Mental Health Nursing in Greece: Nursing Diagnoses and Interventions in Major Depression

Exploration of Nursing Care for Individuals With Bipolar Disorder in a Manic Episode: A Qualitative Study

BACKGROUND

Bipolar disorder is a mental illness that is chronic and has frequent relapses.

OBJECTIVES

The purpose of the research was to study the nursing care of patients with bipolar disorder in the mania phase.

METHODS

A qualitative study was employed in this study. The sample consisted of 10 nurses working in psychiatric clinics and data were collected through semi-structured interviews. Thematic analysis was applied for analysing the data.

RESULTS

Of the 10 participants, 70% were female and 30% were male. The mean age was 48.7 years. All participants were registered nurses and most of them held a Master of Science degree. Their work experience ranged from 10 to 30 years. Three main themes emerged when analysing the data obtained from the interviews with the nurses, those themes were a) Echoes of Vigilance: Navigating the journey, b) Amidst the Tempest: Attending to the Patients' Complex Needs, and c) Restoring Balance: The Nurturing Hands of Bipolar Nursing Care, each of which could be divided into several sub-themes.

CONCLUSIONS

 Nursing care plays an important role in symptom improvement and disease control by providing patient support, managing pharmacotherapy, preventing suicidality, and educating patients about the disease and self-management strategies.

Abnormal expression of miR-135a in patients with depression and its possible involvement in the pathogenesis of the condition

At present, due to the increasing pressures on society and the stress of everyday living, the number of individuals suffering from depression has increased. Therefore, the treatment of depression has also received increasing attention. MicroRNA (miRNA/miR)-135a is a well-studied miRNA. It has been reported that miR-135a is significantly downregulated in patients with depression and may be a potential marker for the diagnosis of the condition. However, the specific mechanisms of action of miR-135a in patients with depression remain unclear. In the present study, it was found that miR-135a was downregulated in patients with depression, and in a mouse model of depression. The effects of miR-135a on depression-related symptoms in mice were then explored. In the mice with chronic unpredictable mild stress (CUMS) that were treated with miR-135a for 3 weeks, a significantly reduced level of weight gain was observed in comparison with the control group. In addition, treatment with miR-135a mimic significantly increased sucrose preference in the sucrose preference test in the mice, and reduced the immobility time in the forced swimming test and tail suspension test. Treatment with miR-135a mimic also inhibited CUMS-induced hippocampal cell apoptosis. Furthermore, treatment with miR-135a mimic and fluoxetine significantly reduced the CUMS-induced increase in the expression levels of inflammatory factors (IL-1β, IL-6 and TNF-α) in the hippocampus of the mice. Subsequently, reverse transcription-quantitative polymerase chain reaction and western blot analysis revealed that treatment with miR-135a mimic significantly inhibited the expression of Toll-like receptor 4 in the mouse hippocampus. In conclusion, the findings of the present study indicate that miR-135a may be a novel potential target for the treatment of depression.

Conceptual development and validation of the nursing diagnosis "Disturbed thought process"

PURPOSE

To validate the content of the nursing diagnosis proposal Disturbed thought process.

METHODS

With an exploratory and descriptive design, the content validation for each component of the diagnosis proposal was pursued, based on a previous broad conceptual work, through consulting experts, applying Fehring's Diagnosis Content Validation Model. The modified Delphi technique was used by sending out three rounds of questionnaires electronically to seek consensus among the experts.

FINDINGS

The nursing diagnosis version validated in this study includes the diagnosis label Disturbed thought process, the corresponding definition, 15 defining characteristics, and 13 related factors. The resulting diagnosis total Diagnosis Content Validation score was 0.99, implying its content validation.

CONCLUSIONS

The validated diagnosis proposal describes a human response for which nursing professionals can autonomously assess and prescribe interventions leading to improvement of this health problem and/or alleviate its consequences, preserving the patient's autonomy and helping them to address their situation. It will be included in the next edition of the nursing diagnosis classification NANDA-I 2021-2023.

IMPLICATIONS FOR NURSING PRACTICE

The results of this study will help nursing professionals reduce the potential impact among patients who suffer from an alteration in cognitive functioning in its executive function dimension, as the validated diagnosis proposal will make it possible to identify and report this problem precisely.

Application of anthropometric methods in the nursing process of nursing research

OBJECTIVES

to identify anthropometric techniques and measurements related to nursing diagnoses and interventions, included in the NANDA International (NANDA-I) and Nursing Interventions Classification (NIC), respectively.

METHODS

descriptive study of the revision of the NANDA-I and NIC taxonomies by professors of Nursing of the Universidad Complutense de Madrid.

RESULTS

A total of 24 nursing diagnoses, 20 nursing interventions and 71 nursing activities were identified that require the use of anthropometric measurements.

CONCLUSIONS

anthropometric measurements are necessary in the conduct of numerous nursing diagnoses and nursing interventions that are commonly used in healthcare practice. It would be useful to systematize the use of anthropometric techniques in the application of the nursing process and to standardize this training process.

Burnout Evaluation and Potential Predictors in a Greek Cohort of Mental Health Nurses

BACKGROUND

Job burnout is one of the most serious occupational health hazards, especially, among mental health nurses. It has been attributed among others to staff shortages, health service changes, poor morale and insufficient employee participation in decision-making.

AIM

The aim of this study was to measure burnout among mental health nurses, investigate relations between burnout and organizational factors and examine potential predictors of nurses' burnout. Specifically, this study aimed to investigate whether role conflict, role ambiguity, organizational commitment and subsequent job satisfaction could predict each of the three dimensions of burnout.

DESIGN/METHODOLOGY/APPROACH

During current cross sectional, the survey was administered to 232 mental health nurses, employed in four private psychiatric clinics in the region of Larissa, Thessaly, Greece in May 2015. Our findings were based on the responses to 78 usable questionnaires. Different statistical analyses, such as correlation analyses, regression analyses and analyses of variance were performed in order to explore possible relations.

FINDINGS

High emotional exhaustion (EE) accounted for 53.8% of the sample, while high depersonalization (DP) and high personal accomplishment (PA) accounted for 24.4% and 25.6%, respectively. The best predictors of burnout were found to be role conflict, satisfaction with workload, satisfaction with training, role ambiguity, satisfaction with pay and presence of serious family issues.

PRACTICAL IMPLICATIONS

These findings have implications for organizational and individual interventions, indicating that mental health nurses' burnout could be reduced, or even prevented by team building strategies, training, application of operation management, clear instructions and psychological support.

Association of 5-HTTLPR Polymorphism with the Nursing Diagnoses and the Achievement of Nursing Outcomes in Patients with Major Depression

The aim of this study is to investigate whether a 44-base-pair insertion/deletion polymorphism in the upstream regulatory region of the serotonin transporter gene (5-HTTLPR) is associated with the nursing diagnoses and the achievement of the desired nursing outcomes in inpatients with major depression. Thirty five patients were evaluated. The nursing diagnoses of risk for suicide and imbalanced nutrition are reported less often in homozygotes of the high-expressing gene (L_A). Carriers of the low-expressing genes (L_G or S) have a worse response to interventions which aim to increase low self-esteem, indicating that they may need more intensive care in order to achieve the desired outcome. Genetics in psychiatric nursing could help refine personalized care, however further studies with large sample sizes and multiple gene evaluations are needed.