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O'Mahony J, Happell B, O'Connell R. "It was a reflection of myself, that i was weak": The impact of depression on the sense of self - An interpretive phenomenological analysis. Int J Ment Health Nurs 2024; 33:907-916. [PMID: 38235852 DOI: 10.1111/inm.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 01/19/2024]
Abstract
The World Health Organisation states that more than 350 million people experience depression globally. The phenomenological changes in individuals experiencing depression are profound Phenomenological research can further researchers' and clinicians' understanding of this experience. This study aimed to gain a phenomenological understanding of how individuals with depression understood and made sense of their experiences. A methodology of interpretative phenomenological analysis was adopted. In-depth semi-structured interviews explored the lived experience of depression for eight individuals. Data were analysed into the superordinate theme Broken Self - Transforming the Self. The superordinate theme developed from the subordinate themes of 'unknown self, loss of self and one's identity', 'desperate for a way out', and thirdly, 'conflict with self and what's known', which related directly to how individuals made sense of their experience of depression. These research findings highlight the human implications of the experience of depression and the limitations of viewing depression from a biological or medical model lens. Understanding the human impact is essential for the effective, holistic practice of mental health nursing.
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Affiliation(s)
- James O'Mahony
- Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, County Cork, Ireland
| | - Brenda Happell
- Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, County Cork, Ireland
- Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia
| | - Rhona O'Connell
- Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, County Cork, Ireland
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2
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Molloy L, Chidarikire S, Pullman J, Havilla S, Patton D, Beckett P. The Impact of Sensory Modulation Interventions on Practice in Acute Inpatient Mental Health Settings: A Meta-Ethnography. Issues Ment Health Nurs 2024; 45:580-588. [PMID: 38810221 DOI: 10.1080/01612840.2024.2341034] [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: 05/31/2024]
Abstract
This review explores the transformative impact of sensory modulation interventions in acute inpatient mental health care setting utilising meta-ethnography. The methodology by Noblit & Hare guided the approach to creating the review. Searches of articles published within the previous 10 years were conducted in Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE, and PsycINFO. Searches aimed to identify rich qualitative data on the area of sensory modulation interventions and acute inpatient mental health care. Seven articles were selected for inclusion and a reciprocal translation synthesis was undertaken. Sensory modulation interventions emerged as a key alternative to traditional inpatient practices, including seclusion and restraint and the use of PRN psychotropic medication. It introduces a new dimension within care strategies that emphasise individual preferences and care plans that empower individuals. Sensory modulation interventions serve as an effective means to de-escalation that promotes shared responsibility between staff and individuals in care. The review highlights this practice as a departure from coercive practices and biomedical interventions, promoting meaningful therapeutic engagement. Our findings show that sensory modulation interventions have the potential to create a culture shift in acute inpatient mental health settings towards person-centred, recovery-orientated, trauma-informed clinical practice.
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Affiliation(s)
- Luke Molloy
- School of Nursing, University of Wollongong, Wollongong, Australia
| | | | - John Pullman
- Social work, Australian College of Applied Professions, Sydney, Australia
| | - Sizwile Havilla
- Illawarra Shoalhaven Local Health District Mental Health service, Shellharbour, Australia
| | - Declan Patton
- School of Nursing and Midwifery, Royal College of Surgeons, University of Medicine and Health Sciences, Dublin, Ireland
| | - Paul Beckett
- School of Nursing and Midwifery, University of Sydney, Sydney, Australia
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3
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Antonsson H, Björk S, Rezai E, Sehlstedt C, Molin J. Monitoring Persons' Rights to Equal Care: Registered Nurses' Experiences of Caring for People with Mental Ill-Health and Somatic Comorbidity in Psychiatric Outpatient Care. Issues Ment Health Nurs 2024; 45:630-638. [PMID: 38652917 DOI: 10.1080/01612840.2024.2335915] [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: 04/25/2024]
Abstract
Persons with severe mental ill-health die early from preventable physical ill-health. Registered nurses in psychiatric outpatient care play a key role in improving persons' physical health, and it is important to examine how they view their responsibility, their experiences of care, and the obstacles they meet in providing person-centred care. The purpose of this study was to explore registered nurses' experiences of caring for persons with mental ill-health and somatic comorbidity in psychiatric outpatient care, using qualitative content analysis to analyze data from semi-structured interviews. The results show that these nurses monitored the person's right to equal care, embraced the whole of the persons suffering, and dealt with unclear boundaries in care. This highlights the unique role that registered nurses play in psychiatric outpatient care via their ability to interpret symptoms and find ways to adapt care based on persons' needs. Registered nurses consider physical health in all care and provide a link between psychiatric and somatic care. Together with mental health nurses at primary health care centers, they are key in reducing persons' suffering. There is a need for structural and functional changes in line with person-centred care including collaboration both within and outside healthcare organizations.
