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El-Haj-Mohamad R, Böttche M, Vöhringer M, Specht F, Stammel N, Nesterko Y, Knaevelsrud C, Wagner B. An internet-based cognitive behavioural intervention for adults with depression in Arabic-speaking countries: A randomized controlled trial. Stress Health 2024:e3432. [PMID: 38806256 DOI: 10.1002/smi.3432] [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: 01/29/2024] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 05/30/2024]
Abstract
Internet-based interventions have proven to be effective for the treatment of depression in different samples, but evidence from the Middle East and North Africa (MENA) region is scarce. The aim of this study was to investigate the acceptance and efficacy of an internet-based cognitive behavioural writing intervention for Arabic-speaking participants with depression living in the MENA region. A total of 259 participants (167 female, age in years: M = 25.58, SD = 6.39) with depressive symptoms indicative of clinical relevance were randomly allocated to a treatment group (TG; nTG = 128) or a waitlist control group (WG; nWG = 131). The TG received an internet-based intervention over a 6-week period. The primary outcome was depressive symptoms, and secondary outcomes were anxiety and quality of life (QoL). T-tests with change scores from pre- to post-treatment were used for data analyses. Intention-to-treat (ITT) as well as completer analyses were calculated. The ITT analysis revealed significant differences between the TG and WG in depression (T257 = -4.89, p < 0.001, d = 0.70) and QoL (T257 = 3.39, p < 0.001, d = 0.47). Significant differences regarding anxiety symptoms (T257 = 3.25, p < 0.05, d = 0.53) were identified for the completer sample. The general dropout rate was 39.9%. The results indicate the feasibility and efficacy of an internet-based cognitive behavioural writing intervention in adults from Arabic-speaking countries. The development and implementation of such interventions can be used to improve access to psychological help and adequate treatment.
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Affiliation(s)
- Rayan El-Haj-Mohamad
- Department for Transcultural and Traumatic Stress Studies, Center ÜBERLEBEN, Berlin, Germany
- Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Maria Böttche
- Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Max Vöhringer
- Department for Transcultural and Traumatic Stress Studies, Center ÜBERLEBEN, Berlin, Germany
| | - Freya Specht
- Department for Transcultural and Traumatic Stress Studies, Center ÜBERLEBEN, Berlin, Germany
| | - Nadine Stammel
- Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Yuriy Nesterko
- Department for Transcultural and Traumatic Stress Studies, Center ÜBERLEBEN, Berlin, Germany
- Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
- Department for Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany
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Eweida R, Ibrahim N. Using Delphi method to address factors contributing to aggressive behaviour in mental health settings. J Psychiatr Ment Health Nurs 2024. [PMID: 38532533 DOI: 10.1111/jpm.13049] [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: 10/21/2023] [Revised: 02/29/2024] [Accepted: 03/16/2024] [Indexed: 03/28/2024]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: Nurses' perspectives and consensus on the possible key factors contributing to aggression at inpatient units can be summarized into patients' related factors, staff related factors and environment related factors. Results of the possible factors contributing to aggression at inpatient units reflect the complicated nature of this problem. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: Perspectives of nurses as frontline mental health professionals on factors contributing to aggression as one of the psychiatric emergencies were considered through an iterative process. This approach gave nurses an opportunity to revisit their own views in each round to provide an in-depth reflection in the light of the contribution of others. WHAT ARE THE IMPLICATIONS FOR MENTAL HEALTH NURSING PRACTICE?: Nursing curricula should focus on nurses' communication skills and emotion regulation training. An open dialogue between nurses and people with mental health issues should be initiated to discuss the possible key factors contributing to aggressive behaviour at inpatient units from both standpoints. Mental health nurses' turnover at inpatient settings could be targeted through the design and implementation of aggression prevention protocols ABSTRACT: Introduction Aggression at inpatient units is a universal problem leading to hazardous outcomes. Aim To generate group consensus about factors contributing to aggressive behaviour among patients with mental health issues at inpatient units. Methods Nurses working at inpatient psychiatric departments were approached, and purposive sampling was employed to implement Delphi technique. A total of three Delphi rounds were conducted online. The average percent of majority opinions method was followed to measure consensus in which questions with a cut-off rate below 69.7% were included in the next round. Results Twenty-one nurse experts with different skills participated in this study. Consensus increased among nurse experts across rounds for the following items: Patients' misinterpretation of the attitude of the healthcare providers, severity of mental health issues, attitude and communication style of the healthcare providers, nurses limited emotional regulation capacity and the inadequate staff-patient ratio in psychiatric wards. Discussion The complicated nature of aggressive behaviour displayed by people with mental health issues is reflected on the results of the current study; patients' related factors, staff related factors and environment related factors constitute interacting facets for this issue. Implications for Mental Health Nurses Nurse scientists could use insights derived from this study to design studies aiming at assessment and management of aggression at inpatient units guided by implementation science frameworks. Additionally, open dialogues between nurses and people with mental health issues could be initiated about factors contributing to aggression at inpatient units. Mental health nursing training should focus on nurses' communication and emotion regulation skills.
