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International Journal of Mental Health... Dec 2022This perspective paper aims to present a personal viewpoint on the impact of psychiatric discourse on the principles of recovery in mental health care. Mental health...
This perspective paper aims to present a personal viewpoint on the impact of psychiatric discourse on the principles of recovery in mental health care. Mental health services espouse these principles, yet psychiatric discourse remains the dominant model. A critical analysis will examine how psychiatry maintains this dominance. The aim is to examine how psychiatric discourse constructs both the nature of mental distress and its treatment, and how it maintains its power as the dominant authority and its relationship to recovery principles. The paper concludes that psychiatric discourse is the antithesis of recovery principles and that its authority is perpetuated through co-opting a medical explanatory model, claiming expertise in the ability to predict social risk, and maintaining a tightly controlled echo chamber. A way forward involves the dismantling of the hierarchical service delivery model based on psychiatric discourse and replacing it with a more horizontal service delivery model in which the lived experience of mental distress is central. Regular audit of services needs to prioritize recovery principles. The implications for mental health nursing are considered.
Topics: Humans; Psychiatric Nursing; Mental Health Services; Mental Disorders; Psychiatry
PubMed: 36379908
DOI: 10.1111/inm.13072 -
Journal of Psychosocial Nursing and... Sep 2023As rates of substance use and mental disorders continue to rise, individuals with mental health and substance use challenges and their supporters could benefit from...
As rates of substance use and mental disorders continue to rise, individuals with mental health and substance use challenges and their supporters could benefit from practical, accessible, cost-effective, wellness-focused tools outlining simple daily strategies to promote long-term recovery. The current article describes such a tool, the Journey to Wellness Guide, based on the Wellness Model, and developed through a co-production process. refers to a process of research, service design, and educational materials development where people with lived experience of mental health and/or substance use challenges share decision-making power throughout all stages of production, including the sharing of results. The co-production process resulted in a well-received wellness tool and tip guides for personal use, supporting others, and use in a group context. The value of this tool for psychosocial nursing and behavioral health care worker self-care and practice is outlined. [(9), 24-30.].
Topics: Humans; Mental Disorders; Mental Health; Mental Health Services; Self Care; Psychiatric Nursing
PubMed: 36989482
DOI: 10.3928/02793695-20230321-02 -
Movement Disorders Clinical Practice Jul 2023Perry disease (or Perry syndrome [PS]) is a hereditary neurodegenerative disorder inevitably leading to death within few years from onset. All previous cases with...
BACKGROUND
Perry disease (or Perry syndrome [PS]) is a hereditary neurodegenerative disorder inevitably leading to death within few years from onset. All previous cases with pathological confirmation were caused by mutations within the cytoskeleton-associated protein glycine-rich (CAP-Gly) domain of the gene.
OBJECTIVES
This paper presents the first clinicopathological report of PS due to a novel mutation outside the CAP-Gly domain.
METHODS
Clinical and pathological features of the new variant carrier are compared with another recently deceased PS case with a well-known pathogenic mutation and other reported cases.
RESULTS AND CONCLUSIONS
We report a novel mutation outside the CAP-Gly domain that we demonstrated to be pathogenic based on clinical and autopsy findings.
PubMed: 37476320
DOI: 10.1002/mdc3.13764 -
Global Health & Medicine Jun 2023Psychiatric home-visit nursing supports the lives of people with mental disorders in the community and plays an important role in the "community-based integrated care...
Psychiatric home-visit nursing supports the lives of people with mental disorders in the community and plays an important role in the "community-based integrated care system" which is rapidly being implemented in Japan. Although the number of responsive home-visit nursing stations (HVNS) is increasing, the current situation of service provision has not yet been clarified. This study aimed to investigate the characteristics and difficulties of psychiatric home-visit nursing provided by HVNS. We further discussed future care provisions and service improvements. We conducted a questionnaire survey of 7,869 member stations of the National Association for Visiting Nurse Service; of this number 2,782 facilities (35.4%) responded. Of the 2,782 facilities, 1,613 (58.0%) provided psychiatric home-visit nursing. The HVNS that provided psychiatric home-visit nursing were diverse, and the percentage of users with mental disorders ranged widely. Majority of the HVNS reported having "difficulty in caring for users/families who refuse care" (56.3%), "difficulty in care for psychiatric symptoms" (54.0%), and "difficulty in assessment of psychiatric symptoms" (49.1%), with differences in difficulty depending on the percentage of psychiatric users. As user needs and HVNS characteristics diversify, it is necessary to take advantage of the characteristics of each station to develop consultation and training systems and collaborative network platforms within each community for future sustainable service provision.