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Affiliation(s)
| | - Sabine Björk
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Emma Rezai
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | - Jenny Molin
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Clinical Science, Division of Psychiatry, Umeå, Sweden
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Mellerup M, Sjöström K, Örmon K. Recovery at an Adult Psychiatric Day Hospital-A Qualitative Interview Study Describing Patients' Experiences. Issues Ment Health Nurs 2024; 45:624-629. [PMID: 38652832 DOI: 10.1080/01612840.2024.2330565] [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: 04/25/2024]
Abstract
Psychiatric Day Hospitals offer time-limited active treatment programmes that are therapeutically intensive, coordinated, and with structured clinical services within a stable environment. No previous studies have described patients' experiences of recovery-oriented care at a Psychiatric Day Hospital in a Swedish or Nordic healthcare context. The aim of the study was to explore patients' experiences of a Psychiatric Day Hospital with focus on patient recovery. A qualitative method was used; 12 in-depth interviews were performed with patients all analysed with content analysis. The theme that emerged was "A safe haven." To do something routinely and meaningful during the days, feelings of security, and to gain increased knowledge about mental ill health were concepts which felt important and contributed to recovery. Feelings of belonging and prevention of loneliness were also highlighted.
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Affiliation(s)
- Marie Mellerup
- Office for Psychiatry, Habilitation and Technical Aids, Department of Adult Psychiatry Malmö/Trelleborg, Region Skåne, Sweden
- 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
| | - Karin Örmon
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- The Västra Götaland Region Competence Centre on Intimate Partner Violence, Gothenburg, Sweden
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
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5
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Pearson M, Long L, Baker C, Doran D, Pringle A. "It's really important work…and celebrating that, I think, is really important" - co-produced qualitative research into future of mental health nurse education. Int J Ment Health Nurs 2024. [PMID: 38812126 DOI: 10.1111/inm.13361] [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: 02/19/2024] [Revised: 05/01/2024] [Accepted: 05/12/2024] [Indexed: 05/31/2024]
Abstract
The education of mental health nurses has long remained a contentious topic in the UK and internationally. This research seeks to gather the perspectives of those directly affected by mental health nurse education. To investigate what knowledge, skills and values current mental health nursing students, graduate mental health nurses and people with lived experience of accessing mental health services believe should be paramount within pre-registration education. Data was gathered through focus groups involving a mix of pre- and post-qualified mental health nurses and people with lived experience of accessing mental health services. Data was collected through audio recordings, which were transcribed and subjected to thematic analysis. The analysis generated four themes of: (i) Values and ethics-based education, (ii) Self-awareness, (iii) Understanding and therapeutically being with others and (iv) Specialism versus Genericism. The findings speak to the special nature of mental health nursing and the need for students to develop specialist mental health knowledge and skills, alongside self-knowledge. The findings provide a unique insight into the aspects of pre-registration nursing felt to be most valuable by the three participant groups in this study. The findings reiterate the importance nurse education celebrating the specialism of mental health nursing and adds to the growing weight of literature for increased specialism with future education standard reviews.
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Affiliation(s)
| | | | | | - Dan Doran
- University of Nottingham, Nottingham, UK
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6
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Liu WI, Hsieh WL, Lai CT, Liu CC, Tai YM, Liu CY. Effectiveness of a needs-tailored nurse-led recovery program for community-dwelling people with schizophrenia: a cluster-randomized controlled trial. BMC Nurs 2024; 23:329. [PMID: 38755582 PMCID: PMC11097421 DOI: 10.1186/s12912-024-01986-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/30/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Meeting people's needs is positively correlated with their recovery. However, recovery services rarely include nurse-led programs tailored to the needs of these people. This study aimed to evaluate the effectiveness of a new needs-tailored recovery program by using a cluster-randomized controlled trial design. METHODS We conducted a parallel randomized controlled trial in two community psychiatric departments, employing nurse-level clustering for intervention delivery and selecting participants through convenience sampling. The participants were people diagnosed with schizophrenia that were receiving homecare services. The experimental group (n = 82) received needs-tailored recovery program for six months. The control group (n = 82) received traditional homecare. Data were collected at baseline, post-intervention, and the three-month follow-up (the study ran from February to December 2021). The outcomes were recovery, needs, hope, empowerment, psychotic symptoms, and medication adherence. We used repeated measures ANOVA tests to examine the effect of the group × time interaction. RESULTS The participants in the experimental group demonstrated statistically significant improvements in recovery, hope, and medication adherence compared to the control group, both immediately post-intervention and at the three-month follow-up. Moreover, they exhibited statistically significant reductions in needs compared to the control group at the three-month follow-up (p < .05). While the interaction effect for psychotic symptoms was not significant, the time effect was significant (p < .05). No significant interaction or time effect was observed for empowerment. CONCLUSION The findings increase our understanding of recovery-oriented care that prioritizes therapeutic alliance, integrated needs assessment, individual goals, hope, and empowerment. TRIAL REGISTRATION The Clinicaltrials.gov identifier NCT05304780 retrospectively registered on 03/31/2022.
