Mental health of nurses involved with COVID-19 patients in Japan, intention to resign, and influencing factors

The purpose of this study was to investigate the association between mental health (posttraumatic stress disorder, depression, anxiety disorder, and burnout) and intention to resign, and influencing factors regarding nurses involved with COVID-19 patients in A Prefecture as subjects.The design is a cross-sectional questionnaire-based study.Methods are conducted between August 4 and October 26, 2020. Basic attributes (gender, age, years of experience, etc.) were examined. Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, Impact of Event Scale-Revised, Maslach Burnout Inventory, "intent to resign," were used to collect data from nurses working at hospitals treating patients with COVID-19 in Japan.As a result, between 20% and 30% of nurses involved with patients with COVID-19 are in a state of high mental distress. Regarding the associations between psychiatric symptoms and intention to resign, "I want to quit being a nurse" was affected by "cynicism" and "professional efficacy"; "I want to change hospitals/wards" was affected by "cynicism"; and "subthreshold depression," "anxiety disorder," and "burnout" affected "I want to continue working as a nurse." The increase in the number of patients with COVID-19 was a factor affecting mental health and intention to resign. When the number of patients increased, anxiety disorders and intention to resign also increased. Damage from harmful rumors increased the severity of every psychiatric symptom. To prepare for a pandemic such as COVID-19, it is necessary in normal times to construct psychological support systems and community systems to prevent damage from harmful rumors.

Prevalence and factors of compassion fatigue among Chinese psychiatric nurses: A cross-sectional study

Compassion fatigue has emerged as a detrimental consequence of experiencing work-related stress among psychiatric nurses, and affected the job performance, emotional and physical health of psychiatric nurses. However, researches on Chinese psychiatric nurses' compassion fatigue are dearth. This cross-sectional study aimed to investigate the prevalence and factors of compassion fatigue among Chinese psychiatric nurses.All participants completed the demographic questionnaire and the Chinese version of Professional Quality of Life Scale (ProQOL-CN). One-way ANOVA, t-tests, Levene test and multiple linear regression analysis were conducted to evaluate factors associated with compassion fatigue.A total of 352 psychiatric nurses in 9 psychiatric hospitals from the Chengdu, Wuhan, and Hefei were surveyed. The mean scores of compassion satisfaction, burnout and secondary traumatic stress were 32.59 ± 7.124, 26.92 ± 6.003 and 25.97 ± 5.365, respectively. Four variables of job satisfaction, exercise, had children, and age range from 36 to 50 years explained 30.7% of the variance in compassion satisfaction. Job satisfaction, sleeping quality, and marital status accounted for 40.4% variables in burnout. Furthermore, job satisfaction, average sleeping quality, and years of nursing experience remained significantly associated with secondary trauma stress, explaining 10.9% of the variance.Compassion satisfaction, burnout and secondary traumatic stress among Chinese psychiatric nurses were at the level of moderate. The higher job satisfaction, healthy lifestyle (high sleep quality and regular exercise), and family support (children, stable and harmonious marital status) positively influenced compassion satisfaction and negatively associated with burnout or secondary traumatic stress.

Exploration of the factors related to self-efficacy among psychiatric nurses

The average length of hospital stay in the psychiatric ward is longer, and the risk of patient-to-nurse violence is higher than that in other departments. Therefore, psychiatric nurses' work environment may differ from that of other nurses. The factors related to psychiatric nurses' self-efficacy may also differ from those of general workers or other nurses. Mental health care that considers the characteristics of psychiatric nurses requires exploration of self-efficacy unique to psychiatric nurses. This cross-sectional study aimed to explore the distinct factors related to psychiatric nurses' self-efficacy. The developed 24 items related to improvement in self-efficacy and 25 items related to decrease in self-efficacy were examined. The Generalized Self-Efficacy Scale was used to measure the validity of the factors. To extract the factors of self-efficacy, data from 132 nurses and assistant nurses who provided informed consent were analyzed, and the reliability and validity of the factors were calculated. The factors associated with improvement in self-efficacy were "Positive reactions by patients," "Ability to positively change nurse-patient relationship," and "Practicability of appropriate nursing." The factors associated with decrease in self-efficacy were "Uncertainty in psychiatric nursing" and "Nurses' role loss." The Cronbach's α for all factors exceeded .70. Of the five factors, four had significant weak-to-moderate correlations with the Japanese version of the Generalized Self-Efficacy Scale; therefore, the validity was quantitatively confirmed with four factors. Interventions based on these four factors may improve psychiatric nurses' self-efficacy. Additionally, it is possible that this tool assesses the unique facets of self-efficacy rather than psychiatric nurses' general self-efficacy. Interventions to improve psychiatric nurses' self-efficacy based on the characteristics of psychiatry are needed.

