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Zabell V, Arnfred SM, Høgsgaard D, Gaede PH, Rønne ST, Jørgensen R. User accounts on received diabetes and mental health care in a Danish setting - An interview study. Int J Ment Health Nurs 2022; 31:1446-1456. [PMID: 35974659 PMCID: PMC9804252 DOI: 10.1111/inm.13045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2022] [Indexed: 01/05/2023]
Abstract
People with coexisting type 1 and 2 diabetes and mental illness have a higher mortality rate compared to the general population, among other reasons due to unregulated diabetes. One explanation might be the complexity of managing both conditions. In this interview study, we explored the accounts of delivered diabetes and mental health care of 16 individuals living with coexisting diabetes and mental illness in Denmark. A thematic analysis by Braun and Clarke was applied in the analysis. Some of the participants described the care for diabetes and mental illness to be inextricably linked to each other. Therefore, health care providers ought to focus and knowledge of both conditions as essential components in the care provided. The participants accounted for support needs in other settings beyond diabetes and mental health outpatient clinics, such as the family doctor, residential institutions, and community care. However, the inefficient collaboration between these health care settings is one of the barriers to supporting the participants' self-management.
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Affiliation(s)
- Vicki Zabell
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sidse Marie Arnfred
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ditte Høgsgaard
- Primary & eHealth care, Soroe, Denmark.,Faculty of Public Health, University of Southern Denmark, Odense, Denmark
| | - Peter Haulund Gaede
- Faculty of Public Health, University of Southern Denmark, Odense, Denmark.,Departments of 5Internal Medicine Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark
| | - Sabrina Trappaud Rønne
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.,Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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2
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Romain AJ, Trottier A, Karelis AD, Abdel-Baki A. Do Mental Health Professionals Promote a Healthy Lifestyle among Individuals Experiencing Serious Mental Illness? Issues Ment Health Nurs 2020; 41:531-539. [PMID: 32286095 DOI: 10.1080/01612840.2019.1688436] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: While a healthy lifestyle would be an asset to people experiencing psychotic disorders, not all mental health professionals provide counselling regarding healthy behaviours, such as physical activity, healthy nutrition, and tobacco cessation. Therefore, the objective of the present study was to investigate the factors associated with health promotion practice (HPP) among mental health professionals.Methods: Cross-sectional survey including mental health professionals across the Province of Quebec (Canada). The promotion of health behaviour and the "Exercise in Mental Illness Questionnaire - Health Practitioner Version" and its adaptation for nutrition improvement and tobacco cessation were used to evaluate knowledge, beliefs, promotion behaviours, and barriers to HPP.Results: One hundred mental health professionals, most being nurses (29%) and medical doctors/psychiatrists (20%) were recruited throughout the province of Quebec (Canada). The rate of formal training among professionals was 11% for physical activity, 26% for nutrition, and 21% for tobacco cessation. Approximately 60% were promoting physical activity, 49% good nutrition, and 41% tobacco cessation. Professionals promoting healthy behaviours had a higher level of self-efficacy in HPP, were more likely to value physical health, and less likely to endorse barriers to HPP.Conclusion: Rates of formal training in lifestyle habits and health promotion (aiming at improving a healthy lifestyle in patients experiencing psychotic disorders) among mental health professionals are currently low in the Province of Quebec and need to be improved. In addition, the level of confidence and barriers that endorse healthy behaviours appear to be key factors in HPP among mental health professionals.
