1
|
Park JS, Kim HK, Lee M. Experience of violence, social support, nursing practice environment, and burnout on mental health among mental health nurses in South Korea: A structural equation modeling analysis. Appl Nurs Res 2024; 78:151819. [PMID: 39053992 DOI: 10.1016/j.apnr.2024.151819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/16/2023] [Accepted: 06/25/2024] [Indexed: 07/27/2024]
Abstract
AIMS This study examined the relationship between the experience of violence, social support, nursing practice environment, and mental health among South Korean mental health nurses. METHODS Structured questionnaires were distributed to participants who worked in twelve mental health hospitals, each with at least 200 beds, in South Korea. We analyzed 243 questionnaires and used AMOS 25.0 to explore the relationships between the constructs. RESULTS The total and indirect effects of the experience of violence and of social support on mental health were significant. The effects of burnout and of the nursing practice environment on mental health were positively significant. Burnout revealed a mediating association with the relationship between the experience of violence, social support, and mental health. CONCLUSION The study confirmed that the experience of violence negatively affects burnout among mental health nurses, while social support relieves burnout and strengthens mental health. IMPLEMENTATION Our research model shows that the experience of violence could affect burnout and mental health among mental health nurses. Therefore, nursing administrators should develop violence prevention policies and manuals for coping with the violence that can frequently occur in psychiatric wards.
Collapse
Affiliation(s)
- Jung Suk Park
- Keyo Mental Health Hospital, 15, Ojeon-ro, Uiwang-si, Gyeonggi-do 16062, South Korea
| | - Hee Kyung Kim
- Department of Nursing, Sangji University, 83 Sangjidae-gil, Wonju-si, Gangwon-do 26339, South Korea.
| | - Mihyoung Lee
- Inha University, 100, Inha-ro, Michuhol-gu, Incheon 22212, South Korea
| |
Collapse
|
2
|
Lerbæk B, Johansen K, Burholt AK, Gregersen LM, Terp MØ, Slade M, Castelein S, Jørgensen R. Non-peer professionals' understanding of recovery and attitudes towards peer support workers joining existing community mental health teams in the North Denmark Region: A qualitative study. Int J Ment Health Nurs 2024. [PMID: 38767087 DOI: 10.1111/inm.13349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/05/2024] [Accepted: 04/23/2024] [Indexed: 05/22/2024]
Abstract
Peer support is a collaborative practice where people with lived experience of mental health conditions engage in supporting like-minded. Peer support impacts on personal recovery and empowerment and creates value at an organisational level. However, the implementation of peer support into existing mental health services is often impeded by barriers embedded in organisational culture and support in role expectations. Non-peer professionals' recovery orientation and attitudes towards peer support workers (PSWs) are essential factors in the implementation of peer support, and this study explored non-peer professionals' understanding of recovery and their attitudes towards PSWs joining existing community mental health teams in one region of Denmark. In total, 17 non-peer professionals participated in three focus groups. Thematic analysis led to three themes: (1) Recovery is a process of "getting better" and balancing personal and clinical perspectives; (2) Realising recovery-oriented practice: a challenging task with conflicting values; and (3) Expectations and concerns about peer support workers joining the team. Recovery-oriented practice faces challenging conditions in contemporary mental health services due to a dominant focus on biomedical aspects in care and treatment. Implementation facilitators and barriers in the employment of PSWs point towards fundamental aspects that must be present when employing PSWs in an organisation. The issues described leading up to the employment of PSWs reflected in this study underpin the importance of preparing an organisation for the employment of PSWs based on the available knowledge.
Collapse
Affiliation(s)
- Birgitte Lerbæk
- Unit for Psychiatric Research, Aalborg University Hospital - Psychiatry, Aalborg, Denmark
| | - Kirsten Johansen
- Unit for Psychiatric Research, Aalborg University Hospital - Psychiatry, Aalborg, Denmark
- Unit for Forensic Research, Mental Health Department Middelfart, Psychiatry Region of Southern Denmark, Middelfart, Denmark
| | - Alice Katrine Burholt
- Unit for Psychiatric Research, Aalborg University Hospital - Psychiatry, Aalborg, Denmark
| | - Line Myrup Gregersen
- Center for Recovery and Co-Creation, Psychiatry - Aalborg University Hospital, Aalborg, Denmark
| | - Malene Østergaard Terp
- Center for Recovery and Co-Creation, Psychiatry - Aalborg University Hospital, Aalborg, Denmark
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
- Health and Community Participation Division, Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway
| | - Stynke Castelein
- Lentis Research, Lentis Psychiatric Institute, Groningen, The Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg University Hospital - Psychiatry, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
3
|
Aggestrup AS, Martiny F, Lund Henriksen L, Davidsen AS, Martiny K. Interventions promoting recovery from depression for patients transitioning from outpatient mental health services to primary care: A scoping review. PLoS One 2024; 19:e0302229. [PMID: 38709769 PMCID: PMC11073719 DOI: 10.1371/journal.pone.0302229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/28/2024] [Indexed: 05/08/2024] Open
Abstract
INTRODUCTION Major Depressive Disorder (MDD) is one of the most prevalent mental disorders worldwide with significant personal and public health consequences. After an episode of MDD, the likelihood of relapse is high. Therefore, there is a need for interventions that prevent relapse of depression when outpatient mental health care treatment has ended. This scoping review aimed to systematically map the evidence and identify knowledge gaps in interventions that aimed to promote recovery from MDD for patients transitioning from outpatient mental health services to primary care. MATERIALS AND METHODS We followed the guidance by Joanna Briggs Institute in tandem with the PRISMA extension for Scoping Reviews checklist. Four electronic databases were systematically searched using controlled index-or thesaurus terms and free text terms, as well as backward and forward citation tracking of included studies. The search strategy was based on the identification of any type of intervention, whether simple, multicomponent, or complex. Three authors independently screened for eligibility and extracted data. RESULTS 18 studies were included for review. The studies had high heterogeneity in design, methods, sample size, recovery rating scales, and type of interventions. All studies used several elements in their interventions; however, the majority used cognitive behavioural therapy conducted in outpatient mental health services. No studies addressed the transitioning phase from outpatient mental health services to primary care. Most studies included patients during their outpatient mental health care treatment of MDD. CONCLUSIONS We identified several knowledge gaps. Recovery interventions for patients with MDD transitioning from outpatient mental health services to primary care are understudied. No studies addressed interventions in this transitioning phase or the patient's experience of the transitioning process. Research is needed to bridge this gap, both regarding interventions for patients transitioning from secondary to primary care, and patients' and health care professionals' experiences of the interventions and of what promotes recovery. REGISTRATION A protocol was prepared in advance and registered in Open Science Framework (https://osf.io/ah3sv), published in the medRxiv server (https://doi.org/10.1101/2022.10.06.22280499) and in PLOS ONE (https://doi.org/10.1371/journal.pone.0291559).
Collapse
Affiliation(s)
- Anne Sofie Aggestrup
- The Research Unit for Mental Health Centre Copenhagen, Copenhagen Affective Disorder Research Centre (CADIC), New Interventions in Depression (NID) Group, Mental Health Services in the Capital Region of Denmark, University of Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Frederik Martiny
- The Research Unit for and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Social Medicine, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Line Lund Henriksen
- The Research Unit for Mental Health Centre Copenhagen, Copenhagen Affective Disorder Research Centre (CADIC), New Interventions in Depression (NID) Group, Mental Health Services in the Capital Region of Denmark, University of Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Annette Sofie Davidsen
- The Research Unit for and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Martiny
- The Research Unit for Mental Health Centre Copenhagen, Copenhagen Affective Disorder Research Centre (CADIC), New Interventions in Depression (NID) Group, Mental Health Services in the Capital Region of Denmark, University of Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| |
Collapse
|
4
|
Payne L, Rologas K, Waters L. Embedding Recovery Principles in Staff Orientation: A New Way of Delivering Multidisciplinary Mental Health Orientation. J Psychosoc Nurs Ment Health Serv 2024:1-8. [PMID: 38709103 DOI: 10.3928/02793695-20240424-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
PURPOSE Recovery-focused mental health treatment continues to grow, yet staff are often uncertain how best to define and implement it. As a quality assurance activity, we examined the effect of a novel orientation program embedded with a recovery framework structure, philosophy, and content, together with true lived experience codesign, on knowledge of recovery principles and acceptability. METHOD Staff of a new sub-acute adolescent mental health inpatient center completed a 6-week orientation in early 2020. Recovery processes of connectedness, hope and optimism, identity, meaning, and empowerment were mapped to session topics and the structure, design, and philosophy of the program. RESULTS Mean knowledge scores improved from pre- to post-assessment and most (≥70%) participants reported topics as relevant, impactful, and would recommend. Approximately all (95%) comments were positive. CONCLUSION Findings suggest that person-centered orientations that embed a recovery framework are promising for mental health staff orientation. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
Collapse
|
5
|
Nisim U, Zlotnick C, Roe D, Gelkopf M, Shadmi E. Risks for re-hospitalization of persons with severe mental illness living in rehabilitation care settings. Isr J Health Policy Res 2024; 13:18. [PMID: 38570853 PMCID: PMC10993576 DOI: 10.1186/s13584-024-00605-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 03/20/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The high rates of psychiatric re-hospitalizations (also termed "revolving door") presents a "wicked problem" which requires a systematic and holistic approach to its resolution. Israel's mental-health rehabilitation law provides a comprehensive set of services intended to support the ability of persons with severe mental illness to rely on community rather than in-patient facilities for their ongoing care needs. Guided by the Health Behavior Model, we examined the relationship between psychiatric re-hospitalizations and the three Health Behavior Model factors (predisposing factor: socio-demographic characteristics and health beliefs; enabling factor: personal and social/vocational relationships facilitated by rehabilitation interventions and services; and need factor: outcomes including symptoms, and mental health and functional status) among persons with severe mental illness receiving rehabilitation services. METHODS Logistic regression models were used to measure the association between re-hospitalization within a year and variables comprising the three Health Behavior Model factors on the sample of consumers utilizing psychiatric services (n = 7,165). The area under the curve for the model was calculated for each factor separately and for all three factors combined. RESULTS A total of 846 (11.8%) consumers were hospitalized within a year after the study began. Although multivariable analyses showed significant associations between re-hospitalization and all three Health Behavior Model factors, the magnitude of the model's area under the curve differed: 0.61 (CI = 0.59-0.64), 0.56 (CI = 0.54-0.58), 0.78 (CI = 0.77-0.80) and 0.78 (CI = 0.76-0.80) for predisposing, enabling, need and the full three-factor Health Behavior Model, respectively. CONCLUSION Findings revealed that among the three Health Behavior Model factors, the need factor best predicted re-hospitalization. The enabling factor, comprised of personal relationships and social/vocational activities facilitated by interventions and services representing many of psychiatric rehabilitation's key goals, had the weakest association with reduced rates of re-hospitalization. Possible explanations may be inaccurate assessments of consumers' personal relationships and social/vocational activities by the mental healthcare professionals, problematic provider-consumer communication on the consumers' involvement in social/vocational activities, or ineffective methods of facilitating consumer participation in these activities. Clearly to reduce the wicked "revolving-door" phenomenon, there is a need for targeted interventions and a review of current psychiatric rehabilitation policies to promote the comprehensive integration of community rehabilitation services by decreasing the fragmentation of care, facilitating continuity of care with other healthcare services, and utilizing effective personal reported outcomes and experiences of consumers with severe mental illness.
