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Journal of Psychosocial Nursing and... Mar 2010
Topics: Cooperative Behavior; Decision Making; Health Care Reform; Humans; Mental Health Services; Models, Nursing; Nurse-Patient Relations; Patient Participation; Patient-Centered Care; Psychiatric Nursing; United States
PubMed: 20302257
DOI: 10.3928/02793695-20100202-03 -
Journal of Gerontological Nursing Jul 2022
Topics: Aged; Delivery of Health Care; Geriatric Nursing; Humans; Psychiatric Nursing
PubMed: 35771071
DOI: 10.3928/00989134-20220606-01 -
Journal of Nursing Management Nov 2019The aim was to describe the ways that nursing staff in psychiatric inpatient care understand nursing.
AIM
The aim was to describe the ways that nursing staff in psychiatric inpatient care understand nursing.
BACKGROUND
Nursing in psychiatric care is marginalized with ambiguous role definitions and imperceptible activities. Nurse managers' capabilities to establish a direction and shared vision are crucial to motivate nursing staff to take part in practice development. However, before establishing a shared vision it is important to identify the different ways nursing can be understood.
METHODS
Sixteen individual semi-structured interviews with nursing staff members were analysed using a phenomenographic approach.
RESULTS
Five ways of understanding nursing were identified. These understandings were interrelated based on the way that the patient, nursing interventions and the goal of nursing were understood.
CONCLUSION
The diversity of identified understandings illuminates the challenges of creating a shared vision of roles, values and goals for nursing.
IMPLICATIONS FOR NURSING MANAGEMENT
Awareness of staff members' different understandings of nursing can help nurse managers to establish a shared vision. To be useful, a shared vision has to be implemented together with clear role definitions, professional autonomy of nurses and support for professional development. Implementation of such measures serves as a foundation to make nursing visible and thereby enhance the quality of patient care.
Topics: Adult; Aged; Attitude of Health Personnel; Female; Hospitalization; Humans; Interviews as Topic; Learning; Male; Middle Aged; Nursing Staff, Hospital; Psychiatric Nursing; Qualitative Research
PubMed: 31556178
DOI: 10.1111/jonm.12882 -
BMC Health Services Research Jun 2021Mental disorders impose heavy burdens on patients' families and children. It is imperative to provide family-focused services to avoid adverse effects from mental...
BACKGROUND
Mental disorders impose heavy burdens on patients' families and children. It is imperative to provide family-focused services to avoid adverse effects from mental disorders on patients' families and children. However, implementing such services requires a great deal of involvement of mental health workers. This study investigated the attitudes, knowledge, skills, and practices in respect to family-focused practices (FFP) in a sample of Chinese mental health workers.
METHODS
A cross-sectional study design was employed to examine the attitudes, knowledge, skills, and practices of a convenience sample of Chinese mental health workers in respect to FFP, using the Chinese version of the Family-Focused Mental Health Practice Questionnaire (FFMHPQ).
RESULTS
In total, 515 mental health workers participated in our study, including 213 psychiatrists, 269 psychiatric nurses, and 34 allied mental health professionals (20 clinical psychologists, 9 mental health social workers, and 4 occupational therapists). Compared with psychiatric nurses, psychiatrists and allied mental health professionals provided more support for families and children of patients with mental illness and were more willing to receive further training in FFP. However, there were no significant differences on knowledge, skills, and confidence across different profession types. After adjusting for demographic and occupational variables, previous training in FFP was positively associated with mental health workers' knowledge, skills, and confidence about FFP, but not actual support to families and children.
CONCLUSIONS
Professional differences on FFP exist in Chinese mental health workers. Training is needed to engage psychiatrists and other allied workforce in dissemination and implementation of FFP in China.
Topics: Child; China; Cross-Sectional Studies; Health Personnel; Humans; Mental Disorders; Mental Health; Psychiatric Nursing
PubMed: 34107937
DOI: 10.1186/s12913-021-06572-4 -
International Journal of Environmental... Sep 2020This integrative review analyzed the research on consumer involvement in mental health nursing education in the last decade. We aimed to derive the main contents,... (Review)
Review
This integrative review analyzed the research on consumer involvement in mental health nursing education in the last decade. We aimed to derive the main contents, methods, and outcomes of education using consumer involvement for mental health nursing students. We searched six electronic databases using English and Korean search terms; two authors independently reviewed the 14 studies that met the selection criteria. Studies on the topic were concentrated in Australia and some European countries; most of them used a qualitative design. The main education subject was recovery, and consumers tended to actively participate in education planning. Moreover, students' perceptions about education using consumer involvement and people with mental health problems changed positively, as well as their experiences of participating in mental health nursing education. There is a lack of interest in the topic in Asian countries, including Korea. Thus, future studies in Asian countries are needed to conduct qualitative and in-depth explorations of students' experiences regarding an educational intervention that uses consumer involvement as a tool rigorously designed for mental health nursing education. Consumer involvement can be an innovative strategy to produce high-quality mental health nurses by minimizing the gap between theory and practice in the undergraduate program.