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Affiliation(s)
- Ahmed Jerome Romain
- Department of Psychiatry, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Alexia Trottier
- Department of Psychiatry, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Antony D Karelis
- Department of Physical Activity Sciences, University of Quebec at Montreal, Montreal, Quebec, Canada
| | - Amal Abdel-Baki
- Department of Psychiatry, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.,Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada.,Department of Psychiatry, University Hospital of Montreal (CHUM) - Notre-Dame Hospital, Montreal, Quebec, Canada
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3
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Stanton R, Rosenbaum S. Temporal trends in exercise physiology services in Australia-Implications for rural and remote service provision. Aust J Rural Health 2019; 27:514-519. [PMID: 31713303 DOI: 10.1111/ajr.12563] [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: 04/02/2019] [Revised: 07/17/2019] [Accepted: 07/30/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess temporal trends in service provision by Accredited Exercise Physiologists based on remoteness classification using Australian Bureau of Statistics remoteness classifications of Major Cities, Inner Regional, Outer Regional, Remote and Very Remote. DESIGN AND PARTICIPANTS Cross-sectional analysis of publicly available Medicare Benefits Schedule datasets, for Medicare item number 10953 from 2012-2013 to 2016-2017. MAIN OUTCOME MEASURE(S) Number of claims, benefits paid, fees charges and number of providers for Medicare item number 10953. RESULTS Accredited Exercise Physiologist service delivery demonstrates growth across all areas of remoteness classification. Rebates and fees mirror service delivery trends. The rate of service growth was significantly greater in Major Cities compared with all other remoteness classifications. Provider numbers show a steady increase from 2012-2013 to 2016-2017 but number remains higher in Major Cities compared with all other remoteness locations. CONCLUSION Given the high proportion of chronic and complex illness in rural and remote areas, and the limited access to allied health care services, we propose more needs to be done to position Accredited Exercise Physiologists in these regions of increasing need. These findings have implications for future development of the Accredited Exercise Physiologist profession.
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Affiliation(s)
- Robert Stanton
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Qld, Australia.,Appleton Institute, Central Queensland University, Adelaide, SA, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Black Dog Institute, Sydney, NSW, Australia
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Dickens GL, Ramjan L, Endrawes G, Barlow EM, Everett B. Effectiveness and experiences of mental health nurses in cases of medical emergency and severe physiological deterioration: A systematic review. Int J Nurs Stud 2019; 95:73-86. [PMID: 31121386 DOI: 10.1016/j.ijnurstu.2019.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 03/21/2019] [Accepted: 04/19/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND From a baseline of near zero, there has in recent years been a growing number of empirical studies related to mental health nurses' delivery of healthcare for severely physically deteriorating patients or in medical emergency situations. To date, this evidence-base has not been systematically identified, appraised, and integrated. OBJECTIVES To systematically identify, appraise and synthesise the available empirical evidence about mental health nurses, medical emergencies, and the severely physiologically deteriorating patient. DESIGN A systematic review in accordance with relevant points of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES Multiple electronic databases (CINAHL; PubMed; MedLine; Scopus, ProQuest Dissertations and Theses) were searched using comprehensive terms. REVIEW METHODS Inclusion criteria: English language papers describing empirical studies (any design) about i) the effectiveness of interventions to improve any outcome related to mental health nurses' delivery of emergency medical care or care for the severely deteriorating patient; or ii) mental health nurses' emergency medical care-related knowledge, skills, experience, attitudes, or training needs. Further information was sought from study authors. Included studies were independently assessed for quality. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative synthesis of study findings was conducted. RESULTS A total of 22 studies, all but one published since 2011, met inclusion criteria. Ten were intervention studies and twelve were cross-sectional observational or qualitative studies. Intervention studies were all of weak quality overall and utilised pre- post designs mostly with limited post intervention follow-up time. Observational and qualitative studies were generally of good quality but only parts of the evidence from these studies were relevant to emergency physical care since most focused on mental health nurses and their routine physical healthcare practice. CONCLUSIONS There are currently no validated instruments to investigate mental health nurses' emergency medical care-related attitudes. More rigorous controlled trials of interventions are needed to better establish an evidence-base for educational interventions to improve this groups' emergency care-related practice.