Collapse
Affiliation(s)
- Uzi Nisim
- Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Khushi Ave, Mt Carmel, Haifa, Israel.
| | - Cheryl Zlotnick
- Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Khushi Ave, Mt Carmel, Haifa, Israel
| | - David Roe
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Khushi Ave, Mt Carmel, Haifa, Israel
| | - Marc Gelkopf
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Khushi Ave, Mt Carmel, Haifa, Israel
| | - Efrat Shadmi
- Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Khushi Ave, Mt Carmel, Haifa, Israel
| |
Collapse
|
6
|
Wangel AM, Persson K, Duerlund S, Fhager J, Mårdhed E, Sjögran L, Sjöström K, Glantz A, Örmon K, Sunnqvist C. The Core Elements of Psychiatric and Mental Health Nursing: Time, Honest Engagement, Therapeutic Relations, Professional Nursing and Lifetime-Perspective. Issues Ment Health Nurs 2024; 45:399-408. [PMID: 38363803 DOI: 10.1080/01612840.2024.2305934] [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: 02/18/2024]
Abstract
Defining psychiatric and mental health nursing has been a challenge for decades, and it is still difficult to find a comprehensive definition. We have identified a possibility to clarify psychiatric and mental health nursing based on humanistic philosophy in a general psychiatric care context. The aim was therefore to identify and synthesize the theoretical frameworks from which psychiatric and mental health nursing models are developed. We systematically collected and evaluated articles based on Grounded Theory (GT) methodology regarding psychiatric or mental health nursing. The PRISMA statement for systematic reviews was used and the formal process of synthesis, as a three-step process of identifying first -, second - and third-order themes following the examples of Howell Major and Savin-Baden. The synthesis resulted in a model describing five core elements of psychiatric and mental health nursing: 'professional nursing', 'therapeutic relationships' and 'honest engagement', with time as the all-encompassing theme, including the patients' 'lifetime perspective'. Psychiatric and mental health nursing is a caring support towards recovery, where the patient's lifetime perspective must be in focus during the caring process with a relationship built on an honest engagement. Time is therefore essential for psychiatric and mental health nursing.
Collapse
Affiliation(s)
- Anne-Marie Wangel
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Karin Persson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Sara Duerlund
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Johan Fhager
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Emma Mårdhed
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Lotta Sjögran
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Karin Sjöström
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Andreas Glantz
- Department of Nursing, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Karin Örmon
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Götaland Region Competence Centre on Intimate Partner Violence, Gothenburg, Sweden
| | - Charlotta Sunnqvist
- The Region Skåne Committee on Psychiatry, Habilitation and Technical Aids, Lund, Sweden
- Department of Clinical Sciences Psychiatry, Lund University, Lund, Sweden
| |
Collapse
|
7
|
Gehri B, Ausserhofer D, Zúñiga F, Bachnick S, Schwendimann R, Simon M. Nursing care left undone in psychiatric hospitals and its association with nurse staffing: A cross-sectional multi-centre study in Switzerland. J Psychiatr Ment Health Nurs 2024; 31:215-227. [PMID: 37697908 DOI: 10.1111/jpm.12978] [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: 10/23/2022] [Revised: 07/27/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023]
Abstract
INTRODUCTION Nursing care left undone occurs when nurses omit activities because of resource shortfalls. Higher levels of nursing care left undone are associated with worse nurse staffing and organizational factors. Plentiful evidence from acute, long-term and community care supports such associations; however, mental healthcare settings are under-studied. AIM The aim of the study was to describe nursing care left undone's frequency in mental health inpatient settings and explore its association with nurse staffing levels. METHOD As part of the multi-centre cross-sectional MatchRN Psychiatry study, data were collected by questionnaire from 114 units in 13 Swiss psychiatric hospitals. Nursing care left undone was analysed describing frequencies descriptively and used linear mixed models to assess its association with staffing. RESULTS Data from 994 nurses were analysed. The most commonly omitted activities were evaluating nursing processes (30.5%), formulating nursing diagnoses (27.4%) and defining care objectives (22.7%). Nursing care left undone was higher in units with low staffing levels. DISCUSSION As in somatic care settings, in psychiatric hospitals, 'indirect' care activities are most commonly omitted. IMPLICATIONS FOR PRACTICE This study highlights factors affecting the frequency of nursing care left undone, including staffing levels and perceived leadership. The findings emphasize the importance of nurse managers taking action to improve work environment factors.
Collapse
Affiliation(s)
- Beatrice Gehri
- Nursing Science (INS), University of Basel, Basel, Switzerland
- University Psychiatric Clinics Basel, Basel, Switzerland
| | - Dietmar Ausserhofer
- Nursing Science (INS), University of Basel, Basel, Switzerland
- College of Health-Care Professions Claudiana, Bozen, Italy
| | | | - Stefanie Bachnick
- HS Gesundheit, University of Applied Sciences Bochum, Bochum, Germany
| | - René Schwendimann
- Nursing Science (INS), University of Basel, Basel, Switzerland
- University Hospital Basel, Basel, Switzerland
| | - Michael Simon
- Nursing Science (INS), University of Basel, Basel, Switzerland
| |
Collapse
|
8
|
Hormazábal-Salgado R, Whitehead D, Osman AD, Hills D. Person-Centred Decision-Making in Mental Health: A Scoping Review. Issues Ment Health Nurs 2024; 45:294-310. [PMID: 38232185 DOI: 10.1080/01612840.2023.2288181] [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: 01/19/2024]
Abstract
Person-centred decision-making approaches in mental health care are crucial to safeguard the autonomy of the person. The use of these approaches, however, has not been fully explored beyond the clinical and policy aspects of shared and supported decision-making. The main goal is to identify and collate studies that have made an essential contribution to the understanding of shared, supported, and other decision-making approaches related to adult mental health care, and how person-centred decision-making approaches could be applied in clinical practice. A scoping review of peer-reviewed primary research was undertaken. A preliminary search and a main search were undertaken. For the main search, eight databases were explored in two rounds, between October and November 2022, and in September 2023, limited to primary research in English, Spanish or Portuguese published from October 2012 to August 2023. From a total of 12,285 studies retrieved, 21 studies were included. These research articles, which had mixed quality ratings, focused on therapeutic relationships and communication in decision-making (30%), patients' involvement in treatment decision-making (40%), and interventions for improving patients' decision-making engagement (30%). While there is promising evidence for shared decision-making in mental health care, it is important that healthcare providers use their communicational skills to enhance the therapeutic relationship and engage patients in the process. More high-quality research on supported decision-making strategies and their implementation in mental health services is also required.
Collapse
Affiliation(s)
- Raúl Hormazábal-Salgado
- Federation University Australia, Institute of Health and Wellbeing, Berwick, Victoria, Australia
| | - Dean Whitehead
- Federation University Australia, Institute of Health and Wellbeing, Berwick, Victoria, Australia
| | - Abdi D Osman
- College of Sports, Health and Engineering, Victoria University, Melbourne, Victoria, Australia
| | - Danny Hills
- Federation University Australia, Institute of Health and Wellbeing, Berwick, Victoria, Australia
| |
Collapse
|
9
|
Fang Q, Li X, Luo Y, Yang Z, Xiao L, Tan W, Liu S, Luo J, Zhang L. Developing a psychological care competences framework for nurses in China: a mixed methods study. BMC Nurs 2024; 23:129. [PMID: 38374069 PMCID: PMC10877790 DOI: 10.1186/s12912-024-01778-3] [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: 11/22/2023] [Accepted: 01/30/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND With social transformation, rapid economic development and deepening awareness of psychological health in China, people's demand for psychological health services is becoming increasingly urgent. A key challenge for Chinese medical organizations is to train enough qualified psychological care nurses. A greater understanding of psychological care competences (PCC) can help in clinical nurse selection, training, and assessment. OBJECTIVE To develop a PCC framework for Chinese nurses and obtain a consensus on the framework among experts. METHODS A descriptive mixed methods study was designed consisting of a literature review and semi-structured interviews followed by three Delphi rounds. The experts (n = 16) involved were nurses, nursing managers and educators from nine Chinese provinces with a specific interest in psychological care. Descriptive statistics assisted in data analysis. RESULTS Using the Iceberg Model as a theoretical foundation, five main dimensions and associated subdomains were integrated from 39 chosen articles. The semi-structured interviews with 24 nursing managers and nurses confirmed all of the themes from the literature review while generating new themes, both of which were incorporated into the initial PCC framework. After three Delphi rounds, the experts reached consensus on the PCC framework, including five domains (knowledge, skills, professional ethics, personal traits, internal motivations) and 22 subdomains with connotations. The response rate (RR) values for the three rounds of consultation were 80.00%, 87.50% and 92.86%, the composite reliability (Cr) values were 0.89-0.90, and the Kendall coordination coefficients were 0.155-0.200 (P < 0.05). CONCLUSIONS On the basis of the Iceberg Model, literature review and qualitative research methods along with Delphi technique were used to develop a scientific and systematic PCC framework. The research methods were feasible and the results were reliable, thereby providing a basis for adopting this framework into nursing education. A formal assessment tool should be developed to test the PCC of nurses in clinical practice.
