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Wangel AM, Persson K, Duerlund S, Fhager J, Mårdhed E, Sjögran L, Sjöström K, Glantz A, Örmon K, Sunnqvist C. The Core Elements of Psychiatric and Mental Health Nursing: Time, Honest Engagement, Therapeutic Relations, Professional Nursing and Lifetime-Perspective. Issues Ment Health Nurs 2024; 45:399-408. [PMID: 38363803 DOI: 10.1080/01612840.2024.2305934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Defining psychiatric and mental health nursing has been a challenge for decades, and it is still difficult to find a comprehensive definition. We have identified a possibility to clarify psychiatric and mental health nursing based on humanistic philosophy in a general psychiatric care context. The aim was therefore to identify and synthesize the theoretical frameworks from which psychiatric and mental health nursing models are developed. We systematically collected and evaluated articles based on Grounded Theory (GT) methodology regarding psychiatric or mental health nursing. The PRISMA statement for systematic reviews was used and the formal process of synthesis, as a three-step process of identifying first -, second - and third-order themes following the examples of Howell Major and Savin-Baden. The synthesis resulted in a model describing five core elements of psychiatric and mental health nursing: 'professional nursing', 'therapeutic relationships' and 'honest engagement', with time as the all-encompassing theme, including the patients' 'lifetime perspective'. Psychiatric and mental health nursing is a caring support towards recovery, where the patient's lifetime perspective must be in focus during the caring process with a relationship built on an honest engagement. Time is therefore essential for psychiatric and mental health nursing.
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Affiliation(s)
- Anne-Marie Wangel
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Karin Persson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Sara Duerlund
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Johan Fhager
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Emma Mårdhed
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Lotta Sjögran
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Karin Sjöström
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Andreas Glantz
- Department of Nursing, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Karin Örmon
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Götaland Region Competence Centre on Intimate Partner Violence, Gothenburg, Sweden
| | - Charlotta Sunnqvist
- The Region Skåne Committee on Psychiatry, Habilitation and Technical Aids, Lund, Sweden
- Department of Clinical Sciences Psychiatry, Lund University, Lund, Sweden
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Bales G, Hasemann W, Kressig RW, Mayer H. Impact, scope of practice and competencies of Advanced Practice Nurses within APN-led models of care for young and middle-aged adult patients with multimorbidity and/or complex chronic conditions in hospital settings: a scoping review protocol. BMJ Open 2023; 13:e077335. [PMID: 37907288 PMCID: PMC10619075 DOI: 10.1136/bmjopen-2023-077335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/04/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION The increase of young and middle-aged adult patients with multimorbid and/or complex chronic conditions has created new challenges for healthcare systems and services. Advanced Practice Nurses (APNs) play an essential role in treating these patients because of their expertise and advanced nursing skills. Little is known about competencies, scope of practice and impact of APNs within APN-led care models for young and middle-aged adult patients with multimorbidity and/or complex chronic conditions in hospital settings. The objective of this scoping review is to describe the impact, scope of practice and competencies of APNs within APN-led care models for young and middle-aged adult patients in hospital settings. METHODS AND ANALYSIS This scoping review will be conducted using the methodological framework proffered by Arksey and O'Malley, incorporating the methodological enhancement of Levac et al. It will comply with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) for Scoping Reviews' guidelines of Tricco et al. Systematic research will be conducted in the databases MEDLINE (PubMed), CINAHL (EBSCO), EMBASE (Ovid), CENTRAL and PsycINFO (Ovid) using all recognised keywords, index terms and search strings. Grey literature will be scanned. Bibliography of all selected studies will be hand searched. Studies will be selected based on defined inclusion and exclusion criteria, screened by title and abstracts. Data from full-text articles meeting the inclusion criteria will be extracted independently by two authors. Disagreements in evaluation will be discussed and resolved by consensus. Results will be reported in the form of descriptive tables. Narrative summery is used to present the results of the review in the context of the study's objectives and questions. ETHICS AND DISSEMINATION This scoping review does not require ethics approval. The review will be handed in as part of a doctoral thesis and published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER OSF 4PM38.