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Affiliation(s)
- Geoffrey L Dickens
- Centre for Applied Nursing Research (CANR), Ingham Institute for Applied Medical Research, Western Sydney University and South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.
| | - Lucie Ramjan
- Centre for Applied Nursing Research (CANR), Ingham Institute for Applied Medical Research, Western Sydney University and South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia; School of Nursing and Midwifery, Western Sydney University, Building EB/LG Room 35, Parramatta South Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Gihane Endrawes
- School of Nursing and Midwifery, Western Sydney University, Building EB/LG Room 35, Parramatta South Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Emily May Barlow
- Division of Mental Health Nursing and Counselling, School of Social and Health Sciences, Abertay University, Bell Street, Dundee, DD1 1HG, United Kingdom.
| | - Bronwyn Everett
- Centre for Applied Nursing Research (CANR), Ingham Institute for Applied Medical Research, Western Sydney University and South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia; School of Nursing and Midwifery, Western Sydney University, Building EB/LG Room 35, Parramatta South Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
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5
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Dickens GL, Ion R, Waters C, Atlantis E, Everett B. Mental health nurses' attitudes, experience, and knowledge regarding routine physical healthcare: systematic, integrative review of studies involving 7,549 nurses working in mental health settings. BMC Nurs 2019; 18:16. [PMID: 31057334 PMCID: PMC6485121 DOI: 10.1186/s12912-019-0339-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 04/01/2019] [Indexed: 12/04/2022] Open
Abstract
Background There has been a recent growth in research addressing mental health nurses’ routine physical healthcare knowledge and attitudes. We aimed to systematically review the empirical evidence about i) mental health nurses’ knowledge, attitudes, and experiences of physical healthcare for mental health patients, and ii) the effectiveness of any interventions to improve these aspects of their work. Methods Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Multiple electronic databases were searched using comprehensive terms. Inclusion criteria: English language papers recounting empirical studies about: i) mental health nurses’ routine physical healthcare-related knowledge, skills, experience, attitudes, or training needs; and ii) the effectiveness of interventions to improve any outcome related to mental health nurses’ delivery of routine physical health care for mental health patients. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative, narrative synthesis of study findings was conducted. Results Fifty-one papers covering studies from 41 unique samples including 7549 mental health nurses in 14 countries met inclusion criteria. Forty-two (82.4%) papers were published since 2010. Eleven were intervention studies; 40 were cross-sectional. Observational and qualitative studies were generally of good quality and establish a baseline picture of the issue. Intervention studies were prone to bias due to lack of randomisation and control groups but produced some large effect sizes for targeted education innovations. Comparisons of international data from studies using the Physical Health Attitudes Scale for Mental Health Nursing revealed differences across the world which may have implications for different models of student nurse preparation. Conclusions Mental health nurses’ ability and increasing enthusiasm for routine physical healthcare has been highlighted in recent years. Contemporary literature provides a base for future research which must now concentrate on determining the effectiveness of nurse preparation for providing physical health care for people with mental disorder, determining the appropriate content for such preparation, and evaluating the effectiveness both in terms of nurse and patient- related outcomes. At the same time, developments are needed which are congruent with the needs and wants of patients. Electronic supplementary material The online version of this article (10.1186/s12912-019-0339-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Geoffrey L Dickens
- 1Professor Mental Health Nursing, Centre for Applied Nursing Research (CANR), Western Sydney University, Sydney, Australia.,2South West Sydney Local Health District, Sydney, Australia
| | - Robin Ion
- 3Division of Mental Health Nursing and Counselling, Abertay University, Dundee, Scotland
| | - Cheryl Waters
- 1Professor Mental Health Nursing, Centre for Applied Nursing Research (CANR), Western Sydney University, Sydney, Australia
| | - Evan Atlantis
- 1Professor Mental Health Nursing, Centre for Applied Nursing Research (CANR), Western Sydney University, Sydney, Australia
| | - Bronwyn Everett
- 1Professor Mental Health Nursing, Centre for Applied Nursing Research (CANR), Western Sydney University, Sydney, Australia
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6
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Wieser H, Mischo-Kelling M, Vittadello F, Cavada L, Lochner L, Fink V, Naletto C, Reeves S. Perceptions of collaborative relationships between seven different health care professions in Northern Italy. J Interprof Care 2018; 33:133-142. [PMID: 30346847 DOI: 10.1080/13561820.2018.1534810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This article presents quantitative findings from a mixed method study that aimed to explore the status quo of interprofessional collaboration (IPC) in a Health Trust, located in a trilingual region in Northern Italy. The survey targeted seven health professions (physicians, nurses, dieticians, occupational therapists, physiotherapists, speech therapists, and psychologists). The survey was distributed online to more than 5,000 health professionals and completed by 2,238. This paper presents results on the frequency of collaboration as well as data from a multiple-group measurement scale for assessing IPC. Descriptive statistics were calculated for continuous variables while categorical data were analysed as counts and percentages. Pearson's Chi-square test and Fisher's exact test were calculated while Mann Whitney and Kruskal Wallis tests were applied to analyse statistical differences in IPC between groups according to sociodemographic variables. In general, our survey data showed that participants, perceived IPC in a positive way, even if the analysis indicated heterogeneity in the level of collaboration expressed. We also found that not all professions had an opportunity to collaborate with others. In addition, we found evidence to suggest that the way health care is organised impacted on perceptions of collaboration between the health professionals in this study. This study provides an initial insight into the perceived levels of IPC within a North Italian context. As such, it offers an account of the strengths and weaknesses of IPC from seven different professional groups based in this region of Europe.
