Richmond, I; Roberson, E
In this age of consumerism, consideration should be given to patients' perceptions of interactions with the health care provider as a factor in assessing the quality of care provided. This article describes a study of 100 psychiatric inpatients in a large urban medical center who evaluated 50 commonly used psychiatric nursing actions. Significant differences were found between the general psychiatric patient population and the substance abuse population in perception of helpfulness and frequency of performance with 7 of the 50 nursing actions. As the consumer's perception of the effectiveness of nursing actions is determined, emphasis can be given to those interventions when planning patient care.
Scott, D J; Philip, A E
A sample of 208 psychiatric nurses and nursing assistants completed a questionnaire assessing attitudes to treatment and patients. Significant attitudinal differences between groups were found in relation to professional grade, age and sex. Staff with more professional training were less authoritarian and impersonal than staff more junior in the hierarchy. Younger males with Registered Mental Nurse training were found to be significantly less inclined towards physical methods of nursing and treatment. Male nurses tended to favour therapeutic techniques which emphasized independent nurse action and psychological proximity to patients. Female nurses were more favourably inclined to physical methods of treatment and were significantly more authoritarian and formal towards patients in line with the traditional stereotype of the general hospital nurse. Results are discussed in relation to the setting up of new treatment regimes within psychiatric hospitals and the influence that staff attitudes have on their functioning.
Looff, P.C. de; Kuijpers, E.; Nijman, H.L.I.
During a total of 30 shifts, the arousal levels of 10 psychiatric nurses were assessed while working on a (forensic) psychiatric admissions ward. Arousal was assessed by means of a small device (wristband) by which the Skin Conductance Level (SCL) of the participating nurses was monitored. Each
Morrison, E G; Shealy, A H; Kowalski, C; LaMont, J; Range, B A
The purpose of this research was to operationalize Peplau's workroles of the psychiatric staff nurse. Thirty registered nurses audiotaped one-to-one interactions with 62 adult, child, and adolescent psychiatric patients. Content analysis was used to identify role behaviors and to identify roles that were different from those outlined by Peplau. The counselor role was the most frequently occurring primary workrole. Overlap was found between behaviors indicative of autocratic leader versus surrogate and those of resource person versus teacher. The findings supported Peplau's contention that the counselor role is central to the practice of psychiatric nursing.
Koen, D; Muller, M; Poggenpoel, M
The nursing service manager is accountable for the quality of nursing care delivered in the nursing service. It is therefore important that the nursing service manager facilitates staff development in the nursing service. It is not only the nursing service manager's responsibility to make provision for staff development--the nurse also has a responsibility in this regard. He/she should purposefully make an effort to keep up to date with the latest developments. This article focuses on the co-responsibility of the psychiatric nurse and nursing service manager regarding staff development. A model for staff development is described, in accordance with the guidelines of Dickoff, James & Wiedenbach for theory development. An inductive approach was primarily followed to describe the provisional model, after which a literature study was employed to refine and purify the model. This model was exposed to expert evaluation, after which the final model for staff development of psychiatric nurses was described. Recommendations include the testing of certain hypotheses and utilisation of this model in psychiatric nursing practice.
Carpenter, Lindsey M; Hubbard, Grace B
The purpose of this article is to inform and educate psychiatric nurse practitioners about the pervasiveness of the rapidly increasing problem of cyberbullying. As more children and adolescents obtain access to the Internet, mobile devices, and social networking sites, the exposure to bullying in the virtual format increases. Cyberbullying is a growing public health concern and can affect mental health and school performance. Cyberbullying often results in a range of psychiatric symptoms and has been linked to suicide attempts and completions. The psychiatric nurse practitioner is uniquely prepared to provide a range of interventions for patients, families, and communities who have experienced cyberbullying. © 2014 Wiley Periodicals, Inc.
Bostrom, Andrea C
Understanding and treating mental illness has improved in many ways as a result of the fast pace of technological advances. The technologies that have the greatest potential impact are those that (1) increase the knowledge of how the brain functions and changes based on interventions, (2) have the potential to personalize interventions based on understanding genetic factors of drug metabolism and pharmacodynamics, and (3) use information technology to provide treatment in the absence of an adequate mental health workforce. Technologies are explored for psychiatric nurses to consider. Psychiatric nurses are encouraged to consider the experiences of psychiatric patients, including poor health, stigmatization, and suffering. Copyright © 2016 Elsevier Inc. All rights reserved.
Nijman, H.; Bowers, L.; Oud, N.; Jansen, G.
Using a survey instrument, the experiences of psychiatric nurses with inpatient aggression were investigated in East London, U.K. On this "Perceptions of Prevalence Of Aggression Scale" (POPAS), annual experiences with 15 types of disruptive and aggressive behavior were rated anonymously. Staff
Nijman, H.L.I.; Bowers, L.; Oud, N.E.; Jansen, G.J.
Using a survey instrument, the experiences of psychiatric nurses with inpatienaggression were investigated in East London, U.K. On this Perceptions of Prevalence Of Aggression Scale (POPAS), annual experiences with 15 types of disruptive and aggressive behavior were rated anonymously. Staff members
Lindström, U A
The main purpose of this research was to determine the professional paradigm of the qualified psychiatric nurse and the factors influencing the formation of this paradigm. The research was both explorative and descriptive, and both qualitative and quantitative methods were used. The research approach was deductive and based on the theory of paradigm of Törnebohm. The test persons comprised three groups: Swedish-speaking Finns, Swedes and Finns. In each group there were eight students in the final stages of their psychiatric nursing training. A total of 40 questionnaires were distributed to each group. The research revealed four different characteristic types of qualified psychiatric nurses: caring science oriented, partly caring science oriented, general humanist and finally the personality- and experience-oriented. The results also indicate that there is a discrepancy between will and ability within caring. This can partly be interpreted as an expression of the discrepancy between philosophical and ideological impressions and real acts but it may partly indicate a lack of information. Many informants had difficulty naming a theoretical frame of reference for their work and stating aspects of psychiatric caring that would be important to know but on which no information so far exists. Many informants expressed the need for more research and development but did not indicate the subjects.
Thóra van der Hafsteinsdóttir; Cokky van der Venne; Yvonne van der Zalm; Nienke Kool; Willem Nugteren; prof Berno van Meijel
PURPOSE: To determine what is known from the literature about nursing care of psychiatric patients with a history of child maltreatment. CONCLUSIONS: Psychiatric nurses underline the importance of a routine inquiry of child abuse on admission of patients to psychiatric care, but are reluctant to
Moller, M D; Pierce, A; Roach, R; Shanahan, C; Loch, E
The academic and clinical content of psychiatric nursing curricula in the registered nurse basic educational programs in Nebraska for academic year 1989-1990 was explored by the Nebraska Sub-group of the Nursing Curriculum and Training Task Force of the National Alliance for the Mentally Ill. The review includes literature regarding the history, development, and future trends of psychiatric nursing; factors affecting nursing student attitudes toward psychiatric patients; basic content included in psychiatric and psychosocial nursing curricula; and concepts essential in working with the seriously, persistently mentally ill. Contrary to current trends in the United States, all Nebraska schools of nursing have a generic psychiatric nursing course taught by clinical specialists in psychiatric-mental health nursing. Hands-on clinical time spent with patients with psychiatric diagnoses as well as those with psychosocial needs varies from 84 to 200 hr per semester. Not all students are exposed to patients with severe and persistent mental illness. Fewer than 5% of Nebraska graduates choose psychiatric nursing as their area of practice. The authors express grave concern for the future of psychiatric nursing education. Implications for curriculum revision and replication studies are suggested.
Lunice B Khoza
Full Text Available This research report comprises part of a larger study, which endeavoured to identified the competencies of newly qualified nurses (NQNs as viewed by senior professional nurses (SPNs in the clinical units. This report concentrates only on the competencies of the NQNs working in the psychiatric nursing units. SPNs (N=29 from certain health services in the Northern Province (NP of the RSA, constituted the population for this research. A descriptive survey was used as a research approach to conduct this research. The fieldwork, entailing the distrib~ltiona nd collection of the questionnaires by a researcher, was done during a period of political and labour unrest in this area. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
Voogt, L.A.; Goossens, P.J.J.; Nugter, A.; Achterberg, T. van
PURPOSE: To observe the actions of psychiatric nurses when providing structure and identify results in order to better understand providing structure as a complex nursing intervention. DESIGN AND METHOD: Participant observation data were collected on a dual diagnosis ward and a crisis intervention
Yada, Hironori; Abe, Hiroshi; Funakoshi, Yayoi; Omori, Hisamitsu; Matsuo, Hisae; Ishida, Yasushi; Katoh, Takahiko
The aim of the present study was to develop a tool, the Psychiatric Nurse Job Stressor Scale (PNJSS), for measuring the stress of psychiatric nurses, and to evaluate the reliability and validity of the PNJSS. A total of 302 psychiatric nurses completed all the questions in an early version of the PNJSS, which was composed of 63 items and is based on past literature of psychiatric nurses' stress. A total of 22 items from four factors, 'Psychiatric Nursing Ability', 'Attitude of Patients', 'Attitude Toward Nursing' and 'Communication', were extracted in exploratory factor analysis. With regard to scale reliability, the item-scale correlation coefficient was r = 0.265-0.570 (P job stressor' scale was r = 0.172-0.420 (P job reaction' scale was r = 0.201-0.453 (P job stressors. © 2011 The Authors. Psychiatry and Clinical Neurosciences © 2011 Japanese Society of Psychiatry and Neurology.
Nursing is an occupation that deals with humans and relies upon human relationships. Nursing care, which is an important component of these relationships, involves protection, forbearance, attention, and worry. The aim of this study is to evaluate the ethical beliefs of psychiatric nurses and ethical problems encountered. The study design was descriptive and cross-sectional. RESEARCH CONTEXT: Methods comprised of a questionnaire administered to psychiatric nurses (n=202) from five psychiatric hospitals in Istanbul, Turkey, instruction in psychiatric nursing ethics, discussion of reported ethical problems by nursing focus groups, and analysis of questionnaires and reports by academicians with clinical experience. PARTICIPANTS consist of the nurses who volunteered to take part in the study from the five psychiatric hospitals (n=202), which were selected with cluster sampling method. Ethical considerations: Written informed consent of each participant was taken prior to the study. The results indicated that nurses needed additional education in psychiatric ethics. Insufficient personnel, excessive workload, working conditions, lack of supervision, and in-service training were identified as leading to unethical behaviors. Ethical code or nursing care -related problems included (a) neglect, (b) rude/careless behavior, (c) disrespect of patient rights and human dignity, (d) bystander apathy, (e) lack of proper communication, (f) stigmatization, (g) authoritarian attitude/intimidation, (h) physical interventions during restraint, (i) manipulation by reactive emotions, (j) not asking for permission, (k) disrespect of privacy, (l) dishonesty or lack of clarity, (m) exposure to unhealthy physical conditions, and (n) violation of confidence. The results indicate that ethical codes of nursing in psychiatric inpatient units are inadequate and standards of care are poor. In order to address those issues, large-scale research needs to be conducted in psychiatric nursing with a
Zarea, K; Nikbakht-Nasrabadi, A; Abbaszadeh, A; Mohammadpour, A
Patients with mental illness require unique and specific care. The purpose of this study was to explore the experiences of nurses, who provide such care for mentally ill people, within the context of Iranian culture. This hermeneutic phenomenological study was carried out in a university-affiliated hospital in an urban area of Iran. We interviewed 10 mental health nurses to capture in detail their experiences in psychiatric units, and the approach developed by Diekelmann et al. was employed to analyse the data. Four themes and five sub-themes were identified: 'being engaged with patients' (sub-themes: 'struggle for monitor/control', 'safety/security concerns', 'supporting physiological and emotional needs'), 'being competent', 'altruistic care' and 'facing difficulties and challenges' (sub-themes: 'socio-cultural' and 'organizational challenges'). The results provide valuable insights and greater understanding of the professional experiences of psychiatric nurses in Iran, and indicate the need for a stable and responsible organizational structure for those nurses who are expected to manage patient care in psychiatric wards. © 2012 Blackwell Publishing.
Finke, L M
Changes in health care policy must be made to pave the way for the appropriate treatment and prevention of child and adolescent mental health problems. Nurses can provide the leadership needed to make the changes. Organizations such as the Association for Child and Adolescent Psychiatric Nurses and the Society for Education and Research in Psychiatric/Mental Health Nursing are already making important contributions. Challenges in the arenas of treatment, education, and research are before us in child psychiatric nursing. We are facing these demands, however, and are moving forward into the twenty-first century.
Mahmoud, Amal Sobhy
This study was to assess psychiatric nurses' attitude and practice toward physical restraint among mentally ill patients. A descriptive research design was used to achieve the study objective. The present study was carried out in three specialized governmental mental hospitals and two psychiatric wards in general hospital. A convenient purposive sample of 96 nurses who were working in the previously mentioned setting was included. The tool used for data collection was the Self-Administered Structured Questionnaire; it included three parts: The first comprised items concerned with demographic characteristics of the nurses, the second comprised 10 item measuring nurses' attitudes toward physical restraint, and the third was used to assess nurses' practices regarding use of physical restraint. There were insignificant differences between attitudes and practices in relation to nurses' sex, level of education, years of experience and work place. Moreover, a positive significant correlation was found between nurses' total attitude scores, and practices regarding use of physical restraint. Psychiatric nurses have positive attitude and adequate practice toward using physical restraints as an alternative management for psychiatric patients. It is important for psychiatric nurses to acknowledge that physical restraints should be implemented as the last resort. The study recommended that it is important for psychiatric nurses to acknowledge that physical restraints should be implemented as the last resort. Copyright © 2016 Elsevier Inc. All rights reserved.
Virve Pekurinen; Laura Willman; Marianna Virtanen; Mika Kivimäki; Jussi Vahtera; Maritta Välimäki
Wellbeing of nurses is associated with patient aggression. Little is known about the differences in these associations between nurses working in different specialties. We aimed to estimate and compare the prevalence of patient aggression and the associations between patient aggression and the wellbeing of nurses in psychiatric and non-psychiatric specialties (medical and surgical, and emergency medicine). A sample of 5288 nurses (923 psychiatric nurses, 4070 medical and surgical nurses, 295 e...
Hein, Laura C; Scharer, Kathleen M
This paper discusses the progression of developments in psychiatric-mental health nursing from the 1960s to the present. The 1960s were a time of shortage of psychiatric APRNs, with legislation expanding the availability of mental health services. We find ourselves in a similar time with 7 million new health insurance enrollees, because of the Affordable Care Act (ACA). The expansion of health insurance coverage comes at a time when some colleges of nursing are closing master's programs in psychiatric-mental health, in lieu of the DNP mandate from the American Association of Colleges of Nursing. Is history repeating itself? Copyright © 2014 Elsevier Inc. All rights reserved.
Feely, M; Long, A
This paper presents a theory of connectivity, which was formulated from the findings of a Classical Grounded Theory study that was designed to capture a sample of people's perceptions of living with depression or caring for individuals with depression. Data were collected from: (1) a focus group consisting of people with depression (n = 7), of which five were patients in the community and two were nurses; (2) one-to-one interviews with patients in the community (n = 5) and nurses (n = 5), three of whom had experienced depression from both sides of the caring process; and (3) two 'happy accident' focus groups (n = 25; n = 18) comprising of healthcare workers with a shared understanding of depression. Purposeful sampling was used initially. Thereafter, in keeping with one of the key tenets of grounded theory, theoretical sampling was used until theoretical saturation occurred. Data were analysed using the constant comparative approach together with the NVivo qualitative analysis software package. The core category that emerged was 'connectivity' relating to the connections and disconnections, which people make in their lives. Six key categories emerged all of which were integrated with the core category. Hence, connectivity provided a significant platform for understanding and responding to the life experience of depression. They were: (1) life encounters on the journey to naming; (2) depression: What's in a name? The silent thief; (3) tentative steps to health care; (4) connective encounters and challenges; (5) connecting with self; and (6) self-connection maintenance. Subsequently, a theory, 'Depression: a psychiatric nursing theory of connectivity', surfaced from the overall findings. We argue that this theory of connectivity provides a framework that people working in the field of holistic treatment and care could use to better understand and respond to the life experience of people living with depression.
Full Text Available Wellbeing of nurses is associated with patient aggression. Little is known about the differences in these associations between nurses working in different specialties. We aimed to estimate and compare the prevalence of patient aggression and the associations between patient aggression and the wellbeing of nurses in psychiatric and non-psychiatric specialties (medical and surgical, and emergency medicine. A sample of 5288 nurses (923 psychiatric nurses, 4070 medical and surgical nurses, 295 emergency nurses participated in the study. Subjective measures were used to assess both the occurrence of patient aggression and the wellbeing of nurses (self-rated health, sleep disturbances, psychological distress and perceived work ability. Binary logistic regression with interaction terms was used to compare the associations between patient aggression and the wellbeing of nurses. Psychiatric nurses reported all types of patient aggression more frequently than medical and surgical nurses, whereas nurses working in emergency settings reported physical violence and verbal aggression more frequently than psychiatric nurses. Psychiatric nurses reported poor self-rated health and reduced work ability more frequently than both of the non-psychiatric nursing groups, whereas medical and surgical nurses reported psychological distress and sleep disturbances more often. Psychiatric nurses who had experienced at least one type of patient aggression or mental abuse in the previous year, were less likely to suffer from psychological distress and sleep disturbances compared to medical and surgical nurses. Psychiatric nurses who had experienced physical assaults and armed threats were less likely to suffer from sleep disturbances compared to nurses working in emergency settings. Compared to medical and surgical nurses, psychiatric nurses face patient aggression more often, but certain types of aggression are more common in emergency settings. Psychiatric nurses have
Sørensen, Ann Lykkegaard; Mainz, Jan; Nielsen, Lars Peter
Background : Potential inappropiate prescribing (IP) is associated with higher mortality, morbidity and risk of hospitalization. Potential IP has only been investigated in elderly populations and never in a psychiatric setting or a general population. Registered nurses are the healthprofessionals...
DeSocio, Janiece E
The aims of this paper are to synthesize and report research findings from neuroscience and epigenetics that contribute to an emerging explanatory framework for advanced practice psychiatric nursing. Discoveries in neuroscience and epigenetics reveal synergistic mechanisms that support the integration of psychotherapy, psychopharmacology, and psychoeducation in practice. Advanced practice psychiatric nurses will benefit from an expanded knowledge base in neuroscience and epigenetics that informs and explains the scientific rationale for our integrated practice. © 2015 Wiley Periodicals, Inc.
Factors influencing the practice of psychiatric nursing in Australian prisons. A qualitative study of psychiatric nurses (N = 30) working in a prison. The psychiatric nurses identified the following factors as influencing their work: challenging patients, threats to personal survival of patients, the technology and artifice of confinement, conflicting values of nurses and corrections staff, stigma by association, and prisoner identification of the nurses with prison administration. Psychiatric nurses who work in forensic settings must adapt to less than optimal practice conditions.
Michaël Bilson is a nurse at the psychiatric hospital of Bingerville, in Ivory Coast. Here, he describes his mission supporting the National Health Worker Training Institute. It is the only nurse training school in Ivory Coast. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Jacob, Jean Daniel
The objective of this article is to examine the tensions that exist between care and custody in correctional environments by presenting the (im)possibilities of psychiatric nursing practice within this context. The analysis will be guided by empirical data obtained from a qualitative research conducted in a correctional setting. Semistructured interviews with nurses were conducted and used as the primary source of data for analysis. This article will explore the contextual characteristics of psychiatric nursing practice in correctional settings, describe the alienating effects of this context on nursing practice, theorize nurses' experience using Festinger's theory on cognitive dissonance, and, finally, explore how some nurses engage in the reconstruction of their care to counter the effects of working in correctional settings.
Cunningham, Patricia D.
The potential of the psychiatric family nurse practitioner (Psych.F.N.P.) to contribute to family practice through physical care and mental health care exists in the here and now. This role is a synthesis of 2 advanced practice roles, the psychiatric clinical nurse specialist (Psych.C.N.S.) and family nurse practitioner (F.N.P.), both of which continue to have great utility independently. This synthesis is a practical application of concepts that have evolved to meet the changing patterns of ...
Gonge, Henrik; Buus, Niels
AIM: To test the effects of a meta-supervision intervention in terms of participation, effectiveness and benefits of clinical supervision of psychiatric nursing staff. BACKGROUND: Clinical supervision is regarded as a central component in developing mental health nursing practices, but the evidence...... supporting positive outcomes of clinical supervision in psychiatric nursing is not convincing. DESIGN: The study was designed as a randomized controlled trial. All permanently employed nursing staff members at three general psychiatric wards at a Danish university hospital (n = 83) were allocated to either...... on individuals or wards already actively engaged in clinical supervision, which suggested that individuals and wards without well-established supervision practices may require more comprehensive interventions targeting individual and organizational barriers to clinical supervision....
Ellilä, Heikki; Välimäki, Maritta; Warne, Tony; Sourander, Andre
Research on nursing ideology and the ethics of child and adolescent psychiatric nursing care is limited. The aim of this study was to describe and explore the ideological approaches guiding psychiatric nursing in child and adolescent psychiatric inpatient wards in Finland, and discuss the ethical, theoretical and practical concerns related to nursing ideologies. Data were collected by means of a national questionnaire survey, which included one open-ended question seeking managers' opinions on the nursing ideology used in their area of practice. Questionnaires were sent to all child and adolescent psychiatric inpatient wards (n = 69) in Finland; 61 ward managers responded. Data were analysed by qualitative and quantitative content analysis. Six categories -- family centred care, individual care, milieu centred care, integrated care, educational care and psychodynamic care -- were formed to specify ideological approaches used in inpatient nursing. The majority of the wards were guided by two or more approaches. Nursing models, theories and codes of ethics were almost totally ignored in the ward managers' ideological descriptions.
Hegney, Desley Gail; Francis, Karen
This article describes action research as a methodology and gives two examples of its application to nursing and health services research. Action research is cyclical in nature and involves the development, evaluation and redefining of an action plan using four basic steps: planning, action, observation and reflection. These cycles of action continue until the research group is satisfied that its objectives have been met. Data generation and analysis are iterative processes that occur continuously throughout the project, which is usually time-limited. Factors that should be taken into account to ensure success include: engaging the community, consideration of 'insider' versus 'outsider' perspectives, competing agendas, expectations not being met and the integrity of the research methodology.
