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Green G, Adawi S. Understanding Clinical Learning Quality Aspects in Mental Health Nursing Practice Course among Students: A Comprehensive Examination. NURSING REPORTS 2024; 14:1136-1147. [PMID: 38804419 PMCID: PMC11130877 DOI: 10.3390/nursrep14020086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 05/29/2024] Open
Abstract
There is a growing demand for comprehensive evaluations of the clinical learning quality of nursing education and the necessity to establish robust predictors and mediators for enhancing its outcomes within the context of mental health practice. This study is threefold: 1. Evaluating nursing students' clinical learning quality before and after mental health nursing practice; 2. Establish if the grade of a theoretical course in mental health nursing and the student's perception of their theoretical knowledge level predicts the grade of mental health nursing practice; 3. Explore how model learning opportunities, self-directed learning, safety, and nursing care quality mediate learning environment quality and tutorial strategies quality following mental health nursing practice. Using a before and after the study, 107 undergraduate nursing students at an Israeli university completed a questionnaire and the Clinical Learning Quality Evaluation Index tool to assess their perceptions of clinical learning quality before and after mental health nursing practice. The results showed a decline in students' perceptions of tutorial strategy quality following mental health practical learning in clinical settings, with the theoretical course grade predicting the practical experience grade and underscoring the mediating role of learning opportunities between the learning environment and tutorial strategies. The study's findings emphasize the importance of an adaptive learning environment and a solid theoretical foundation in fostering effective tutorial strategies and enhancing the overall learning outcomes for nursing students in mental health education.
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Affiliation(s)
- Gizell Green
- Nursing Department, School of Health Sciences, Ariel University, Ariel 407000, Israel
| | - Sanaa Adawi
- Department of Health System Management, School of Health Sciences, Ariel University, Ariel 407000, Israel;
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Moreno-Poyato AR, El Abidi K, González-Palau F, Tolosa-Merlos D, Rodríguez-Nogueira Ó, Pérez-Toribio A, Casanova-Garrigos G, Roviralta-Vilella M, Roldán-Merino JF. The Effects of a Participatory Intervention in Mental Health Units on Nurses' Perceptions of the Practice Environment: A Mixed Methods Study. J Am Psychiatr Nurses Assoc 2024; 30:74-85. [PMID: 34979817 DOI: 10.1177/10783903211066127] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND The practice environment influences the quality of care and the nursing outcomes achieved in their workplaces. AIMS To examine the perception of the clinical practice environment among nurses working in mental health units in the context of their participation in an action research study aimed at improving the nurse-patient relationship. METHOD An explanatory sequential mixed methods study was designed. The data were collected in three phases in 18 mental health units (n = 95 nurses). Quantitative data were collected through the Practice Environment Scale of the Nursing Work Index, and qualitative data were collected through reflective diaries and focus groups in the context of participatory action research. RESULTS The nurses' assessment of their practice environment shifted from positive to negative. Nurse manager leadership was the aspect that worsened the most. In addition, the perception of their participation in the affairs of the center and nursing foundations for quality of care decreased. The nurses considered it essential to be able to influence decision-making bodies and that the institution should promote a model of care that upholds the therapeutic relationship in actual clinical practice. CONCLUSIONS Nurses perceived that they should be involved in organizational decisions and required more presence and understanding from managers. Furthermore, nurses stated that institutions should promote nursing foundations for quality of care. This study contributes to understanding how nurses in mental health units perceive their work environment and how it affects the improvement of the nurse-patient relationship in clinical practice.
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Affiliation(s)
- Antonio R Moreno-Poyato
- Antonio R. Moreno-Poyato, PhD, MSc, MHN, RN, Department of Public Health, Mental Health and Maternal and Child Health Nursing, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
| | - Khadija El Abidi
- Khadija El Abidi, MSc, RN, Institut de Neuropisquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Francesca González-Palau
- Francesca González-Palau, PhD, MSc, MHN, RN, Hospital Santa Maria, Salut/Gestió de Serveis Sanitaris, Lleida, Catalonia, Spain
| | - Diana Tolosa-Merlos
- Diana Tolosa-Merlos, PhD, MSc, RN, Institut de Neuropisquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Óscar Rodríguez-Nogueira
- Óscar Rodríguez-Nogueira, PhD, MSc, PT, SALBIS Research Group, Department of Nursing and Physiotherapy, Universidad de León, Campus de Ponferrada, Ponferrada, Spain
| | - Alonso Pérez-Toribio
- Alonso Pérez-Toribio, PhD, MSc, RN, Unitat de Salut Mental de l'Hospitalet, Gerència Territorial Metropolitana Sud/Institut Català de la Salut, L'Hospitalet de Llobregat, Spain
| | - Georgina Casanova-Garrigos
- Georgina Casanova-Garrigos, PhD, MSc, RN, Department and Faculty of Nursing, Universitat Rovira i Virgili, Tortosa, Catalonia, Spain
| | | | - Juan F Roldán-Merino
- Juan F. Roldán-Merino, PhD, MSc, MHN, RN, Campus Docent Sant Joan de Déu Fundació Privada. School of Nursing, University of Barcelona, Barcelona, Spain
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Creen J, Kennedy-Behr A, Donkin R, Verdonck M. Understanding parent engagement in advanced allied health single session therapy for children with developmental and behavioural disabilities. Child Care Health Dev 2024; 50:e13148. [PMID: 37369641 DOI: 10.1111/cch.13148] [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: 08/26/2022] [Revised: 05/31/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Increasingly, health services are adopting short-term consultative therapy models, such as single session therapy, to cope with increased service demands, finite budgets and changing consumer expectations. Within the paediatric sub-specialty of child development and behaviour, allied health clinicians are central to supporting families to understand their children, provide therapeutic interventions and help achieve optimal developmental and health outcomes. This study aimed to describe parents'/caregivers' engagement during advanced allied health consultations utilizing a single session therapy framework for managing neurodevelopmental and behavioural concerns in children. METHODS Between March to June 2021, 14 parents participated in a qualitative study involving focus groups. Reflexive thematic analysis was used to code and interpret the data to understand and explore families' engagement in single session therapy. RESULTS Three overarching themes relating to parents' engagement during consultations emerged from the data: connection with the clinician, parental attributes and organizational influences. Clinician connection was the prominent construct that enhanced parent attributes and the positive perception of the organization in an ongoing manner. There was a complex interplay between the behavioural and affective components of the clinician, parents and the organization to create mutual presence, valued time, understanding and action. CONCLUSIONS This study demonstrates the importance of clinician connection, parental attributes and organizational influences to enhance engagement in therapeutic consultations. These factors are interrelated and are a complex blend of behaviour and internal states and highly individualized for each family. Understanding how services can continue to engage families is integral to ongoing sustainability and overall health and well-being.