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Affiliation(s)
- Rasha Eweida
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
- Psychiatric and Mental Health Specialty, Nursing Department, College of Health and Sport Sciences, University of Bahrain, Zallaq, Bahrain
| | - Nashwa Ibrahim
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
- Mental Health Nursing Department, Faculty of Nursing, The British University in Egypt, El Sherouk City, Egypt
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Salzmann-Erikson M. An Integrative Review on Psychiatric Intensive Care. Issues Ment Health Nurs 2023; 44:1035-1049. [PMID: 37874667 DOI: 10.1080/01612840.2023.2260478] [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: 10/26/2023]
Abstract
Psychiatric intensive care units (PICUs) provide care and treatment when psychiatric symptoms and behaviors exceed general inpatient resources. This integrative review aimed to synthesize PICU research published over the past 5 years. A comprehensive search in MEDLINE, PsycINFO, PubMed and Scopus identified 47 recent articles on PICU care delivery, populations, environments, and models. Research continues describing patient demographics, and high rates of challenging behaviors, self-harm, and aggression continue being reported. Research on relatives was minimal. Patients describe restrictive practices incongruent with recovery philosophies, including controlling approaches and sensory deprivation. Some initiatives promote greater patient autonomy and responsibility in shaping recovery, yet full emancipatory integration remains limited within PICU environments. Multidisciplinary collaboration is needed to holistically advance patient-centered, equitable, and integrative PICU care. This review reveals the complex tensions between clinical risk management and emancipatory values in contemporary PICU settings. Ongoing reporting of controlling practices counters the recovery movement progressing in wider mental healthcare contexts. However, care innovations centered on patient empowerment and humane environments provide hope for continued evolution toward more liberation-focused PICU approaches that uphold both patient and provider perspectives.
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Affiliation(s)
- Martin Salzmann-Erikson
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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Furuno T, Fujino N, Fujimoto Y, Yamaguchi F, Furuno N. Development of a scale to evaluate nurses' recovery orientation in the dementia care. J Psychiatr Ment Health Nurs 2023. [PMID: 36932911 DOI: 10.1111/jpm.12917] [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: 03/17/2022] [Revised: 01/23/2023] [Accepted: 02/22/2023] [Indexed: 03/19/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Much research has been conducted on the relationship between recovery orientation and people diagnosed with mental illnesses such as schizophrenia and mood disorders. A recovery-oriented approach by mental health professionals can reduce hospital stays and medical costs for people diagnosed with mental illness. There are similarities and differences between recovery-oriented approaches for individuals diagnosed with dementia and those diagnosed with mental illness. This reflects the characteristics of irreversible dementia. Although dementia courses at recovery colleges are increasing, dementia recovery is in its infancy and course content varies. The core of the recovery framework for individuals diagnosed with dementia is 'Continue to be me'. Recovery-oriented approaches and programmes have been developed by mental health workers for older adults, including those with dementia, but there are no outcome measures that reflect the characteristics of dementia care. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We developed a scale to assess nurses' recovery orientation in dementia care, which has been found to be reliable, and although some validity issues remain, it is the first scale to objectively assess recovery orientation in dementia care. The emphasis is on helping people diagnosed with dementia maintain their identity, which is not adequately covered by existing measures of recovery. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The ability to objectively assess recovery orientation in dementia care allows us to identify areas of inadequacy. It can be used to reduce variation in the content of recovery college courses and as an indicator for evaluating training in recovery-oriented approaches to dementia care. ABSTRACT INTRODUCTION: Programmes regarding recovery-oriented approaches for older people, including those with dementia, have been developed, but there are no clear indicators, and the process is still in its infancy. PURPOSE We developed a scale to assess nurses' recovery orientation in dementia care. METHODS A draft of a 28-item scale was developed based on interviews with 10 nurses, skilled in dementia care with a Japanese mental health perspective, and a literature review. A self-administered questionnaire was developed for nurses working in a dementia ward, and an exploratory factor analysis was conducted. A confirmatory factor analysis was conducted to test for convergent and discriminant validity. The Recovery Attitude Questionnaire was used to examine criterion-related validity. RESULTS An exploratory factor analysis produced a 19-item scale and identified five factors (KMO value: 0.854). The Cronbach's alpha for the overall scale was .856, with each subfactor showing a range of .742-.792, validating its reliability. DISCUSSION The results of confirmatory factor analysis supported the five-factor construct. Reliability was verified, but some issues remained in convergent and discriminant validity. IMPLICATIONS FOR PRACTICE This scale can be used to objectively assess nurses' recovery orientation in dementia care and as a measure of training in recovery-oriented approaches.