Mobile community learning programme's effectiveness in case management for psychiatric nurses: A preliminary randomised controlled trial

BACKGROUND

The global health care system has applied case management (CM) as a care delivery service provided by nurses. Nurses require continuing education in CM to enhance their professional knowledge and competence. Mobile communities have been used to promote continuing education for medical professionals. However, limited studies have examined the effectiveness of such learning programmes in CM for psychiatric nurses.

OBJECTIVE

To evaluate the effectiveness of a mobile community learning (MCL) programme in CM for psychiatric nurses.

DESIGN

This study used an experimental two-group pre- and post-test design.

SETTINGS AND PARTICIPANTS

Psychiatric nurses employed in a psychiatric teaching hospital situated in northern Taiwan were recruited.

METHODS

Nurses were randomly allocated to the experimental or comparison group. The former participated in the learning intervention in CM. The CM knowledge index and a competence scale were used to determine outcomes. Pre-tests and 2-month post-tests were conducted. The MCL programme comprised five simulated learning modules, self-assessment questions, learning cases, learning resources and experience sharing. A two-way repeated-measures analysis of variance was performed to evaluate the effect of the intervention on target outcomes.

RESULTS

The questionnaires were completed by 48 participants. The two groups possessed high homogeneity with regard to characteristics and pre-test outcomes. Differences between the two groups regarding CM knowledge (F = 22.99, p < .01) and competence (F = 6.33, p = .015) were significant. The programme had a positive benefit on the learning experience in the experimental group; the mean satisfaction score for the programme reached 4.27 (range, 1-5).

CONCLUSIONS

MCL programmes for psychiatric nurses can effectively enhance CM knowledge and competence. However, these methods cannot completely replace the continuing education approach for achieving CM competence.

"A great stress among students" - mental health nurses' views of medication education: A qualitative descriptive study

BACKGROUND

Registered mental health nurses report dissatisfaction with the level of medication knowledge demonstrated by undergraduate nurses. However, little is known about which particular areas staff nurses are concerned about, and how they feel education can be enhanced in both academic and clinical settings.

OBJECTIVE

To investigate the views of staff nurses on the delivery of medication education to undergraduate mental health nurses.

DESIGN

A qualitative descriptive design was adopted.

METHODS

Two focus groups were held with registered nurses in two acute mental health facilities. Data were analysed using qualitative content analysis.

RESULTS

The first theme reports on the difficulties staff nurses observed with both undergraduate and newly qualified nurses around medication. It was noted that these individuals had difficulties interpreting medication charts/Kardexes, and were unable to provide medication-related education to service users. The second theme reports on strategies to enhance medication education, as recommended by participants. It was suggested that more practical education should be delivered in academic settings, with a focus on simulation and presentations from clinical staff. In the clinical settings, it was suggested that preceptors should provide education at less busy times on the ward.

CONCLUSIONS

This study gives insight into areas in which education needs to be strengthened, in order to improve the medication knowledge of undergraduate and newly qualified nurses. Further research is needed to develop evidence-based strategies to enhance this education.

Increasing Psychiatric Mental Health Nursing HESI Grade Allocation Percentage in a Psychiatric Nursing Course

BACKGROUND

Scant evidence is found in the literature regarding the unit-level Health Education Systems, Inc. (HESI) examinations. This study aims to (a) compare student Psych HESI examination scores between cohorts after increasing grade allocation from 5% to 15%, and (b) examine student perceptions of the impact of increasing the percentage of course grade allocation.

METHOD

An ex post facto research design analyzed differences in Psych HESI examination scores. HESI examination mean score differences between groups were analyzed using ANOVA. Narrative responses were analyzed using content analysis.

RESULTS

Psych HESI examination means increased from 836 in spring 2015 (5% of course grade) to 905 in fall 2015 (15% of course grade). Narrative response themes included (a) Validated Learning; (b) Compelled Participants to Study More; (c) Incongruent With Class Content and Preparation Books; and (d) Stress-Producing.

CONCLUSION

HESI examination scores improved with increasing course grade percentage allocated to the HESI score. Students indicated positive and negative perceptions of the increased grade allocation. [J Nurs Educ. 2018;57(10):604-608.].

Admission and discharge criteria for adolescents requiring inpatient or residential mental healthcare: a scoping review protocol

The question of this review is: what are the admission and discharge criteria for mental health inpatient care for adolescents?The objective is to identify the criteria.