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Affiliation(s)
- Julie Creen
- Sunshine Coast Hospital and Health Service, Birtinya, Queensland, Australia
- School of Health, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
| | - Ann Kennedy-Behr
- School of Health, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
| | - Rebecca Donkin
- School of Health, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
| | - Michele Verdonck
- School of Health, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
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Duran S, Polat S. Psychometric properties of the Turkish version of the therapeutic relationship assessment scale for nurses. J Res Nurs 2023; 28:630-641. [PMID: 38162719 PMCID: PMC10756177 DOI: 10.1177/17449871231213830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Background It is essential for nurses who care for individuals diagnosed with mental illness to establish a therapeutic relationship. There is no measurement tool available in Türkiye to assess the therapeutic relationship between patient and nurse. Aim The objective of this study is to perform a validity and reliability study of the Turkish version of a scale that enables the evaluation of the quality of the therapeutic relationship established between nurses and patients. Methods 140 nurses were included in this study. The data were analysed using the exploratory and confirmatory analyses. Results The scale consists of 25 items and four sub-dimensions. In confirmatory factor analysis (CFA), all factor loads were >0.30. As a result of CFA, all fit indices were >0.85 and the root mean square approximation was <0.080. Cronbach alpha was 0.93 for the whole scale. Conclusion The Turkish version of the TRAS-Nurse scale and its original version were compatible with each other and gave similar results. This scale can be used to determine the therapeutic relationship of nurses who care for psychiatric patients in Türkiye and can be a useful measurement tool when evaluating the factors that may be effective in improving the therapeutic relationship.
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Affiliation(s)
- Songül Duran
- Associate Professor, Izmir Democracy University, Health Services Vocational College, Care of Elderly Program, Izmir, Türkiye
| | - Selda Polat
- Assistant Professor, Faculty of Health Sciences, Department of Nursing, Bahçeşehir University, İstanbul, Türkiye
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Bright AM, Doody O. Mental health service users' experiences of telehealth interventions facilitated during the COVID-19 pandemic and their relevance to nursing: An integrative review. J Psychiatr Ment Health Nurs 2023; 30:1114-1129. [PMID: 37278201 DOI: 10.1111/jpm.12943] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/03/2023] [Accepted: 05/21/2023] [Indexed: 06/07/2023]
Abstract
WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Service users report telehealth interventions to be useful in terms of access and convenience however, a preference for face-to-face interventions remains. Nurses are using telehealth interventions in clinical practice however, further research is necessary in this area as the evidence of their involvement is limited. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This paper highlights the use of telehealth interventions should augment rather than replace face-to-face care provision. ABSTRACT INTRODUCTION: The Covid-19 pandemic saw the swift implementation of physical and social distancing that impacted the way in which mental health services were facilitated. Consequently, telehealth/e-health interventions are increasing in use. AIM This integrative review aims to explore existing literature regarding mental health service users' experiences of telehealth interventions facilitated through the COVID-19 pandemic, to determine the visibility of nursing involvement in the facilitation of telehealth interventions and to use these experiences to inform nursing practice. METHOD A methodical search of eight (n = 8) academic databases was undertaken using CINAHL, SCOPUS, EMBASE, PsycINFO, Web of Science, Cochrane, MEDLINE and Academic Search Complete between January 2020 and January 2022. RESULTS A total of 5133 papers were screened by title and abstract of which (n = 77) progressed for full-text screening. Five (n = 5) papers met the inclusion criteria for this review and results were mapped onto the four meta-paradigms of nursing: person; where the findings discuss the acceptability of telehealth interventions; environment; where the findings highlight barriers and facilitators to the use of telehealth interventions; health; where the findings discuss staff time and logistical issues relating to telehealth interventions and nursing; where the findings centre around the therapeutic relationship. DISCUSSION This review highlights there is a paucity of direct evidence relating to nursing involvement in the facilitation of telehealth interventions. However, there are benefits to the use of telehealth interventions that include increased access to services, less perceived stigma and increased engagement which are relevant to nursing practice. A lack of individual contact and concerns relating to infrastructure indicates a fondness for face-to-face interventions remains high. IMPLICATIONS FOR PRACTICE There is a need for further research on the role of the nurse in the facilitation of telehealth interventions, specific interventions used and outcomes of such interventions.
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Affiliation(s)
- Ann-Marie Bright
- Department of Nursing & Midwifery, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing & Midwifery, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Morera-Balaguer J, Martínez-González MC, Río-Medina S, Zamora-Conesa V, Leal-Clavel M, Botella-Rico JM, Leirós-Rodríguez R, Rodríguez-Nogueira Ó. The influence of the environment on the patient-centered therapeutic relationship in physical therapy: a qualitative study. Arch Public Health 2023; 81:92. [PMID: 37198648 DOI: 10.1186/s13690-023-01064-9] [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: 10/19/2022] [Accepted: 03/18/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Currently, in the scientific literature there is a great interest on the study of strategies to implement patient-centered care. One of the main tools for this is the therapeutic relationship. Some studies suggest that the perception of the environment in which the treatment takes place can influence the perception of its quality, but this is not explored in physical therapy. For all these reasons, the aim of this study was to understand the influence of the environment in which physical therapy treatment takes place on the patients' perception of the quality of the patient-centered therapeutic relationship in public health centers in Spain. METHODS A qualitative study analysed thematically using a modified grounded theory approach. Data collection used semistructured interviewing during focus groups. RESULTS We conducted four focus groups. The size of the focus groups ranged from six to nine participants. In total, 31 patients participated in these focus groups. Participants described a series of specific experiences and perceptions relating to the environment, which they felt were influential in the establishment of therapeutic patient-centered relationships, including six physical factors (Architectural barriers, Furniture, Use of the computer, Physical space, Ambiet conditions, and Privacy) and six organizational factors (Patient-physical therapist ratio, Treatment interruptions, Social factors, Continuity with the professional, Lack of professional autonomy, and Coordination or communication among team members). CONCLUSION The results of this study highlight environmental factors that affect the quality of the therapeutic patient-centered relationship in physical therapy from the patient's point of view, and emphasize the need for physical therapists and administrators to underline the need to review these factors and take them into account in their service delivery.
