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Pettit Bruns D, Reeves CL. Trauma Informed Care in the Prevention of High-Risk Sexual Behaviors and Unplanned Pregnancy in Adolescents with Mental Health Disorders. Issues Ment Health Nurs 2024; 45:666-675. [PMID: 38901020 DOI: 10.1080/01612840.2024.2352592] [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: 06/22/2024]
Abstract
Although teen pregnancy and birth rates have declined over the decades, all adolescentpopulations are at risk. Disparities among adolescent pregnancies still exist, including increased risk and rates of unplanned pregnancy among vulnerable adolescents, including those with a mental health diagnosis.Adolescent girls with mental health disorders are notably at higher risk and are three timesmore likely to become pregnant than those without a mental illness. Adolescents who have experienced trauma and have a mental health diagnosis are much more likely to engage in high-risk sexual activity, to not participate in contraceptive use, and to become pregnant than their counterparts.Using Trauma Informed Care (TIC) to assess mental health diagnoses, high-risk sexual behaviors, and risk for unplanned pregnancy among adolescent populations can be an effective approach for primary prevention. There is increased expectation for clinicians to practice TIC and to establish relationships with patients while understanding how mental health diagnoses can impact health behaviors. The focus of this paper is to examine the effects of adolescent unplanned pregnancy, identify the increased risk for adolescents with mental health disorders, and discuss general methods for TIC in clinical practice.
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Affiliation(s)
- Debra Pettit Bruns
- The University of Alabama, Capstone College of Nursing, Tuscaloosa, Alabama, USA
- Children's of Alabama, Emergency Department, Birmingham, Alabama, USA
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Wilson A, Hurley J, Hutchinson M, Lakeman R. In their own words: Mental health nurses' experiences of trauma-informed care in acute mental health settings or hospitals. Int J Ment Health Nurs 2024; 33:703-713. [PMID: 38146780 DOI: 10.1111/inm.13280] [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: 09/26/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/27/2023]
Abstract
Trauma-informed care has emerged as a prominent strategy to eliminate coercive practices and improve experiences of care in mental health settings, with advocacy from international bodies for mental health reform. Despite this, there remains a significant gap in research understanding the integration of trauma-informed care in mental health nursing practice, particularly when applied to the acute mental health or hospital-based setting. The study aimed to explore the experiences of mental health nurses employed in acute hospital-based settings from a trauma-informed care perspective. The study design was qualitative, using a phenomenological approach to research. A total of 29 nurses employed in acute mental health or hospital-based environments participated. Three over-arching themes were uncovered: 'Embodied Awareness': highlighting mental health nursing emotional capabilities are deeply rooted in bodily awareness. 'Navigating Safety': signifying spatial elements of fear and how some mental health nurses' resort to coercive or restrictive practices for self-preservation. 'Caring Amidst Uncertainty': revealing the relational influences of security guards in mental health nursing. The study reveals a significant gap in trauma-informed care implementation when applied to the context of mental health nursing practice in this setting. Limited evidence on trauma-informed care for mental health nurses, coupled with inadequate workforce preparation and challenging work environments, hinder the effective integration of it. To genuinely embed TIC in acute mental health settings, the study emphasises the need for a thorough exploration of what this entails for mental health nurses.
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Affiliation(s)
- Allyson Wilson
- Southern Cross University, Lismore, New South Wales, Australia
| | - John Hurley
- Southern Cross University, Lismore, New South Wales, Australia
| | | | - Richard Lakeman
- Southern Cross University, Lismore, New South Wales, Australia
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Schimmels J, Schneider J. Trauma Informed Care for Nursing Action Bachelor of Science in Nursing Course. J Nurs Educ 2024; 63:233-240. [PMID: 38581710 DOI: 10.3928/01484834-20240207-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
BACKGROUND Nurses commonly experience psychological trauma with high risk for a host of mental health concerns such as suicide, depression, anxiety, and substance use disorders, as well as high rates of burnout and moral injury. Despite rigorous academic preparation, baccalaureate nursing education curricula lack content on the widespread effects of trauma. METHOD Using a trauma informed care (TIC) model, an innovative course called Trauma Informed Care for Nursing Action (TIC4NA) was created. RESULTS This course allows students to safely explore the profession of nursing to transform their learning about trauma related to patient care, the nursing community, and society. CONCLUSION TIC curriculum delivery offers supportive strategies to mitigate negative outcomes during nursing school. This content could have positive effects on nurse and nursing student retention as well as mitigating a barrage of negative outcomes for individual nurses and the nursing profession. [J Nurs Educ. 2024;63(4):233-240.].
