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BMJ Open Jun 2024There is a lack of distinct and measurable outcomes in psychiatric and/or mental health nursing which negatively impacts guiding clinical practice, assessing...
INTRODUCTION
There is a lack of distinct and measurable outcomes in psychiatric and/or mental health nursing which negatively impacts guiding clinical practice, assessing evidence-based nursing interventions, ensuring future-proof nursing education and establishing visibility as a profession and discipline. Psychiatric and/or mental health nursing struggle to demonstrate patient-reported outcomes to assess the effectiveness of their practice. A systematic review that summarising patient-reported outcomes, associated factors, measured nursing care/interventions and used measurement scales of psychiatric and/or mental health nursing in the adult population in acute, intensive and forensic psychiatric wards in hospitals will capture important information on how care can be improved by better understanding what matters and what is important to patients themselves. This review can contribute to the design, planning, delivery and assessment of the quality of current and future nursing care METHODS AND ANALYSIS: This protocol follows the Cochrane methodological guidance on systematic reviews of interventions and The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol. The search strategy will be identified by consultations with clinical and methodological experts and by exploring the literature. The databases Ovid MEDLINE, CINAHL, EMBASE, APA PsychARTICLES, Web of Science and Scopus will be searched for all published studies. Studies will be screened and selected with criteria described in the population, intervention, control and outcomes format after a pilot test by two researchers. Studies will be screened in two stages: (1) title and abstract screening and (2) full-text screening. Data extraction and the quality assessment based on the Johanna Briggs Institute guidelines will be conducted by two researchers. Data will be presented in a narrative synthesis.
ETHICS AND DISSEMINATION
No ethical approval is needed since all data are already publicly accessible. The results of this work will be published in a peer-reviewed scientific journal.
PROSPERO REGISTRATION NUMBER
CRD42023363806.
Topics: Humans; Systematic Reviews as Topic; Patient Reported Outcome Measures; Psychiatric Nursing; Research Design; Mental Disorders
PubMed: 38851230
DOI: 10.1136/bmjopen-2024-085808 -
Indian Journal of Public Health Jan 2024Depression is a serious illness; approximately 40%-60% of patients develop relapse, and this risk increases up to 90%. Interpersonal psychotherapy (IPT) is an effective... (Randomized Controlled Trial)
Randomized Controlled Trial
A Randomized Control Trial Study to Assess the Effectiveness of Interpersonal Psychotherapy on Symptom Reduction and Relapse Prevention for Depression among the Depression Patients.
BACKGROUND
Depression is a serious illness; approximately 40%-60% of patients develop relapse, and this risk increases up to 90%. Interpersonal psychotherapy (IPT) is an effective method to minimize depressive symptoms and relapse.
OBJECTIVES
This randomized control trial study is designed to assess the effectiveness of IPT on depression symptom reduction and relapse prevention.
MATERIALS AND METHODS
Three hundred depressed patients from a selected psychiatric hospital in UP, India, were recruited by a simple random sampling technique that randomly allocated 150 participants to the experimental group and 150 to the control group by tossing a coin. Depressive symptoms were assessed using the Hamilton Depression Rating Scale, which has 17 items. On the 2nd day of the trial, the experimental group received IPT. It helped the participants recognize their emotions and urge themselves to express them, both of which had a direct positive impact on their sad mood. The IPT efficacy assessment was done at the end of the 4 weeks of the intervention, and the relapse prevention assessment was undertaken 4 months later. The control group was kept with the actual treatment modalities and psychoeducation sessions, and they were assessed in the same way as the experimental group.
RESULTS
Findings illustrated that the reduction of depressive symptoms with (t = 33.61) (P = 0.0000) and relapse prevention with (t = 2.7484) (P = 0.0067) are significant, respectively. Furthermore, symptom reduction and relapse prevention had an association with some demographical data at P < 0.05, 0.001.
CONCLUSION
IPT is an effective intervention for reducing depressive symptoms and preventing relapse.
Topics: Humans; Male; Female; Adult; Secondary Prevention; India; Depression; Interpersonal Psychotherapy; Middle Aged; Young Adult; Psychiatric Status Rating Scales
PubMed: 38847631
DOI: 10.4103/ijph.ijph_26_22 -
Annals of Medicine and Surgery (2012) Jun 2024A mental disorder is characterized by a clinically significant impairment of cognition, emotion regulation, or behavior. As a result of the shift in care from medical...