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Affiliation(s)
- Jaume Morera-Balaguer
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, 03201, Spain
| | - Mª Carmen Martínez-González
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, 03201, Spain
| | - Sonia Río-Medina
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, 03201, Spain
| | - Víctor Zamora-Conesa
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, 03201, Spain
| | - Marina Leal-Clavel
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, 03201, Spain
| | - José Martín Botella-Rico
- Nursing and Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, 03201, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, Faculty of Health Sciences, University of León, Astorga Ave. 15, Ponferrada, 24401, Spain.
| | - Óscar Rodríguez-Nogueira
- SALBIS Research Group, Nursing and Physical Therapy Department, Faculty of Health Sciences, University of León, Astorga Ave. 15, Ponferrada, 24401, Spain
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7
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Moreno-Poyato AR, El Abidi K, Lluch-Canut T, Cañabate-Ros M, Puig-Llobet M, Roldán-Merino JF. Impact of the 'reserved therapeutic space' nursing intervention on patient health outcomes: An intervention study in acute mental health units. Nurs Open 2023. [PMID: 37084278 DOI: 10.1002/nop2.1750] [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: 04/16/2022] [Revised: 01/10/2023] [Accepted: 03/24/2023] [Indexed: 04/23/2023] Open
Abstract
AIMS To evaluate the effectiveness of the 'reserved therapeutic space' intervention for improving the nurse-patient therapeutic relationship in acute mental health units in Spain. DESIGN Multicentre intervention study with control group. METHODS The study will be carried out in 12 mental health units. The 'reserved therapeutic space' intervention to be tested has been co-designed and validated by both nurses and patients. The quality of the therapeutic relationship, the care received and perceived coercion among patients will be assessed. An estimated 131 patients per group are expected to participate. Funding was granted by the Instituto de Salud Carlos III. Co-financed by the European Union (European Regional Development Fund (ERDF) (PI21/00605)) and College of Nurses of Barcelona (PR-487/2021). The proposal was approved by all the Research Ethics Committees of participating centres. RESULTS This project will lead to changes in clinical practice, transforming the current models of organization and care management in mental health hospitalization units. No patient or public contribution.
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Affiliation(s)
- Antonio R Moreno-Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
| | - Khadija El Abidi
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Teresa Lluch-Canut
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
| | - Montserrat Cañabate-Ros
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castelló de la Plana, Spain
- Hospital Clínico Universitario Valencia, Valencia, Spain
| | - Montserrat Puig-Llobet
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
| | - Juan F Roldán-Merino
- Campus Docent Sant Joan de Déu Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
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Tabvuma T, Stanton R, Happell B. The physical health nurse consultant and mental health consumer: An important therapeutic partnership. Int J Ment Health Nurs 2023; 32:579-589. [PMID: 36567487 DOI: 10.1111/inm.13104] [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] [Accepted: 11/30/2022] [Indexed: 12/27/2022]
Abstract
People diagnosed with mental illness (hereon referred to as consumers) experience a disproportionately lower life expectancy of up 30 years compared to the general population. Systemic issues such as diagnostic overshadowing and stigma from healthcare professionals have inhibited the development of positive therapeutic partnerships that enable consumers to seek and engage support for their physical health concerns. Consumers have called for healthcare professionals to skillfully develop and prioritize therapeutic partnerships whilst coordinating and providing physical healthcare. The aim of this qualitative descriptive research was to explore consumer views and experiences of their interactions with a specialist mental health nursing role, the Physical Health Nurse Consultant. Semi-structured interviews were conducted with 14 consumers from a large public Community Mental Health Service in the Australian Capital Territory. Interviews were transcribed and thematically analysed. Therapeutic partnerships were an overarching theme identified from the data and included three sub-themes: personal attributes of the Physical Health Nurse Consultant; behaviour change engagement strategies; and impact of the therapeutic partnership. Consumers described the personal and professional attributes of the Physical Health Nurse Consultant that enabled the establishment and maintenance of their highly valued therapeutic partnership. This therapeutic partnership was perceived to positively impact their personal and clinical outcomes. With increasing support from consumers, clinical practice settings should move towards embedding a Physical Health Nurse Consultant role in routine practice. Further research exploring the co-development of health behaviour change goals and, barriers and facilitators experienced by the consumers regarding the Physical Health Nurse Consultant is required to further role development.
