Showing papers in "Journal of Psychiatric and Mental Health Nursing in 2009"
TL;DR: The aim of this paper was to review the existing literature pertaining to stigma, negative attitudes and discrimination towards mental illness, specifically as viewed through the lens of the nursing profession, and the major themes drawn were found to correspond with Schulze's model identifying three positions that healthcare workers may assume in relation to stigma of mental illness.
Abstract: The aim of this paper was to review the existing literature pertaining to stigma, negative attitudes and discrimination towards mental illness, specifically as viewed through the lens of the nursing profession. The results of the literature review were synthesized and analysed, and the major themes drawn from this were found to correspond with Schulze's model identifying three positions that healthcare workers may assume in relation to stigma of mental illness: 'stigmatizers', 'stigmatized' and 'de-stigmatizers'. In this paper, the nursing profession is examined from the perspectives of the first two major themes: the 'stigmatizers' and 'stigmatized'. Their primary sub-themes are identified and discussed: (1) Nurses as 'the stigmatizers': (a) nurses' attitudes in general medical settings towards patients with psychiatric illness and (b) psychiatric nurses; (2) Nurses as 'the stigmatized': (a) nurses who have mental illness and (b) stigma within the profession against psychiatric nurses and/or psychiatry in general. The secondary and tertiary sub-themes are also identified and reviewed.
365 citations
293 citations
TL;DR: Assessment of attitudes among health professionals directed towards patients with mental health problems suggested that health professionals have stigmatized attitudes towards an illness such as schizophrenia and this is worse towards patients from a secure hospital.
Abstract: The project aimed to assess stigmatized attitudes among health professionals directed towards patients with mental health problems. The Attitude to Mental Illness Questionnaire was used to assess participants' attitudes towards fictitious patients from a secure forensic hospital and patients with schizophrenia and substance use disorders. Participants were health professionals from acute and mental health settings. In total, 108 completed questionnaires were received. Participants had highly stigmatized attitudes towards patients from a forensic hospital and those with active substance use disorders. Attitudes were less stigmatized to people with substance use disorders who were recovering in remission. This suggested that health professionals have stigmatized attitudes towards an illness such as schizophrenia and this is worse towards patients from a secure hospital. The manner in which patients with substance use disorder are presented can have a significant effect on stigmatized attitudes by health professionals.
207 citations
TL;DR: This paper summarizes the constraining barriers and issues for the psychiatric workforce according to policy and management; interagency collaboration; worker attitude, skill and knowledge; the parent-consumer; and the consumer's family, including children.
Abstract: Many consumers of psychiatric services are parents, making these services the opportunistic point for supporting consumers' children. While evidence suggests that assisting such children improves their mental health, there is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This paper summarizes the constraining barriers and issues for the psychiatric workforce according to: (1) policy and management; (2) interagency collaboration; (3) worker attitude,skill and knowledge; (4) the parent-consumer; and (5) the consumer's family, including children. Potential solutions are presented, with a particular focus on the hierarchical nature of these barriers. Recommendations are made, including organizational audits to identify the most pressing barriers that impede family sensitive practice.
192 citations
TL;DR: Hospitals' expectations of mental health nurses will need to be reconsidered if these nurses are to provide the time and resources necessary to meet current service users' expectations.
Abstract: To provide efficient and effective inpatient mental health services, it is imperative to not only ascertain if service users are satisfied with the care received from nurses, but also the degree to which initial expectations are being met. Ten reports of primary research on service users' experiences, perceptions and expectations of inpatient mental health care were examined to understand what service users' expect of inpatient mental health care and the implications for nursing practice. The World Health Organization's description of responsiveness to service users' non-medical expectations of care was used as a framework for retrieving literature and organizing the research outcomes. Responsiveness includes seven categories of healthcare performance ranging from respect for the dignity of the person, to adequacy of amenities, and choice of provider. Service users expect to form interpersonal relationships with nurses; however, non-clinical responsibilities serve as barriers which consume considerable available nursing time that otherwise could be spent developing therapeutic relationships. In addition, inpatient programming ideas are identified for the provision of better services. Hospitals' expectations of mental health nurses will need to be reconsidered if these nurses are to provide the time and resources necessary to meet current service users' expectations.
