Brief training in child and adolescent mental health: Impact on the knowledge and attitudes of pediatric nurses in Nigeria

Development of the clinical competency assessment scale in child and adolescent mental health nursing

WHAT IS KNOWN ON THE SUBJECT?: Children and adolescents' mental health problems, such as autism spectrum disorder, anxiety disorder and attention-deficit hyperactivity disorder, are a global public health concern, and nurses require advanced expertise and skills to properly care for this population. There is a gap between the required competencies and the actual skills and knowledge of CAMHN practitioners. Previous studies suggest that educational interventions for nurses are necessary to enhance the quality of care for children and adolescents with mental health problems. However, the corresponding evaluation indicators have not been verified, making it difficult to determine the most effective methods. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The present study developed the two-factor (direct care for children and their family members and approach to the care environment) Clinical Competency Assessment Scale in Child and Adolescent Mental Health Nursing (CCAS-CAMHN). We demonstrated that the assessment scale was reliable and valid, based on its adequate internal consistency and temporal stability, the acceptable range of its model-fit indexes, and its good concurrent and divergent validity. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The newly developed scale is useful for assessing nurses' competency and could help them identify their difficulties in CAMHN. The scale could contribute to the development of effective educational interventions to enhance the quality of care for children and adolescents with mental health problems.

ABSTRACT

INTRODUCTION: Caring for children and adolescents with mental health problems, such as autism spectrum disorder, anxiety disorder and attention-deficit hyperactivity disorder, requires expertise and skills. A quantitative clinical competency measurement tool in child and adolescent mental health nursing (CAMHN) is needed to evaluate the indicators of advanced expertise.

AIM

The aim of this study was to develop a clinical competency assessment scale in CAMHN and evaluate its psychometric properties.

METHOD

Scale items were derived from previous studies and adjusted based on cognitive interviews with five CAMHN experts. In total, 505 nurses in CAMHN from 29 hospitals in Japan participated in the self-administered survey. The scale's construct validity, criterion-related validity, internal consistency and test-retest reliability were assessed.

RESULTS

A two-factor (direct care for children and their family members and approach to the care environment) scale was constructed. A secondary structural model showed that a two-factor model fits best. The total score was significantly and positively correlated with excellence in nursing practice, amount of clinical experience and mental status. The overall scale exhibited good validity and reliability.

DISCUSSION

The scale is reliable and valid for assessing CAMHN clinical competency.

IMPLICATIONS FOR PRACTICE

The scale is useful for assessing nurses' competency and evaluating educational interventions' effectiveness for nurses.

Knowledge, attitudes, and practices on child and adolescent mental health among healthcare workers in sub-Saharan Africa: a scoping review

INTRODUCTION

Child and adolescent mental health is a global priority. In sub-Saharan Africa, despite the high burden, there is a gap in health services for children and adolescents with mental health disorders. To bridge this gap, healthcare workers require a good understanding of child and adolescent mental health, the right attitude, and practices geared to improving child and adolescent mental health. This scoping review examined the knowledge, attitudes, and practices related to child and adolescent mental health among sub-Saharan African healthcare workers.

METHODS

The search was restricted between January 2010, the year when the Mental Health Gap Action Programme guidelines were launched, and April 2024. The review followed the methodological framework proposed by Arksey and O'Malley for conducting scoping reviews. The databases searched included CINHAL, PubMed, Web of Science, PsycINFO, and grey literature databases. Additional articles were identified through cited references of the studies included. A data extraction template was used to retrieve relevant text. A narrative synthesis approach was adopted to explore the relationships within and between the included studies.

RESULTS

The literature search yielded 4658 studies. Among these, 817 were identified as duplicates, and 3740 were excluded after screening. Only twenty-one articles met the criteria for inclusion in the review. The findings showed that healthcare workers have insufficient knowledge of child and adolescent mental health, hold negative attitudes toward children and adolescents with mental health problems, and exhibit poor practices related to child and adolescent mental health.

CONCLUSION

It is crucial to build capacity and improve healthcare workers' practices, knowledge, and attitudes toward child and adolescent mental health in sub-Saharan Africa. This could lead to better access to mental health services for children and adolescents in the region.

Educational programs to improve nurses' knowledge, attitude, and practice in adolescent and young adult health: An integrative review

OBJECTIVE

Nurses working in adolescent health often lack educational opportunities to develop their knowledge and practical skills to address the challenges faced by adolescents and young adults. This integrative review synthesised the evidence from peer-reviewed research that focused on educational programs to improve nurses' knowledge, attitude, and practice in adolescent and young adult health.

DESIGN

The five-stage framework by Whittemore and Knafl guided the integrative literature review and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement.

DATA SOURCES

A single search strategy was replicated across five electronic databases (CINAHL Plus, APA PsycInfo, PubMed, Scopus, and ERIC). Studies of educational interventions or training programs for nurses on adolescent and young adult health, published in English in the last 10 years were included.

REVIEW METHODS

All studies found were reviewed for relevance independently by two authors, who likewise critically appraised the quality using the "Critical appraisal checklist for an article on an educational intervention" adapted from Morrison et al. (1999), with a third author providing consensus. Data were extracted using study specific standardised proforma and thematically analysed.

RESULTS

Seven studies met the inclusion criteria. Topics covered included cancer care, mental health and self-harm, with only one program including general adolescent health. A mix of face-to-face and digital asynchronous mode of delivery was employed in these programs with multi-strategic approaches used to enhance accessibility and engagement. While all studies reported improvement in knowledge and practice, including enhanced communication skills, some studies reported limited change in attitude. Success of the interventions was attributed to the flexibility of programs to accommodate nurses' workloads.

CONCLUSION

Education interventions for nurses delivering care to adolescent and young adults enhance knowledge and skills, however, programs with institutional support for flexibility and accessibility are needed to influence a positive change in attitude.