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Affiliation(s)
- Wen-I Liu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.
| | - Wen-Ling Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Ching-Ting Lai
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Chia-Chen Liu
- Tri-Service General Hospital Beitou Branch, Taipei City, Taiwan
| | - Yueh-Ming Tai
- Tri-Service General Hospital Beitou Branch, Taipei City, Taiwan
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
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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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8
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Söderberg A, Lindgren BM, Looi GME, Bäckström J, Gabrielsson S. Psychiatric inpatient care for persons with dissociative identity disorder: a scoping review protocol. BMJ Open 2024; 14:e079207. [PMID: 38365290 PMCID: PMC10973692 DOI: 10.1136/bmjopen-2023-079207] [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: 08/25/2023] [Accepted: 02/02/2024] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Psychiatric inpatient care (PIC) is often characterised by high pressure and thresholds for admission, brief periods of care and limited time for caring activities. Dissociative identity disorder (DID) is a contested diagnosis, and persons with DID are at risk of not receiving adequate support when cared for in PIC. Because the limited literature addressing the topic includes no overview on how persons with DID are cared for in psychiatric inpatient settings, the aim of this scoping review is to map the area of knowledge on PIC for persons experiencing DID. This scoping review will provide an overview with the possibility to elucidate gaps in the evidence base and needs for future research on PIC for persons experiencing DID. METHODS AND ANALYSIS This scoping review will follow Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews and steps 1-5 described in the established method for scoping reviews: identifying research question, identifying relevant studies, study selection, charting the data and collating, summarising and reporting results. ETHICS APPROVAL Not applicable. DISSEMINATION This scoping review will be submitted for publication in an international, peer-reviewed journal.
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Affiliation(s)
- Anja Söderberg
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | | | - Git-Marie Ejneborn Looi
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Josefin Bäckström
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Sebastian Gabrielsson
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
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Leal TMDO, Souza CBD, Gabriel IM, Alexandrin LG, Okido ACC, Silva L, Carlos DM. Meanings of nurses' role in Child and Adolescent Psychosocial Care Centers. Rev Bras Enferm 2023; 76:e20230124. [PMID: 38055494 DOI: 10.1590/0034-7167-2023-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/07/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE to analyze the meaning attributed to nurses' role in mental health care in Child and Adolescent Psychosocial Care Centers. METHODS qualitative research, anchored in the paradigm of complexity. Data collection was carried out through online semi-structured interviews with ten nurses from São Paulo, between March and September 2022, being analyzed thematically. RESULTS the diversity and specificity of a child and adolescent mental health clinic, with the need for expanded, territorial and intersectoral care, were unveiled in addition to a fragmented training in the area. There was a need for a deconstruction of being a nurse to make it possible to produce more inclusive and salutogenic practices. FINAL CONSIDERATIONS the need for training nurses with adequate knowledge and skills to care for the mental health of children, adolescents and their families is reinforced as well as permanent education of working teams.
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Affiliation(s)
| | | | | | | | | | - Lucía Silva
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
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10
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Antonsson H, Dahliavy L, Mouline H, Molin J. Struggling with unnecessary suffering-Registered nurses' experiences of delayed decisions on treatment without consent in forensic psychiatric inpatient care. Int J Ment Health Nurs 2023; 32:1681-1690. [PMID: 37458217 DOI: 10.1111/inm.13194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/26/2023] [Accepted: 07/08/2023] [Indexed: 11/22/2023]
Abstract
Chemical restraints are used in forensic psychiatric inpatient care, however with caution as it can feel like an assault against patients' integrity. When waiting for decisions on treatment without consent, nursing staff are expected to care for patients with severe mental ill-health without the use of medical treatment, often with a feeling of already having tried all other available means. Knowledge about how registered nurses experience such situations is sparse but could contribute to the development of both teamwork and nursing approaches that could mean reduced suffering for patients. The aim of this study was to describe registered nurses' experiences of delayed decisions on treatment without consent in forensic psychiatric inpatient care. Eleven semi-structured interviews were conducted with registered nurses working in forensic psychiatric units in Sweden. Data were analysed through qualitative content analysis. The result showed that experiences of treatment without consent were about striving to protect patients from harm, striving for collaboration during difficult circumstances and striving to do good. This was interpreted as a struggle with unnecessary suffering. For registered nurses to be able to handle such challenging situations and relieve suffering for patients, experience and master-level education in mental health nursing are highlighted. Another aspect that is highlighted is the importance of having consultants familiar with the circumstances at the unit. A method for joint reflection is suggested, to promote an open-minded work culture with a well-functioning decision-making process and ensure that both consultants and nursing staff have support.