109 citations
TL;DR: Investigation of factors that help and hinder college students with ADHD as they learn to cope with everyday challenges of life and academics found three global themes: gaining insight about ADHD, managing life and utilizing sources of support.
Abstract: Older adolescents with Attention Deficit Hyperactivity Disorder (ADHD) often struggle as they make the transition to college. Loss of parental supervision and structure, variable course schedules and the freedom and distractions of campus life can lead to health-risk behaviours for the college student with ADHD. The purpose of this study was to determine factors that help, as well as hinder, college students with ADHD as they learn to cope with everyday challenges of life and academics once they leave the structure and support of their parents' home. Investigators conducted semi-structured qualitative interviews with 15 college students with ADHD. Follow-up interviews confirmed and validated information obtained during initial interviews. In-depth qualitative analysis of transcribed interviews resulted in identification of three global themes: gaining insight about ADHD, managing life and utilizing sources of support. Each global theme contains factors that hinder, as well as factors that help the college student with ADHD. The factors that college students described as helping and hindering their transition to college can serve as the basis for interventions to educate and empower younger adolescents with ADHD well in advance of their transition to college.
108 citations
TL;DR: Investigation of nurses' efforts and rewards, as well as the effort-reward imbalance (ERI) and burnout, differ between subjects working in psychiatric vs. medical hospitals and between nurses under education and examined nurses respectively found all ERI scales to be significant predictors for emotional exhaustion.
Abstract: The aim of this study was to investigate whether nurses' efforts and rewards, as well as the effort-reward imbalance (ERI) and burnout, differ between subjects working in psychiatric vs. medical hospitals and between nurses under education and examined nurses respectively. Furthermore, the relationship between ERI and burnout was evaluated. Nursing is associated with high levels of emotional strain and heavy workloads. Burnout and a negative ERI can result in high absenteeism and turnover and have been identified as reasons why nurses leave their profession. In the last decade, working conditions of the nursing profession have changed in Germany, but somatic and psychiatric hospitals developed in different ways. This development may lead to different profiles. A sample of 389 nurses (78.8% female) in four German hospitals was investigated. A total of 147 nurses worked in psychiatric hospitals and 236 nurses worked in medical (somatic) hospitals. Fifty participants were still under education. The Effort-Reward Imbalance Inventory measures effort, reward and overcommitment at job and provides an imbalance score between effort and reward. The Maslach Burnout Inventory with the subscales, emotional exhaustion, lack of accomplishment and depersonalization, was also used. Nurses working in medical hospitals reported more burnout and had higher ERI scores. Subjects under education were comparable to examined nurses in terms of burnout but had lower ERI scores. Multiple regression analyses showed all ERI scales to be significant predictors for emotional exhaustion, while age, field of work and educational status further predict effort or ERI respectively. At present, the working situation of nurses in different settings appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.
106 citations
TL;DR: Mental health professionals surveyed indicated their positive approach to the adoption of recovery as an approach to care in the delivery of mental health services, but were less comfortable in encouraging healthy risk taking with service users.
Abstract: Recovery is the model of care presently advocated for mental health services internationally. The aim of this study was to examine the knowledge and attitudes of mental health professionals to the concept of recovery in mental health. A descriptive survey approach was adopted, and 153 health care professionals (nurses, doctors, social workers, occupational therapists and psychologists) completed an adapted version of the Recovery Knowledge Inventory. The respondents indicated their positive approach to the adoption of recovery as an approach to care in the delivery of mental health services. However, respondents were less comfortable in encouraging healthy risk taking with service users. This finding is important because therapeutic risk taking and hope are essential aspects in the creation of a care environment that promotes recovery. Respondents were also less familiar with the non-linearity of the recovery process and placed greater emphasis on symptom management and compliance with treatment. Multidisciplinary mental health care teams need to examine their attitudes and approach to a recovery model of care. The challenge for the present and into the future is to strive to equip professionals with the necessary skills in the form of information and training.
103 citations
TL;DR: It is suggested that the nurses' experience of restraint and seclusion created a dynamic movement between the release and suppression of distressing emotions, reminiscent of a model of suffering developed by Morse in 2001.