PubMed: 37397945
DOI: 10.35772/ghm.2023.01034 -
Soins; La Revue de Reference Infirmiere Sep 2022Within the framework of its establishment project, a public mental health establishment located in Essonne wished to develop paramedical research. The theme of the... (Review)
Review
Within the framework of its establishment project, a public mental health establishment located in Essonne wished to develop paramedical research. The theme of the stigmatization of nurses working in psychiatry was chosen. Using a qualitative methodology, interviews were conducted with two groups of professionals and one group of student nurses, the aim being to find out whether they felt stigmatized by their peers and/or by society in general. The results obtained are interesting.
Topics: Humans; Stereotyping; Psychiatric Nursing; Students, Nursing; Psychiatry; Emotions
PubMed: 36442919
DOI: 10.1016/j.soin.2022.09.023 -
Archives of Psychiatric Nursing Oct 2020This article provides a brief overview of the early development of geropsychiatric nursing (GPN) as background for examining its advancement subsequent to the 2010... (Review)
Review
This article provides a brief overview of the early development of geropsychiatric nursing (GPN) as background for examining its advancement subsequent to the 2010 Future of Nursing (FON) Report. The FON's education, practice and leadership recommendations form the three pillars that have supported geropsychiatric nursing's continuing evolution, framed within a practice and policy perspective. Lessons learned are relevant to developing the next phase of FON recommendations. The importance of overcoming challenges faced by the field of GPN is supported by the aging global population, the directions of nursing as a discipline, and the clear necessity of an intra- and inter-professional approach to mental health and aging.
Topics: Education, Nursing; Geriatrics; Health Knowledge, Attitudes, Practice; Humans; Leadership; Nursing Education Research; Psychiatric Nursing
PubMed: 33032747
DOI: 10.1016/j.apnu.2020.07.006 -
BMC Nursing Jun 2022We developed and psychometrically tested the Nursing Presence Scale.
AIM
We developed and psychometrically tested the Nursing Presence Scale.
BACKGROUND
Nursing presence is a foundation for professional nursing practice; therefore, it is critical to measure this concept.
INTRODUCTION
This instrument development study was designed to generate an itemized scale and psychometric testing using a sample of Iranian patients.
METHODS
Based on both a concept development and literature review, and finally face and content validity 44-item draft scale was generated. During November 2018-2019, 774 patients were surveyed. Exploratory and confirmatory factor analyses were used to evaluate the scale's construct validity; concurrent and predictive reliability of the nursing presence scale were also evaluated. We also examine the weighting to scale items.
RESULTS
The analyses yielded a 36-item, 4-factor scale that adequately fit the data. Cronbach's alpha coefficient for the whole instrument was 0.94. The intra class correlation coefficient was 0.91. Nursing Presence Scale scores were positively correlated with Revised Humane Caring Scale and predicted 25% of missed nursing care.
CONCLUSION
This 36-item has good reliability and validity, making it useful for measuring the current condition of nursing presence.
IMPLICATIONS FOR NURSING AND HEALTH POLICY
Measuring the frequency of nursing presence allows for data-driven planning and upgrading the inpatient care services.
PubMed: 35655206
DOI: 10.1186/s12912-022-00896-0 -
BMJ Open Jan 2022To develop the Psychiatric Nurse Self-Efficacy Scales, and to examine their reliability and validity.
OBJECTIVES
To develop the Psychiatric Nurse Self-Efficacy Scales, and to examine their reliability and validity.
DESIGN
We developed the Improved Self-Efficacy Scale (ISES) and Decreased Self-Efficacy Scale (DSES) using existing evidence. Statistical analysis was conducted on the data to test reliability and validity.
SETTING
The study's setting was psychiatric facilities in three prefectures in Japan.
PARTICIPANTS
Data from 514 valid responses were extracted of the 786 responses by psychiatric nurses.
OUTCOME MEASURES
The study measured the reliability and validity of the scales.