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Affiliation(s)
- Takaomi Furuno
- Institute of Nursing, Faculty of Medicine, Saga University, Saga, Japan
| | - Narumi Fujino
- Institute of Nursing, Faculty of Medicine, Saga University, Saga, Japan
| | - Yuji Fujimoto
- Institute of Nursing, Faculty of Medicine, Saga University, Saga, Japan
| | - Fumi Yamaguchi
- Institute of Nursing, Faculty of Health Science, Hiroshima Cosmopolitan University, Hiroshima, Japan
| | - Nozomi Furuno
- Fukuoka Prefectural Psychiatric Center Dazaifu Hospital, Dazaif, Japan
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Ibrahim N, Selim A, Ng F, Kasaby M, Ali AM, Eweida R, Almakki D, Elaagib A, Slade M. Experiences of peer support workers supporting individuals with substance use disorders in Egypt: phenomenological analysis. BMC Health Serv Res 2022; 22:1012. [PMID: 35941645 PMCID: PMC9361559 DOI: 10.1186/s12913-022-08393-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/29/2022] [Indexed: 11/25/2022] Open
Abstract
Background Peer support work for substance use disorders is widely implemented in high-income countries. More research is still needed to understand its applicability in settings which have proportionately low budgets allocated to mental health. Peer Support Workers are individuals who managed to achieve recovery from substance use disorders and help people remain engaged in their recovery and prevent relapse through shared understanding. Aim To investigate the experience of peer support workers providing recovery support to people with substance use disorders in Egypt. Methods A qualitative phenomenological design was used in which 17 adults working as peer support workers for substance use disorders were recruited by means of purposive and snowball sampling. A semi-structured interview with participants was conducted by phone or video-call. Interviews were transcribed and thematically analysed based on descriptive phenomenology. Results Three superordinate themes were identified: role responsibility, Peer Support Workers’ need for organizational and stakeholders’ support, and challenges to the role integrity. Conclusion and recommendations The findings indicate the need for national and governmental support to peer support workers engaged with people with substance use disorders in Egypt and educating families and the public about the role of peer support workers in substance use disorders.
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Affiliation(s)
- Nashwa Ibrahim
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt.
| | - Abeer Selim
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt.,College of Nursing, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Muhamed Kasaby
- Center for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, 21527, Egypt
| | - Rasha Eweida
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, 21527, Egypt
| | | | | | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK.,Nord University, Postboks 474, 7801, Namsos, Norway
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Ibrahim N, Ng F, Selim A, Ghallab E, Ali A, Slade M. Posttraumatic growth and recovery among a sample of Egyptian mental health service users: a phenomenological study. BMC Psychiatry 2022; 22:255. [PMID: 35410151 PMCID: PMC9004105 DOI: 10.1186/s12888-022-03919-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Delivery of recovery-oriented mental health practice is fundamental to personal recovery. Yet, there is lack of service users' accounts on what constitutes mental health recovery in Egypt. OBJECTIVES The aim of this study was to explore mental health recovery meaning informed by people with personal experience of recovery. METHODS A phenomenological research design was used. Semi-structured qualitative interviews were conducted with 17 adult community-dwelling individuals who identified as recovered/recovering from mental health issues. An inductive thematic analysis approach was used to analyses participants' responses. RESULTS Participants predominately reported personal and functional definitions of mental health recovery. Posttraumatic growth was the strongest theme comprising: relation to others, spirituality, new possibilities, identity & strengths, and appreciation of life. Themes of acceptance and forgiveness, functional and clinical recovery, and finding hope were also identified. CONCLUSIONS This is the first study to explore mental health recovery meaning among a sample of people with lived experience of mental health issues in Egypt. Findings suggest that developing and implementing psychosocial interventions to support posttraumatic growth among people with mental health issues is a priority.
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Affiliation(s)
- Nashwa Ibrahim
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt.
| | - Fiona Ng
- grid.4563.40000 0004 1936 8868School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Abeer Selim
- grid.10251.370000000103426662Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt ,grid.412149.b0000 0004 0608 0662College of Nursing, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia ,grid.452607.20000 0004 0580 0891King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Eman Ghallab
- grid.7155.60000 0001 2260 6941Nursing Education Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Amira Ali
- grid.136594.c0000 0001 0689 5974Tokyo University of Agriculture and Technology, Fuchu, Japan ,grid.7155.60000 0001 2260 6941Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, 21527 Egypt
| | - Mike Slade
- grid.4563.40000 0004 1936 8868School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK ,grid.465487.cNord University, Postboks 474, 7801 Namsos, Norway
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