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Journal of Psychiatric and Mental... Jun 2024People living with schizophrenia spectrum disorder (SSD) have a higher death rate which is caused, in part, by poorer adherence to treatment as compared to those with...
WHAT IS KNOWN ON THE SUBJECT
People living with schizophrenia spectrum disorder (SSD) have a higher death rate which is caused, in part, by poorer adherence to treatment as compared to those with other mental illnesses. Using long-acting injectable antipsychotic (LAI) medications can improve medication adherence and reduce hospitalizations for people living with SSD but are often underutilized.
WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE
As compared to oral antipsychotic medications provided to patients with SSD at discharge from a psychiatric hospitalization, being provided with an LAI antipsychotic medication may reduce subsequent rehospitalization. Specifically, patients discharged on an atypical or second-generation LAI medication are less likely to be readmitted to the hospital when compared to those discharged on a typical first-generation oral medication.
WHAT ARE THE IMPLICATIONS FOR PRACTICE
Because LAI antipsychotic medications are often underutilized as treatment options, the study findings suggest that this modality may be considered for patients with SSD when being discharged from a psychiatric hospitalization. Ideally, psychiatric-mental health nurses can educate patients about indications, benefits, and risks of using atypical or second-generation LAI antipsychotic medications during hospitalization and at discharge prevent the risk for future rehospitalizations.
ABSTRACT
INTRODUCTION: People living with schizophrenia spectrum disorder (SSD) have poorer medication adherence compared to those with other mental illnesses. Long-acting injectable antipsychotic (LAI) medication use is associated with greater adherence, reduced re-hospitalizations, and improved recovery outcomes when compared to oral formulations.
AIM
To compare LAI antipsychotic medication use versus oral formulations on readmission to an inpatient hospital.
METHOD
Medical records (N = 707) from a state psychiatric hospital in the southern region of the United States were reviewed. Controlling for demographic variables, logistic regression analyses were used to examine LAI compared to oral formulations on readmission.
RESULTS
Compared to patients discharged with oral antipsychotic medications, those with LAIs had a lower proportion of readmission rates in 6-month and 1-year periods, but not 30-day or 2-year periods. When controlling for demographic variables, those discharged with an atypical LAI had significantly lower odds of being readmitted within the 24-year period compared to those discharged on a typical oral antipsychotic.
DISCUSSION
Compared to orals, LAIs do not increase and may mitigate readmissions to psychiatric hospitalization.
IMPLICATIONS FOR PRACTICE
Psychiatric-mental health nurses and other professionals may recommend LAIs when indicated for those with SSD.
PubMed: 38922793
DOI: 10.1111/jpm.13075 -
Journal of Psychiatric and Mental... Jun 2024WHAT IS KNOWN ON THE SUBJECT?: Continuous observation is often used in mental health wards to support the safety of service users, where they will be constantly watched...
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WHAT IS KNOWN ON THE SUBJECT?: Continuous observation is often used in mental health wards to support the safety of service users, where they will be constantly watched by a member of staff. Evidence suggests that continuous observations may be unhelpful and restrictive, but not enough is known about the practice or the best ways to improve it. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This evaluation integrates the perspectives of service users, informal carers and staff to explore current continuous observation experiences and inform future improvements. While previous research highlights the importance of therapeutic engagement, this study additionally emphasizes how the observation procedure could be adapted to individual needs. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Continuous observations could be more beneficial if they are therapeutic, proportional to the level of risk and co-developed with the service user, informal carer and staff. Further training about communication could support staff engagement and the observation process could be formalized to ensure regular collaborative reviews.
ABSTRACT
INTRODUCTION: Continuous observation is a frequently used tool to manage high levels of risk on psychiatric wards. However, there is little previous research on its use in practice.
AIM
This qualitative service evaluation aims to explore the continuous observation experiences of service users, informal carers and staff in a local NHS Mental Health Trust, informing suggested future improvements to current practice.
METHOD
Five service users, three informal carers and seven healthcare staff completed semi-structured interviews, which were thematically analysed to create four themes.
RESULTS
Positive interaction and engagement in activities were critical for a therapeutic approach to observations, supporting service users and staff to minimize the unproductive behaviours that can arise. Difficulties balancing safety with privacy could suggest the importance of proportionate and tailored observation procedures for each service user. Ensuring the voices of service users and informal carers remain central to decisions regarding care could further improve the observation experience.
IMPLICATIONS FOR PRACTICE
This study highlights therapeutic, proportionate and co-produced observations as key characteristics to improve practice. Further training and formalization of the observation process could foster cultural changes towards more long-term approaches to risk management.
