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Happell B, Furness T, Jacob A, Stimson A, Curtis J, Watkins A, Platania-Phung C, Scholz B, Stanton R. Nurse-Led Physical Health Interventions for People with Mental Illness: A Scoping Review of International Literature. Issues Ment Health Nurs 2023:1-16. [PMID: 37294933 DOI: 10.1080/01612840.2023.2212772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
People with mental illness have a higher prevalence of co-occurring physical health conditions and poor health behaviors, leading a mortality gap of up to 16 years, compared with the general population. Nurses working in mental health settings play an important role in addressing factors influencing sub-optimal physical health. Therefore, this scoping review aimed to identify nurse-led physical health interventions and align interventions to eight recognized physical healthcare priority areas (i.e. Equally Well in Victoria Framework). A systematic search strategy was used to identify relevant literature. Data extraction included alignment to the Equally Well priority areas, research design, and indication of co-design (meaningful and collaborative involvement of consumers and significant others) and recovery-oriented practice (focusing on needs and goals of a consumer's recovery journey). All included papers (n = 74) were aligned to at least one of eight Equally Well priority areas. Papers were predominately quantitative (n = 64, 86%), with the remainder mixed methods (n = 9, 9%) or qualitative (n = 4, 5%). Most papers were aligned to improving metabolic health and support to quit smoking. One study focused on nurse-led intervention designed to reduce falls. Recovery-oriented practice was evident in six papers. No paper described evidence of co-design. A research gap was identified for nurse-led intervention to reduce falls and improve dental/oral care. Relative to mental healthcare policy, there is a need for future nurse-led physical health research to be co-designed and include recovery-oriented practice. Evaluation and description of future nurse-led physical interventions should seek to report perspectives of key stakeholders as these remain relatively unknown.
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Affiliation(s)
- Brenda Happell
- Mental Health and Psychosocial Well-being Theme, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Alycia Jacob
- School of Nursing and Midwifery, Australian Catholic University, Fitzroy, Australia
| | - Alisa Stimson
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Rockhampton, Queensland, Australia
| | - Jackie Curtis
- Mindgardens Neuroscience Network, South East Sydney Local Health District, University of New South Wales - Cliffbrook Campus, Coogee, Australia
| | - Andrew Watkins
- Mindgardens Neuroscience Network, South East Sydney Local Health District, University of New South Wales - Cliffbrook Campus, Coogee, Australia
| | | | - Brett Scholz
- Medical School, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Robert Stanton
- Cluster for Resilience and Wellbeing, Appleton Institute, Rockhampton, South Australia, Australia
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Queensland, Australia
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2
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Jacob A, Stimson A, Furness T, Stanton R, Happell B. Knowing who is leading: Defining nurse-led projects. J Clin Nurs 2023; 32:e1-e2. [PMID: 36303328 DOI: 10.1111/jocn.16550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/20/2022] [Indexed: 01/18/2023]
Affiliation(s)
- Alycia Jacob
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Vic., Australia
| | - Alisa Stimson
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia.,School of Nursing, Midwifery and Social Sciences, CQUniversity, Rockhampton, Qld, Australia
| | - Trentham Furness
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia.,Forensicare, Melbourne, Vic., Australia
| | - Robert Stanton
- Cluster for Resilience and Wellbeing, Appleton Institute, Adelaide, SA, Australia.,School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Qld, Australia
| | - Brenda Happell
- Faculty of Health, Southern Cross University, Gold Coast, Qld, Australia.,School of Nursing and Midwifery, University College Cork, Cork, Ireland
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3
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Bernardo-Filho M, Bemben MG, Taiar R, Sañudo B, Furness T, Clark BC. Editorial: Interventional strategies for enhancing quality of life and health span in older adults, volume II. Front Aging Neurosci 2022; 14:1073762. [DOI: 10.3389/fnagi.2022.1073762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/08/2022] [Indexed: 11/23/2022] Open
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4
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Foster K, Roche M, Giandinoto JA, Platania-Phung C, Furness T. Mental health matters: A cross-sectional study of mental health nurses' health-related quality of life and work-related stressors. Int J Ment Health Nurs 2021; 30:624-634. [PMID: 33280229 DOI: 10.1111/inm.12823] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022]
Abstract
Mental health nursing is widely recognized as a stressful occupation; however, little is known about the relationship between work-related stress and health-related quality of life of mental health nurses (MHN). This study aimed to identify MHN health-related quality of life (HR-QoL) and work-related stressors; associations between stressors and HR-QoL; and predictors of HR-QoL. An online cross-sectional survey collected demographic data, work-related stressors and HR-QoL (SF-12v2) of n = 498 Australian MHN. Prominent consumer/carer-related stressors were verbal (90%) and physical aggression (85%). Collegial stressors included staff conflict (71%) and bullying (55%), and colleague-perpetrated verbal (34%) and physical aggression (7%). Key organizational stressors included high workloads (74%), lack of organizational support (60%) and lack of adequate resources to perform nursing role (58%). The mean physical health score was 52.62 (SD = 8.30), and mental health score was 43.59 (SD = 11.34), with mental health substantially lower than national norms (mean difference = 10.11). There were statistically significant negative correlations between the number of work-related stressors and HR-QoL. Younger (21-30 years) and less experienced (<1-4 years) MHN had substantially lower mental health. Higher mental health was predicted with < 15 stressors, >4 years' experience and working in the community. The poorer mental health of MHN has concerning implications for the well-being, retention and practice of the largest group in the mental health workforce. There is a critical need for organizations to enact effective policy and initiatives to reduce workplace aggression, improve staff psychological and physical safety, and strengthen well-being and resilience. New graduates are a priority group for urgent intervention.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Michael Roche
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Jo-Ann Giandinoto
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Chris Platania-Phung
- Australian College of Applied Psychology, Navitas, Melbourne, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
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5
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Suggett J, Foster K, Lakra V, Steele M, Furness T. Natural cause mortality of mental health consumers: A 10-year retrospective cohort study. Int J Ment Health Nurs 2021; 30:390-400. [PMID: 33035405 DOI: 10.1111/inm.12797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/02/2020] [Accepted: 09/14/2020] [Indexed: 01/09/2023]
Abstract
People with mental illness have substantially lower life expectancy than the general population, with mortality from natural causes most commonly attributed to cardiovascular diseases. The study aim was to identify characteristics of consumers who died of natural causes between 2009 and 2018 at one of Australia's largest publicly funded mental health services. Data were collected with a retrospective medical record review of 102 consumers. Mean mortality age was 52.4 years (SD = 10.7) (with females 51.9 years [SD = 12.0], and males 52.7 years [SD = 9.9]), which was more than 30 years lower than the Australian population. Cardiovascular diseases were the most frequent mortality cause (39%), followed by respiratory conditions (23%), cancers (20%), and all other causes (19%). Sixty (61%) consumers had at least three co-occurring physical health conditions. Seventy-five (74%) smoked tobacco. Consumers who died from cardiovascular diseases were less likely to attend specialist medical follow-up for their condition (P = 0.004), and more likely to die at home (P = 0.001). Consumers whose mortality age was above 55 years were more likely to have three co-occurring physical health conditions (P = 0.034). Consumers whose mortality age was below 55 years were more likely to have sub-optimal nutritional intake (P = 0.014) and higher body mass index (P = 0.008). There is a critical need to close the life expectancy gap for consumers. This requires dedicated focus on reducing mortality risk due to modifiable clinical characteristics which lead to consumer mortality. Mental health nurses play a key role in helping reduce consumers' mortality and morbidity risk through prevention and early intervention strategies.
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Affiliation(s)
- Joanne Suggett
- North West Area Mental Health Service, NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Kim Foster
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Vinay Lakra
- North West Area Mental Health Service, NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Michael Steele
- School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
| | - Trentham Furness
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
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Foster K, Giandinoto JA, Furness T, Blanco A, Withers E, Alexander L. 'Anyone can have a mental illness': A qualitative inquiry of pre-registration nursing students' experiences of traditional mental health clinical placements. Int J Ment Health Nurs 2021; 30:83-92. [PMID: 33145951 DOI: 10.1111/inm.12808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 01/11/2023]
Abstract
Nurses play a crucial role in mental healthcare provision. Like many countries, Australian nursing students are educated in comprehensive pre-registration programmes which include mental health clinical placements. Placements play a vital role in students' education, providing the opportunity to engage with consumers and develop mental health nursing knowledge and skills. There is limited knowledge of student perspectives on traditional placements in contemporary recovery-oriented mental health services. This interpretive qualitative inquiry aimed to explore nursing students' experience of traditional mental health clinical placement and how it influenced their practice and their understandings of recovery from mental illness. Data were collected from focus groups with n = 31 nursing students in a large metropolitan public mental health service. Thematic analysis resulted in three themes of experience: humanizing people with mental illness; learning about recovery; and shifting perspectives on mental health nursing. Through a positive placement experience where they felt supported and included by staff, students came to see consumers as people rather than diagnoses, developed greater understanding of mental health nursing work and were more likely to consider mental health nursing as a career choice. Peer-support workers were an important influence on students' understandings of recovery and have a key role to play in educating students on placement. Students need to be prepared and supported by university and clinical staff to deal with vicarious trauma that may occur on placement. Mental health placements play a crucial role in attracting students into the field, and it is imperative they remain part of comprehensive pre-registration education.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,Melbourne Health, NorthWestern Mental Health, Parkville, Victoria, Australia
| | - Jo-Ann Giandinoto
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,Melbourne Health, NorthWestern Mental Health, Parkville, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,Melbourne Health, NorthWestern Mental Health, Parkville, Victoria, Australia
| | - Anthony Blanco
- Melbourne Health, NorthWestern Mental Health, Parkville, Victoria, Australia
| | - Elaine Withers
- Melbourne Health, NorthWestern Mental Health, Parkville, Victoria, Australia
| | - Louise Alexander
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
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7
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Williamson J, Henning AJ, Martin H, Furness T, Fletcher S, Jiang X. Flexible gauge length intrinsic fiber-optic strain sensor using broadband interferometry [Invited]. J Opt Soc Am A Opt Image Sci Vis 2020; 37:1950-1957. [PMID: 33362138 DOI: 10.1364/josaa.403294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/29/2020] [Indexed: 06/12/2023]
Abstract
Monitoring strain is important in precision engineering applications that require maintaining the precise alignments of structures over time, such as those found in machine tools and metrology frames. We present a fiber-optic strain measurement technique based upon broadband interferometry that is variously configurable in terms of gauge length and sensitivity. This is achieved by the use of an unbalanced interrogation interferometer configuration that alleviates the cavity length limit imposed by the temporal coherence of the system. We also demonstrate that dispersion in fiber sensors based on intrinsic Fabry-Perot interferometers must be considered to optimize performance. The possibility of multisensor interrogation using the same optical system is also reported.