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Affiliation(s)
| | - Liv Dahliavy
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | - Jenny Molin
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Clinical Science, Division of Psychiatry, Umeå University, Umeå, Sweden
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11
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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. Associated factors of nurse-sensitive patient outcomes: A multicentred cross-sectional study in psychiatric inpatient hospitals. J Psychiatr Ment Health Nurs 2023; 30:1231-1244. [PMID: 37409521 DOI: 10.1111/jpm.12951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 06/06/2023] [Accepted: 06/22/2023] [Indexed: 07/07/2023]
Abstract
WHAT IS ALREADY KNOWN?: The nurse-patient relationship in mental health care is an important focus of mental health nursing theories and research. There is limited evidence about which factors influence nurse-sensitive patient outcomes of the nurse-patient relationship. This hinders the development, planning, delivering, and quality assurance of the nurse-patient relationship in nursing practice and nursing education. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: To our best knowledge, this is the first study to examine associations between nurse-sensitive patient outcomes of the nurse-patient relationship and a range of patient characteristics and relationship-contextual factors. In this study, we found that gender, age, hospital characteristics, nurse availability when needed, nurse contact, and nurse stimulation were associated with the scores on the nurse-sensitive patient outcome scale. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Having insight into the factors associated with nurse-sensitive patient outcomes of the nurse-patient relationship can help nurses, nursing students, nursing management and also patients to enhance the nurse-patient relationship, trying to influence outcomes of nursing care. ABSTRACT: Introduction The lack of evidence on patient characteristics and relational-contextual factors influencing nurse-sensitive patient outcomes of a nurse-patient relationship is a possible threat to the quality and education of the nurse-patient relationship. Aim To measure nurse-sensitive patient outcomes of the nurse-patient relationship and to explore the associations between nurse-sensitive patient outcomes and a range of patient characteristics and relational-contextual factors. Method In a multicenter cross-sectional study, 340 inpatients from 30 units in five psychiatric hospitals completed the Mental Health Nurse-Sensitive Patient Outcome Scale. Descriptive, univariate and Linear Mixed Model analyses were conducted. Results Overall, patient-reported outcomes were moderate to good. Female participants, nurse availability when needed, more nurse contact and nurse stimulation were associated with higher outcomes. Age differences were observed for some of the outcomes. Outcomes also varied across hospitals but were not related to the number of times patients were hospitalized or to their current length of stay in the hospital. Discussion The results may help nurses to become more sensitive and responsive to factors associated with nurse-sensitive patient outcomes of the nurse-patient relationship. Implications The nurse-sensitive results can support nurses in designing future nurse-patient relationships.
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Affiliation(s)
- Karel Desmet
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- AZ Damiaan, Ostend, Belgium
| | - Piet Bracke
- Department of Sociology, Ghent University, Ghent, Belgium
| | - Eddy Deproost
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Centre for Psychiatry and Psychotherapy Clinic Sint-Jozef, Pittem, Belgium
| | - Peter J J Goossens
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Dimence Mental Health Center for Bipolar Disorder, Deventer, the Netherlands
| | | | - Lieke Vercruysse
- Centre for Psychiatry and Psychotherapy Clinic Sint-Jozef, Pittem, Belgium
| | - Dimitri Beeckman
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, 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
- Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Ann Van Hecke
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Lise-Marie Kinnaer
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Sofie Verhaeghe
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, 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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12
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Cleary M, West S, Hungerford C. Mental Health Nurses Overcoming Adversity: A Discursive Review. Issues Ment Health Nurs 2023; 44:944-950. [PMID: 37616589 DOI: 10.1080/01612840.2023.2236698] [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: 08/26/2023]
Abstract
The mental health nursing profession has experienced various challenges since its inception. This discursive review considers these challenges, including how mental health nurses have and can continue to overcome adversity as individuals and as a profession. The discussion examines the influence of the profession's historical involvement in institutionalization and coercive care; the continuing impact of stigma; and the increasing demand for mental health services, amidst chronic staff shortages. Collectively, mental health nurses must harness strong therapeutic relationships, intra- and multi-disciplinary collaboration, personal and professional resilience, education that prepares them for the future, and sector-wide planning and innovation, to respond positively to these challenges. These approaches will support mental health nurses to overcome adversity and achieve positive outcomes for the profession and people with the lived experience of mental illness.
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Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
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13
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Zetterström L, Linde M, Blomqvist M, Jormfeldt H. Anxiety Communication Notes-A Tool to Facilitate Anxiety Management and Improve the Nurse-Patient Relationship in Mental Health Nursing. Issues Ment Health Nurs 2023; 44:900-910. [PMID: 37734062 DOI: 10.1080/01612840.2023.2251058] [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: 09/23/2023]
Abstract
Mental health care tends to be dominated by a biomedical perspective at the expense of a more recovery-oriented approach. Research on nurse-led interventions intended to strengthen the patient's ability to manage anxiety is sparse in this context. The aim of this study was to describe nurses' experiences of the use of anxiety communication notes in nursing patients experiencing anxiety in mental health inpatient care. Data were collected by interviewing twelve nurses working in two mental health inpatient care wards in southwestern Sweden. Semi-structured interviews were conducted, and qualitative content analysis was used to analyze the data. Findings showed that the use of anxiety communication notes was perceived to provide a nursing structure to foster the development and practice of adaptive anxiety management through a visual representation for mutual understanding of the patient's anxiety pattern. The nurses could also use the anxiety communication notes to support nurse-patient communication and facilitate increased participation and empowerment in the patients' anxiety management.
