Cognitive-behavioral therapy training for multidisciplinary inpatient psychiatric teams: A novel curriculum using animated simulations

Inpatient pediatric nursing staff experiences treating psychiatric patients: A mixed methods study

PROBLEM

A gap in the literature exists attempting to understand the impact that the influx of pediatric psychiatric patients has had on inpatient general medicine pediatric nursing staff.

METHODS

A mixed-method research study was conducted among full- and part-time pediatric nurses and nursing assistants working on general pediatric units. Quantitative data was collected via an anonymous survey using the Professional Quality of Life Scale version 5 and Support Appraisal for Work Stressors scale. Surveys were followed by semistructured interviews.

FINDINGS

Of the 158 staff eligible, 47 (29.7%) participated in the quantitative portion. [Correction added on 29 September 2023, after the first online publication: In the preceding sentence, the participation rate was revised from 23.5% to 29.7% in this version.] Significant differences were found between roles, with nurses experiencing lower levels of compassion satisfaction and higher levels of burnout. Role differences were seen in supervisor support and nonwork support, with nurses reporting less support from both. Supervisor support showed a significant correlational relationship with compassion satisfaction and burnout. Nonwork support showed similar correlations with compassion satisfaction and burnout. Themes that emerged from the interviews were Barriers to Care, Emotional Impact, and "Help Me Help You."

CONCLUSION

Nurses may be at greater risk for compassion fatigue due to perceived inadequate support from leadership, unclear role expectations, and lack of resources.

A Hero's Journey: Supporting children throughout inpatient psychiatric hospitalization using a therapeutic comic book

PROBLEM

Art- and narrative-based interventions are an integral component of pediatric inpatient psychiatric care. We describe a novel therapeutic comic book we developed for hospitalized children and young adolescents.

METHODS

A Hero's Journey is a 38-page zine that can be freely downloaded and photocopied for distribution. The short booklet is intended to demystify and offer guidance throughout the experience of hospitalization, promote interaction and socialization, provide scaffolding for skill-building, and prepare patients for moving forward after discharge.

FINDINGS

The underlying foundations of the booklet include: 1) Theoretical sources (Joseph Campbell's hero's journey; Donald Schön's reflective practice; and the principles of narrative medicine); and 2) Clinical sources (collaborative problem solving; cognitive-behavioral therapy, and trauma-informed care). We articulate how each page relates to the different components, and how individual pages can be used as worksheets for practice of specific skills. We next provide suggestions on how best to use the booklet: from arrival at the emergency room, through inpatient hospitalization, and toward discharge. We also propose ways for staff, caregivers, and any child-facing adult to make use of this clinical resource in support of a patient's recovery and reintegration into their community.

CONCLUSIONS

Even though not yet empirically tested, this therapeutic comic book is available for dissemination free of cost. We encourage leaders in nursing and therapeutic recreation to try using this resource in their emergency room and milieu settings.

Evaluating Simulation-Based Tobacco Treatment Scenarios for Providers Delivering Treatment for People Living With Mental Illnesses

BACKGROUND

People living with mental illnesses (PMI) experience elevated tobacco use and related morbidity and mortality. Despite the availability of effective and safe tobacco treatments along with evidence that PMI are motivated and able to quit successfully, few Mental and behavioral healthcare providers (MHPs) engage PMI in such treatment. MHPs may lack the confidence or skills to engage their clients in tobacco treatment. Currently, there are limited training modalities to prepare MHPs in delivering tobacco treatment for PMI. However, animated scenario-based simulated encounters can bridge this gap to effectively provide tailored MHP training to enhance treatment delivery. Hence, the purpose of this study was to evaluate simulated tobacco treatment education scenarios tailored to MHPs.

METHODS

For this evaluation, we used a pretest-posttest design to assess changes in MHPs tobacco treatment knowledge and behavioral intentions after viewing simulated treatment encounters. We developed four animated scenarios, using brief tobacco treatment interventions, simulating treatment encounters with PMI. MHPs were primarily recruited from mental or behavioral healthcare facilities and were asked to complete a web-based questionnaire. Their knowledge, views, and experiences in providing tobacco treatment were assessed prior to viewing the animated scenarios. Participants were then asked to evaluate the desirability, acceptability, and applicability of the animated scenarios; and thereafter, their knowledge of and intentions to provide evidence-based tobacco treatment (i.e., ASK, ADVISE, ASSESS, ASSIST, ARRANGE) were again assessed.

RESULTS

Participants (N = 81) were on average 41.0 years of age, mostly female (79.0%), and non-Hispanic White (86.4%). Nearly a quarter endorsed current tobacco use and few had tobacco treatment training (14.8%). Overall knowledge of tobacco treatment scores significantly increased before and after viewing the videos (M = 3.5 [SD = 1.0] to M = 4.1 [SD = 1.0], p < 0.0001). After viewing the simulated scenario videos, participants endorsed moderate to high mean scores (ranging from 4.0-4.2 on a 0 to 5 scale) on the desirability, acceptability, and applicability of the different animated scenarios. In addition, after viewing the scenarios the proportion of participants who endorsed that they intended to occasionally/very often engage clients in evidence based tobacco treatment were high for ASK (94.9%), followed by ADVISE and ASSESS (84.7% each), followed by ASSIST (81.4%), and ARRANGE (74.6%). Evaluation scores significantly differed by type of animated scenario and participants' work settings and discipline.

CONCLUSIONS

These findings suggest that the use of brief animated scenarios may be a useful modality to enhance MHPs knowledge acquisition and treatment delivery intentions. Such approaches may be integrated into tobacco treatment trainings for MHPs.