Validating the psychiatric nurses methods of coping questionnaire: Arabic version

BACKGROUND

The aim of the study was to undertake a psychometric analysis of the Psychiatric Nurses Methods of Coping Questionnaire (PNMCQ) - Arabic version when used to measure coping skills in psychiatric nurses in Jordan.

METHOD

A descriptive, cross-sectional design was adopted in this study. A demographic questionnaire and the 35-item PNMCQ -Arabic were the measures used to collect data.

RESULT

The PNMCQ demonstrated valid and reliable values when administered to psychiatric nurses in Jordan after it had been submitted to factor analysis.

CONCLUSION

The development of PNMCQ: Arabic Version adequately measures coping skills in psychiatric nurses from a culturally appropriate context. Use of the tool can determine coping skills in psychiatric nurses with the view to positive staff development. Strategies identified based on results of the PNMCQ could ultimately result in better nurse retention and patient outcomes.

Using Participatory Action Research to Develop a Working Model That Enhances Psychiatric Nurses' Professionalism: The Architecture of Stability

Ward rules in psychiatric care aim to promote safety for both patients and staff. Simultaneously, ward rules are associated with increased patient violence, leading to neither a safe work environment nor a safe caring environment. Although ward rules are routinely used, few studies have explicitly accounted for their impact. To describe the process of a team development project considering ward rule issues, and to develop a working model to empower staff in their daily in-patient psychiatric nursing practices. The design of this study is explorative and descriptive. Participatory action research methodology was applied to understand ward rules. Data consists of audio-recorded group discussions, observations and field notes, together creating a data set of 556 text pages. More than 100 specific ward rules were identified. In this process, the word rules was relinquished in favor of adopting the term principles, since rules are inconsistent with a caring ideology. A linguistic transition led to the development of a framework embracing the (1) Principle of Safety, (2) Principle of Structure and (3) Principle of Interplay. The principles were linked to normative guidelines and applied ethical theories: deontology, consequentialism and ethics of care. The work model reminded staff about the principles, empowered their professional decision-making, decreased collegial conflicts because of increased acceptance for individual decisions, and, in general, improved well-being at work. Furthermore, the work model also empowered staff to find support for their decisions based on principles that are grounded in the ethics of totality.

The Mentally Ill in Jail: Contemporary Clinical and Practice Perspectives for Psychiatric-Mental Health Nursing

Individuals with serious mental illnesses (SMI) who are incarcerated pose major treatment challenges for both correctional personnel and healthcare providers, yet deserve the same high standards of care as those in traditional mental health facilities. The literature references these challenges as types of mental health treatment disparities, and calls for improvement measures from clinicians, researchers, policy-makers, and advocates. From the standpoint of psychiatric-mental health (PMH) nursing, this paper explores, examines, and offers some contemporary clinical and practice perspectives for providing best-practice psychiatric care for SMI individuals who are in jails. The diverse roles of PMH nursing can contribute meaningfully to tackling quality improvement initiatives on mental health treatment agendas for SMI inmates.

Genetic Testing for Psychopharmacology: Is It Ready for Prime Time?

Genetic testing in psychiatric practice may be a beneficial adjunct to the nursing toolbox of considerations used to improve patient outcomes. Since 2004, the psychiatric community has used genotyping to personalize medication options for their patients. Although not a definitive or exact science, pharmacogenetic testing for psychopharmacological treatment options offers nurses and their patients insights into potential treatments that will reduce the current trial-and-error prescribing practices and more quickly improve patients' quality of life. The current article guides nurses through the process of conducting genetic testing, interpreting the results, and applying the results in clinical practice using a fictitious case example. [Journal of Psychosocial Nursing and Mental Health Services, 55(3), 19-23.].

Restraint and the Question of Validity

Restraint as an intervention in the management of acute mental distress has a long history that predates the existence of psychiatry. However, it remains a source of controversy with an ongoing debate as to its role. This article critically explores what to date has seemingly been only implicit in the debate surrounding the role of restraint: how should the concept of validity be interpreted when applied to restraint as an intervention? The practice of restraint in mental health is critically examined using two post-positivist constructions of validity, the pragmatic and the psychopolitical, by means of a critical examination of the literature. The current literature provides only weak support for the pragmatic validity of restraint as an intervention and no support to date for its psychopolitical validity. Judgements regarding the validity of any intervention that is coercive must include reference to the psychopolitical dimensions of both practice and policy.