Collapse
Affiliation(s)
- Qinghong Fang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Xingwen Li
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yuanyuan Luo
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Lin Xiao
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Wenxuan Tan
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Suting Liu
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jiahui Luo
- Department of Nursing, Taikang Tongji (Wuhan) Hospital, Wuhan, Hubei Province, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China.
| |
Collapse
|
10
|
Matsuoka S. Development of a Culturally Sensitive Recovery-Oriented Nursing Care Model in Community Psychiatric Nursing. J Psychosoc Nurs Ment Health Serv 2023; 61:25-33. [PMID: 36479868 DOI: 10.3928/02793695-20221202-01] [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: 08/09/2023]
Abstract
The current study aimed to develop a culturally sensitive recovery-oriented nursing care model in community psychiatric nursing. Through an exploration of recovery-oriented nursing care based on cultural sensitivity, which was done in a prior study and through a literature review, an initial model with six categories was developed. Semi-structured interviews were performed with eight community psychiatric nurses who used the model for 2 months in practice. Qualitative description was used to analyze the data. Participants completed a list of care items in each category of the model to compare ease of practice. The model was further refined to three levels of culturally sensitive nursing care. The model showed the importance of reflection based on recognition of cultural influences, relinquishing the power of the profession, and cooperation that accepts diverse values. [Journal of Psychosocial Nursing and Mental Health Services, 61(8), 25-33.].
Collapse
|
11
|
Lakshman SJ, Mohd Daud TI, Midin M, Ahmad F, Tommy K. Validation of the Malay-Version of Recovery Knowledge Inventory among mental health providers in Malaysia. Front Psychiatry 2023; 14:1078423. [PMID: 37383615 PMCID: PMC10293667 DOI: 10.3389/fpsyt.2023.1078423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/30/2023] [Indexed: 06/30/2023] Open
Abstract
Background The Recovery Knowledge Inventory (RKI) is a widely used self-report instrument that assesses recovery-oriented knowledge among mental health professionals. The purpose of this study is to translate the RKI into the Malay language (RKI-M) and to examine its psychometric properties among Malaysian health care workers. Methods A cross-sectional study involving 143 participants was conducted at an urban teaching hospital, an urban government hospital, and a rural government hospital. Following the translation of the RKI, its internal reliability was determined using Cronbach's alpha. Construct validity was also determined using confirmatory factor analysis. Results The Malay-Version RKI (RKI-M) has good internal reliability with a Cronbach's alpha of 0.83. However, the Malay-version RKI failed to replicate the original four-factor structure. The final model only achieved the best model fit after the removal of 9 items with two-factor loadings: (GFI = 0.92; AGFI = 0 0.87; CFI = 0.91; RMSEA = 0.074). Conclusion The 20-item RKI-M is reliable but has poor construct validity. However, the modified 11-item Malay-version RKI is a more reliable measure as it has good construct validity, with room for future studies to examine the psychometric properties of the modified 11-item RKI among mental health care workers. More training on recovery knowledge should be done, and a simple worded questionnaire should be developed in keeping with local practitioners.
Collapse
Affiliation(s)
- Stella Jane Lakshman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
- Department of Psychiatry, Hospital Selayang, Batu Caves, Selangor, Malaysia
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | | | - Kezia Tommy
- Faculty of Business and Economics, University Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
12
|
Chirio-Espitalier M, Harscoët YA, Duval M, Jupille J, Moret L, Grall-Bronnec M. The experience of caregivers providing therapeutic patient education for people living with bipolar disorder: a qualitative study. BMC Psychiatry 2023; 23:196. [PMID: 36964544 PMCID: PMC10039597 DOI: 10.1186/s12888-023-04623-0] [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: 11/14/2022] [Accepted: 02/22/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Therapeutic patient education (TPE) programs are psycho-educational treatments suggested for all chronic diseases. For several years, these programs have been developing for people living with bipolar disorder. However, to date, only few qualitative studies have explored the experience of caregivers. We wanted to explore the experience of caregivers working in psychiatry as facilitators of a therapeutic education program for people living with bipolar disorder. METHOD A single-center qualitative study was carried out. We conducted an inductive exploration, examining the content of the discourse produced in a focus group of eight caregivers in therapeutic education. The corpus was transcribed manually and a thematic analysis was conducted by two authors in a blinded fashion before combining. RESULTS Four dimensions and twenty themes were identified: i) facilitators' pleasant experiences of the TPE sessions with a secure climate and a sense of belonging to a group, ii) being a TPE facilitator with a new horizontal and collaborative posture valuing the experiential knowledge, iii) the role of the TPE sessions with knowledge provision, empowerment and destigmatization, and iv) perceived changes in patients with an appeasement, the awareness of a shared experience, openness to others, a phenomenon of identification to peers and a new commitment. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The observations noted overlap with the elements of the personal recovery well known CHIME framework (Connectedness, Hope, positive Identity, Meaning in life and Empowerment). Therapeutic education is a developing form of psychosocial rehabilitation care: through the mobilization of a new attitude of caring, the facilitation of TPE programs could be a lever for changing the posture of caregivers in favor of supporting the personal recovery of people with bipolar disorder. These results would need to be confirmed by further studies.
Collapse
Affiliation(s)
- Marion Chirio-Espitalier
- Psychiatry and Mental Health Department, University Hospital of Nantes, 85 Rue Saint-Jacques, 44093, Nantes Cedex 1, France.
- UMR INSERM U1246-SPHERE 'methodS for Patients-Centered Outcomes & HEalth REsearch', University of Nantes, University of Tours, 22 Boulevard Benoni Goullin, 44000, Nantes, France.
- CRehab'S, Support Center for Psychosocial Rehabilitation in the Loire Region, Nantes University Hospital and Angevin Mental Health Center, Nantes, France.
| | - Yves-Antoine Harscoët
- Psychiatry and Mental Health Department, University Hospital of Nantes, 85 Rue Saint-Jacques, 44093, Nantes Cedex 1, France
- CRehab'S, Support Center for Psychosocial Rehabilitation in the Loire Region, Nantes University Hospital and Angevin Mental Health Center, Nantes, France
| | - Mélanie Duval
- Public Health Department, University Hospital of Nantes, 85 Rue Saint-Jacques, 44093, Nantes Cedex 1, France
| | - Julien Jupille
- CRehab'S, Support Center for Psychosocial Rehabilitation in the Loire Region, Nantes University Hospital and Angevin Mental Health Center, Nantes, France
| | - Leïla Moret
- UMR INSERM U1246-SPHERE 'methodS for Patients-Centered Outcomes & HEalth REsearch', University of Nantes, University of Tours, 22 Boulevard Benoni Goullin, 44000, Nantes, France
- Public Health Department, University Hospital of Nantes, 85 Rue Saint-Jacques, 44093, Nantes Cedex 1, France
| | - Marie Grall-Bronnec
- Psychiatry and Mental Health Department, University Hospital of Nantes, 85 Rue Saint-Jacques, 44093, Nantes Cedex 1, France
- UMR INSERM U1246-SPHERE 'methodS for Patients-Centered Outcomes & HEalth REsearch', University of Nantes, University of Tours, 22 Boulevard Benoni Goullin, 44000, Nantes, France
| |
Collapse
|
13
|
Carozza P. La formazione del personale nei Dipartimenti di Salute Mentale. PSICOTERAPIA E SCIENZE UMANE 2023. [DOI: 10.3280/pu2023-001002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Oggi la crescente domanda di Servizi di Salute Mentale capaci di dare prestazioni di alto livello qualitativo sul piano assistenziale, coniugato con sostenibili ricadute su quello economico, richiede nuove conoscenze, nuove abilità e nuove attitudini, anche in virtù dell'emergere di altrettanto nuove questioni che pongono sfide molto alte. È necessario un ripensamento radicale sui contenuti dei programmi formativi e sulle modalità con le quali essi vengono offerti, alla luce delle acqui-sizioni più aggiornate basate sull'evidenza scientifica e sul paradigma biopsicosociale, favorendo le formazioni dell'intero Dipartimento di Salute Mentale affinché, in qualsiasi nodo della rete dipartimentale si imbatta, un cittadino riceva la stessa qualità di trattamento e la stessa metodologia di intervento.
Collapse
|
14
|
Desmet K, Bracke P, Deproost E, Goossens PJJ, Vandewalle J, Vercruysse L, Beeckman D, Van Hecke A, Kinnaer LM, Verhaeghe S. Patient-reported outcomes of the nurse-patient relationship in psychiatric inpatient hospitals: A multicentred descriptive cross-sectional study. J Psychiatr Ment Health Nurs 2023; 30:568-579. [PMID: 36588478 DOI: 10.1111/jpm.12895] [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: 07/19/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Psychiatric and/or mental health nurses are struggling to measure the outcomes of the nurse-patient relationship. Collecting nurse-sensitive patient outcomes is a strategy to provide outcomes of a nurse-patient relationship from patients' perspectives. Because there was no validated scale, the Mental Health Nurse-Sensitive Patient Outcome-Scale (six-point Likert-scale) was recently developed and psychometrically evaluated. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study using the Mental Health Nurse-Sensitive Patient Outcome-scale to measure nurse-sensitive patient outcomes of the nurse-patient relationship in psychiatric hospitals. Moderate to good average scores for the MH-NURSE-POS total (4.42) and domains scores (≥4.09). are observed. Especially outcomes related to 'motivation' to follow and stay committed to the treatment received high average scores (≥4.60). Our results are consistent with the patient-reported effect(s) of relation-based nursing in qualitative research. The scores generate evidence to support the outcomes of the nurse-patient relationship and implicates that further investment in (re)defining and elaborating nurse-patient relationships in mental healthcare is meaningful and justified. More comparative patient-reported data can determine how nurse-sensitive patient outcomes are affected by the patient, nurse, and context. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Demonstrating patient-reported outcomes of the nurse-patient relationship can be important to enhance the therapeutic alliance between nurses and patients, organize responsive nursing care, and create nursing visibility in mental healthcare. Further nursing staff training on interpersonal competencies, such as self-awareness and cultural sensitivity, can be pivotal to achieving the patient-reported outcomes for inpatients with mental health problems. ABSTRACT INTRODUCTION: Identifying patient-reported outcomes of the nurse-patient relationship is a priority in inpatient mental healthcare to guide clinical decision-making and quality improvement initiatives. Moreover, demonstrating nurse-sensitive patient outcomes can be a strategy to avoid further erosion of the specialism of psychiatric and/or mental health nursing. AIM/QUESTION To measure nurse-sensitive patient outcomes of the nurse-patient relationship. METHOD In a multicentred cross-sectional study, 296 inpatients admitted to five psychiatric hospitals completed the recently developed and validated Mental Health Nurse-Sensitive Patient Outcome-Scale (MH-NURSE-POS). The MH-NURSE-POS consists of 21 items (six-point Likert-scale) in four domains: 'growth', 'expression', 'control', and 'motivation'. RESULTS Participants displayed moderate to good average scores for the MH-NURSE-POS total (4.42) and domain scores (≥4.09). Especially outcomes related to 'motivation' to follow and stay committed to the treatment received high average scores (≥4.60). DISCUSSION The results demonstrate that patients perceive the nurse-patient relationship and the care given by psychiatric and/or mental health nurses as contributing to their treatment. IMPLICATIONS FOR PRACTICES Patient-reported outcomes can guide nurses and managers to provide and organize nursing care and to build a nurse-patient relationship that has a positive impact on these outcomes. Additionally, outcomes can create nursing visibility as a profession in- and outside mental healthcare.
