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Juliá-Sanchis R, Sastre-Rus M, Puig-Llobet M, Tomás-Sábado J, Roldán-Merino JF, Lluch-Canut MT. Reducing mental health stigma among nursing students through an educational intervention. Contemp Nurse 2024:1-13. [PMID: 38885065 DOI: 10.1080/10376178.2024.2363906] [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: 08/03/2021] [Accepted: 05/30/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Patient-centred care must consider service consumers' needs and improve their health and well-being as well as their satisfaction and the quality of their healthcare assistance. However, individuals experiencing mental illness often struggle with barriers and misunderstandings by health care professionals. Nursing Faculties are uniquely positioned to reduce stigmatising attitudes via new educational interventions that could align nursing curricula and individuals with mental illness needs. However, there are few studies about the stigma toward mental illness among nursing students in Spain. OBJECTIVES The present study aimed to analyse the effect of a 9-month educational intervention on the level of stigma in nursing students. DESIGN a one-group pre-postintervention design with no control group was conducted. METHODS A total of 194 nursing students completed the EVEPEM scale before and after the intervention. The intervention comprised 55 hours of campus sessions and 150 h practicum in mental health settings. RESULTS A destigmatising tendency was captured by a large main effect and a statistically significant stigma reduction. CONCLUSIONS The educational 9-month intervention was effective in reducing students' stigma by providing theoretical education, personal contact with mental health service consumers, and critical reflection activities.
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Affiliation(s)
- Rocío Juliá-Sanchis
- Department of Nursing, Faculty of Health Sciences, Institute for Health and Biomedical Research (ISABIAL), University of Alicante, San Vicente del Raspeig, Spain
| | - Meritxell Sastre-Rus
- School of Nursing Gimbernat, University Autònoma de Barcelona, Av. De la Generalitat, Barcelona 202-206 08174, Spain
| | - Montserrat Puig-Llobet
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Joaquín Tomás-Sábado
- School of Nursing Gimbernat, University Autònoma de Barcelona, Av. De la Generalitat, Barcelona 202-206 08174, Spain
| | - Juan Francisco Roldán-Merino
- Department of Public Health, Mental Health and Maternal-Child Nursing, Sant Joan de Deu School of Nursing, University of Barcelona, Barcelona, Spain
| | - M Teresa Lluch-Canut
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Spain
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Ayre MJ, Lewis PJ, Phipps DL, Keers RN. unDerstandIng the cauSes of mediCation errOrs and adVerse drug evEnts for patients with mental illness in community caRe (DISCOVER): a qualitative study. Front Psychiatry 2023; 14:1241445. [PMID: 38144479 PMCID: PMC10746165 DOI: 10.3389/fpsyt.2023.1241445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Background It is estimated that 237 million medication errors occur in England each year with a significant number occurring in the community. Our understanding of the causes of preventable medication errors and adverse drug events (ADE) affecting patients with mental illness is limited in this setting. Better understanding of the factors that contribute to errors can support the development of theory-driven improvement interventions. Methods Remote qualitative semi-structured interviews with 26 community-based healthcare professionals in England and Wales were undertaken between June-November 2022. Recruitment was undertaken using purposive sampling via professional networks. Interviews were guided by the critical incident technique and analysed using the framework method. Any data that involved speculation was not included in the analysis. Independent analysis was carried out by the research team to extract themes guided by the London Protocol. Results A total of 43 medication errors and 12 preventable ADEs were discussed, with two ADEs having an unknown error origin. Prescribing errors were discussed most commonly (n = 24), followed by monitoring errors (n = 8). Six contributory factor themes were identified: the individual (staff); the work environment; the teams/interfaces; the organisation and management; the patient; and the task and technology. The individual (staff) factors were involved in just over 80% of all errors discussed. Participants reported a lack of knowledge regarding psychotropic medication and mental illnesses which accompanied diffusion of responsibility. There were difficulties with team communication, particularly across care interfaces, such as ambiguity/brevity of information being communicated and uncertainty concerning roles which created confusion amongst staff. Unique patient social/behavioural contributory factors were identified such as presenting with challenging behaviour and complex lifestyles, which caused difficulties attending appointments as well as affecting overall clinical management. Conclusion These findings highlight that the causes of errors are multifactorial with some unique to this patient group. Key areas to target for improvement include the education/training of healthcare professionals regarding neuropharmacology/mental illnesses and enhancing communication across care interfaces. Future research should explore patient perspectives regarding this topic to help develop a holistic picture. These findings can be used to guide future intervention research to ameliorate medication safety challenges for this patient group.