Experience of Psychiatric Mental Health Nurse Practitioners in Public Mental Health

Expansion of health insurance coverage under the Accountable Care Act has meant that millions of people are now insured for mental health treatment, but with no significant increase in the mental health workforce. Services of psychiatric mental health nurse practitioners (PMHNPs) may be best utilized to improve access to and quality of public mental health services if the financial, political, scope of practice, and treatment model barriers that limit their ability or willingness to practice in these settings are better understood. This article reports qualitative results from a study that assessed barriers and best practices in the use of PMHNPs in county mental health services in California. Results indicate that PMHNPs are valued for their "whole person" perspective, collaborative approach, and interpersonal communication skills, but that significant knowledge gaps, regulatory constraints, and bureaucratic barriers in public mental health systems inhibit PMHNPs from practicing at the top of their scope.

Cultural competence in mental health nursing: validity and internal consistency of the Portuguese version of the multicultural mental health awareness scale-MMHAS

BACKGROUND

Cultural competence is an essential component in rendering effective and culturally responsive services to culturally and ethnically diverse clients. Still, great difficulty exists in assessing the cultural competence of mental health nurses. There are no Portuguese validated measurement instruments to assess cultural competence in mental health nurses. This paper reports a study testing the reliability and validity of the Portuguese version of the Multicultural Mental Health Awareness Scale-MMHAS in a sample of Portuguese nurses.

METHODS

Following a standard forward/backward translation into Portuguese, the adapted version of MMHAS, along with a sociodemographic questionnaire, were applied to a sample of 306 Portuguese nurses (299 males, 77 females; ages 21-68 years, M = 35.43, SD = 9.85 years). A psychometric research design was used with content and construct validity and reliability. Reliability was assessed using internal consistency and item-total correlations. Construct validity was determined using factor analysis.

RESULTS

The factor analysis confirmed that the Portuguese version of MMHAS has a three-factor structure of multicultural competencies (Awareness, Knowledge, and Skills) explaining 59.51% of the total variance. Strong content validity and reliability correlations were demonstrated. The Portuguese version of MMHAS has a strong internal consistency, with a Cronbach's alpha of 0.958 for the total scale.

CONCLUSIONS

The results supported the construct validity and reliability of the Portuguese version of MMHAS, proving that is a reliable and valid measure of multicultural counselling competencies in mental health nursing. The MMHAS Portuguese version can be used to evaluate the effectiveness of multicultural competency training programs in Portuguese-speaking mental health nurses. The scale can also be a useful in future studies of multicultural competencies in Portuguese-speaking nurses.

Achieving Excellence Through Contemporary and Relevant Psychiatric-Mental Health Nursing Standards of Practice

Standards of practice (SOPs) comprise competency statements, which are grounded in current knowledge and research, and provide foundations for performance that support professional accountability. The nursing profession, and specifically the psychiatric-mental health specialty of nursing practice in Canada, develops and revises practice standards regularly. The current article describes the collaborative, evidence-informed journey of the Canadian Federation of Mental Health Nurses during its fourth revision of the Canadian Psychiatric-Mental Health Nursing SOPs. An intraprofessional team of psychiatric-mental health nurses from the clinical, academic, research, and policy areas developed and nurtured collaborative processes that emphasize collegial and authentic relationships. Effective communication and a respectful learning environment supported the process for all members of the team. The current article provides recommendations for other professional organizations considering developing and/or revising SOPs.

Psycho–Educational Group treatment for the Severely and Persistently Mentally Ill: How Much Leader Training Is Necessary?

Psycho-educational groups (PEGs) have been shown to be a particularly effective form of treatment for patients classified under the rubric of severely and persistently mentally ill (SPMI). However, recent surveys suggest that certain professionals, such as nurses and clinical psychologists, called on to conduct these groups may have limited to no training. This study tested three methods (self-instructional, workshop, and workshop plus clinical supervision) designed to provide on-the-job training to practicing clinicians. Specifically, training was based on two manuals; one that operationalized the basic knowledge and skills needed to run an effective PEG and the second being a commonly used PEG program for symptom management targeted at SPMI patients. Eight nurses from four adult units at a state psychiatric hospital initially received self-instructional or workshop training and then conducted a 12-session symptom management PEG composed of four to five SPMI patients (e.g., schizophrenia, schizoaffective or major depression disorders). In a second wave of additional training, nurses received workshop training or clinical supervision and then conducted a second PEG. Differences between training methods were assessed by nurse- and patient-completed measures that tapped the knowledge and skills emphasized in the symptom management and PEG (nurses only) manuals. Results indicated limited support for the superiority of the workshop method on the nurse measures alone. Implications for training working professionals in group treatments and assessing outcomes with chronic SPMI patients are discussed.