Abstract: The effectiveness of restraint and seclusion interventions in the nursing management of disturbed and aggressive clients remains questionable. Considerable debate continues regarding the use of these treatment options in psychiatric hospitals. The existing literature suggests that the controversial nature of restraint and seclusion creates a complex dilemma for nurses, which initiates emotional distress. This study specifically explored the emotions and feelings experienced by a group of psychiatric nurses working in Ireland in relation to incidents of restraint and seclusion. A qualitative research approach was employed incorporating focus group discussions. A total of 23 nurses participated in three focus group interviews. The data were analysed using qualitative interpretive analysis. Three themes were created consisting of: (1) the last resort - restraint and seclusion; (2) emotional distress; and (3) suppressing unpleasant emotions. It is suggested that the nurses' experience of restraint and seclusion created a dynamic movement between the release and suppression of distressing emotions. The oscillatory characteristics embedded within the nurses' emotional responses were reminiscent of a model of suffering developed by Morse in 2001. Consequently, this model is incorporated throughout the discussion of the findings to provide a more in-depth description of the emotional distress experienced by the nurses in the study.
98 citations
TL;DR: The purpose of this paper is to set out and categorize the factors in play in aggression- and agitation-management situations as perceived by the healthcare teams, particularly the nurses, to reduce recourse to coercive measures and enhance professional practices.
Abstract: Seclusion with or without restraint is a measure for managing aggressive or agitated clients and promoting site security, particularly in an emergency psychiatric setting. The decision to control a potentially dangerous person's behaviour by removal or seclusion seems ethically justifiable in such a setting. However, although the decisions on these restrictive measures are based on rational needs, they are also influenced by the healthcare team's perceptions of the client and by the characteristics of the team and the environment. The purpose of this paper is to set out and categorize the factors in play in aggression- and agitation-management situations as perceived by the healthcare teams, particularly the nurses. The first part of the paper deals briefly with the settings in which control measures are applied in a province in eastern Canada and the effect of such measures on patients and healthcare teams. The second part identifies the factors involved in the management of agitation and aggression behaviour. The final part discusses the current spin-offs from this knowledge as well as promising paths for further research on the factors involved. The ultimate objective is to reduce recourse to coercive measures and enhance professional practices.
87 citations
TL;DR: Four challenges are examined: assumptions about the nature of the problems, the power of defining 'true knowledge', the power domination in service provision and community mental health care as an accommodating arena for maximizing the service user role.
Abstract: Although user involvement has been the vision of mental health care for the last decades, there are indications of this vision remaining as rhetoric rather than reality in many clinical settings. The objective of this paper is to raise some fundamental questions associated with user involvement. Four challenges are examined: assumptions about the nature of the problems, the power of defining ‘true knowledge’, the power domination in service provision and community mental health care as an accommodating arena for maximizing the service user role. Finally, some strategies are suggested in order to overcome barriers towards realizing the intentions of user involvement.
TL;DR: The need for nurses to be aware of the concept of 'place' in the process of recovery from mental illness is highlighted, after individuals with major mental illnesses have obtained permanent housing with supports.
Abstract: This narrative study explores the experience of 'moving on' from homelessness for individuals with major mental illnesses, after they have obtained permanent housing with supports. Twelve participants were interviewed up to three times over 6 months. There were various routes to homelessness, participants were homeless for varying lengths of time, and they described different journeys of 'moving on' in their lives. Place, and a series of places, were central for participants in this experience. The experience of homelessness for many could be described as 'on the move', in a circular pattern from shelter to shelter or street. Permanent housing and supports allowed participants to 'move on', reconnecting with family, getting jobs and planning for the future. Several participants wanted their stories used to send messages of hope, courage and survival. This study highlights the need for nurses to be aware of the concept of 'place' in the process of recovery from mental illness.
TL;DR: The SMI physical Health Improvement Profile is developed to help mental health nurses profile the physical health of the SMI patients they work with and direct them towards the evidence base interventions available to address identified health problems.