BACKGROUND
A mental disorder is characterized by a clinically significant impairment of cognition, emotion regulation, or behavior. As a result of the shift in care from medical centers and hospitals to home care, we now see a change in the treatment of patients with chronic mental disorders. Consequently, families have become the main support system in the progressive care of these patients, leading to psychological and social problems. The current qualitative study investigated the social and psychological health needs and problems of family caregivers of patients with chronic mental disorders in Iran's cultural and social context.
METHODS
This was a content analysis qualitative study. The study was conducted in three psychiatric hospitals in Farabi, Noor, Modares. Purposive sampling was done and continued until data saturation. Semi-structured, face-to-face, and individual interviews were conducted with 49 participants (15 family caregivers of patients with CMD and 34 members of the mental health care team). Data analysis was done using the conventional content analysis method.
RESULTS
Eight hundred seventy-five primary codes were obtained, which were classified into 10 subcategories and 3 main categories of 'health challenges of caregiver', 'confused concept of care' and "the need for a coherent support system.
CONCLUSION
In Iranian society, after the patient is discharged from the hospital or care center, family members will change their role to the most important caregivers of these patients. The psychological and social health of these caregivers is destroyed because of the problems they have in providing care for their patients and their needs, which are not met.
PubMed: 38846850
DOI: 10.1097/MS9.0000000000000626 -
Indian Journal of Palliative Care 2024The use of physical restraints (PR) in healthcare settings, especially in psychiatric units, is a controversial topic. The attitude, knowledge, and practices of nurses... (Review)
Review
The use of physical restraints (PR) in healthcare settings, especially in psychiatric units, is a controversial topic. The attitude, knowledge, and practices of nurses towards PR can influence its application, which raises concerns about the balance between patient safety and individual rights. With mental disorders being a leading cause of disability globally, understanding the complexities surrounding PR use becomes paramount. A comprehensive literature review was conducted using multiple databases, including PubMed, Medline, CINAHL, PsycINFO, ProQuest, The Cochrane Library, the Saudi Digital Library, and Google Scholar. The search spanned literature published up to December 2022, focusing on studies that explored the relationship between nurses' knowledge, attitudes, and practices regarding PR in psychiatric settings. Inclusion and exclusion criteria were applied to filter out relevant studies. From 220 records initially retrieved, 12 articles were identified for the final review. The reviewed studies highlighted a moderate knowledge and attitude among nurses concerning PR. Many nurses were found to be uncertain about the reasons for PR application and its alternatives. Educational interventions were emphasized in several studies as beneficial in improving nurses' knowledge, attitudes, and practices. However, inconsistencies were observed regarding the impact of these interventions on nurses' attitudes. Experience, higher education, and continuous training sessions were found to be correlated with better knowledge and more favourable attitudes towards PR. This review emphasizes the critical need for consistent training and education for nurses regarding PR, given the profound implications for patient care and safety. While educational interventions show promise in enhancing knowledge and practice, their impact on attitudes remains contested. Future research should consider the gaps identified in this review, including the exploration of alternatives to PR, larger sample sizes and longitudinal studies to understand the long-term effects of interventions.
PubMed: 38846135
DOI: 10.25259/IJPC_227_2023 -
Creative Nursing Jun 2024The transition of new nurses from training to employment in rural practice can be difficult in the best of times. The COVID-19 pandemic amplified challenges in...
The transition of new nurses from training to employment in rural practice can be difficult in the best of times. The COVID-19 pandemic amplified challenges in supporting new nurses transitioning from education to employment. Drawing together Benner's novice-to-expert model and the concept of human flourishing, this article reports on research that explored new nurses' experiences transitioning from training to employment in rural nursing during the initial years of the COVID-19 pandemic, using case study methodology combining an online recruitment survey and in-depth semi-structured interviews. Participants identified a lack of on-the-job training and mentorship, feeling unprepared for the acuity of patients and concerns about patient safety, feeling unprepared for leadership roles, feeling unsupported by management, feeling fatigued and anxious, and a lack of optimism about the future of rural health care. On the positive side, participants reported valuing social connections and teamwork, gratitude from patients, and a sense of community, as well as increasing competency at work. Their stories and self-rated flourishing revealed both strengths and challenges in transitioning to practice in rural settings during times of adversity. This research can inform theories of nursing development as well as policies and practices that support new nurses to thrive in rural contexts.
PubMed: 38845338
DOI: 10.1177/10784535241255398 -
Scientific Reports Jun 2024The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative...