Collapse
Affiliation(s)
- Karel Desmet
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Piet Bracke
- Department of Sociology, Ghent University, Ghent, Belgium
| | - Eddy Deproost
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Centre for Psychiatry and Psychotherapy Clinic St-Joseph, Pittem, Belgium
| | - Peter J J Goossens
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Dimence Mental Health Center for Bipolar Disorder, Deventer, The Netherlands
| | | | - Lieke Vercruysse
- Centre for Psychiatry and Psychotherapy Clinic St-Joseph, Pittem, Belgium
| | - Dimitri Beeckman
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,School of Health Sciences, Örebro University, Örebro, Sweden.,School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Lise-Marie Kinnaer
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium.,Faculty of Medicine and Life Science, University Hasselt, Hasselt, Belgium
| |
Collapse
|
15
|
Punzo K, Skoglund M, Carlsson IM, Jormfeldt H. Experiences of an Equine-Assisted Therapy Intervention among Children and Adolescents with Mental Illness in Sweden - A Nursing Perspective. Issues Ment Health Nurs 2022; 43:1080-1092. [PMID: 36178465 DOI: 10.1080/01612840.2022.2126571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Mental illness among children and adolescents is increasing globally, and prescription of psychiatric drugs for children and adolescents with mental illness is increasing worldwide, including Sweden. Holistic health-promoting interventions have shown promising long-lasting significant health benefits in young individuals with mental illness, but holistic health-promoting mental health interventions are often disregarded due to a lack of systematic theory-based knowledge. Consequently, the lack of scientific knowledge thwarts implementation of equine-assisted therapy as an established intervention in mental health nursing for children and adolescents with mental illness. The purpose of the study was to better understand experiences of equine-assisted therapy among children and adolescents with mental illness. The study adopted an inductive approach and data was collected using photovoice methodology. Six young persons, 7-18 years of age, referred by a psychologist to the equine-assisted intervention due to mental health issues, were included in the study. Data was analyzed using qualitative content analysis. The results could be summarized by an overarching theme, a physical, emotional, and social milieu for growth, consisting of three subcategories: feeling relief from everyday stress and anxiety; nurturing self-esteem in a mutual friendship; and strengthening self-reliance through synchronized interplay. The results indicate that equine-assisted therapy has essential values closely related to the goals of mental health nursing. Further research should strive to attain even gender distribution in study samples and focus on how equine-assisted therapy could be thoroughly integrated into established nursing intervention for children and adolescents with mental illness.
Collapse
Affiliation(s)
- Kim Punzo
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Matilda Skoglund
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | | | |
Collapse
|
16
|
Moyo N, Jones M, Kushemererwa D, Arefadib N, Jones A, Pantha S, Gray R. Service User and Carer Views and Expectations of Mental Health Nurses: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11001. [PMID: 36078717 PMCID: PMC9517907 DOI: 10.3390/ijerph191711001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/21/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Service users' views and expectations of mental health nurses in a UK context were previously reviewed in 2008. The aim of this systematic review is to extend previous research by reviewing international research and work published after the original review. Five databases were searched for studies of any design, published since 2008, that addressed service user and carer views and expectations of mental health nurses. Two reviewers independently completed title and abstract, full-text screening and data extraction. A narrative synthesis was undertaken. We included 49 studies. Most included studies (n = 39, 80%) were qualitative. The importance of the therapeutic relationship and service users being supported in their personal recovery by mental health nurses were core themes identified across included studies. Service users frequently expressed concern about the quality of the therapeutic relationship and indicated that nurses lacked time to spend with them. Carers reported that their concerns were not taken seriously and were often excluded from the care of their relatives. Our critical appraisal identified important sources of bias in included studies. The findings of our review are broadly consistent with previous reviews however the importance of adopting a recovery approach has emerged as a new focus.
Collapse
Affiliation(s)
- Nompilo Moyo
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
- Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC 3000, Australia
| | - Martin Jones
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
- Department of Rural Health, University of South Australia, Whyalla Campus, Whyalla Norrie, SA 5608, Australia
- IIMPACT in Health, University of South Australia, Adelaide, SA 5000, Australia
| | - Diana Kushemererwa
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
| | - Noushin Arefadib
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
| | - Adrian Jones
- Faculty of Life Sciences, Wrexham Glyndwr University, Wrexham LL11 2AW, UK
| | - Sandesh Pantha
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
- Department of Rural Health, University of South Australia, Whyalla Campus, Whyalla Norrie, SA 5608, Australia
| |
Collapse
|
17
|
Ibrahim N, Ghallab E, Ng F, Eweida R, Slade M. Perspectives on mental health recovery from Egyptian mental health professionals: A qualitative study. J Psychiatr Ment Health Nurs 2022; 29:484-492. [PMID: 33740825 DOI: 10.1111/jpm.12754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Personal recovery concept is dominant in mental health systems when service user involvement is emphasized; however, service user involvement in mental health research and practice does not exist in Egypt. Definitions of recovery from high-income and English-speaking countries should be carefully adapted to other settings. Nurses providing mental health care in Egypt generally do not have specialized mental health nursing qualifications. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Both cultural and contextual uniqueness of Egypt as a Middle Eastern, low-middle-income country were clear in the findings of this paper. There are differences in the definition of family and service user engagement in the current study and in high-income countries. Seeking faith healers as a barrier to mental health recovery is culturally unique. Functional recovery prevails as a model in Egypt as there is limited service user involvement. Nursing values and code of ethics are consistent with enablers of mental health recovery. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Changing the pre-registration nursing education to prepare specialized graduates in mental health nursing. Training of mental health professionals on recovery approaches which involve service users is needed in Egypt. Mental health nurses in Egypt can use the current findings to implement national campaigns to raise public awareness of mental health problems. ABSTRACT: Introduction Recovery-oriented mental health practice is an emerging approach that aims to empower individuals to define their goals and take responsibility for their own recovery. However, mental health practice in Egypt is still custodial. Aim To explore perspectives of Egyptian mental health professionals on recovery. Method Semi-structured interviews were conducted with 15 mental health professionals identified through snowball sampling. Results The current study identified that functional recovery outweighed other definitions. Four facilitators of mental health recovery were identified: therapeutic relationship; family engagement; cultural sensitivity; and professionals' self-awareness. Six barriers to recovery were found, comprising mental health stigma and lack of awareness, seeking traditional healers, shortage of psychiatrists, cost of treatment, lack of training and effective rehabilitation programs. Discussion The concept of functional recovery predominates among nurses and other mental health professionals, which may be due to limited training and the historical lack of service user involvement in Egypt. Lack of support from family and society, inadequate training MHPs and perceived system inefficiencies are also major impeding factors for recovery. Implications for Practice There is a need for nurses to be involved in designing intervention programs targeting the general public and to support increased involvement of people with mental health issues.
Collapse
Affiliation(s)
- Nashwa Ibrahim
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Eman Ghallab
- Nursing Education Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Rasha Eweida
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| |
Collapse
|
18
|
Salberg J, Ekselius L, Hursti T, Öster C. Staff experiences related to implementation of a recovery-oriented nursing programme in psychiatric inpatient care. Int J Ment Health Nurs 2022; 31:731-742. [PMID: 35315194 PMCID: PMC9311143 DOI: 10.1111/inm.12995] [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] [Received: 05/24/2021] [Revised: 02/28/2022] [Accepted: 03/11/2022] [Indexed: 11/28/2022]
Abstract
Nursing in psychiatric inpatient care is peripheral to a dominating biomedical model of care. Efforts are being made to implement nursing models based on core values and theories for nursing, such as recovery-oriented practices. The aim of the study was to explore experiences of a recovery-oriented nursing programme (Steps Towards Recovery, STR) among nursing staff in psychiatric inpatient care and their ratings of stress (Maslach Burnout Inventory scores), quality of care (Quality of Psychiatric Care - Inpatient staff scores) and satisfaction with nursing care (Satisfaction with Nursing Care and Work scale scores), before and after the implementation-and compare with ratings from reference wards. A quasi-experimental and prospective, pretest-post-test design was used. Specific questions about the nursing programme were answered by staff at the intervention wards. Staff reported predominantly positive experiences of the nursing programme. At follow-up, higher ratings were reported in two dimensions of quality of care in the STR group, and lower ratings in one dimension of stress were evident in the reference group. No differences in ratings between the STR and reference wards were found. Staff members' positive experiences of STR and higher ratings regarding participation and secure environment after implementation suggest that STR is a well-accepted and promising nursing programme. It is important to implement and evaluate recovery-oriented interventions in psychiatric inpatient care, where a focus on symptom relief still prevails. The results indicate that there is potential for further exploration of STR in this context.
Collapse
Affiliation(s)
- Johanna Salberg
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Lisa Ekselius
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Timo Hursti
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Caisa Öster
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| |
Collapse
|
19
|
McCluskey A, Watson C, Nugent L, O'Connor T, Moore Z, O'Brien N, Molloy L, Patton D. Psychiatric nurse's perceptions of their interactions with people who hear voices: A qualitative systematic review and thematic analysis. J Psychiatr Ment Health Nurs 2022; 29:395-407. [PMID: 35394099 PMCID: PMC9322272 DOI: 10.1111/jpm.12829] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: There is no qualitative systematic review of nurses' perceptions of their interactions with people hearing voices. There are some studies exploring the interventions provided by community psychiatric nurses to people hearing voices; these give a sense of what interactions may contain. WHAT THE PAPER ADDS TO THE EXISTING KNOWLEDGE?: Nurses across both community and inpatient mental healthcare settings feel uncertain about how to interact with people hearing voices, sometimes feeling like they can do little to help. Their interactions are affected by the workplace culture, education and training and concern for their own safety. Nurses rely on a therapeutic relationship for all interactions. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This is an under investigated area of mental healthcare. None the less this qualitative systematic review highlights that nurses are unclear about how to interact with service users hearing voices with the resultant outcome that service users in great distress may only be receiving minimal benefit from their interactions with the nurses caring for them. ABSTRACT: Aims and Objectives The aim of this qualitative systematic review and thematic analysis was to identify and synthesize results from studies that explored psychiatric nurses' perceptions of their interactions with service users experiencing auditory hallucinations (hearing voices). Method Qualitative systematic review and thematic analysis. Results Five studies that met the inclusion criteria were identified. Nurses reported that they felt uncertain about what to do for service users hearing voices, struggled to have interactions with voice hearers, but greatly valued the therapeutic relationship with service users. Nurses also reported that they required more education and training on how to interact effectively with people hearing voices. Finally, various workplace challenges were identified as an important factor mediating nurse interaction with service users hearing voices. Discussion Existing evidence shows that nurses lack clarity about how they can interact effectively and in a way that helps service users who are hearing voices. Significant barriers that they must overcome in order to be more certain of their role in caring for people hearing voices are difficult to engage service users and workplace challenges that were not conducive to helpful interactions and conversations. Implications for Practice Nurses caring for people hearing voices require more and better education and training with a view to them becoming more confident and competent when interacting with this service user group. Furthermore, healthy workplace cultures and maintaining a safe environment are necessary for effective caring interactions with people hearing voices.