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Affiliation(s)
- Matthew J. Ayre
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Penny J. Lewis
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Denham L. Phipps
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, United Kingdom
| | - Richard N. Keers
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, United Kingdom
- Optimising Outcomes with Medicines (OptiMed) Research Unit, Pennine Care NHS Foundation Trust, Manchester, United Kingdom
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Bhugra D, Smith A, Ventriglio A, Hermans MHM, Ng R, Javed A, Chumakov E, Kar A, Ruiz R, Oquendo M, Chisolm MS, Werneke U, Suryadevara U, Jibson M, Hobbs J, Castaldelli-Maia J, Nair M, Seshadri S, Subramanyam A, Patil N, Chandra P, Liebrenz M. World Psychiatric Association-Asian Journal of Psychiatry Commission on Psychiatric Education in the 21st century. Asian J Psychiatr 2023; 88:103739. [PMID: 37619422 DOI: 10.1016/j.ajp.2023.103739] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023]
Abstract
Psychiatric practice faces many challenges in the first quarter of 21st century. Society has transformed, as have training requirements and patient expectations, underlining an urgent need to look at educational programmes. Meanwhile, awareness has grown around psychiatric disorders and there are evolving workforce trends, with more women going to medical school and specialising in psychiatry. Trainee psychiatrists carry different expectations for work-life balance and are increasingly becoming conscious of their own mental health. A tendency to see health as a commodity and the litigious nature of society has elicited additional pressures for healthcare professionals. Cartesian mind-body dualism has created further complexity and this can often be frustrating for patients and care-partners alike. In many cultures across Asia and beyond, patients can present with physical symptoms to express underlying psychological distress with increasing physical investigations. Simultaneously, in various countries, a shift from asylums to community-based interventions and then home treatments have changed psychiatric care in remarkable ways. These changes have added to pressures faced by mental healthcare professionals. However, trainees and other mental healthcare professionals continue to receive similar training as they did a generation ago. The tensions and differences in ideology/orientation between different branches of psychiatry have made responses to patient needs challenging. Recognising that it is difficult to predict the future, this World Psychiatric Association-Asian Journal of Psychiatry Commission makes recommendations that could help institutions and individuals enhance psychiatric education. This Commission draws from existing resources and recent developments to propose a training framework for future psychiatrists.
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Affiliation(s)
- Dinesh Bhugra
- Institute of Psychiatry, Psychology and Neurosciences, Kings College, London SE5 8AF, UK.
| | - Alexander Smith
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| | | | | | - Roger Ng
- Secretary for Education, WPA, Geneva, Switzerland
| | - Afzal Javed
- World Psychiatric Association, Geneva. Switzerland. Fountain House, Lahore. Pakistan
| | - Egor Chumakov
- Department of Psychiatry & Addiction, St Petersburg State University, St Petersburg, Russia
| | - Anindya Kar
- Advanced Neuropsychiatry Institute, Kolkata, India
| | - Roxanna Ruiz
- University of Francisco Moaroquin, Guatemala City, Guatemala
| | - Maria Oquendo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States
| | | | - Ursula Werneke
- Department of Clinical Sciences, Psychiatry, Umeå University, Sunderby Research Unit, Umeå, Sweden
| | - Uma Suryadevara
- Geriatric Division, Department of Psychiatry, University of Florida, Gainesville, United States
| | - Michael Jibson
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Jacqueline Hobbs
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, United States
| | | | - Muralidharan Nair
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala 695011, India
| | - Shekhar Seshadri
- Department of Child Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka 560029, India
| | - Alka Subramanyam
- Department of Psychiatry, Topiwala Nair Medical College, Mumbai, Maharashtra 400008, India
| | - Nanasaheb Patil
- Department of Psychiatry, J.N. Medical College, Belgavi, Karnataka 590010, India
| | - Prabha Chandra
- Behavioral Sciences, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
| | - Michael Liebrenz
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
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Komasawa N, Yokohira M. Simulation-Based Education in the Artificial Intelligence Era. Cureus 2023; 15:e40940. [PMID: 37496549 PMCID: PMC10368461 DOI: 10.7759/cureus.40940] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/28/2023] Open
Abstract
Simulation-based medical education (SBME) has been widely implemented in skill training in various clinical specialties. SBME has contributed not only to patient and medical safety but also to undergraduate and specialist education in the healthcare field. In this review, we discuss the challenges and future directions of SBME in the artificial intelligence (AI) era. While SBME fidelity or methods may become highly complicated in the AI era, the fact is that learners play a central role. As SBME and clinical education are complementary, mutual feedback and improvement are essential, especially in non-technical skill development. For the development of sustainable SBME in the clinical field in the AI era, continuous improvement is needed by academia, educators, and learners.
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Affiliation(s)
- Nobuyasu Komasawa
- Community Medicine Education Promotion Office, Faculty of Medicine, Kagawa University, Miki-cho, JPN
| | - Masanao Yokohira
- Department of Medical Education, Faculty of Medicine, Kagawa University, Miki-cho, JPN
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