The development of a family intervention competency assessment and reflection scale (FICARS) for psychosis

Cultural adaptation and validation of the Family Nursing Practice Scale (FNPS) for use with Spanish-speaking Nursing Degree students

AIM

The task proposed was to conduct a cultural adaptation of the Family Nursing Practice Scale and to assess the psychometric properties of the resulting instrument.

BACKGROUND

Nursing students must obtain sufficient personal competence and confidence to act with patients and their families. For this purpose, an assessment scale is needed to inform teachers of the student's progress and to determine whether further training or changes in teaching methods are required.

DESIGN

A cross-sectional study design was used.

METHODS

The researchers conducted this study with 202 students of nursing at two Spanish universities. In the cultural adaptation, the following steps were followed: definition of concepts, translation, back translation, expert group review and implementation by a pilot group with a subsequent cognitive interview. Internal consistency was determined by Cronbach's alpha. Reliability was verified by an initial application of the scale, followed by a repetition after seven days, analysing the results obtained in terms of the intraclass correlation coefficient, the construct validity (by Spearman's non-parametric correlation test) and confirmatory factor analysis (using JASP 0.16.4 statistical software).

RESULTS

Cronbach's alpha resulted in 0.95. Spearman's correlation coefficient Family Nursing Practice Scale total with the course year was -0.26 < 0.001. The intraclass correlation coefficient for the total score of the scale was 0.91. The confirmatory factor analysis was performed on a model in which the total score for the scale was considered in relation to the two subscales, and each subscale in relation to its constituent items. The p-value associated with the chi-square was 0.550. The root mean square error of approximation and comparative fit indices presented values of <0.001 (90 % C.I. <0.001-0.048) and 1.000, respectively.

CONCLUSIONS

These results indicate that the Spanish version presents good internal consistency, construct validity and reliability. Moreover, the confirmatory factor analysis confirms that it presents a good fit to the model initially proposed for this scale for Nursing Degree students.

Impact of a Family Interventions Module on Students' Knowledge, Skills and Attitudes

Current evidence strongly supports the implementation of family interventions as a recognised approach to working with families. The aim of this study was to evaluate postgraduate students' learning experiences and skills development whilst undertaking a Master of Science module in family interventions. Questionnaires were used to elicit students' learning and experiences in relation to their work with families. Following analysis of students' responses, the key themes that emerged in relation to family interventions included: prior learning and experiences, changes in practice, skills development, supports in practice, and course strengths and challenges. Participants particularly valued the simulated learning and reflective elements of the module. The results of the study suggest that more staff should have access to education and training to enable practitioners to work more effectively with families. However, they will need to have support mechanisms in practice to effectively implement family interventions.

Investment in Australian mental health carer services: how much and does it reflect evidence of effectiveness?

Objective The aims of this study were to quantify Australian federal and state government expenditure on mental health carer services for 2014-15, map the types of services being provided and explore how funded service types compare with the evidence base for the outcomes of these carer services. Methods Web searches were conducted to identify in-scope mental health carer services in Australia funded by federal and state and territory governments. Funding estimates were confirmed where possible with available government and carer organisation contacts. A literature search was conducted for reviews of studies investigating mental health carer service outcomes. Results In 2014-15, the estimated Australian national, state and territory government expenditure on mental health carer services was approximately A$90.6million. This comprised A$65.6million in federal expenditure and A$25.0million in state and territory expenditure. Most funding streams provided respite and psychoeducation. The literature showed positive carer outcomes for psychoeducation and intensive family interventions. Evidence was lacking for the effectiveness of respite services. Conclusions These findings suggest a mismatch between what is known about the extent to which different service types deliver positive carer outcomes and the current allocation of funds across Australia's mental health system. This study also highlights the fragmentation of the mental health carer services system, supporting the need to streamline access. What is known about this topic? Informal carers of people with mental disorders provide a critical role to the significant number of individuals with mental illness in Australia, and provide an unpaid workforce to the Australian mental health system. This role comes with significant physical, emotional and financial burden, which government-funded services can assist with to allow mental health carers to continue to serve in their caring role while improving their quality of life. What does this paper add? Using both published data and communication with health and non-government officials, we have estimated federal and state expenditure on mental health carer services at A$90.6million in 2014-15 fiscal year and have provided a mapping of the services this expenditure funds. In addition, through analysis of the literature on outcomes of carer services provided, we have seen a mismatch of expenditure and the evidence base. What are the implications for practitioners? There is a necessity for both more research into service outcomes aimed particularly at mental health carers and thinking critically about whether the current prioritisation of funds can be increased and/or reallocated to create better outcomes for mental health carers.

Advancing the knowledge, skills and attitudes of mental health nurses working with families and caregivers: A critical review of the literature

Involving and supporting the family members and caregivers of people with mental illness is essential to high-quality mental health services. However, literature suggests that there is a lack of engagement between family members and mental health nurses (MHNs). Lack of knowledge among MHNs is often cited as one of the main reasons for this lack of engagement. The aim of this review was to explore the knowledge, skills and attitudes that are required by MHNs to enable to them to work more effectively with families affected by mental illness. A literature based critical review was used to access and review 35 papers in order to extract concepts that could inform the design of eLearning materials to assist MHNs advance their knowledge in this area. Two overarching themes were identified; 'Mental health problems and the family' and 'Working with the family'. From these themes, the knowledge, skills and attitudes required to work more effectively with families are described. The findings from this review provide a descriptive account of the knowledge skills and attitudes that are required for effective family work. In addition, the review provides an empirical foundation for education programmes in the area.