Abstract: People with serious mental illness (SMI), such as schizophrenia and bipolar disorder, are more likely to suffer from a range of long-term physical conditions including diabetes and cardiovascular disease. Consequently they will die 10–15 years earlier than the general population. Health services have failed to address this major health inequality because of a lack of consensus about the type and frequency of monitoring people with SMI require and a lack of knowledge and skills in the mental health workforce. We developed the SMI physical Health Improvement Profile to help mental health nurses profile the physical health of the SMI patients they work with and direct them towards the evidence base interventions available to address identified health problems.
TL;DR: Larger and more complex studies are needed to examine how manual restraint is used in response to different types of incident and in different service settings.
Abstract: Relatively little is known about the prevalence of manual restraint to manage violent or challenging behaviour in hospital psychiatric services or the circumstances of its use. This review identified 45 empirical studies of manual restraint of adult psychiatric inpatients, mostly from the UK. On average, up to five episodes per month of manual restraint might be expected on an average 20-bed ward. Episodes last around 10 min, with about half involving the restraint of patients on the floor, usually in the prone position. Manually restrained patients tend to be younger, male and detained under mental health legislation. Staff value restraint-related training, but its impact on nursing practice has not been evaluated. Research has tended to focus on official reports of violent incidents rather than manual restraint per se. Larger and more complex studies are needed to examine how manual restraint is used in response to different types of incident and in different service settings.
TL;DR: L Locked wards were associated with increased patient aggression, poorer satisfaction with treatment and more severe symptoms, showing the urgent need for research to determine the real effects of locked doors in inpatient psychiatry.
Abstract: Many acute inpatient psychiatric wards in the UK are permanently locked, although this is contrary to the current Mental Health Act Code of Practice. To conduct a literature review of empirical articles concerning locked doors in acute psychiatric inpatient wards, an extensive literature search was performed in SAGE Journals Online, EBM Reviews, British Nursing Index, CINAHL, EMBASE Psychiatry, International Bibliography of the Social Sciences, Ovid MEDLINE, PsycINFO and Google, using the search terms 'open$', 'close$', '$lock$', 'door', 'ward', 'hospital', 'psychiatr', 'mental health', 'inpatient' and 'asylum'. A total of 11 empirical papers were included in the review. Both staff and patients reported advantages (e.g. preventing illegal substances from entering the ward and preventing patients from absconding and harming themselves or others) and disadvantages (e.g. making patients feel depressed, confined and creating extra work for staff) regarding locked doors. Locked wards were associated with increased patient aggression, poorer satisfaction with treatment and more severe symptoms. The limited literature available showed the urgent need for research to determine the real effects of locked doors in inpatient psychiatry.
TL;DR: Experiences of rejection were negatively associated with sense of coherence, empowerment and self-esteem, suggesting that experiences of rejection might be a target for coping interventions.
Abstract: The aim of the study was to explore the relationship between stigmatizing rejection experiences and self-related variables. Our hypothesis was that rejection experiences would be negatively associated with perceptions of self-esteem, empowerment and sense of coherence. A cross-sectional study assessing rejection experiences, empowerment, sense of coherence and self-esteem was performed, including 200 persons in current or earlier contact with mental health services. The results showed that experiences of rejection were negatively associated with sense of coherence, empowerment and self-esteem. This exploratory investigation suggests that experiences of rejection might be a target for coping interventions. Mental health nurses are in a key position to identify patients' experiences of stigma and by that to understand what consequences of devaluation/discrimination can have for the afflicted.
TL;DR: The study supported the importance for nurses to understand the cultural aspects of mental illness, particularly the widespread cultural beliefs and patterns of help seeking behaviours, in order to provide culturally sensitive health care.
Abstract: Schizophrenia is a severe illness with little hope of recovery and requires long-term care. The purpose of this study was to explore the experiences of carers who live with someone with long-term schizophrenia, within the cultural context of Taiwan. The study was conducted in a community setting in central Taiwan. A qualitative phenomenological approach was used to explore the experiences of carers. Purposive sampling was used by selecting the carers who were close relatives of the clients, had lived with the clients for at least 1 year and bore most of the responsibilities. Semi-structured face-to-face interviews were conducted to collect the data and narratives were analysed using Colaizzi's (1978) seven-step method. Data saturation was achieved after interviewing 10 carers. Three themes and eight sub-themes were identified: burdens of caring (helping clients' illness, lack of professional support and family conflicts), emotional burdens (sadness, worry and fear) and strategies of coping (cognitive and religious coping strategies). Our study supported the importance for nurses to understand the cultural aspects of mental illness, particularly the widespread cultural beliefs and patterns of help seeking behaviours, in order to provide culturally sensitive health care.