Frauenfelder, Fritz; van Achterberg, Theo; Müller Staub, Maria
To detect the prevalence of NANDA-I diagnoses and possible relationships between those and patient characteristics such as gender, age, medical diagnoses and psychiatric specialty/setting. There is a lack on studies about psychiatric inpatient characteristics and possible relationships among these characteristics with nursing diagnoses. A quantitative-descriptive, cross-sectional, completed data sampling study was performed. The data were collected from the electronic patient record system. Frequencies for the social-demographic data, the prevalence of the NANDA-I diagnoses and the explanatory variables were calculated. In total, 410 nursing phenomena were found representing 85 different NANDA-I diagnoses in 312 patients. The NANDA-I diagnosis "Ineffective Coping" was the most frequently stated diagnosis followed by "Ineffective Health Maintenance," "Hopelessness" and "Risk for Other-Directed Violence". Men were more frequently affected by the diagnoses "Ineffective Coping," "Hopelessness," "Risk for Self-Directed Violence," "Defensive Coping" and "Risk for Suicide," whereas the diagnoses "Insomnia," "Chronic Confusion," "Chronic Low Self-Esteem" and "Anxiety" were more common in women. Patients under the age of 45 years were more frequently affected by "Chronic Low Self-Esteem" and "Anxiety" than older patients. "Ineffective Coping" was the most prevalent diagnosis by patients with mental disorders due to psychoactive substance use. Patients with schizophrenia were primarily affected by the diagnoses "Ineffective Coping," "Impaired Social Interaction" and "Chronic Low Self-Esteem." This study demonstrates the complexity and diversity of nursing care in inpatient psychiatric settings. Patients' gender, age and psychiatric diagnoses and settings are a key factor for specific nursing diagnosis. There are tendencies for relationships between certain nursing diagnosis and patient characteristics in psychiatric adult inpatients. This enhances the specific, extended
Psychiatric nursing and psychiatric nurses have been referred to in various ways over the course of history. These articulations reflect and constitute the ways in which nursing is comprehended during specific periods. A rupture in these descriptions and conceptions of Danish psychiatric nursing...... over the period 1965--75 is identified using a discourse analytical framework, inspired primarily by Foucault. This rupture influenced all aspects of psychiatric nursing: the perception of the psychiatric patient, the expertise and knowledge of the nurse and the care given by the nurse. The study...
Full Text Available Observation is a method that is used in place of other control methods such as chemical and physical detention, isolation. Observation is used especially as an interference method to ensure the safety of the patients with suicidal and aggressive behaviors in acute psychiatric care in many countries. Especially in acute psychiatric wards using observations of nursing as a professional control method is an important issue. This article aims to draw attention to the importance of the subject in our country about using nursing observations as a control method in acute psychiatric care from the view of the literature. In this article several studies related to risk assessment, decision making, the levels of observation, the application of observation and the ethical aspects of observation on acute psychiatric care have been discussed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(1.000: 79-91
Koivunen, Marita; Hätönen, Heli; Välimäki, Maritta
The implementation of information technology (IT) applications in nursing practice requires systematic investments and guidance. A collaborative organisational culture, and systematic and close clinical and administrative cooperation during the implementation process support the acceptance of IT among users in organisation. Although knowledge of IT projects management exists, there is a lack of knowledge about nursing management in IT implementation processes in psychiatric nursing.
Military mental health nurses are tasked with providing psychiatric liaison to British forces deployed to combat zones. This forms part of a wider effort to maintain the combat effectiveness of the fighting force. During a recent deployment, I maintained a reflexive journal of my experience of liaising with the British Chain of Command. I then used line by line coding via the NVIVO 9 software package to formulate the core themes that became a framework for this autoethnography. My personality and social anxieties shaped how I performed the psychiatric liaison role. I was able to develop a template for liaison that accounted for both 'me' and my need to feel authentic or credible as a nurse, yet still enabled me to communicate effectively with the Chain of Command. One template for psychiatric nursing liaison with British combat forces is to focus upon key stakeholders within the Chain of Command, specifically, the Officer Commanding, the Sergeant Major, the Trauma Risk Management co-ordinator (usually the Sergeant Major) and the embedded medical asset. Further research is needed to establish how other nurses approach psychiatric nursing liaison. © 2012 John Wiley & Sons Ltd.
Jansen, Gerard J.; Middel, Berry; Dassen, Theodoor; Reijneveld, Menno S A
Little is currently known about the attitudes of psychiatric nurses toward patient aggression, particularly from an international perspective. Attitudes toward patient aggression of psychiatric nurses from five European countries were investigated using a recently developed and tested attitude
Psychiatric nurses are expert care providers for individuals with mental health needs. The art of caring spans across multiple species, is important to understand, and is universal whether intentions are toward individuals or animals. Pets are often cared for and viewed as family members. The current research examined psychiatric nurses' views on the similarities and differences of caring for patients and their pet dogs. Twenty-five nurses were interviewed. Similarities of caring for patients and canines included trusting relationships, companionship, daily basic needs, and improved communication through monitored body language. Differences in caring included personal expectations, unconditional love, and professional boundaries. Understanding the concepts of caring for patients and pet dogs will provide the opportunity for insight into familial versus professional relationships, improve communication with others, and strengthen the human-animal bond. [Journal of Psychosocial Nursing and Mental Health Services, 55(3), 46-52.]. Copyright 2017, SLACK Incorporated.
Gimba, Solomon Musa; Duma, Sinegugu
This qualitative case study explored barriers to provision of psychiatric nursing care in a hospital in Plateau State, Nigeria, and revealed motivational factors that helped the nurses to cope with these barriers. Data collection methods included grand tour and in-depth interviews and participant observation. Motivational factors were related to the psychiatric nurse's individual intrinsic belief system, as well as to their intrinsic belief system as influenced by the environment. These motivational factors highlight how psychiatric nurses continue to cope with the barriers they face in provision of care. The findings indicate the need for hospital management to create and sustain an environment to complement the existing intrinsic motivation of psychiatric nurses to provide psychiatric nursing care, and to provide prompt and appropriate emotional and psychological support to psychiatric nurses worldwide.
Full Text Available Abstract Aims: In general, nurses who work in department of psychiatric are in fact interacting with emotional disorders of patients once providing their care services. higher levels of job motivation and satisfaction can markedly foster service improvement. The aim of this study was to evaluate the correlation between anger and job motivation in nurses of a psychiatric hospital. Instrument & Methods: In this cross-sectional descriptive research in 2014, all 50 psychiatry nurses working at Kargarnejad Hospital of Kashan City, Iran, were entirely studied. A demographical questionnaire, the Anger Multiple Scale and the Job Motivation Scale were used for data gathering. Data were analyzed by SPSS 19 software using Pearson correlation coefficient. Findings: The mean score of anger was 3.01±0.36 and of job motivation was 1.70±0.86. There was a significant relationship between job motivation and the number of family members and conditions of employment of nurses (p=0.001. There was a significant inverse relationship between scores of anger and job motivation of psychiatry nurses of the hospital (r=-0.712; p=0.001. Conclusion: There is a relationship between anger and job motivation in nurses of Kashan Psychiatric hospital.
Oct 10, 2014 ... to psychiatric nursing. This study aimed to increase the awareness of the needs and benefits of in-service training of psychiatric nurses and to formulate recommendations for in- service training for psychiatric nursing. Research method and design. Design. A qualitative research design with explorative, ...
Psychiatric nurses commonly refer to ‘providing structure’ (PS) as a key intervention. But, no consensus exists about what PS entails. PS can be understood as a complex intervention. In five studies a definition, activities and context-variables were described. On the basis of results of a
Garwood, Janet K
The current longitudinal, descriptive, and correlational study explored which traditional teaching strategies can engage Millennial students and adequately prepare them for the ultimate test of nursing competence: the National Council Licensure Examination. The study comprised a convenience sample of 40 baccalaureate nursing students enrolled in a psychiatric nursing course. The students were exposed to a variety of traditional (e.g., PowerPoint(®)-guided lectures) and nontraditional (e.g., concept maps, group activities) teaching and learning strategies, and rated their effectiveness. The students' scores on the final examination demonstrated that student learning outcomes met or exceeded national benchmarks. Copyright 2015, SLACK Incorporated.
Full Text Available Background: Research has not adequately focused on the issue of burnout in Psychiatric nurses, despite the fact that they suffer considerable stress in their work. Till date no study has been conducted on burnout among psychiatric nurses in India. Further, there is a particular lack of research in internal variables predicting burnout in them. Aims: To determine whether there are any internal psychological factors relevant to burnout in psychiatric nurses in India. Materials and Methods: We recruited 101 psychiatric nurses scoring less than two in General Health Questionnaire, version 12 (GHQ-12 from two psychiatric hospitals after obtaining informed consent. All subjects filled up a sociodemographic data sheet along with global adjustment scale, emotional maturity scale, PGI general well-being scale, locus of control scale, and Copenhagen burnout inventory (CBI. Correlations between burnout and sociodemographic/clinical variables were done by Pearson′s r or Spearman′s rho. Signi ficant variables were entered in a stepwise multiple linear regression analysis with total burnout score as dependent variable. Results: Age, duration of total period of nursing, prior military training, locus of control, sense of general well-being, adjustment capabilities, and emotional maturity had significant relation with burnout. Of them, emotional maturity was the most significant protective factors against burnout along with adjustment capabilities, sense of physical well-being, and military training in decreasing significance. Together they explained 41% variation in total burnout score which is significant at <0.001 level. An internal locus of control was inversely correlated with burnout, but failed to predict it in regression analysis. Conclusion: Emotional maturity, adjustability, sense of general physical well-being as well as prior military training significantly predicted lower burnout. Of them, emotional maturity was the most important predictor
Full Text Available The demand for psychiatric services in modern health care system will increase due to the growth in number of mental diseases. The role of nurses in prevention, treatment and rehabilitation of mental illness has a number of features. These features are related to care of patients with high level of aggressiveness, behavioral deviations, and problems in self-service. Differences in procedure practice and communicative space specialize and make narrower the nurses' professional practice in psychiatry and determine appearance of specific mechanisms and norms bound up with the necessity of supervision of patients while respecting their rights. Personnel's oversight functions, deviant behavior of patients, high degree of closure of psychiatric medical institutions — are the reasons for specialization of nurses' professional group in psychiatry, forming special mechanisms of maintaining tolerance to patients in professional sphere of this community.
Wang, Shu Mi; Lai, Chien Yu; Chang, Yong-Yuan; Huang, Chiung-Yu; Zauszniewski, Jaclene A; Yu, Ching-Yun
Psychiatric nurses are exposed to highly stressful work environments that can lead to depression over time. This study aimed to explore the relationships among work stress, resourcefulness, and depression levels of psychiatric nurses. A cross-sectional design with randomized sampling was used; 154 psychiatric nurses were recruited from six medical centers in Taiwan. Psychiatric nurses' work stress was found positively correlated with their depression level, and negatively related to resourcefulness. Work stress significantly predicted depression level. These results suggest that the hospital administrative units may develop training courses about resourcefulness skills to reduce psychiatric nurses' work stress, and improve their mental health. Copyright © 2014 Elsevier Inc. All rights reserved.
Karshmer, J F
The eight "rules of thumb" offered here are representative of numerous more that have been helpful stimulators for psychiatric nursing students. The suggest to the students a consistent approach based upon a rationale and do not encourage rote memorization of techniques. Students are encouraged to critically analyze the reasons and conceptual underpinnings for each encounter they have with patients. The "rules of thumb" encourage this self-exploration and attention to "What is it I'm really asking, or feeling, or thinking?" Only with this sort of continuous evaluation and reassessment can even the most novice of students begin to establish a therapeutic treatment approach with psychiatric patients.
Marc De Hert
Full Text Available When psychiatric patients express a wish for euthanasia, this should first and foremost be interpreted as a cry for help. Due to their close day-to-day relationship, psychiatric nurses may play an important and central role in responding to such requests. However, little is known about nurses' attitudes towards euthanasia motivated by unbearable mental suffering.The aim of this study was to provide insight into the attitudes and actions taken by psychiatric nurses when confronted with a patient's euthanasia request based on unbearable mental suffering (UMS.A questionnaire was sent to 11 psychiatric hospitals in the Flemish part of Belgium.The overall response rate was 70% (N = 627. Psychiatric nurses were frequently confronted with a request for euthanasia, either directly (N = 329, 53% or through a colleague (N = 427, 69%. A majority (N = 536, 84% did not object to euthanasia in a psychiatrically ill population with UMS. Confounding factors were the psychiatric diagnosis and the type of ward where the nurses were working. Most participants acknowledged a lack of knowledge and skills to adequately address the euthanasia request (N = 434, 71%. Nearly unanimously (N = 618, 99%, study participants indicated that dealing with euthanasia requests and other end-of-life issues should be part of the formal training of nurses.The results highlight the need for ethically sound and comprehensive provision of care. Psychiatric nurses play an important role in dealing with the complex issue of requests for euthanasia. There is also a need for education, training and clear guidelines on the level of health care organizations.
De Hert, Marc; Van Bos, Liesbet; Sweers, Kim; Wampers, Martien; De Lepeleire, Jan; Correll, Christophe U
When psychiatric patients express a wish for euthanasia, this should first and foremost be interpreted as a cry for help. Due to their close day-to-day relationship, psychiatric nurses may play an important and central role in responding to such requests. However, little is known about nurses' attitudes towards euthanasia motivated by unbearable mental suffering. The aim of this study was to provide insight into the attitudes and actions taken by psychiatric nurses when confronted with a patient's euthanasia request based on unbearable mental suffering (UMS). A questionnaire was sent to 11 psychiatric hospitals in the Flemish part of Belgium. The overall response rate was 70% (N = 627). Psychiatric nurses were frequently confronted with a request for euthanasia, either directly (N = 329, 53%) or through a colleague (N = 427, 69%). A majority (N = 536, 84%) did not object to euthanasia in a psychiatrically ill population with UMS. Confounding factors were the psychiatric diagnosis and the type of ward where the nurses were working. Most participants acknowledged a lack of knowledge and skills to adequately address the euthanasia request (N = 434, 71%). Nearly unanimously (N = 618, 99%), study participants indicated that dealing with euthanasia requests and other end-of-life issues should be part of the formal training of nurses. The results highlight the need for ethically sound and comprehensive provision of care. Psychiatric nurses play an important role in dealing with the complex issue of requests for euthanasia. There is also a need for education, training and clear guidelines on the level of health care organizations.
Shahirose S. Premji
Full Text Available The 13 million nurses worldwide constitute most of the global healthcare workforce and are uniquely positioned to engage with others to address disparities in healthcare to achieve the goal of better health for all. A new vision for nurses involves active participation and collaboration with international colleagues across research practice and policy domains. Nursing can embrace new concepts and a new approach—“One World, One Health”—to animate nursing engagement in global health, as it is uniquely positioned to participate in novel ways to improve healthcare for the well-being of the global community. This opinion paper takes a historical and reflective approach to inform and inspire nurses to engage in global health practice, research, and policy to achieve the Sustainable Development Goals. It can be argued that a colonial perspective currently informs scholarship pertaining to nursing global health engagement. The notion of unidirectional relationships where those with resources support training of those less fortunate has dominated the framing of nursing involvement in low- and middle-income countries. This paper suggests moving beyond this conceptualization to a more collaborative and equitable approach that positions nurses as cocreators and brokers of knowledge. We propose two concepts, reverse innovation and two-way learning, to guide global partnerships where nurses are active participants.
Premji, Shahirose S.; Hatfield, Jennifer
The 13 million nurses worldwide constitute most of the global healthcare workforce and are uniquely positioned to engage with others to address disparities in healthcare to achieve the goal of better health for all. A new vision for nurses involves active participation and collaboration with international colleagues across research practice and policy domains. Nursing can embrace new concepts and a new approach—“One World, One Health”—to animate nursing engagement in global health, as it is uniquely positioned to participate in novel ways to improve healthcare for the well-being of the global community. This opinion paper takes a historical and reflective approach to inform and inspire nurses to engage in global health practice, research, and policy to achieve the Sustainable Development Goals. It can be argued that a colonial perspective currently informs scholarship pertaining to nursing global health engagement. The notion of unidirectional relationships where those with resources support training of those less fortunate has dominated the framing of nursing involvement in low- and middle-income countries. This paper suggests moving beyond this conceptualization to a more collaborative and equitable approach that positions nurses as cocreators and brokers of knowledge. We propose two concepts, reverse innovation and two-way learning, to guide global partnerships where nurses are active participants. PMID:27144160
Choi, Heeseung; Hwang, Boyoung; Kim, Sungjae; Ko, Heesung; Kim, Sumi; Kim, Chanhee
In response to current challenges in psychiatric mental health nursing education, nursing schools have implemented new strategies in teaching undergraduate nursing students. The objectives of the study were to evaluate learning outcomes of a mental health nursing clinical practicum and to explore students' perceptions of the clinical practicum. This was a mixed-method study. Sixty-three undergraduate nursing students, who were undertaking their first mental health clinical practicum, completed a set of structured questionnaires and answered open-ended questions about the clinical practicum. Answers to open-ended questions were analyzed qualitatively, and learning outcomes (i.e., empathy, mental illness prejudice, simulation-related efficacy, and satisfaction) were measured at three time points: pre-clinical, post-simulation, and post-clinical. Students reported improvement in empathy and simulation-related self-efficacy after the clinical practicum, but no change was found in mental illness prejudice. Students' expectations for and evaluation of the clinical practicum are summarized. The observed improvement in learning outcomes of the clinical practicum may be attributed to the unique contribution of each component of the clinical practicum and the synergic effect of these diverse components. To manage emerging challenges in clinical settings and nursing education, it is critical to develop systematic and comprehensive mental health nursing clinical practicums for undergraduate nursing students. Copyright © 2016 Elsevier Ltd. All rights reserved.
Björkdahl, A; Palmstierna, T; Hansebo, G
Demanding conditions in acute psychiatric wards inhibit provision of safe, therapeutic care and leave nurses torn between humanistic ideals and the harsh reality of their daily work. The aim of this study was to describe nurses' caring approaches within this context. Data were collected from interviews with nurses working in acute psychiatric intensive care. Data were analysed using qualitative analysis, based on interpretive description. Results revealed a caring-approach continuum on which two approaches formed the main themes: the bulldozer and the ballet dancer. The bulldozer approach functioned as a shield of power that protected the ward from chaos. The ballet dancer approach functioned as a means of initiating relationships with patients. When examining the data from a theoretical perspective of caring and uncaring encounters in nursing, the ballet dancer approach was consistent with a caring approach, while the bulldozer approach was more complex and somewhat aligned with uncaring approaches. Conclusions drawn from the study are that although the bulldozer approach involves a risk for uncaring and harming actions, it also brings a potential for caring. This potential needs to be further explored and nurses should be encouraged to reflect on how they integrate paternalistic nursing styles with person-centred care.
Duman, Zekiye Çetinkaya; Günüşen, Neslihan Partlak; İnan, Figen Şengün; Ince, Sevecen Çelik; Sari, Ayşe
This quasi-experimental study was carried out to compare the attitudes towards psychiatry patients of students educated with problem-based learning and students educated with a traditional method in western Turkey. The students' perceptions of psychiatric nursing and their career choices were also evaluated. The sample consisted of 202 students; 130 were educated with a problem-based learning model and 72 were educated with a traditional method. Students educated with the problem-based learning method developed more positive attitudes towards mental illness after the psychiatric nursing course in comparison with students educated with the traditional method. Students educated with the traditional method preferred psychiatric nursing in comparison with nursing students educated with problem-based learning. It is important that the psychiatric nursing curriculum includes topics and programs that will create awareness in students regarding stigmatization of mental illness and its effects. In addition, we suggest that studies are performed to determine the perceptions of students towards psychiatric nursing and the factors that affect their career choices. Copyright © 2017 Elsevier Inc. All rights reserved.
Jansen, Trine-Lise; Hanssen, Ingrid
The aim of this study was to explore psychiatric nurses' experiences and perspectives regarding patient participation. Patient participation is an ambiguous, complex and poorly defined concept with practical/clinical, organisational, legal and ethical aspects, some of which in psychiatric units may cause ethical predicaments and moral stress in nurses, for instance when moral caring acts are thwarted by constraints. An explorative quantitative pilot study was conducted at a psychiatric subacute unit through three focus group interviews with a total of nine participants. A thematic analytic approach was chosen. Preliminary empirical findings were discussed with participants before the final data analysis. Ethical research guidelines were followed. Patient participation is a difficult ideal to realise because of vagueness of aim and content. What was regarded as patient participation differed. Some interviewees held that patients may have a say within the framework of restraints while others saw patient participation as superficial. The interviewees describe themselves as patient's spokespersons and contributing to patients participating in their treatment as a great responsibility. They felt squeezed between their ethical values and the 'system'. They found themselves in a negotiator role trying to collaborate with both the doctors and the patients. Privatisation of a political ideal makes nurses vulnerable to burn out and moral distress. Nurses have a particular ethical responsibility towards vulnerable patients, and may themselves be vulnerable when caught in situations where their professional and moral values are threatened. Unclear concepts make for unclear division of responsibility. Patient participation is often a neglected value in current psychiatric treatment philosophy. When healthcare workers' ethical sensibilities are compromised, this may result in moral stress. © 2016 Nordic College of Caring Science.
van der Zalm, Y.C.; Nugteren, W.A.; Hafsteinsdottir, T.B.; van der Venne, C.G.J.M.; Kool, N.; van Meijel, B.
Purpose: To determine what is known from the literature about nursing care of psychiatric patients with a history of child maltreatment. Conclusions: Psychiatric nurses underline the importance of a routine inquiry of child abuse on admission of patients to psychiatric care, but are reluctant to ask
Moch, Susan D; Vandenbark, R Todd; Pehler, Shelley-Rae; Stombaugh, Angela
Purpose. The purpose of this article is to describe action research in nursing education and to propose a definition of action research for providing guidelines for research proposals and criteria for assessing potential publications for nursing higher education. Methods. The first part of this project involved a search of the literature on action research in nursing higher education from 1994 to 2013. Searches were conducted in the CINAHL and MEDLINE databases. Applying the criteria identified, 80 publications were reviewed. The second part of the project involved a literature review of action research methodology from several disciplines to assist in assessing articles in this review. Results. This article summarizes the nursing higher education literature reviewed and provides processes and content related to four topic areas in nursing higher education. The descriptions assist researchers in learning more about the complexity of both the action research process and the varied outcomes. The literature review of action research in many disciplines along with the review of action research in higher education provided a framework for developing a nursing-education-centric definition of action research. Conclusions. Although guidelines for developing action research and criteria for publication are suggested, continued development of methods for synthesizing action research is recommended.