Collapse
Affiliation(s)
- Anita McCluskey
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Chanel Watson
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Linda Nugent
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Tom O'Connor
- Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Zena Moore
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Niall O'Brien
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Luke Molloy
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Declan Patton
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| |
Collapse
|
20
|
Söderberg A, Ejneborn Looi GM, Gabrielsson S. Constrained nursing: Nurses' and assistant nurses' experiences working in a child and adolescent psychiatric ward. Int J Ment Health Nurs 2022; 31:189-198. [PMID: 34723444 DOI: 10.1111/inm.12949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/15/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022]
Abstract
The role of nurses and nursing in CAP inpatient care is unclear, and nurses are at risk of moral distress due to having to deal with complex demands while lacking organizational support. This study aimed to describe nurses' and assistant nurses' experiences working in child and adolescent psychiatric inpatient care. Eight nurses and seven assistant nurses working in a child and adolescent ward in Sweden participated in the study. Data were collected in 2019 using semi-structured qualitative interviews and subject to qualitative content analysis. Results describe nurses' and assistant nurses' experiences of child and adolescent psychiatric inpatient care in one theme, Constrained nursing, and four categories: Striving to be there for children and parents; Finding a way to manage work; Depending on others; Lacking nursing leadership. Findings suggest that good, person-centred and recovery-oriented nursing practice can exist in CAP inpatient care but remain unrecognized and lacking support due to unclear roles and responsibilities and lack of nursing leadership. This study is reported in accordance with the COREQ guidelines.
Collapse
Affiliation(s)
- Anja Söderberg
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Git-Marie Ejneborn Looi
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Sebastian Gabrielsson
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| |
Collapse
|
21
|
Pilar M, Jost E, Walsh-Bailey C, Powell BJ, Mazzucca S, Eyler A, Purtle J, Allen P, Brownson RC. Quantitative measures used in empirical evaluations of mental health policy implementation: A systematic review. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895221141116. [PMID: 37091091 PMCID: PMC9924289 DOI: 10.1177/26334895221141116] [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] [Indexed: 12/11/2022] Open
Abstract
Background Mental health is a critical component of wellness. Public policies present an opportunity for large-scale mental health impact, but policy implementation is complex and can vary significantly across contexts, making it crucial to evaluate implementation. The objective of this study was to (1) identify quantitative measurement tools used to evaluate the implementation of public mental health policies; (2) describe implementation determinants and outcomes assessed in the measures; and (3) assess the pragmatic and psychometric quality of identified measures. Method Guided by the Consolidated Framework for Implementation Research, Policy Implementation Determinants Framework, and Implementation Outcomes Framework, we conducted a systematic review of peer-reviewed journal articles published in 1995-2020. Data extracted included study characteristics, measure development and testing, implementation determinants and outcomes, and measure quality using the Psychometric and Pragmatic Evidence Rating Scale. Results We identified 34 tools from 25 articles, which were designed for mental health policies or used to evaluate constructs that impact implementation. Many measures lacked information regarding measurement development and testing. The most assessed implementation determinants were readiness for implementation, which encompassed training (n = 20, 57%) and other resources (n = 12, 34%), actor relationships/networks (n = 15, 43%), and organizational culture and climate (n = 11, 31%). Fidelity was the most prevalent implementation outcome (n = 9, 26%), followed by penetration (n = 8, 23%) and acceptability (n = 7, 20%). Apart from internal consistency and sample norms, psychometric properties were frequently unreported. Most measures were accessible and brief, though minimal information was provided regarding interpreting scores, handling missing data, or training needed to administer tools. Conclusions This work contributes to the nascent field of policy-focused implementation science by providing an overview of existing measurement tools used to evaluate mental health policy implementation and recommendations for measure development and refinement. To advance this field, more valid, reliable, and pragmatic measures are needed to evaluate policy implementation and close the policy-to-practice gap. Plain Language Summary Mental health is a critical component of wellness, and public policies present an opportunity to improve mental health on a large scale. Policy implementation is complex because it involves action by multiple entities at several levels of society. Policy implementation is also challenging because it can be impacted by many factors, such as political will, stakeholder relationships, and resources available for implementation. Because of these factors, implementation can vary between locations, such as states or countries. It is crucial to evaluate policy implementation, thus we conducted a systematic review to identify and evaluate the quality of measurement tools used in mental health policy implementation studies. Our search and screening procedures resulted in 34 measurement tools. We rated their quality to determine if these tools were practical to use and would yield consistent (i.e., reliable) and accurate (i.e., valid) data. These tools most frequently assessed whether implementing organizations complied with policy mandates and whether organizations had the training and other resources required to implement a policy. Though many were relatively brief and available at little-to-no cost, these findings highlight that more reliable, valid, and practical measurement tools are needed to assess and inform mental health policy implementation. Findings from this review can guide future efforts to select or develop policy implementation measures.
Collapse
Affiliation(s)
- Meagan Pilar
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
- Department of Infectious Diseases, Washington University School of Medicine,
Washington University in St. Louis, St. Louis, MO, USA
| | - Eliot Jost
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Callie Walsh-Bailey
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Byron J. Powell
- Center for Mental Health Services Research, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
- Division of Infectious Diseases, John T. Milliken Department of
Medicine, Washington University School of Medicine, Washington University in St.
Louis, St. Louis, MO, USA
| | - Stephanie Mazzucca
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Amy Eyler
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Jonathan Purtle
- Department of Public Health Policy & Management, New York
University School of Global Public Health, Global Center for Implementation Science, New York University, New York, NY, USA
| | - Peg Allen
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Ross C. Brownson
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
- Department of Surgery (Division of Public Health Sciences) and Alvin
J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St.
Louis, St. Louis, MO, USA
| |
Collapse
|
22
|
Nardella N, Hooper S, Lau R, Hutchinson A. Developing acute care-based mental health nurses' knowledge and skills in providing recovery-orientated care: A mixed methods study. Int J Ment Health Nurs 2021; 30:1170-1182. [PMID: 33848046 DOI: 10.1111/inm.12868] [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: 09/15/2020] [Revised: 03/10/2021] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
Recovery-oriented principles have progressively been accepted as a standard of mental health practice in many countries, including Australia. A private mental health Clinic in Melbourne, Australia, is dedicated to embedding the principles of recovery-oriented practice into care by (i) providing recovery education and training for their staff and (ii) co-designing resources with consumers to promote active consumer engagement and participation. The purpose of this study was to evaluate the impact of these initiatives on staff knowledge and provision of recovery-oriented care in acute care. Two groups of study participants were recruited: the first group completed the staff training programme introducing the concept of recovery-oriented practice, and the second group was a convenience sample of nurses recruited 12 months later working on the acute inpatient wards at the study site. Nurses completed Recovery Knowledge Inventory (RKI) and Recovery Self-Assessment (RSA-Provider) surveys and participated in a focus group discussion. The three major themes identified from the focus group discussion were as follows: (i) nurses' understanding of personal recovery-orientated practice, (ii) how to embed personal recovery-oriented care into practice, and (iii) barriers to consumer participation in recovery-oriented activities in acute care. There were significant differences between the two groups on the RKI subscale scores of 'Expectations regarding recovery' and the 'Roles of self-definition and peers in recovery' and 'Life goals' and 'Choice' factors on the RSA subscale scores. There were some gaps in the nurses' knowledge and implementation of personal recovery-oriented concepts, highlighting the need for further training and cultural change.
Collapse
Affiliation(s)
- Natalie Nardella
- Epworth Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Victoria, Australia
| | - Suzie Hooper
- Epworth Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Victoria, Australia
| | - Rosalind Lau
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research Epworth/Deakin Partnership, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Anastasia Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research Epworth/Deakin Partnership, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
23
|
Hawsawi T, Stein-Parbury J, Orr F, Roche M, Gill K. Exploring recovery-focused educational programmes for advancing mental health nursing: An integrative systematic literature review. Int J Ment Health Nurs 2021; 30 Suppl 1:1310-1341. [PMID: 34231293 DOI: 10.1111/inm.12908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 01/10/2023]
Abstract
Recovery-focused educational programmes have been implemented in mental health services in an attempt to transform care from a purely biomedical orientation to a more recovery-oriented approach. Mental health nurses have identified the need for enhancing their abilities and confidence in translating recovery knowledge into mental health nursing practice. However, recovery-focused educational programmes have not fully address nurses' learning needs. Therefore, this review synthesized the evidence of the effectiveness of recovery-focused educational programmes for mental health nurses. A systematic search of electronic databases and hand-searched references was conducted. It identified 35 programmes and 55 educational materials within 39 studies. Synthesizing the literature revealed three themes and nine subthemes. The first theme, a framework for understanding and supporting consumers' recovery, had four subthemes: consumers' involvement, multidisciplinary approach, profession-specific training, and performance indicators. The second theme, contents of educational materials, included the subthemes: knowledge development and recovery-focused care planning. The final theme, nurses' learning experiences, included the subthemes: understanding recovery, the positive effects of recovery-focused educational programmes, and implementation of recovery-oriented practices. Based on these findings, a mental health nursing recovery-focused educational programme framework is proposed. Further research should investigate the effectiveness of the framework, especially in relation to recovery-focused care planning and consumer and carer involvement in the development, delivery, participation, and evaluation of these educational programmes.