Topics: Community Participation; Curriculum; Education, Nursing; Humans; Psychiatric Nursing; Qualitative Research; Students, Nursing
PubMed: 32948052
DOI: 10.3390/ijerph17186756 -
How may cultural and political ideals cause moral distress in acute psychiatry? A qualitative study.BMC Psychiatry Mar 2022There is growing public criticism of the use of restraints or coercion. Demands for strengthened patient participation and prevention of coercive measures in mental...
BACKGROUND
There is growing public criticism of the use of restraints or coercion. Demands for strengthened patient participation and prevention of coercive measures in mental health care has become a priority for care professionals, researchers, and policymakers in Norway, as in many other countries. We have studied in what ways this current ideal of reducing the use of restraints or coercion and attempting to practice in a least restrictive manner may raise morals issues and create experiences of moral distress in nurses working in acute psychiatric contexts.
METHODS
Qualitative interview study, individual and focus group interviews, with altogether 30 nurses working in acute psychiatric wards in two mental health hospitals in Norway. Interviews were recorded and transcribed. A thematic analytic approach was chosen.
RESULTS
While nurses sense a strong expectation to minimise the use of restraints/coercion, patients on acute psychiatric wards are being increasingly ill with a greater tendency to violence. This creates moral doubt and dilemmas regarding how much nurses should endure on their own and their patients' behalf and may expose patients and healthcare personnel to greater risk of violence. Nurses worry that new legislation and ideals may prevent acutely mentally ill and vulnerable patients from receiving the treatment they need as well as their ability to create a psychological safe climate on the ward. Furthermore, persuading the patient to stay on the ward can cause guilt and uneasiness. Inadequate resources function as external constraints that may frustrate nurses from realising the treatment ideals set before them.
CONCLUSIONS
Mental health nurses working in acute psychiatric care are involved in a complex interplay between political and professional ideals to reduce the use of coercion while being responsible for the safety of both patients and staff as well as creating a therapeutic atmosphere. External constraints like inadequate resources may furthermore hinder the healthcare workers/nurses from realising the treatment ideals set before them. Caught in the middle nurses may experience moral distress that may lead to physical discomfort, uneasiness and feelings of guilt, shame, and defeat. Pressure on nurses and care providers to reduce or eliminate the use of coercion and reduction of health care spending are incompatible demands.
Topics: Coercion; Humans; Morals; Psychiatric Nursing; Psychiatry; Qualitative Research
PubMed: 35321674
DOI: 10.1186/s12888-022-03832-3 -
International Journal of Mental Health... Feb 2019To evaluate and describe the physical and mental health of staff on acute psychiatric wards and examine whether violence exposure is linked with health status. We...
To evaluate and describe the physical and mental health of staff on acute psychiatric wards and examine whether violence exposure is linked with health status. We undertook a cross-sectional survey with 564 nursing staff and healthcare assistants from 31 psychiatric wards in nine NHS Trusts using the SF-36, a reliable and valid measure of health status and compared summary scores with national normative data. Additional violence exposure data were collated simultaneously and also compared with health status. The physical health of staff was worse, and their mental health was better than the general population. Physical health data were skewed and showed a small number of staff in relatively poor health while the majority were above average. Better physical health was associated with less time in the current post, a higher pay grade, and less exposure to mild physical violence in the past year. Better mental health was associated with being older and from an ethnic minority background. Violence exposure influenced physical health but not mental health when possible confounders were considered. Mental health was strongly influenced by ethnicity, and further research might highlight the impact on own-group ethnic density on the quality of care. The impact of staff whom are physically unwell or impaired in the workplace needs to be considered as the quality of care may be compromised despite this being an example of inclusiveness, equal opportunities employment, and positive staff motivation.
Topics: Adult; Cross-Sectional Studies; Female; Health Status; Humans; Male; Mental Health; Middle Aged; Psychiatric Department, Hospital; Psychiatric Nursing; Violence
PubMed: 30152005
DOI: 10.1111/inm.12530 -
Journal of Psychiatric and Mental... Feb 2022WHAT IS KNOWN ON THE SUBJECT?: Research indicates many clients using mental health services have trauma histories. Consequently, mental health professionals must be...