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8
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Bernardo-Filho M, Bemben MG, Taiar R, Sañudo B, Furness T, Clark BC. Editorial: Interventional Strategies for Enhancing Quality of Life and Health Span in Older Adults. Front Aging Neurosci 2020; 12:253. [PMID: 33192446 PMCID: PMC7533608 DOI: 10.3389/fnagi.2020.00253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/23/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mario Bernardo-Filho
- Departamento de Biofísica e Biometria and Policlínica Piquet Carneiro, Rio de Janeiro State University, Rio de Janeiro, Brazil
- *Correspondence: Mario Bernardo-Filho
| | - Michael G. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Redha Taiar
- Groupe de Recherche en Science pour l'Ingénieur (GRESPI), Université de Reims Champagne-Ardenne, Reims, France
| | - Borja Sañudo
- Departamento de Educación Física Y Deporte, Universidad de Sevilla, Seville, Spain
| | - Trentham Furness
- Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia
| | - Brian C. Clark
- Department of Biomedical Sciences, Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, United States
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9
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Sañudo B, Seixas A, Gloeckl R, Rittweger J, Rawer R, Taiar R, van der Zee EA, van Heuvelen MJ, Lacerda AC, Sartorio A, Bemben M, Cochrane D, Furness T, de Sá-Caputo D, Bernardo-Filho M. Potential Application of Whole Body Vibration Exercise For Improving The Clinical Conditions of COVID-19 Infected Individuals: A Narrative Review From the World Association of Vibration Exercise Experts (WAVex) Panel. Int J Environ Res Public Health 2020; 17:E3650. [PMID: 32455961 PMCID: PMC7277771 DOI: 10.3390/ijerph17103650] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/30/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022]
Abstract
COVID-19 is a highly infectious respiratory disease which leads to several clinical conditions related to the dysfunction of the respiratory system along with other physical and psychological complaints. Severely affected patients are referred to intensive care units (ICUs), limiting their possibilities for physical exercise. Whole body vibration (WBV) exercise is a non-invasive, physical therapy, that has been suggested as part of the procedures involved with pulmonary rehabilitation, even in ICU settings. Therefore, in the current review, the World Association of Vibration Exercise Experts (WAVEX) reviewed the potential of WBV exercise as a useful and safe intervention for the management of infected individuals with COVID-19 by mitigating the inactivity-related declines in physical condition and reducing the time in ICU. Recommendations regarding the reduction of fatigue and the risk of dyspnea, the improvement of the inflammatory and redox status favoring cellular homeostasis and the overall improvement in the quality of life are provided. Finally, practical applications for the use of this paradigm leading to a better prognosis in bed bound and ICU-bound subjects is proposed.
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Affiliation(s)
- Borja Sañudo
- Departamento de Educación Física y Deporte, Universidad de Sevilla, 41013 Seville, Spain;
| | - Adérito Seixas
- Escola Superior de Saúde, Universidade Fernando Pessoa, 4200-253 Porto, Portugal
| | - Rainer Gloeckl
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, 83471 Schoenau am Koenigssee, Germany;
- Department of Pulmonary Rehabilitation, Philipps–University of Marburg, German Center for Lung Research (DZL), 35037 Marburg, Germany
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), 51147 Cologne, Germany;
- Department of Pediatrics and Adolescent Medicine, University of Cologne, D50931 Cologne, Germany
| | - Rainer Rawer
- Head of Research & Development Department, Novotec Medical GmbH & Galileo Training, 75172 Pforzheim, Germany;
| | - Redha Taiar
- Université de Reims Champagne Ardenne, 51100 Grand Est, France;
| | - Eddy A. van der Zee
- Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, 9747 AG Groningen, The Netherlands;
| | - Marieke J.G. van Heuvelen
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, 9713 AV Groningen, The Netherlands;
| | - Ana Cristina Lacerda
- Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina 39100-000, MG, Brazil;
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-endocrinological Research & Division of Metabolic Diseases, 20145 Milan, Italy;
| | - Michael Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK 73019, USA;
| | - Darryl Cochrane
- School of Sport, Exercise and Nutrition, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand;
| | - Trentham Furness
- Faculty of Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia;
| | - Danúbia de Sá-Caputo
- Laboratório de Vibrações Mecânicas, Policlínica Piquet Carneiro, Instituto de Biología Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20950-003, Brazil; (D.d.S.-C.); (M.B.-F.)
- Faculdade Bezerra de Araújo, Rio de Janeiro 23052-180, Brazil
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas, Policlínica Piquet Carneiro, Instituto de Biología Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20950-003, Brazil; (D.d.S.-C.); (M.B.-F.)
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Furness T, Giandinoto JA, Wordie-Thompson E, Woolley S, Dempster V, Foster K. Improving physical health outcomes for people with severe mental illness: A proof-of-concept study of nurse practitioner candidate practice. Int J Ment Health Nurs 2020; 29:266-277. [PMID: 31793176 DOI: 10.1111/inm.12680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2019] [Indexed: 01/20/2023]
Abstract
People with severe mental illness have significantly reduced life expectancy and higher risk of cardiovascular diseases than the general population. There is a critical need for quality physical health care to improve consumers' health outcomes. There is minimal knowledge, however, on the impact of mental health nurse practitioner candidate (NPC) practices on consumers' health outcomes. The aim of this proof-of-concept study was to describe the impacts of NPC practices on the quality of physical healthcare provision and physical health outcomes (cardiovascular and cardiometabolic) of consumers in community mental health service settings. Using a mixed methods design, quantitative data were collected for 12 months prior to (Period 1), and 12 months during (Period 2), the candidacy period. Qualitative interviews were conducted with a purposive sample of n = 10 consumers to explore their perspectives on physical healthcare provision by the NPCs. During the 12-month candidacy period, the number of metabolic monitoring assessments rose from n = 55 in Period 1 to n = 146 in Period 2 (P < 0.01, χ2 = 41.20). Advanced practices provided by NPCs included taking an extensive holistic history and clinical examination, ordering diagnostic pathology, and clinical simulation of physical health medication prescription (under medical supervision). Analysis of consumer interviews resulted in two themes: (i) positive and helpful NPC health care and (ii) improvements in physical and mental health. The findings add new knowledge on specialist mental health nurse practitioner candidate roles and demonstrate the benefits these roles can have in reducing the significant morbidity and mortality of mental health consumers.
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Affiliation(s)
- Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Jo-Ann Giandinoto
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Emily Wordie-Thompson
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - Steve Woolley
- NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Vesna Dempster
- NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
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11
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Foster K, Roche M, Giandinoto JA, Furness T. Workplace stressors, psychological well-being, resilience, and caring behaviours of mental health nurses: A descriptive correlational study. Int J Ment Health Nurs 2020; 29:56-68. [PMID: 31127973 DOI: 10.1111/inm.12610] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2019] [Indexed: 12/30/2022]
Abstract
There is widespread recognition that workplace stress can have profound negative impacts on nurses' well-being and practice. Resilience is a process of positive adaptation to stress and adversity. This study aimed to describe mental health nurses' most challenging workplace stressors, and their psychological well-being, workplace resilience, and level of caring behaviours, explore the relationships between these factors, and describe differences in workplace resilience for sociodemographic characteristics. In a descriptive correlational study using convenience sampling, data were collected from N = 498 nurses working in mental health roles or settings in Victoria Australia via an online cross-sectional survey. Key findings included weak to strong (r = 0.301 to r = 0.750) positive relationships between workplace resilience with psychological well-being across all stressor categories (consumer/carer; colleague; organizational role; and organizational service). Psychological well-being was moderately high, but lower for nurses indicating consumer/carer-related stressors as their most stressful challenge. There were weak to moderate (r = 0.306 to r = 0.549) positive relationships between workplace resilience and psychological well-being, and no relationship between resilience and caring behaviours. Workplace resilience was lower (P < 0.05) for less experienced nurses compared with those with >5 years' experience, and lower for younger nurses compared with those aged ≥40 years. To improve their resilience and prevent psychological distress, there is prime opportunity to support nursing students with well-being and resilience-building strategies during their undergraduate education, and to support new graduates with similar programmes when they enter the workforce.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Michael Roche
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Jo-Ann Giandinoto
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
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12
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Isobel S, Gladstone B, Goodyear M, Furness T, Foster K. A qualitative inquiry into psychiatrists' perspectives on the relationship of psychological trauma to mental illness and treatment: implications for trauma-informed care. J Ment Health 2020; 30:667-673. [PMID: 31997673 DOI: 10.1080/09638237.2020.1714012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Trauma is a factor impacting the lives of many people experiencing psychiatric disorders. Trauma affects people's responses to illness as well as their interactions with services.Aim: This study aimed to explore the understandings and experiences of psychiatrists of working with trauma and emerging models of Trauma-Informed Care.Methods: An interpretive qualitative inquiry was undertaken using semi-structured in-depth interviews with psychiatrists.Results: Four themes were identified: Making sense of trauma; A contentious relationship between trauma and mental illness; Treatment made more challenging by trauma; Trauma-Informed Care highlights tensions. Psychiatrists are familiar with the concept of trauma but there are differences in beliefs about its relationship to mental illness that are consequential for practice. Trauma-Informed Care is seen as an effort to humanise mental health services, but with perceived limited impact on psychiatrists' roles.Conclusion: Findings indicate need for further consultation and collaboration with psychiatrists around trauma-informed care implementation; as well as consideration of what is required to develop professional consensus on trauma and its relationship to illness.