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Affiliation(s)
| | - Maria Linde
- Department of Psychiatry, Region Halland, Halmstad, Sweden
| | - Marjut Blomqvist
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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14
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Glantz A, Sunnqvist C, Örmon K. The time, places, and activities of nurses in a psychiatric inpatient context - A time and motion study with a time-geographic perspective. Issues Ment Health Nurs 2023; 44:387-395. [PMID: 37126738 DOI: 10.1080/01612840.2023.2194990] [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: 05/03/2023]
Abstract
Nurses in psychiatric inpatient care spend less time than desired with patients and investigation of the nature of nursing in this setting is needed. This study explores how nursing activities in psychiatric inpatient wards is distributed over time, and with a time-geographic perspective show how this relates to places. Observations were used to register place, activity, and time. A constructed time-geographic chart mapped the nurses' path which showed that nurses spent little time in places where patients are. There might be constraints that affect nursing. Nurses need to evaluate where time is spent and interventions that facilitate relationships are needed.
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Affiliation(s)
- Andreas Glantz
- Department of Nursing, Faculty of Medicine, Umeå University, Umeå, Sweden
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Charlotta Sunnqvist
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Committee on Psychiatry, Habilitation and Technical Aids, Lund, Sweden
| | - Karin Örmon
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Västra Götaland Region Competence Centre on Intimate Partner Violence, Gothenburg, Sweden
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15
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Ahn S, Shin S. 'I felt alive': A qualitative study of inpatients' perspectives on good mental health nursing in South Korea. Int J Ment Health Nurs 2023; 32:791-800. [PMID: 36718048 DOI: 10.1111/inm.13122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/28/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023]
Abstract
Although mental health nurses continuously strive for patients' well-being, patients still experience inpatient care negatively. To identify an individual's actual, mental health nursing care needs and offers them optimal benefits during their hospital stay, determining what patients perceive as good nursing should be prioritized. This qualitative descriptive study aimed to understand good mental health nursing from the inpatients' perspective. The data were collected through semi-structured interviews with 13 patients admitted to a psychiatric ward in South Korea, and analysed using thematic analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used to ensure transparency and rigour. The results revealed that patients experienced good mental health nursing when nurses respected their humanity, adopted a practical approach to solve problems pragmatically, and facilitated their recovery. These practices stem from mental health nurses' attitudes towards humanity based on individualized respect, professional ability to handle patients' individual needs, and offering patients hope and confidence for recovery and the future. Therefore, mental health nurses need to focus their efforts on these aspects of nursing attitudes and competencies to ensure that inpatients experience good mental health nursing.
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Affiliation(s)
- Suyoun Ahn
- Samsung Medical Center, Seoul, South Korea
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16
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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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17
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Punzo K, Skoglund M, Carlsson IM, Jormfeldt H. Experiences of an Equine-Assisted Therapy Intervention among Children and Adolescents with Mental Illness in Sweden - A Nursing Perspective. Issues Ment Health Nurs 2022; 43:1080-1092. [PMID: 36178465 DOI: 10.1080/01612840.2022.2126571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Mental illness among children and adolescents is increasing globally, and prescription of psychiatric drugs for children and adolescents with mental illness is increasing worldwide, including Sweden. Holistic health-promoting interventions have shown promising long-lasting significant health benefits in young individuals with mental illness, but holistic health-promoting mental health interventions are often disregarded due to a lack of systematic theory-based knowledge. Consequently, the lack of scientific knowledge thwarts implementation of equine-assisted therapy as an established intervention in mental health nursing for children and adolescents with mental illness. The purpose of the study was to better understand experiences of equine-assisted therapy among children and adolescents with mental illness. The study adopted an inductive approach and data was collected using photovoice methodology. Six young persons, 7-18 years of age, referred by a psychologist to the equine-assisted intervention due to mental health issues, were included in the study. Data was analyzed using qualitative content analysis. The results could be summarized by an overarching theme, a physical, emotional, and social milieu for growth, consisting of three subcategories: feeling relief from everyday stress and anxiety; nurturing self-esteem in a mutual friendship; and strengthening self-reliance through synchronized interplay. The results indicate that equine-assisted therapy has essential values closely related to the goals of mental health nursing. Further research should strive to attain even gender distribution in study samples and focus on how equine-assisted therapy could be thoroughly integrated into established nursing intervention for children and adolescents with mental illness.