Peter, Elizabeth; Lunardi, Valeria Lerch; Macfarlane, Amy
Much has been written about nursing as a predominantly female profession whose members display passivity, submission, obedience and powerlessness. Alternatively, some authors have presented evidence of nurses' capacity to exercise power, revealing the possible relationship between powerlessness and ethical compromise. Thus, empowerment strategies for nurses can yield ethical action. The aim of this paper is to use analysis of the literature to demonstrate how the actions and responses of nurses to ethical concerns are examples of nurses exercising power. Empirical studies published in the nursing literature between 1990 and 2003 have been analysed to illustrate how nurses' actions of resistance can ensure that moral values are realized in practice. Foucauldian notions of power relations and feminist ethics provide the theoretical framework. Nurses were found to resist in situations where they experienced moral conflicts in relation to the actions of health professionals; however, instances were cited where they did not. Consequently, strategies for nursing education and management are proposed to increase nurses' understanding of the potential acts of resistance that they could employ in situations of moral conflict or concern.
Lee, Joo Yun; Park, Hyeoun-Ae
The aim of this study is to test the applicability of the International Standards Organization (ISO) Reference terminology model (RTM) for nursing action to describe Detailed Clinical Models (DCMs) for nursing action. All verb and target terms were mapped to 'Action' and 'Target' category of RTM for nursing actions. Among 72 attributes qualifying the verb terms, 50 attributes were mapped to Means, Route, Timing, or Site categories of the nursing action model. Among 142 attributes qualifying the target terms, 20 attributes were mapped to Means, Timing, or Site categories of the nursing action model and 6 attributes were mapped to Degree or Judgment categories of the nursing diagnosis model. The findings suggest the need for an integrated RTM for nursing.
Bimenyimana, E; Poggenpoel, M; Myburgh, C; van Niekerk, V
Caring for good people is difficult enough; to care for people who are either aggressive or violent is even more difficult. This is what psychiatric nurses working in the psychiatric institution in which research was done are exposed to on a daily basis. The aim of the research was to explore and describe the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews and naïve sketches. Tesch 's (Creswell, 2004: 256) method of open coding and an independent coder were utilised for data analysis. This study shed some light on the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. The findings show that the level of violence and aggression to which psychiatric nurses are exposed is overwhelming and the consequences are alarming. The contributing factors to this violence and aggression are: the mental status and the conditions in which patients are admitted; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT); and the lack of structured and comprehensive orientation among newly appointed staff members. As a result, psychiatric nurses are emotionally, psychologically, and physically affected. They then respond with the following emotions and behaviour: fear, anger, frustration, despair, hopelessness and helplessness, substance abuse, absenteeism, retaliation and the development of an "I don't care" attitude.
Pitkänen, Anneli; Hätönen, Heli; Kollanen, Marjo; Kuosmanen, Lauri; Välimäki, Maritta
This study aimed to examine nurses' (N=29) perceptions of nursing interventions in supporting patients' quality of life (QoL) in acute psychiatric inpatient settings. An explorative descriptive study design was applied. The data were generated through seven focus group interviews and analyzed with qualitative content analysis. Five main categories of nursing interventions to support patients' QoL were identified. Interventions were related to care planning, empowering interventions, social interventions, activating interventions, and security interventions. Emphasis should be placed on nurses' opportunities to improve patients' QoL according to patients' individual needs. © 2010 Wiley Periodicals, Inc.
When the Danish government converted the national practice-oriented nursing qualification from a vocational course to a bachelor’s degree in 2002, the clinical training component was scaled back. Accordingly, mentors needed to optimise students’ learning from this curtailed clinical practice....... A fuller understanding of how student nurses function and learn during clinical training is vital. This article presents the findings of a qualitative investigation of student nurses’ learning processes during their clinical placement in psychiatric nursing practice. An explorative and qualitative...... to understanding and analysing the content of student nurses’ learning processes. Data was generated from qualitative, semi-structured interviews with, observations of, and obser-views with, eleven students. The obser-view process is my development. It is a common reflection between researcher and research...
Ong, Hui Lin; Seow, Esmond; Chua, Boon Yiang; Xie, Huiting; Wang, Jia; Lau, Ying Wen; Chong, Siow Ann; Subramaniam, Mythily
There is a shortage of nurses working in the mental health field globally. The aim of the present study was to examine Singapore nursing students' attitudes towards specializing in psychiatric nursing by examining the pre-nursing and nursing school factors as well as attitudes towards psychiatry and personality traits. A cross-sectional online survey was conducted with 500 nursing students from four nursing institutions in Singapore. Students' attitudes towards psychiatry (ATP-18), perception of psychiatric nursing career aspects relative to other fields, and personality traits (mini-IPIP) were assessed. The main outcome measure was likelihood of specializing in psychiatric nursing. Logistic regression was used to examine the combined effect of factors upon the outcome. Twenty-six students (5.2%) rated "definitely decided to do" psychiatric nursing. Pre-nursing school factors associated with choosing psychiatry included ethnicity, current education, parents' wishes, having personal/family experience of mental illness, prior work experience, interest in psychiatric nursing and psychology module taken prior to current school admission. Nursing school factors such as teaching methods and clinical exposure were not associated with choosing psychiatric nursing. Positive attitudes towards psychiatry, perception of better career aspects in psychiatric nursing relative to other fields, and the personality traits of extraversion and intellect/imagination were associated with likelihood of choosing psychiatric nursing. Logistic regression revealed Malay (OR: 1.90, 1.14-3.16, p=0.013) and Indian ethnicity (OR: 2.56, 1.32-4.96, p=0.005), interest in psychiatry (OR: 22.56, 8.22-61.92, pnursing than other fields (OR: 1.91, 1.21-3.04, p=0.006), extraversion (OR: 1.09, 1.02-1.17, p=0.012) and positive attitude towards psychiatry (OR: 2.72, 1.75-4.23, pstudents choosing psychiatric nursing. The selection of psychiatry as a specialty by nursing students was affected by pre-nursing
Alexander, Robbi K; Diefenbeck, Cynthia A; Brown, Carlton G
The demand for mental health services in the United States taxes the existing care continuum and is projected to increase as federal initiatives such as the Affordable Care Act and mental health parity improve access to, and coverage for, mental health services. Quality health care providers, such as psychiatric-mental health nurses, are needed to bolster the mental health system. Prior research has focused on the unpopularity of psychiatric nursing as a career choice for nursing students. The purpose of this study is to understand how seasoned psychiatric nurses came to choose and remain in the specialty; descriptive phenomenology is used. In a face-to-face interview, eight registered nurses described their experiences with psychiatric nursing as a student, their entry into psychiatric nursing, and factors related to their longevity in the specialty. Giorgi's Existential Phenomenological Research Method was employed to analyze the interview data. Three themes emerged related to career choice: Interest Developed Prior to or While in Nursing School, Personal Relevance, and Validation of Potential. Three themes emerged related to retention: Overcoming Stereotypes to Develop Career Pride, Positive Team Dynamics, and Remaining Hopeful. Nurse educators play an important role in identifying talent, validating capability, enhancing interest, and increasing students' confidence to pursue a psychiatric nursing career, while nursing administrators and clinical specialists play a key role in retention. Findings also stimulate pertinent questions surrounding the long-term viability of the psychiatric-mental health nursing specialty.
Sharp, T P
This research used Herzberg et al.'s two-factor theory as a framework with which to examine job satisfaction in a sample of 161 registered psychiatric nurses in the states of Connecticut, Maine and Massachusetts (USA). Weiss et al.'s Minnesota Satisfaction Questionnaire short form was used to measure possible relationships between ability utilization, compensation, co-workers, achievement and job satisfaction. Findings support Herzberg et al.'s theory, showing moderate correlations among nurses' ability utilization, achievement and job satisfaction. Mean general satisfaction of respondents was closer to satisfied than neutral; respondents indicated greatest satisfaction with ability utilization (86%) and achievement (83%); 67% were satisfied with co-workers, and 52% with compensation. Respondents were least satisfied with compensation, with 14% indicating that they were very dissatisfied. Although compensation was an issue, it is possible that other factors, such as safety, management conflict, and balancing the needs of job and family, if addressed, may help increase job satisfaction and retention of psychiatric nursing staff.
This paper reports a study illuminating the factors that either facilitate or constrain the ability of community psychiatric nurses, in their role as care co-ordinators, to meet service users' and carers' needs. The Care Programme Approach is the key policy underpinning community-focused mental health services in England, but has been unevenly implemented and is associated with increased inpatient bed use. The care co-ordinator role is central to the Care Programme Approach and is most often held by community psychiatric nurses, but there has been little research into how this role is performed or how it affects the work of community psychiatric nurses and their ability to meet the needs of service users. A multiple case study of seven sectorised community mental health teams was employed over 2 years using predominantly qualitative methods including participant observation, semi-structured interviews and document review. The data were collected in one National Health Service trust in south England between 1999 and 2001. Additional duties and responsibilities specifically associated with the care co-ordinator role and multidisciplinary working, combined with heavy workloads, produced 'limited nursing', whereby community psychiatric nurses were unable to provide evidence-based psychosocial interventions that are recognized to reduce relapse amongst people with severe mental illness. The role of the Care Programme Approach care co-ordinator was not designed to support the provision of psychosocial interventions. Consequently, community psychiatric nurses in the co-ordinator role are faced with competing demands and are unable to provide the range of structured, evidence-based interventions required. This may partially account for the increased inpatient bed use associated with the Care Programme Approach.
Thaís Helena Piai-Morais
Full Text Available OBJECTIVE Evaluate and correlate individual, work-related and organizational factors that influence adherence to standard precautions among nursing professionals of psychiatric hospitals in São Paulo. METHOD An exploratory cross-sectional study conducted with 35 nursing professionals, using the assessment tool for adherence to standard precautions through the Likert scale, ranging from 1 to 5. RESULTS Knowledge of the precautions received a high score (4.69; adherence received (3.86 and obstacles (3.78, while intermediaries and the scales of organizational factors received low scores (2.61. There was a strong correlation between the magnitude adherence scale and the personal protective equipment availability (r = 0.643; p = 0.000. The training scale for prevention of HIV exposure (p = 0.007 was statistically different between the nurses and nursing assistants. CONCLUSION The organizational factors negatively contributed to adherence to standard precautions, indicating that psychiatric institutions lack safe working conditions, ongoing training and management actions to control infections.
Buus, Niels; Angel, Sanne; Traynor, Michael
Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses' experiences of participating in groupbased supervision and identifying psychosocial...... reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense...... of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses....
Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.
Collet, Janine; de Vugt, Marjolein E; Verhey, Frans R J; Schols, Jos M G A
Nursing home residents needing both psychiatric care and nursing home care for either somatic illness or dementia combined with psychiatric disorders or severe behavioural problems are referred to as Double Care Demanding patients, or DCD patients. Integrated models of care seem to be necessary in order to improve the well-being of these residents. Two research questions were addressed. First, which integrated interventions combining both psychiatric care and nursing home care in DCD nursing home residents are described in the research literature? And second, which outcomes of integrated interventions combining both psychiatric care and nursing home care in DCD nursing home residents are reported in the literature? A critical review of studies was done that involved integrated interventions combining both psychiatric care and nursing home care on psychiatric disorders and severe behavioural problems in nursing home patients. A systematic literature search was performed in a number of international databases. Eight intervention trials, including four RCTs (2b level of evidence), were identified as relevant studies for the purpose of this review. Seven studies, three of which were RCTs, showed beneficial effects of a comprehensive, integrated multidisciplinary approach combining medical, psychiatric and nursing interventions on severe behavioural problems in DCD nursing home patients. Important elements of a successful treatment strategy for DCD nursing home patients include a thorough assessment of psychiatric, medical and environmental causes as well as programmes for teaching behavioural management skills to nurses. DCD nursing home patients were found to benefit from short-term mental hospital admission.This review underlines the need for more rigorously designed studies to assess the effects of a comprehensive, integrated multidisciplinary approach towards DCD nursing home residents. (c) 2009 John Wiley & Sons, Ltd.
Full Text Available Stigma can complicate people’s mental health problems by affecting different sides of personal life, increasing negative attitudes, causing discriminatory behavior towards them, and reducing the chances of recovery and returning to normal life. This research aims to compare the stigma of mental illness among nurses working in psychiatric and non-psychiatric wards in Tabriz University of Medical Sciences. A total of 240 nurses participated in this descriptive and analytic study. The data were collected using a demographic questionnaire and the Community Attitudes towards the Mentally Ill (CAMI Scale, which is a 40-item self-report questionnaire. All data were analyzed using SPSS 13. The majority of nurses have a medium level of stigma toward people with mental illness, and there is no significant relation between the type of wards and mean stigma scores. After eliminating factors such as mental illness in nurses and their families, it seems that only working with people with mental illness in psychiatric wards is not enough to create a positive attitude toward them. Additionally, the less physical activity and taking advantage of legal benefits of work hardship for psychiatric nurses, low income, and stigma toward psychiatric nursing, probably may make a difference in inclining to work in psychiatry ward between the two groups in spite of relatively equal stigma scores.
Wilkin, P E
I begin with an Orwellian dilemma [Orwell G. (1968) The Collected Essays, Journalism and Letters of George Orwell, Vol. 1, p. 239. Harcourt Brace Jovanovich, New York]: do I 'shoot the elephant' (by writing the abstract) to impress the editor? Or, with the courage of my postmodern convictions, do I lay down my rifle and disregard such suppressive editorial instructions? Bang! My words strafe the paper and the elephant is dead. How difficult it is to stay standing against the powerful currents of the dominant tradition. How easy it is to disavow the inequalities and injustices of that tradition when your livelihood (and your ego) depends upon it. So goes the theme of my paper, that, despite the clarion calls of the illustrious minority to reject the patriarchal model of medical psychiatry, psychiatric nurses continue to be propelled by the twin engines of illness and diagnosis. Yet as soon as psychiatry encounters the 'other' it becomes, in Homi K. Bhabha's words, 'hybridized': a pregnant pause created from the seeds of two different cultures. In this sense, every psychiatric moment becomes a golden opportunity for the psychiatric nurse to abdicate her role as medical factotum. Freed from these contractual obligations, she can join the 'other' and share in his experiences, sustaining rather than negating him within a truly therapeutic alliance. In similar fashion, this article has become a mixture of rhetorical fluidity and structured reality: a hybridized compromise which acknowledges the journal's publication boundaries yet still revels, at times, in the freedom of an open and lyrical text.
Koekkoek, B.W.; Meijel, B.K.G. van; Schene, A.; Hutschemaekers, G.J.M.
The aim of this paper is to describe and analyse the Dutch community psychiatric nursing profession. In spite of their large numbers, estimated at 2900, Dutch community psychiatric nurses (CPNs) have contributed little to the international literature. The history of the profession reveals a
Lanza, M L
Power and leadership in psychiatric nursing. To describe power, leadership, and their relationship to psychiatric nursing, with suggestions for the future of the discipline. Review of literature and author's observations of the discipline. The relationship of power and leadership focuses on leader qualities, a model for the interrelationship of leaders and colleagues, and the leader's achievement of a power position.
Full Text Available The graduate advanced psychiatric nursing (psychiatric nursing specialist from master degree in Indonesia are about 70 nurses, 67 nurses were graduated from University of Indonesia. They are working at mental health services and educational setting around Indonesia and yet seem not ready to perform some specific advanced competencies in clinical area. The mastery on mental health assessment, neurochemical perspectives, medical management and psychotherapy have not yet performed by the psychiatric nurse specialist in the clinical area or community.To have those competencies and its performances, therefore the curriculum in a psychiatric nursing graduate program must include advanced courses in physiopsychology, psychopathology, advanced psychopharmacology, neurobehavioral science, advanced mental health assessment, and advanced treatment interventions such as psychotherapy and prescription and management of psychotropic medications as their core and major courses in the curriculum. Those courses should be performed in their clinical practice courses or other related learning experiences. When those qualifications are met, then they are competent to be called advanced psychiatric nurse.As advanced practice registered nurses, the advanced psychiatric nurses should be able to demonstrate their direct expertise and roles in advanced mental health assessment, diagnostic evaluation, psychopharmacology management, psychotherapy with individuals, group and families, case management, millieu management, liason and counselling from prevention, promotion until psychiatric rehabilitation. Meanwhile the skill such as psycho-education, teaching, unit management, research and staff development can be added as their indirect roles.
Full Text Available Caring for good people is difficult enough; to care for people who are either aggressive or violent is even more difficult. This is what psychiatric nurses working in the psychiatric institution in which research was done are exposed to on a daily basis. The aim of the research was to explore and describe the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews and naïve sketches. Tesch’s (Creswell, 2004:256 method of open coding and an independent coder were utilised for data analysis. This study shed some light on the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. The findings show that the level of violence and aggression to which psychiatric nurses are exposed is overwhelming and the consequences are alarming. The contributing factors to this violence and aggression are: the mental status and the conditions in which patients are admitted; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT; and the lack of structured and comprehensive orientation among newly appointed staff members. As a result, psychiatric nurses are emotionally, psychologically, and physically affected. They then respond with the following emotions and behaviour: fear, anger, frustration, despair, hopelessness and helplessness, substance abuse, absenteeism, retaliation and the development of an “I don’t care” attitude.
Andersen, John; Bilfeldt, Anette
quality in a joint effort between care workers, residents at the nursing home, and researchers. It concludes that the project led to empowerment of the residents and staff and played an important role in the development of democratic knowledge building about better quality and ethics in elder care...
Andersen, John; Bilfeldt, Annette
quality in a joint effort between care workers, residents at the nursing home, and researchers. It concludes that the project led to empowerment of the residents and staff and played an important role in the development of democratic knowledge building about better quality and ethics in elder care....
Rose, Donald N; Peter, Elizabeth; Gallop, Ruth; Angus, Jan E; Liaschenko, Joan
The context of forensic psychiatric nursing is distinct from other psychiatric settings as, it involves placement of patients in secure environments with restrictions determined by the courts. Previous literature has identified that nurses morally struggle with respecting patients who have committed heinous offences, which can lead to the patient being depersonalized and dehumanized. Although respect is fundamental to ethical nursing practice, it has not been adequately explored conceptually or empirically. As a result, little knowledge exists that identifies how nurses develop, maintain, and express respect for patients. The purpose of this study is to analyze the concept of respect systematically, from a forensic psychiatric nurse's perspective using the qualitative methodology of focused ethnography. Forensic psychiatric nurses were recruited from two medium secure forensic rehabilitation units. In the first interview, 13 registered nurses (RNs) and two registered practical nurses (RPNs) participated, and although all informants were invited to the second interview, six RNs were lost to follow-up. Despite this loss, saturation was achieved and the data were interpreted through a feminist philosophical lens. Respect was influenced by factors categorized into four themes: (1) emotive-cognitive reactions, (2) nonjudgmental approach, (3) social identity and power, and (4) context. The data from the themes indicate that forensic psychiatric nurses strike a practical compromise, in their understanding and enactment of respect in therapeutic relationships with forensic psychiatric patients. © 2011 International Association of Forensic Nurses.
Zarea, Kourosh; Nikbakht-Nasrabadi, Alireza; Abbaszadeh, Abbas; Mohammadpour, Ali
Psychiatric nurses play an important role in the process of caring for mentally ill patients and are continually faced with the numerous challenges and complex issues related to this field. This study aimed to understand the perspectives of psychiatric nurses regarding the issues they face while providing care and examine the possible solutions for improvement of inpatient care in clinical settings. The study adopted a qualitative approach that utilized a content analysis of audio taped, semi-structured interviews that had been conducted with 24 nurses. Two main themes emerged from the data. The first, Challenges in Providing Care within Psychiatric Wards, had the following subthemes: Politics and Rules of Organization, Safety and Security Issues, Uncertainty about the Role, Lack of Trained Staff, and Sociocultural Issues. The second theme, Solutions for Improving Psychiatric Care, had the subthemes of Empowerment across four domains: Psychiatric Nurses, Mentally Ill Patients and their Families, The Psychiatric Mental Health System, and the Cultural Context. The results indicated that if nurses are expected to provide optimal nursing care within a psychiatric ward, then there is a need for a stable and responsible organizational structure, skilled psychiatric nurses, and community-based care along with an anti-stigma program.
Mousa, Marwa Abd El-Gawad Ahmed
Empathy is an ability and skill that can be learned and developed through appropriate education and practice. While the importance of nurses' empathy is widely acknowledged, little is known about the impact of passing through the psychiatric nursing and mental health educational experience at the Faculty of Nursing, Alexandria University on…
Haglund, K; von Knorring, L; von Essen, L
To describe nurses' and mental health nurse assistants' perceptions of advantages and disadvantages about working on a psychiatric ward with a locked entrance door. Psychiatric staff sometimes needs to protect patients from harming themselves or others. To keep the entrance door locked may help staff to achieve this goal. How locked entrance doors at psychiatric wards are experienced by staff, working on these wards, has been investigated to a very limited extent. The study was explorative and descriptive. Audio taped, semi-structured interviews with open-ended questions about advantages and disadvantages about working on a psychiatric ward with a locked entrance door, were conducted with 20 nurses and 20 mental health nurse assistants. Data were analyzed with content analysis. A content analysis revealed eight categories of advantages and 18 categories of disadvantages. Most advantages mentioned by nurses and mental health nurse assistants were categorized as providing staff with control over patients, providing patients with a secure and efficient care and protecting patients and staff against 'the outside'. Most disadvantages mentioned by nurses were categorized as causing extra work for staff, making patients feel confined, making patients feel dependent and creating a non-caring environment. Most disadvantages mentioned by mental health nurse assistants were categorized as causing extra work for staff, making patients feel confined, causing emotional problems for patients, making staff's power obvious and forcing patients to adapt to other patients' needs. Nurses and mental health nurse assistants mentioned more disadvantages than advantages and nurses mentioned more disadvantages than mental health nurse assistants. Nurses and mental health nurse assistants perceive a number of advantages and disadvantages for themselves, patients and significant others with a locked door at a psychiatric ward. Most of these concern patients' experiences. It is important for
Buus, Niels; Angel, Sanne; Traynor, Michael
This paper is a report of an interview study exploring psychiatric hospital nursing staff members' reflections on participating in supervision. Clinical supervision is a pedagogical process designed to direct, develop, and support clinical nurses. Participation rates in clinical supervision...... they influence participation rates. Twenty-two psychiatric hospital nursing staff members were interviewed with a semistructured interview guide. Interview transcripts were interpreted by means of Ricoeur's hermeneutic method. The respondents understood clinical supervision to be beneficial, but with very...
