase the specificity of the settings by including the tasks and activities of the community and public mental health nurses.

Bucking the system: Mitigating psychiatric patient rule breaking for a safer milieu

This article examines patients' understandings of rule breaking in the hospital setting. This work is important to inpatient psychiatric nursing because considering patients' perspectives about their own rule breaking can help nurses provide more therapeutic and safer patient care. The study finds that rule breaking behaviors are often a manifestation of patient resistance to institutionalization and loss of power. These behaviors are also related to nursing practice, as patients closely observe staff and look for gaps in the system to get away with or circumvent the rules. These findings suggest rule breaking behaviors can be reduced not by trying to further curtail the patient's autonomy but, rather, by changing the rules and/or how they are administered by staff to accommodate patients' perspectives and needs for freedom. Also, nurses must be clear in communicating with patients about the rationale for rules, and be consistent in how they enforce them.

Efficacy of the computer simulation-based, interactive communication education program for nursing students

BACKGROUND

Simulation-based education using standardized patients or high fidelity patient simulators is resource-intensive and can be limited in its consistency and repeatability. Standardized, interactive, and effective computer simulation-based education programs that improve communication skills among nursing students are greatly needed.

OBJECTIVES

This study aimed to (1) compare the efficacy of a computer simulation-based, interactive communication education (ComEd) program and an attention control (AC) program on communication knowledge, learning self-efficacy, and communication efficacy at baseline and twice after the intervention (immediately after and two weeks after); and (2) assess the acceptability and satisfaction of the ComEd reported by the participants.

DESIGN

This study employed a mixed-method, randomized controlled design with repeated measures.

METHODS

Students were recruited from four nursing schools and randomly assigned to either the intervention or AC group. They received either the ComEd or AC program installed on a tablet PC or a desktop computer in the classrooms and completed a 15-item communication knowledge scale, 10-item learning self-efficacy scale, 22-item communication efficacy scale, and 14-item satisfaction scale. In addition, six open-ended questions were used to help participants reflect on their learning experiences and explore their satisfaction with the programs. The Generalized Estimating Equation (GEE) model was the main model employed to examine the effects of the ComEd program over time in comparison with the AC program, and the content analysis method was used for qualitative data.

RESULTS

In total, 131 nursing students (66 in ComEd and 65 in AC) completed the programs and 127 participated through the two-week follow-up test. Compared to the AC group, the ComEd group significantly improved communication knowledge, learning self-efficacy, and communication efficacy; these effects were maintained at two weeks. The ComEd program was well accepted by the participants.

CONCLUSIONS

The ComEd is a promising approach because it is highly accessible, consistent, and repeatable, and has positive learning effects.

'A different kind of space': Mixed methods evaluation of facilitated reflective practice groups for nurses in an acute inpatient mental health unit

Despite recognising the value of reflective practice, there are challenges in implementation of clinical supervision for nurses. This study reports on the implementation of Reflective Practice Groups for nurses in an acute inpatient mental health setting as a means of introducing nurses to reflective practice. A mixed-methods approach explored participant and facilitator experiences through session evaluation questionnaires, facilitator field notes, and interviews with participants. Findings demonstrate challenges in implementing Reflective Practice Groups however the perceived benefits suggest promise in using Reflective Practice Groups to engage busy nurses in facilitated reflection with an aim to transition to reflective clinical supervision.

Family experiences in the identification of the first-episode psychosis in young patients

The study aimed to understand the family experience in the identification of the first-episode psychosis in young family members. Qualitative research using symbolic interactionism and narrative. Data were collected through depth interview with 13 relatives of 11 young patients treated for the first-episode psychosis. The families showed behavior consistent with the meanings they gave to the disease process of the young relatives, represented by categories: "waiting move: trying to justify the behavior of the adolescent", "not understanding the psychosis", and "seeking help". This research fostered the understanding of how families decided to seek help in the healthcare system. The nursing interventions with these families could contribute to early detection and beginning of treatment.

Assistance related to suicidal behavior at a mobile emergency service: Sociodemographic and clinical associated factors

It is important to investigate the care given to people with suicidal behavior, as it is an important predictor of future death by suicide and there is a lack of studies on this issue in Brazil. This study had the objective of investigating assistance related to suicidal behavior at a mobile emergency service and sociodemographic and clinical associated factors. This was a quantitative, cross-sectional study based on documental information. The data were collected through manual consultation of nursing records in which call-outs for suicidal behavior in the year 2014 were documented. The data were analyzed using descriptive statistics, Chi-squared test, Fisher's exact test, correlation tests, and comparison of means tests. In the 313 records analyzed there was a predominance of adult women with self-inflicted drug poisoning, attended to in their own residence and referred to pre-hospital emergency medical services. There was a lack of documentation on signs, symptoms, and grievances in most cases. The interventions most carried out by the nurses were related to monitoring of clinical parameters. There were differences related to the victim's sex and lethality, suicide attempt method, referral to emergency services, and semester of occurrence (January-June, July-December). Suicide attempts through self-poisoning or self-inflicted injuries differed in relation to time of call-out, waiting time, lethality, documentation on clinical assessment and interventions, and referral to emergency services. This study enabled the charting of factors linked with suicidal behavior and associated factors; it offers reflections on limitations and nursing care potential in the prevention of reoccurrence of suicidal behavior.