RESULTS
The ISES has two factors ('Positive changes in the patient' and 'Prospect of continuing in psychiatric nursing') and the DSES has three ('Devaluation of own role as a psychiatric nurse', 'Decrease in nursing ability due to overload' and 'Difficulty in seeing any results in psychiatric nursing'). With regard to scale reliability, the Cronbach's alpha coefficient was 0.634-0.845. With regard to scale validity, as the factorial validity of the ISES and DSES, for the ISES, χ/df (110.625/37) ratio=2.990 (p<0.001), goodness-of-fit index (GFI)=0.962, adjusted GFI (AGFI)=0.932, comparative fit index (CFI)=0.967 and root mean square error of approximation (RMSEA)=0.062; for the DSES, χ/df (101.982/37) ratio=2.756 (p<0.001), GFI=0.966, AGFI=0.940, CFI=0.943, RMSEA=0.059 and Akaike Information Criterion=159.982. The concurrent validity of the General Self-Efficacy Scale was r=0.149-0.446 (p<0.01) for ISES and r=-0.154 to -0.462 (p<0.01) for DSES, and the concurrent validity of the Stress Reaction Scale was r=-0.128 to 0.168 for ISES, r=0.214-0.398 for DSES (p<0.01).Statistical analyses showed the scales to be reliable and valid measures.
CONCLUSIONS
The ISES and DSES can accurately assess psychiatric nurses' self-efficacy. Using these scales, it is possible to formulate programmes for improving psychiatric nurses' feelings of self-efficacy.
Topics: Cross-Sectional Studies; Humans; Nurses; Psychiatric Nursing; Psychometrics; Reproducibility of Results; Self Efficacy
PubMed: 34996799
DOI: 10.1136/bmjopen-2021-055922 -
Journal of Psychiatric and Mental... Apr 2022WHAT IS KNOWN ABOUT THE SUBJECT?: The evaluation of nurse care practices poses many challenges, including the identification of all the aspects of the care given. Few... (Observational Study)
Observational Study
WHAT IS KNOWN ABOUT THE SUBJECT?: The evaluation of nurse care practices poses many challenges, including the identification of all the aspects of the care given. Few studies have looked at the scope of nursing practice in psychiatry. However, the evaluation of care practices in the mental health field poses many challenges, including the identification of all aspects of care. WHAT THE DOCUMENT ADDS TO EXISTING KNOWLEDGE?: Findings demonstrated that mental health nurses do not invest in all domains of their scope of practice in the same way and the time spent with patients is low. Several factors contributed to this, including the increasing complexity of care, stagnant staffing levels, and a culture of care that continues to be influenced by the medical model. Current models of care still retain the stigma of this past, prioritizing medically delegated tasks rather than promoting a holistic approach to care. Although the professional identity of nurses is evolving and asserting itself, the paradigm shift in practice is still incomplete. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is essential to describe concretely what is actually expected of nurses, to help them allocate their time effectively and to identify opportunities for improvement. The field of practice of nurses is put under stress by a demanding work environment subject to many pressures and constraints. Changing practices so that nurses can use the full scope of nursing practice requires strong nursing leadership and action on education and the organization of care, particularly on clinical assessment. ABSTRACT: Introduction The evaluation of nursing care practices poses many challenges, including identifying all the aspects of the care given. However, few studies have examined the scope of nursing practice in psychiatry. Aim The aim of this study was to describe the intensity of nursing activities on a psychiatric unit based on the adaptation of Déry and D'Amour's (2017, Perspect Infirm Rev Off Ordre Infirm Qué, 14, 51) Scope of Nursing Practice Model. Method This 56-day descriptive observational study used the time and motion method to follow eight nurses. Results 500 h of observations were carried out. The greatest lengths of time were allocated to communication and coordination of care activities and to "non-healthcare" domains. Less time was devoted to activities related to clinical evaluation and therapeutic education. Discussion Findings demonstrated that MHNs do not perform all the possible functions in the domains of their scope of practice in the same way, and time spent with patients was short. Several factors contributed to this, including the fact that nurses are working in increasingly demanding care settings that keep them under constant pressure.
Topics: Delivery of Health Care; Humans; Mental Health; Psychiatric Nursing; Psychiatry; Time and Motion Studies
PubMed: 34310817
DOI: 10.1111/jpm.12790