Collapse
Affiliation(s)
- Tahani Hawsawi
- Faculty of Nursing, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Jane Stein-Parbury
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Fiona Orr
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Michael Roche
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | | |
Collapse
|
24
|
Rudes G, Fantuzzi C. The Association Between Racism and Suicidality Among Young Minority Groups: A Systematic Review. J Transcult Nurs 2021; 33:228-238. [PMID: 34551644 DOI: 10.1177/10436596211046983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The World Health Organization states that suicide is the second leading cause of death among youngs, and racism has been proven to have detrimental effects on both physical and mental health. These two plagues represent a public health priority, especially for susceptible minorities. METHOD This systematic review analyzed 23 studies from multiple database searches, to understand the relationship between racism and suicidality in young minority groups. RESULTS The review demonstrated the correlation between racism and suicidality with the consequent development of mental disorders. There is strong evidence that the main suicide risk factor is acculturation, interpreted as the assimilation of the dominant culture with the loss of values from one's cultural background. DISCUSSION Health care professionals should not underestimate the risk of suicidality associated with racism. Prevention is crucial and it should be implemented from a young age, in schools, through a joint intervention with children and their families, aiming toward integration without acculturation.
Collapse
Affiliation(s)
- Giorgia Rudes
- IRCCS Burlo Garofolo Pediatric Institute, Trieste, Italy
| | - Claudia Fantuzzi
- School of Nursing, University of Trieste, Italy.,Azienda Sanitaria Universitaria Integrata, Trieste, Italy
| |
Collapse
|
25
|
Student mental health nurses' understanding of recovery: A phenomenographic study. Nurse Educ Pract 2021; 53:103082. [PMID: 34023663 DOI: 10.1016/j.nepr.2021.103082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 04/28/2021] [Accepted: 05/11/2021] [Indexed: 11/20/2022]
Abstract
AIM To explore the variation in mental health nursing students' understanding of recovery. BACKGROUND In mental health practice clinical understanding of recovery has been challenged with a new understanding based on the individualised experiences of the person, often referred to as personal recovery. Despite international policy endorsement, practice has been slow to embrace the principles of personal recovery and little is known about student nurses' understanding of the concept. DESIGN Qualitative phenomenographic study METHOD: In-depth semi-structured interviews including discussion of a clinical scenario, were conducted with 13 pre-registration student nurses. Data was analysed iteratively using a seven stage phenomenographic framework, identifying categories of description and the outcome space. RESULTS Analysis revealed a branched outcome space with four qualitatively distinct ways of understanding recovery. Branch one can be broadly aligned to clinical recovery and contains one category only, 'Recovery as Clinical Improvement'. It is distinctly different from branch two which contains three categories on a continuum, which represent more and less complete ways of understanding personal recovery: 'Recovery as Making Progress', 'Recovery as Managing to Live Well' and 'Recovery as Learning to Live Differently'. Most participants demonstrated understanding in the less sophisticated categories. CONCLUSION Recovery is central to mental health nursing, yet this study suggests it is a problematic concept for students. Features of personal recovery can be found in the second branch of the outcome space, with the most sophisticated category 'Learning to Live Differently' best representing the principles of recovery espoused in nursing literature and international policy. Phenomenography has allowed a more complex picture to emerge, replacing the dichotomy between clinical and personal recovery and enabling a differentiation between more and less complete ways of understanding personal recovery. This study addresses the lack of attention given to student nurse experiences of recovery. The insights support educators, both in clinical and academic settings, to address personal recovery in more explicit way where partial understanding can be explored.
Collapse
|
26
|
McCluskey A, de Vries J. Help, I can't help: A qualitative study of psychiatric nurse's perspectives on their care for people who hear voices. J Psychiatr Ment Health Nurs 2021; 28:138-148. [PMID: 32348615 DOI: 10.1111/jpm.12642] [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: 05/30/2019] [Revised: 03/20/2020] [Accepted: 04/17/2020] [Indexed: 12/20/2022]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: There are no studies on the perceptions of psychiatric nurses on interventions they provided to people hearing voices while in an acute psychiatric unit in Ireland. There are three studies focussed on psychiatric nurses' experiences of caring for people that hear voices, two based in England and one based in Australia. Only two of these studies is focussed on nurses working in an acute psychiatric unit. WHAT IS THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study used semi-structured interviews to explore perceptions of psychiatric nurses in the Republic of Ireland on interventions they provided people hearing voices while in an acute psychiatric unit. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further quantitative and qualitative research into the nursing practice for people experiencing auditory hallucinations, in both in-patient and community settings. Follow up supports and supervision after the completion training programmes should be implemented, to ensure the transition of skills and knowledge to the clinical environment. Further investigation into whether or not psychiatric nurses are well prepared for the developments outlined in national polices. ABSTRACT: Aims and Objectives To explore the perspectives and experiences of Irish psychiatric nurses working in acute care in regard to their role in addressing hearing voices in the people in their care, with a view to gain insight in the nurses' personal experiences, interventions they provide, attitudes, knowledge, facilitating factors and challenges. Background Treatment of auditory hallucinations often takes place in acute psychiatric care. Traditionally treatment was focused on medication, but this is no longer the sole approach, with psychosocial interventions gaining ground. Psychiatric nurses have the potential to provide these interventions. As part of the changing emphasis of mental health care in Ireland towards more responsibilities for psychiatric nurses, there is a need to establish whether psychiatric nurses are prepared to take up these added responsibilities. Design A qualitative study, comprising of semi-structured interviews (n = 16). Results Four themes emerged through thematic analysis. These included (a) the importance of therapeutic relationships; (b) reservations about the emphasis on medication; (c) limitations to interventions; and (d) the lack of focus/structure of interventions. Conclusions The use of systematic psychosocial interventions for people who hear voices is not well supported in the acute psychiatric settings the psychiatric nurses in the study worked in.
Collapse
Affiliation(s)
| | - Jan de Vries
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
27
|
Horgan A, O Donovan M, Manning F, Doody R, Savage E, Dorrity C, O'Sullivan H, Goodwin J, Greaney S, Biering P, Bjornsson E, Bocking J, Russell S, Griffin M, MacGabhann L, van der Vaart KJ, Allon J, Granerud A, Hals E, Pulli J, Vatula A, Ellilä H, Lahti M, Happell B. 'Meet Me Where I Am': Mental health service users' perspectives on the desirable qualities of a mental health nurse. Int J Ment Health Nurs 2021; 30:136-147. [PMID: 32808438 DOI: 10.1111/inm.12768] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/02/2020] [Accepted: 07/09/2020] [Indexed: 12/15/2022]
Abstract
Nurses play a central role in the delivery of quality mental health services. Desired qualities of a mental health nurse, in particular therapeutic relationships, have been described in the literature, primarily reflecting the nursing paradigm. Service users' perspectives must be more fully understood to reflect contemporary mental health policy and to recognize their position at the centre of mental health service delivery and to directly influence and contribute their perspectives and experiences to mental health nursing education. A qualitative exploratory research project was undertaken to inform and enhance understanding of what service users see as the desired qualities of a mental health nurse. The project was co-produced by service users as experts by experience, and mental health nurse academics to ensure the service user perspective was privileged. This international project conducted in Europe and Australia included a series of focus groups with service users (n = 50). Data were analysed thematically. Being with me was a major theme identified and reflected the sub-themes: respect towards service users as persons; empathy, compassion and effective communication; understanding service users; knowledge of services; and fostering hope and believing that recovery is possible. These qualities specifically reflecting the service user perspective must be central to mental health nursing curricula to facilitate the development of holistic care and recovery-oriented practice. These findings were utilized to directly inform development of a co-produced mental health nursing learning module, to maximize genuine service user involvement, and to fully realize the benefits of service user led education for undergraduate nursing students.
Collapse
Affiliation(s)
- Aine Horgan
- School of Nursing and Midwifery, ENGAGE: Interdisciplinary Clinical Mental health Research Network, University College Cork, Cork, Ireland
| | - Moira O Donovan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Fionnuala Manning
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Rory Doody
- School of Nursing and Midwifery, ENGAGE: Interdisciplinary Clinical Mental health Research Network, University College Cork, Cork, Ireland
| | - Eileen Savage
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Claire Dorrity
- School of Applied Social Sciences, University College Cork, Cork, Ireland
| | - Hazel O'Sullivan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - John Goodwin
- School of Nursing and Midwifery, ENGAGE: Interdisciplinary Clinical Mental health Research Network, University College Cork, Cork, Ireland
| | - Sonya Greaney
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Pall Biering
- School of Applied Social Sciences, University College Cork, Cork, Ireland
| | - Einar Bjornsson
- Department of Nursing, University of Iceland, Reykjavik, Iceland
| | - Julia Bocking
- ANU Medical School, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Siobhan Russell
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Martha Griffin
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Liam MacGabhann
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | | | - Jerry Allon
- Institute for Nursing Studies, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Arild Granerud
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Elisabeth Hals
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Jarmo Pulli
- Turku University of Applied Sciences, Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Annaliina Vatula
- Turku University of Applied Sciences, Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Heikki Ellilä
- Turku University of Applied Sciences, Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Mari Lahti
- Turku University of Applied Sciences, Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Brenda Happell
- School of Nursing and Midwifery, Faculty of Health and Medicine, Health and Medical Research Institute, Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
| |
Collapse
|
28
|
Goodwin J, Kilty C, Harman M, Horgan A. 'There need to be a balance': Mental health nurses' perspectives on medication education in university and clinical practice. Int J Ment Health Nurs 2020; 29:177-186. [PMID: 31498552 DOI: 10.1111/inm.12657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2019] [Indexed: 01/29/2023]
Abstract
Working with medication is an important role of the mental health nurse. However, little research has focused on staff nurses' perspectives on where the responsibility lies for preparing student nurses for safe, competent medication management. This study investigated mental health nurses' perspectives on medication education. An interpretive descriptive approach was used. Two focus groups were conducted, and data were analysed using inductive content analysis. It was found that participants embraced a medical approach to servicer user care, with less positive attitudes demonstrated towards psychosocial approaches. There were also tensions expressed between clinical practice and the university, with uncertainty voiced about whose responsibility it was to educate students about medication management. It is important that both environments complement each other in order to enhance the student nurse educational experience. While mental health nurses should be educated in this area to practice in a safe and competent manner, it is also key that a holistic approach to care is considered.