Khankeh, Hamidreza; Khorasani-Zavareh, Davoud; Hoseini, Seyaid-Ali; Khodai-Ardekandi, Mohammad-Reza; Ekman, Sirkka-Liisa; Bohm, Katarina; Nakhaie, Maryam; Ranjbar, Maryam; Castrén, Maaret
Understanding how novice nurses perceive their career in the psychiatric ward can be helpful for nurse educators and managers to gain insight into psychiatric nursing care and adding applicable knowledge to the development of support strategies for this group. The aim of this study was to describe and illuminate experiences of new graduated nurses working at a psychiatric ward in an Iranian context. A descriptive phenomenology has been chosen. Participants with baccalaureate degrees in nursing were selected purposefully and they all had less than 6 months of work experience in psychiatric wards beforehand. The study was conducted at the Razi Hospital in Iran. Data were collected through unstructured individual in-depth interviews and analyzed according to the Colaizzi method by means of Husserlian phenomenology. Three main themes were found in this study, of which six sub-themes were constructed as follows: Being in the world of fear and complaint, which has been abstracted by having mixed feelings of conflict and compliant on entry to the psychiatric ward, doubt about adequacy of being a psychiatric nurse and working in psychiatric ward and a frightening and non-supportive environment; A sense of imprisoned and confined, which has been constructed by different experience with different environmental milieu in psychiatric ward, as a lock sense; Becoming a psychiatric nurse, which has been constructed as a sense of usefulness, a sense of sympathy and compassion for patients and a sense of professional identity. This study identified areas that require modification by providing insight into lived experiences of beginners' nurses as the value in psychiatric ward. New graduated nurses may face negative perceptions and feelings due to confrontation with a new environment, patients and colleagues as well as shortcomings in the preparation.
W.J.C. Van Rhyn
Full Text Available An exploratory study was conducted with the aim of discovering and describing experiences of psychiatric nursing students during clinical placement in a psychiatric unit. For the purpose of the study an unstructured interview was conducted with each participant during their first placement in a psychiatric unit to identify the factors experienced as stressful. The results indicated that all eight participants experienced average to high stress. Sources of stress identified included, among others, ineffective teaching and learning programmes, poor managerial governance of the service, detachment of professional nurses from their teaching role, poor relationships among staff, overreliance on the medical model of care and patient neglect. Psychiatric nursing students sampled indicated universal support for in-service education and training for professional nurses, attitude change of professional nurses towards students, support for student initiatives, student involvement in patient care and adequate allocation of resources for patient care and nurse training. The exploration and description of experiences of the psychiatric nursing students will help nurse educators plan clinical learning opportunities in such a way that they are less stressful, thus ensuring that psychiatric nursing students are equipped to utilise themselves as therapeutic instruments.
James, B O; Isa, E W; Oud, N
Aggression is a common feature in psychiatric in-patient units in Africa. The attitudes of psychiatric nurses and their perceptions of the frequency of in-patient aggression have not been explored in the Nigerian context. Using a crosssectional study design, two self-report questionnaires (the Attitudes toward Aggression Scale (ATAS) and the Perception of the Prevalence of Aggression Scale (POPAS)) were administered to nursing staff (n=73) at two psychiatric facilities in Benin City, Nigeria. Overall, nurses viewed aggression as offensive, destructive and intrusive. They were less likely to view it as a means of communication or serving protective functions. Verbal aggression was the commonest type of aggression experienced while sexual intimidation and suicide attempts were least common. Male nurses were more likely to experience physical violence and aggressive 'splitting' behaviours, while nurses with over a decade of professional experience were more likely to experience verbal and humiliating aggressive behaviours. In contrast to previous studies, fewer nurses required days off work due to aggressive behaviour. Aggression is commonly experienced by nurses in in-patient units in Nigeria. Their views were predominantly negative. Training programmes are required to change staff attitudes as well as research on the cultural factors mediating these attitude dispositions.
Alhadidi, Majdi M B; Abdalrahim, Maysoon S; Al-Hussami, Mahmoud
Nurses working in psychiatric hospitals need to acquire the skills of therapeutic communication and empathy, and have higher levels of caring. The present study aims to investigate the level of caring and empathy among nurses working in psychiatric hospitals. A cross-sectional survey was utilized to collect data from 205 nurses recruited from three psychiatric hospitals in Jordan. The Background Information Questionnaire, Modified Caring Dimensions Inventory, and Toronto Empathy Questionnaire were administered to the recruited participants. The findings revealed that the sampled nurses had a high level of caring and empathy. Significant correlations were found between caring and having a specialized training in mental health nursing, and having organizational and managerial support. However, no significant correlations were found between empathy and participants' characteristics. Specialized training in mental health nursing, having organizational and managerial support, and empathy were found predictors for caring. © 2016 Australian College of Mental Health Nurses Inc.
Yoshizawa, Kaori; Sugawara, Norio; Yasui-Furukori, Norio; Danjo, Kazuma; Furukori, Hanako; Sato, Yasushi; Tomita, Tetsu; Fujii, Akira; Nakagam, Taku; Sasaki, Masahide; Nakamura, Kazuhiko
Psychiatric nursing is a stressful area of nursing practice. The purpose of this study was to examine occupational stress among psychiatric nurses in Japan. In this cross-sectional study, 238 psychiatric nurses were recruited from 7 hospitals. Data regarding the Generic Job Stress Questionnaire (GJSQ), the Center for Epidemiologic Studies for Depression Scale (CES-D), and the Health Practice Index (HPI) were obtained via self-report questionnaires. After adjusting for all the variables, CES-D scores were associated with job stress, but social support reduced the effect of stress on depression among psychiatric nurses. However, the interpretation of these results was hampered by the lack of data concerning important occupational factors, such as working position, personal income, and working hours. Further longitudinal investigation into the factors associated with depression may yield useful information for administrative and psychological interventions.
Mahoney, Jane S; Marfurt, Stephanie; daCunha, Miguel; Engebretson, Joan
Psychiatric nurse educators are challenged to prepare graduates in meeting the needs of individuals with a mental illness within an increasingly technology-based environment. This requires the development and evaluation of educational strategies that immerse students in web-based learning. This article presents an overview of a hybrid teaching design that includes classroom teaching and asynchronous threaded discussion in a teaching module in an undergraduate psychiatric nursing course. Evaluation of student preferences, advantages and disadvantages, and learning, as well as qualitative evaluation of students' description of critical thinking, supports the value of online teaching in psychiatric nursing education.
Jansen, GJ; Dassen, TWN; Burgerhof, JGM; Middel, B
Professional skills to adequately manage patient aggression are a prerequisite for nurses working in psychiatric hospitals. These 'technical' skills, however, are necessary but not sufficient for effective nurse intervention. 'The attitude of nurses' towards client aggression also contributes to
Temane, Annie M; Poggenpoel, Marie; Myburgh, Chris P H
Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field. The aim of this study was to explore and describe advanced psychiatric nursepractitioners' ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa. A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch's method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature. The data analysis generated the following themes - that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa. This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.
Annie M. Temane
Full Text Available Background: Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field.Objectives: The aim of this study was to explore and describe advanced psychiatric nursepractitioners’ ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa.Method: A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch’s method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature.Results: The data analysis generated the following themes – that the supervisor should have or possess: (a professional competencies, (b personal competencies and (c specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa.Conclusion: This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.
Smith, Kylie M
In 1952, Hildegard Peplau published her textbook Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing. This was the same year the American Psychiatric Association (APA) published the first edition of the Diagnostic and Statistical Manual of Mental Disorders (1st ed.; DSM-I; APA). These events occurred in the context of a rapidly changing policy and practice environment in the United States after World War II, where the passing of the National Mental Health Act in 1946 released vast amounts of funding for the establishment of the National Institute of Mental Health and the development of advanced educational programs for the mental health professions including nursing. This article explores the work of two nurse leaders, Hildegard Peplau and Dorothy Mereness, as they developed their respective graduate psychiatric nursing programs and sought to create new knowledge for psychiatric nursing that would facilitate the development of advanced nursing practice. Both nurses had strong ideas about what they felt this practice should look like and developed distinct and particular approaches to their respective programs. This reflected a common belief that it was only through nurse-led education that psychiatric nursing could shape its own practice and control its own future. At the same time, there are similarities in the thinking of Peplau and Mereness that demonstrate the link between the specific social context of mental health immediately after World War II and the development of modern psychiatric nursing. Psychiatric nurses were able to gain significant control of their own education and practice after the war, but this was not without a struggle and some limitations, which continue to impact on the profession today.
Fung, Yuen-Ling; Chan, Zenobia C Y; Chien, Wai-Tong
Many studies have affirmed that psychiatric advanced practice nurses (APNs) perform multifaceted roles. However, only a limited amount of research has been conducted on their perceptions of the performance of their roles. To explore the lived experiences of psychiatric APNs concerning the performance of their roles. Data were collected from individual semi-structured interviews and analysed using the interpretative phenomenological analysis method. The study was conducted in a hospital cluster in Hong Kong. Thirteen psychiatric APNs were purposively recruited. Three themes were discerned, namely, 'We are different', 'Who am I?', and 'I am who I am'. The findings can help psychiatric APNs and nurse administrators to better understand the needs of the role-bearers (APNs) and to develop strategies to support the development of advanced psychiatric nursing practices in Hong Kong and worldwide.
Delaney, Kathleen R; Johnson, Mary E
Inpatient psychiatric nurses are a large workforce, but their work is poorly articulated and thus poorly understood outside of the professional inpatient community. To learn how inpatient psychiatric nurses depict their work, define important aspects of their role, and view the impact of the unit environment on their clinical practice. Metasynthesis of research that has focused on the ideas and perceptions of inpatient psychiatric nurses around their role and practice on inpatient psychiatric units. Three themes emerged from the analysis; the first was an umbrella for three important aspects of nursing work: the nurses' efforts to forge engagement with patients; their activities which maintained the safety of the unit and interventions nurses viewed as educating/empowering patients. The second theme captures the conditions that enabled nurses to do this work such as a cohesive nursing team and their sense of self-direction in their role. The final theme centers on difficulties nurses encountered in enacting their role which included multiple responsibilities for patient care and management of the milieu; intense work often with low visibility and scant support within the organization. Nurses need to articulate their practice so they can assert for the staffing and resources needed to keep units safe and promote patients' well-being, strive toward quality, and promote the development of the specialty.
Zheng, Zhimin; Gangaram, Poornima; Xie, Huiting; Chua, Stephanie; Ong, Samantha Bee Cheng; Koh, Sioh Eng
Job satisfaction ranks highly as one of the main factors influencing turnover rates among nurses. Mental health nursing has been reported to be a particularly stressful specialty, yet little is known about the level of job satisfaction among psychiatric nurses in Singapore. Resilience is defined as a means of adapting to stress at the workplace, and could serve as a factor influencing job satisfaction. The present study aimed to explore the current level of job satisfaction among psychiatric nurses working in the only tertiary psychiatric institution in Singapore, the influencing factors, and the relationship between resilience and job satisfaction. A survey questionnaire consisting of the following was administered to all eligible nurses working in the Institute of Mental Health between the period of 16-24 December 2014: (i) The McCloskey and Mueller Satisfaction Scale; (ii) The Resilience Scale; and (iii) sociodemographic data form. A total of 874 nurses were eligible for participation in the study, and a total of 748 nurses responded, totalling 85.6% response. A mean satisfaction score of 95.21 and mean resilience score of 125.74 were obtained. Mean satisfaction and resilience scores were the highest for nurses with longer working experience and those of older age. A positive and significant association between satisfaction and resilience scores (P = 0.001) was obtained. Psychiatric nurses in Singapore are generally satisfied with their job, but this can be further improved with the strengthening of personal resilience. © 2017 Australian College of Mental Health Nurses Inc.
Gonge, Henrik; Buus, Niels
This article reports findings from a longitudinal controlled intervention study of 115 psychiatric nursing staff. The twofold objective of the study was: (a) To test whether the intervention could increase clinical supervision participation and effectiveness of existing supervision practices...
Aldiabat, Khaldoun M; Clinton, Michael
A better understanding of how male Jordanian psychiatric nurses become smokers and continue the habit mainly at work is necessary if smoking reduction and cessation programs are to help them better...
Fung, Y L; Chan, Z; Chien, W T
This paper discusses findings from a systematic review of literature pertaining to the role performance of psychiatric nurses in advanced practice. A search of 11 electronic databases was conducted to identify research involving interventions by psychiatric (or mental health) nurses in advanced practice. A total of 14 studies were identified. In this review, the role performance of psychiatric nurses in advanced practice was categorized into three themes: (1) the provision of psychosocial interventions; (2) the provision of nurse-directed services in health-care contexts; and (3) the provision of psychiatric nursing consultation services. Our results document that psychiatric nurses in advanced practice perform multifaceted roles and provide mental health-care services in various contexts. This systematic review reveals that the nurses obtain significant results in managing clients with depression and psychological stress, and demonstrates their value when developing partnerships with non-mental health service providers. One study, however, showed that the nurses had insignificant results in performing transitional care for pre-discharged mental health service users. © 2013 John Wiley & Sons Ltd.
W.J.C. Van Rhyn; M.R. Gontsana
An exploratory study was conducted with the aim of discovering and describing experiences of psychiatric nursing students during clinical placement in a psychiatric unit. For the purpose of the study an unstructured interview was conducted with each participant during their first placement in a psychiatric unit to identify the factors experienced as stressful. The results indicated that all eight participants experienced average to high stress. Sources of stress identified included, among oth...
Williams, Susan G; Godfrey, Alice J
Cyberbullying is an emerging issue within our society, particularly among adolescents. The phenomenon is similar to traditional bullying in that it is hurtful, repetitive behavior involving a power imbalance, often causing psychosocial issues. With the availability of cell phones, Internet, and video gaming systems, adolescents are constantly plugged into technology and therefore at risk of being a victim or a perpetrator of cyberbullying. Both physical and mental health problems can result from cyberbullying, which, in turn, can affect an adolescent's performance in school and other crucial areas of life. Legal action is an option, but many times the law is not clear. Psychiatric-mental health nurses are in a position to help educate children about resources to prevent or cope with cyberbullying in a way that will help not only the patients themselves but also parents, teachers, school administrators, and the community. Copyright 2011, SLACK Incorporated.
Baek, Suyon; Kim, Sunah
The purpose of this study is to examine the attributes and verify the definition of the recovery-oriented psychiatric nursing concept using the hybrid model suggested by Schwartz-Barcott and Kim ( 2000 ). In the theoretical analysis phase, a literature search was conducted and data were collected using the Pubmed, CINAHL, and Google Scholar databases. This study considered of 7 empirical studies, 21 guidelines, 12 instruments, 2 related theories, 3 practical models, and 2 intervention programs. In the fieldwork phase, this study performed in-depth interviews with nine psychiatric nurses. After comprehensively analyzing the attributes of recovery-oriented psychiatric nursing through a literature review and the fieldwork phase, this study rearranged the final attributes and definition of recovery-oriented psychiatric nursing in the final analytic phase as follows: "Placing consumers in the center of nursing as human beings"; "Expecting with hope"; "Encouraging them to lead a satisfactory life"; "Guiding them to live along with their peers, family and the community"; "Becoming a companion"; "Growing together"; and "Establishing a nursing organizational culture and system." The results of this study will be used as the basic data for developing educational contents and practice guidelines for the quick resolution and activation of recovery-oriented psychiatric nursing.
Boomsma, J.; Dassen, T.WN; Dingemans, T.; van den Heuvel, W.J.A.
Psychiatric nurses in The Netherlands are moving out of residential mental health institutions and are pioneering home care for the acutely and chronically mentally ill. The purpose of this study was to identify the interventions nurses currently use and to describe the differences between
Xu, Xiuying; Li, Xin-Min; Xu, Dongmei; Wang, Wenqiang
The mental health service model and policy have undergone dramatic changes and are moving toward the establishment of integrated service network-based community mental health services in China. But there are still some issues, such as shortage of resources, a relatively low rate of psychiatric treatment, lack of the knowledge about mental health in the general population, and stigma associated with mental disorders. This paper summarizes the history of psychiatric and mental health nursing in China and analyzes the characteristics of the current situation. There are healthcare challenges for psychiatric and mental health nurses with the mental health services reform by government, and in this paper we discuss future trends and provide suggestions for development of the psychiatric nursing profession, and mental health services reform. Copyright © 2017 Elsevier Inc. All rights reserved.
McTiernan, K; McDonald, N
Burnout negatively impacts the delivery of mental health services. Psychiatric nurses face stressors that are distinct from other nursing specialities. The research was conducted in Ireland and captured a relatively large sample of respondents. The results compared the stressors, coping strategies and burnout levels between hospital and community-based psychiatric nurses. Occupational stress can negatively impact on the well-being of psychiatric nurses, which in turn can lead to poor client care. There is a dearth of published research conducted in Ireland that examines stress within the discipline. A between-groups study, undertaken in February 2011, investigated stressors, burnout and coping strategies between hospital and community-based psychiatric nurses in a Dublin region. Sixty-nine participants (8 males and 61 females), aged between 18 to 60 years voluntarily completed the Mental Health Professional Stress Scale, the Maslach Burnout Inventory and the PsychNurse Methods of Coping Scale. The findings revealed that nurses were operating in a moderately stressful environment. Stressors focused on organizational issues as opposed to client issues. The main stressors identified were lack of resources, workload and organizational structures/processes. Both groups reported average levels of emotional exhaustion, low levels of depersonalization and average levels of personal accomplishment. A Mann-Whitney U-test and Independent Samples t-test found significant differences between hospital and community-based nurses regarding depersonalization and personal accomplishment, respectively. Hospital nurses reported higher depersonalization scores, and community nurses had a greater sense of personal accomplishment. The personal accomplishment scores of hospital nurses were below mental health professional norms. No significant differences emerged regarding coping strategies. Avoidant coping strategies were favoured by both groups. It is recommended that interventions
Rutledge, Dana N; Wickman, Mary E; Cacciata, Marysol; Winokur, Elizabeth J; Loucks, Jeannine; Drake, Diane
Disruptive behaviors are common among hospitalized patients with psychiatric and substance abuse behaviors. Nurses working on nonpsychiatric units, however, may lack competencies to care for patients with such behaviors. A survey was developed and administered to 844 nurses across three hospital settings that revealed a lack of nurse confidence to intervene in situations that require de-escalation techniques and crisis communication. This study provides direction for further research and interventions in hospital settings with similar professional development needs.
Ertem, Melike Yonder; Kececi, Ayla
Objective: An effective interpersonal communication is an essential nursing skill required to help provide quality health care and meet the treatment objectives. The aim of this study was to investigate the communication between the psychiatric nurses and the patients in terms of Transactional Analysis Theory ego states. Methods: The quantitative and qualitative research methods were used. The descriptive statistics (frequency, percentage, mean, standard deviation) were used in the data analysis and Kendall’s Tau-c coefficient was used to assess the agreement among the observers. Results: Of the psychiatric nurses, 66.7% (n = 14) had served as a psychiatric nurse for 1-10 years. Among the nurses, 52.4% (n=11) had received training about communication from any institution/organization. The agreement among the opinions of the nurses, the researcher and the charge nurses about the psychiatric nurses’ ego states showed that there was a significant relationship between the researcher’s opinion of the nurses’ ego states and the charge nurses’ opinion of the nurses’ ego states in terms of Critical Parent, Nurturing Parent, Adult, Adapted Child and Natural Child ego states. Conclusion: It is suggested that training be offered in regards to raising awareness about ulterior transactions that can affect communication negatively, patient autonomy and therapeutic communication in particular, and patients requiring the use of special communication methods. PMID:27182267
Pitkänen, Anneli; Hätönen, Heli; Kuosmanen, Lauri; Välimäki, Maritta
People with mental disorders suffer from impaired quality of life (QoL). In psychiatric hospital wards nurses are in a close relationship with patients and have good opportunities to support patients' QoL. Still, relatively little is known about patients' perceptions related to nursing interventions by which nurses can support the QoL of patients with severe mental illness. To explore patients' perceptions of nursing interventions in supporting patients' QoL in acute psychiatric inpatient settings. Explorative descriptive study design. The study was conducted in seven acute 24-h psychiatric wards of general hospitals in Southern Finland. Thirty-five inpatients diagnosed with schizophrenia, schizotypal disorder or delusional disorder. The data were generated through semi-structured interviews and processed by means of qualitative content analysis. Five main categories of patients' perceptions of nursing interventions were identified to support QoL from patients' descriptions: empowering interventions, social interventions, activating interventions, security interventions and interventions to support physical health. Impaired QoL of patients with severe mental illness can be supported in acute psychiatric wards through nursing interventions. However, we are not sure how effective these interventions are. Thus, research on the effectiveness of nursing interventions to support patients' QoL is needed.
Achor Justin U
Full Text Available Abstract Background There is increasing public and professional awareness of autism spectrum disorders with early recognition, diagnosis and interventions that are known to improve prognosis. Poor knowledge about childhood autism among paediatric and psychiatric nurses who are members of multidisciplinary teams that care for such children may be a major barrier to early interventions that could improve quality of life and prognosis in childhood autism. Factors that influence knowledge about childhood autism among these nurses are not known. This study assessed knowledge about childhood autism among paediatric and psychiatric nurses in Ebonyi state, Nigeria and determined the factors that could be influencing such knowledge. Methods Forty specialist paediatric and forty psychiatric nurses, making a total sample of eighty, were randomly selected from all the health care facilities in Ebonyi state, Nigeria. A socio-demographic questionnaire and knowledge about childhood autism among health workers (KCAHW questionnaire were administered to them and the study was a point survey. Results The total mean score on the KCAHW questionnaire among the nurses that participated in the study was 12.56 ± 3.23 out of a total of 19 possible. The mean score for the paediatric nurses was 11.78 ± 3.64 while psychiatric nurses had mean score of 13.35 ± 2.58. The mean scores in Domain 1 were 6.17 ± 1.75 for the paediatric nurses and 6.52 ± 1.43 for the psychiatric nurses. The mean scores in Domain 2 were 0.65 ± 0.48 for the paediatric nurses and 0.80 ± 0.41 for the psychiatric nurses. Domain 3 showed mean scores of 1.97 ± 1.25 for the paediatric nurses while psychiatric nurses scored 2.62 ± 1.23. Domain 4 yielded the mean scores of 2.97 ± 1.54 and 3.42 ± 0.98 for the paediatric and psychiatric nurses respectively. There was significant relationship between the total mean score on the KCAHW questionnaire for the two groups and the area of specialisation of
Landeweer, Elleke G M; Abma, Tineke A; Widdershoven, Guy A M
In this article, we focus on core values of psychiatric nurses in relation to coercion and constraint. We analyze changes that took place in a project aiming at reducing coercion at a closed inpatient ward of a psychiatric hospital. Using the philosophy of Hans-Georg Gadamer and Margaret Urban Walker, we analyze both the process of moral changes through dialogue and the outcome in terms of new identities and moral responsibilities. We conclude that the project stimulated nurses to redefine their roles and develop a deeper intersubjective understanding of core values of their profession.
