Clients with schizophrenia and their caregivers' perceptions of frequent psychiatric rehospitalizations

Hope and interpersonal psychiatric/mental health nursing: a systematic review of the literature--part one

Psychiatric/mental health (P/MH) nursing is inherently an interpersonal endeavour; one that includes a broad range of 'helping activities'. The interpersonal activities and skills are enshrined in our underpinning philosophy, explored and learned in our curricula (all around the world) and enacted in our everyday clinical practice. Within this interpersonal context and framework, it is heartening to see that understated, abstract and yet-lasting concepts such as hope are gaining more acknowledgement, recognition and subsequently attention. While it is recognized that hope in mental health care is increasingly becoming the focal point of disciplined inquiry, the authors believe it is perhaps necessary and timely to re-examine these two concepts, namely: interpersonal P/MH nursing and hope/inspiring hope in people with mental health problems. Accordingly, this two-part article reports on a systematic review of the literature that focuses on hope (inspiring hope) within interpersonal (counselling) focused P/MH nursing. Part one focuses on the method used and the results, indicating that a total of 57 articles were included in the review: 39 were categorized as empirical studies involving either a quantitative or qualitative methodological design, and 18 were considered theoretical/clinical/review articles. Though not a product of an empirical investigation per se, it was clear that many of the articles shared and covered common ground. Thus, these were arranged into six 'loose' thematic groupings. The first three of these areas, schizophrenia, suicidality and depression form the remainder of part one of this article, and the remaining areas are included in part two.

'Give me a break'? respite care for older carers of mentally ill persons

BACKGROUND

The concept of respite care has been widely accepted and used throughout most developed countries, although primarily in connection with frail elderly, people with dementia, people with developmental disability or children. This paper aims at exploring older family carers' needs for, access to and use of respite services when caring for people with a mental illness (excluding dementia) in the community.

METHOD

Data were collected through: semi-structured interviews with 26 mental health professionals, 21 family carers aged over 55 years and 25 respite service providers; demographic questionnaires; field notes; and local area, state and national documents relating to respite care services. Demographic data were analysed using descriptive statistics. All 72 interviews, field notes and other documents were analysed using content analysis.

RESULTS

Current respite services are not adequate to meet the needs of mentally ill patients and older carers. The unique aspects of respite care for older carers of persons with mental illness are poorly understood.

CONCLUSION

Bringing these issues to light creates the potential to address the unmet needs of older carers, improve provision of respite services, enhance quality of life of those who can benefit from respite services, and assist mental health professionals to work better with carers.

Hope and schizophrenia: an integrative review

The purpose of this article is to describe the current status of research on hope and schizophrenia. The CINAHL database was used to identify the articles that met the criteria. The searches were conducted using the terms 'hope', 'hope instillation (IOWA NIC)', 'hope (IOWA NOC)', 'schizophrenia' and their combinations. The findings were limited to research articles. In addition, Pub Medical database was used by searching the words 'hope' and 'schizophrenia' from the fields 'title' or 'abstract'. Four new articles were found. The data consist of 17 articles on hope and schizophrenia published in peer-reviewed journals, which were analysed using content analysis. Existing research has focused on people with schizophrenia (n = 8), significant others (n = 4), staff (n = 2), hope-engendering interventions (n = 2) and treatment evaluation related to hope (n = 2) in the care of people with schizophrenia. Different data collection methods have been used in these studies. The most common method was interview (n = 9), followed by questionnaires (n = 8) and observation (n = 1). Most studies used quantitative methods (n = 9). Hope is considered a positive factor in the life of a person living with schizophrenia, in significant others as well as in staff members. Existing research provides evidence of the following themes: factors associated with hope and factors contributing to hope in people with schizophrenia; hope from the perspective of significant others of people with schizophrenia; staff hopefulness and factors contributing to their hope, hope-engendering interventions and treatment evaluation in regard to hope. Based on this review, research evidence of hope in the context of schizophrenia is quite scant and limited, even though the importance of hope in schizophrenia has been underlined in research reports and the literature. It is clear that hope is important to people with schizophrenia, their significant others and the healthcare personnel caring for them. It is therefore also important to study hope among these people.

Respite care for caregivers and people with severe mental illness: literature review

AIM

The aim of this study was to review research literature over the past 10 years on respite care for people affected by severe mental illness; and identify key implications for nursing practice in provision of respite care for family caregivers of people with severe mental illness.

BACKGROUND

Family caregivers play an important role in health care, but need regular breaks to maintain their own health and well-being. Respite care is one of the few services available with a primary focus on supporting family caregivers. In most developed countries the notion of respite care as an extension of the health care service has been embraced, evidenced by a growing body of literature in health and health-related disciplines.

METHODS

An initial literature search was undertaken using the key words "respite", "short-term care", "shared care" and "day care" in major electronic databases for nursing, psychiatry, psychology and sociology literature between 1967 and 2002, identifying 704 articles. Closer examination of the literature from 1993 to 2002 on gaps and trends in respite care for people affected by severe mental illness was conducted. This is discussed in the context of the broader literature, particularly on dementia, where the mainstream research on respite care is found.

RESULTS

The majority of family caregiving studies identified a need for greater quality, quantity, variety and flexibility in respite provision, and the literature has remained largely silent in relation to those affected by severe mental illness. There are contradictory findings on outcomes of respite care services and a lack of controlled empirical studies and evaluative research on effectiveness.

CONCLUSIONS

Respite care is beneficial for caregivers, there is significant unmet need in provision of services for the mentally ill, and greater flexibility and the needs of caregivers should be recognised and addressed.

The practice of early recognition and early intervention to prevent psychotic relapse in patients with schizophrenia: an exploratory study. Part 1

In this article we describe the findings of an exploratory study into the application of early recognition and early intervention methods aimed at prevention of psychotic relapses in patients with schizophrenia. We addressed several models of symptom recognition plans and indicated how patients, healthcare professionals and other persons involved may be able to list and evaluate early warning signs systematically. We also paid attention to the role of the patient's family and to the potential effects of using early recognition and early intervention methods. In a follow-up article (part 2), we will focus more specifically on factors which favourably or adversely affect the use of early recognition and early intervention methods. The results of this exploratory study will be used to design an intervention protocol for nursing staff to serve as a tool for preparing symptoms recognition plans with the individual patient and his/her social network.