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Affiliation(s)
- Sophie Isobel
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Sydney Local Health District, Concord, Australia
| | - Brenda Gladstone
- Centre for Critical Qualitative Health Research, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Melinda Goodyear
- School of Rural Health, Monash University, Moe, Australia.,The Parenting Research Centre, La Trobe University, Melbourne, Australia
| | - Trentham Furness
- Australian Catholic University, Melbourne, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Australia
| | - Kim Foster
- Australian Catholic University, Melbourne, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Australia
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13
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Foster K, Withers E, Blanco T, Lupson C, Steele M, Giandinoto JA, Furness T. Undergraduate nursing students' stigma and recovery attitudes during mental health clinical placement: A pre/post-test survey study. Int J Ment Health Nurs 2019; 28:1065-1077. [PMID: 31338978 DOI: 10.1111/inm.12634] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2019] [Indexed: 01/30/2023]
Abstract
Undergraduate nursing students have been reported to hold negative and stigmatizing attitudes towards mental health consumers and to be under-prepared for mental health clinical placement. This study aimed to investigate undergraduate nurses' stigma and recovery attitudes to mental illness, and describe their understandings of personal recovery on entry and exit to traditional mental health clinical placement. A pre/post-test survey was administered to N = 249 nursing students in Australia. Demographic data, attitudes towards mental health nursing and clinical placement, the Opening Minds Scale for Healthcare Providers (OMS-HC), Recovery Attitudes Questionnaire (RAQ-7), and an open-ended question on understandings of personal recovery from mental illness were collected on entry (T1) and exit (T2) to placement. At T1, students reported moderate stigma and positive attitudes towards recovery (OMS-HC mean = 34.6; RAQ-7 mean = 4.0). At T2, there was a reduction in stigma (social distance P = 0.02, d = 0.26) and improvement in recovery attitudes (P < 0.01, d = 0.40). Attitudes towards mental health nursing and placement also improved (P < 0.01). Having a family member with mental illness predicted improvements in stigma and recovery attitudes. On entry to placement, most students described accurate understandings of personal recovery, which were maintained during placement. The findings indicate that mental health clinical placements are effective in improving students' mental health stigma and recovery attitudes and provide a prime opportunity to attract students into the field. Co-produced or consumer-led education provided by peer workers during clinical placements may improve students' stigmatizing attitudes and stimulate their interest to work in the field.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Elaine Withers
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Tony Blanco
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Christine Lupson
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Michael Steele
- School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
| | - Jo-Ann Giandinoto
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
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14
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Foster K, Roche M, Delgado C, Cuzzillo C, Giandinoto JA, Furness T. Resilience and mental health nursing: An integrative review of international literature. Int J Ment Health Nurs 2019; 28:71-85. [PMID: 30294937 DOI: 10.1111/inm.12548] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2018] [Indexed: 12/15/2022]
Abstract
Mental health nurses work in challenging and potentially high stress settings. Stressors can occur in the context of consumer, family, and/or staff relationships, as well as the work environment and organization. The cumulative effects of stress and professional challenges can lead to harmful impacts for mental health nurses including burnout and poorer physical and mental health. Resilience involves a process of positive adaptation to stress and adversity. The aims of this integrative review were to examine understandings and perspectives on resilience, and explore and synthesize the state of knowledge on resilience in mental health nursing. Following systematic search processes, screening, and data extraction, 12 articles were included. Constant comparative analysis and synthesis of the data resulted in two key categories: Theoretical concepts of resilience and Knowledge on mental health nurses' resilience. In mental health nursing, resilience has been variously constructed as an individual ability, collective capacity, or as an interactive person-environment process. Resilience was most often reported as low-moderate, with positive correlations with hardiness, self-esteem, life and job satisfaction, and negative correlations with depression and burnout. A resilience programme improved mental health nurses' coping self-efficacy and capacity to regulate thoughts and emotions and developed their resilient practice. Use of contemporary resilience definitions will inform more consistent investigation and progressively scaffold knowledge of this emergent construct in mental health nursing. Future research on the implementation of resilience programmes and resilience-building strategies for mental health nurses at the individual, work unit, and organizational levels is needed.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Michael Roche
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,Northern Sydney Local Health District Mental Health Drug and Alcohol Services, Sydney, New South Wales, Australia
| | - Cynthia Delgado
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,Sydney Local Health District Mental Health Services, Professor Marie Bashir Centre, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Celeste Cuzzillo
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Jo-Ann Giandinoto
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
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15
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Isobel S, Goodyear M, Furness T, Foster K. Preventing intergenerational trauma transmission: A critical interpretive synthesis. J Clin Nurs 2019; 28:1100-1113. [PMID: 30556334 DOI: 10.1111/jocn.14735] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 11/25/2018] [Accepted: 11/30/2018] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVE To synthesise and critically interpret literature of relevance to intervening in intergenerational transmission of relational trauma within parent-infant relationships. BACKGROUND Intergenerational trauma is a discrete process and form of psychological trauma transmitted within families and communities. Intergenerational trauma can be transmitted through attachment relationships where the parent has experienced relational trauma and have significant impacts upon individuals across the lifespan, including predisposition to further trauma. DESIGN Critical interpretive synthesis (CIS) was used. CIS is an inductive qualitative process that generates new theory grounded within reviewed literature. METHODS The review commenced by systematically searching for literature on interventions for intergenerational trauma. As the core theoretical construct emerged, elements that may contribute to preventing intergenerational trauma were identified iteratively and influenced further searching. In the final synthesis, 77 articles were included from the fields of intergenerational trauma, trauma interventions and attachment interventions. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. RESULTS The key construct is that prevention of intergenerational trauma transmission is the key intervention. The two contributing constructs were identified as "resolving parental trauma" and "actively supporting parent-infant attachment." CONCLUSIONS Prevention is the most effective intervention approach for intergenerational transmission of trauma. Prevention requires trauma-specific interventions with adults and attachment-focused interventions within families. Preventative strategies need to target individual, relationship, familial, community and societal levels, as addressing and preventing trauma requires a multipronged, multisystemic approach. RELEVANCE TO CLINICAL PRACTICE Systematic trauma-informed attachment-focused interventions in health and social service settings are recommended. There are opportunities to provide multifocal individual and relational interventions within existing services that work with parents to help prevent the likelihood and impact of transmission of intergenerational relational trauma within families. Nurses are well placed to provide preventative interventions in mental health, early childhood and primary health settings.
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Affiliation(s)
- Sophie Isobel
- ACU School of Nursing, Midwifery and Paramedicine, Melbourne, Victoria, Australia.,Mental Health Research, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Melinda Goodyear
- Monash University & the Parenting Research Centre, Melbourne, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
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16
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Furness T, Wallace E, McElhinney J, McKenna B, Cuzzillo C, Foster K. Colocating an accredited practising dietitian to an adult community mental health service: An exploratory study. Int J Ment Health Nurs 2018; 27:1709-1718. [PMID: 29704288 DOI: 10.1111/inm.12470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/08/2018] [Indexed: 11/30/2022]
Abstract
For people with severe mental illness, accredited practising dietitians may assist with a nutrition care plan that considers the medical, psychiatric, psychological, social, spiritual, and pharmacological aspects of their care. However, consumers' access to care has been limited by difficulties attending appointments and suboptimal interface between nutritional and mental health services. Therefore, the objectives of this exploratory study were to describe access to, and key stakeholder perspectives of, the accredited practising dietitian role colocated in a community mental health service. A total of 16 key stakeholders participated in one-to-one interviews. Two main themes with subthemes were derived from analysis of interviews: (i) 'building empowerment and collaboration' and included the subthemes, (a) nutrition awareness and education and (b) healthy lifestyle changes, and (ii) 'overcoming challenges to optimal nutrition and effective health care'. In addition, improved access to the role was demonstrated with 124 (79%) consumers attending at least one appointment with an accredited practising dietitian. A total of 15 (12%) consumers attended more than 10 appointments during their outpatient admission to the community mental health service. Colocating an accredited practising dietitian was perceived to build empowerment and collaboration, and overcome challenges to optimal nutrition and effective health care for consumers, carers, and clinicians. The colocation of a dietitian can empower consumers' to make health-informed decisions and support their willingness to engage with physical healthcare provision when it is prioritized alongside mental healthcare provision.
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Affiliation(s)
- Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Elizabeth Wallace
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Jo McElhinney
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Brian McKenna
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.,Centre for Forensic Behavioural Science, Swinburne University of Technology, Hawthorne, Victoria, Australia
| | - Celeste Cuzzillo
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
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17
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Sá-Caputo D, Paineiras-Domingos L, Oliveira R, Neves MF, Brandão A, Marin PJ, Sañudo B, Furness T, Taiar R, Bernardo-Filho M. Acute Effects of Whole-Body Vibration on the Pain Level, Flexibility, and Cardiovascular Responses in Individuals With Metabolic Syndrome. Dose Response 2018; 16:1559325818802139. [PMID: 30305807 PMCID: PMC6176544 DOI: 10.1177/1559325818802139] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 08/14/2018] [Accepted: 08/23/2018] [Indexed: 01/05/2023] Open
Abstract
The aim of the study was to assess the acute effect of whole-body vibration (WBV) exercise, with low frequency (5 Hz), on the pain level (PL), trunk flexibility, and cardiovascular responses (blood pressure [BP] and heart rate [HR]) in individuals with metabolic syndrome (MetS). Forty-four individuals were included in the study (control: 15) or in (WBV exercise: 29) groups. They were submitted to 3 bouts (1 minute each) of WBV exercise (5 Hz and peak-to-peak displacements of 2.5, 5.0, and 7.5 mm, corresponding to peak accelerations of 0.12, 0.25, and 0.35 g, respectively, sitting in a chair with the feet on the platform with knees flexed, followed by 1 minute of interset rest. The Control Group performed the same protocol, but the platform was turned off. The PL was measured through the visual analog pain scale, and the flexibility was measured through the anterior trunk flexion test. Significant improvements on PL (P = .031) and flexibility (P = .004) were found only in the WBV exercise group. The BP and HR remained at physiological levels. In conclusion, the WBV exercise would lead to physiological response decreasing PL and increasing flexibility as well as maintaining the cardiovascular responses in individuals with MetS.
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Affiliation(s)
- D.C. Sá-Caputo
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental,
Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de
Janeiro, RJ, Brazil
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Centro Universitário Serra dos Órgãos, Teresópolis, RJ, Brazil
- Faculdade Bezerra de Araújo, Rio de Janeiro, RJ, Brazil
| | - L.L. Paineiras-Domingos
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Faculdade Bezerra de Araújo, Rio de Janeiro, RJ, Brazil
- Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências
Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ricardo Oliveira
- Departamento de Clínica Médica do Hospital Universitário Pedro
Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mario F.T. Neves
- Departamento de Clínica Médica do Hospital Universitário Pedro
Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Andrea Brandão
- Departamento de Cardiologia do Hospital Universitário Pedro Ernesto,
Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Pedro J. Marin
- Universidad Europea Miguel de Cervantes, Laboratorio de Fisiologia,
Valladolid, Spain
| | - Borja Sañudo
- Universidad de Sevilha, Facultad de Ciencias de la Educación,
Departamento de Educación Física y Deporte, Sevilla, Spain
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic
University, Fitzroy, VIC, Australia
| | - Redha Taiar
- GRESPI, Research Group in Engineering Sciences, University of Reims
Champagne-Ardenne, France
| | - M. Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas,
Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara
Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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18
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Foster K, Shochet I, Wurfl A, Roche M, Maybery D, Shakespeare-Finch J, Furness T. On PAR: A feasibility study of the Promoting Adult Resilience programme with mental health nurses. Int J Ment Health Nurs 2018; 27:1470-1480. [PMID: 29488298 DOI: 10.1111/inm.12447] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 01/07/2023]
Abstract
Mental health settings are recognized as complex, unpredictable environments, and challenging interpersonal situations are common for nurses in acute adult mental health services. Occupational stressors include verbal aggression and physical assault and are correlated with poor physical and mental health outcomes for nurses. There is a clear need for proactive approaches that address the negative impacts of stressors on the mental health nursing workforce. Resilience interventions are a preventive approach to strengthening skills for addressing workplace stress, improving health and well-being, and preventing adverse outcomes associated with occupational stressors. The aim of this study was to evaluate the feasibility of a workplace resilience education programme for nurses in high-acuity adult mental health settings. The outcomes were measured using a single-group pretest post-test design with follow-up at 3 months postintervention. The feasibility and acceptability of the programme were identified with descriptors of mental health, well-being, resilience, facilitator fidelity checklists, and participant satisfaction questionnaires. The programme was found to be feasible for nurses working in high-acuity inpatient settings. There were significant changes to mental health, well-being, and workplace resilience. The programme was delivered with fidelity by facilitators and accepted with high levels of satisfaction by participants. The study findings indicated that nurses can benefit from resilience education that equips them with cognitive, emotion regulation, and relational skills, in conjunction with available external supports and resources, to address workplace challenges. There is a need for comprehensive organizational approaches that include individual, work unit, and organizational-level strategies to support staff well-being.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Ian Shochet
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Astrid Wurfl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael Roche
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,Northern Sydney Local Health District Mental Health Drug and Alcohol Services, Sydney, New South Wales, Australia
| | - Darryl Maybery
- Department of Rural Health, Monash University, Moe, Victoria, Australia
| | - Jane Shakespeare-Finch
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
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19
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Lopes-Souza P, Dionello CF, Sá-Caputo DDC, Moreira-Marconi E, Frederico EHFF, Marchon RM, Bergmann A, Furness T, Bernardo-Filho M. Whole body vibration exercise in the management of cancer therapy-related morbidities: A systematic review. Drug Discov Ther 2018; 12:239-247. [PMID: 30224596 DOI: 10.5582/ddt.2018.01039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The purpose of this systematic review was to investigate the effects of whole body vibration (WBV) exercise in the management of cancer therapy-related morbidities. The PubMED and PEDro databases were used to access publications published in English about the use of whole body vibration (WBV) exercises in cancer patients until February 22nd 2017. The studies included were classified according to the level of evidence (LE) by the National Health and Medical Research Council Hierarchy of evidence and the methodological quality (MQ) by the PEDro scale. The four included studies (2 of them with "high" LE-II and MQ) were performed in patients with different types of cancer (i.e. breast, lung, prostate, solid or hematological), treated with WBV exercise to counteract the cancer therapy-related morbidities. The variables evaluated were muscle activity, subjective rate of perceived exertion, exercise capacity, muscle strength, quality of life, resting urinary incontinence and severity of peripheral neuropathy. Although WBV exercise appears to be a potential treatment procedure of cancer therapy-related morbidities, further additional studies are required to determine specific and tailored protocols to be used in the different stages of the disease.