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Affiliation(s)
- Kim Punzo
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Matilda Skoglund
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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18
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Damsgaard JB, Overgaard C, Dürr D, Lunde A, Thybo P, Birkelund R. Psychiatric care and education understood from a student perspective: Enhancing competences empowering personal and social recovery. Scand J Caring Sci 2022; 36:1241-1250. [PMID: 35686718 PMCID: PMC9796937 DOI: 10.1111/scs.13097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/25/2022] [Accepted: 05/30/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND During the last decades, a recovery-based approach has called for a change in mental health care services. Several programmes have been presented, and the need to develop student and professional competences in education and clinical practice has been documented. AIM The aim of this study was to explore how psychiatric care is understood seen from a student perspective (nursing students, masters nurses and a master in applied philosophy) with focus on their personal competences and the educational interventions empowering processes for users' personal and social recovery. METHOD A qualitative design with a phenomenological-hermeneutic approach based on the French philosopher Paul Ricoeur's theory of interpretation. Data were collected through semi-structured interviews. FINDINGS All interviewees expressed that both theoretically and clinically students did not experience a recovery-oriented approach empowering users' personal and social recovery process. On the contrary, they experienced that both education and practice were dominated by a biomedical approach providing clinical recovery. However, several students were aware of their need of developing personal and relational competences to be able to support the users' personal and social recovery journey. The students expressed that there is a need for educational processes targeting personal competences in 'becoming a professional' supporting 'presentness and awareness' and thereby the development of relational abilities and the courage to engage. The results relate to two nursing schools and two universities. CONCLUSION A biomedical approach dominates and makes it difficult to develop students' personal competences during education in practice and theory vital to the development of personal and social recovery-oriented practices. It is recommended that educators-in practice and in school-accentuate presentness, awareness and creativity as crucial relational capabilities and incorporate this in their teaching and supervision method, supporting the education and formation of the students' (and teachers' and supervisors') personal development processes.
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Affiliation(s)
| | | | | | - Anita Lunde
- Department of NursingVia University CollegeHorsensDenmark
| | - Peter Thybo
- Psychiatric Research Unit, Central Denmark RegionHerningDenmark
| | - Regner Birkelund
- University Hospital of Southern DenmarkVejleDenmark,Department of Regional Health Research, University of Southern DenmarkOdenseDenmark
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19
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Chao PY, Hsieh WL, Yeh ST, Hsieh CJ, Liu CY, Liu WI. Factors associated with personal recovery among psychiatric nursing home residents. J Psychiatr Ment Health Nurs 2022; 29:852-860. [PMID: 34957650 DOI: 10.1111/jpm.12814] [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: 05/31/2021] [Revised: 11/29/2021] [Accepted: 12/17/2021] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: Poor recovery will cause harm to the quality of life and well-being of residents and that the scope of influence includes the self, family and society. No study to date has investigated empowerment and the other multiple factors associated with personal recovery among psychiatric nursing home residents. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The factors associated with personal recovery are empowerment, social support and global functioning. This pioneer study contributes new evidence that personal recovery is mainly predicted by empowerment, social support and global function, with empowerment exhibiting the highest predictive value. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Strengthening empowerment in mental health nursing may contribute more to the personal recovery of psychiatric nursing home residents than improving global function or social support. Mental health professionals should shift to empowerment-oriented care to improve individuals' personal recovery, such as offering more opportunities to achieve autonomy, encouraging individuals' involvement in decision-making and promoting individuals' motivation for achieving their goals. ABSTRACT: Introduction Individuals diagnosed with mental illness have a need for recovery. No study to date has investigated empowerment and the other multiple factors associated with personal recovery among psychiatric nursing home residents. Aim The study aimed to identify the factors associated with personal recovery among psychiatric nursing home residents. Methods This was a cross-sectional study with convenience sampling. Participants were recruited from a psychiatric nursing home in Northern Taiwan between April and June 2018. Data were collected through self-reported, structured questionnaires with verified reliability and validity. Descriptive and hierarchical regression analyses were performed. The present study followed the STROBE guidelines. Results The study included 158 participants. The factors associated with recovery according to bivariate associations were religious belief, psychotic symptoms, global function, social support and empowerment. In the hierarchical regression, empowerment, social support and global function were the main predictive factors of recovery, with the explained variation reaching 40.8%. Empowerment exhibited the highest predictive value for the recovery. Implications for clinical practice Strengthening empowerment in mental health nursing may contribute more to the personal recovery of psychiatric nursing home residents than improving global function or social support.
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Affiliation(s)
- Pei-Yi Chao
- Department of nursing, Bali Psychiatric Center, New Taipei City, Taiwan
| | - Wen Ling Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Shin Ting Yeh
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Chia Jung Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Wen-I Liu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
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20
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Sunnqvist C, Berngarn A, Ezinne Ekezie P, Lundgren E, Nilsson E, Örmon K. A pilot evaluation of a prehospital emergency psychiatric unit: The experiences of patients, psychiatric and mental health nurses, and significant others. Perspect Psychiatr Care 2022; 58:2255-2262. [PMID: 35148425 PMCID: PMC9790504 DOI: 10.1111/ppc.13055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To explore the significance of the alliance with the Prehospital Emergency Psychiatric Unit for patients, psychiatric and mental health nurses, and significant others, and to evaluate their experiences of treatment and care. DESIGN AND METHODS A qualitative inductive interview study with 11 participants: four patients, six nurses, and one significant other. The interviews were analyzed with content analysis. FINDINGS The analysis resulted in four subcategories: To be met with respect, presence and time, knowledge and experience, and feeling of support, and one category: A psychiatric team with knowledge and experience creating stability and a sense of self-worth. PRACTICE IMPLICATION The Prehospital Emergency Psychiatric Unit enables a safe, person-centered service.