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Steimle L, von Peter S, Frank F. Professional relationships during crisis interventions: A scoping review. PLoS One 2024; 19:e0298726. [PMID: 38394216 PMCID: PMC10890742 DOI: 10.1371/journal.pone.0298726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION A crisis can be described as subjective experience that threatens and overwhelms a person's ability to handle a specific situation. In dealing with crises some people are looking for support from professionals. The "professional relationship" between people experiencing a crisis and professionals plays an important role in the successful management of a crisis which has been widely researched in many contexts. However, regarding outpatient services (e. g. crisis resolution home treatment teams), yet empirical evidence remains limited. OBJECTIVE We aim to explore descriptions of supportive professional relationships during outpatient crisis interventions in empirical literature. Accordingly, a scoping review was conducted to identify types of evidence, map the key concepts, and point out research gaps. METHODS MEDLINE, PsycINFO, CINAHL and Social Science Citation Index were searched for studies reporting empirical data on the professional relationship between people experiencing a crisis (18+) and professionals (e. g. social workers, psychiatrists) during a crisis intervention, defined as a short-term, face-to-face, low threshold, time-limited, outpatient, and voluntary intervention to cope with crises. Studies were excluded if they were published before 2007, in languages other than English and German, and if they couldn't be accessed. Included studies were summarized, compared, and synthesized using qualitative content analyses. RESULTS 3.741 records were identified, of which 8 met the eligibility criteria. Only one study directly focused on the relationship; the others addressed varied aspects. Two studies explored the perspectives of service users, five focused on those of the professionals and one study examined both. The empirical literature was categorized into three main themes: strategies used to develop a supportive professional relationship, factors influencing the relationship and the nature of these relationships. DISCUSSION The results reveal a gap in understanding the nature of supportive professional relationships from the service users' perspective, as well as how professionals construct these relationships.
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Affiliation(s)
- Larissa Steimle
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Faculty of Health and Social Work, Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Sebastian von Peter
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Fabian Frank
- Department of Social Work, Protestant University of Applied Sciences Freiburg, Freiburg, Germany
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Petreca VG, Barros JT, Hoblock C, Burgess AW. The Nurse-Police Assistance Crisis Team (N-PACT): A new role for nursing. J Adv Nurs 2024. [PMID: 38225816 DOI: 10.1111/jan.16056] [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: 10/30/2023] [Revised: 12/09/2023] [Accepted: 12/30/2023] [Indexed: 01/17/2024]
Abstract
AIM This study aimed to gain insights into forensic nurses' perspectives and approaches to behavioural crisis situations, comparing them to disciplines traditionally involved in first-line behavioural crisis response. DESIGN This study used a descriptive, qualitative exploratory design and was informed by Systems Theory. METHODS The study was carried in the United States, between 2022 and 2023. Data were gathered through four focus groups: police officers (n = 12), co-response (mental health) clinicians (n = 13), sexual assault nurse examiners (n = 6) and correctional nurses (n = 4). Thematic analysis was performed. REPORTING METHOD The Standards for Reporting Qualitative Research (SRQR) guidelines were used. RESULTS Findings revealed temporal themes in crisis response: (1) Searching for Historical Information; (2) Safety and Acting at the Present Scene; and (3) Future Strategies and Interventions. Common priorities (e.g. safety and de-escalation) were identified across groups. Notably, nurses demonstrated a comprehensive approach, addressing physical and mental health assessments, substance involvement, and physical injury evaluation. CONCLUSION This study proposes the creation of a novel nursing role within first-line multidisciplinary teams (MDTs) for crisis response-the Nurse-Police Assistance Crisis Team (N-PACT). Nurses bring expertise and comprehensive assessment skills to enhance crisis responses, particularly in cases involving mental health emergencies, medical crises, and drug-related incidents. IMPLICATIONS Forensic nurses, with their diverse competencies and comprehensive training, are highly valuable assets within MDTs. Their expertise extends to proficiently conducting mental and physical assessments, ensuring safety and adeptly navigating situations that intersect with the legal system. IMPACT The N-PACT concept can improve outcomes and streamline the allocation of resources, particularly considering the number of police calls involving behavioural crises. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Wilson A, Hurley J, Hutchinson M, Lakeman R. Trauma-informed care in acute mental health units through the lifeworld of mental health nurses: A phenomenological study. Int J Ment Health Nurs 2023; 32:829-838. [PMID: 36705234 DOI: 10.1111/inm.13120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 01/02/2023] [Accepted: 01/07/2023] [Indexed: 01/28/2023]
Abstract
Trauma-informed care has gained increasing popularity in mental health services over the past two decades. Mental health nurses remain one of the largest occupations employed in acute mental health settings and arguably have a critical role in supporting trauma-informed care in this environment. Despite this, there remains a limited understanding on how trauma-informed care is applied to the context of mental health nursing in the hospital environment. The aim of this study was to explore what it means for mental health nurses to provide trauma-informed care in the acute mental health setting. The study design was qualitative, using van Manen's (Researching lived experience: human science for an action sensitive pedagogy. State University of New York Press, 1990) approach to hermeneutic phenomenological inquiry. A total of 29 mental health nurses participated in this study. There were three overarching themes that emerged; these entail: embodied trauma-informed milieu, trauma-informed relationality and temporal dimensions of trauma-informed mental health nursing. The study found that for mental health nurses, there are elements of trauma-informed care that extend far beyond the routine application of the principles to nursing practice. For mental health nurses working in the acute setting, trauma-informed care may offer a restorative function in practice back to the core tenants of therapeutic interpersonal dynamics it was once based upon.