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Affiliation(s)
- Heike Wieser
- a Research Unit , College of Health-Care Professions - Claudiana , Bolzano/Bozen , Italy
| | - Maria Mischo-Kelling
- a Research Unit , College of Health-Care Professions - Claudiana , Bolzano/Bozen , Italy.,b Hochschule Ravensburg- Weingarten , Weingarten , Germany
| | | | - Luisa Cavada
- d Department of Nursing , College of Health-Care Professions - Claudiana , Bolzano/Bozen , Italy
| | - Lukas Lochner
- e Teaching Support Office , College of Health-Care Professions - Claudiana , Bolzano/Bozen , Italy
| | - Verena Fink
- f Department of Physiotherapy , Hospital of Bolzano , Bolzano/Bozen , Italy
| | - Carla Naletto
- g Department of Physiotherapy , College of Health-Care Professions - Claudiana , Bolzano/Bozen , Italy
| | - Scott Reeves
- h Centre for Health and Social Care Research , Kingston University and St George's University of London , London , UK
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7
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Fibbins H, Czosnek L, Stanton R, Davison K, Lederman O, Morell R, Ward P, Rosenbaum S. Self-reported physical activity levels of the 2017 Royal Australian and New Zealand College of Psychiatrists (RANZCP) conference delegates and their exercise referral practices. J Ment Health 2018; 29:565-572. [PMID: 30322334 DOI: 10.1080/09638237.2018.1521935] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Physical activity (PA) significantly improves physical health and clinical symptoms across mental disorders. Accredited Exercise Physiologists (AEPs) are trained to lead PA interventions for people with mental illness, but referrals to AEPs are low.Aims: To determine the knowledge and attitudes of delegates attending the 2017 Royal Australian and New Zealand College of Psychiatrists (RANZCP) conference toward physical health monitoring and exercise interventions for people with mental illness.Methods: A cross-sectional survey of RANZCP delegates investigated knowledge and attitudes toward PA for people with mental illness, self-reported PA, and their understanding of AEP's role within mental health settings. A subgroup of delegates underwent fitness assessments.Results: Seventy-three delegates completed surveys and 24 underwent fitness assessments. Delegates demonstrated good knowledge regarding associations between PA and cardiovascular disease risk. Delegates were less knowledgeable of AEP's role within mental health settings. Forty-six participants (63%) did not meet the Australian recommended guidelines for PA. No association between referrals to AEPs and self-reported PA or fitness measures were evident.Conclusions: Promoting PA participation for mental health professionals, coupled with education on the important role AEPs play in the multidisciplinary treatment of mental health consumers is vital to improve health outcomes for this vulnerable group.