TL;DR: Although formal structured training was introduced in response to concerns around patient safety during restraint, concerns remain that PI is sometimes construed as a stand-alone violence prevention initiative.
Abstract: As a principal control measure, physical intervention is intended to be a skilled manual, or hands-on, method of physical restraint implemented by trained individuals, with the intention of controlling the aggressive patient, to restore safety in the clinical environment. Physical intervention is however a contentious practice. There have been reports in the literature of negative psychological views from staff and patients on the procedure. Although formal structured training was introduced in response to concerns around patient safety during restraint, concerns remain that PI is sometimes construed as a stand-alone violence prevention initiative. Its potential for misuse, and overuse, in corrupted cultures of care has emerged as a social policy issue. The following paper critically explores the literature on training in physical intervention in the United Kingdom.
TL;DR: Dental health was described in terms of sound, missing and/or filled teeth, and showed a relation between these categories and types of psychiatric diagnosis, age and numbers of antidepressant and neuroleptic drugs, and the need of dental treatment was widespread, although regular dental visits were commonly reported.
Abstract: Impaired mental health has been associated with an increased need for dental care. Population surveys have indicated that people with enduring mental health problems make less frequent planned visits to the dentist and report a greater number of missing teeth than the general population. The study aims to examine oral health status, attendance to dental care, and medication in an outpatient psychiatric sample. A descriptive study combining a structured interview with a visual oral examination carried out in 113 outpatients under psychiatric care. Dental health was described in terms of sound, missing and/or filled teeth, and showed a relation between these categories and types of psychiatric diagnosis, age and numbers of antidepressant and neuroleptic drugs. Oral hygiene was found to be more neglected among men and in patients with the diagnosis of schizophrenia. The need of dental treatment was widespread, although regular dental visits were commonly reported. In order to maintain good oral health, regular dental check-ups should be encouraged for patients under psychiatric care. Further studies are required to reveal contributory causes for/to decreased oral health. The difficulty such individuals have in maintaining additional self-efficacy raises questions about the necessity for oral health interventions in outpatient psychiatric services.
TL;DR: Analysis of relationships between personal resilience and willingness of undiagnosed, community dwelling older adults to seek mental health care for depressive symptoms found that resilience may be applicable to vulnerable, marginalized and minority older adults worldwide.
Abstract: The purpose was to explore influence of resilience on the willingness of African Americans aged 65 and over to seek mental health care for depressive symptoms. Specifically, the study examined relationships between personal resilience and willingness of undiagnosed, community dwelling older adults to seek mental health care for depressive symptoms. A cross-sectional, correlational, causal modelling design was used to study older African Americans (N= 158; 121 women and 37 men) recruited from churches, retirement organizations and senior nutrition centres. Participants completed study instruments to measure depressive symptoms, resilience, willingness to seek mental health care, and general demographics information. Descriptive statistics and multiple regression analyses were preformed. Depressive symptoms and resilience accounted for 15.4% of the willingness to seek mental health care variance; extraction of resilience lowered variance to 0.9%. A direct, predictive relationship between resilience and willingness to seek mental health care was documented. Understanding resilience and willingness to seek mental health care supports future research for interventions that bolster resilience in older adults. Identifying the influence of resilience on such willingness may provide direction for developing interventions for older African Americans and may be applicable to vulnerable, marginalized and minority older adults worldwide.
TL;DR: The present study found that the MHAPs are valid measures, though more complex triggering algorithms capable of differentiating individuals based on outcomes were suggested to enhance their clinical relevance to care planning.