The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative disorder, which manifests with progressive declines in cognitive functioning and ability to perform activities of daily living. As polices discourage institutionalized care, family members act as primary caregivers and endure increased vulnerability to physical and mental health problems secondary to care-related changes in life routine and relationships. Targeting clinically significant distress at earlier stages through valid brief measures may promote caregivers' wellbeing and dementia care continuity/quality. This study aimed to determine the optimal cutoff score of the Depression Anxiety Stress Scale 8-items (DASS-8) in a convenience sample of 571 European caregivers (Mean age = 53 ± 12 years, Italian = 74.4%, Swiss = 25.6%) through three methods. K-means clustering classified the sample into high- and low-distress clusters based on DASS-8 score of 19. Receiver operator curve (ROC) analysis using 48 and 7 cutoffs of the Zarit Burden Interview (ZBI) and the Three-Item University of California, Los Angeles, Loneliness Scale-version 3 (UCLALS3), revealed two DASS-8 cutoffs (12.5 and 14.5, area under the curve (AUC) = 0.85 and 0.92, p values < .001, 95% CI 0.82-0.88 and 0.89 to 0.94, sensitivity = 0.81 and 0.78, specificity = 0.76 and 0.89, Youden index = 0.57 and 0.67, respectively). Decision modeling produced two DASS-8 cutoffs (9.5 and 14.5) for predicting low and high caregiving burden and loneliness, respectively. According to the median of all DASS-8 cutoffs (14.5) the prevalence of mental distress was 50.8%. Distress correlated with key mental problems such as burnout and loneliness-in path analysis, DASS-8 scores were predicted by the ZBI, UCLALS3, care dependency, and receiving help with care, especially among older, female, and spouse caregivers. Further diagnostic workup should follow to confirm psycho-pathogenicity among caregivers with DASS-8 scores above 14.5. Investigations of the DASS-8 in other countries/populations may confirm the validity of this cutoff score.
Topics: Humans; Caregivers; Female; Dementia; Male; Middle Aged; Loneliness; Adult; Depression; Aged; Burnout, Psychological; Stress, Psychological; Anxiety; ROC Curve; Psychiatric Status Rating Scales
PubMed: 38844485
DOI: 10.1038/s41598-024-60127-1 -
The South African Journal of Psychiatry... 2024Psychiatric nurses play an important role in advocating for mental health care users such as advocating for the care, treatment and rehabilitation of mental health care...
BACKGROUND
Psychiatric nurses play an important role in advocating for mental health care users such as advocating for the care, treatment and rehabilitation of mental health care users (MHCUs). Psychiatric nurses face various challenges while advocating for the human rights of MHCUs, particularly those unable to protect their rights because of the severity of their mental health conditions.
AIM
This study aimed to explore and describe psychiatric nurses' lived experiences in advocating for the human rights of MHCUs in the Gauteng province.
SETTING
The study was conducted within the primary healthcare (PHC) setting's mental health services, Sedibeng District, Gauteng province.
METHODS
The study employed a qualitative, exploratory, descriptive and contextual research design. Three phenomenological focus group interviews were conducted, and audio recorded to collect data. Data were analysed using Tesch's method.
RESULTS
Three themes emerged: (1) advocating for human rights was a strong push and an exhausting plea for psychiatric nurses in their attempts to voice and protect MHCUs' rights; (2) MHCUs and mental health services were discriminated against and excluded by various stakeholders; mental health awareness should be raised and (3) training needs to be conducted as a matter of urgency in order to destigmatise mental illness from government to societal level.
CONCLUSION
Psychiatric nurses experienced feelings of disempowerment, frustration and helplessness in advocating for MHCUs' human rights.
CONTRIBUTION
The study's findings will contribute to the body of knowledge in clinical psychiatric mental health practice on advocating for the human rights of MHCUs.
PubMed: 38841714
DOI: 10.4102/sajpsychiatry.v30i0.2233 -
Health Science Reports Jun 2024The burden of care after a stroke is gaining recognition as a significant healthcare issue. Factors like religion and spirituality, encompassing religious coping and...
BACKGROUND AND AIMS
The burden of care after a stroke is gaining recognition as a significant healthcare issue. Factors like religion and spirituality, encompassing religious coping and spiritual health, prove to be influential in anticipating the challenges faced by caregivers. The present study aimed to determine the relationship between care burden, spiritual health, and religious coping among caregivers of stroke patients.
METHODS
This cross-sectional research was conducted with the participation of 129 caregivers of stroke patients. The data was collected using the Ellison and Paloutzian spiritual well-being instruments, Pargament Religious Coping (RCOPE) brief version, and the Zarit burden interview (ZBI). Through a census, participants were recruited for the investigation. Data were analyzed using descriptive and inferential statistics (multivariate linear regression analysis).