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Affiliation(s)
- Hamish Fibbins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, UNSW Sydney, Australia
| | - Louise Czosnek
- Exercise and Sports Science Australia, Brisbane, Australia.,Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Robert Stanton
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Kade Davison
- School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Oscar Lederman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Medical Science, UNSW Sydney, Sydney, Australia
| | - Rachel Morell
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, UNSW Sydney, Australia
| | - Philip Ward
- School of Psychiatry, UNSW Sydney, Australia.,Schizophrenia Research Unit, Liverpool Hospital and Ingham Institute of Applied Medical Research, Sydney, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney, Australia.,The Black Dog Institute, Prince of Wales Hospital, Randwick, Australia
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Stanton R, Rosenbaum S, Lederman O, Happell B. Implementation in action: how Australian Exercise Physiologists approach exercise prescription for people with mental illness. J Ment Health 2017. [PMID: 28645230 DOI: 10.1080/09638237.2017.1340627] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Accredited Exercise Physiologists (AEPs) are trained to deliver exercise and physical activity interventions for people with chronic and complex health conditions including those with mental illness. However, their views on exercise for mental illness, their exercise prescription practices, and need for further training are unknown. AIMS To examine the way in which Australian AEPs prescribe exercise for people with mental illness. METHODS Eighty-one AEPs (33.3 ± 10.4 years) completed an online version of the Exercise in Mental Illness Questionnaire. Findings are reported using descriptive statistics. RESULTS AEPs report a high level of knowledge and confidence in prescribing exercise for people with mental illness. AEPs rate exercise to be at least of equal value to many established treatments for mental illness, and frequently prescribe exercise based on current best-practice principles. A need for additional training was identified. The response rate was low (2.4%) making generalisations from the findings difficult. CONCLUSIONS Exercise prescription practices utilised by AEPs are consistent with current best-practice guidelines and there is frequent consultation with consumers to individualise exercise based on their preferences and available resources. Further training is deemed important.
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Affiliation(s)
- Robert Stanton
- a School of Health , Medical and Applied Sciences, Central Queensland University , Rockhampton , Australia
| | - Simon Rosenbaum
- b School of Psychiatry , University of New South Wales , Sydney , Australia.,c The Black Dog Institute, University of New South Wales , Sydney , Australia
| | - Oscar Lederman
- d School of Medical Sciences , University of New South Wales , Sydney , Australia , and
| | - Brenda Happell
- e SYNERGY, Nursing and Midwifery Research Centre, University of Canberra, Faculty of Health, ACT Health , Woden , Australia
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Furness T, Hewavasam J, Barnfield J, McKenna B, Joseph C. Adding an accredited exercise physiologist role to a new model of care at a secure extended care mental health service: a qualitative study. J Ment Health 2017. [PMID: 28635440 DOI: 10.1080/09638237.2017.1294744] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Accredited exercise physiologists (AEPs) are emerging as essential members of allied health in the management of non-communicable chronic diseases. People diagnosed with severe mental illness (SMI) are at greater risk of cardiovascular diseases. Secure extended care units (SECUs) provide treatment, supervision and support for people with SMI whose needs cannot be met adequately in the community. However, the role of AEPs in SECUs has not been described. AIM Describe the processes and outcomes of adding an AEP to a new model of care at a SECU. METHODS An exploratory study with emphasis on qualitative data. Interviews with a purposive sample of SECU staff. RESULTS Participants articulated concern about poor physical health of which two themes emerged (1) the development of the AEP role; a calculated gamble and (2) the practical application of the role. CONCLUSIONS An AEP was identified as the role to best implement the organisations vision to improve physical health of people with SMI. Implementation and practical application of the role relied on an informed calculated gamble. Yet, once embedded in the service, the AEP role was able to capacity build among clinical staff, develop a treatment pathway, and implement consumer specific physical health interventions.
