1
|
Botke JA, van Woerkom M. The effect of self‐leadership training on detached concern and the proactivity of human service professionals. INTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT 2023. [DOI: 10.1111/ijtd.12300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- Jolanda A. Botke
- Department of Human Resource Studies Tilburg University Tilburg The Netherlands
| | - Marianne van Woerkom
- Department of Human Resource Studies Tilburg University Tilburg The Netherlands
- Department of Psychology, Education and Child Studies Erasmus University Rotterdam Rotterdam The Netherlands
| |
Collapse
|
2
|
Ireland CA, Chu S, Ireland JL, Hartley V, Ozanne R, Lewis M. Extreme Stress Events in a Forensic Hospital Setting: Prevalence, Impact, and Protective Factors in Staff. Issues Ment Health Nurs 2022; 43:418-433. [PMID: 34905419 DOI: 10.1080/01612840.2021.2003492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The current research explored the prevalence of stressful events in a forensic hospital setting, and their impact on staff. A systematic review of the literature on responses following exposure to extreme stress comprised 46 articles. This was followed by a Delphi study of professionals based in a forensic hospital (n = 43) to explore views on the factors that affect responses to extreme stress. This comprised three rounds to build consensus. Finally, a study of forensic hospital staff was conducted (n = 153, 47% male) to capture current trauma symptoms. The systematic review indicated three superordinate themes: outcomes adversely impacting staff and patients; personal characteristics moderating the impact of events; and organisational and interpersonal support moderating the impact of events. The Delphi supported these themes and noted the importance of factors external to the workplace and internal factors, such as self-blame. The final study demonstrated how a fifth of the workforce showed at least some trauma symptomology. Those who experienced less burnout reported lower trauma symptoms, while staff who experienced higher levels of secondary trauma at work reported higher levels of trauma symptoms. A higher level of resilience was related to lower levels of trauma symptomology. Findings are discussed in relation to the importance of recognising trauma in staff and implementing strategies to reduce and/or buffer the impact of stress on wellbeing. In doing so, the research presents a new model for consideration and development, the Impact and Amelioration of extreme stress events Model (IA-Model).
Collapse
Affiliation(s)
- Carol A Ireland
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| | - Simon Chu
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| | - Jane L Ireland
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| | - Victoria Hartley
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| | - Rebecca Ozanne
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| | - Michael Lewis
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| |
Collapse
|
3
|
Martin K, Ricciardelli R, Dror I. How forensic mental health nurses' perspectives of their patients can bias healthcare: A qualitative review of nursing documentation. J Clin Nurs 2020; 29:2482-2494. [PMID: 32242997 DOI: 10.1111/jocn.15264] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/12/2020] [Accepted: 03/12/2020] [Indexed: 01/05/2023]
Abstract
AIMS AND OBJECTIVES Our aim was to examine the notes produced by nurses, paying specific attention to the style in which these notes are written and observing whether there are concerns of distortions and biases. BACKGROUND Clinicians are responsible to document and record accurately. However, nurses' attitudes towards their patients can influence the quality of care they provide their patients and this inevitably impacts their perceptions and judgments, with implications to patients' care, treatment, and recovery. Negative attitudes or bias can cascade to other care providers and professionals. DESIGN This study used a retrospective chart review design and qualitative exploration of documentation using an emergent theme analysis. METHODS We examined the notes taken by 55 mental health nurses working with inpatients in the forensic services department at a psychiatric hospital. The study complies with the SRQR Checklist (Appendix S1) published in 2014. RESULTS The results highlight some evidence of nurses' empathic responses to patients, but suggest that most nurses have a style of writing that much of the time includes themes that are negative in nature to discount, pathologise, or paternalise their patients. CONCLUSIONS When reviewing the documentation of nurses in this study, it is easy to see how they can influence and bias the perspective of other staff. Such bias cascade and bias snowball have been shown in many domains, and in the context of nursing it can bias the type of care provided, the assessments made and the decisions formed by other professionals. RELEVANCE TO CLINICAL PRACTICE Given the critical role documentation plays in healthcare, our results indicate that efforts to improve documentation made by mental health nurses are needed and specifically, attention needs to be given to the writing styles of the notation.