PubMed: 38922777
DOI: 10.1111/jpm.13072 -
Research in Nursing & Health Jun 2024
PubMed: 38922765
DOI: 10.1002/nur.22407 -
Journal of Psychiatric and Mental... Jun 2024WHAT IS KNOWN ON THE SUBJECT?: Recovery-oriented practices in community-based mental health services are of increasing importance. The recovery journey of individuals...
UNLABELLED
WHAT IS KNOWN ON THE SUBJECT?: Recovery-oriented practices in community-based mental health services are of increasing importance. The recovery journey of individuals with mental illness starts with a sense of agency, and a therapeutic relationship with the providers who support them is a prerequisite. In Japan, the construction of community-based integrated care systems for individuals with mental illness is positioned as a priority health issue, with communication with familiar individuals being particularly important for recovery in Japanese and Asian cultures. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study is the first to examine effective communication factors for personal agency in the recovery of individuals with mental illness, focusing on addressing uncertainty about treatment choices and dissatisfaction with decision-making, and considering the user's personal recovery journey. In recovery-oriented practice, it is important to prioritize addressing the emotional aspects of decision-making alongside the mental illness condition, supporting users' self-determination in their unique recovery journeys. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings emphasized the need to actively engage with users' perspectives and emotions, emphasize shared life planning, and foster a therapeutic relationship based on partnership. Providers should approach dialogue as carefully as medication prescriptions, prioritizing the establishment of an effective therapeutic relationship with the user. These characteristics are essential for developing a strong therapeutic relationship and effectively facilitating users' recovery. The findings are applicable not only to nurses but to all mental health service providers, contributing to the advancement of recovery-oriented practice.
ABSTRACT
INTRODUCTION: Recovery-oriented practice in community-based mental health services is crucial for individuals with mental illness, with communication with familiar individuals being important for recovery in Japanese and Asian cultures.
AIM
This study aimed to examine effective communication factors for personal agency in recovery by investigating the association between perceived support provided through communication and personal agency of individuals with mental illness.
METHOD
A cross-sectional study was conducted among community-dwelling Japanese mental health service users, assessing subjective agency, decisional conflict, staff support for personal recovery, activation for mental health self-management, demographic variables and living difficulties. Multiple linear regression analysis identified factors predicting subjective agency, revealing characteristics of effective provider communication for recovery.
RESULTS
Data from 222 users were analysed, revealing negative correlations between uncertainty about treatment choices and ineffective decision-making with higher subjective agency, while staff support for personal recovery positively correlated with higher subjective agency.
DISCUSSION
In recovery-oriented practice, prioritizing users' emotional experiences during decision-making and supporting their self-determination in their unique recovery journeys is crucial.
IMPLICATIONS FOR PRACTICE
Providers should approach dialogue as carefully as medication prescriptions, prioritizing therapeutic partnerships with users. The findings extend beyond nursing to all mental health service providers, advancing the theory of recovery-oriented practice.
PubMed: 38922746
DOI: 10.1111/jpm.13078 -
Nursing Reports (Pavia, Italy) Jun 2024The use of standardized patient simulation in psychiatric nursing education addresses the unique challenges presented by mental healthcare settings. Students' attitudes...
The use of standardized patient simulation in psychiatric nursing education addresses the unique challenges presented by mental healthcare settings. Students' attitudes toward clinical simulation remain predominantly favorable, with many expressing enthusiasm for the opportunities it provides in terms of embracing challenges, enhancing realism, and promoting critical thinking through problem solving, decision-making, and adaptability. This quantitative study used a cross-sectional, descriptive, correlation design to investigate the effectiveness of standardized patient simulation as a teaching method in the Psychiatric and Mental Health nursing course in a university setting. A total of 84 nursing students were recruited for the convenience sample. Data were collected using a three-part questionnaire survey which included the following: a demographic data sheet, the Student Satisfaction and Self-confidence in Learning Scale, and a narrative open-ended question asking the participants to write the advantages and disadvantages of their simulation experience. Data were analyzed using the statistical software JMP pro17. The total satisfaction with learning subscale score ranged between 5 and 25 with a mean score of 19.36 ± 6.32. The total self-confidence subscale score ranged between 8 and 40 with a mean score of 30.87 ± 9.1. Pearson's correlation coefficient r revealed a statistically significant positive relationship between the participants' satisfaction with the learning experience and their self-confidence (t = 0.923, < 0.0001). Approximately 91.7% of the students recommended using simulation. The results confirmed the students' recommendations of simulation use in teaching psychiatric and mental health courses; furthermore, the results showed a statistically significant positive correlation with the total SSLS ( = 0.01) and satisfaction with learning subscale (0.003). Participants reported that authentic, practical, comfortable, and safe learning environments contributed to an enriched learning experience. Additionally, factors such as timesaving, access to information, cost-effectiveness, standardized teaching, varied exposure, skill development, and immediate feedback also enhanced the learning experience through patient simulation in psychiatric and mental health nursing. Simulations can contribute efficiently and positively to psychiatric and mental health nursing education in a manner that optimizes the learning experience while ensuring the consistency of student learning in a safe learning environment.