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Affiliation(s)
- Patrícia Lopes-Souza
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro.,Departamento de Biofísica e Biometria, Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro
| | - Carla Fontoura Dionello
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro.,Departamento de Biofísica e Biometria, Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro
| | - Danúbia da Cunha Sá-Caputo
- Departamento de Biofísica e Biometria, Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro.,Curso de Fisioterapia, Faculdade Bezerra de Araújo
| | - Eloá Moreira-Marconi
- Departamento de Biofísica e Biometria, Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro.,Programa de Pós-graduação em Fisiopatologia Clínica e Experimental, Universidade do Estado do Rio de Janeiro
| | - Eric Heleno Freire Ferreira Frederico
- Departamento de Biofísica e Biometria, Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro.,Programa de Pós-Graduação em Biociências, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro
| | - Renata Marques Marchon
- Departamento de Biofísica e Biometria, Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro.,Programa de Pós-graduação em Fisiopatologia Clínica e Experimental, Universidade do Estado do Rio de Janeiro
| | - Anke Bergmann
- Programa de Carcinogênese Molecular, Instituto Nacional de Câncer (INCA)
| | - Trentham Furness
- Mental Health Nursing Research Unit, NorthWestern Mental Health & Australian Catholic University
| | - Mario Bernardo-Filho
- Departamento de Biofísica e Biometria, Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro
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20
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Foster K, Cuzzillo C, Furness T. Strengthening mental health nurses' resilience through a workplace resilience programme: A qualitative inquiry. J Psychiatr Ment Health Nurs 2018; 25:338-348. [PMID: 29920873 DOI: 10.1111/jpm.12467] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/10/2018] [Accepted: 05/03/2018] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Mental health nurses are affected by interpersonal, practice-related and organizational factors that can increase workplace stress and reduce their physical and mental health and well-being. Resilience programmes are a strength-based preventative approach to supporting individuals to overcome workplace adversities. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This qualitative inquiry is the first study to report mental health nurses' perspectives and experiences on a workplace resilience programme. Strengthening mental health nurses' resilience through a resilience programme involved a process of understanding resilience, and applying resilience strategies such as positive self-talk, managing negative self-talk, detaching from stressful situations, being aware of and managing emotions, and showing more empathy, to address workplace challenges. To address the range of resources needed to support mental health nurses' resilience, a social-ecological approach to workplace resilience can be used to promote resource provision at individual, work unit, organizational and professional levels. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Resilience programmes are one resource for addressing the impacts of workplace stressors on mental health nurses. Organizational barriers and risks to staff well-being need to also be addressed to build a resilient workforce. Incorporating resilience strategies into clinical supervision or reflective practice models may help sustain beneficial outcomes following a resilience programme and support resilient practice. ABSTRACT: Introduction Mental health settings are potentially high-stress workplaces that can lead to nurses' poorer health and well-being. Resilience programmes are a strengths-based preventative approach for promoting mental health and well-being in the face of adversity; however, there is no prior research on mental health nurses' perspectives on resilience programmes. Aim To explore the perspectives of mental health nurses participating in a mental health service-initiated resilience programme (Promoting Adult Resilience). Method An exploratory qualitative inquiry was undertaken. Multiple qualitative data: open-ended responses and semi-structured interviews and focus groups, were thematically analysed. Results Twenty-nine registered nurses from a metropolitan mental health service participated. Four main themes were as follows: being confronted by adversity; reinforcing understandings of resilience; strengthening resilience; and applying resilience skills at work. Discussion This is the first study to report mental health nurses' perspectives on a resilience programme. Resilience programmes can help improve nurses' self-efficacy and ability to realistically appraise stressful situations and to moderate their emotional responses to others. Implications for practice It is recommended resilience programmes are provided to promote nurses' well-being and resilient practices. To build a resilient workforce, the wider barriers and risks to staff well-being need to be addressed at a unit, organizational and professional level.
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Affiliation(s)
- Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Vic., Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Vic., Australia
| | - Celeste Cuzzillo
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Vic., Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Vic., Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Vic., Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Vic., Australia
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Brown T, McKenna B, Furness T. Impact of a nurse practitioner role on metabolic monitoring completion and referrals for consumers admitted to the intensive care area of an acute inpatient psychiatric unit. Int J Ment Health Nurs 2018; 27:341-348. [PMID: 28299868 DOI: 10.1111/inm.12327] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2017] [Indexed: 12/20/2022]
Abstract
Mental illness increases a person's risk of physical health issues, including cardiovascular disease, leading to premature morbidity and mortality. Screening for cardiovascular disease through metabolic monitoring is recommended to aid in early detection. The aim of the present study was to ascertain whether consumers admitted to an inpatient mental health unit receive routine metabolic monitoring, and to explore the contribution of a nurse practitioner to metabolic monitoring and the actioning of abnormal results. The present study used a retrospective mirror image cohort method to look at clinical consumer files for two separate 6-month periods before and after a nurse practitioner role commenced. Metabolic monitoring variables were computed as completion frequencies and percentages. Univariate analyses were computed to describe differences among metabolic monitoring variables. A total of 497 consumers were admitted to the mental health inpatient unit's intensive care area across the two 6-month data-collection periods. Prior to the nurse practitioner role, only 2% of consumers had their body mass index (BMI) risk calculated; less than 1% had their waist circumference measured, and no abnormal results were referred to a general practitioner (GP). After the nurse practitioner role commenced, BMI risk was calculated for 67% of consumers, waist circumference recorded for 68%, and referrals for abnormal results were forwarded to 37 consumers' GPs. A nurse practitioner on the inpatient mental health unit has allowed for a considerable increase in the metabolic screening of admitted consumers resulting in a number of referrals being forwarded to consumers' GPs to be acted upon.
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Affiliation(s)
- Trudy Brown
- Northern Area Mental Health Service, The Northern Hospital, Epping, Melbourne, Victoria, Australia.,NorthWestern Mental Health, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Brian McKenna
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.,Auckland Regional Forensic Psychiatry Services, Auckland, New Zealand
| | - Trentham Furness
- NorthWestern Mental Health, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,School of Nursing, Midwifery, and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
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McEvedy SM, Furness T, McKenna B. Introduction of a drug-detection dog programme in mental health inpatient units: A mixed-methods study of consumer, staff, and carers' perceptions. Int J Ment Health Nurs 2018; 27:408-421. [PMID: 28589658 DOI: 10.1111/inm.12335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2017] [Indexed: 11/30/2022]
Abstract
Many consumers admitted to mental health inpatient units also use illicit drugs, and some continue to do so while receiving treatment. In an attempt to curb the impact of illicit drug use, one of Australia's largest mental health services introduced a programme of drug-detection dog (DDD) searches. Our aim was to evaluate perceptions of the DDD programme among mental health consumers, staff, and carers. A mixed-methods research design using a concurrent triangulation approach was adopted, involving three focus group discussions with consumer, staff, and carer groups, and a structured survey among 94 consumers who were receiving treatment and 102 staff working in the units at the time of a DDD visit. Data were analysed using thematic analysis, and descriptive and inferential statistics. Major themes were that: (i) drug use in these units is perceived as 'prevalent' and 'destructive'; (ii) the DDD programme is 'beneficial' but 'incongruous' in a health-care setting; (iii) consumers are 'uninformed'; and (iv) consequences should be 'customized' to circumstances. Survey results corroborated qualitative themes, with the exception that although concerns about incongruity do exist, they were not prevalent and were outweighed by positive perceptions of the programme. Most perceptions were consistent between consumers and staff. However, consumers tended to think that, if found, drugs should be confiscated, whereas staff were more strongly in favour of the consumer being discharged. In conclusion, the DDD programme was seen as a positive step towards addressing drug use in mental health units. However, improved dissemination of information to consumers through verbal and written communication is required.
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Affiliation(s)
- Samantha M McEvedy
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Brian McKenna
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.,Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand
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McKenna B, McEvedy S, Maguire T, Ryan J, Furness T. Prolonged use of seclusion and mechanical restraint in mental health services: A statewide retrospective cohort study. Int J Ment Health Nurs 2017; 26:491-499. [PMID: 28960741 DOI: 10.1111/inm.12383] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2017] [Indexed: 01/09/2023]
Abstract
Seclusion and mechanical restraint are restrictive interventions that should be used only as a last resort and for the shortest possible time, yet little is known about duration of use in the broader context. Adult area mental health services throughout Victoria, Australia, were asked to complete a report form for prolonged episodes of seclusion (>8 hours) and mechanical restraint (>1 hour). The present, retrospective cohort study aimed to understand the individual (age, sex, type of service, duration of intervention) and contextual factors associated with prolonged use of restrictive interventions. Contextual factors describing the reasons for prolonged use of the restrictive interventions were captured qualitatively, and then coded using content analysis. Median duration was compared across individual factors using Mann-Whitney U-tests. During 2014, 690 episodes of prolonged restrictive intervention involving 311 consumers were reported. Close to half (n = 320, 46%) involved mechanical restraint. Seclusion episodes (n = 370) were longer in forensic mental health services compared to adult area mental health services (median: 24 hours and 18 min vs 16 hours and 42 min, P < 0.001). Mechanical restraint episodes (n = 320) were shorter in forensic mental health services compared to adult area mental health services (median: 3 hours and 25 min vs 4 hours and 15 min, P = 0.008). Some consumers were subject to multiple episodes of prolonged seclusion (55/206, 27%) and/or prolonged mechanical restraint (31/131, 24%). The most commonly occurring contextual factor for prolonged restrictive interventions was 'risk of harm to others'. Means for reducing the use of prolonged restrictive interventions are discussed in light of the findings.