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Affiliation(s)
- Trentham Furness
- a School of Nursing, Midwifery and Paramedicine, Australian Catholic University , Fitzroy , Australia.,b NorthWestern Mental Health, Melbourne Health , Parkville , Australia
| | - Jude Hewavasam
- c Mental Health Program, Monash Health , Dandenong , Australia
| | - Jakqui Barnfield
- c Mental Health Program, Monash Health , Dandenong , Australia.,d School of Nursing, Faculty of Medicine, Nursing and Health Sciences, Monash University , Clayton , Australia
| | - Brian McKenna
- e School of Clinical Sciences, Auckland University of Technology , Auckland , New Zealand.,f Centre for Forensic Behavioural Science, Swinburne University of Technology , Melbourne , Vivtoria , and
| | - Corey Joseph
- g Clinical Research Centre for Movement Disorders & Gait, Kingston Centre, Monash Health , Cheltenham , Australia
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10
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Stanton R, Reaburn P, Happell B. Barriers to exercise prescription and participation in people with mental illness: the perspectives of nurses working in mental health. J Psychiatr Ment Health Nurs 2015; 22:440-8. [PMID: 25855247 DOI: 10.1111/jpm.12205] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 12/11/2022]
Abstract
ACCESSIBLE SUMMARY Exercise is valuable in the treatment of mental illness, yet personal and organizational barriers limit widespread implementation by nurses in mental health settings. Using a self-report questionnaire, we sought to identify how often nurses prescribe exercise and their level of agreement with previously identified barriers to exercise prescription and participation for mental health consumers. Nurses disagree that many of the previously identified barriers should impede exercise prescription for people with mental illness. Nurses agree that many of the barriers expressed by mental health consumers might prevent exercise participation. Our study provides valuable new insight into the role of nurses in the provision of exercise for people with mental illness; however, it is limited to a small sample. Confirmation of these findings in larger, geographically and professionally diverse groups is needed. ABSTRACT Evidence is mounting for the efficacy of exercise in the treatment of people with mental illness. Nurses working in mental health settings are well placed to provide exercise advice for people with mental illness. However, quantitative examinations of the barriers to exercise prescription experienced by nurses, or their views regarding the barriers to exercise participation experienced by people with mental illness, are lacking. In this study, 34 nurses completed the Exercise in Mental Illness Questionnaire-Health Professionals Version (EMIQ-HP). This survey examined the frequency of exercise prescription and the level of agreement with statements regarding barriers to exercise prescription for, and exercise participation by, people with mental illness. The level of agreement scores for statements for each section was summed, with a higher score indicating a higher level of agreement. Nurses disagree with many of the barriers to exercise prescription presented in the literature. The level of agreement scores did not differ between nurses who prescribe exercise 'Always', 'Most of the time', 'Occasionally' or 'Never'. We found a non-significant negative relationship between frequency of exercise prescription and summed level of agreement scores for barriers to exercise prescription. Consensus regarding barriers to exercise participation by mental health consumers is less clear. This study provides valuable new insight into the role of nurses in the provision of exercise for people with mental illness. Confirmation in larger samples is needed before translation of research to practice.
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Affiliation(s)
- R Stanton
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - P Reaburn
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - B Happell
- Research Centre for Nursing and Midwifery Practice, University of Canberra, Canberra, ACT, Australia.,Research Centre for Nursing and Midwifery Practice, ACT Health, Canberra, ACT, Australia
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Stanton R, Happell B, Reaburn P. Investigating the exercise-prescription practices of nurses working in inpatient mental health settings. Int J Ment Health Nurs 2015; 24:112-20. [PMID: 25639383 DOI: 10.1111/inm.12125] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Nurses working in mental health are well positioned to prescribe exercise to people with mental illness. However, little is known regarding their exercise-prescription practices. We examined the self-reported physical activity and exercise-prescription practices of nurses working in inpatient mental health facilities. Thirty-four nurses completed the Exercise in Mental Illness Questionnaire - Health Practitioner Version. Non-parametric bivariate statistics revealed no relationship between nurses' self-reported physical activity participation and the frequency of exercise prescription for people with mental illness. Exercise-prescription parameters used by nurses are consistent with those recommended for both the general population and for people with mental illness. A substantial number of barriers to effective exercise prescription, including lack of training, systemic issues (such as prioritization and lack of time), and lack of consumer motivation, impact on the prescription of exercise for people with mental illness. Addressing the barriers to exercise prescription could improve the proportion of nurses who routinely prescribe exercise. Collaboration with exercise professionals, such as accredited exercise physiologists or physiotherapists, might improve knowledge of evidence-based exercise-prescription practices for people with mental illness, thereby improving both physical and mental health outcomes for this vulnerable population.