Intention to leave and associated factors among psychiatric nurses in China: A nationwide cross-sectional study

BACKGROUND

The retention of psychiatric nurses is an important concern for healthcare administrators in China. However, Chinese psychiatric nurses' intention to leave their jobs and the factors associated with it have been scarcely studied.

OBJECTIVE

To investigate Chinese psychiatric nurses' intention to leave their jobs, and to explore the associations between the intention to leave and individual characteristics, job-related factors and job satisfaction.

DESIGN

A cross-sectional, anonymous survey of a nationwide sample was conducted.

SETTINGS

Thirty-two tertiary psychiatric hospitals in 29 provincial capital cities in China.

PARTICIPANTS

All 9907 nurses in 32 hospitals were targeted for this survey conducted in December 2017; 8493 responded (response rate = 85.7%), and 7933 (without logic errors in the data) were included in the analysis.

METHODS

A questionnaire was used to investigate the respondent's intention to leave their job and to collect data on related factors, including individual characteristics (gender, age, marital status, educational background and self-rated health), job-related factors (professional title, working years, income, work hours, history of patient-initiated violence, perceived respect from patients, social recognition as well as physician-nurse coordination and trust) and job satisfaction. The short version of the Minnesota Satisfaction Questionnaire was used to assess job satisfaction. Chi-square tests and multilevel logistic regression analysis were used to examine associations between an intention to leave and other factors.

RESULTS

Among 7933 respondents, 20.2% reported an intention to leave their current jobs. The multiple regression analysis showed that better self-rated health (i.e. OR = 0.373, 95%CI = 0.308-0.452 for good health, reference: poor health), working more than 20 years (OR = 0.479, 95%CI = 0.389-0.590, reference: 20 years or less), higher monthly income (i.e. OR = 0.521, 95%CI = 0.399-0.680 for 6001-8000 RMBs, reference: 4500 RMB or less), perceived patient respect (OR = 0.727, 95%CI = 0.623-0.849), physician-nurse coordination (OR = 0.549, 95%CI = 0.480-0.629) and being satisfied with one's job (OR = 0.373, 95%CI = 0.308-0.452) were negatively associated with an intention to leave; while those who were male (OR = 1.879, 95%CI = 1.605-2.199), working more than 40 hours per week (OR = 1.584, 95%CI = 1.374-1.825) and experienced patient-initiated violence in the past 12 months (OR = 1.566, 95%CI = 1.376-1.781) had a higher odds of reporting an intention to leave.

CONCLUSIONS

Self-rated health, monthly income, work hours, patient-initiated violence, perceived patient respect, physician-nurse coordination and job satisfaction are significant factors associated with a nurse's intention to quit their job. In order to retain nurses in Chinese tertiary psychiatric hospitals, the government and hospital administrators should consider ways to address these factors.

Are care staff equipped for end-of-life communication? A cross-sectional study in long-term care facilities to identify determinants of self-efficacy

Background

End-of-life conversations are rarely initiated by care staff in long-term care facilities. A possible explanation is care staff’s lack of self-efficacy in such conversations. Research into the determinants of self-efficacy for nurses and care assistants in end-of-life communication is scarce and self-efficacy might differ between care staff of mental health facilities, nursing homes, and care homes. This study aimed to explore differences between care staff in mental health facilities, nursing homes, and care homes with regard to knowledge about palliative care, time pressure, and self-efficacy in end-of-life communication, as well as aiming to identify determinants of high self-efficacy in end-of-life communication.

Methods

Two cross-sectional Dutch studies, one in mental health facilities and one in nursing and care homes (PACE study). Nurses and care assistants were invited to complete a questionnaire in 2015. Multivariable logistic regression analyses were performed to identify determinants of high self-efficacy.

Results

Five hundred forty one nurses and care assistants completed a survey; 137 worked in mental health facilities, 172 in nursing homes, and 232 in care homes. Care staff at mental health facilities were the most knowledgeable about the World Health Organization’s definition of palliative care: 76% answered 4–5 out of 5 items correctly compared to 38% of nursing home staff and 40% of care home staff (p < 0.001). Around 60% of care staff in all settings experienced time pressure. Care staff had high self-efficacy regarding end-of-life communication with patients: the overall mean score across all facilities was 5.47 out of 7 (standard deviation 1.25). Determinants of high self-efficacy were working in a mental health facility, age > 36, female, with formal palliative care training, and knowledge of the palliative care definition.

Conclusion

Mental healthcare staff knew more about palliative care and had higher self-efficacy in end-of-life communication compared to nursing and care home staff. Educating care staff about providing palliative care and training them in it might improve end-of-life communication in these facilities.