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Affiliation(s)
- Brian McKenna
- School of Clinical Sciences, Auckland University of Technology, and Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand.,Centre for Forensic Behavioural Science, Swinburne University of Technology, Hawthorn, Melbourne, Victoria, Australia
| | - Samantha McEvedy
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Tessa Maguire
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Hawthorn, Melbourne, Victoria, Australia.,Nursing Practice Development Unit, Forensicare, Melbourne, Victoria, Australia
| | - Jo Ryan
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Hawthorn, Melbourne, Victoria, Australia.,Nursing Practice Development Unit, Forensicare, Melbourne, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Para medicine, Australian Catholic University and North Western Mental Health, Melbourne Health, Melbourne, Victoria, Australia
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24
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McEvedy S, Maguire T, Furness T, McKenna B. Sensory modulation and trauma-informed-care knowledge transfer and translation in mental health services in Victoria: Evaluation of a statewide train-the-trainer intervention. Nurse Educ Pract 2017; 25:36-42. [DOI: 10.1016/j.nepr.2017.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 02/18/2017] [Accepted: 04/27/2017] [Indexed: 11/24/2022]
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25
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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26
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Delgado C, Upton D, Ranse K, Furness T, Foster K. Nurses' resilience and the emotional labour of nursing work: An integrative review of empirical literature. Int J Nurs Stud 2017; 70:71-88. [PMID: 28235694 DOI: 10.1016/j.ijnurstu.2017.02.008] [Citation(s) in RCA: 190] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/05/2017] [Accepted: 02/07/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND The emotional labour of nursing work involves managing the emotional demands of relating with patients, families and colleagues. Building nurses' resilience is an important strategy in mitigating the stress and burnout that may be caused by ongoing exposure to these demands. Understandings of resilience in the context of emotional labour in nursing, however, are limited. OBJECTIVES To investigate the state of knowledge on resilience in the context of emotional labour in nursing. DESIGN Integrative literature review. DATA SOURCES CINAHL, Medline, Scopus, and PsycINFO electronic databases were searched for abstracts published between 2005 and 2015 and written in English. Reference lists were hand searched. REVIEW METHODS Whittemore and Knafl's integrative review method was used to guide this review. The constant comparative method was used to analyze and synthesize data from 27 peer-reviewed quantitative and qualitative articles. Methodological quality of included studies was assessed using the Mixed Methods Assessment Tool. RESULTS Emotional labour is a facet of all aspects of nursing work and nurse-patient/family/collegial interactions. Emotional dissonance arising from surface acting in emotional labour can lead to stress and burnout. Resilience can be a protective process for the negative effects of emotional labour. Several resilience interventions have been designed to strengthen nurses' individual resources and reduce the negative effects of workplace stress; however they do not specifically address emotional labour. Inclusion of emotional labour-mitigating strategies is recommended for future resilience interventions. CONCLUSION Resilience is a significant intervention that can build nurses' resources and address the effects of emotional dissonance in nursing work. There is a need for further investigation of the relationship between resilience and emotional labour in nursing, and robust evaluation of the impact of resilience interventions that address emotional labour.
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Affiliation(s)
- Cynthia Delgado
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Fitzroy VIC 3065, Australia; Sydney Nursing School, The University of Sydney, Camperdown NSW 2050, Australia; Consultation Liaison Mental Health, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown NSW 2050, Australia.
| | - Dominic Upton
- Faculty of Health, University of Canberra, Bruce ACT 2617, Australia.
| | - Kristen Ranse
- Faculty of Health, University of Canberra, Bruce ACT 2617, Australia.
| | - Trentham Furness
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Fitzroy VIC 3065, Australia; The Royal Melbourne Hospital & Northwestern Mental Health, Melbourne Health, Parkville VIC 3050, Australia.
| | - Kim Foster
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Fitzroy VIC 3065, Australia; The Royal Melbourne Hospital & Northwestern Mental Health, Melbourne Health, Parkville VIC 3050, Australia.
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27
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McKenna B, McEvedy S, Kelly K, Long B, Anderson J, Dalzell E, Maguire T, Tacey M, Furness T. Association of methamphetamine use and restrictive interventions in an acute adult inpatient mental health unit: A retrospective cohort study. Int J Ment Health Nurs 2017; 26:49-55. [PMID: 27860236 DOI: 10.1111/inm.12283] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2016] [Indexed: 11/29/2022]
Abstract
The aim of the present study was to describe incidences of restrictive interventions and the association of methamphetamine use at an acute adult inpatient mental health unit in metropolitan Melbourne, Victoria, Australia. A total of 232 consecutive consumer admissions to the inpatient unit across a 3-month period were described for illicit substance use and the use of restrictive interventions (seclusion, mechanical restraint, and physical restraint) prior to and during admission. Of all admissions, 25 (10.8%) involved consumers subjected to a restrictive intervention. Methamphetamine use was either self-reported or detected by saliva test for 71 (30.6%) consumers. Following multivariate analyses, methamphetamine use (odds ratio (OR): 7.83, 95% confidence interval (CI): 2.33-26.31) and restrictive intervention in the emergency department prior to admission (OR: 8.85, 95% CI: 2.83-27.70) were significant independent predictors of the use of restrictive interventions after inpatient admission. Anecdotal observations provided by clinical mental health staff that consumers intoxicated with methamphetamine appear to require restrictive intervention more frequently than other consumers was confirmed with the results of the current study. As the state of Victoria in Australia is on a pathway to the elimination of the use of restrictive interventions in mental health services, clinicians need to develop management strategies that provide specialist mental health care using the least-restrictive interventions. Although 26.8% of methamphetamine users were secluded after admission, restrictive interventions should not be the default management strategy for consumers who present with self-report or positive screen for methamphetamine use.
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Affiliation(s)
- Brian McKenna
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.,Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand
| | - Samantha McEvedy
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,The Royal Melbourne Hospital, NorthWestern Mental Health, Parkville, Victoria, Australia
| | - Kathleen Kelly
- Sunshine Acute Adult Psychiatric Unit, NorthWestern Mental Health, Sunshine, Melbourne, Australia
| | - Bec Long
- Sunshine Acute Adult Psychiatric Unit, NorthWestern Mental Health, Sunshine, Melbourne, Australia
| | - Jess Anderson
- Sunshine Acute Adult Psychiatric Unit, NorthWestern Mental Health, Sunshine, Melbourne, Australia
| | - Elaine Dalzell
- Sunshine Acute Adult Psychiatric Unit, NorthWestern Mental Health, Sunshine, Melbourne, Australia
| | - Tessa Maguire
- Forensicare, Melbourne, Victoria, Australia.,Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Mark Tacey
- Melbourne EpiCentre, The Royal Melbourne Hospital and Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,The Royal Melbourne Hospital, NorthWestern Mental Health, Parkville, Victoria, Australia
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Blackburn J, McKenna B, Jackson B, Hitch D, Benitez J, McLennan C, Furness T. Educating Mental Health Clinicians About Sensory Modulation to Enhance Clinical Practice in a Youth Acute Inpatient Mental Health Unit: A Feasibility Study. Issues Ment Health Nurs 2016; 37:517-25. [PMID: 27253182 DOI: 10.1080/01612840.2016.1184361] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
There is an emergence of literature describing effective sensory modulation (SM) interventions to de-escalate violence and aggression among mental health inpatients. However, the evidence is limited to adult settings, with the effect of SM in youth acute settings unknown. Yet, before SM may be used as a de-escalation intervention in youth acute settings, multidisciplinary staff need to be educated about and supported in the clinical application of SM. In the current study, an online SM education package was developed to assist mental health staff understand SM. This was blended with action learning sets (ALS), small group experiential opportunities consisting staff and consumers to learn about SM resources, and the support of SM trained nurses. The aims of the study were to evaluate the effectiveness of this SM education intervention in (a) transferring knowledge of SM to staff, and (b) translating this knowledge into practice in a youth acute inpatient mental health unit. A mixed methods research design with an 11-item pre- and post-education questionnaire was used along with three-month follow-up focus groups. The SM education improved understanding about SM (all 11-items p ≤ 0.004, r ≥ 0.47). Three-months after SM education, four themes evident in the focus group data emerged about the practice and process of SM; (1) translating of learning into practice, (2) SM in practice, (3) perceptions of SM benefits, and (4) limitations of SM. A blended SM education process enhanced clinical practice in the unit, yet participants were mindful of limitations of SM in situations of distress or escalating agitation.
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Affiliation(s)
- Julie Blackburn
- a NorthWestern Mental Health, Orygen Youth Health , Footscray , Victoria , Australia
| | - Brian McKenna
- b Auckland University of Technology, School of Clinical Sciences , Auckland , New Zealand
| | - Brian Jackson
- c NorthWestern Mental Health, The Royal Melbourne Hospital , Parlkville , Australia
| | - Danielle Hitch
- d NorthWestern Mental Health, Psychosocial Research Centre , Coburg , Victoria , Australia
| | - Jessica Benitez
- a NorthWestern Mental Health, Orygen Youth Health , Footscray , Victoria , Australia
| | - Cathy McLennan
- a NorthWestern Mental Health, Orygen Youth Health , Footscray , Victoria , Australia
| | - Trentham Furness
- e Australian Catholic University , School of Nursing, Midwifery and Paramedicine, Faculty of Health Science , Fitzroy , Victoria , Australia
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29
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Hall A, McKenna B, Dearie V, Maguire T, Charleston R, Furness T. Educating emergency department nurses about trauma informed care for people presenting with mental health crisis: a pilot study. BMC Nurs 2016; 15:21. [PMID: 27013926 PMCID: PMC4806472 DOI: 10.1186/s12912-016-0141-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 03/16/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Practicing with trauma informed care (TIC) can strengthen nurses' knowledge about the association of past trauma and the impact of trauma on the patient's current mental illness. An aim of TIC is to avoid potentially re-traumatising a patient during their episode of care. A TIC education package can provide nurses with content that describes the interplay of neurological, biological, psychological, and social effects of trauma that may reduce the likelihood of re-traumatisation. Although mental health nurses can be TIC leads in multidisciplinary environments, the translation of TIC into clinical practice by nurses working in emergency departments (EDs) is unknown. However, before ED nurses can begin to practice TIC, they must first be provided with meaningful and specific education about TIC. Therefore, the aims of this study were to; (1) evaluate the effectiveness of TIC education for ED nursing staff and (2) describe subsequent clinical practice that was trauma informed. METHODS This project was conducted as exploratory research with a mixed methods design. Quantitative data were collected with an 18-item pre-education and post-education questionnaire. Qualitative data were collected with two one-off focus groups conducted at least three-months after the TIC education. Two EDs were involved in the study. RESULTS A total of 34 ED nurses participated in the TIC education and 14 ED nurses participated in the focus groups. There was meaningful change (p < 0.01, r ≥ 0.35) in 9 of the 18-items after TIC education. Two themes, each with two sub-themes, were evident in the data. The themes were based on the perceived effectiveness of TIC education and the subsequent changes in clinical practice in the period after TIC education. CONCLUSION Emergency department nurses became more informed of the interplay of trauma on an individual's mental health. However, providing care with a TIC framework in an ED setting was a considerable challenge primarily due to time constraints relative to the day-to-day ED environment and rapid turnover of patients with potentially multiple and complex presentations. Despite this, nurses understood the effect of TIC to reduce the likelihood of re-traumatisation and expressed a desire to use a TIC framework.