PubMed: 38921717
DOI: 10.3390/nursrep14020107 -
Healthcare (Basel, Switzerland) Jun 2024Child abuse is a global problem. Shaken baby syndrome (SBS) is a result of child abuse, with shaking being the most common form of maltreatment, causing mortality or...
Child abuse is a global problem. Shaken baby syndrome (SBS) is a result of child abuse, with shaking being the most common form of maltreatment, causing mortality or severe brain damage in infants. A lack of awareness of SBS among current and future healthcare professionals can have serious consequences. To date, no studies have been conducted in Saudi Arabia to examine student nurses' awareness of SBS, so we sought to assess this issue in an academic institution in Riyadh, Saudi Arabia. For this questionnaire-based study, we employed a cross-sectional, descriptive design. The target population was nursing students from every year of study in the institution's five-year undergraduate nursing programme, who received an online questionnaire during the 2022-2023 academic year. The data were analysed using descriptive and inferential statistical analysis. Of the 293 respondents, 100.0% confirmed that they were not aware of SBS through their nursing curricula, and 62.1% reported not being made aware of SBS at all during their academic journey. The majority of participants were unaware of the negative consequences of shaking a baby. Most were not aware that shaking a baby vigorously can cause permanent blindness (73.4%), postural impairments (56.7%), sleep disorders (61.1%), or convulsions (60.1%). The results of our study revealed a statistically significant relationship between nursing students' awareness of SBS and both their year of study and marital status. Those at higher academic levels and those who were married were more aware of SBS. To improve nursing students' knowledge of SBS and help them to better inform the public of this syndrome, particularly parents, child maltreatment topics should be added to nursing curricula in Saudi Arabia, and their importance should be emphasised. This will help reduce the prevalence and burden of SBS nationally.
PubMed: 38921317
DOI: 10.3390/healthcare12121203 -
Healthcare (Basel, Switzerland) Jun 2024(1) Background: While medication and various forms of psychotherapy are common treatments for severe mental illness, peer support programs have also proven to be... (Review)
Review
(1) Background: While medication and various forms of psychotherapy are common treatments for severe mental illness, peer support programs have also proven to be effective in managing mental disorders. These programs, which involve individuals with similar experiences in navigating mental health challenges, aim to improve coping skills and foster supportive community networks. However, despite the prevalent mention of peer support programs, especially those with supervision, there has been no systematic review or meta-analysis of peer support supervision. This study aimed to systematically review and meta-analyze the forms and effectiveness of peer support programs for individuals with severe mental illnesses. (2) Methods: A literature search focusing on randomized controlled trials (RCTs) published between February 2003 and January 2024 was conducted. (3) Results: Sixteen RCTs meeting the inclusion criteria and involving a total of 4008 participants were reviewed. These studies utilized various peer support program strategies, with eight studies included in the qualitative analysis. The combined effect sizes for depressive symptoms (d = 0.12; 95% CI, -0.14, 0.37; = 0.37), empowerment (d = 1.17; 95% CI, -0.81, 3.15; = 0.25), quality of life (d = 0.70; 95% CI, -0.12, 1.52; = 0.09), psychiatric symptoms (d = -0.05; 95% CI, -0.20, 0.10; = 0.54), and self-efficacy (d = 0.20; 95% CI, 0.05, 0.36; = 0.01) were assessed. (4) Conclusions: Our analysis emphasizes the need for further studies on peer support programs for individuals with severe mental illness, particularly those focused on self-efficacy outcomes across diverse geographic locations involving more countries and with larger scales to bolster the strength of the evidence.
PubMed: 38921293
DOI: 10.3390/healthcare12121179 -
Healthcare (Basel, Switzerland) Jun 2024(1) Background: There is a global demand for more psychiatric nurses, with nursing students' attitudes toward mental illness and working in mental health facilities...