Salzmann-Erikson, Martin; L Tz N, Kim; Ivarsson, Ann-Britt; Eriksson, Henrik
This article presents intensive psychiatric nurses' work and nursing care. The aim of the study was to describe expressions of cultural knowing in nursing care in psychiatric intensive care units (PICU). Spradley's ethnographic methodology was applied. Six themes emerged as frames for nursing care in psychiatric intensive care: providing surveillance, soothing, being present, trading information, maintaining security and reducing. These themes are used to strike a balance between turbulence and stability and to achieve equilibrium. As the nursing care intervenes when turbulence emerges, the PICU becomes a sanctuary that offers tranquility, peace and rest.
Yadav, B L
Evidence-based practice (EBP) is an approach to health care in which health professionals use the best evidence available to guide their clinical decisions and practice. Evidence is drawn from a range of sources, including published research, educational content and practical experience. This paper reports the findings of a study that investigated the sources of knowledge or evidence for practice used by psychiatric nurses in Ireland. The paper is part of a larger study, which also investigated barriers, facilitators and level of skills in achieving EBP among Irish psychiatric nurses. Data were collected in a postal survey of a random sample of Irish psychiatric nurses using the Development of Evidence-Based Practice Questionnaire. The findings revealed that the majority of survey respondents based their practice on information which was derived from interactions with patients, from their personal experience and from information shared by colleagues and members of the multidisciplinary team, in preference to published sources of empirically derived evidence. These findings are consistent with those of the previous similar studies among general nurses and suggest that Irish psychiatric nurses face similar challenges to their general nursing counterparts in attaining of EBP.
De Hert, Marc; De Beugher, Annelien; Sweers, Kim; Wampers, Martien; Correll, Christoph U; Cohen, Dan
Clozapine is an antipsychotic with superior efficacy in treatment refractory patients, and has unique anti-suicidal properties and a low propensity to cause extrapyramidal side-effects. Despite these advantages, clozapine utilization is low. This can in part be explained by a number of potentially lethal side effects of clozapine. Next to psychiatrists nurses play a crucial role in the long-term management of patients with schizophrenia. It is therefore important that nurses know, inform and monitor patients about the specific side-effects of clozapine. A recent study of psychiatrists published in 2011 has shown that there was a gap in the knowledge about side-effects of clozapine. The knowledge about side-effects of clozapine in nurses has never been studied. This cross-sectional study evaluated the knowledge base regarding the safety of clozapine, and its potential mediators, of psychiatric nurses in 3 psychiatric hospitals in Belgium with a specifically developed questionnaire based on the literature and expert opinion (3 clozapine experts). A total of 85 nurses completed the questionnaire. The mean total score was 6.1 of a potential maximum score of 18. Only 3 of the 18 multiple choice knowledge questions were answered correctly by more than 50% of nurses. Only 24.9% of participants passed the test (>50% correct answers). Nurses working on psychosis units were more likely to pass the test (xx.y% vs yy.z%, p=0.0124). There was a trend that nurses with a lower nursing diploma were more likely to fail the test (p=0.0561). Our study clearly identifies a large gap in the basic knowledge of psychiatric nurses about clozapine and its side-effects. Knowledge could be increased by more emphasis on the topic in nurse's training curricula as well as targeted onsite training. Only 23.5% of participants indicate that there was sufficient information in their basic nursing training. Copyright © 2015 Elsevier Inc. All rights reserved.
Flannelly, L; Inouye, J
The advanced practice psychiatric nurse must be prepared to meet the changing demands being placed on the nursing profession. Some changes are the product of health care reforms, especially managed care. Others are more fundamental, because continuing scientific advances drive rapid changes in the knowledge base required of mental health nurses. Curricular reforms initiated earlier this decade were intended to equip nurses with the problem-solving and critical-thinking skills required to deal with novel and complex situations in a rapidly changing healthcare system. This article describes how the Inquiry-Based Learning tutorial method attends to the mental processes of graduate students and fosters critical-thinking skills.
was highly dependent on the individual nurses' practical ability to participate in the game. Furthermore, the nurses colluded in their mutual communication to enable the collective display and sense of knowing that protected them against explicit signs of uncertainty about the clinic. The game of clinical...... knowledge influenced processes of clinical decision-making among the nurses as the game added to a distorted widening of a 'fictional distance' between patients and the representations produced by the nurses.......Nursing practices at psychiatric hospitals have changed significantly over the last decades. In this paper, everyday nursing practices were interpreted in light of these institutional changes. The objective was to examine how mental health nurses' production of clinical knowledge was influenced...
Kane, Catherine F
The 2014 Psychiatric-Mental Health Nursing: Scope and Standards of Practice is the specialty's description of competent nursing practice. The scope portion of this document identifies the focus of the specialty by defining nursing practice extents and limits. Standards are statements that identify the duties and obligations for which specialty nurses are held accountable, including general registered nurses and advanced practice nurses. This article begins with a brief overview of the revision process. The author describes key factors that influenced the revision, such as external documents and current priorities in healthcare, and synthesizes significant changes to the document, including commentary and comparisons to the generalist Scope and Standards of Practice. Implications for nursing education and a companion resource are discussed.
Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S
Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care. © 2012 John Wiley & Sons Ltd.
The introduction of undergraduate comprehensive nursing education in Victoria, Australia, during the 1990s has resulted in significant changes in undergraduate preparation for psychiatric/mental health nursing. Comprehensive programs became charged with the responsibility of preparing graduates to provide care for people experiencing a mental illness across a broad range of health-care settings, as well as providing a pathway for graduates with an interest in specialist practice in this field. The aim of this article is to clearly articulate the issues associated with psychiatric/mental health nursing education at the undergraduate level, including prevalence of mental illness, the inadequacy of psychiatric/mental health nursing theory and practice at undergraduate level, the negative attitudes of students toward this field of practice, and the subsequent failure of nursing education and practice initiatives to provide a clear mechanism for specialization in this important area of nursing practice. Throughout the article, the distinction between generalist and specialist preparation is argued and accompanied by a call for nursing education to recognize and address the issues associated with both domains.
Madathil, Renee; Heck, Nicholas C; Schuldberg, David
It is important to consider ways in which nurses can be protected from experiencing the effects of burnout. This study examined the relationships between leadership style of psychiatric nurse supervisors, work role autonomy, and psychological distress in relation to psychiatric nurse burnout. Eighty-nine psychiatric nurses from Montana and New York hospitals completed an online survey that assessed their work-related experiences. Overall, results of this study indicate that the participants were experiencing high levels of emotional exhaustion and depersonalization when compared to a normative sample of mental health workers. Results also showed that leadership style and work role autonomy are likely to be environmental factors that protect against burnout in nurses. Finally, it was shown that the relationship between depressive symptoms and the burnout component of personal accomplishment may be influenced by nurses' perceptions of the leadership style in their work environment. These findings are important because nurse supervisor leadership styles and amount of autonomy are characteristics of the work environment that may be amenable to change through training and intervention. Copyright © 2014 Elsevier Inc. All rights reserved.
Sung, Su-Ching; Lin, Yen-Chin; Hong, Chi-Mei; Cho, Pei-Pei
The purpose of this study was to explore psychiatric patient needs and current nursing practice with regard to sexual counseling and to understand differences in individual patient characteristics. A total of 182 psychiatric patients and 44 psychiatric nurses were purposively selected from a mental hospital in northern Taiwan. Results revealed that 63.2% of subjects had not been given sexuality information and 81.9% had not been approached by nurses to discuss such issues. While 35.2% of study patients treated sexual issues as psychological or private issues that should only be discussed with psychologists, 33.5% expressed a desire to discuss issues related to sexuality with nurses. Even so, most subjects preferred to discuss sexual issues in a private way, and asked for assistance from same-gender professionals. Also, patients with higher education levels placed greater attention on the counseling topics of how to express sexual needs and the impacts of mental illness on sexuality. With regard to nurses participating in the study, female nurses had a generally more conservative attitude toward sexual values than males. Those who were married, older, or had received continuing sexuality education were more comfortable with conducting sexual counseling. Those with clinical experience and continuing sexuality education were able to take more responsibility and a more professional role in sexual counseling. Data collected on the specific subject groups in order to provide effective comparisons can be employed to refine current sexual counseling training programs for nurses in order to improve patient care.
Slemon, Allie; Jenkins, Emily; Bungay, Vicky
The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self-harm. In this paper, we argue that within current psychiatric inpatient environments, safety is maintained as the predominant value, and risk management is the cornerstone of nursing care. Practices that accord with this value are legitimized and perpetuated through the safety discourse, despite evidence refuting their efficacy, and patient perspectives demonstrating harm. To illustrate this growing concern in mental health nursing care, we provide four exemplars of risk management strategies utilized in psychiatric inpatient settings: close observations, seclusion, door locking and defensive nursing practice. The use of these strategies demonstrates the necessity to shift perspectives on safety and risk in nursing care. We suggest that to re-centre meaningful support and treatment of clients, nurses should provide individualized, flexible care that incorporates safety measures while also fundamentally re-evaluating the risk management culture that gives rise to and legitimizes harmful practices. © 2017 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.
Moylan, Lois Biggin
Violence in the acute care psychiatric setting is an ongoing serious problem. Maintenance of a safe therapeutic environment is a paramount responsibility of nurses practicing in this area. Ethical and legal standards demand that the nurse intervenes in aggressive situations in a manner that employs the least intrusive and restrictive measures necessary to provide safety. Therefore, accurate and effective decision-making in aggressive situations, which can escalate rapidly, is of great importance. This paper discusses a theoretical model for decision-making in selecting interventions with aggressive psychiatric patients. This model may provide a basis for the development of training and education programs for effective decision-making in this area.
Baradell, J G
Survey research was conducted to examine clinical outcomes and satisfaction of patients of psychiatric mental health clinical nurse specialists (CNSs). Patients who had terminated from outpatient psychotherapy with 6 CNSs in 1993 were mailed a questionnaire (N = 223). Follow-ups by mail yielded a response rate of 45% (n = 100). The questionnaires included the Profile of Mood States-Short Form ([POMS-SF]; McNair, Lorr, & Droppleman, 1992). Quality of Life Function ([QOL]; Lehman, 1991), and Patient Satisfaction Scale (Baradell, 1994). Paired difference t-tests were used to evaluate clinical outcomes. Percentages were used to report satisfaction, and Pearson correlations were used to examine the relationship between clinical outcomes and patient satisfaction. The mean age for respondents was 37 years; 82% were female. Diagnoses included depression (46%), adjustment disorders (34%), anxiety (10%), and other (10%). Patients reported significant improvement in all clinical symptoms: anxiety, depression, anger, confusion, fatigue and vigor. Patients reported significant improvement in all domains of QOL: family, social, and job. Patients reported a very high level of satisfaction with the care provided. The more clinical improvement the patients reported, the more satisfied they were with the care provided. If nurses are to be included in a reformed health care delivery system in the future, additional research is essential.
D.Cur. The purpose of this research study was to describe a model to facilitate collaboration between the institutions of higher education and psychiatric health care services in order to promote psychiatric clinical nursing education, with guidelines to operationalise the model. In spite of the calls by statutory bodies and contemporary legislation for collaboration between institutions of higher education and psychiatric health care services, there are few instances where formalised coll...
Latvala, E; Vuokila-Oikkonen, P; Janhonen, S
This paper describes videotaped recording as a data collection method when conducting participant observation in a psychiatric nursing study. The videotaped episodes were part of the daily life of psychiatric nursing in a hospital environment. The advantages and limitations of using videotaped recording in nursing research will be discussed. This paper is based on two studies. The data consisted of 21 videotaped episodes of nursing report sessions or interdisciplinary team meetings in the psychiatric clinic of a university hospital. The participants consisted of patients, their significant others, nurses, doctors, social workers and physiotherapists. All videotaped material was transcribed verbatim. An essential advantage of videotaping is that most potentially useful interaction and behaviour can be captured. The advantage in terms of the credibility of videotaping was that the investigator was able to review the same videotaped situations again and again. Videotaped material is rich and provides several possibilities for analysing the data. In these studies data and source triangulation enabled the researchers to reduce personal influence on the results. The investigator must also be aware of the limitations concerning this method. The most essential limitations are mechanical problems and the influence of videotaping on behaviour. Careful ethical considerations are important concerning personal privacy, informed consent and respect for the self-determination of psychiatric patients.
Andrea Gossett Zakrajsek
Full Text Available Despite preference for community-based living, large numbers of people with psychiatric disabilities live in nursing homes throughout the US. Community-based services for this population are limited by public policy and service system barriers. This paper summarizes these barriers and presents the second phase of a participatory action research project jointly developed by university-based researchers and two Centers for Independent Living. A qualitative case study methodology was used to understand the experiences of three individuals with psychiatric disabilities reintegrating into the community from nursing homes. Findings revealed themes of social isolation, participation in virtual communities, variability of impairment experiences and unmet needs for community supports. In addition to thematic findings, action products were generated for the benefit of community partners. These products included national best practice resources and a needs assessment survey tool. Study findings and products point to specific systems change and policy recommendations to better support community reintegration for this population. These recommendations are discussed in light of U.S. healthcare reform and broader disability advocacy efforts.
McLaughlin, Dorcas E; Freed, Patricia E; Tadych, Rita A
Nursing education recognizes the need for a framework of experiential learning that supports the development of professional roles. Action methods, originated by Jacob L. Moreno (1953), can be readily adapted to any nursing classroom to create the conditions under which students learn and practice professional nursing roles. While nurse faculty can learn to use action methods, they may not fully comprehend their theoretical underpinnings or may believe they are only used in therapy. This article explores Moreno's ideas related to psychodrama and sociodrama applied in classroom settings, and presents many examples and tips for classroom teachers who wish to incorporate action methods into their classes.
Voogt, L.A.; Nugter, A.; Achterberg, T. van; Goossens, P.J.J.
BACKGROUND: Psychiatric nurses commonly refer to "providing structure" (PS) as a key intervention. But no consensus exists about what PS entails. PS can be understood as a complex intervention. In four previous studies, a definition, activities, and context variables were described that were
Özcan, Neslihan Keser; Bilgin, Hülya; Akın, Münevver; Badırgalı Boyacıoğlu, Nur Elçin
The aim of this study was to determine nurses' attitudes towards professional containment methods and to explore the relationship between those attitudes and nurses' perception of aggression. Different containment methods are used in psychiatric wards when patients behave aggressively towards others or exhibit self-harm. It is known that in addition to patient-specific and environmental influences, many factors related to the staff influence the choice of containment method. One of these factors is the perception of aggression. A cross-sectional descriptive design was used and the sample consisted of 144 nurses who are employed in a psychiatric hospital in Istanbul and who volunteered to participate in the study. Data were collected using a questionnaire addressing the socio-demographic and professional features of nurses and using the attitudes to professional containment methods and Perception of Aggression Scale. While pro re nata medication was used commonly, time-out was infrequently used in the wards. Intermittent observation, pro re nata medication and containment in the psychiatric intensive care unit were the most approved methods. The use of net beds was the least approved method. Nurses who perceive aggression as dysfunctional/undesirable are more likely to approve compulsory intramuscular medication and mechanical restraint. These results showed that nurses' perception of aggression is an important factor influencing the choice of a professional containment method. This study might lead to closer critiquing of psychiatric ward nurses' attitudes towards professional containment methods, leading to a decrease in the usage of these methods. © 2015 John Wiley & Sons Ltd.
Martha N. Hill
Full Text Available There is a need and opportunity for China to develop education and practice innovations given that advance practice nurses (APNs improve health care and outcomes. The China Medical Board (CMB China Nursing Network (CCNN began planning for an Advanced Nursing Practice Program for education and career development that will facilitate CCNN's contributions to meeting national nursing policy priorities. This paper presents the discussion, recommendations and action plans developed at the inaugural planning meeting on June 26, 2015 at Fudan University in Shanghai. The recommendations are: Develop standards for advanced nursing practice; Develop Master's level curricula based on the standards; Commence pilot projects across a number of University affiliated hospitals; and Prepare clinical tutors and faculty. The strategic directions and actions are: Develop a clinical career ladder system; Expand the nursing role from hospital to community; and Build a specialty nurse accreditation system.
SCID), 57% of the 100 study sample of female nurses of the University of Benin Teaching Hospital, Nigeria met definitive diagnoses for Anxiety Disorder, Dysthymia, Major Depressive Disorder, and Major Depression with probable Panic Disorder.
Full Text Available Abstract Background The nurses working in psychiatric hospitals and wards are prone to encounter completed suicides. The research was conducted to examine post-suicide stress in nurses and the availability of suicide-related mental health care services and education. Methods Experiences with inpatient suicide were investigated using an anonymous, self-reported questionnaire, which was, along with the Impact of Event Scale-Revised, administered to 531 psychiatric nurses. Results The rate of nurses who had encountered patient suicide was 55.0%. The mean Impact of Event Scale-Revised (IES-R score was 11.4. The proportion of respondents at a high risk (≥ 25 on the 88-point IES-R score for post-traumatic stress disorder (PTSD was 13.7%. However, only 15.8% of respondents indicated that they had access to post-suicide mental health care programmes. The survey also revealed a low rate of nurses who reported attending in-hospital seminars on suicide prevention or mental health care for nurses (26.4% and 12.8%, respectively. Conclusions These results indicated that nurses exposed to inpatient suicide suffer significant mental distress. However, the low availability of systematic post-suicide mental health care programmes for such nurses and the lack of suicide-related education initiatives and mental health care for nurses are problematic. The situation is likely related to the fact that there are no formal systems in place for identifying and evaluating the psychological effects of patient suicide in nurses and to the pressures stemming from the public perception of nurses as suppliers rather than recipients of health care.
Takahashi, Chizuko; Chida, Fuminori; Nakamura, Hikaru; Akasaka, Hiroshi; Yagi, Junko; Koeda, Atsuhiko; Takusari, Eri; Otsuka, Kotaro; Sakai, Akio
The nurses working in psychiatric hospitals and wards are prone to encounter completed suicides. The research was conducted to examine post-suicide stress in nurses and the availability of suicide-related mental health care services and education. Experiences with inpatient suicide were investigated using an anonymous, self-reported questionnaire, which was, along with the Impact of Event Scale-Revised, administered to 531 psychiatric nurses. The rate of nurses who had encountered patient suicide was 55.0%. The mean Impact of Event Scale-Revised (IES-R) score was 11.4. The proportion of respondents at a high risk (≥ 25 on the 88-point IES-R score) for post-traumatic stress disorder (PTSD) was 13.7%. However, only 15.8% of respondents indicated that they had access to post-suicide mental health care programmes. The survey also revealed a low rate of nurses who reported attending in-hospital seminars on suicide prevention or mental health care for nurses (26.4% and 12.8%, respectively). These results indicated that nurses exposed to inpatient suicide suffer significant mental distress. However, the low availability of systematic post-suicide mental health care programmes for such nurses and the lack of suicide-related education initiatives and mental health care for nurses are problematic. The situation is likely related to the fact that there are no formal systems in place for identifying and evaluating the psychological effects of patient suicide in nurses and to the pressures stemming from the public perception of nurses as suppliers rather than recipients of health care.
Jervis, Lori L; Manson, Spero M
Residents' cognitive, psychiatric, and behavioral statuses were examined as part of a larger study of care in a nursing home (NH) owned and operated by a Northern Plains American Indian tribe. Reviews of 45 medical records and semistructured interviews with 36 staff were completed. Creekside residents had considerable psychiatric and behavioral morbidity. High prevalences of non-Alzheimer's disease dementia, cognitive impairment, anxious symptomatology, and resistance to care were met with psychopharmacotherapy, reorientation, and informal techniques for behavior management. Significant depressive, anxious, psychotic, and behavioral symptoms remained. Staff interpretations of resident problems consisted of an ethnopsychological schema emphasizing resident loneliness, grumpiness, and propensity to "fight" rather than formal psychiatric nosology. Tribal NH residents were likely underdiagnosed for dementia and anxiety. Residual behavioral and psychiatric symptomatology suggest room for improvement in the NH's behavioral management regimen. Need for greater attention to conceptual, diagnostic, clinical, and documentation processes in the NH setting is noted.
Ketola, J; Stein, J V
Psychiatric nursing teaches students how to engage and communicate with patients who have severe emotional distress. Nurses need this knowledge as the majority of patients encountered in hospitals are distressed. This study explores the impact of a psychiatric clinical course in helping students learn to relate to distressed patients. The study used a mixed research methodology to survey 67 baccalaureate students about their experiences in the placement portion of the psychiatric nursing course. The pre-clinical questions focused on students' anticipation regarding individuals with mental illness and how the clinical experience would affect them as nurses and as individuals. The post-clinical questions asked how the clinical experience affected them. The students stated that their time with patients had changed them. Ninety-nine per cent were no longer frightened of the patients. Students realized the patients were distressed and were glad to help them. This work sensitized them to the individual rather than the generic patient. It initiated a process in self-awareness, in sensitivity to the feelings of another person and in communication skills. These are steps in the development of an empathetic presence. The students recognized the need for these skills in all nursing. The authors recommend strategies to assist students in developing an empathetic presence. © 2012 Blackwell Publishing.
Kelly, Teresa; Howie, Linsey
Psychiatric nurses interested in extending their interpersonal and psychotherapeutic skills sometimes undertake postgraduate training in gestalt therapy. Little is known about how this new knowledge and psychotherapeutic skill base informs their practice. This paper presents the findings of a qualitative study that aimed to explore the influence of gestalt therapy training on psychiatric nursing practice. Within a framework of narrative inquiry, four psychiatric nurses trained in gestalt therapy were invited to tell their stories of training in a gestalt approach to therapy, and recount their experiences of how it influenced their practice. In keeping with narrative analysis methods, the research findings were presented as a collection of four stories. Eight themes were derived from a thematic analysis conducted within and across the four stories. The discussion of the themes encapsulates the similarities and differences across the storied collection, providing a community and cultural context for understanding the individual stories. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
Claudia Mara de Melo Tavares
Full Text Available The present study is aimed at describing the perception of the nursing team concerning the care in a psychiatric hospital. The research used a qualitative approach, exploratory type, using focus group technique, with five participants, in August 2011, in Niteroi, RJ, Brazil. From the data analysis five categories emerged, covering: sensitive listening; personal availability; therapeutic projects; human issues of the team; Traditional Psychiatry vs. Psychosocial Paradigm tension. It was concluded that despite the research, the subjects were still working at the hospital model. It was possible to bring awareness in a human, comprehensive and complete manner. But this perception of care has frailties once it does not bring any evidence of scientific basis of nursing. It is recommended that the professional nursing team invest in their role of caring in the context of the Psychiatric Reform, in the pursuit of an approach centered on the subject and in his way of living.