Depression in patients with chronic kidney disease

Chronic kidney disease affects 10 per cent of the general population. A number of studies over the last decade have established that there is a higher prevalence of depression amongst those with chronic kidney disease (CKD). Biological, psychological and socio-economic factors influence the higher prevalence of depression in this population. The complex interplay between bio-psycho-social factors helps explain the bidirectional relationship between progress of CKD and depression. We summarize the prevalence and etiology of depression in those suffering from CKD and describe in brief the impact of depression in CKD on outcomes such as mortality and morbidity, as well as the different management options that are available. The purpose of this article is to provide a summarized and clinically applicable update on depression for nurses, which will assist them in recognizing and seeking treatment for depression, as well as highlight what is already being done and what needs to be done in terms of recognition and treatment of this common psychiatric condition.

Impact of a stress management program on stress perception of nurses working with psychiatric patients

Nurses caring for psychiatric patients may have to face violent emotions and unpredictable behaviour which can be quite stressful. A stress management program may equip nurses with skills to cope effectively with the stress. A one group pre-test and post-test design was adopted to test this hypothesis. Both gender nurses caring for psychiatric patients were invited to undergo 10 consecutive, one hour sessions of a stress management program. The DCL Stress scale (The De Villiers, Carson & Leary Stress Scale; Carson et al., 1997a,b,c) was used to collect data immediately after intervention and four weeks later. RM ANOVA with spss 16 showed that pre-intervention mean stress reduced significantly (p=0.000) from 57.45±16.42 to 41.06±16.51 immediately following the intervention and 26.43±12.82 (p=0.000) four weeks after the intervention. The stress management strategies positively impacted on nurses' stress levels.

The 2014 Scope and Standards of Practice for Psychiatric Mental Health Nursing: Key Updates

The 2014 Psychiatric-Mental Health Nursing: Scope and Standards of Practice is the specialty's description of competent nursing practice. The scope portion of this document identifies the focus of the specialty by defining nursing practice extents and limits. Standards are statements that identify the duties and obligations for which specialty nurses are held accountable, including general registered nurses and advanced practice nurses. This article begins with a brief overview of the revision process. The author describes key factors that influenced the revision, such as external documents and current priorities in healthcare, and synthesizes significant changes to the document, including commentary and comparisons to the generalist Scope and Standards of Practice. Implications for nursing education and a companion resource are discussed.

Ray Rowden 1952-2014. Mental health nurse and leading healthcare figure, who was a force to be reckoned with right to the end

Nursing has lost one of its most flamboyant and colourful characters with the death of inspirational mental health nurse Ray Rowden at the age of just 62.

Theory into practice (sometimes doesn't go)

Ed Freshwater is a third-year mental health nursing student. In this month's column, he writes about his concerns surrounding care provision for patients with mental ill health. At a time when health professionals are under numerous pressures, is the patient still at the centre of everything we do?

Resilience of institutional culture: mental nursing in a decade of radical change

Mental nursing has continued to be neglected in the history of psychiatry. This paper considers the impact of a decade of radical developments on the role and outlook of nurses in British mental hospitals during the 1930s. The Mental Treatment Act 1930 introduced voluntary admission for early, supposedly treatable cases, although there was paucity of effective treatment. In the mid-1930s shock therapies, administered with great enthusiasm by asylum doctors, promised to cure insanity by physical means. Although these were important milestones in the progress of psychiatry, for the majority of nurses and patients life continued much as before. Despite advances in training, working conditions and therapeutic activity, the institutional culture of nursing was remarkably resilient to the forces of change.

Advanced psychiatric nurse practitioners’ ideas and needs for supervision in private practice in South Africa

Background: Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field.Objectives: The aim of this study was to explore and describe advanced psychiatric nursepractitioners’ ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa.Method: A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch’s method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature.Results: The data analysis generated the following themes – that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa.Conclusion: This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.

Health promotion in psychosis services

Early intervention in psychosis (EIIP) services work to detect and treat the condition early, which improves prognosis and saves money. This article reports on the impact of an EIIP team's efforts to promote health by raising awareness of psychosis and services available. An audit before and after health promotional activities showed referrals to EIIP increased by 10% and admissions to acute inpatient units fell by 75%.

Medicines management in mental health

This article provides evidence to suggest that mental health nurses may not be as competent in medicines management as they believe themselves to be. A psychological model of skills awareness is used throughout the article to offer a theoretical explanation of this putative deficit and provide discussion of the possible causes. Training directed towards improving medicines management skills will be introduced. Training such as this is essential if mental health nurses are to offer the best care to those in receipt of their services and make best use of the opportunities provided by prescribing legislation.