Collapse
Affiliation(s)
- Krystle Martin
- Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada.,Ontario Tech University, Oshawa, Ontario, Canada
| | - Rosemary Ricciardelli
- Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada.,Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Itiel Dror
- University College London (UCL), London, UK
| |
Collapse
|
4
|
Wagner SL, Pasca R, Regehr C. Firefighters and Empathy: Does It Hurt to Care Too Much? JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2018.1525035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Shannon L. Wagner
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Romana Pasca
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | | |
Collapse
|
5
|
Lindholm LH, Koivukangas A, Lassila A, Kampman O. What is important for the sustained implementation of evidence-based brief psychotherapy interventions in psychiatric care? A quantitative evaluation of a real-world programme. Nord J Psychiatry 2019; 73:185-194. [PMID: 30888233 DOI: 10.1080/08039488.2019.1582698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Behavioural activation and motivational interviewing, both evidence-based treatments (EBTs), were implemented in secondary psychiatric care. This longitudinal evaluation of a real-world programme focused on the penetration of EBT adoption and its associations with therapist-related and perceived intervention-related variables. The implementation plan was also compared to sub-processes of Normalization Process Theory. MATERIAL AND METHODS Six participating units employed 72 therapists regularly and they comprise the target group. Due to staff turnover, a total of 84 therapists were trained stepwise. Three survey points (q1, q2, q3) were set for a four-year cycle beginning a year after the initial training and completed 4-5 months after closing patient recruitment. The implementation plan included two workshop days, one for each EBT, and subsequent case consultation groups and other more general strategies. RESULTS Fifty-seven (68%) of programme-trained therapists responded to one or more of three questionnaires. The self-reported penetration covers about a third of the target group a few months after the completion of the programme. Therapists' favourable perceptions of the EBTs regarding relative advantage, compatibility and complexity were associated with their sustained adoption. Therapists' background factors (e.g. work experience) and positive adoption intention at q1 did not predict the actual adoption of the EBTs at q3. No specific sustainment strategies were included in the implementation plan. CONCLUSION Brief but multi-faceted training with subsequent case consultations promoted the adoption of EBTs in a real-world setting. Adding specific sustainment strategies to the implementation plan is proposed to ensure the long-term survival of the implementation outcomes.
Collapse
Affiliation(s)
- Lars H Lindholm
- a Department of Psychiatry , South Ostrobothnia Hospital District , Seinäjoki , Finland.,b Faculty of Medicine and Life Sciences , Tampere University , Tampere , Finland
| | - Antti Koivukangas
- a Department of Psychiatry , South Ostrobothnia Hospital District , Seinäjoki , Finland.,b Faculty of Medicine and Life Sciences , Tampere University , Tampere , Finland
| | - Antero Lassila
- a Department of Psychiatry , South Ostrobothnia Hospital District , Seinäjoki , Finland
| | - Olli Kampman
- a Department of Psychiatry , South Ostrobothnia Hospital District , Seinäjoki , Finland.,b Faculty of Medicine and Life Sciences , Tampere University , Tampere , Finland
| |
Collapse
|
6
|
Dias MGPF, de Vargas D. Psychiatric Nurses' Attitudes Towards Violent Behaviour: A Brazilian Study. Issues Ment Health Nurs 2018; 39:687-692. [PMID: 29436881 DOI: 10.1080/01612840.2017.1422198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examines nurses' attitudes towards violent behaviour and the management of aggressiveness. A convenience sample of 185 nurses working in psychiatric urgent care and emergency services in Brazil responded to the MAVAS-BR. The results show that nurses' attitudes are more reflective of the external and situational models of violent behaviour and the use of control methods to manage aggressiveness. The mapping of this phenomenon using the same tools in a different context from those traditionally studied while observing similar results suggests a pattern of attitudes towards violent behaviour and the management of aggressiveness among nurses around the world.
Collapse
Affiliation(s)
| | - Divane de Vargas
- a São Paulo University , Department of Maternal-Child and Psychiatric Nursing, School of Nursing , São Paulo , SP , Brazil
| |
Collapse
|
7
|
Lindholm LH, Koivukangas A, Lassila A, Kampman O. Early assessment of implementing evidence-based brief therapy interventions among secondary service psychiatric therapists. EVALUATION AND PROGRAM PLANNING 2015; 52:182-188. [PMID: 26113263 DOI: 10.1016/j.evalprogplan.2015.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 05/21/2015] [Accepted: 05/22/2015] [Indexed: 06/04/2023]
Abstract
This implementation study was part of the Ostrobothnia Depression Study, in Finland, which covered implementation of motivational interviewing (MI) and behavioral activation (BA) within regional public psychiatric secondary care. It aimed to evaluate the mid-term progress of implementation and related factors. Altogether, 80 therapists had been educated through the implementation program by the point of the mid-term evaluation. Eligible information for evaluation was gathered using two questionnaires (q1, q2) with a one-year interval. A total of 45 of the 80 therapists completed q1, 30 completed q2, and 24 completed both questionnaires. Professional education was the only background factor associated with adopting the interventions (q1: p=0.059, q2: p=0.023), with higher education indicating greater activity. On the basis of trends such as changes in overall usefulness score from q1 to q2, the most involved therapists were slightly more likely to adopt MI/BA. Our experience so far suggests that encouraging staff to begin using new interventions during education is very important. The Consolidated Framework for Implementation Research was found to be a useful tool for constructing the evaluation.