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Affiliation(s)
- Charlotta Sunnqvist
- Department of Care Sciences, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | | | | | - Emma Lundgren
- Office of Psychiatry and Habilitation, Region Skane, Malmö, Sweden
| | - Emma Nilsson
- Office of Psychiatry and Habilitation, Region Skane, Malmö, Sweden
| | - Karin Örmon
- Department of Care Sciences, Faculty of Health and Society, Malmö University, Malmö, Sweden.,Office of Psychiatry and Habilitation, Region Skane, Malmö, Sweden
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21
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Salberg J, Ekselius L, Hursti T, Öster C. Staff experiences related to implementation of a recovery-oriented nursing programme in psychiatric inpatient care. Int J Ment Health Nurs 2022; 31:731-742. [PMID: 35315194 PMCID: PMC9311143 DOI: 10.1111/inm.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 02/28/2022] [Accepted: 03/11/2022] [Indexed: 11/28/2022]
Abstract
Nursing in psychiatric inpatient care is peripheral to a dominating biomedical model of care. Efforts are being made to implement nursing models based on core values and theories for nursing, such as recovery-oriented practices. The aim of the study was to explore experiences of a recovery-oriented nursing programme (Steps Towards Recovery, STR) among nursing staff in psychiatric inpatient care and their ratings of stress (Maslach Burnout Inventory scores), quality of care (Quality of Psychiatric Care - Inpatient staff scores) and satisfaction with nursing care (Satisfaction with Nursing Care and Work scale scores), before and after the implementation-and compare with ratings from reference wards. A quasi-experimental and prospective, pretest-post-test design was used. Specific questions about the nursing programme were answered by staff at the intervention wards. Staff reported predominantly positive experiences of the nursing programme. At follow-up, higher ratings were reported in two dimensions of quality of care in the STR group, and lower ratings in one dimension of stress were evident in the reference group. No differences in ratings between the STR and reference wards were found. Staff members' positive experiences of STR and higher ratings regarding participation and secure environment after implementation suggest that STR is a well-accepted and promising nursing programme. It is important to implement and evaluate recovery-oriented interventions in psychiatric inpatient care, where a focus on symptom relief still prevails. The results indicate that there is potential for further exploration of STR in this context.
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Affiliation(s)
- Johanna Salberg
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Lisa Ekselius
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Timo Hursti
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Caisa Öster
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
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22
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Olsson A, Hedlund S, Landgren K. To Use or Not Use Complementary and Alternative Medicine (CAM) in Psychiatric Care: Interviews with Clinical Decision-Makers in Sweden. Issues Ment Health Nurs 2022; 43:463-472. [PMID: 34666589 DOI: 10.1080/01612840.2021.1986759] [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: 10/18/2022]
Abstract
Complementary and alternative medicine (CAM) is used as a complementary intervention in psychiatric healthcare. The reasons for using or not using CAM in psychiatric care in Sweden, and how such decisions are taken, are largely unknown. The aim was to investigate arguments for and against the use of CAM in Swedish psychiatric care, and how decisions are made. Interviews with 10 persons in decision-making positions in psychiatric health care were analysed thematically. The result shows diverging understandings of the evidence base for CAM. Arguments against CAM referred to scepticism, the importance of evidence-based practice and the obligation to follow national guidelines. Arguments in favour of CAM were that CAM was person-centred, safe, cost-effective, nursing interventions with positive effects, appreciated and demanded by patients, providing space for non-verbal communication and reflection, supporting the therapeutic alliance. Decision paths were described as top-down through a hierarchical structure, or bottom-up, driven by committed staff members. We discuss how detailed national guidelines should be to achieve equal and evidence-based care, while still allowing clinics to make local exceptions, adjusting the care according to clinical expertise and patients' preferences. Conclusion: Evidence-based, safe and cost-effective CAM methods may be relevant complementary interventions in psychiatric care, or as self-care, not to cure the psychiatric disease, but to reduce symptoms and promote sleep. With better knowledge of CAM, health professionals could guide patients through the jungle of CAM methods. Due to research problems on complex multicomponent interventions, high-quality pragmatic trials, including biomarkers, and qualitative studies are recommended.
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Affiliation(s)
- Anna Olsson
- Health Sciences Centre, Faculty of Medicine, Lund University, Lund, Sweden
| | - Siiri Hedlund
- Health Sciences Centre, Faculty of Medicine, Lund University, Lund, Sweden
| | - Kajsa Landgren
- Health Sciences Centre, Faculty of Medicine, Lund University, Lund, Sweden.,Psychiatric Clinic in Lund, Region Skåne, Lund, Sweden
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23
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Gabrielsson S, Karim H, Looi GME. Learning your limits: Nurses' experiences of caring for young unaccompanied refugees in acute psychiatric care. Int J Ment Health Nurs 2022; 31:369-378. [PMID: 34913549 DOI: 10.1111/inm.12965] [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: 06/18/2021] [Revised: 11/13/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022]
Abstract
Young unaccompanied refugees come in contact with acute psychiatric care due to pre-existing mental health conditions as well as stressful and traumatic experiences before, during, and after migration. Previous research on nurses' experiences of caring for refugees has primarily reported on difficulties related to cultural differences and communication and how nurses might distrust refugees. This study aimed to describe registered nurses' experiences of caring for young unaccompanied refugees in acute psychiatric care. Semi-structured interviews with ten nurses were analysed using a method for qualitative content analysis. Data were collected in Sweden during 2019 and 2020. Results describe nurses' experiences of caring for young unaccompanied refugees in acute psychiatric care in one theme: learning your limits and three sub-themes: feeling powerless but doing what you can; taking a stance in a politicized environment; and being frustrated and in need of support. Findings highlight the potential and limitations of mental health nursing, the importance of reflection and peer support, and the importance of viewing the roles and responsibilities of mental health nurses and nursing in a societal context. These findings suggest that nurses can make a difference for young unaccompanied refugees in acute psychiatric care. However, in doing so, nurses need support in realizing what they can and cannot achieve. The study is reported in accordance with the COREQ guidelines.