Although the free-floating discussion format is widely used in group therapy, the application of this format in the context of supervisory groups has yet to be clarified. The purpose of this study was to explore the mechanisms involved in facilitating and learning the free-floating discussion format in a supervisory group. A phenomenological approach was used to investigate the group content and personal feedback of a psychiatric-nurse supervisory group. The group held on 12 sessions. Each session was conducted once weekly and lasting 150 minutes. The findings identified the functions of free-floating discussions in the context of supervisory groups as: embodied interaction and initiation by handling. Embodied interaction included: reflection on the experience of the other, sense of body, and present action. Initiation by handling included: facilitating the self-narrative, following the lead of the group, and reflecting in accordance with the group. The role of the facilitator is to parallel process rather than to lead in order to produce practical wisdom. Free-floating discussion and self-evidence from initiation by handling has the potential to promote spontaneity, creativity, and self-confidence in clinical practice and to promote deep learning.
Zaki, Rania. A.
Nursing stress is considered a problem that affects the practice worldwide. Job stress is a harmful response physically and emotionally when the nurses' skills, resources, and needs could not fulfill the requirement of the job. This study was aimed to assess job stress and self-efficacy among psychiatric nursing working in mental health hospitals…
Monique da Silva Carvalho
Full Text Available The aim of this study was to describe the teaching of psychiatric nursing at Ana Néri Nursing School (EAN, between 1925 and 1954. Methodology: Socio-historical research whose sources were written documents and the oral statement of an ex-professor. The documentary analysis technique was used for data treatment. Results: For 27 years, the EAN did not introduce students into the psychiatric field due to the mental illness stigma, offering only theoretical disciplines, which were taught by physicians. Later there were theoretical disciplines with practical training in the classroom, and then theoretical disciplines with practice in psychiatric hospitals, taught by nurses. In conclusion, the law 775/49 lead the EAN to qualify a professor and initiate the reformulation of the nursing care provided at the Institute of Psychiatry of the University of Brazil, so as to adjust it to serve as a practical field and a model for teaching psychiatric nursing in Brazil.
Full Text Available Objective. To examine undergraduate nursing student' attitudes toward people with mental illness and mental health nursing. Methodology. This was a cross sectional descriptive study carried out among conveniently selected nursing students (N=116. Data was collected through self- reported questionnaires. Results: Majority of the participants agreed that the theoretical (81.1% and cpnical placement (85.4% was adequate. Similarly, 62.9% would pke to apply for a post-basic program in Psychiatric nursing and 69.8% of the students intend to pursue their career as mental health nurses. However, a majority expressed that people with mental illness are unpredictable (80.2%, cannot handle too much responsibipty (71.5%, more pkely to commit offences or crimes (84.5% and more pkely to be violent (44%. Negative stereotype domain had significant relationships with future career (r=-0.2, p= 0.003, course effectiveness (r=-0.4, p<0.001, valuable contribution (r=-0.3, p<0.001 and readiness of the students (r=-.3, p<.000 domains. Conclusion. There is an urgent need to address these negative perceptions among nursing students towards people with mental illness. Innovative teaching strategies and appropriate changes in the nursing curriculum is required to prepare future nurses to deal mental health problems effectively.
Burriss, F Antoinette; Breland-Noble, Alfiee M; Webster, Joe L; Soto, Jose A
Juvenile mental health courts for adjudicated youth. To describe the role of psychiatric nurses in reducing mental health disparities for adjudicated youth via juvenile mental health courts. ISI Web of Knowledge; Sage Journals Online; HighWire; PubMed; Google Scholar and Wiley Online Library and websites for psychiatric nursing organizations. Years included: 2000-2010. Juvenile mental health courts may provide a positive and effective alternative to incarceration for youth with mental health problems with psychiatric nurses playing a key role in program implementation. © 2011 Wiley Periodicals, Inc.
Chen, Shing-Chia; Lee, Shih-Kai; Rong, Jiin-Ru; Wu, Chien-Chang; Liu, Wen-I
Case management is a complex process involving multiple activities. It is vital that nurses are competent in all related tasks for case management. A competence scale is a valuable tool for assessing task-related competency. The aims of this study were to examine the reliability and validity of an assessment scale for nurse case management competence and to use this scale to assess the current competency of nurses. A nurse case management competence scale was developed in three stages: (a) selection of assessment items according to standards of practice for case management and literature review, (b) determination of content validity using the Delphi technique with a panel of experts, and (c) psychometric testing of the developed competence scale using a cross-sectional design. Convenience sampling was used to recruit psychiatric nurses at seven psychiatric centers in Taiwan to complete the scale anonymously. An exploratory factor analysis was performed to analyze construct validity. Discriminant validity, internal consistency, and 2-week test-retest reliability were also examined. Two hundred eighty-five psychiatric nurses completed an assessment scale comprising 18 items (originally 25 items). The content validity index reached 0.96 after the Delphi technique was applied twice in the expert panel. Seventy-eight percent of the total variance was explained by two dimension factors: coordination facilitation competence and direct care competence. Participants who had undertaken case management courses had superior case management ability compared with those who had not, indicating that the scale possesses excellent discriminant validity. Cronbach's α and the test-retest results showed excellent reliability. Of the two competence factors, direct care competence (3.03) was better than coordination facilitation competence (2.81). There is a dearth of studies investigating the development and psychometric testing of case management competence scales. The results of this
Hamaideh, S H
Mental health nurses have a crucial role in preventing medical incidents and in promoting safety culture because they provide and coordinate most of patients' care. Therefore, they are able to enhance patients' outcomes and reduce nurses' injuries. The aims of this study were to assess the perception of mental health nurses about patients' safety culture and to detect the factors which may affect patients' safety culture at psychiatric hospitals. A predictive correlational design was employed to collect data about patient safety culture and safety outcomes from 224 mental health nurses working in psychiatric hospitals using Hospital Survey on Patient Safety Culture. Positive scores to patients' safety culture dimensions ranged between 13.4% and 81.2%. Two-thirds of mental health nurses perceived safety as excellent/very good, 20.5% perceived it as acceptable and 10.8% perceived it as poor/failing. Overall perception of safety correlated significantly with four dimensions and explained 32.6% of the variance. Frequency of events reported correlated significantly with six dimensions and explained 23.1% of the variance. Of the 12 dimensions of patients' safety culture, only one was strong, six within acceptable range and five were weak and need improvement. Healthcare managers and policy-makers should encourage educational interventions and help to establish a reporting system that focus on improving systems, not on blaming individuals and encourage open communication among mental healthcare workers. © 2016 International Council of Nurses.
Hayward, Brent A
Psychiatric nurses are familiar with the concept of personality disorder because of their contact with persons with the most common personality disorder in clinical settings - borderline type, who frequently engage mental health services. Perhaps it is this familiarity that has focused research and clinical attention on borderline personality disorder compared with the other personality disorders. The significance of cluster A personality disorders for nursing is multifaceted because of their severity, prevalence, inaccurate diagnosis, poor response to treatment, and similarities to axis I diagnoses. Despite this, literature reviews have established that relatively few studies have focused on the treatment of the cluster A personality disorders - paranoid, schizotypal, and schizoid - resulting in a dearth of evidence-based interventions for this group of clients. A discussion of these disorders in the context of personality disorder and their individual characteristics demonstrates the distinctive and challenging engagement techniques required by psychiatric nurses to provide effective treatment and care. It is also strongly indicated that the discipline of psychiatric nursing has not yet begun to address the care of persons with cluster A personality disorders.
Full Text Available This is a systematic compilation study which aimed to determine whether psychiatry nurses were fatigue of compassion, or not. The screening of several databases revealed four articles fulfilling inclusion criteria of the study. While three of the articles examined were descriptive; one was in cross-sectional pattern. Along the inclusion criterions, no any Turkish article was determined regarding the subject. In these articles, compassion fatigue concept has usually been considered with compassion satisfaction and burnout concepts. According to the findings of aforesaid articles, it was determined that compassion satisfaction of psychiatry nurses was at low level; that their compassion fatigue and burnout levels were high; and as well that they showed post-traumatic stress symptoms. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(4.000: 421-420
Vijayalakshmi, Poreddi; Thimmaiah, Rohini; Chandra, Rama; BadaMath, Suresh
To examine undergraduate nursing student' attitudes toward people with mental illness and mental health nursing. This was a cross sectional descriptive study carried out among conveniently selected nursing students (N=116). Data was collected through self- reported questionnaires. Majority of the participants agreed that the theoretical (81.1%) and clinical placement (85.4%) was adequate. Similarly, 62.9% would like to apply for a post-basic program in Psychiatric nursing and 69.8% of the students intend to pursue their career as mental health nurses. However, a majority expressed that people with mental illness are unpredictable (80.2%), cannot handle too much responsibility(71.5%), more likely to commit offences or crimes (84.5%) and more likely to be violent (44%). Negative stereotype domain had significant relationships with future career (r=-0.2, p= 0.003), course effectiveness (r=-0.4, pstudents (r=-.3, pstudents towards people with mental illness. Innovative teaching strategies and appropriate changes in the nursing curriculum is required to prepare future nurses to deal mental health problems effectively.
Sørensen, Ann Lykkegaard; Nielsen, Lars Peter; Poulsen, Birgitte Klindt
nurses are the health professionals spending most time directly with the patient and very few studies investigate nurses’ role and potential in improving the appropriateness of medication. Therefore, the main objective of this study is to investigate the effect of educating nurses in general pharmacology...... and conducting systematic medication reviews using computer based screening. The effect is evaluated in a controlled interventional study. METHODS: An interventional study including 2 acute psychiatric wards. In one ward nurses’ will receive pharmacological training and the other ward will function as a control....... The nurses will perform approximately 250 medication reviews followed by medication reviews performed by pharmacologists. Primary outcomes are the respective frequencies, types and severity of potential inappropriate prescriptions identified by the nurses and pharmacologists and an estimation...
Dewing, Jan; Traynor, Victoria
Admiral Nurses are specialist dementia care nurses working in the community with carers of those who have a dementia. The aim of the competency project (2000-2003) was threefold. Firstly to work collaboratively with these specialist nurses to facilitate the development a competency framework that reflects the needs of the Admiral Nursing Service. Secondly, to provide a way to structure evidence demonstrating evolving competency. Thirdly, to specifically enable the nurses to demonstrate evidence of achieving the UK Nursing and Midwifery Council's Higher Level Practice standard. The two complementary approaches of emancipatory action research and systematic practice development were adopted. Methods were taken from action research and systematic practice development approaches with an emphasis on promoting and enabling enlightenment, critical reflection, ownership and creating the best conditions for long-term commitment to the competency framework. The main outcome from this project was the development of a specialist nursing competency framework. The Admiral Nurses' Competency Framework is made up of a set of eight core competencies with three levels of competency statements, loosely structured around the Higher Level Practice standard, and guidance documentation to illustrate how work-based evidence can be generated to demonstrate competence. There were also process-derived outcomes associated with combining systematic practice development with emancipatory action research that had an impact on the culture. The main outcomes here were that practitioners engaged in and experienced learning about how to research their own practice and the consequences of doing this. They also learnt about specialist nursing practice more widely than Admiral Nursing. Finally, there was some increase in awareness about the culture within their teams and organizations. The final competency framework reflects the needs of the service, is owned by the majority of practitioners and
Salgado,Patrícia de Oliveira; Chianca,Tânia Couto Machado
This is a descriptive study with the aim of examining the nursing diagnoses labels and actions prescribed by nurses in the clinical records of patients hospitalized in an Adult Intensive Care Unit. A sample of 44 clinical records was obtained and a total of 1087 nursing diagnoses and 2260 nursing actions were identified. After exclusion of repetitions 28 different nursing diagnoses labels and 124 different nursing actions were found. Twenty-five nursing diagnoses labels were related to human ...
Angermeyer, Matthias C; Bull, Nadine; Bernert, Sebastian; Dietrich, Sandra; Kopf, Andrea
Care of a person with mental illness involves multiple burdens, possibly leading to burnout. This study compares partners of persons with schizophrenia and depression with nursing staff based on dimensions of burnout. Nursing staff and partners of patients with schizophrenia or depression were consecutively recruited from psychiatric hospitals and interviewed with the Maslach Burnout Inventory. No significant differences were found in the three dimensions of burnout (emotional exhaustion, depersonalization, and personal accomplishment) for the two groups of caregivers. About one fourth of the respondents in both groups showed a high degree of burnout. Professional and nonprofessional caregivers face a similar degree of burden and need support to perform their caretaking tasks.
Sørensen, Ann Lykkegaard; Mainz, Jan; Poulsen, Birgitte Klindt
nurses are the health professionals spending most time directly with the patient and very few studies investigate nurses’ role and potential in improving the appropriateness of medication. Therefore, the main objective of this study is to investigate the effect of educating nurses in general pharmacology......OBJECTIVES: There is an increasing demand for medication reviews to improve the quality of prescribing for patients with chronic illness such as psychiatric patients. Traditionally, this has been undertaken by physicians. Pharmacists have also proven to be a resource in this field but registered...... and conducting systematic medication reviews using computer based screening. The effect is evaluated in a controlled interventional study. METHODS: An interventional study including 2 acute psychiatric wards. In one ward nurses’ will receive pharmacological training and the other ward will function as a control...
Full Text Available Increasing number of people who live with mental health problems for many years in the community brings into focus the need for recovery within a coping and mental health promotion perspective. The value of the salutogenic theory is that it emphasizes promoting coping and health. This article aims to illustrate how Antonovskys salutogenic theory and its central concept of sense of coherence and discusses how mental health nurses can use the theories in their praxis. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(3.000: 284-300
Newby, Amy; McGuinness, Teena M
Psychiatric nurses are in key positions to identify and stop human trafficking, as well as aid its survivors. The combination of emotional trauma, sexual violence, and physical injuries experienced by these victims leads to high rates of posttraumatic stress disorder, depression, and anxiety. To detect human trafficking, it is important to identify the salient risk factors of homelessness and runaway history. This article offers key questions to help identify victims, as well as web-based resources. Copyright 2012, SLACK Incorporated.
Full Text Available This study explored the factor structure of psychiatric nurses’ job-related stress and examined the specificity of the related stressors using the job stressor scale of the Brief Job Stress Questionnaire (BJSQ. The stressor scale of the BJSQ was administered to 296 nurses and assistant nurses. Answers were examined statistically. Exploratory factor analysis was performed to identify factor structures; two factors (overload and job environment were valid. Confirmatory factor analysis was conducted to examine the two-factor structure and found 11 items with factor loadings of >0.40 (model 1, 13 items with factor loadings from 0.30 to <0.40 (model 2, and 17 items with factor loadings from 0.20 to <0.30 (model 3 for one factor; model 1 demonstrated the highest goodness of fit. Then, we observed that the two-factor structure (model 1 showed a higher goodness of fit than the original six-factor structure. This differed from subscales based on general workers’ job-related stressors, suggesting that the factor structure of psychiatric nurses’ job-related stressors is specific. Further steps may be necessary to reduce job-related stress specifically related to overload including attention to many needs of patients and job environment including complex ethical dilemmas in psychiatric nursing.
Horton-Deutsch, Sara; McNelis, Angela M; Day, Pamela O'Haver
This article discusses theoretical underpinnings, teaching strategies, and preliminary evaluation relative to the development of a reflective curriculum used in our distance-accessible graduate psychiatric nursing program. Influenced by the collective ideas of J. Dewey (1993), J. Reed and S. Proctor (1993), D. A. Kolbe (1984), J. Mezirow (1981), C. Johns (2006), D. Schön (1983), D. Freshwater (2008), and others who have promoted reflection as a transformative teaching and learning process, we sought to develop a curriculum that balanced knowledge and skill acquisition with critical reflective practices that would instill habits of lifelong learning. We began with traditional approaches to psychiatric nursing education, including case study analysis and modified lectures that we call mini lectures. We then added principles and practices of reflection to allow for merging these traditional approaches with contemporary reflection-focused approaches. Specific ways to use reflection in a graduate psychiatric nursing curriculum are described to demonstrate how we have taken our curriculum beyond traditional ways of teaching and learning toward one that emphasizes building knowledge and skill through reflective practice. Copyright © 2012 Elsevier Inc. All rights reserved.
Robertson, Maggie; Paterson, Brodie; Lauder, Billy; Fenton, Rosemary; Gavin, John
Whilst the experience of a patient suicide is likely to have a significant impact upon the nurses who had been providing care, little work has actually explored this experience in any depth. In this article we explore how two psychiatric nurses construct and orient to accountability when talking of their experiences of a patient suicide. Discourse analysis was used to explore particular phases that the nurses oriented to in their accounts: scene setting; risk assessment; attributing for the suicide. Findings highlight the different, sometimes contradictory, ways the nurses attended to interactional concerns relating to implicit accountability and potential inferences of blame. Analysis of the nurses' talk can make a valuable contribution to understanding the nature and the impact of 'accountability' in a mental health setting and so help nurses and other professionals gain an insight into their practice. The results from this study suggest that as a consequence of internalising fundamentally unrealisable expectations regarding suicide prevention, nurses can hold themselves to blame raising significant concerns around their needs in terms of support, which may not be recognised. This paper also makes a valuable contribution to our methodological understanding and the value of using discourse analysis in this setting.
Canciani, Eleonora; Spotti, Daniela; Bonetti, Loris
Moral distress (MD) is a painful feeling and/or psychological disequilibrium, which may lead to negative consequences into the wellness of a nurse's working life. Nurses who work in psychiatry are more likely to experience a different type of MD compared with nurses of other contexts. In Italy a tool to evaluate MD in nurses who work in psychiatry doesn't exist. The aim of this study is to validate the Moral Distress Scale for Psychiatric Nurses (MDS-P) in Italian language. For translation the forward and back-translation has been used; the effectiveness regarding content and face validity of the translated scale has been analyzed through a focus group with experts of the field. In order to check the reliability of the scale the test-retest method has been used, by means of the determination of Spearman's correlation coefficient, Intraclass Correlation Coefficient (ICC) and Cronbach's alpha. The forward and back-translation process was successful. During the focus group analysis, 8 items were added to the 15 items of the original scale, due to experts suggestions. 32 nurses took part in the test-retest phase. Spearman's correlation coefficient resulted to be 0,91, ICC > 0,9, Cronbach's alpha calculated on test and retest, was always >0,9. The Italian version of the MDS-P proves to be an effective, appropriate and reliable instrument to measure the MD phenomenon within the population of nurses who work in the psychia- tric field in Italy.
DeCoux Hampton, Michelle
With the popularity of accelerated pre-licensure nursing programmes and the growth in nursing student enrolments, traditional clinical education continues to be a challenge to deliver. Nursing faculty members are required to develop and implement educational innovations that achieve effective learning outcomes, while using fewer resources. The purpose of this qualitative study was to explore the effectiveness of a constructivism-based learning project to achieve specific learning outcomes and to supplement approximately 30 clinical hours in a psychiatric-mental health nursing course. Students participated in a 10-week, multistage project that examined life histories, treatment resources, and evidence-based practice, as applied to a single individual with a mental illness. Students reported increased understanding of mental health and illness, developed personal relevance associated with the knowledge gained, and learned to problem solve with regard to nursing care of individuals diagnosed with mental illness. For many students, there also appeared to be a reduction in stigmatized attitudes towards mental illness. Constructivism-based learning is a promising alternative to supplement clinical hours, while effectively achieving learning outcomes. Future research is needed to further validate the use of this method for the learning of course content, as well as the reduction of stigma. © 2011 The Author. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
Full Text Available Moral distress of psychiatric nurses may affect their job satisfaction or quality of nursing care, thus examination of their moral distress is a significant issue for practice. The purpose of this study was to investigate the level of moral distress and job satisfaction, and association between moral distress and job satisfaction. One hundred and thirty nurses who worked in psychiatric wards in a hospital in Japan completed the Moral Distress Scale for psychiatric nurses (MDS-P and the Job Satisfaction scale (JS. The MDS-P consisted of subdomains such as “unethical conduct by caregivers,” “low staffing,” and “acquiescence to violations of patients’ rights” in intensity and frequency; the JS consisted of seven subcategories. An institutional review board in the researcher’s college approved this study. Results showed that the “acquiescence to violations of patients’ rights” was the highest of the subdomains of MDS-P, and the “interactions among nurses” was the highest of the subdomains of the JS. The unethical conduct by caregivers (MDS-P score was negatively correlated with administration (JS for intensity (r = -.40, p < .001 and frequency (r = .37, p < .001. Moreover “acquiescence to violations of patients’ rights (MDS-P” was also negatively correlated with the “task requirement (JS” score for intensity (r = -0.49, p < .001 and for frequency (r = -0.50, p < .001. These results suggest that reduction of moral distress increases job satisfaction particularly for administration and task requirement in nursing care.
This study explored registered psychiatric nurses\\' (RPNs\\') interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD). A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the "staff-patient interaction response scale" (SPIRS). Four themes emerged following data analysis: "challenging and difficult," "manipulative, destructive and threatening behaviour," "preying on the vulnerable resulting in splitting staff and other service users," and "boundaries and structure." Additionally, low levels of empathy were evident in the majority of participants\\' responses to the SPIRS. The findings provide further insight on nurses\\' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.
Full Text Available This study explored registered psychiatric nurses' (RPNs' interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD. A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the “staff-patient interaction response scale” (SPIRS. Four themes emerged following data analysis: “challenging and difficult,” “manipulative, destructive and threatening behaviour,” “preying on the vulnerable resulting in splitting staff and other service users,” and “boundaries and structure.” Additionally, low levels of empathy were evident in the majority of participants' responses to the SPIRS. The findings provide further insight on nurses' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.
Delaney, Kathleen R
The mental health service delivery transformation has created models of care that generate demand for a workforce with particular competencies. This article develops a psychiatric mental health (PMH) nursing workforce agenda in light of demand generated by new models of care and the capacity/capabilities of the PMH RN and advanced practice nurse (APN) workforce. Examine the current capacity of the PMH nursing workforce and how health care reform and related service delivery models create demand for a particular set of behavioral health workforce competencies. PMH RNs and APNs have an educational background that facilitates development of competencies in screening, care coordination, leveling care, and wellness education. PMH RNs are a large workforce but the size of the PMH APN group is inadequate to meet demand. The specialty must strategize on how to build requisite PMH RN and APN competencies for the evolving service landscape. © The Author(s) 2016.
Escalada Hernández, Paula; Muñoz Hermoso, Paula; Marro Larrañaga, Itxaso
The purpose of this literature review is to provide a synthesis of the most relevant studies describing nursing work in mental health by means of NNN taxonomy. Literature from 1990 to September 2011 was reviewed using the "scoping review" methodology. Three independent reviewers examined the articles which were found and selected those fulfilling the inclusion criteria for subsequent analysis. From the 220 articles obtained, 14 studies were finally included and divided into two groups. The aim of the first ten papers was examining the most frequent NANDA nursing diagnosis or/and NIC nursing interventions in different mental health care settings. The remaining four articles describe health care plans for psychiatric patients developed with NNN taxonomy. Combining results from both groups, the most prevalent diagnostic labels are: disturbed thought processes and impaired social interaction. This review has illustrated the lack of evidence in relation to NNN taxonomy in the field of mental health and the need of further research in this area.