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Affiliation(s)
- Andrea Hall
- Emergency Department, The Royal Melbourne Hospital, Melbourne Health, Parkville, Australia
| | - Brian McKenna
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Vikki Dearie
- Western Victorian Mental Health Learning & Development Cluster, Melbourne Health, Parkville, Australia
| | - Tessa Maguire
- Forensicare, Fairfield, Australia ; Centre for Forensic Behavioural Science, Swinburne University, Clifton Hill, Australia
| | - Rosemary Charleston
- Western Victorian Mental Health Learning & Development Cluster, Melbourne Health, Parkville, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia ; NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Australia
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McKenna B, Oakes J, Fourniotis N, Toomey N, Furness T. Recovery-Oriented Mental Health Practice in a Community Care Unit: An Exploratory Study. J Forensic Nurs 2016; 12:167-175. [PMID: 27782924 DOI: 10.1097/jfn.0000000000000127] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A recovery-oriented model of care has become the major focus of mental health service delivery in the state of Victoria, Australia. However, there is a total absence of knowledge of recovery-oriented mental health practice in community care units (CCUs). Therefore, the aims of this exploratory study were to: (a) describe what aspects of the current model of care fit within the domains of recovery; and (b) describe the pragmatic processes that staff use to mold their care within the domains of recovery. Twenty-one key stakeholders provided informed voluntary consent to participate in one-to-one interviews. Six content domains evolved to include: (a) a common vision: "a continuous journey"; (b) promoting hope; (c) promoting autonomy and self-determination; (d) meaningful engagement; (e) holistic and personalized care; and (f) community participation and citizenship. The CCU appeared to be on a journey of transformation toward personal recovery. However, clinicians were grappling with an identified tension among personal recovery and clinical recovery. The tension among personal recovery and clinical recovery may be attributed to the psychosocial rehabilitation model of care, which was previously systemic in Victorian CCUs.
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Affiliation(s)
- Brian McKenna
- Author Affiliations: 1School of Clinical Sciences, Auckland University of Technology; 2Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board; 3Centre for Forensic Behavioural Science, Swinburne University of Technology; 4Turning Point, Eastern Health; 5NorthWestern Mental Health, The Royal Melbourne Hospital; and 6School of Nursing, Midwifery and Paramedicine, Australian Catholic University
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McKenna B, Furness T, Oakes J, Brown S. Police and mental health clinician partnership in response to mental health crisis: A qualitative study. Int J Ment Health Nurs 2015; 24:386-93. [PMID: 26040444 DOI: 10.1111/inm.12140] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Police officers as first responders to acute mental health crisis in the community, commonly transport people in mental health crisis to a hospital emergency department. However, emergency departments are not the optimal environments to provide assessment and care to those experiencing mental health crises. In 2012, the Northern Police and Clinician Emergency Response (NPACER) team combining police and mental health clinicians was created to reduce behavioural escalation and provide better outcomes for people with mental health needs through diversion to appropriate mental health and community services. The aim of this study was to describe the perceptions of major stakeholders on the ability of the team to reduce behavioural escalation and improve the service utilization of people in mental health crisis. Responses of a purposive sample of 17 people (carer or consumer advisors, mental health or emergency department staff, and police or ambulance officers) who had knowledge of, or had interfaced with, the NPACER were thematically analyzed after one-to-one semistructured interviews. Themes emerged about the challenge created by a stand-alone police response, with the collaborative strengths of the NPACER (communication, information sharing, and knowledge/skill development) seen as the solution. Themes on improvements in service utilization were revealed at the point of community contact, in police stations, transition through the emergency department, and admission to acute inpatient units. The NPACER enabled emergency department diversion, direct access to inpatient mental health services, reduced police officer 'down-time', improved interagency collaboration and knowledge transfer, and improvements in service utilization and transition.
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Affiliation(s)
- Brian McKenna
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Jane Oakes
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Steve Brown
- The Northern Hospital, Northern Health, Melbourne, Victoria, Australia
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32
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Happell B, Galletly C, Castle D, Platania-Phung C, Stanton R, Scott D, McKenna B, Millar F, Liu D, Browne M, Furness T. Scoping review of research in Australia on the co-occurrence of physical and serious mental illness and integrated care. Int J Ment Health Nurs 2015. [PMID: 26220151 DOI: 10.1111/inm.12142] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The physical health of people with serious mental illness (SMI) has become a focal area of research. The aim of the present study was to ascertain the attention and distribution of research from within Australia on physical illness and SMI co-occurrence, and to identify gaps. A scoping review of peer-reviewed research literature from Australia, published between January 2000 and March 2014, was undertaken through an electronic literature search and coding of papers to chart trends. Four trends are highlighted: (i) an almost threefold increase in publications per year from 2000-2006 to 2007-2013; (ii) a steady release of literature reviews, especially from 2010; (iii) health-related behaviours, smoking, integrated-care programmes, and antipsychotic side-effects as the most common topics presented; and (iv) paucity of randomized, controlled trials on integrated-care models. Despite a marked increase in research attention to poorer physical health, there remains a large gap between research and the scale of the problem previously identified. More papers were descriptive or reviews, rather than evaluations of interventions. To foster more research, 12 research gaps are outlined. Addressing these gaps will facilitate the reduction of inequalities in physical health for people with SMI. Mental health nurses are well placed to lead multidisciplinary, consumer-informed research in this area.
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Affiliation(s)
- Brenda Happell
- Synergy, Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra Hospital, ACT, Canberra, Australia
| | - Cherrie Galletly
- The Adelaide Clinic, Adelaide, South Australia, Australia.,School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - David Castle
- St Vincent's Hospital, Melbourne, Victoria, Australia.,School of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Chris Platania-Phung
- Synergy, Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra Hospital, ACT, Canberra, Australia
| | - Robert Stanton
- Central Queensland University, Central Queensland University, School of Human Health and Social Sciences, Bundaberg, Queensland, Australia
| | - David Scott
- Central Queensland University, School of Medical and Applied Sciences, Melbourne, Victoria, Australia
| | - Brian McKenna
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne, Victoria, Australia
| | | | - Dennis Liu
- Northern Mental Health Service, Salisbury, South Australia, Australia
| | - Matthew Browne
- Central Queensland University, Central Queensland University, School of Human Health and Social Sciences, Bundaberg, Queensland, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne, Victoria, Australia
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McKenna B, Fernbacher S, Furness T, Hannon M. "Cultural brokerage" and beyond: piloting the role of an urban Aboriginal Mental Health Liaison Officer. BMC Public Health 2015; 15:881. [PMID: 26358718 PMCID: PMC4566419 DOI: 10.1186/s12889-015-2221-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 09/03/2015] [Indexed: 11/10/2022] Open
Abstract
Background Suboptimal use of mental health services persists for Aboriginal and Torres Strait Islander peoples1. Coupled with poorer life expectancy than other Australians, barriers to care have included poorly established partnership and communication among mental health services and Aboriginal peoples, and cultural insensitivity. As such, a goal of the Aboriginal mental health workforce is to engage their people and improve the social and emotional well-being of Aboriginal peoples. In 2013, the Northern Area Mental Health Service piloted a 0.8 full time equivalent position of an Aboriginal Mental Health Liaison Officer in an urban setting. Therefore, aims of this study were to describe the development of the role and stakeholder perceptions on how the role impacts on the typical journey of Aboriginal consumers engaging with mental health services. Meeting the aims may provide an exemplar for other mental health services. Methods An illustrative case study using quantitative and qualitative data collection was undertaken. Descriptive statistics were computed to profile consumers and referral pathways. Thematic analysis was used to profile key stakeholder perceptions of the role. Results The Aboriginal Mental Health Liaison Officer received 37 referrals over a 9 month period. The major source of referral was from an emergency department (49 %). Seventy-three percent of referrals by the Aboriginal mental health liaison officer at discharge were to community mental health teams. Thematic analysis of data on the development of the role resulted in two themes themes; (1) realisation of the need to improve accessibility and (2) advocating for change. The description of the role resulted in four themes; (1) the initiator: initiating access to the service, (2) the translator: brokering understanding among consumers and clinicians, (3) the networker: discharging to the community, and (4) the facilitator: providing cyclic continuity of care. Conclusions The liaison component of the role was only a part of the multiple tasks the urban Aboriginal Mental Health Liaison Officer fulfils. As such, the role was positively described as influencing the lives of Aboriginal consumers and their families and improving engagement with health professionals in the mental health service in question.
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Affiliation(s)
- Brian McKenna
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia. .,NorthWestern Mental Health, Level 1 North, City Campus, The Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia.
| | - Sabin Fernbacher
- NorthWestern Mental Health, Level 1 North, City Campus, The Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia.,Northern Area Mental Health Service, Epping, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia.,NorthWestern Mental Health, Level 1 North, City Campus, The Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia
| | - Michelle Hannon
- NorthWestern Mental Health, Level 1 North, City Campus, The Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia.,Northern Area Mental Health Service, Epping, Australia
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McKenna B, Furness T, Brown S, Tacey M, Hiam A, Wise M. Police and clinician diversion of people in mental health crisis from the Emergency Department: a trend analysis and cross comparison study. BMC Emerg Med 2015; 15:14. [PMID: 26160447 PMCID: PMC4496862 DOI: 10.1186/s12873-015-0040-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 06/29/2015] [Indexed: 11/25/2022] Open
Abstract
Background The Northern Police and Clinician Emergency Response (NPACER), a combined police and clinician second response team, was created to divert people in mental health crisis away from the hospital emergency department (ED) to care in the community or direct admission to acute inpatient services. The aim of this study was to evaluate the NPACER by comparing trends in service utilisation prior to and following its inception. Methods A retrospective comparison of electronic records was undertaken with interrupted time series analysis to assess the impact of NPACER on ED presentations over 27-months (N = 1776). Chi-squared tests were used to analyze service utilization; (1) in the six-months before and after the implementation of NPACER and (2) within the post NPACER period between times of the day it was operational. Results NPACER reduced the number of mental health crisis presentations to the ED. When the NPACER team was operational, 16 % of people in crisis went to ED compared with 100 % for all other times of the day, over a six-month period. The NPACER team enabled direct access to the inpatient unit for 51 people assessed at a police station and in the community compared with no direct access when NPACER was not operational. Conclusions NPACER enabled reductions in presentations to the ED by diverting people to more appropriate and less restrictive environments. The model also facilitated direct admission to acute inpatient mental health services when people in crisis were assessed in the community or transported to a police station for assessment.
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Affiliation(s)
- Brian McKenna
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 115 Victoria Parade, 3065, Fitzroy, Australia. .,NorthWestern Mental Health, Level 1 North, City Campus, The Royal Melbourne Hospital, Grattan Street, 3050, Parkville, Victoria, Australia.
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 115 Victoria Parade, 3065, Fitzroy, Australia. .,NorthWestern Mental Health, Level 1 North, City Campus, The Royal Melbourne Hospital, Grattan Street, 3050, Parkville, Victoria, Australia.
| | - Steve Brown
- Northern Area Mental Health Service, NorthWestern Mental Health, The Northern Hospital, 185 Cooper Street, 3076, Epping, Australia.
| | - Mark Tacey
- Melbourne EpiCentre, The Royal Melbourne Hospital and Department of Medicine, The University of Melbourne, Grattan Street, 3050, Parkville, Australia.
| | - Andrew Hiam
- Epping Police Station, Victoria Police, Police Station, 785 High Street, 3076, Epping, Australia.
| | - Morgan Wise
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 115 Victoria Parade, 3065, Fitzroy, Australia.