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Affiliation(s)
- Tracy Tabvuma
- Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
| | - Robert Stanton
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Brenda Happell
- Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia.,School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Berg J, Lipponen E, Sailas E, Soininen P, Varpula J, Välimäki M, Lahti M. Nurses' perceptions of nurse-patient communication in seclusion rooms in psychiatric inpatient care: A focus group study. J Psychiatr Ment Health Nurs 2023. [PMID: 36718606 DOI: 10.1111/jpm.12907] [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: 12/21/2021] [Revised: 12/16/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Communication between nurses and patients is essential in mental health nursing. In coercive situations (e.g. seclusion), the importance of nurse-patient communication is highlighted. However, research related to nurses' perceptions of nurse-patient communication during seclusion is scant. AIM The aim of this study was to describe nurses' perceptions of nurse-patient communication during patient seclusion and the ways nurse-patient communication can be improved. METHOD A qualitative study design using focus group interviews was adopted. Thirty-two nurses working in psychiatric wards were recruited to participate. The data were analysed using inductive qualitative content analysis. RESULTS Nurses aimed to communicate in a patient-centred way in seclusion events, and various issues affected the quality of communication. Nurses recognized several ways to improve communication during seclusion. DISCUSSION Treating patients in seclusion rooms presents highly demanding care situations for nurses. Seclusion events require nurses to have good communication skills to provide ethically sound care. CONCLUSION Improved nurse-patient communication may contribute to shorter seclusion times and a higher quality of care. Improving nurses' communication skills may help support the dignity of the secluded patients. Safewards practices, such as respectful communication and recognizing the effect of non-verbal behaviour, could be considered when developing nurse-patient communication in seclusion events. RELEVANCE STATEMENT This study deepens the understanding of nurse-patient communication during seclusion events from the perspective of nurses. Caring for patients in seclusion presents challenging situations for nurses and demands that they have good communication skills. To enhance their communication skills in seclusion events, nurses require opportunities to take part in further training after education related to communication skills for demanding care situations. Knowing the appropriate ways to interact with individual patients during seclusion can help nurses create and maintain communication with patients. For mental health nursing, nurses' enhanced communication may promote increased use of noncoercive practices in psychiatric settings. For patients, improving nurses' communication skills may help support dignity and autonomy during seclusion and shorten the time spent in seclusion, resulting in a better quality of care and more positive patient experiences related to care offered in seclusion. In this, the perspectives of people with lived experience of mental health problems should be acknowledged. Components of Safewards practices, such as using respectful and individual communication and paying attention to one's non-verbal communication (Soft Words), could be useful when developing nurse-patient communication in seclusion events.
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Affiliation(s)
- Johanna Berg
- Turku University of Applied Sciences, Turku, Finland
| | | | - Eila Sailas
- Helsinki University Hospital, Kellokoski Hospital, Kellokoski, Finland
| | - Päivi Soininen
- Helsinki University Hospital, Kellokoski Hospital, Kellokoski, Finland.,Department of Nursing Science, University of Turku, Turku, Finland
| | - Jaakko Varpula
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,Xiangya Nursing School, Central South University, Changsha, China
| | - Mari Lahti
- Turku University of Applied Sciences, Turku, Finland.,Department of Nursing Science, University of Turku, Turku, Finland
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Hansen A, Hazelton M, Rosina R, Inder K. What do we know about the experience of seclusion in a forensic setting? An integrative literature review. Int J Ment Health Nurs 2022; 31:1109-1124. [PMID: 35592928 PMCID: PMC9546340 DOI: 10.1111/inm.13022] [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] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
Abstract
Seclusion is used in forensic and general mental health settings to protect a person or others from harm. However, seclusion can result in trauma-related harm and re-traumatization with little known about the experience of seclusion for consumers in forensic mental health settings from their perspectives. This article explores consumer experiences of seclusion in forensic mental health settings and explores the differences between female and male experiences of seclusion. Five electronic databases were systematically searched using keywords and variations of experience, attitude, seclusion, coercion, forensic mental health, and forensic psychiatry. Inclusion criteria were original peer-reviewed studies conducted in adult forensic mental health settings reporting data on the experiences of or attitudes towards seclusion. Seven studies met the criteria for inclusion and a quality assessment was undertaken. Results found consumers in forensic mental health settings perceive seclusion to be harmful, a punishment for their behaviour, and largely a negative experience that impacts their emotional health. Some consumers report positive experiences of seclusion. Differences in the experience of seclusion for females and males are unclear. Further research is required to understand the experience of seclusion for women in forensic mental health settings. Identification and consideration of differences in the experience of seclusion for males and females may assist in identifying sex-specific interventions and may inform policy and practices to eliminate or reduce the trauma associated with seclusion use.
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Affiliation(s)
- Alison Hansen
- School of Nursing & Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,School of Nursing & Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michael Hazelton
- School of Nursing & Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Robyn Rosina
- Independent Researcher, Sydney, New South Wales, Australia
| | - Kerry Inder
- School of Nursing & Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton, New South Wales, Australia
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11
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Bui MV, McInnes E, Ennis G, Foster K. Protocol for a mixed methods process evaluation of the Promoting Resilience in Nurses (PRiN) trial. Int J Ment Health Nurs 2022; 31:687-696. [PMID: 35279934 PMCID: PMC9314145 DOI: 10.1111/inm.12989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/31/2022] [Accepted: 02/28/2022] [Indexed: 11/30/2022]
Abstract
Mental health nurses are exposed frequently to occupational stress and can experience a range of negative impacts on their well-being and intention to stay in the nursing workforce. Promoting Resilience in Nurses (PRiN) is a strength-based resilience education programme that incorporates evidence-based cognitive behavioural and interpersonal approaches with post-traumatic growth theory. A partially clustered randomized controlled trial at a large public mental health service will be used to examine the effects of PRiN on mental health nurses' coping self-efficacy, resilience, well-being, mental health, emotional regulation, post-traumatic growth, workplace belonging, and turnover intention as compared to controls. Process evaluations are increasingly used to help understand and interpret trial results for complex interventions. This paper describes the protocol for an embedded mixed methods process evaluation that aims to evaluate the PRiN programme implementation and identify factors that may explain variation in participant outcomes in the trial. Data collection includes a programme participant satisfaction survey; a follow-up semi-structured interview with selected programme participants; a unit/team manager survey on barriers and facilitators to staff recruitment and programme participation; and a fidelity checklist completed by programme facilitators. Normalisation Process Theory will be used to inform data analysis and integration. The findings will provide insights into factors that affect programme implementation, particularly in the context of the COVID-19 pandemic and may help explain differences in participant outcomes. Findings will also inform post-trial programme sustainability as well as potential future upscale and adaptation for implementation across healthcare settings.
