Maximising psychiatric nurses' contribution to interdisciplinary working

Recovery-oriented nursing care based on cultural sensitivity in community psychiatric nursing

Transforming to recovery-oriented care is an urgent issue in community psychiatric nursing in Japan. Because traditional psychiatry is still influential, nurses are required to possess cultural sensitivity to objectively view conflicts between values when providing recovery-oriented care. If recovery-oriented care based on cultural sensitivity is clarified, it would help nurses providing recovery-oriented care in non-recovery-oriented environments. Therefore, this study aimed to clarify recovery-oriented nursing care based on cultural sensitivity in community psychiatric nursing in Japan. A semi-structured interview with 21 community psychiatric nurses and participant observations for seven of them were performed. A qualitative description was undertaken to analyse the data. The relationships between categories were examined. The study conforms to the COREQ checklist. Through the analysis, six categories were revealed: 1. Continuously reflecting on one's own practice and the influence of the traditional mental health culture; 2. Constructing a partnership with clients to uphold their rights and responsibilities; 3. Having client-centred dialogue to help them enjoy life and grow; 4. Supporting clients' lives and strengthening their self-management; 5. Working as a team to achieve clients' wishes, which includes some risks, and 6. Maintaining a relationship between clients and the people who care for them. Category 1 was central and enclosed by categories 2, 3 and 4. Categories 5 and 6 were located outside of categories 1 to 4. The results showed cultural sensitivity enables recovery-oriented care even in non-recovery-oriented environments and include recognizing the traditional mental health culture, understanding clients' experiences and accepting other's values.

Diagnostic Masking and Overshadowing in Intellectual Disability-How Structured Evaluation Helps

PROBLEM

Comorbid psychiatric diagnoses tend to be underdiagnosed in patients with intellectual disability. Diagnosing anxiety disorders in such patients can pose challenges, in particular with regard to obsessive and compulsive disorder (OCD).

METHODS

We present the case of an adolescent diagnosed with intellectual disability with poor expressive language skills who presented with nonspecific mood and behavioral symptoms, not improving with routine clinical evaluations and treatment. A structured assessment was done to decipher the psychopathology.

FINDINGS

The structured evaluation was able to diagnose OCD, and the treatment response was accentuated, bringing about a significant reduction in patient and caregiver distress. Psychosocial interventions through nurses played a significant role.

CONCLUSIONS

The case highlights the need for a systematic assessment of patients with intellectual disability to arrive at reliable diagnoses and to plan appropriate treatment strategies.

Mental health nursing in Australia: resilience as a means of sustaining the specialty

As a concept, resilience is continuing to attract considerable attention and its importance across various life domains is increasingly recognised. Few studies, however, have defined or considered the notion of the group or collective resilience of a profession, including the capacity of that profession to withstand adversity and continue to develop positively in the face of change. This article considers the notion of resilience from the perspective of the specialty of mental health nursing, including the ways the specialty has adapted--and continues to develop--to changes experienced since deinstitutionalisation. Insights are drawn from a national Delphi study undertaken in Australia to develop a Scope of Practice for Mental Health Nurses, with responses used as a springboard to consider the impact of the perceived loss of professional identity on the collective resilience of the profession. Recommendations for a way forward for the profession are considered, including the ways in which a collective professional resilience could be developed to sustain and strengthen the professional identity of mental health nursing in Australia and across the globe.