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Affiliation(s)
- Allyson Wilson
- Southern Cross University, Lismore, New South Wales, Australia
| | - John Hurley
- Southern Cross University, Lismore, New South Wales, Australia
| | | | - Richard Lakeman
- Southern Cross University, Lismore, New South Wales, Australia
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McTavish JR, Chandra PS, Stewart DE, Herrman H, MacMillan HL. Child Maltreatment and Intimate Partner Violence in Mental Health Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315672. [PMID: 36497747 PMCID: PMC9735990 DOI: 10.3390/ijerph192315672] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 06/01/2023]
Abstract
Intimate partner violence (IPV) and child maltreatment (physical, emotional, sexual abuse, neglect, and children's exposure to IPV) are two of the most common types of family violence; they are associated with a broad range of health consequences. We summarize evidence addressing the need for safe and culturally-informed clinical responses to child maltreatment and IPV, focusing on mental health settings. This considers clinical features of child maltreatment and IPV; applications of rights-based and trauma- and violence-informed care; how to ask about potential experiences of violence; safe responses to disclosures; assessment and interventions that include referral networks and resources developed in partnership with multidisciplinary and community actors; and the need for policy and practice frameworks, appropriate training and continuing professional development provisions and resources for mental health providers. Principles for a common approach to recognizing and safely responding to child maltreatment and IPV are discussed, recognizing the needs in well-resourced and scarce resource settings, and for marginalized groups in any setting.
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Affiliation(s)
- Jill R. McTavish
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington St. North, Hamilton, ON L8L 8E7, Canada
| | - Prabha S. Chandra
- NIMHANS Hospital, Hosur Rd, near Bangalore Milk Dairy, Hombegowda Nagar, Bengaluru 560029, Karnataka, India
| | - Donna E. Stewart
- Centre for Mental Health, University Health Network, 200 Elizabeth St, 7EN229, Toronto, ON M5G 2C4, Canada
| | - Helen Herrman
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
- Orygen, Parkville, VIC 3052, Australia
| | - Harriet L. MacMillan
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington St. North, Hamilton, ON L8L 8E7, Canada
- Department of Pediatrics, McMaster University, Health Sciences Centre 3A, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
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Robinson M, Robinson Esq CD. The silent cry: A psychiatric-mental health nurse's guide for fathers experiencing perinatal loss. J Psychiatr Ment Health Nurs 2022; 29:619-623. [PMID: 35661485 PMCID: PMC9544921 DOI: 10.1111/jpm.12849] [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: 11/30/2020] [Revised: 02/10/2022] [Accepted: 03/24/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The effects of grief on fathers that have experienced perinatal loss merit further exploration. AIM The purpose of this paper is to draw attention to the experience of grief felt by fathers when facing perinatal loss. A father's grief and loss are frequently unrecognized and underappreciated by healthcare professionals who customarily attend only to the needs of mothers. RESULTS Data for this study were based on a couple's lived experience. This is a co-authored piece by a husband and wife. This literature suggests that the lack of resources for fathers might result in unresolved grief which if prolonged could be expressed in potential losses during subsequent pregnancies. IMPLICATIONS FOR PRACTICE Content from a review of the literature provides evidence helpful in addressing the recognition and management of grief in fathers experiencing perinatal losses. The grief and any related trauma due to prenatal losses can be managed in fathers with different methods, including support services, counselling, and if needed psychotherapy and pharmacotherapy. Psychiatric-mental health nurses can play an important role in the recognition and management of grief and planning interventions to support grieving fathers.
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Affiliation(s)
- Mamilda Robinson
- Rutgers University School of Nursing, Rutgers the State University of New Jersey, Newark, New Jersey, USA
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Investigating the Mediating Role of Self-Compassion in the Relationship between Spiritual Intelligence and Hope in Female Nurses of Neyshabur-Iran Hospitals in 2019. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2022. [DOI: 10.52547/pcnm.12.2.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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Collins M, Higgs P. Improving suicide awareness in rural service providers: Some considerations arising from stakeholder consultations. Aust J Rural Health 2021; 29:999-1001. [PMID: 34757646 DOI: 10.1111/ajr.12798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/04/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Michael Collins
- Department of Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Peter Higgs
- Department of Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
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