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Affiliation(s)
- Minh Viet Bui
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Elizabeth McInnes
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,Nursing Research Institute - St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Parkville, Victoria, Australia
| | - Gary Ennis
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
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Missouridou E, Fradelos EC, Kritsiotakis E, Mangoulia P, Segredou E, Papathanasiou IV. Containment and therapeutic relationships in acute psychiatric care spaces: the symbolic dimensions of doors. BMC Psychiatry 2022; 22:2. [PMID: 34983447 PMCID: PMC8725636 DOI: 10.1186/s12888-021-03607-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is an increasing trend of door locking practices in acute psychiatric care. The aim of the present study was to illuminate the symbolic dimensions of doors in Greek mental health nurses' experiences of open and locked working spaces. RESULTS A sequential mixed-method designexplored the experiences of nurses working in both open and locked psychiatric acute care units. Participants experiences revealed four types of doors related to the quality of recovery-oriented care: (a) the open door, (b) the invisible door, (c) the restraining door, and (d) the revolving door. Open doors and permeable spacesgenerated trust and facilitated the diffusion of tension and the necessary perception of feeling safe in order to be involved in therapeutic engagement. When the locked unit was experienced as a caring environment, the locked doors appeared to be "invisible". The restraining doors symbolized loss of control, social distance and stigma echoing the consequences of restrictingpeople's crucial control over spaceduring the COVID-19 pandemicin relation toviolence within families, groups and communities. The revolving door (service users' abscondence/re-admission) symbolised the rejection of the offered therapeutic environment and was a source of indignation and compassion fatigue in both open and locked spaces attributed to internal structural acute care characteristics (limited staffing levels, support, resources and activities for service users) as well as 'locked doors' in the community (limited or no care continuity and stigma). CONCLUSIONS The impact of COVID-19 restrictions on people's crucial control of space provides an impetus for erecting barriers masked by the veil of habit and reconsidering the impact of the simple act of leaving the door open/locked to allow both psychiatric acute care unit staff and service users to reach their potential.
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Affiliation(s)
- Evdokia Missouridou
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Saint Spiridonos 12243, Egaleo, Athens, Greece.
| | - Evangelos C. Fradelos
- grid.410558.d0000 0001 0035 6670Community Nursing Lab, Department of Nursing, University of Thessaly, Larissa, Greece
| | - Emmanouel Kritsiotakis
- grid.499377.70000 0004 7222 9074 Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Saint Spiridonos 12243, Egaleo, Athens, Greece ,Psychiatric Department, General State Hospital “Sismanoglio”, Marousi, Greece
| | - Polyxeni Mangoulia
- grid.499377.70000 0004 7222 9074 Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Saint Spiridonos 12243, Egaleo, Athens, Greece ,Psychiatric Liaison Unit, General State Hospital “Evangelismos”, Athens, Greece
| | - Eirini Segredou
- Alcohol Treatment Unit, Psychiatric Hospital of Attica, Chaidari, Greece
| | - Ioanna V. Papathanasiou
- grid.410558.d0000 0001 0035 6670Community Nursing Lab, Department of Nursing, University of Thessaly, Larissa, Greece
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Rodríguez-Nogueira Ó, Leirós-Rodríguez R, Pinto-Carral A, Álvarez-Álvarez MJ, Morera-Balaguer J, Moreno-Poyato AR. Examining the Association between Evidence-Based Practice and Burnout among Spanish Physical Therapists: A Cross-Sectional Study. J Pers Med 2021; 11:jpm11080805. [PMID: 34442449 PMCID: PMC8400199 DOI: 10.3390/jpm11080805] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to quantify the level of burnout and competence for evidence-based practice among Spanish physical therapists and to determine if there is a relationship between these and other socio-professional factors. A cross-sectional study with 472 Spanish Physiotherapists. An electronic survey was conducted that included the Maslach Burnout Inventory, Evidence-Based Practice Questionnaire and sociodemographic data. The three subscales of the Burnout correlated with attitude and total Evidence-Based Practice Questionnaire. Attitude and practice for evidence-based practice, educational level and experience were the variables that showed the greatest influence on burnout. Burnout and the degree of evidence-based practice were identified as being discretely related. Specifically, it seems that the evidence-based practice could improve the lack of personal accomplishment, meaning that through interventions perceived as more effective and advantageous, a sense of mastery and self-efficacy is experienced.
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Affiliation(s)
- Óscar Rodríguez-Nogueira
- SALBIS Research Group, Nursing and Physical Therapy Department, Universidad de León, Astorga Ave. 15, 24401 Ponferrada, Spain; (Ó.R.-N.); (A.P.-C.); (M.J.Á.-Á.)
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, Universidad de León, Astorga Ave. 15, 24401 Ponferrada, Spain; (Ó.R.-N.); (A.P.-C.); (M.J.Á.-Á.)
- Correspondence:
| | - Arrate Pinto-Carral
- SALBIS Research Group, Nursing and Physical Therapy Department, Universidad de León, Astorga Ave. 15, 24401 Ponferrada, Spain; (Ó.R.-N.); (A.P.-C.); (M.J.Á.-Á.)
| | - Mª José Álvarez-Álvarez
- SALBIS Research Group, Nursing and Physical Therapy Department, Universidad de León, Astorga Ave. 15, 24401 Ponferrada, Spain; (Ó.R.-N.); (A.P.-C.); (M.J.Á.-Á.)
