BackgroundThe aim was to examine barriers to initiation and continuation of treatment among individuals with common mental disorders in the US general population.MethodRespondents in the National Comorbidity Survey Replication with common 12-month DSM-IV mood, anxiety, substance, impulse control and childhood disorders were asked about perceived need for treatment, structural barriers and attitudinal/evaluative barriers to initiation and continuation of treatment.ResultsLow perceived need was reported by 44.8% of respondents with a disorder who did not seek treatment. Desire to handle the problem on one's own was the most common reason among respondents with perceived need both for not seeking treatment (72.6%) and for dropping out of treatment (42.2%). Attitudinal/evaluative factors were much more important than structural barriers both to initiating (97.4% v. 22.2%) and to continuing (81.9% v. 31.8%) of treatment. Reasons for not seeking treatment varied with illness severity. Low perceived need was a more common reason for not seeking treatment among individuals with mild (57.0%) than moderate (39.3%) or severe (25.9%) disorders, whereas structural and attitudinal/evaluative barriers were more common among respondents with more severe conditions.ConclusionsLow perceived need and attitudinal/evaluative barriers are the major barriers to treatment seeking and staying in treatment among individuals with common mental disorders. Efforts to increase treatment seeking and reduce treatment drop-out need to take these barriers into consideration as well as to recognize that barriers differ as a function of sociodemographic and clinical characteristics.

/pdf/barriers-to-mental-health-treatment-results-from-the-1lrtmfzc92.pdf

Barriers to mental health treatment: results from the National Comorbidity Survey Replication.

The role of conformity to dominant U.S. masculine norms as an antecedent to help-seeking attitudes in men has been established using convenience samples made up largely of college-age and European American males. However, the role of conformity to masculine norms on help-seeking attitudes for noncollege-age men or for men from diverse backgrounds is not well understood. To fill this gap in the literature, the present study examined the cross-cultural relevance of a mediational model of the relationships between conformity to dominant U.S. masculine norms and attitudes toward counseling through the mediator of self-stigma of seeking counseling for 4,773 men from both majority and nonmajority populations (race/ethnicity and sexual orientation). Structural equation modeling results showed that the model established using college males from majority groups (European American, heterosexual) may be applicable to a community sample of males from differing racial/ethnic groups and sexual orientations. However, some important differences in the presence and strengths of the relationships between conformity to dominant masculine norms and the other variables in the model were present across different racial/ethnic groups and sexual orientations. These findings suggest the need to pay specific theoretical and clinical attention to how conformity to dominant masculine norms and self-stigma are linked to unfavorable attitudes toward help seeking for these men, in order to encourage underserved men's help-seeking behavior.

http://healthcareguild.com/presentations_files/boys%20dont%20cry%20-%20exampination%20of%20links%20between%20endorsement%20of%20masculine%20norms,%20selfstigma,%20helpseeking%20attitudes%20for%20men.pdf

“Boys don't cry”: Examination of the links between endorsement of masculine norms, self-stigma, and help-seeking attitudes for men from diverse backgrounds.

Nursing Research: A Qualitative Perspective

Evidence is accumulating that nurses completing pre-licensure programs are not equipped with the essential knowledge and skills for today’s nursing practice, nor prepared to continue learning for tomorrow’s nursing. Citing the need to improve quality and increase capacity, this paper offers three recommendations for transforming nursing education: (1) Create new nursing education systems which use existing resources in community colleges and universities and which provide for common prerequisites and a shared competency-based nursing curriculum and instructional materials. (2) Convene one or more expert panels to develop model pre-licensure curricula which: (a) can be used as a framework by faculty in community college-university partnerships for development of their local curriculum; (b) are based on emerging health care needs and widely accepted nursing competencies as interpreted for new care delivery models; (c) incorporate best practices in teaching and learning. (3) Invest in a national initiative to develop and evaluate new approaches to pre-licensure clinical education, including a required post-graduate residency under a restricted license. The author notes that these changes will require significant investment in the reforms, as well as in nursing education research and faculty development. The return on investment would be improved educational capacity and a better prepared nursing workforce, responsive to emerging health care needs and rapidly changing health care delivery systems. TRANSFORMING PRE-LICENSURE NURSING EDUCATION: PREPARING THE NEW NURSE TO MEET EMERGING HEALTH CARE NEEDS The Carnegie Foundation for the Advancement of Teaching joins a chorus of calls for transformation of pre-licensure nursing education (Benner et al., 2009b). Citing the shift of significant responsibility to nurses for managing complex medical regimens, as well as increasing complexity of community based practices, Benner and colleagues concluded that nurses entering the field are not equipped with the essential knowledge and skills for today’s practice nor prepared to continue learning for tomorrow’s nursing (p. 31). They found (1) weak curricula in natural sciences, technology, social sciences and humanities, and in developing cultural competency; (2) weak classroom instruction and limited integration between classroom and clinical experiences; (3) limited strategies in helping The Future of Nursing: Leading Change, Advancing Health Copyright National Academy of Sciences. All rights reserved.

The Future of Nursing: Leading Change, Advancing Health Key Messages and Report Recommendations

LIM J., BOGOSSIAN F. & AHERN K. (2010) Stress and coping in Australian nurses: a systematic review. International Nursing Review57, 22–31

Aim:  To identify factors that contribute to stress in Australian nurses, consider the coping strategies they use and examine the effects of stressors on nurses' health and well-being.

Background:  Stress is a major concern in the nursing profession with work overload, nurse shortages and high turnover rates as the common stressors. Although nursing stress has been studied extensively, there is a lack of clarity on the nursing situation in Australia.