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Affiliation(s)
- Yan Liu
- The General Hospital of the People's Liberation Army (PLAGH); Nanlou Neurology; 28 Fuxing Road Haidian District Beijing Beijing China 100853
| | - Li Bo
- Xiyuan Hospital; China Academy of Chinese Medical Sciences; 1 Xi Yuan Cao Chang Haidian District Beijing China 100091
| | - Trentham Furness
- Australian Catholic University & NorthWestern Mental Health; School of Nursing, Midwifery and Paramedicine (Melbourne Campus); The Royal Melbourne Hospital, City Campus Grattan Street Parkville, Melbourne Victoria Australia 3050
| | - Jun Xia
- The University of Nottingham; Cochrane Schizophrenia Group; Institute of Mental Health University of Nottingham Innovation Park, Triumph Road, Nottingham UK NG7 2TU
| | - Corey WJ Joseph
- Queen Mary University of London; Centre for Sports and Exercise Medicine; School of Medicine and Dentistry Mile End Road London UK E1 4NS
| | - Xudong Tang
- China Academy of Chinese Medical Sciences; Xiyuan Hospital; 1 Xi Yuan Cao Chang Haidian District Beijing China 100091
| | - Jingchen Zheng
- The General Hospital of Chinese People's Armed Police Forces; 69 Yongding Road Haidian District Beijing China 100039
| | - Zhenfu Wang
- The General Hospital of PLA; 28 Fuxing Road Haidan District Beijing China 100853
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Happell B, Platania-Phung C, Webster S, McKenna B, Millar F, Stanton R, Galletly C, Castle D, Furness T, Liu D, Scott D. Applying the World Health Organization Mental Health Action Plan to evaluate policy on addressing co-occurrence of physical and mental illnesses in Australia. AUST HEALTH REV 2015; 39:370-378. [DOI: 10.1071/ah14098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 01/27/2015] [Indexed: 02/02/2023]
Abstract
Objectives The aim of the present study was to document Australian policies on the physical health of people with mental illness and evaluate the capacity of policy to support health needs. Methods A search of state and federal policies on mental and physical illness was conducted, as well as detailed analysis of policy content and the relationships between policies, by applying the World Health Organization Mental Health Action Plan 2013–2020 as an evaluative framework. Results National policy attention to the physical health of people with mental illness has grown, but there is little interconnection at the national and state levels. State policies across the country are inconsistent, and there is little evidence of consistent policy implementation. Conclusions A coherent national health policy framework on addressing co-occurring physical and mental illnesses that includes healthcare system reforms and ensuring the interconnectedness of other relevant services should be prioritised. What is known about the topic? People with mental illness have a lower life expectancy and poorer physical health than people who do not have a mental illness. Government policy is critical to reducing inequalities in physical health and increasing longevity. What does this paper add? Evaluating policy developments against the World Health Organization’s Mental Health Action Plan 2013–2020, this review identified a lack of cohesive national-level policy on how to improve the physical health of people with mental illness. Although there are some state-based policies regarding strategies for better prevention and management of the physical health of people with mental illness, evidence of policy implementation is either scarce or inconsistent. The capacity of current policy to translate into reforms that increase the physical and overall health of people suffering mental health difficulties seems very limited. What are the implications for practitioners? This paper outlines major policy gaps and an overall need for a national-level policy. National-level leadership on integrated health care is required, with monitoring to ensure health care reforms are genuinely informed by consumer and clinician views and are effective.
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Bullock R, McKenna B, Kelly T, Furness T, Tacey M. When reduction strategies are put in place and mental health consumers are still secluded: an analysis of clinical and sociodemographic characteristics. Int J Ment Health Nurs 2014; 23:506-12. [PMID: 25069674 DOI: 10.1111/inm.12078] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Internationally, seclusion practices continue to be the subject of intense clinical health service and academic scrutiny. Despite extensive efforts to reduce and eliminate this controversial practice, seclusion remains a clinical intervention widely used in contemporary mental health service settings. Early identification of people who are at risk for seclusion and the timely application of alternative evidence-based interventions are critical for reducing incidents of seclusion in real-world practice settings. This retrospective study aimed to determine the relationship between sociodemographic and clinical characteristics, and the use of seclusion for those mental health consumers for whom evidence-based seclusion-reduction initiatives had little impact. A 12-month centred moving average was fitted to seclusion data from a psychiatric inpatient unit over 2 years to determine stabilization in seclusion reduction. The number of consumers admitted was calculated from the point of stabilization for 1 year (n = 469). In this cohort, univariate analysis sought to compare the characteristics of those who were secluded and those who were not. A multivariate logistic regression model was undertaken to associate future seclusion based on significant independent variables. Of those people admitted, 88 (19%) were secluded. The majority of seclusions occurred in the first 5 days (70/88, 79%). Multivariate logistic regression indicated that three variables maintained their independent associative risk of seclusion: (i) age less than 35 years; (ii) assessment of risk of violence to others; and (iii) a history of seclusion. The implications of these findings for nursing practice are discussed.
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Affiliation(s)
- Rebecca Bullock
- Northern Area Mental Health Service, NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
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McKenna B, Furness T, Dhital D, Park M, Connally F. The transformation from custodial to recovery-oriented care: a paradigm shift that needed to happen. J Forensic Nurs 2014; 10:226-233. [PMID: 25347034 DOI: 10.1097/jfn.0000000000000045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
As custodial mental health services are beginning to adopt a recovery-oriented model of care, it is imperative that successes in the transformation to recovery are captured. The aim of this illustrative case study was to describe the organizational procedure that enabled the systematic transformation of a custodial mental health service to a service with a self-professed recovery orientation as its model of service delivery. One-to-one interviews with key stakeholders and a document analysis were completed to thoroughly describe the transformation of the service. Four major themes arose from the data: (a) "We had this whole paradigm shift that needed to happen;" (b) "Think recovery," the development of a manualized guide; (c) "Stepping out my recovery;" adaptation of the service guide to the secure care context; and (d) developing the culture. The "developing the culture" major theme was subcategorized to consist of (a) the right people, (b) education, (c) reflective learning, and (d) leadership. The themes provided insights to assist mental health nurses to understand the processes involved in systems transformation. However, the major successes of the service, although only recently evaluated, commenced over a decade ago and yet continue to evolve.
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Affiliation(s)
- Brian McKenna
- Author Affiliations: 1School of Nursing, Midwifery and Paramedicine, Australian Catholic University; and 2NorthWestern Mental Health, The Royal Melbourne Hospital
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McKenna B, Furness T, Dhital D, Ireland S. Recovery-Oriented Care in Older-Adult Acute Inpatient Mental Health Settings in Australia: An Exploratory Study. J Am Geriatr Soc 2014; 62:1938-42. [DOI: 10.1111/jgs.13028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Brian McKenna
- School of Nursing; Midwifery and Paramedicine; Australian Catholic University; Fitzroy Vic. Australia
- NorthWestern Mental Health; Royal Melbourne Hospital; Parkville Vic. Australia
| | - Trentham Furness
- School of Nursing; Midwifery and Paramedicine; Australian Catholic University; Fitzroy Vic. Australia
- NorthWestern Mental Health; Royal Melbourne Hospital; Parkville Vic. Australia
| | - Deepa Dhital
- School of Nursing; Midwifery and Paramedicine; Australian Catholic University; Fitzroy Vic. Australia
- NorthWestern Mental Health; Royal Melbourne Hospital; Parkville Vic. Australia
| | - Susan Ireland
- NorthWestern Mental Health; Royal Melbourne Hospital; Parkville Vic. Australia
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McKenna B, Furness T, Wallace E, Happell B, Stanton R, Platania-Phung C, Edward KL, Castle D. The effectiveness of specialist roles in mental health metabolic monitoring: a retrospective cross-sectional comparison study. BMC Psychiatry 2014; 14:234. [PMID: 25196125 PMCID: PMC4156616 DOI: 10.1186/s12888-014-0234-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 08/07/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with serious mental illness (SMI) exhibit a high prevalence of cardiovascular diseases. Mental health services have a responsibility to address poor physical health in their consumers. One way of doing this is to conduct metabolic monitoring (MM) of risk factors for cardiovascular diseases. This study compares two models of MM among consumers with SMI and describes referral pathways for those at high risk of cardiovascular diseases. METHODS A retrospective cross-sectional comparison design was used. The two models were: (1) MM integrated with case managers, and (2) MM integrated with case managers and specialist roles. Retrospective data were collected for all new episodes at two community mental health services (CMHS) over a 12-month period (September 2012 - August 2013). RESULTS A total of 432 consumers with SMI across the two community mental health services were included in the analysis. At the service with the specialist roles, MM was undertaken for 78% of all new episode consumers, compared with 3% at the mental health service with case managers undertaking the role. Incomplete MM was systemic to both CMHS, although all consumers identified with high risk of cardiovascular diseases were referred to a general practitioner or other community based health services. The specialist roles enabled more varied referral options. CONCLUSIONS The results of this study support incorporating specialist roles over case manager only roles for more effective MM among new episode consumers with SMI.
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Affiliation(s)
- Brian McKenna
- NorthWestern Mental Health, The Royal Melbourne Hospital, Level 1 North, City Campus, Grattan Street, Parkville, Victoria 3050 Australia ,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria 3065 Australia
| | - Trentham Furness
- NorthWestern Mental Health, The Royal Melbourne Hospital, Level 1 North, City Campus, Grattan Street, Parkville, Victoria 3050 Australia ,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria 3065 Australia
| | - Elizabeth Wallace
- NorthWestern Mental Health, The Royal Melbourne Hospital, Level 1 North, City Campus, Grattan Street, Parkville, Victoria 3050 Australia
| | - Brenda Happell
- Institute for Health and Social Science Research Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, CQUniversity, Bruce Highway, Rockhampton, Queensland 4702 Australia
| | - Robert Stanton
- Institute for Health and Social Science Research Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, CQUniversity, Bruce Highway, Rockhampton, Queensland 4702 Australia
| | - Chris Platania-Phung
- Institute for Health and Social Science Research Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, CQUniversity, Bruce Highway, Rockhampton, Queensland 4702 Australia
| | - Karen-leigh Edward
- St. Vincent’s Private Hospital Melbourne Nursing Research Unit, St. Vincent’s Private Hospital Melbourne, 59-61 Victoria Parade, Fitzroy, Victoria 3065 Australia ,Faculty of Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria 3065 Australia
| | - David Castle
- Faculty of Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria 3065 Australia ,St. Vincent’s Hospital Mental Health, St. Vincent’s Private Hospital Melbourne, 59-61 Victoria Parade, Fitzroy, Victoria 3065 Australia ,Department of Psychiatry, University of Melbourne, Grattan Street, Parkville, Victoria 3050 Australia
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McKenna B, Furness T, Dhital D, Ennis G, Houghton J, Lupson C, Toomey N. Recovery-oriented care in acute inpatient mental health settings: an exploratory study. Issues Ment Health Nurs 2014; 35:526-32. [PMID: 24963853 DOI: 10.3109/01612840.2014.890684] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Australian mental health nurses will need to care with consumers of mental health services, within the domains of recovery. However, in acute inpatient mental health settings, nurses are without a clear description of how to be recovery-oriented. The intent of this qualitative study was to ask nurses to reflect on and describe current practice within acute inpatient services that are not overtly recovery-oriented. Results show that nurses can identify recovery and articulate with pragmatic clarity how to care within a recovery-oriented paradigm. Pragmatic modes of care described by nurses support using "champions" to assist with eventual system transformation in the delivery of mental health services.