| | - Jaume Morera-Balaguer
- Nursing and Physical Therapy Department, Universidad Cardenal Herrera-CEU, Plaça Reis Catòlics 19, 03204 Elche, Spain;
| | - Antonio R. Moreno-Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Universitat de Barcelona, 08907 L’Hospitalet de Llobregat, Spain;
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14
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Kritsotakis G, Gkorezis P, Andreadaki E, Theodoropoulou M, Grigoriou G, Alvizou A, Kostagiolas P, Ratsika N. Nursing practice environment and employee silence about patient safety: The mediating role of professional discrimination experienced by nurses. J Adv Nurs 2021; 78:434-445. [PMID: 34337760 DOI: 10.1111/jan.14994] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 05/18/2021] [Accepted: 07/20/2021] [Indexed: 12/29/2022]
Abstract
AIMS To examine the associations between nurse work environment with nurses' silence about patient safety and the mediating effects of professional discrimination experienced by nurses. DESIGN Multicentre cross-sectional study. METHODS Between January and April 2019, 607 nurses and nursing assistants from seven hospitals in Greece assessed their clinical environment using the 'Practice Environment Scale of the Nursing Work Index Revised-PES-NWIR', and the silence about patient safety. The 'Experiences of Discrimination Index' was adapted to specifically address experienced discrimination based on the nursing profession. The PROCESS macros for SPSS were used to examine the above associations. FINDINGS Better nurse practice environment, with the exception of 'staffing and resource adequacy' dimension, was directly associated with less experienced professional discrimination, and directly and indirectly associated with less silence about patient safety, through the mediating role of professional discrimination experienced by nurses. CONCLUSIONS Silence about patient safety is dependent on the clinical work environment and may be a response of nurses to discrimination in the work context. Both an improvement in the nurse work environment and a decrease in professional discrimination would minimize silence about patient safety. IMPACT On many occasions, nurses are directly or indirectly discouraged from voicing their concerns about patient safety or are ignored when they do, leading to employee silence and decreasing the standard of care (Alingh et al., BMJ Quality & Safety, 2019, 28, 39; Pope, Journal of Change Management, 2019, 19, 45). Nurses' work-related determinants for silence are not clearly understood in the patient safety context. A favourably evaluated nurse practice environment is associated with less experienced professional discrimination and less silence about patient safety. To minimize silence about patient safety, both the nurse work environment and the experienced professional discrimination should be taken into consideration by nurse and healthcare managers.
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Affiliation(s)
- George Kritsotakis
- Department of Bussiness Administration & Tourism, Hellenic Mediterranean University, Crete, Greece.,School of Social Sciences, Hellenic Open University, Patras, Greece
| | - Panagiotis Gkorezis
- School of Social Sciences, Hellenic Open University, Patras, Greece.,Faculty of Economics and Political Sciences, Aristotle University of Thessaloniki, Thesaloniki, Greece
| | - Eirini Andreadaki
- School of Social Sciences, Hellenic Open University, Patras, Greece.,Aghios Nikolaos General Hospital, Crete, Greece
| | | | | | | | - Petros Kostagiolas
- School of Social Sciences, Hellenic Open University, Patras, Greece.,Department of Archives, Library Science and Museology, School of Information Science and Informatics, Ionian University, Kerkyra, Greece
| | - Nikoleta Ratsika
- Department of Social Work, Hellenic Mediterranean University, Crete, Greece
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15
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Moreno-Poyato AR, Roviralta-Vilella M, Abidi KE, Bordera-Antequera S, Triviño-Briones SR, Olives CUD, Lluch-Canut T, Puig-Llobet M. Nursing Practice Environment in Psychiatric Units: A Scoping Review. J Psychosoc Nurs Ment Health Serv 2021; 59:33-40. [PMID: 34142913 DOI: 10.3928/02793695-20210526-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The practice environment is a key element that influences the quality of psychiatric-mental health nursing care; however, little is known about it. For the current study, to explore the evidence on environmental factors influencing nursing practice in psychiatric inpatient units, a scoping review of primary research published between 2009 and 2019 was performed. PubMed, Web of Science, Scopus, and CINAHL databases were searched. Eleven articles were included. Main findings were: (a) the biomedical approach limits the development of the nursing model; (b) lack of opportunities, representation, and recognition of nurses in the organization; (c) greater support from managers for a greater perception of nurses' competence and therapeutic commitment; and (d) the need for a feeling of belonging to the team and the perception of emotional exhaustion, workload, and administrative tasks. Although psychiatric nurses have a slightly positive view of their practice environment, certain factors limit quality of care. The current review points to the need for nurses to have greater organizational support and the importance of promoting effective teamwork. Implications for mental health services include the need for support and recognition by managers, as well as the existence of a nursing model within the units. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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16
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Moreno-Poyato AR, El Abidi K, Rodríguez-Nogueira Ó, Lluch-Canut T, Puig-Llobet M. A qualitative study exploring the patients' perspective from the 'Reserved Therapeutic Space' nursing intervention in acute mental health units. Int J Ment Health Nurs 2021; 30:783-797. [PMID: 33599014 DOI: 10.1111/inm.12848] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/12/2021] [Accepted: 01/26/2021] [Indexed: 11/28/2022]
Abstract
This study aimed to explore the perspective of people who had experienced treatment as patients at acute mental health units, regarding an intervention model to improve therapeutic relationships in the units, which had been previously designed by the nurses. The study participants were people linked to collectives for social activism in mental health. Six focus groups were held. The results were classified into three themes: (a) the meaning of a space to enable the establishment of a therapeutic relationship, (b) the procedures to implement the space, and (c) the difficulties to overcome to establish the space. For the participants, the Reserved Therapeutic Space intervention was perceived as a space where they could share expectations and needs with the nurses, considering it as both valid and useful to improve the therapeutic relationship in acute units. For the participants, the intervention should be structured in three stages: orientation, follow-up, and discharge. The content of the intervention should be proposed by the patients based on their needs and concerns. The barriers identified for carrying out the intervention were the lack of relational competence, the violation of rights, and the lack of accessibility of nurses. The facilitating elements were the availability of nurses, active listening, and empathy. The resulting intervention model includes realities of both groups, providing insights for nurses to initiate a space with patients and improve their therapeutic relationship. This intervention model could be used by managers to test its effectiveness.
