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Bouhadana R, Modini M, Abbott MJ. Mental Health Nurses' Perception of Overnight Observations on Mental Health Inpatient Units: A Qualitative Study. Issues Ment Health Nurs 2024; 45:831-839. [PMID: 38995878 DOI: 10.1080/01612840.2024.2355544] [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: 07/14/2024]
Abstract
Overnight observations of mental health inpatients have been criticised for interrupting inpatients' sleep and potentially undermining recovery. No studies have examined the perceptions of mental health nurses who complete overnight observations, limiting key information necessary to guide improvements. This study aims to understand mental health nurses' perceptions on overnight observations and views on practice re-evaluations, as well as assess whether nurses' perceptions align with inpatients as reported in previous research. To fulfil the aims ten mental health nurses working on mental health inpatient units engaged in semi-structured interviews which were analysed using Content Analysis. Nine themes were identified and grouped into three categories: (1) staff and inpatient experiences, (2) impacts on treatment, recovery, and risk management, and (3) opinions on change. Majority of participants were critical of overnight observations, describing their negative impacts on inpatients' sleep and wellbeing. This aligns with previously reported inpatient views. There is scope for reassessment on how overnight observations are conducted to promote inpatients' sleep, recovery, and safety.
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Affiliation(s)
- Ruby Bouhadana
- School of Psychology, The University of Sydney, Camperdown, Australia
| | - Matthew Modini
- School of Psychology, The University of Sydney, Camperdown, Australia
- Concord Centre for Mental Health, Sydney Local Health District, Sydney, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Camperdown, Australia
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Shepard CA, Rufino KA, Lee J, Tran T, Paddock K, Wu C, Oldham JM, Mathew SJ, Patriquin MA. Nighttime Sleep Quality and Daytime Sleepiness Predicts Suicide Risk in Adults Admitted to an Inpatient Psychiatric Hospital. Behav Sleep Med 2023; 21:129-141. [PMID: 35296204 DOI: 10.1080/15402002.2022.2050724] [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: 11/02/2022]
Abstract
As sleep problems have been identified as an important, yet understudied, predictor of suicide risk, the present study analyzed the relationship between daytime sleepiness and nighttime sleep disturbance in a high-risk population of adults admitted to an inpatient psychiatric hospital. Objectives were to (1) examine the time course of subjective daytime sleepiness, nighttime sleep disturbance, and suicide risk throughout inpatient psychiatric treatment, (2) examine pre- to post-treatment changes in sleep disturbance with treatment as usual in an inpatient psychiatric setting, and (3) investigate whether daytime sleepiness and nighttime sleep disturbance predicted suicide risk above and beyond anxiety and depression. Participants were 500 consecutively admitted adults admitted to an intermediate length of stay (4-6 weeks) inpatient psychiatric hospital (47% female; 18-87 years of age). Measures of sleep, suicide risk, depression, and anxiety were completed at admission, weeks 1 through 4, and at discharge. Latent growth curve modeling (LGM) and hierarchal linear modeling (HLM) were conducted. The LGM analysis demonstrated that daytime sleepiness, nighttime sleep disturbance, and suicide risk all improved throughout inpatient treatment. Further, HLM showed that daytime sleepiness predicted suicide risk above and beyond symptoms of anxiety, depression, major sleep medications, and prior suicidal ideation and attempts, while nighttime sleep disturbance predicted suicide risk above and beyond symptoms of anxiety, major sleep medications, and prior suicidal ideation and attempts. Findings indicate the need to reevaluate safety protocols that may impact sleep, particularly that may increase daytime sleepiness, and to develop evidence-based sleep interventions for individuals admitted to inpatient psychiatric hospitals.
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Affiliation(s)
| | - Katrina A Rufino
- The Menninger Clinic, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,University of Houston-Downtown, Houston, TX, USA
| | - Jaehoon Lee
- Department of Educational Psychology & Leadership, Texas Tech University, Lubbock, TX, USA
| | | | | | - Chester Wu
- The Menninger Clinic, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - John M Oldham
- The Menninger Clinic, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Sanjay J Mathew
- The Menninger Clinic, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Michelle A Patriquin
- The Menninger Clinic, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
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