WHAT IS KNOWN ON THE SUBJECT?: Research indicates many clients using mental health services have trauma histories. Consequently, mental health professionals must be aware of the impact of trauma and of how they can avoid retraumatizing service-users. Care delivered with this awareness is known as trauma-informed care (TIC). There is little research on attitudes towards TIC. To date, only one study explored these attitudes among MHNs exclusively. Additionally, a richer understanding of TIC attitudes using methods like in-depth interviews is needed. It is unclear whether knowledge of TIC results in more favourable attitudes. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: MHNs in this study had little knowledge of TIC but expressed overall favourable TIC attitudes. Traumatic histories were not appreciated as causes of challenging behaviour. On rehabilitation wards, clients come to be perceived as family members and this makes it harder for MHNs to not take challenging behaviour of clients personally. MHNs face work-related traumas which interfere with their ability to provide TIC. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Findings of this study can be used to guide plans to implement TIC in psychiatric hospitals. Policymakers are called to appreciate that ensuring MHN well-being on the workplace will facilitate their delivery of TIC. TIC training initiatives for MHNs must stress the importance of acknowledging traumatic histories as causes of challenging behaviour and of maintaining professional boundaries with long-term clients. This would benefit service-users by ensuring MHNs are more trauma-informed. More research on attitudes towards TIC among MHNs is needed. ABSTRACT: Introduction Quantitative studies exploring trauma-informed care (TIC) attitudes have not used samples made up exclusively of mental health nurses (MHNs). Qualitative methods were sparingly used. Aim To examine nurses' TIC attitudes at a psychiatric hospital. Method A mixed-method design was used. One hundred and thirty-six MHNs completed the Attitudes Related to Trauma-Informed Care scale. Data were analysed using inferential statistics. A focus group interview among ten MHNs ensued. Thematic analysis was used. Results MHNs demonstrated favourable TIC attitudes. Ambivalent attitudes for the subscale "Causes" were identified. MHNs employed for less than 5 years at the hospital and those in acute settings displayed more favourable attitudes on some subscales. Three themes "Awareness," "Unhealthy boundaries" and "Inhibition" emerged from qualitative analysis. Discussion Challenges uncovered in the provision of TIC include the unacknowledged impact of trauma on challenging behaviour among MHNS, the influence of blurred professional boundaries with long-term clients on the cycle of perpetuated trauma identified by previous research and MHNs work-related traumas. Implications for practice Identified challenges to TIC integration among MHNs can facilitate the implementation of TIC in hospitals. TIC educational packages for MHNs should acknowledge traumatic histories in the aetiology of challenging behaviour and stress the importance of maintaining professional boundaries with clients.
Topics: Attitude of Health Personnel; Hospitals, Psychiatric; Humans; Mental Health Services; Nurses; Psychiatric Nursing
PubMed: 33639009
DOI: 10.1111/jpm.12747 -
PloS One 2020The 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,...
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.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Nurse-Patient Relations; Nursing Staff, Hospital; Occupational Stress; Practice Guidelines as Topic; Psychiatric Department, Hospital; Psychiatric Nursing; Psychometrics; Reproducibility of Results; Self Efficacy; Surveys and Questionnaires; Young Adult
PubMed: 32240210
DOI: 10.1371/journal.pone.0230740 -
Archives of Psychiatric Nursing Jun 2001Tobacco use is treatable and the benefits of smoking cessation are impressive, yet like other health care providers, psychiatric nurses have failed to consistently... (Review)
Review
Tobacco use is treatable and the benefits of smoking cessation are impressive, yet like other health care providers, psychiatric nurses have failed to consistently assess and treat tobacco use effectively. Tobacco use continues to cause illness, disability, and death at unprecedented rates. Nicotine addiction is drug abuse and it is a chronic disease and needs to be treated as such. There are clear health benefits to smoking cessation regardless of the age of smoking initiation or the age of smoking cessation. Advanced practice psychiatric nurses (APPNs) are in a unique position to make an impact on a smoker's risk of suffering from tobacco-related diseases: the treatment of choice is the combination of pharmacotherapy and psychosocial interventions, both within the realm of APPN practice; psychiatric and substance abusing patients consistently demonstrate increased rates of cigarette smoking compared with healthy controls; and tobacco use is drug abuse, a treatable chronic disease. The ability of APPNs to deliver psychotherapeutic and pharmacologic care secures a position in the forefront of treating tobacco use. In addition to intervention, psychiatric nurses need to step up and take an active role in initiating and supporting tobacco control policy and legislation.
Topics: Counseling; Humans; Job Description; Motivation; Nurse Clinicians; Nurse-Patient Relations; Nursing Assessment; Nursing Evaluation Research; Patient Education as Topic; Practice Guidelines as Topic; Psychiatric Nursing; Risk Factors; Smoking; Smoking Cessation; Smoking Prevention; Social Support; Tobacco Use Disorder
PubMed: 11413502
DOI: 10.1053/apnu.2001.23749