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Affiliation(s)
- Antonio R Moreno-Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L´Hospitalet de Llobregat, Spain
| | - Khadija El Abidi
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Óscar Rodríguez-Nogueira
- SALBIS Research Group, Department of Nursing and Physiotherapy, Universidad de León, Ponferrada, Spain
| | - Teresa Lluch-Canut
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L´Hospitalet de Llobregat, Spain
| | - Montserrat Puig-Llobet
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L´Hospitalet de Llobregat, Spain
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17
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Foster K, Roche M, Giandinoto JA, Platania-Phung C, Furness T. Mental health matters: A cross-sectional study of mental health nurses' health-related quality of life and work-related stressors. Int J Ment Health Nurs 2021; 30:624-634. [PMID: 33280229 DOI: 10.1111/inm.12823] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022]
Abstract
Mental health nursing is widely recognized as a stressful occupation; however, little is known about the relationship between work-related stress and health-related quality of life of mental health nurses (MHN). This study aimed to identify MHN health-related quality of life (HR-QoL) and work-related stressors; associations between stressors and HR-QoL; and predictors of HR-QoL. An online cross-sectional survey collected demographic data, work-related stressors and HR-QoL (SF-12v2) of n = 498 Australian MHN. Prominent consumer/carer-related stressors were verbal (90%) and physical aggression (85%). Collegial stressors included staff conflict (71%) and bullying (55%), and colleague-perpetrated verbal (34%) and physical aggression (7%). Key organizational stressors included high workloads (74%), lack of organizational support (60%) and lack of adequate resources to perform nursing role (58%). The mean physical health score was 52.62 (SD = 8.30), and mental health score was 43.59 (SD = 11.34), with mental health substantially lower than national norms (mean difference = 10.11). There were statistically significant negative correlations between the number of work-related stressors and HR-QoL. Younger (21-30 years) and less experienced (<1-4 years) MHN had substantially lower mental health. Higher mental health was predicted with < 15 stressors, >4 years' experience and working in the community. The poorer mental health of MHN has concerning implications for the well-being, retention and practice of the largest group in the mental health workforce. There is a critical need for organizations to enact effective policy and initiatives to reduce workplace aggression, improve staff psychological and physical safety, and strengthen well-being and resilience. New graduates are a priority group for urgent intervention.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Michael Roche
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Jo-Ann Giandinoto
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Chris Platania-Phung
- Australian College of Applied Psychology, Navitas, Melbourne, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
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18
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Background characteristics and exposure to violence predict well-being at work among psychiatric outpatient nurses. Arch Psychiatr Nurs 2021; 35:223-231. [PMID: 33781405 DOI: 10.1016/j.apnu.2020.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/03/2020] [Accepted: 06/11/2020] [Indexed: 11/24/2022]
Abstract
AIMS To investigate the well-being at work and analyze relevant predictors of it among nurses working in psychiatric outpatient settings including following specific objectives 1) describe the current state of well-being at work among psychiatric nurses; and 2) examine how background characteristics and exposure to violence predict well-being at work. DESIGN A cross-sectional survey design. METHODS Two-staged sampling was used to select participants from psychiatric outpatient units. Data were collected with printed Nordic Questionnaire for Monitoring the Age Diverse Workforce (QPSNordic-ADW) and Violence Incidence Assessment (VIA-Q) questionnaire from January 2019 to June 2019. Descriptive statistics were performed to summarize the collected data and binary logistic regression was used to identify predictors related to the well-being at work. RESULTS The respondents (n = 181) generally evaluated well-being at work quite positively but were more critical towards interaction with their immediate superior, organizational culture, interaction between work and private life, and organizational commitment. Working experience in psychiatric nursing and experiences of harassment were identified as strong predictors of well-being at work. CONCLUSION The management of healthcare organizations should discuss nursing ethics and morale more, as well as pay attention to the ethical environment to prevent moral distress among nurses. Several weaknesses seem to exist especially in the management of psychiatric outpatient units which influence nurses' well-being at work. Identification of these can help organizations to develop management and implement interventions to increase nurses' well-being at work. Conversations about the managerial culture and collegial climate should also arise at the organizational and unit levels.
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19
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Moreno-Poyato AR, Rodríguez-Nogueira Ó, Casanova-Garrigos G, El Abidi K, Roldán-Merino JF. The impact of a participatory intervention on the therapeutic relationship in mental health nurses: A multicentre study. J Adv Nurs 2021; 77:3104-3115. [PMID: 33748977 DOI: 10.1111/jan.14835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/25/2021] [Accepted: 03/05/2021] [Indexed: 12/01/2022]
Abstract
AIMS To evaluate the effects of an intervention aimed at improving the therapeutic relationship, using the participatory-action research method, in terms of improving the quality of the nurse-patient therapeutic relationship. DESIGN A single-group pre-post research design. METHODS Quantitative data were collected between January 2018 and June 2019 using an online form completed by nurses from 18 mental health units (N = 95). Data were collected before and after the intervention, which consisted of the design, implementation and evaluation of strategies to improve the therapeutic relationship through participatory-action research involving nurses. The Working Alliance Inventory-Short, Interpersonal Reactivity Index, Evidence-Based Practice Questionnaire and Practice Environment Scale of the Nursing Work Index were used. The Wilcoxon rank-sum test was used together with the Spearman's correlation coefficient. Two multiple linear regressions models were constructed. RESULTS Overall, the intervention improved the nurse-patient therapeutic relationship. In addition, the results revealed that, above all, the improvement in evidence-based practice along with a decrease in nurses' personal distress were the factors associated with the improvement of the nurse-patient therapeutic relationship. CONCLUSION In mental health units, the therapeutic nurse-patient relationship can be improved through participatory interventions that include the implementation of evidence-based practices. IMPACT This research examined the effects of an intervention aimed at improving the therapeutic relationship among nurses working at mental health units using participatory action research. The results show that the therapeutic relationship can be improved through participatory methods where evidence-based practice is implemented and enhanced among nurses, since a better therapeutic relationship along with reduced staff discomfort are determining factors that influence the quality of the therapeutic relationship. Institutional managers should promote participatory group interventions to enable nurses to develop evidence-based aspects of the therapeutic relationship together with expanding personal aspects and self-knowledge.