Abstract: For persons with mental illness and addictions, comprehensive assessment of their strengths, preferences and needs is central to person-centred care planning. In this study, the validity of the Mental Health Assessment Protocols (MHAPs) embedded in the Resident Assessment Instrument Mental Health instrument (the mandated assessment system for Ontario adult inpatient psychiatry) is examined, and triggering rates are compared in inpatient and community-based mental health settings. The sample is based on adults admitted to a psychiatric facility (n = 963) and to community mental health programmes (n = 1505) participating in the study. An international panel of mental health experts further evaluated study results. Among the 27 MHAPs, all but one had sensitivity rates above 80%, and the specificity was over 80% for 74% of the MHAPs. The expert panel found that the MHAPs worked well and could be used to support mental health care. The present study found that the MHAPs are valid measures, though more complex triggering algorithms capable of differentiating individuals based on outcomes were suggested to enhance their clinical relevance to care planning. Further, the use of compatible instrumentation in community-based mental health settings was promoted to enhance continuity of care.
TL;DR: It is concluded that expressed preferences of service users and carers for pre-emptive services that are delivered flexibly will present a challenge for service commissioners and providers, particularly where stringent access criteria are used.
Abstract: There is emerging evidence that crisis resolution services can provide alternatives to hospital admission, reducing demand on inpatient beds. Following a public consultation exercise in Lancashire (England), a team of nurses undertook a study, using interactive research methodology, to gain an understanding of how users and carers define a crisis and what range of crisis services, resources and interventions service users and carers thought would help avoid unnecessary hospital admission. Data collection comprised postal questionnaires and 24 group meetings with service users and carers, which were held during 2006. Data were analysed, and seven themes were identified: (1) definitions of a crisis; (2) access to services; (3) interventions; (4) range of services required (before, during and after crisis); (5) place of treatment; (6) recovery and rehabilitation; and (7) community support. We conclude that expressed preferences of service users and carers for pre-emptive services that are delivered flexibly will present a challenge for service commissioners and providers, particularly where stringent access criteria are used. Home-based pre-emptive services that reduce the need for unnecessary hospital treatment may avoid progression to social exclusion of service users.
TL;DR: The risk factors of the students' suicidal thoughts were determined to be issues of gender, school problems, family relationships, anger expression, somatization, hostility, psychotic symptoms, phobic anxiety, anxiety disorder and interpersonal sensitivity.
Abstract: This research was planned as a descriptive study for the purpose of examining the suicidal thoughts of first-year university students and the factors that might affect them. The research was conducted with the participation of first-year students (class of 1992) at Ege University between January 2003 and October 2004. The research data were collected on a form prepared by the researcher to determine the university students' socio-demographic characteristics and their suicidal thoughts, the trait anger, expression of anger inventory and the brief symptom inventory. It was determined that 2.4% of the students had suicidal thoughts, and 11.2% of the students had previously attempted suicide. The risk factors of the students' suicidal thoughts were determined to be issues of gender, school problems, family relationships, anger expression, somatization, hostility, psychotic symptoms, phobic anxiety, anxiety disorder and interpersonal sensitivity.
TL;DR: The aim of this study is to illuminate the meaning of encounters with a troubled conscience among psychiatric therapists and interpreted in light of Lögstrup's ethics of trust, according to which conscience alerts us to silent but radical ethical demand and the risk of self-deception.
Abstract: The aim of this study is to illuminate the meaning of encounters with a troubled conscience among psychiatric therapists. Psychiatric care involves ethical dilemmas which may affect conscience. Con ...
TL;DR: Grief that occurs as a result of relinquishing an infant for adoption is explored and the role of psychiatric-mental health nurse and interventions aimed at assisting the birthmother to grieve are suggested.
Abstract: Grief that occurs as a result of relinquishing an infant for adoption is explored. Traditional grief models are cited as ineffectual for the satisfactory resolution of grief resulting from the relinquishment of a child for adoption. The reasons for disenfranchised grief are described and narratives of personal interviews provide insight into the grief process of birthmothers and evidence of their disenfranchisement. The role of psychiatric-mental health nurse is discussed and interventions aimed at assisting the birthmother to grieve are suggested.
TL;DR: The current nature and extent of stigma and discrimination in an area of the north of England is explored and findings are compared with those from a study undertaken a decade ago, which found close similarities in both sets of data.