Methods:  A systematic review of the current literature was conducted on stress and coping strategies within the Australian nursing population.

Results:  Stressors included work overload, role conflicts and experiences of aggression. Coping strategies included seeking support, problem solving and self-control. The majority of the studies reported detrimental effects on nurses' physical and mental well-being with little consideration given to the spillover effects of nursing work stress to their family and social relationships.

Conclusion:  Recommendations included factoring in personal and work stresses, promoting the use of effective coping strategies and maintaining supportive social relationships.

Stress and coping in Australian nurses: a systematic review

This paper presents the findings of a qualitative study to identify factors that influence Asian communities' access to mental health care and how mental health care is delivered to them. Semistructured interviews were completed with Asian community members/leaders and health-care professionals. Content analysis identified major themes. Participants also completed a demographic data sheet. The research aimed to provide health professionals with an increased understanding of the values and beliefs held by people from Asian communities regarding the cause and treatment of mental illness. Data analysis identified six main themes that influenced Asian communities' access to mental health care and how mental health care is delivered to them. They were: shame and stigma; causes of mental illness; family reputation; hiding up; seeking help; and lack of collaboration. The findings highlighted that people from Asian communities are unwilling to access help from mainstream services because of their beliefs, and that stigma and shame are key factors that influence this reluctance. The findings also highlight that the mental health needs of refugee women are significant, and that they comprise a vulnerable group within Australian society.

Factors that influence Asian communities' access to mental health care.

Journal of Advanced Nursing55(5), 559–567Male nurses’ experiences of providing intimate care for women clientsAim. This paper reports a study of male nurses’ experiences of providing intimatecare for women clients.Background. The number of men entering the nursing profession has increasedworldwide. As a consequence of the move to a more gender-balanced profession,debate has ensued over how intimate care should be performed when thisrequires male nurses to be physically close to women clients. As there was littleprevious work on this topic, we wished to provide nurses, clients and otherhealthcare professionals with a better understanding of male nurses’ experiencesof working with women clients and within a healthcare system where they oftenfeel excluded.Method. Semi-structured, open-ended interviews were conducted with malenurses working in various clinical settings in Western Australia. Latent contentanalysis was used to analyse the interviews, which were carried out between Juneand July 2004.Findings. Three themes were identiﬁed: the deﬁnition of intimate care, theemotional experience associated with providing intimate care and strategies usedto assist in the delivery of intimate care for women clients. Providing intimatecare for women clients was a challenging experience for male nurses. Participantsdescribed how it required them to invade these clients’ personal space. Conse-quently, they often experienced various negative feelings and used several strat-egies to assist them during care delivery.Conclusions. Nurse educators should assist male nurses to be better prepared tointeract with women clients in various settings. Furthermore, workplace envi-ronments need to provide additional support and guidance for male nurses toenable them to develop effective coping strategies to manage challenging situa-tions.Keywords: interviews, male nurses, personal space, qualitative research, womenclients’ intimate care

Male nurses' experiences of providing intimate care for women clients.

What general emergency nurses want to know about mental health patients presenting to their emergency department

Aims and objectives
Investigate effects of teamwork on missed nursing care across a healthcare network in Australia.

Background
Missed care is universally used as an indicator of quality nursing care, however, little is known about mitigating effects of teamwork on these events.

Design
A descriptive exploratory study.

Methods
Missed Care and Team Work surveys were completed by 334 nurses. Using Stata software, nursing staff demographic information and components of missed care and teamwork were compared across the healthcare network. Statistical tests were performed to identify predicting factors for missed care.

Results
The most commonly reported components of missed care were as follows: ambulation three times per day (43·3%), turning patient every two hours (29%) and mouth care (27·7%). The commonest reasons mentioned for missed care were as follows: inadequate labour resources (range 69·8–52·7%), followed by material resources (range 59·3–33·3%) and communication (range 39·3–27·2%). There were significant differences in missed care scores across units. Using the mean scores in regression correlation matrix, the negative relationship of missed care and teamwork was supported (r = −0·34, p < 0·001). Controlling for occupation of the staff member and staff characteristics in multiple regression models, teamwork alone accounted for about 9% of missed nursing care.

Conclusion
Similar to previous international research findings, our results showed nursing teamwork significantly impacted on missed nursing care. Teamwork may be a mitigating factor to address missed care and future research is needed.

Relevance to clinical practice
These results may provide administrators, educators and clinicians with information to develop practices and policies to improve patient care internationally.

Impact of teamwork on missed care in four Australian hospitals.

This phenomenological study was designed to understand the lived experience of nursing students coping with the demands of their clinical practice. The Husserlian phenomenological approach was used. The data revealed several strategies that fourteen student nurses utilised to cope with the demands of their undergraduate clinical program. The participants discussed having a strong determination to complete their course and talking things over with family, friends, and other students as means of helping them get through it. They considered that only other nursing students could really understand the experience of being a student nurse. Therefore, a very effective student grapevine operated in their undergraduate program. The grapevine was used to disseminate information about all aspects of the course. Other strategies discussed by the participants were 'playing the game' and doing only what was necessary to complete the undergraduate program. This paper describes the learning strategies used by nursing students during their clinical practice, which has implications for clinical teachers and schools of nursing. (author abstract)

Rose Chapman

Papers

Factors that influence Asian communities' access to mental health care.

Male nurses' experiences of providing intimate care for women clients.

What general emergency nurses want to know about mental health patients presenting to their emergency department

Impact of teamwork on missed care in four Australian hospitals.

Coping strategies in clinical practice: the nursing students' lived experience.