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Affiliation(s)
- Gabriele Bales
- University Department of Geriatric Medicine, FELIX PLATTER, Basel, Switzerland
- Faculty of Social Sciences, Department of Nursing Science, University of Vienna, Vienna, Austria
| | - Wolfgang Hasemann
- University Department of Geriatric Medicine, FELIX PLATTER, Basel, Switzerland
| | - Reto W Kressig
- University Department of Geriatric Medicine, FELIX PLATTER, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Hanna Mayer
- Department of General Health Studies, Division Nursing Science with focus on Person-Centered-Care-Research, Karl Landsteiner University of Health Sciences, Krems, Austria
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Giuffrida S, Silano V, Ramacciati N, Prandi C, Baldon A, Bianchi M. Teaching strategies of clinical reasoning in advanced nursing clinical practice: A scoping review. Nurse Educ Pract 2023; 67:103548. [PMID: 36708638 DOI: 10.1016/j.nepr.2023.103548] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/17/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023]
Abstract
AIM/OBJECTIVE To report and synthesize the main strategies for teaching clinical reasoning described in the literature in the context of advanced clinical practice and promote new areas of research to improve the pedagogical approach to clinical reasoning in Advanced Practice Nursing. BACKGROUND Clinical reasoning and clinical thinking are essential elements in the advanced nursing clinical practice decision-making process. The quality improvement of care is related to the development of those skills. Therefore, it is crucial to optimize teaching strategies that can enhance the role of clinical reasoning in advanced clinical practice. DESIGN A scoping review was conducted using the framework developed by Arksey and O'Malley as a research strategy. Consistent with the nature of scoping reviews, a study protocol has been established. METHODS The studies included and analyzed in this scoping review cover from January 2016 to June 2022. Primary studies and secondary revision studies, published in biomedical databases, were selected, including qualitative ones. Electronic databases used were: CINAHL, PubMed, Cochrane Library, Scopus, and OVID. Three authors independently evaluated the articles for titles, abstracts, and full text. RESULTS 1433 articles were examined, applying the eligibility and exclusion criteria 73 studies were assessed for eligibility, and 27 were included in the scoping review. The results that emerged from the review were interpreted and grouped into three macro strategies (simulations-based education, art and visual thinking, and other learning approaches) and nineteen educational interventions. CONCLUSIONS Among the different strategies, the simulations are the most used. Despite this, our scoping review reveals that is necessary to use different teaching strategies to stimulate critical thinking, improve diagnostic reasoning, refine clinical judgment, and strengthen decision-making. However, it is not possible to demonstrate which methodology is more effective in obtaining the learning outcomes necessary to acquire an adequate level of judgment and critical thinking. Therefore, it will be necessary to relate teaching methodologies with the skills developed.
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Affiliation(s)
- Silvia Giuffrida
- Department of Cardiology and Cardiac Surgery, Cardio Centro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland.
| | - Verdiana Silano
- Nursing Direction of Settore Anziani Città di Bellinzona, Bellinzona, Switzerland.
| | - Nicola Ramacciati
- Department of Pharmacy, Health and Nutritional Sciences (DFSSN), University of Calabria, Rende, Italy.
| | - Cesarina Prandi
- Department of Business Economics, Health and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
| | - Alessia Baldon
- Department of Business Economics, Health and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
| | - Monica Bianchi
- Department of Business Economics, Health and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
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Desmet K, Bracke P, Deproost E, Goossens PJJ, Vandewalle J, Vercruysse L, Beeckman D, Van Hecke A, Kinnaer LM, Verhaeghe S. Patient-reported outcomes of the nurse-patient relationship in psychiatric inpatient hospitals: A multicentred descriptive cross-sectional study. J Psychiatr Ment Health Nurs 2023; 30:568-579. [PMID: 36588478 DOI: 10.1111/jpm.12895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Psychiatric and/or mental health nurses are struggling to measure the outcomes of the nurse-patient relationship. Collecting nurse-sensitive patient outcomes is a strategy to provide outcomes of a nurse-patient relationship from patients' perspectives. Because there was no validated scale, the Mental Health Nurse-Sensitive Patient Outcome-Scale (six-point Likert-scale) was recently developed and psychometrically evaluated. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study using the Mental Health Nurse-Sensitive Patient Outcome-scale to measure nurse-sensitive patient outcomes of the nurse-patient relationship in psychiatric hospitals. Moderate to good average scores for the MH-NURSE-POS total (4.42) and domains scores (≥4.09). are observed. Especially outcomes related to 'motivation' to follow and stay committed to the treatment received high average scores (≥4.60). Our results are consistent with the patient-reported effect(s) of relation-based nursing in qualitative research. The scores generate evidence to support the outcomes of the nurse-patient relationship and implicates that further investment in (re)defining and elaborating nurse-patient relationships in mental healthcare is meaningful and justified. More comparative patient-reported data can determine how nurse-sensitive patient outcomes are affected by the patient, nurse, and context. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Demonstrating patient-reported outcomes of the nurse-patient relationship can be important to enhance the therapeutic alliance between nurses and patients, organize responsive nursing care, and create nursing visibility in mental healthcare. Further nursing staff training on interpersonal competencies, such as self-awareness and cultural sensitivity, can be pivotal to achieving the patient-reported outcomes for inpatients with mental health problems. ABSTRACT INTRODUCTION: Identifying patient-reported outcomes of the nurse-patient relationship is a priority in inpatient mental healthcare to guide clinical decision-making and quality improvement initiatives. Moreover, demonstrating nurse-sensitive patient outcomes can be a strategy to avoid further erosion of the specialism of psychiatric and/or mental health nursing. AIM/QUESTION To measure nurse-sensitive patient outcomes of the nurse-patient relationship. METHOD In a multicentred cross-sectional study, 296 inpatients admitted to five psychiatric hospitals completed the recently developed and validated Mental Health Nurse-Sensitive Patient Outcome-Scale (MH-NURSE-POS). The MH-NURSE-POS consists of 21 items (six-point Likert-scale) in four domains: 'growth', 'expression', 'control', and 'motivation'. RESULTS Participants displayed moderate to good average scores for the MH-NURSE-POS total (4.42) and domain scores (≥4.09). Especially outcomes related to 'motivation' to follow and stay committed to the treatment received high average scores (≥4.60). DISCUSSION The results demonstrate that patients perceive the nurse-patient relationship and the care given by psychiatric and/or mental health nurses as contributing to their treatment. IMPLICATIONS FOR PRACTICES Patient-reported outcomes can guide nurses and managers to provide and organize nursing care and to build a nurse-patient relationship that has a positive impact on these outcomes. Additionally, outcomes can create nursing visibility as a profession in- and outside mental healthcare.