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Affiliation(s)
- Antonio R Moreno-Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L´Hospitalet de Llobregat, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Óscar Rodríguez-Nogueira
- SALBIS Research Group, Department of Nursing and Physiotherapy, Universidad de León, Ponferrada, Spain
| | | | - Khadija El Abidi
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Juan F Roldán-Merino
- Campus Docent Sant Joan de Déu Fundació Privada, School of Nursing, University of Barcelona, Esplugues de llobregat, Spain
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20
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Clua-García R, Casanova-Garrigós G, Moreno-Poyato AR. Suicide care from the nursing perspective: A meta-synthesis of qualitative studies. J Adv Nurs 2021; 77:2995-3007. [PMID: 33591582 DOI: 10.1111/jan.14789] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/24/2020] [Accepted: 01/23/2021] [Indexed: 11/28/2022]
Abstract
AIMS To explore nurses' experiences of suicide care and to identify and synthesize the most suitable interventions for the care of people with suicidal behaviour from a nursing perspective. DESIGN Qualitative meta-synthesis. DATA SOURCES Comprehensive search of five electronic databases for qualitative studies published between January 2015 and June 2019. REVIEW METHODS The PRISMA statement was used for reporting the different phases of the literature search and the Critical Appraisal Skills Programme (CASP) qualitative research checklist was used as an appraisal framework. Data synthesis was conducted using Sandelowski and Barroso's method. RESULTS Seventeen articles met the inclusion criteria. The data analysis revealed 13 subcategories from which four main categories emerged: 'Understanding suicidal behaviour as a consequence of suffering', 'Nurses' personal distress in suicide care', 'The presence of the nurse as the axis of suicide care' and, 'Improving nurses' relational competences for a better therapeutic environment'. CONCLUSION Further training of nurses on the therapeutic relationship, particularly in non-mental health care work settings, and monitoring of the emotional impact on nurses in relation to suicide is required to promote more effective prevention and care. IMPACT This review provides new insights on how suicide is interpreted, the associated emotions, the way suicide is approached and proposals for improving clinical practice from the point of view of nurses. The results demonstrate that the nurse-patient relationship, ongoing assessment, and the promotion of a sense of security and hope are critical in nursing care for patients who exhibit suicidal behaviour. Consequently, to promote an effective nursing care of suicide, nurses should be provided with further training on the therapeutic relationship. Thus, health institutions do not only provide the time and space to conduct an adequate therapeutic relationship, but also, through their managers, they should supervise and address the emotional impact that is generated in nurses caring for patients who exhibit suicidal behaviour.
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Affiliation(s)
- Rafael Clua-García
- Faculty of Health Sciences at Manresa, University of Vic - Central University of Catalonia, Barcelona, Spain
| | | | - Antonio R Moreno-Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L´Hospitalet de Llobregat, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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21
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MacLeay E, Fry M, Roche MA, Montilla T. Care planning and nonpharmacological interventions in a metropolitan inpatient dual diagnosis service: A retrospective exploratory study. Int J Ment Health Nurs 2020; 29:856-867. [PMID: 32243035 DOI: 10.1111/inm.12719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/22/2020] [Accepted: 02/23/2020] [Indexed: 11/30/2022]
Abstract
In Australia, the terms dual diagnosis and comorbidity are commonly used, often interchangeably, to describe the experience of consumers with both mental health difficulties and difficulties with alcohol and other drug use. Consumers with comorbidity often have complex needs that require comprehensive assessment, multidisciplinary team support, and trauma-focused management. More information about the demographics of consumers admitted with comorbidity, and the documented assessed needs, care, and interventions provided, would provide the foundations for working towards improved quality and continuity of care. Therefore, the aim of this study was to explore the documentation of inpatient assessment, care, and interventions provided to people with comorbidity. The research design was a retrospective exploratory study, and data collection involved a 12-month healthcare record audit. Forty-one records were screened, and 36 consumer healthcare records were identified as eligible for inclusion in the study. Most consumers (n = 34, 94%) were admitted on an involuntary basis, and 8 (22.2%) were female. Consumers had a median length of stay of almost six months. In most healthcare records, there was no documented evidence of care planning involvement by consumers or the multidisciplinary team. There was great variance in the delivery of nonpharmacological interventions. Most consumers did not receive trauma-focused assessment or intervention, and assessment tools were often incomplete with outcome measures poorly documented. This study has demonstrated significant gaps in consumer and multidisciplinary engagement with care planning and goal setting. There was poor documentation of comprehensive assessment and nonpharmacological interventions.
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Affiliation(s)
- Euan MacLeay
- Mental Health Drug and Alcohol, Northern Sydney Local Health Service, Sydney, New South Wales, Australia.,UTS: School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.,Macquarie Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Margaret Fry
- UTS: School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.,NSLHD Research and Practice Development, Nursing and Midwifery Directorate, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Michael Anthony Roche
- Mental Health Drug and Alcohol, Northern Sydney Local Health Service, Sydney, New South Wales, Australia.,UTS: School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Tim Montilla
- Mental Health Drug and Alcohol, Northern Sydney Local Health Service, Sydney, New South Wales, Australia.,UTS: School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
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22
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Cutler NA, Sim J, Halcomb E, Moxham L, Stephens M. Nurses' influence on consumers' experience of safety in acute mental health units: A qualitative study. J Clin Nurs 2020; 29:4379-4386. [DOI: 10.1111/jocn.15480] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Natalie Ann Cutler
- School of Nursing University of Wollongong Northfields Ave Wollongong NSW 2522 Australia
- Illawarra Health and Medical Research Institute University of Wollongong Wollongong NSW Australia
| | - Jenny Sim
- School of Nursing University of Wollongong Northfields Ave Wollongong NSW 2522 Australia
- Illawarra Health and Medical Research Institute University of Wollongong Wollongong NSW Australia
| | - Elizabeth Halcomb
- School of Nursing University of Wollongong Northfields Ave Wollongong NSW 2522 Australia
- Illawarra Health and Medical Research Institute University of Wollongong Wollongong NSW Australia
| | - Lorna Moxham
- School of Nursing University of Wollongong Northfields Ave Wollongong NSW 2522 Australia
- Illawarra Health and Medical Research Institute University of Wollongong Wollongong NSW Australia
| | - Moira Stephens
- School of Nursing University of Wollongong Northfields Ave Wollongong NSW 2522 Australia
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