Abstract: In recent years, efforts to combat stigma and discrimination experienced by mental health service users have ranged from small local initiatives to national and international campaigns. Success has been mixed, with significant, lasting benefits appearing to be elusive. This paper explores the current nature and extent of stigma and discrimination in an area of the north of England and compares findings with those from a study undertaken a decade previously in 1997. Qualitative responses to a postal questionnaire received in 2007 were thematically analysed and compared and contrasted with findings from the 1997 study. Four broad categories of discrimination – (1) employment; (2) professional; (3) communities; and (4) family and friends – arose from the 2007 data, the most common being discrimination in employment. There were close similarities in both sets of data. Stigma and discrimination remain largely as strong, damaging and enduring as they were a decade ago. A range of pre-emptive interventions that support people prior to the escalation of mental health crises could limit the impact of stigma.
TL;DR: Because nursing students need to be mental health literate when they complete their course, mental health nursing content should be incorporated earlier in comprehensive undergraduate curricula and incrementally increased in each year of study.
Abstract: Many students have poor mental health literacy when they finish Bachelor of Nursing courses. This paper presents the findings of a longitudinal study of Australian Bachelor of Nursing students' mental health literacy about the effectiveness of interventions for people with schizophrenia. The 'Attitudes and Beliefs about Mental Health Problems: Professional and Public Views' questionnaire was used with a non-probability sample of nursing students. A time series approach to data collection was used, with data collected on three occasions between 2005 and 2007. Ethics approval was obtained from a university ethics committee. Data were analysed using SPSS Version 15.0. The students' views about the helpfulness of interventions showed a significant and positive improvement as they progressed through the course. There were significant differences over time in their views about the helpfulness of professional and lay interventions, their opinions about the helpfulness of mental health and other medications, and the usefulness of activity and non-pharmacological interventions. Because nursing students need to be mental health literate when they complete their course, mental health nursing content should be incorporated earlier in comprehensive undergraduate curricula and incrementally increased in each year of study.
TL;DR: The findings indicated that physical touch was used in mental health nursing; however, it was only considered to be therapeutic to clients if used judiciously, with effective interpersonal skills.
Abstract: The aim of this study was to explore psychiatric nurses' perceptions of physical touch with people who experience mental health problems. A descriptive exploratory qualitative research design was used. Semi-structured interviews were carried out with 10 registered psychiatric nurses who met the inclusion criteria and were randomly selected to participate in the study. Burnard's 14 stage-by-stage process of coding and categorization was used to analyse the data. Watson distinguished between two kinds of physical touch: instrumental and expressive. The findings indicated that physical touch was used in mental health nursing; however, it was only considered to be therapeutic to clients if used judiciously, with effective interpersonal skills. The participants in this study clearly identified the need to be sensitive to both the individual client needs, and honour their personal space and cultural background. A significant issue in this study was male participants concerns that touching female clients would be misinterpreted as a sexual advance. To protect themselves, male participants used touch in a cautious and minimal manner, and only in a public space, where others could view the interaction. In the absence of research on physical touch in mental health nursing there is a need for further research to explore in detail these findings.
TL;DR: Three items in the survey, which were independently significant associates of overall consumer satisfaction, included being happy with the service provided by the consumer support worker, having support for services on discharge and feeling safe and secure on the ward.
Abstract: Consumer satisfaction is today, widely accepted as a measure of the level and quality of service received by consumers. The aim of this survey-based study is to explore consumer satisfaction with quality of care, staff, environment and discharge in a south eastern Sydney adult acute inpatient mental health unit. A cross-sectional analysis is pursued in order to identify aspects of the patient stay, which form an associative relationship with an overall rating of consumer satisfaction on a 10-point scale. During the survey period, there were 182 discharges. Seventy questionnaires (38.5%) were returned from this group. The survey results highlight a number of areas of identified need, enabling the service to prioritize organizational systems around meeting these needs. Multiple regression analysis identified three items in the survey, which were independently significant associates of overall consumer satisfaction. They included being happy with the service provided by the consumer support worker, having support for services on discharge and feeling safe and secure on the ward. The model containing these three items accounted for 50% of the variation in overall satisfaction. Two primary interventions have been developed because survey administration which, it is hoped, will address issues raised in the survey. The interventions were the development of an admission and discharge pathway and a ward-based psychosocial intervention programme, which includes the involvement of consumer support workers.