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Affiliation(s)
- Brian McKenna
- Australian Catholic University, School of Nursing, Midwifery and Paramedicine, Fitzroy and NorthWestern Mental Health, Melbourne Health, Parkville, Australia
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McKenna B, Furness T, Dhital D, Park M, Connally F. Recovery-oriented care in a secure mental health setting: "striving for a good life". J Forensic Nurs 2014; 10:63-69. [PMID: 24847869 DOI: 10.1097/jfn.0000000000000027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Recovery-oriented care acknowledges the unique journey of the consumer to regain control of his or her life in order to live a good life. Recovery has become a dominant policy-directed model of mental health service delivery. Even services that have traditionally been institutional and custodial have been challenged to embrace a recovery-oriented model. The aim of this qualitative study was to provide a description of service delivery in a secure in-patient mental health service, which has developed a self-professed recovery-oriented model of service delivery. An in-depth case study of the secure in-patient service using an exploratory research design was undertaken to meet the aim of this study. Qualitative data was gathered from interviews with consumers and staff (n = 15) and a focus group with carers (n = 5). Data were analyzed using a content analysis approach. Ethical approval for the study was obtained. The stakeholders readily described the secure service within recovery domains. They described a common vision; ways to promote hope and autonomy; examples of collaborative partnership which enhanced the goal of community integration; a focus on strength-based, holistic care; and the management of risk by taking calculated risks. Discrepancies in the perceptions of stakeholders were determined. This case study research provides a demonstrable example of recovery-in-action in one secure mental health service in Australia. It is intended to assist mental health services and clinicians seeking guidance in developing strategies for building and maintaining partnerships with consumers and carers in order for secure services to become truly recovery-oriented.
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Affiliation(s)
- Brian McKenna
- Author Affiliations: 1School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia. 2NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Australia
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Furness T, Joseph C, Naughton G, Welsh L, Lorenzen C. Benefits of whole-body vibration to people with COPD: a community-based efficacy trial. BMC Pulm Med 2014; 14:38. [PMID: 24606997 PMCID: PMC3975320 DOI: 10.1186/1471-2466-14-38] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 03/03/2014] [Indexed: 12/26/2022] Open
Abstract
Background Benefits of community-based whole-body vibration (WBV) as a mode of exercise training for people with chronic obstructive pulmonary disease (COPD) have not been investigated. The low skill demand of WBV may enhance habitual sustainability to physical activity by people with COPD, provided efficacy of WBV can be established. The purpose of this trial was to compare a community-based WBV intervention with a sham WBV (SWBV) intervention and monitor exacerbations, exercise tolerance, and functional performance of the lower limbs of people with COPD. Methods Community-dwelling adults with a GOLD clinical diagnosis of COPD were recruited to the trial. This was a Phase II efficacy trial with crossover to sham intervention interspersed with two-week washout. Each six-week intervention consisted of two sessions per week of either WBV or SWBV. The interventions were completed in the home of each participant under supervision. The outcome measures were selected psychological (perceived dyspnoea) and physiological (heart rate and oxygen saturation) responses to exercise, simulated activities of daily living (timed-up-and got test and 5-chair stands test), and selected kinematic variables of gait across the 14-week trial. Results Sixteen adults with stable COPD were recruited to the trial. No exacerbations were reported during the WBV or SWBV interventions. After WBV, performance of activities of daily living (ADLs) and gait improved (p ≤ 0.05), while there was no change after SWBV (p > 0.05). Despite five withdrawals during the washout period, a 100% compliance to each six-week intervention was noted. Conclusions Results showed that WBV did not exacerbate symptoms of COPD that can be associated with physical inactivity. The WBV intervention improved tests to simulate ADLs such as rising from a chair, turning, and walking gait with greater effect than a SWBV intervention. If a placebo effect was systemic to the WBV intervention, the effect was negligible. As a standalone community-based intervention, WBV was an efficacious mode of exercise training for people with stable COPD that did not negatively effect exercise tolerance or exacerbate the disease, while concurrently improving functional performance of the lower limbs. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12612000508875.
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Affiliation(s)
- Trentham Furness
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Fitzroy, Australia.
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Furness T, Joseph C, Welsh L, Naughton G, Lorenzen C. Whole-body vibration as a mode of dyspnoea free physical activity: a community-based proof-of-concept trial. BMC Res Notes 2013; 6:452. [PMID: 24209408 PMCID: PMC3827829 DOI: 10.1186/1756-0500-6-452] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/08/2013] [Indexed: 11/18/2022] Open
Abstract
Background The potential of whole-body vibration (WBV) as a mode of dyspnoea free physical activity for people with chronic obstructive pulmonary disease (COPD) is unknown among community-based settings. Furthermore, the acute effects of WBV on people with COPD have not been profiled in community-based settings. The aim of this community-based proof-of-concept trial was to describe acute effects of WBV by profiling subjective and objective responses to physical activity. Findings Seventeen community-dwelling older adults with COPD were recruited to participate in two sessions; WBV and sham WBV (SWBV). Each session consisted of five one-minute bouts interspersed with five one-minute passive rest periods. The gravitational force was ~2.5 g for WBV and ~0.0 g for SWBV. Reliability of baseline dyspnoea, heart rate, and oxygen saturation was first established and then profiled for both sessions. Acute responses to both WBV and SWBV were compared with repeated measures analysis of variance and repeated contrasts. Small changes in dyspnoea and oxygen saturation lacked subjective and clinical meaningfulness. One session of WBV and SWBV significantly increased heart rate (p ≤ 0.02), although there was no difference among WBV and SWBV (p = 0.67). Conclusions This community-based proof-of-concept trial showed that a session of WBV can be completed with the absence of dyspnoea for people with COPD. Furthermore, there were no meaningful differences among WBV and SWBV for heart rate and oxygen saturation. There is scope for long-term community-based intervention research using WBV given the known effects of WBV on peripheral muscle function and functional independence.
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Affiliation(s)
- Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia.
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Graudins A, Meek R, Egerton-Warburton D, Seith R, Furness T, Chapman R. The PICHFORK (Pain InCHildren Fentanyl OR Ketamine) trial comparing the efficacy of intranasal ketamine and fentanyl in the relief of moderate to severe pain in children with limb injuries: study protocol for a randomized controlled trial. Trials 2013; 14:208. [PMID: 23842536 PMCID: PMC3716920 DOI: 10.1186/1745-6215-14-208] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 07/04/2013] [Indexed: 11/18/2022] Open
Abstract
Background The effectiveness of intranasal (IN) fentanyl as an analgesic for painful pediatric limb injuries in the Emergency Department (ED) has been reported previously. However, efficacy of IN ketamine in sub-dissociative doses is not well studied in the ED setting. A non-blinded pilot study undertaken by this study group suggested that IN ketamine showed similar analgesic effectiveness to that reported with IN fentanyl in similar non-blinded studies. The aim of this randomized, controlled, equivalence trial is to compare the analgesic effect of sub-dissociative dose IN ketamine with IN fentanyl for children with isolated musculoskeletal limb injuries. Methods/Design This is a prospective, randomized, controlled, double-blind equivalence trial of children agedthree to thirteen years and less than 50 kg body weight, with isolated musculoskeletal limb injury, presenting to the ED with moderate to severe pain, defined as a verbal response of at least six to a standard 11-point scale (0 = none, 10 = worst pain imaginable). Pain score, sedation, satisfaction with analgesic intervention, and adverse effects will be assessed over a 60 minute interval for each participant. Intranasal ketamine (1 mg/kg) or fentanyl (1.5 microgram/kg) will be administered via blinded syringe and mucosal atomization device in a standardized volume at 0.03 ml/kg, with a maximum volume of 1.5 ml divided equally to both nares. Participants will also receive 10 mg/kg ibuprofen orally. The primary outcome measure will be median change in pain score from pre-administration to 30 minutes post-administration. Non-parametric Mann–Whitney U tests will be computed to compare median change in the primary outcome measure for IN ketamine and fentanyl. A sample size of 36 participants per group is needed to detect the expected 40 mm reduction in pain rating with a 95% confidence interval (CI) no greater than ± 10 mm at 30 minutes. Rescue analgesia will be given as IN fentanyl or intravenous morphine. Discussion This is the first randomized-controlled trial comparing the efficacy of these two analgesic agents via the intranasal route. If IN ketamine is found to be equally effective to IN fentanyl for this indication, it will provide another analgesic agent that may be considered for the relief of acute pain in children in the ED. Trial registration Australian New Zealand Clinical Trials Registry
ACTRN12612000795897.
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Furness T, Bate N, Kurzel A, Joseph C, Naughotn G, Lorenzen C. Long-term effects of WBV on gait of people with COPD. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Furness T, Bate N, Browne B, Naughton G, Lorenzen C. Safety of a single WBV session for people with COPD. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Furness T, Bate N, Welsh L, Naughton G, Lorenzen C. Efficacy of a whole-body vibration intervention to effect exercise tolerance and functional performance of the lower limbs of people with chronic obstructive pulmonary disease. BMC Pulm Med 2012; 12:71. [PMID: 23181339 PMCID: PMC3538660 DOI: 10.1186/1471-2466-12-71] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 11/16/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a respiratory condition characterised by dyspnoea, excessive sputum production, chronic cough, bronchitis and emphysema. Functionally, exercise tolerance is poor for people with COPD and is linked to difficulty in performing daily tasks. More specifically, exercise difficulties are due partly to dyspnoea and lower limb skeletal muscle dysfunction. The benefit of exercise that does not exacerbate the disease while improving exercise tolerance is salient. Whole-body vibration (WBV) is a mode of physical activity known to improve muscular function of the lower limbs, yet efficacy has not been investigated for a WBV intervention conducted in a home-based setting for people with COPD. METHODS/DESIGN This clinically registered trial is a non-randomised placebo cross-over intervention based in the home of each participant (ACTRN12612000508875). Participants diagnosed with COPD will complete a six-week WBV intervention and then after a two-week washout period, will complete a six-week placebo training intervention. Participants will complete sessions twice a week. The duration of the trial is 14 weeks. Community-dwelling older adults with COPD will provide informed voluntary consent to participate. Outcome measures will include immediate, acute, and long-term responses to exercise. DISCUSSION Quantifying responses to WBV among people with COPD will allow discussion of efficacy of WBV as a mode of physical activity. The skill required by the participant to perform physical activity with WBV is not demanding and may enhance habitual sustainability. The results of this trial could be used to support further research in both clinical and community settings. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR12612000508875).
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Affiliation(s)
- Trentham Furness
- Department of Medicine, Monash University, Monash Medical Centre, Clayton, Australia
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
- Monash Medical Centre, Southern Health, Clayton, Australia
| | - Nicole Bate
- Monash Medical Centre, Southern Health, Clayton, Australia
| | - Liam Welsh
- The Royal Children’s Hospital, Melbourne, Australia
| | - Geraldine Naughton
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
| | - Christian Lorenzen
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
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Furness T. Validation of two different amazing super health vibro-trainers. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2009.10.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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