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Affiliation(s)
- Sebastian Gabrielsson
- Department of Health, Education and Technology, Luleå University of Technology, Lulea, Sweden
| | - Hannan Karim
- Department of Psychiatry, Sunderby Hospital, Region Norrbotten, Lulea, Sweden
| | - Git-Marie Ejneborn Looi
- Department of Health, Education and Technology, Luleå University of Technology, Lulea, Sweden
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24
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Söderberg A, Ejneborn Looi GM, Gabrielsson S. Constrained nursing: Nurses' and assistant nurses' experiences working in a child and adolescent psychiatric ward. Int J Ment Health Nurs 2022; 31:189-198. [PMID: 34723444 DOI: 10.1111/inm.12949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/15/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022]
Abstract
The role of nurses and nursing in CAP inpatient care is unclear, and nurses are at risk of moral distress due to having to deal with complex demands while lacking organizational support. This study aimed to describe nurses' and assistant nurses' experiences working in child and adolescent psychiatric inpatient care. Eight nurses and seven assistant nurses working in a child and adolescent ward in Sweden participated in the study. Data were collected in 2019 using semi-structured qualitative interviews and subject to qualitative content analysis. Results describe nurses' and assistant nurses' experiences of child and adolescent psychiatric inpatient care in one theme, Constrained nursing, and four categories: Striving to be there for children and parents; Finding a way to manage work; Depending on others; Lacking nursing leadership. Findings suggest that good, person-centred and recovery-oriented nursing practice can exist in CAP inpatient care but remain unrecognized and lacking support due to unclear roles and responsibilities and lack of nursing leadership. This study is reported in accordance with the COREQ guidelines.
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Affiliation(s)
- Anja Söderberg
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Git-Marie Ejneborn Looi
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Sebastian Gabrielsson
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
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25
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Vuckovic V, Carlson E, Sunnqvist C. 'Working as a Real Nurse': Nursing Students' Experiences of a Clinical Education Ward in Psychiatric Care. Issues Ment Health Nurs 2021; 42:1038-1047. [PMID: 34129430 DOI: 10.1080/01612840.2021.1929595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Although the concept of clinical education wards has shown encouraging outcomes regarding nursing students' satisfaction with clinical placements in somatic care, the existing research in a psychiatric context is sparse. This study aims to explore nursing students' experience during clinical education at a psychiatric clinical education ward. A qualitive descriptive study with content analysis, using interviews with 16 bachelor's degree nursing students was conducted. The results indicated that an enriched and adapted learning environment focusing on psychiatric nursing with peer learning supported independence and progression into the future nursing role.
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Affiliation(s)
- Verica Vuckovic
- Office of Psychiatry and Habilitation, Psychiatric Clinic in Helsingborg, Region Skane, Sweden.,Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Elisabeth Carlson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Charlotta Sunnqvist
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
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26
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Gabrielsson S, Salberg J, Bäckström J. Zombies Wanted! Descriptions of Nurses in Psychiatric-Mental Health Care in Swedish Recruitment Advertisements. Issues Ment Health Nurs 2021; 42:899-908. [PMID: 33929921 DOI: 10.1080/01612840.2021.1910758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Knowledge of how nurses are described in recruitment advertisements can aid assessment of the current status of professional psychiatric-mental health nursing and inform services dealing with the challenges of nurse recruitment. This study used content analysis to explore descriptions of nurses in psychiatric-mental health care in a purposive sample of 75 recruitment advertisements collected in Sweden in February 2019. The descriptions were interpreted as focussing on their being willing and able to function in discouraging practice environments, matching the ideal of psychiatric-mental health nursing poorly. The study suggested a need to align the ideals and realities of the nursing profession.
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Affiliation(s)
- Sebastian Gabrielsson
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Johanna Salberg
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Josefin Bäckström
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.,Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Delaney KR. Moving into 2021: Refocusing on the critical issues in child mental health. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2021; 34:5-6. [PMID: 33491258 DOI: 10.1111/jcap.12307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Kathleen R Delaney
- Department of Community, Rush College of Nursing, Systems and Mental Health, Chicago, Illinois, USA
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