RESULTS
The study results indicate a strong and statistically significant relationship between the burden of caring and spiritual health ( < 0.001, = 0.33). Furthermore, specific variables were identified as indicators of an increased burden of care, including positive religious coping ( = 0.04, = 0.63), the familial relationship between the caregiver and patient, specifically as a child ( = 0.001, = 29.26), and a sister ( < 0.001, = 35.93).
CONCLUSION
It is advisable to consider adopting and implementing appropriate support measures for coping strategies rooted in religion and spirituality. So, it is recommended to enhance the provision of comprehensive support, including psychological and religious interventions. This can be achieved through the collaborative efforts of support groups comprising psychiatric nurses, psychiatrists, psychologists, and religious experts.
PubMed: 38841117
DOI: 10.1002/hsr2.2155 -
Journal of Multidisciplinary Healthcare 2024The rate of cesarean section is increasing from 15% to 40% in recent years. The type of delivery influences the hormonal, emotional and mental health of the mother,...
BACKGROUND
The rate of cesarean section is increasing from 15% to 40% in recent years. The type of delivery influences the hormonal, emotional and mental health of the mother, which correlates positively or negatively with the health benefits of the newborn. There have been many published studies on kangaroo mother care for mothers undergoing elective cesarean section, but there is still a lack of understanding about emergency cesarean section.
OBJECTIVE
This study aimed to evaluate the benefits of KMC practice for mothers undergoing emergency cesarean section in terms of hormone levels such as oxytocin, cortisol, prolactin, interleukin-6 and interleukin-10.
METHODS
This retrospective analysis used remnant serum (KMC group = 16; control group = 9), and clinical data such as KMC practice (15-30 minutes three or four times daily until discharge), breastfeeding initiation time, feeding time, crying time and hospital stay were extracted from the electronic database. All hormone and cytokine expressions were quantitatively determined by ELISA. Comparisons within and between groups were performed using appropriate statistical tests.
RESULTS
In the KMC group, increased levels of the hormone oxytocin significantly reduced cortisol and IL-6 and negatively influenced prolactin and IL-10 levels. The elevated prolactin facilitates overall lactation behaviour, of which 64% reported breastfeeding directly at the breast. The cytokine analysis revealed a reduction in pro-inflammatory cytokines and thereby an improved wound healing was seen in the KMC group.
CONCLUSION
These quantitative results strongly encourage the use of KMC for mothers undergoing emergency cesarean section. These simple yet effective breastfeeding strategies promote maternal and infant health, which can reduce medication use.
PubMed: 38840703
DOI: 10.2147/JMDH.S444172 -
Neuropsychopharmacology Reports Jun 2024The aim of the study was to identify the clinical significance of anxiety in those with depression, the Diagnostic and Statistical Manual of Mental Disorders 5th edition...
A psychometric analysis of the Japanese version of the clinically useful depression outcome scale supplemented with questions for the DSM-5 anxious distress specifier (CUDOS-A).
AIM
The aim of the study was to identify the clinical significance of anxiety in those with depression, the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) defined criteria for an anxious distress specifier for major depressive disorder (MDD). The Clinically Useful Depression Outcome Scale (CUDOS) supplemented with questions for the DSM-5 anxious distress specifier (CUDOS-A) is a self-report instrument to assess the clinical significance of anxiety in addition to assess symptoms and the severity of depression. This study aimed to evaluate the psychometric properties of the Japanese version of the CUDOS-A.
METHODS
An observational, prospective study was conducted with 131 MDD outpatients and 200 healthy controls. The Japanese version of the CUDOS-A, along with other measures, was administered to assess depressive symptoms, anxiety, social function, and biological rhythm. Reliability and validity analyses were performed, including internal consistency, test-retest reliability, convergent validity, and contrasted-groups validity.
RESULTS
The Japanese version of the CUDOS-A demonstrated excellent internal consistency (Cronbach's alpha = 0.96) and test-retest reliability (ICC = 0.78). Significant positive correlations were found between the CUDOS-A and measures of depression, anxiety, social function, and biological rhythm (all, p < 0.001), supporting its convergent validity. The CUDOS-A effectively differentiated between patients with MDD and healthy controls (p < 0.001), indicating good contrasted-groups validity.
CONCLUSIONS
The Japanese version of the CUDOS-A is a useful measure for research and for clinical practice, enabling the efficient assessment of anxious distress in individuals with depression.
PubMed: 38838706
DOI: 10.1002/npr2.12432