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Affiliation(s)
- Karel Desmet
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Piet Bracke
- Department of Sociology, Ghent University, Ghent, Belgium
| | - Eddy Deproost
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Centre for Psychiatry and Psychotherapy Clinic St-Joseph, Pittem, Belgium
| | - Peter J J Goossens
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Dimence Mental Health Center for Bipolar Disorder, Deventer, The Netherlands
| | | | - Lieke Vercruysse
- Centre for Psychiatry and Psychotherapy Clinic St-Joseph, Pittem, Belgium
| | - Dimitri Beeckman
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,School of Health Sciences, Örebro University, Örebro, Sweden.,School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Lise-Marie Kinnaer
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium.,Faculty of Medicine and Life Science, University Hasselt, Hasselt, Belgium
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Weidling K, Herwig G, Ayerle GM. Advanced Nursing Practice (ANP) in der psychiatrischen Pflege in Deutschland. Pflege 2022; 36:147-155. [DOI: 10.1024/1012-5302/a000921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Zusammenfassung. Hintergrund: Die Anforderungen einer qualitativ hochwertigen Pflegepraxis in der sich stetig verändernden psychiatrischen Versorgungslandschaft rechtfertigen die Integration von Advanced Practice Nurses (APNs). In der Literatur sind APNs in psychiatrischen Kontexten facettenreich beschrieben. Je nach Versorgungskontext zeigen sich individuelle Ausprägungen. Forschungslücken bestehen unter anderem hinsichtlich der tatsächlichen klinischen Ausgestaltung. Fragestellung: Wie gestaltet sich das Phänomen ANP in der klinischen psychiatrischen Praxis in Deutschland? Methoden: Zwischen April und Oktober 2019fanden problemzentrierte Interviews mit drei APNs aus unterschiedlichen psychiatrischen Kliniken statt. Zur Analyse und Interpretation diente die Angewandte Phänomenologie. Ergebnisse: Soft Skills und Clinical Leadership sind zentrale Kompetenzen, um als psychiatrische APN in der klinischen Praxis das eigene Potenzial entfalten zu können. Ausgeprägte Lebens- und Berufserfahrungen stellen weitere entscheidende Wirkfaktoren dar. Schlussfolgerung: Um die facettenreiche Tätigkeit als psychiatrische APN wirksam gestalten zu können, bedarf es (neben Fach- und Methodenkompetenz auf Masterniveau) ausgeprägter Soft Skills und Clinical-Leadership-Kompetenzen. Eine curriculare Weiterentwicklung der hochschulischen Ausbildungen ist notwendig. Die Etablierung der APN-Rolle in der Praxis ist von der Entscheidung des Pflegemanagements abhängig. Die Bereitschaft des Managements, sich konsequent neuen Versorgungsstrukturen zu öffnen, ist erforderlich.
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Affiliation(s)
- Katja Weidling
- Kompetenzzentrum für psychische Gesundheit, Ostschweizer Fachhochschule (OST), St. Gallen, Schweiz
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Gitte Herwig
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
- Klinik für Forensische Psychiatrie und Psychotherapie, Zentrum für Psychiatrie (ZfP), Emmendingen, Deutschland
| | - Gertrud M. Ayerle
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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Advanced Practice Nurses Globally: Responding to Health Challenges, Improving Outcomes. Int J Nurs Stud 2022; 132:104262. [PMID: 35633596 PMCID: PMC9040455 DOI: 10.1016/j.ijnurstu.2022.104262] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 11/23/2022]
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