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Affiliation(s)
- Robert Stanton
- Central Queensland University, Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, Rockhampton, Queensland, Australia
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Happell B, Platania-Phung C, Stanton R, Millar F. Exploring the views of nurses on the cardiometabolic health nurse in mental health services in australia. Issues Ment Health Nurs 2015; 36:135-44. [PMID: 25397354 DOI: 10.3109/01612840.2014.901449] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
People with serious mental illness experience premature death due to higher rates of cardiometabolic conditions (e.g. cardiovascular disease, diabetes) than the general population. Mental health services often do not provide sufficient cardiometabolic clinical care to address these risks. The cardiometabolic health nurse (CHN) role has been suggested as a strategy for ensuring integrated care is provided and sustained. The views of nurses in mental health would be essential in informing the viability and development for this initiative. This paper presents the findings of open-ended comments from a cross-sectional online survey of nurses working in mental health in Australia (n = 643) eliciting views about the possible introduction of the cardiometabolic nurse. Thematic analysis was undertaken, of 133 open comments on this topic. The findings suggest that nurses see the specialist role as suitable and valuable for mental health services. Some nurses voiced concern about specialisation leading to fragmentation (e.g. in responsibilities for physical health, division of mental and physical health care, and less emphasis on equipping all nurses with comprehensive care skills), especially for settings where generalist nursing was seen as already available. The findings suggest this role is viewed favourably by nurses, provided that it is consistent with holistic and comprehensive care. Empirical research is needed to see whether this role increases holism (as valued by consumers and nurses) and cardiometabolic outcomes.
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Affiliation(s)
- Brenda Happell
- Central Queensland University, Institute for Health and Social Science Research and Centre for Mental Health Nursing Innovation , Rockhampton , Australia
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Stanton R, Rosenbaum S, Kalucy M, Reaburn P, Happell B. A call to action: exercise as treatment for patients with mental illness. Aust J Prim Health 2015; 21:120-5. [DOI: 10.1071/py14054] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 07/01/2014] [Indexed: 12/17/2022]
Abstract
Mental illness affects the lives of a significant number of Australians. In addition to pharmacological and psychological interventions, exercise has demonstrated benefits for people with mental illness including symptom reduction, improved cardiovascular risk profile and improved physical capacity. Unfortunately, evidence shows that clinician-delivered exercise advice is not routinely offered. This is despite patient acceptability for exercise. This article summarises the recent evidence supporting the prescription of exercise for people with mental illness and offers a model incorporating basic exercise prescription, and referral pathways for specialised advice. Current exercise prescription patterns for people with mental illness may not meet patient expectations; therefore, clinicians should consider exercise referral schemes to increase the accessibility of interventions for people with a mental illness.
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Martins AC, Oliveira FRA, Delfino BM, Pereira TM, de Moraes FHP, Barbosa GV, de Macedo LF, Domingos TDS, Da Silva DP, Menezes CCR, Oliveira Filho ES, Pereira TADS, Piccirilli ES, Pinto WDJ. How we enhanced medical academics skills and reduced social inequities using an academic teaching program. MEDICAL TEACHER 2014; 37:1003-1007. [PMID: 25301145 DOI: 10.3109/0142159x.2014.970618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The training of future physicians should be concurrent with the development of different skills and attitudes. This warrants the need to regularly provide students with opportunities for self-development throughout their academic career. This approach was exemplified in a medical school in the Brazilian Amazon, where students were allowed to play the role of high school teachers. As part of this exercise, they conducted reinforcement classes for high school students to increase the number of university admissions. The medical students were solely responsible for organizing and implementing this project, giving them the opportunity to develop teaching and leadership skills, enhance their understanding of communication and administration and contribute toward the society.
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