Kirchmeyer, Catherine; Bullin, Carol
A study of 12 emergency, 27 operating, 25 intensive care, and 22 psychiatric nurses in Canada demonstrated that, although gender roles appeared androgynous, the masculine component of nursing was more valued and rewarded. High masculinity was associated with higher pay, high femininity with low experience. Gender roles represented complex…
Collins, Anita; Vanderheide, Rebecca; McKenna, Lisa
Abstract Noise overload within the clinical environment has been found to interfere with the healing process for patients, as well as nurses' ability to assess patients effectively. Awareness and responsibility for noise production begins during initial nursing training and consequently a program to enhance aural awareness skills was designed for graduate entry nursing students in an Australian university. The program utilized an innovative combination of music education activities to develop the students' ability to distinguishing individual sounds (hearing), appreciate patients' experience of sounds (listening) and improve their auscultation skills and reduce the negative effects of noise on patients (action). Using a mixed methods approach, students reported heightened auscultation skills and greater recognition of both patients' and clinicians' aural overload. Results of this pilot suggest that music education activities can assist nursing students to develop their aural awareness and to action changes within the clinical environment to improve the patient's experience of noise.
Aline Carniato Dalle Nogario
Full Text Available OBJECTIVEUnderstanding nursing actions in the practice of inpatient advocacy in a burn unit.METHODA single and descriptive case study, carried out with nurses working in a referral burn center in southern Brazil. Data were collected through focus group technique, between February and March 2014, in three meetings. Data was analysed through discursive textual analysis.RESULTSThree emerging categories were identified, namely: (1 instructing the patient; (2 protecting the patient; and (3 ensuring the quality of care.CONCLUSIONSThis study identified that the nurses investigated exercised patient advocacy and that the recognition of their actions is an advance for the profession, contributing to the autonomy of nurses and the effectiveness of patients' rights and social justice.
Hou, Shu-Ying; Pan, Shung-Mei; Ko, Nai-Ying; Liu, Hsiu-Chin; Wu, Shu-Jung; Yang, Wen-Chiung; Yang, Hsing-Hu; Shieh, Shiu-Fen; Chuang, Li-Yu; Yen, Cheng-Fang
This study examined the association between attitudes toward homosexual individuals and intention to provide care and demographic and occupational factors, sexual orientation, knowledge about homosexuality, and experiences of contact with homosexual people among psychiatric nurses in southern Taiwan. In total, 133 psychiatric nurses from a medical center, three regional teaching hospitals, and one psychiatric hospital in southern Taiwan were recruited into this study. Their attitudes toward homosexual people as recorded on the Attitudes Toward Homosexuality Questionnaire, intention to provide care to homosexual individuals, and related factors were examined. The results revealed that psychiatric nurses who had a bachelor's or master's degree, higher level of knowledge about homosexuality, and friends or relatives with a homosexual orientation had a more positive attitude toward homosexuality. These psychiatric nurses, with more positive attitudes, and who worked in the medical center or regional teaching hospitals had a higher intention to care for homosexual people. The factors related to attitudes toward homosexuality and intention to care for homosexual people identified in this study should be taken into consideration when intervening in psychiatric nurses' attitudes toward homosexuality and intention to care for homosexual people.
McLoughlin, Kris A; Du Wick, Amanda; Collazzi, Charlene M; Puntil, Cheryl
There is a national initiative to integrate recovery-oriented practices into the delivery of mental health services. Few empirical studies have been conducted to measure these practices in psychiatric-mental health (PMH) nursing, particularly in short-term acute hospital settings. This study examined the reliability of the Recovery Self Assessment-Registered Nurse Version (RSA-RN) and explored recovery practices of PMH nurses and nursing staff in an acute treatment setting. A descriptive one-group design with convenience sampling was employed. One hundred and five participants completed the RSA-RN and the demographic data form. The RSA-RN full-scale instrument demonstrated excellent internal consistency, and the five subscales demonstrated acceptable internal consistency. Significant, favorable relationships were found between RSA-RN scores and nursing staff who (a) had formal education in mental health recovery, (b) considered themselves knowledgeable about recovery, and (c) considered their place of work to be "recovery-oriented." The RSA-RN is a useful tool in measuring recovery-oriented practice. Formal education should be considered as an intervention to increase recovery-oriented practices in PMH nursing.
Machado, Márcia Maria Tavares; Leitão, Glória da Conceição Mesquita; de Holanda, Francisco Uribam Xavier
Nurses often adopt a mechanist view, perceiving the individual from a biological standpoint and giving little attention to psychological, historical and cultural aspects. This evidences the need for a more humane approach, in which the communication between nurses and health service users can be achieved with more comprehension and participation. The aim of this paper is to introduce the concepts of language and communication in nursing consultation, using as a theoretical and conceptual framework Jürgen Habermas' theory of universal pragmatism. In nurses' everyday routine, it is important to intermediate and adapt knowledge and technical skills with a view to effective performance in humanized care for individuals and the community. The dialogic practice, through reflexive and participative communicative action by nurses, is needed for more humane care.
Casey, Mary; O' Leary, Denise; Coghlan, David
The aim of this study was to unpack the key concepts of action research and implementation science thereby enabling appropriate use of these methods in nursing. A key issue in action research is not so much the methodology employed to gather data/evidence but who decides the research agenda and who benefits from it. Implementation science is a way to ensure that evidence is translated into practice. The question arises as to how action research and implementation may be understood in relation to one another in nursing. Discussion Paper DATA SOURCES: This discussion paper is based on our own experiences and offers an exploration of action research and implementation science with the aim of clarifying what each involves and what synergies, if any, exist between them. Using action research to secure the voice of patients in their own care is essential to delivering quality nursing care. Using implementation science frameworks to get research evidence into practice is effective. Familiarity with both these concepts may enable their improved use and have a positive impact on quality of care. There is a tension between action researchers and the protagonists of implementation science related to perceived "trade offs" between what constitutes "science" and the necessity of community participation. Nevertheless, the use of an implementation science framework in an action research approach can reduce the research practice time lag and action research provides sound theoretical and philosophical underpinnings that can be used by those in the implementation science field. © 2017 John Wiley & Sons Ltd.
Moreno-Poyato, Antonio R; Montesó-Curto, Pilar; Delgado-Hito, Pilar; Suárez-Pérez, Raquel; Aceña-Domínguez, Rosa; Carreras-Salvador, Regina; Leyva-Moral, Juan M; Lluch-Canut, Teresa; Roldán-Merino, Juan F
To study the significance of 'therapeutic relationship' between nurses and patients within the context of a psychiatric hospital. Narrative literature review. Content analysis. The significance of the therapeutic relationship is quite similar for both nurses and patients in psychiatric hospital units. Nevertheless, several factors may separate the two positions: the time available for the relationship, the negative perceptions on the part of both parties, and the insecurity of the setting. Increased knowledge and understanding of the significance of the therapeutic relationship from the perspective of nurses and patients would allow the strengthening of areas of mutual interest. Copyright Â© 2016 Elsevier Inc. All rights reserved.
Ehlers, V J
Students who followed the above course did so as part of the Nursing Education III course offered at UNISA. This research aims at establishing a profile of these students. Aspects covered include age, sex, marital status, professional and academic qualifications, professional posts held and current fields of occupation. Such knowledge will clarify who the psychiatric nurse educators of the future might be, and also what the target population for the above course could be. Students' personal perceptions of the above course are sought in the second part of the questionnaire. Such information should be valuable in improving future courses for educators of psychiatric nurses.
Salgado, Patrícia de Oliveira; Chianca, Tânia Couto Machado
This is a descriptive study with the aim of examining the nursing diagnoses labels and actions prescribed by nurses in the clinical records of patients hospitalized in an Adult Intensive Care Unit. A sample of 44 clinical records was obtained and a total of 1087 nursing diagnoses and 2260 nursing actions were identified. After exclusion of repetitions 28 different nursing diagnoses labels and 124 different nursing actions were found. Twenty-five nursing diagnoses labels were related to human psychobiological needs and three to psychosocial needs. All the nursing actions were mapped to the physiological needs and also to interventions of the Nursing Interventions Classification-NIC. Concordance of 100% was obtained between the experts in the validation process of the mapping performed, both for the nursing diagnoses labels and actions. Similar studies should be conducted for the identification and development of nursing diagnoses and actions.
Gandhi, Sailaxmi; Sangeetha, G; Ahmed, Nurnahar; Chaturvedi, S K
High stress perception by nurses caring for psychiatric patients can lead to somatic symptoms which impact on their job satisfaction perception. To assess and correlate the level of somatic symptoms, perceived stress and perceived job satisfaction among the subjects. The authors used a descriptive correlation design to invite 150 nurses of both genders working for more than one year with psychiatric patients. The Scale for Assessment of Somatic Symptoms (Chaturvedi et al., 1987) and a Visual Analogue Scale (VAS) for stress and job satisfaction perception were used to collect data. The nurses (128) reported mainly pain related (4.87±2.97) somatic symptoms. Somatic symptoms positively correlated (r=0.302) with stress perception and negatively correlated (r=-0.231) with perceived job satisfaction, while perceived stress and perceived job satisfaction were negatively correlated (r=-0.460, p=0.000). The results indicate a need for stress management interventions. Copyright © 2014 Elsevier B.V. All rights reserved.
Yadav, B L
Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient\\'s clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses\\' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.
Kelly da Silva Rocha Estrela
Full Text Available This qualitative study aimed to analyze the clinical criteria used for the administration of prescribed medications for use when needed (SOS; and discuss the implication of the findings in this research to clinical psychiatric nursing. The records of female patients admitted to a psychiatric institution in the city of Rio de Janeiro, in the time frame from May to June 2009, were analyzed. In the 38 patient records, 16 prescriptions for medications SOS were found. The mean age of patients was around 45-55 years with a clinical diagnosis of Bipolar Mood Disorder. The medication category most prescribed as SOS was of benzodiazepines, followed by antipsychotics. It was noticed a tendency to not valuing the administration of medication in SOS notes. The study points out the importance to establish clinical criteria to indicate the need, or not, to administer prescribed SOS medications.
Smith, G B
Stereotypic and stigmatic attitudes toward homosexuality may interfere both directly and indirectly with the care provided to gay and lesbian patients. The purpose of this study was to measure attitudes toward gays and lesbians and assess homophobia among psychiatric nurses. The demographic characteristics of education, religious identification, and knowledge of gays and lesbians had positive affects on attitudes and homophobia. The Attitudes Towards Gays and Lesbians Scale (ATGLS) developed by the researcher specifically for this study assessed cognitive attitudes and the Index of Homophobia (IHP), developed by Hudson and Ricketts (1980), measured homophobia, the affective response to gays and lesbians.
Full Text Available Changes to Earth’s climate are occurring globally at unprecedented rates with significant impacts to human and population health, including increased likelihood of mental health illnesses, food and water insecurity, insect-borne and heat-related illnesses, and respiratory diseases. Those in the health sector are seeing the challenges patients and community members are experiencing as a result of current and projected climate threats. Health professionals, including nurses, have an opportunity to lead the charge to significantly improve society’s response to climate change and foster the strategies needed to promote health. This article highlights the current work of the Alliance of Nurses for Healthy Environments, a national nursing organization focused solely on environmental health concerns, in inspiring and empowering nurses across the country to engage in action to reduce their climate impact, move climate solutions forward, and improve the ability of health care institutions and communities to respond to the health impacts of climate change.
Camargo, Ana Luiza Lourenço Simões; Maluf Neto, Alfredo; Colman, Fátima Tahira; Citero, Vanessa de Albuquerque
There is high prevalence of mental and behavioral disorders in general hospitals, thus triggering psychiatric risk situations. This study aimed to develop a psychiatric risk assessment checklist and routine for nurses, the Psychiatric Risk Evaluation Check-List (PRE-CL), as an alternative model for early identification and management of these situations in general hospitals. Ethnographic qualitative study in a tertiary-level private hospital. Three hundred general-unit nurses participated in the study. Reports were gathered through open groups conducted by a trained nurse, at shift changes for two months. The questions used were: "Would you consider it helpful to discuss daily practice situations with a psychiatrist? Which situations?" The data were qualitatively analyzed through an ethnographic approach. The nurses considered it useful to discuss daily practice situations relating to mental and behavioral disorders with a psychiatrist. Their reports were used to develop PRE-CL, within the patient overall risk assessment routine for all inpatients within 24 hours after admission and every 48 hours thereafter. Whenever one item was present, the psychosomatic medicine team was notified. They went to the unit, gathered data from the nurses, patient files and, if necessary, attending doctors, and decided on the risk management: guidance, safety measures or mental health consultation. It is possible to develop a model for detecting and intervening in psychiatric and behavioral disorders at general hospitals based on nursing team observations, through a checklist that takes these observations into account and a routine inserted into daily practice.
Heydari, Abbas; Meshkinyazd, Ali; Soudmand, Parvaneh
Objective: Nurses are the most important staff in the health care system, thus, their job satisfaction is important in nursing management. The present study aimed at determining the impact of teaching spiritual intelligence on the job satisfaction of psychiatric nurses. Method: The participants were divided into 2 groups by random allocation. Data were collected in 3 stages of before intervention, 4 weeks, and 8 weeks post intervention using Brayfield & Rother Job Satisfaction Questionnaire. Results: The results of this study revealed that the mean score of job satisfaction in the experimental group was 65.5±9.9 in the pre intervention stage, which increased to 69.8±6.3 one month after the intervention and to 72.5±8.9 in 2 months after the intervention, and it was significantly more than that of the control group. Conclusion: The job satisfaction rate of the control group decreased admirably in both 1 month and 2 months after the intervention stage. Thus, spiritual intelligence training is an effective method to increase job satisfaction, and it is suggested that managers consider spiritual intelligence training to increase job satisfaction in nurses.
Lakatos, Barbara E; Delisle, Leslie; Mitchell, Monique; Etheredge, Mary Lou
The role of the psychiatric advanced practice nurse in promoting psychological health and resiliency for patients, their families and staff following the Boston Marathon bombings is reviewed. On April 15, 2013, 2 bombs exploded near the finish line at the Boston Marathon. Within minutes, 39 patients suffering from multiple injuries presented at a level I trauma center. The magnitude of this event and its effect on our hospital required a comprehensive response that would promote resiliency and healing. Lessons shared from responders to other tragedies were helpful in guiding our interprofessional efforts. The multiple layers of our response are reviewed to offer learnings that may inform others as they work to promote resiliency and healing following traumatic events. In response to this event, we utilized a trauma-informed care framework emphasizing physical, psychological, and emotional safety to assist staff, survivors, and families on their journey of healing. Emotional reactions were dramatic but were eased by the psychological care and education that our patients, their families, and staff received in the first days to weeks after the bombings. The psychiatric advanced practice nurse can influence positive outcomes by utilizing a trauma-informed care framework.
Bennett, Clare; Perry, Jane; Lapworth, Tracy; Davies, Judith; Preece, Vicky
Since April 2006, commissioning responsibility for healthcare services in public prisons has been fully devolved to NHS primary care trusts (PCTs), with the expectation that offenders will have access to the same range and quality of health services available to the wider population. In order to support prison nurses in meeting this goal, a PCT and university established a partnership, which used an action research approach to develop, instigate and evaluate a bespoke educational programme for nurses working in two local prisons. This article outlines the processes involved in the design and implementation of the programme. It also reports on findings from pre- and post-intervention questionnaires and focus groups with course participants, and semi-structured interviews with key stakeholders, which suggest that the innovation had a positive impact on the nurses' confidence, assertiveness, clinical expertise and approach to change. The article concludes that the action research project should continue, but its scope should now broaden to address educational support for healthcare assistants, collaborative learning between prison officers and prison nurses, and the implementation of clinical supervision and action learning sets.
Lia Leão Ciuffo
Full Text Available Objective. Understanding the role of nurses as members of interdisciplinary teams in the care of children with suspected sexual abuse. Methodology. This is a qualitative research based on the sociological phenomenology of Alfred Schutz. In 2008 were interviewed eleven nurses who worked in reference institutions for the care of child victims of sexual abuse in Rio de Janeiro. Results. The category called 'Interacting with other professionals in child care' emerged from the analysis of performance of professionals. The intersubjective relations between the nurses and the interdisciplinary team will enable to understand the intent of care from the perspective of social, emotional and psychological needs of children and their families. Conclusion. Interdisciplinarity favored the development of actions based on acceptance, listening and agreements on possible solutions in the care of children with suspected sexual abuse.
Full Text Available Abstract Background The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. Methods 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. Results The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. Conclusions The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways.
Ebrahimi, Hossein; Namdar, Hossein; Vahidi, Maryam
Stigma is one of the obstacles in the treatment and regaining the mental health of people with mental illness. The aim was determination of mental illness stigma among nurses in psychiatric wards. This study was conducted in psychiatric wards of teaching hospitals in Tabriz, Urmia, and Ardabil in the north-west of Iran. This research is a descriptive analysis study in which 80 nurses participated. A researcher-made questionnaire was used, which measured demographic characteristics and mental illness stigma in the three components of cognitive, emotional, and behavioral. All data were analyzed using SPSS13 software and descriptive and analytical statistics. Majority of nurses (72.5%) had medium level of stigma toward people with mental illness. About half of them (48.8%) had great inclination toward the social isolation of patients. The majority of them (62.5%) had positive emotional responses and 27.5% had stereotypical views. There was a significant correlation between experience of living with and kinship of nurses to person with mental illness, with prejudice toward and discrimination of patients. There was also a significant correlation between interest in the continuation of work in the psychiatric ward and prejudice, and also between educational degree and stereotypical views. The data suggest there is a close correlation between the personal experience of nurses and existence of mental illness stigma among them. Therefore, the implementation of constant educational programs on mental illness for nurses and opportunities for them to have direct contact with treated patients is suggested.
McGarry, Denise; Cashin, Andrew; Fowler, Cathrine
Child and adolescent psychiatric nursing (CAPN) as a discipline has been remarkably slow in the uptake of high fidelity human patient simulation (HFHPS) as an education tool. Assuming HFHPS has potential use, and the issue is one of change management, this paper speculates about how Lewin's paradigm for Planned Change might provide guidance to the specialty discipline of CAPN in development of strategies to promote adoption of HFHPS to education of pre-registration nurses. Kurt Lewin (1890-1947) was a seminal theorist of change, whose pioneering work has had significant impact across many disciplines. His theory of Planned Change has four components - field theory, group dynamics, action research and the three-step model of change. Each component is considered briefly and then combined within an example of application.
A society that values mental health and helps people live enjoyable and meaningful lives is a clear aspiration echoed throughout our Canadian health care system. The Mental Health Commission of Canada has put forth a framework for a mental health strategy with goals that reflect the virtue of optimal mental health for all Canadians (Mental Health Commission Canada, 2009). Canadian nurses, the largest group of health care workers, have a vital role in achieving these goals. In Canada, two-thirds of those who experience mental health problems do not receive mental health services (Statistics Canada, 2003). Through a gendered, critical, and sociological perspective the goal of this paper is to further understand how the past has shaped the present state of psychiatric mental health nursing (PMHN). This integrative literature review offers a depiction of Canadian PMHN in light of the intersections of history, gender, education, and quality of nursing work life. Fourteen articles were selected, which provide a partial reflection of contemporary Canadian PMHN. Findings include the association between gender and professional status, inconsistencies in psychiatric nursing education, and the limitations for Canadian nurse practitioners to advance the role of the psychiatric mental health nurse practitioner. PMID:23710367
Smith, Mary; Khanlou, Nazilla
A society that values mental health and helps people live enjoyable and meaningful lives is a clear aspiration echoed throughout our Canadian health care system. The Mental Health Commission of Canada has put forth a framework for a mental health strategy with goals that reflect the virtue of optimal mental health for all Canadians (Mental Health Commission Canada, 2009). Canadian nurses, the largest group of health care workers, have a vital role in achieving these goals. In Canada, two-thirds of those who experience mental health problems do not receive mental health services (Statistics Canada, 2003). Through a gendered, critical, and sociological perspective the goal of this paper is to further understand how the past has shaped the present state of psychiatric mental health nursing (PMHN). This integrative literature review offers a depiction of Canadian PMHN in light of the intersections of history, gender, education, and quality of nursing work life. Fourteen articles were selected, which provide a partial reflection of contemporary Canadian PMHN. Findings include the association between gender and professional status, inconsistencies in psychiatric nursing education, and the limitations for Canadian nurse practitioners to advance the role of the psychiatric mental health nurse practitioner.
Elisha M. Okaisu
Full Text Available Background: Documentation is an important function of professional nursing practise. In spite of numerous improvement efforts globally, inadequate documentation continues to be reported as nurse authors investigate barriers and challenges. Objectives: The project aimed to improve nurses’ documentation of their patient assessments at the CURE Children’s Hospital of Uganda in order to enhance the quality of nursing practise. Method: An action research methodology, using repeated cycles of planning, intervention, reflection and modification, was used to establish best practise approaches in this context for improving nurses’ efficacy in documenting assessments in the patient record. The researchers gathered data from chart audits, literature reviews and key informant interviews. Through analysis and critical reflection, these data informed three cycles of systems and practise modifications to improve the quality of documentation. Results: The initial cycle revealed that staff training alone was insufficient to achievethe project goal. To achieve improved documentation, broader changes were necessary, including building a critical mass of competent staff, redesigned orientation and continuing education, documentation form redesign, changes in nurse skill mix, and continuous leadership support. Conclusion: Improving nursing documentation involved complex challenges in this setting and demanded multiple approaches. Evidence-based practise was the foundation of changes in systems required to produce visible improvement in practise. The involved role of leadership in these efforts was very important.
Scerri, Josianne; Cassar, Rebecca
Individuals with adult or juvenile Huntington disease can be cared for within psychiatric hospitals. In this paper, nurses' perceptions about the appropriateness of a psychiatric setting for these patients were explored. Semistructured interviews were conducted with 10 Maltese nurses involved in the care of these individuals. Their responses were analyzed using thematic analysis. Three main themes were identified from this study: (i) Huntington disease is not a mental illness; (ii) the lack of specialized staff and equipment within a psychiatric setting; and (iii) a need for alternative care options. The findings provide an insight into the perceptions of nurses, as they play a key role in the care and management of individuals with Huntington disease in a psychiatric setting. The findings demonstrated the need to provide alternative residential options in the community, and to improve the care and support provided both within psychiatric hospitals and the community through staff education and the provision of necessary facilities and equipment. © 2013 Wiley Publishing Asia Pty Ltd.