Collapse
Affiliation(s)
- John Goodwin
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Caroline Kilty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Mark Harman
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Aine Horgan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| |
Collapse
|
29
|
Evans AM, Quinn C, McKenna B. The governance of sexuality in a Recovery-oriented mental health service: Psychosis, consumers and clinical approaches. J Psychiatr Ment Health Nurs 2020; 27:194-202. [PMID: 31610067 DOI: 10.1111/jpm.12569] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/29/2019] [Accepted: 10/11/2019] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT The intersection of sexuality and psychosis has a long history, yet research in this area has been minimal over the past few decades. Mental health clinicians practice from within the confines of a mental health system that is founded on a conflict between containment and care and that positions the consumer as an object of care. At the same time, mental health services often have a Recovery approach to care. This presents a difficulty and tension in mental health clinical work because the Recovery approach is opposed to positioning the consumer as an object. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE The findings suggest that sexuality and sexual needs are common to both clinicians and consumers, and via identification, make the two groups more similar than different. Sexuality can problematize and so open up questions about the objectification of consumers. Consideration of consumers' sexuality and sexual needs can therefore work as a resistance to the dominant mental health approach and, in doing so, produce a more Recovery-oriented approach to treatment in terms of how the consumer is positioned. Other aspects of living that escape capture by the diagnostic system may also operate as organizing factors for a more subject-to-subject approach to treatment. THE IMPLICATIONS FOR PRACTICE Focusing on sexuality and other aspects of living that escape capture by the diagnostic system can bring into question the way consumers are objectified by the psychiatric model of care. Abstract Introduction The Recovery approach introduced a radical shift in the positioning of consumers as subjects rather than objects of mental health treatment. While this approach has been internationally adopted, the practice of Recovery has been under-researched and a knowledge gap exists regarding the intersection of sexuality and psychosis. Aim The study aim was to investigate how sexuality was governed in a long-stay mental health rehabilitation facility that was Recovery-oriented. Method A case study methodology with a conceptual framework using Foucault's work on disciplinary power was used. Results The findings illustrated how mental health clinicians were caught between two main and incompatible models of care: a psychiatric one and a Recovery one. Discussion While the policy framework authorized a Recovery approach, clinicians practised surveillance, hierarchical observation and normalization, which are tenants of a psychiatric model of care. However, the study found that sexuality was an area that opened questions about the psychiatric model for clinicians. Consideration of consumers' sexual needs allowed the clinicians to think of consumers more as subjects like themselves than as objects to be treated. Implications for practice Consideration of consumers' sexuality opens up possibilities for questioning the objectification of the consumer via the psychiatric model.
Collapse
Affiliation(s)
- Alicia M Evans
- Australian Catholic University, Melbourne, Victoria, Australia
| | | | - Brian McKenna
- Auckland University of Technology, The Auckland Regional Forensic Psychiatry Services, Auckland, New Zealand.,Swinburne University of Technology, Melbourne, Australia
| |
Collapse
|
30
|
Tanaka K. Experiences of community mental health nurses in Japan as the basis of their nursing philosophies. Perspect Psychiatr Care 2019; 55:636-643. [PMID: 31004364 DOI: 10.1111/ppc.12386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 03/20/2019] [Accepted: 04/08/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To investigate the experiences of Japanese community mental health nurses (CMHNs) that help form the basis of their nursing philosophies. DESIGN AND METHODS This study uses the narrative research method. I conducted participant observation and narrative interviews with nine CMHNs in Japan. FINDINGS Four themes emerged: (1) experiences as consumers' peers; (2) nurses' own recovery; (3) high levels of spirituality; and (4) a free spirit. PRACTICE IMPLICATIONS Recognizing these nurses' intrinsic experiences could help to shift mental health nursing paradigms from those based on biomedical models to newer perspectives found in recovery models.
Collapse
Affiliation(s)
- Koji Tanaka
- Department of Nursing, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| |
Collapse
|
31
|
Happell B, Waks S, Bocking J, Horgan A, Manning F, Greaney S, Goodwin J, Scholz B, van der Vaart KJ, Allon J, Granerud A, Hals E, Doody R, Russell S, Griffin M, MacGabhann L, Lahti M, Ellilä H, Pulli J, Vatula A, Platania-Phung C, Bjornsson E, Biering P. 'There's more to a person than what's in front of you': Nursing students' experiences of consumer taught mental health education. Int J Ment Health Nurs 2019; 28:950-959. [PMID: 30953420 DOI: 10.1111/inm.12596] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2019] [Indexed: 10/27/2022]
Abstract
Holistic and person-centred nursing care is commonly regarded as fundamental to nursing practice. These approaches are complementary to recovery which is rapidly becoming the preferred mode of practice within mental health. The willingness and ability of nurses to adopt recovery-oriented practice is essential to services realizing recovery goals. Involving consumers (referred herein as Experts by Experience) in mental health nursing education has demonstrated positive impact on the skills and attitudes of nursing students. A qualitative exploratory research project was undertaken to examine the perspectives of undergraduate nursing students to Expert by Experience-led teaching as part of a co-produced learning module developed through an international study. Focus groups were held with students at each site. Data were analysed thematically. Understanding the person behind the diagnosis was a major theme, including subthemes: person-centred care/seeing the whole person; getting to know the person, understanding, listening; and challenging the medical model, embracing recovery. Participants described recognizing consumers as far more than their psychiatric diagnoses, and the importance of person-centred care and recovery-oriented practice. Understanding the individuality of consumers, their needs and goals, is crucial in mental health and all areas of nursing practice. These findings suggest that recovery, taught by Experts by Experience, is effective and impactful on students' approach to practice. Further research addressing the impact of Experts by Experience is crucial to enhance our understanding of ways to facilitate the development of recovery-oriented practice in mental health and holistic and person-centred practice in all areas of health care.
Collapse
Affiliation(s)
- Brenda Happell
- School of Nursing and Midwifery, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Shifra Waks
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Julia Bocking
- Medical School, Australian National University, Acton, Canberra, Australian Capital Territory, Australia.,Faculty of Health, University of Canberra, University Drive, Bruce, Australian Capital Territory, Australia
| | - Aine Horgan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Fionnuala Manning
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Sonya Greaney
- Southern Area Mental Health Services, School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - John Goodwin
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Brett Scholz
- ANU Medical School, College of Health and Medicine, The Australian National University, Woden, Canberra, Australia
| | | | - Jerry Allon
- Institute for Nursing Studies, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Arild Granerud
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Elisabeth Hals
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Rory Doody
- Area Lead for Mental Health Engagement, Southern Area Health Service Executive, School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Siobhan Russell
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Martha Griffin
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Liam MacGabhann
- Mental Health Practice, Healthy Living Centre, Dublin City University, Dublin, Ireland
| | - Mari Lahti
- Turku University of Applied Sciences, Turku, Finland.,Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Heikki Ellilä
- Turku University of Applied Sciences, Turku, Finland.,Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Jarmo Pulli
- Turku University of Applied Sciences, Turku, Finland.,Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Annaliina Vatula
- Turku University of Applied Sciences, Turku, Finland.,Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Chris Platania-Phung
- School of Nursing and Midwifery, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Einar Bjornsson
- Department of Nursing, University of Iceland, Reykjavik, Iceland
| | - Pall Biering
- Department of Nursing, University of Iceland, Reykjavik, Iceland
| |
Collapse
|
32
|
Fletcher J, Hamilton B, Kinner SA, Brophy L. Safewards Impact in Inpatient Mental Health Units in Victoria, Australia: Staff Perspectives. Front Psychiatry 2019; 10:462. [PMID: 31354541 PMCID: PMC6635577 DOI: 10.3389/fpsyt.2019.00462] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/12/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction: Mental health professionals working in acute inpatient mental health wards are involved in a complex interplay between an espoused commitment by government and organizational policy to be recovery-oriented and a persistent culture of risk management and tolerance of restrictive practices. This tension is overlain on their own professional drive to deliver person-centered care and the challenging environment of inpatient wards. Safewards is designed to reduce conflict and containment through the implementation of 10 interventions that serve to improve the relationship between staff and consumers. The aim of the current study was to understand the impact of Safewards from the perspectives of the staff. Methods: One hundred and three staff from 14 inpatient mental health wards completed a survey 12 months after the implementation of Safewards. Staff represented four service settings: adolescent, adult, and aged acute and secure extended care units. Results: Quantitative results from the survey indicate that staff believed there to be a reduction in physical and verbal aggression since the introduction of Safewards. Staff were more positive about being part of the ward and felt safer and more connected with consumers. Qualitative data highlight four key themes regarding the model and interventions: structured and relevant; conflict prevention and reducing restrictive practices; ward culture change; and promotes recovery principles. Discussion: This study found that from the perspective of staff, Safewards contributes to a reduction in conflict events and is an acceptable practice change intervention. Staff perspectives concur with those of consumers regarding an equalizing of staff consumer relationships and the promotion of more recovery-oriented care in acute inpatient mental health services.
Collapse
Affiliation(s)
- Justine Fletcher
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Bridget Hamilton
- Centre for Psychiatric Nursing, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Stuart A. Kinner
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Heidelberg, VIC, Australia
- Mater Research Institute-UQ, University of Queensland, Brisbane, QLD, Australia
- Griffith Criminology Institute, Griffith University, Mt Gravatt, QLD, Australia
| | - Lisa Brophy
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
- Mind Australia Limited, Heidelberg, VIC, Australia
| |
Collapse
|
33
|
Jimu M, Doyle L. The Administration of Pro re nata Medication by Mental Health Nurses: A Thematic Analysis. Issues Ment Health Nurs 2019; 40:511-517. [PMID: 30917088 DOI: 10.1080/01612840.2018.1543739] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Pro re nata (PRN) medication is medication administered by nurses as required commonly in response to a patient's symptoms or behaviour including insomnia, agitation or anxiety. There is a paucity of research around the process of PRN administration in mental health settings in Ireland and international evidence suggests inconsistencies in practices. This study aimed to explore the process of PRN medication administration by mental health nurses. Using a qualitative descriptive design, semi-structured interviews were undertaken with 19 mental health nurses in three acute inpatient units in one mental health service in Ireland. Most participants reported undertaking an assessment of the patient before administering PRN medication; however, many also reported having observed incidents of poor practice. There was evidence of some interdisciplinary sensitivities around instructions regarding the use of PRN medications between doctors who prescribed them and nurses who dispensed them. A need for service improvements were also identified including the use of alternative strategies to PRN use such as de-escalation techniques and education around psychopharmacology. PRN medication is commonly used in mental health settings; however, this study suggests that there is potential for improvement in relation to how it is prescribed and administered. Overuse of PRN medication has been associated with increased morbidity. Mental health nurses are required to carefully consider whether PRN medication is warranted in the first instance and how its use might impact on patients.