Collapse
Affiliation(s)
- Lars H Lindholm
- Department of Psychiatry, South Ostrobothnia Hospital District, Huhtalantie 53, FI-60220 Seinäjoki, Finland; School of Medicine, University of Tampere, FI-33014 Tampere, Finland.
| | - Antti Koivukangas
- Department of Psychiatry, South Ostrobothnia Hospital District, Huhtalantie 53, FI-60220 Seinäjoki, Finland; School of Medicine, University of Tampere, FI-33014 Tampere, Finland.
| | - Antero Lassila
- Department of Psychiatry, South Ostrobothnia Hospital District, Huhtalantie 53, FI-60220 Seinäjoki, Finland.
| | - Olli Kampman
- Department of Psychiatry, South Ostrobothnia Hospital District, Huhtalantie 53, FI-60220 Seinäjoki, Finland; School of Medicine, University of Tampere, FI-33014 Tampere, Finland.
| |
Collapse
|
8
|
Harris DM, Happell B, Manias E. Working with people who have killed: the experience and attitudes of forensic mental health clinicians working with forensic patients. Int J Ment Health Nurs 2015; 24:130-8. [PMID: 25522179 DOI: 10.1111/inm.12113] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Forensic mental health (FMH) clinicians sometimes feel unsupported and unprepared for their work. This article explores their experiences of working in a FMH setting in Australia. The research examined the clinical context of clinicians working with forensic patients (FP), particularly those individuals who have killed while experiencing a mental illness. A qualitative, exploratory design was selected. Data were collected through focus groups and individual interviews with hospital and community-based forensic clinicians from all professional groups: psychiatric medicine, social work, psychology, mental health nursing, occupational therapy, and psychiatric service officers. The main themes identified were orientation and adjustment to FMH, training in FMH, vicarious traumatization, clinical debriefing and clinical supervision, and therapeutic relationships. Participants described being frustrated and unsupported in making the transition to working with FP and felt conflicted by the emotional response that was generated when developing therapeutic relationships. Recommendations include the development of programmes that might assist clinicians and address gaps in service delivery, such as clinical governance, targeted orientation programmes, and clinical supervision.
Collapse
Affiliation(s)
- Derith M Harris
- School of Nursing and Midwifery, University of Tasmania, Hobart, Tasmania, Australia
| | | | | |
Collapse
|
9
|
Fluttert FAJ, Van Meijel B, Van Leeuwen M, Bjørkly S, Nijman H, Grypdonck M. The development of the Forensic Early Warning Signs of Aggression Inventory: preliminary findings toward a better management of inpatient aggression. Arch Psychiatr Nurs 2011; 25:129-37. [PMID: 21421164 DOI: 10.1016/j.apnu.2010.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Revised: 06/29/2010] [Accepted: 07/01/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE "Early warning signs of aggression" refers to recurring changes in behaviors, thoughts, perceptions, and feelings of the patient that are considered to be precursors of aggressive behavior. The early recognition of these signs offers possibilities for early intervention and prevention of aggressive behaviors in forensic patients. The Forensic Early warning Signs of Aggression Inventory (FESAI) was developed to assist nurses and patients in identifying and monitoring these early warning signs of aggression. METHODS The FESAI was developed by means of qualitative and quantitative strategies. One hundred seventy six early detection plans were studied to construct a list of early warning signs of aggression. Inventory drafting was done by merging and categorizing early warning signs. Forensic nursing professionals assessed face validity, and interrater agreement was tested. RESULTS The investigation of early detection plans resulted in the FESAI, which contains 44 early warning signs of aggression subdivided into 15 main categories. The face validity of the form was very good, and the interrater agreement was satisfactory. CONCLUSIONS Preliminary findings indicate that the FESAI provides a useful listing of early warning signs of aggression in forensic patients. It may facilitate the construction of early detection plans for the prevention of aggressive behaviors in forensic psychiatry.
Collapse
|