(1) Background: There is a global demand for more psychiatric nurses, with nursing students' attitudes toward mental illness and working in mental health facilities playing a pivotal role in their career choices. This study aims to evaluate attitudes toward working in mental health facilities among undergraduate nursing students in Saudi Arabia, both before and after exposure to psychiatry courses, and examine their relationship with perceptions of mental illness. (2) Methods: A quantitative descriptive and correlational cross-sectional design was employed. Nursing students' attitudes toward working in mental health facilities were assessed using the Attitude Toward Psychiatry 18 (ATP-18) questionnaire and the Beliefs Toward Mental Illness (BMI) scale. (3) Results: No significant relationship has been found between the frequency of negative views of both ATP-18 and BMI, and exposure to the psychiatry course. However, nurses who completed the psychiatry course held more positive views towards psychiatrists and found psychiatric patients less demanding, were less likely to view psychological disorders as dangerous, more confident in trusting mentally ill colleagues, and felt less embarrassed by the term "psychological disorder" compared to those who had not taken the course. (4) Conclusion: Based on our findings, it is evident that exposure to psychiatric courses and training enhances the potential of nursing students to contribute effectively to the psychiatric field. Therefore, integrating mental health and illness community services training into nursing education programs can play a pivotal role in raising awareness and attracting students who may hold negative attitudes towards individuals with mental illness.
PubMed: 38921283
DOI: 10.3390/healthcare12121168 -
BMC Nursing Jun 2024Mental illness stigma is often common among mentally ill patients. This stigma can come from others or the patients themselves, which is called 'self-stigma'. The...
BACKGROUND
Mental illness stigma is often common among mentally ill patients. This stigma can come from others or the patients themselves, which is called 'self-stigma'. The present study explored the widespread impacts of self-stigma on adult patients with depression. Additionally, this review compared the severity of self-stigma levels among psychiatric disorders and to review and update thoughts about self-stigma of depression.
METHODS
An etiology and risk systematic review was conducted using the Joanna Briggs Institute (JBI) approach as a guideline. The search process was performed via research databases including MEDLINE, EMBASE and CINAHL. The inclusion criteria are studies include participants diagnosed with depressive disorders, both genders, participants' exposure to mental illness self-stigma, participants' experience of self-stigma consequences and any geographical site or clinical settings are included, the type of the included studies must be observational studies. The included studies were limited to the English language studies that were published from 2016 and onwards. Patients with depression under the age of eighteen and patients diagnosed with multiple mental illnesses were excluded. The JBI critical appraisal checklist were adopted to assess the risk of bias.
RESULTS
In December 2022, a comprehensive search yielded eight cross-sectional studies that were included in this systematic review, involving a total of 783 patients diagnosed with depression, and 28 studies were excluded for not fulfilling the inclusion criteria of the review. The findings were extracted and synthesized through textual narrative synthesis into three main categories negatively affected by self-stigma of depression. These are: (1) the impact on the quality of life, (2) the impact on self-esteem and (3) the impact on self-worth. Moreover, in regard to the comparison of self-stigma levels among psychiatric disorders, self-stigma for people with schizophrenia was higher than self-stigma of depression.
CONCLUSION
Self-stigma of depression has negatively impacted multiple aspects of the patient's life. Thus, the review brings the following recommendations: increase community awareness, educate the healthcare providers, include the topic of mental illness stigma in academic curriculums. The main limitation of the review is the limited number of included studies.
TRIAL REGISTRATION
The research proposal for this review has been registered to Prospero (ID number: CRD42022366555).
PubMed: 38918754
DOI: 10.1186/s12912-024-02047-z -
BMC Psychiatry Jun 2024Post-traumatic stress disorder (PTSD) can lead to complications such as depression and grief, which are more prevalent in veterans than in the general population.... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Post-traumatic stress disorder (PTSD) can lead to complications such as depression and grief, which are more prevalent in veterans than in the general population. Recently, art-making, including mandala coloring, has gained attention as a potential treatment for PTSD patients.
METHODS
This randomized clinical trial was conducted on 84 male veterans diagnosed with PTSD and hospitalized at the Milad Psychiatric Center in Tehran, Iran. The patients were recruited using a convenience sampling method and were assigned to either the mandala coloring group or the free coloring group. The Post-Traumatic Stress Disorder Checklist DSM-5 and the Oxford Happiness Scale were used to collect data. The intervention group colored mandala designs, while the control group colored squares freely. Coloring was done twice a week for three weeks.
RESULTS
The mean baseline happiness scores did not differ significantly between mandala coloring group and free coloring group (p = 0.376). However, at the end of study, happiness scores were significantly higher in mandala coloring group than in free coloring group (p < 0.001). After the intervention, happiness score of both groups increased significantly (p < 0.001).
CONCLUSION
Both coloring methods increased veterans' happiness scores; however, mandala coloring was more effective than free coloring. It is recommended that art-making be added to conventional treatments for veterans with PTSD.
TRIAL REGISTRATION
This study was registered in Iranian Registry of clinical trials (No. IRCT20210604051491N1, 29/08/2021).
Topics: Humans; Stress Disorders, Post-Traumatic; Veterans; Male; Happiness; Iran; COVID-19; Adult; Middle Aged; Art Therapy
PubMed: 38918742
DOI: 10.1186/s12888-024-05886-x