Collapse
Affiliation(s)
| | - Louise Doyle
- b School of Nursing and Midwifery , Trinity College , Dublin , Ireland
| |
Collapse
|
34
|
Jørgensen R, Christiansen J, Nissen HB, Kristoffersen K, Zoffmann V. The deadlock of saying "That is what we already do!" A thematic analysis of mental healthcare professionals' reactions to using an evidence-based intervention. J Psychiatr Ment Health Nurs 2019; 26:39-48. [PMID: 30576042 DOI: 10.1111/jpm.12509] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN ON THIS SUBJECT?: There is a need to shed light on healthcare professionals' reactions to the use of the Guided Self-Determination method in a mental health hospital to better understand and adjust the implementation process of evidence-based practice. Healthcare professionals´ values and beliefs play an important role when implementing evidence-based practice in real-world healthcare settings. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The study identifies opposite positions in mental healthcare professionals: being ready or resistant to change when implementing an evidence-based intervention. The positions are elaborated in four thematic dynamic continuums describing reactions to using the intervention. In addition, this is the first study to explore mental healthcare professionals´ reactions to using the Guided Self-Determination method in a mental health context. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: When preparing implementation of an evidence-based intervention, it is important to consider adaptation of the intervention, the mental healthcare professionals' acceptability, support from management and participation in supervision. In future research, it is important to consider collecting data from mental healthcare professionals trained in using an evidence-based intervention, however not using it in clinical practice, to understand barriers towards evidence-based practice. ABSTRACT: Introduction Evidence-based interventions are required in mental health nursing to improve quality and outcome for patients. However, there is a need to shed light on professionals' reactions to the use of evidence-based interventions to better understand and adjust the implementation process. Aim To explore mental healthcare professionals´ reactions to using the evidence-based intervention Guided Self-Determination method in the care of inpatients with severe mental illness. Method A qualitative study conducted in relation to an 8 months implementation program. Data collection: 9 qualitative interviews and field notes generated from supervision of the intervention. Results Four themes emerged from a thematic analysis: "The expert becomes novice," "Theory used as a looking glass," "Guided Self-Determination perceived as an interruption" and "Becoming an informer of the impact of GSD." Discussion Using the themes may help leaders or researchers predict or discover the support needed by individual professionals. Implications for practice When preparing implementation of an evidence-based intervention, it is important to consider adaptation and acceptability, as well as support from management and participation in supervision. Finally, it is worth to consider collecting data from trained professionals, who did not use the intervention in practice to understand barriers towards evidence-based practise.
Collapse
Affiliation(s)
- Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg University Hospital - Psychiatry, Aalborg, Denmark
| | - Jette Christiansen
- Clinic South, Aalborg University Hospital - Psychiatry, Aalborg, Denmark
| | | | - Karin Kristoffersen
- Clinic North and Clinic South, Aalborg University Hospital - Psychiatry, Aalborg, Denmark
| | - Vibeke Zoffmann
- Research Unit Women´s and Children´s Health, The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
35
|
Fullam J, Cusack E, Nugent LE. Research excellence across clinical healthcare: a novel research capacity building programme for nurses and midwives in a large Irish region. J Res Nurs 2018; 23:692-706. [PMID: 34394491 DOI: 10.1177/1744987118806543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: A lack of support and research skills development has contributed to low research output by clinically based nurses and midwives in Ireland, including those in specialised and advanced roles. A novel research capacity building (RCB) programme was developed to address existing barriers. The programme was developed and implemented using Cooke's principles of RCB. Nurses and midwives participated from acute hospital, community, public health, mental health, older adult, intellectual disability, addiction and palliative care settings. Aims: This paper provides an evaluation of the Research Excellence Across Clinical Healthcare (REACH) programme from 2013-2016. Methods: Document analysis was used to evaluate RCB activities and outputs. Data were extracted from programme reports, conference proceedings, paper references, and workshop and conference sign-in/evaluation forms. Results: Individuals (n = 17) and small research groups (n = 4) were supported. Increased research capacity was demonstrated through dissemination of research in peer-reviewed journals, posters and oral presentations at national and international conferences. Sustainability was demonstrated by progression of participants to PhD (n = 3) and research projects that remain ongoing (n = 5). Skills development was facilitated by the organisation of workshops and conferences. Conclusions: A programme that provides academic support and mentorship in the clinical environment along with skills development can build research capacity. Future research should involve follow-up to determine any long-term effects.
Collapse
Affiliation(s)
- James Fullam
- Postdoctoral Research Fellow, NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, UK
| | - Eithne Cusack
- Director of Nursing and Midwifery Planning and Development, Quality and Clinical Care Directorate, Health Service Executive Dublin North, Ireland
| | - Linda E Nugent
- Lecturer & Programme Director, RCSI School of Nursing & Midwifery, Royal College of Surgeons in Ireland, Ireland
| |
Collapse
|
36
|
Balint B, Killaspy H, Marston L, Barnes T, Latorre A, Joyce E, Clarke CS, De Micco R, Edwards MJ, Erro R, Foltynie T, Hunter RM, Nolan F, Schrag A, Freemantle N, Foreshaw Y, Green N, Bhatia KP, Martino D. Development and clinimetric assessment of a nurse-administered screening tool for movement disorders in psychosis. BJPsych Open 2018; 4:404-410. [PMID: 30294450 PMCID: PMC6171333 DOI: 10.1192/bjo.2018.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Movement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed. AIMS To develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses. METHOD Item selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales. RESULTS Interreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia. CONCLUSIONS The ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia. DECLARATION OF INTEREST None.
Collapse
Affiliation(s)
- Bettina Balint
- Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, UK and Department of Neurology, University of Heidelberg, Germany
| | - Helen Killaspy
- Psychiatrist, Division of Psychiatry, Department of Primary Care and Population Health, University College London and Priment Clinical Trials Unit, University College London, UK
| | - Louise Marston
- Research Associate, Department of Primary Care and Population Health, University College London and Priment Clinical Trials Unit, University College London, UK
| | - Thomas Barnes
- Psychiatrist, Department of Psychiatry, Imperial College London, UK
| | - Anna Latorre
- Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK and Department of Neurology and Psychiatry, Sapienza, University of Rome, Italy
| | - Eileen Joyce
- Psychiatrist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK
| | - Caroline S Clarke
- Research Associate, Department of Primary Care and Population Health and Priment Clinical Trials Unit, University College London, UK
| | - Rosa De Micco
- Neurologist, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences and MRI Research Center SUN-FISM, University of Campania 'Luigi Vanvitelli', Italy
| | - Mark J Edwards
- Neurologist, Institute of Cardiovascular and Cell Sciences, St George's University, UK
| | - Roberto Erro
- Neurologist, Neurodegenerative Diseases Center (CEMAND) Department of Medicine, Surgery and Dentistry, University of Salerno, Italy
| | - Thomas Foltynie
- Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK
| | - Rachael M Hunter
- Research Associate, Department of Primary Care and Population Health, and Priment Clinical Trials Unit, University College London, UK
| | - Fiona Nolan
- Research Nurse, School of Health and Social Care, University of Essex, UK
| | - Anette Schrag
- Neurologist, Department of Clinical Neurosciences, Royal Free Campus, UCL Institute of Neurology, University College London, UK
| | - Nick Freemantle
- Statistician, Department of Primary Care and Population Health, University College London and Priment Clinical Trials Unit, University College London, UK
| | - Yvonne Foreshaw
- Research Nurse, Camden and Islington NHS Foundation Trust, St Pancras Hospital, UK
| | - Nicholas Green
- Research Nurse, Camden and Islington NHS Foundation Trust, St Pancras Hospital, UK
| | - Kailash P Bhatia
- Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK
| | - Davide Martino
- Neurologist, Department of Clinical Neurosciences, University of Calgary, Canada
| |
Collapse
|
37
|
De Vecchi N, Kenny A, Dickson-Swift V, Kidd S. Continuing professional development in mental health: Promoting dialogue and reflection through art. Nurse Educ Pract 2018; 32:34-36. [DOI: 10.1016/j.nepr.2018.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 04/02/2018] [Accepted: 07/06/2018] [Indexed: 11/25/2022]
|
38
|
Walsh FP, Meskell P, Burke E, Dowling M. Recovery-based Training in Mental Health: Effects on Staff Knowledge and Attitudes to Recovery. Issues Ment Health Nurs 2017; 38:886-895. [PMID: 28745921 DOI: 10.1080/01612840.2017.1346014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This longitudinal study describes the effects of recovery-based training on staff knowledge and attitudes to recovery. Mental health staff (n = 101) completed the study questionnaire (the Recovery Knowledge Inventory (RKI-20) and Recovery Attitudes' Questionnaire (RAQ-16)) before training and after six months. On the RKI, significant changes between pre- and post-training scores (p < 0.01) were found. On the RAQ, the scores showed significant changes in Factors 1 (p < 0.001) and 2 (p < 0.009). The results indicate a significant difference in confidence using a recovery model of care following training suggesting that recovery-based training positively affects staff knowledge and attitudes to recovery overall.
Collapse
Affiliation(s)
| | - Pauline Meskell
- b School of nursing , University College Limerick , Limerick , Ireland
| | - Emer Burke
- c School of Nursing , National University of Ireland , Galway , Ireland
| | - Maura Dowling
- d School of Nursing and Midwifery , National University of Ireland , Galway , Ireland
| |
Collapse
|
39
|
Zuaboni G, Hahn S, Wolfensberger P, Schwarze T, Richter D. Impact of a Mental Health Nursing Training-Programme on the Perceived Recovery-Orientation of Patients and Nurses on Acute Psychiatric Wards: Results of a Pilot Study. Issues Ment Health Nurs 2017; 38:907-914. [PMID: 28933576 DOI: 10.1080/01612840.2017.1359350] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In mental health nursing, recovery-orientation is regarded as a best practice approach for patient care. To assess the effect of an intervention utilising a recovery-oriented approach in acute practice, a controlled pilot trial was conducted. On intervention wards, mental health nurses received special training. Recovery Self-Assessment Scale was used to assess the effects of the training. No statistically significant effects were found, between the experimental conditions. Reasons for this result may be methodological, practical or due an intervention that was not powerful enough. Recovery-oriented intervention studies in mental health nursing should be conducted with caution.
Collapse
Affiliation(s)
- Gianfranco Zuaboni
- a Sanatorium Kilchberg AG, Kilchberg , Switzerland & Martin Luther University of Halle-Wittenberg , Halle-Saale , Germany
| | - Sabine Hahn
- b Bern University of Applied Sciences , Bern , Switzerland
| | - Peter Wolfensberger
- c Integrated Psychiatry Winterthur , Switzerland & Bournemouth University , Bournemouth , UK
| | | | - Dirk Richter
- b Bern University of Applied Sciences , Bern , Switzerland
| |
Collapse
|