Ehnfors, Margareta; Angermo, Lilly Marit; Berring, Lene
The aims of this study were to analyze the coherence between the concepts for nursing interventions in the Swedish VIPS model for nursing recording and the ISO Reference Terminology Model for Nursing Actions and to identify areas in the two models for further development. Seven Scandinavian experts...... analyzed the VIPS model's concepts for nursing interventions using prototypical examples of nursing actions, involving 233 units of analyses, and collaborated in mapping the two models. All nursing interventions in the VIPS model comprise actions and targets, but a few lack explicit expressions of means....... In most cases, the recipient of care is implicit. Expressions for the aim of an action are absent from the ISO model. By this mapping we identified areas for future development of the VIPS model and the experience from nursing terminology work in Scandinavia can contribute to the international...
Lauge Berring, Lene; Ehnfors, Margareta; Angermo, Lilly
The aims of this study were to analyze the coherence between the concepts for nursing interventions in the Swedish VIPS model for nursing recording and the ISO Reference Terminology Model for Nursing Actions and to identify areas in the two models for further development. Seven Scandinavian experts...... analyzed the VIPS model's concepts for nursing interventions using prototypical examples of nursing actions, involving 233 units of analyses, and collaborated in mapping the two models. All nursing interventions in the VIPS model comprise actions and targets, but a few lack explicit expressions of means....... In most cases, the recipient of care is implicit. Expressions for the aim of an action are absent from the ISO model. By this mapping we identified areas for future development of the VIPS model and the experience from nursing terminology work in Scandinavia can contribute to the international...
Parry-Jones, Beth; Grant, Gordon; McGrath, Morag; Caldock, Kerry; Ramcharan, Paul; Robinson, Catherine A.
The introduction in April 1993 of new arrangements for assessment and care management following the NHS and Community Care Act 1990 (Department of Health 1990a) heralded a period of major transition for front-line workers in the health and social services. Policy expectations for the development of the purchaser/provider split and the 'new managerialism' have posed unprecedented ideological, organizational and professional challenges. Two years after the full implementation of the reforms a postal survey of the experiences of care managers about policy and practice changes was undertaken in Wales. This paper focuses on the stresses and satisfactions of care management practice among three distinct groups of front-line workers: social workers, community nurses and community psychiatric nurses. The results of multiple regression analyses, corroborated by qualitative data, implicate an increased workload in general and administrative work in particular, combined with reduced opportunities for client contact, as the main sources of stress. Being able to control or shape those factors impinging on the experience of stress and job satisfaction appears to lie at the heart of the dilemma. Practice and policy implications are considered.
Horton-Deutsch, Sara; McNelis, Angela M; Day, Pamela O'Haver
In 2008, we created a program that incorporated pedagogical approaches to support distance education for graduate psychiatric mental health nursing students in Indiana and adjacent states. This narrative provides a brief description of the five initiatives we originally proposed, our experiences with them, and future plans as our program continues to evolve.
Gildberg, Frederik Alkier; Bradley, Stephen K.; Hounsgaard, Lise
interviews. Findings show that both acute and forensic mental health nursing practice is characterized by two overriding themes; ‘trust and relationship-enabling care’ and ‘behavior and perception-corrective care.’ The comparison of the two studies shows no major differences in the characteristics of staff......This article reports on and compares two separate studies of the interactional characteristics of forensic mental health staff and acute mental health staff as they interact with inpatients, respectively. Both studies were conducted using participant observation, along with informal and formal...
Kgalabi J. Ngako
Full Text Available Psychiatric nurse practitioners (PNPs working with mental health care users presenting with acute symptoms work in a complex environment. This environment is characterised by mental health care users who may present with a history of violence, sexual assault and substance misuse.The objectives of this study were twofold: firstly, to explore and describe the experiences of PNPs working with mental health care users (MHCUs presenting with acute symptoms; and secondly, to make recommendations for the advanced PNPs to facilitate promotion of the mental health of PNPs with reference to nursing practice, research and education.A qualitative, explorative, descriptive and contextual design was used. The target population was PNPs working with MHCUs presenting with acute symptoms in a public mental health care institution in Gauteng. Data were collected by means of four focus group interviews involving 21 PNPs. The researcher made use of drawings, naïve sketches and field notes for the purpose of data triangulation. Data were analysed in accordance with Tesch’s method of open coding.The three themes that emerged were: PNPs experienced working with these MHCUs as entering an unsafe world where care became a burden; they experienced negative emotional reactions and attitudes towards these MHCUs that compromised quality nursing care; and they made a plea for a nurturing environment that would enhance quality nursing care.The PNPs suggest skills and competency development, organisational support, and a need for external resources. Creation of a positive environment and mobilisation of resources as well as the identification and bridging of obstacles are essential in the promotion of the overall wellbeing and mental health of PNPs.
Rocha, Fernanda Ludmilla Rossi; Gaioli, Cheila Cristina Leonardo de Oliveira; Camelo, Silvia Helena Henriques; Mininel, Vivian Aline; Vegro, Thamiris Cavazzani
to analyze the organizational culture of a psychiatric hospital and identify the capacity of resilience of nursing workers. quantitative research. For data collection, were used the Brazilian Instrument for Evaluation of Organizational Culture (IBACO - Instrumento Brasileiro para Avaliação da Cultura Organizacional) and the Resilience Scale (RS). participants reported the existence of centralization of power and devaluation of workers, despite recognizing the existence of collaboration at work and practices for improving interpersonal relations. In relation to the capacity of resilience, 50% of workers showed high level, and 42.9% a medium level of resilience. The correlation tests revealed negative values between the IBACO and RS domains, indicating that the lower the appreciation of individuals in the institution, the greater their capacity of resilience. the organizational values reflect the work organization model in the institution that devalues the workers' needs and requires greater capacity of resilience.
Zengin, A Z; Yanik, K; Celenk, P; Unal-Erzurumlu, Z; Yilmaz, H; Bulut, N
The World Health Organization has stated that psychiatric patients are a group of people who have oral and dental illnesses. The aims of this study were to document the oral hygiene of individuals with chronic psychiatric illness, to determine the extraoral and intraoral findings, to detect the dominant microorganisms in oral flora, and to inform clinicians of these findings. The study included 100 patients (69 men and 31 women) with different psychiatric illnesses living in a nursing home. They were 19-96 years old (median, 48 years). The participants completed a questionnaire about patients' oral health. They underwent extraoral and intraoral examinations. Two swab samples were obtained from the oral mucosa of these patients. Gram preparations were analyzed for leukocytes, bacteria, and yeast. Chi-square test and z-test were used. All patients (100%) had the necessary equipment for oral hygiene; however, many (43%) patients had poor oral hygiene. There was a high prevalence of xerostomia (56%) and fissured tongue (61.4%) (among other tongue anomalies). The most commonly isolated microorganisms were coagulase-negative Staphylococcus0 (35.9%), Streptococcus spp. (30.3%), nondiphtheroid Bacilli (16.9%), Staphylococcus aureus (2.3%), Candida spp. (11.8%), and Gram-negative Bacilli (2.8%). The oral hygiene of most patients was insufficient. The presence of Gram-negative Bacilli growth in the oral flora can be explained by poor hand hygiene. These findings suggest that it is useful to educate individuals about oral hygiene and hand hygiene and to inform the staff and families about this issue.
Ruane, Jean; Hayter, Mark
The issue of relationships between patients in long-term care settings can present nurses with numerous challenges. However, addressing this element of patient care is recognised as an important element of nursing in this sphere of practice. What nurses think about patient sexual relationships and the difficulties of incorporating these into care is closely linked to the care they provide. However, the issue of patients sexual relationships within high security psychiatric hospitals is a relatively poorly researched area of clinical practice. To explore the attitudes towards patients' sexual relationships held by nurses working in high security psychiatric hospitals in England. A qualitative methodology was employed with data collected from 10 in-depth interviews with nurses working within secure psychiatric hospitals in England. Interview data were subjected to thematic analysis. Practitioners reject permissive policy in relation to patients' sexual relationships on account of perceived perpetuation of abuse and exploitation. Practices and attitudes are dominated by personal (lay) values that seek to restrict patient experience and undermine professional mores whilst also seeming to uphold a professional duty of care. Lay understandings are constructed as moral rights and priorities that are of higher order concern than professional values or the rights of the individual. This constitutes a clash of values and the minimisation of professional mores within the clinical context raises questions about the role of professional teaching, knowledge and policy in relation to professional socialisation.
Dutta, Snigdha; Majid, Shazmin; Völlm, Birgit
Forensic psychiatric nursing is a demanding nursing specialty that deals with a highly complex group of patients who are detained in restrictive environments, often for lengthy periods. There is little information about the daily experiences of these nurses. This study sought to explore the roles and relationships of forensic psychiatric nurses with long-stay patients in a high secure hospital in England. The study obtained data via three focus groups, and thematic analysis was carried out using NVIVO 10 software. Five prominent themes emerged: First, nurses elaborated on their roles with patients and the kinds of interactions they had with them. The next two themes explored the reasons why some patients are long-stay patients and the challenges nurses face while working with this group. The fourth theme was the impact of external support, such as the patient's families, on length of stay. The final theme covered the changes that the nurses observed in these patients and in themselves over time. It was noticeable that those interviewed were committed professionals, eager to provide an optimistic and hopeful environment for the patients to help them progress through "the system". The study presents a number of pertinent issues regarding long-stay patients that provide a basis for further research and to inform policy, educational reforms, and clinical practice.
Hamilton, Bridget; Manias, Elizabeth
Remarks such as 'she's manipulative' and 'he's right off' are familiar to psychiatric nurses. This paper critiques the language nurses use in acute inpatient psychiatry services, highlighting the diverse discourses implicated in nurses' writing and speaking about patients. Based on a review of the literature, this paper examines ethnographic studies and discourse analyses of psychiatric nurses' oral and written language. A prominent debate in the literature surrounds nurses' use of standardized language, which is the use of set terms for symptoms and nursing activities. This review of spoken descriptions of patients highlights nurses' use of informal and local descriptions, incorporating elements of moral judgement, common sense language and empathy. Research into written accounts in patient files and records show nurses' use of objectifying language, the dominance of medicine and the emergence of the language of bureaucracy in health services. Challenges to the language of psychiatry and psychiatric nursing arise from fields as diverse as bioscience, humanism and social theory. Authors who focus on the relationship between language, power and the discipline of nursing disagree in regard to their analysis of particular language as a constructive exercise of power by nurses. Thus, particular language is in some instances endorsed and in other instances censured, by nurses in research and practice. In this paper, a Foucauldian analysis provides further critique of taken-for-granted practices of speech and writing. Rather than censoring language, we recommend that nurses, researchers and educators attend to nurses' everyday language and explore what it produces for nurses, patients and society.
Cusack, E; Killoury, F; Nugent, L E
WHAT IS KNOWN ON THE SUBJECT?: Nationally and internationally there has been a movement away from the traditional medical model towards a more holistic recovery-oriented approach to mental health care delivery. At every level of service provision the emphasis is firmly on recovery and on facilitating active partnership working and involvement of service users, their carers and family members. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to identify on a national level specific areas of care that are addressed most or least by psychiatric and mental health nurses in care planning for mental health service users in Ireland. In addition, this is the first study to identify nationally how the recovery approach is being implemented by psychiatric and mental health nurses in relation to current recovery-orientated policy. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental healthcare staff require more education on the recovery concept and this needs to be multidisciplinary team wide. Further research is required to establish how best to develop a shared approach to working with service users and their families within the mental healthcare environment. Further investigation is required to help determine how funding could be allocated appropriately for education and training and service development nationally. Introduction The restructuring of national mental health policy to an integrated recovery ethos demands a clarification in the psychiatric/mental health nurse's role, skills and competencies. Aim/Question To explore the psychiatric/mental health nurse's role and identify skills, competencies and supports required to adopt recovery-orientated policy in practice. Method An exploratory mixed methods study in multiple health services in Ireland with N = 1249 psychiatric/mental health nurses. Data collection used a survey, focus groups and written submissions. Data analysis used descriptive statistics and thematic analysis. Results The medical
Ana Luiza Lourenço Simões Camargo
Full Text Available CONTEXT AND OBJECTIVE:There is high prevalence of mental and behavioral disorders in general hospitals, thus triggering psychiatric risk situations. This study aimed to develop a psychiatric risk assessment checklist and routine for nurses, the Psychiatric Risk Evaluation Check-List (PRE-CL, as an alternative model for early identification and management of these situations in general hospitals.DESIGN AND SETTING:Ethnographic qualitative study in a tertiary-level private hospital.METHOD:Three hundred general-unit nurses participated in the study. Reports were gathered through open groups conducted by a trained nurse, at shift changes for two months. The questions used were: "Would you consider it helpful to discuss daily practice situations with a psychiatrist? Which situations?" The data were qualitatively analyzed through an ethnographic approach.RESULTS:The nurses considered it useful to discuss daily practice situations relating to mental and behavioral disorders with a psychiatrist. Their reports were used to develop PRE-CL, within the patient overall risk assessment routine for all inpatients within 24 hours after admission and every 48 hours thereafter. Whenever one item was present, the psychosomatic medicine team was notified. They went to the unit, gathered data from the nurses, patient files and, if necessary, attending doctors, and decided on the risk management: guidance, safety measures or mental health consultation.CONCLUSION:It is possible to develop a model for detecting and intervening in psychiatric and behavioral disorders at general hospitals based on nursing team observations, through a checklist that takes these observations into account and a routine inserted into daily practice.
Addresses historical issues in psychiatric/mental health nursing in the United Kingdom including attempts to integrate it with general nursing, the balance of theory/research and practice, and tensions over the recent shift to university-level nurse preparation. Discusses needs for the future. (Contains 42 references and commentary by Sheri…
The purpose of sharing these ideas about the role of the psychiatric clinical specialist in the medical setting has been threefold: first, to stimulate the interest of others by communicating the needs for and the value of such a role in improving health care; secondly, to convey the variety of potential opportunities available in the role; and third, to share some ideas about specific activities which can be pursued in such a role. The clinical specialist who chooses to work in the medical setting will discover opportunities to develop creativeness, to explore innovative ideas, and to utilize the variety of one's personal resources and past learning experiences. It affords one with opportunities to serve as a change agent, to influence the quality of patient care, and to stimulate the growth of other nurses. It allows for on-going contact and exchange with other professional groups comprising the health care team, and finally, it provides the nurses with a high level of autonomy and challenge in defining their own roles.
Coscrato, Gisele; Villela Bueno, Sonia Maria
To know the conceptions of undergraduates from the Teaching Diploma Program with Bachelor degree in Nursing at a public state-owned higher education institution in an interior city in the State of São Paulo about spirituality and humanization, as well as to propose educative action in that sense. Methodoly. A qualitative study was undertaken, using the action research method. The data were collected in the second semester of 2012 through participant observation, registered in a field diary, and interviews with the help of questionnaires. For the interpretative data analysis, categorization was used. The implicit predominance of the technical-procedure care discourse was observed, to the detriment of the educational care discourse, as complementary constructs, according to the participant' statements. Nevertheless, the educational action permitted constructivism and the problematization of knowledge. Although the results may not reflect the reality at the investigated institution, it is concluded that the academic education of nurse educators is a moment of possibilities to include spirituality and humanization, regarding the development of competences that grant individual support to patients and families, in health promotion and coping with disease situations.
Full Text Available Objective. To know the conceptions of undergraduates from the Teaching Diploma Program with Bachelor degree in Nursing at a public state-owned higher education institution in an interior city in the State of São Paulo about spirituality and humanization, as well as to propose educative action in that sense. Methodoly. A qualitative study was undertaken, using the action research method. The data were collected in the second semester of 2012 through participant observation, registered in a field diary, and interviews with the help of questionnaires. For the interpretative data analysis, categorization was used. Results. The implicit predominance of the technical-procedure care discourse was observed, to the detriment of the educational care discourse, as complementary constructs, according to the participant' statements. Nevertheless, the educational action permitted constructivism and the problematization of knowledge. Conclusion. Although the results may not reflect the reality at the investigated institution, it is concluded that the academic education of nurse educators is a moment of possibilities to include spirituality and humanization, regarding the development of competences that grant individual support to patients and families, in health promotion and coping with disease situations.
Rosser, Elizabeth; Grey, Rachael; Neal, Deborah; Reeve, Julie; Smith, Caroline; Valentine, Janine
To evaluate the effectiveness of an action learning set to enhance clinical leadership and extend their scope and confidence more strategically. As the most senior clinical role in most healthcare systems, the consultant nurse role is a solitary one. They are required to develop personal resilience, commitment and a belief in their ability to lead, with new consultants needing a strong support network to succeed. Following a 2-year action learning set, four nurse consultants, one therapy consultant, and a university educationalist engaged in a cooperative inquiry approach using four cycles of discussion, reflection, analysis and action over an 18-month period from March 2015-July 2016, to learn how to change and enhance their working practices. Data were analysed thematically. Four themes emerged where the action learning set (i) offered structure and support, (ii) enabled a wider influence and (iii) empowered them to lead. The cooperative inquiry helped them realise how much they had gained from their collective learning and they felt empowered to lead. Their motivation to "make a difference" remains palpable. The outcomes of the cooperative inquiry included an enhanced understanding of the importance of openness and trust and a willingness to share and learn from each other in a respectful and confidential environment with a receptiveness to change. Self-leadership has clearly been accepted and embraced, and their collaboration has improved communication across the organisation, enhanced their strategic leadership capability and given confidence to disseminate externally. The action learning set offered structure to support these clinical leaders to keep them focused across the breadth of their role. Additionally, peer review with external facilitation has enabled these clinical leaders to gain a wider influence and empowered them to lead. © 2017 John Wiley & Sons Ltd.
Delgado Sevilla, David; Juarez Vela, Raúl; Pellicer García, Begoña; Redondo Castán, Luis Carlos; Ramón Arbués, Enrique; López Martín, Inmaculada; De Blas Gómez, Irene; Alburquerque Medina, Eulalia
Palliative care is a group of actions performed by nurses in order to increase the comfort and well-being of patients with terminal illnesses. The World Health Organization (WHO) defines this term as: An approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual . Cicely Mary Strode Saunders is considered as the precursor of the palliative care, who explained the need to change the Palliative Care Units in order to improve the quality of life of patients with terminal illnesses. Palliative care is necessary for patients with a terminal illness. In such cases, the life expectancy is less than six months. Human being is considered a biopsychosocial model. For this reason, the nurse must take into account all the requirements arising from these three dimensions of the human being. In this essay, we deal with palliative care in patients with terminal illnesses, considering the role of the nurse as an important reference when teaching palliative care to the main carer.
Tuvesson, Hanna; Eklund, Mona; Wann-Hansson, Christine
The aims of this study were to investigate (1) perceived stress as felt by the nursing staff working in psychiatric inpatient care, (2) possible differences between nurses and nurse assistants, and (3) associations among individual characteristics, the ward atmosphere, the psychosocial work environment, and perceived stress. Ninety-three members of the nursing staff completed three instruments-one each measuring perceived stress, the ward atmosphere, and the psychosocial work environment. The...
Biley, F C
Fundamental differences in the philosophy of history as an academic discipline are briefly explored, primarily from two perspectives. The traditional psychiatric and mental health nursing historian objectively uses primary sources in order to be able to make 'truth' claims about the past. The post-modern psychiatric nursing historian, on the other hand, constructs truth claims, rather than discovers them, and in the process of doing so creates historical discourses that are different from the past. To the postmodern psychiatric nursing historian, all histories are fictions, created with the use of imagination, and have characteristics that are similar to the literary constructions that are more traditionally identified as fiction. A variety of literature is used in order to explore such claims, and the conclusion is drawn that, with caution and careful attention to the rigorous use of historical method, fiction can be used as a valid source for historical research in psychiatric and mental health nursing.
The growing debate surrounding the role of the community psychiatric nurse (CPN) in the United Kingdom is reviewed. Issues which have attracted significant interest and which form the focus of this paper are the prioritization of CPN services, CPN attachment to primary health care (PHC), and the effectiveness of clinical interventions. The requirement for CPNs is now to concentrate services on people experiencing severe and enduring mental health problems. Innovative and effective clinical and social interventions for this client group are beginning to disseminate into everyday CPN practice. Problem-solving family interventions, cognitive therapies and case management are three such examples. The past, present and possible future role for CPNs working in primary health care settings with people experiencing nonpsychotic mental health problems is a particular focus in this paper. Drawing on the relevant literature, central issues addressed are the process and outcome of CPN work with nonpsychotic service users, reasons for the growth of CPN involvement in PHC, and the overall expansion of interest in mental health interventions within the primary health care environment. The literature suggests that this expansion has been strategically unplanned, but that mental health need amongst primary health care service users is significant. The concluding contention of this paper is that a future role for CPNs in primary care does exist.
Li, Jin-Biau; Tsai, Sing-Ling
Evidence-based nursing science has identified psychological recovery, partnership, and medication adherence as factors that have influenced the development of mental health care. This article discusses the process by which mental health care has developed from a medical / rehabilitation-focused model to a model that focuses on patient empowerment. The current model aims to assist patients to achieve self-awareness and to develop coping skills that enhance their motivation to transform. Medical advances have improved the control of psychiatric symptoms. Following the introduction of 2nd generation antipsychotics, patients were invited to establish decisions related to these prescription medications. Under the principles of patient-centered service, Taiwanese mental health professionals have changed their relationship with patients from a therapeutic model to a mutual-partnership model. Furthermore, investigations of the therapeutic care of patients with mental illness have used the needs of patients as their starting point and emphasized various aspects of patient and caregiver needs. Taiwanese mental health professionals are searching for a model of mental health care that is superior to the traditional operative framework of medical authority.
Masters, Joan C; Kane, Mary Frances; Pike, Mary Ellen
A tabletop simulation was developed as a patient safety activity that involved checking in a patient admitted to a psychiatric care unit. Students were second-degree (n = 79) and traditional (n = 53) BSN students. They were given suitcases or backpacks containing various items, and following a fictional hospital policy, they had to decide whether to give the items to the patient, place them in a secured area, or send them to the pharmacy or security personnel. The activity was evaluated using the Simulation Effectiveness Tool (SET) and two open-ended questions. Students reported that they found the simulation to be enjoyable and a good learning experience. Checking in a patient's belongings is not an activity students typically perform, but the simulation can help prepare them for situations they will experience in the workplace. This inexpensive activity can easily be adapted for staff orientation and competencies. [Journal of Psychosocial Nursing and Mental Health Services, 52(8), 39-44.]. Copyright 2014, SLACK Incorporated.
Silverstein, Christine M
During World War II, psychiatric nurses learned valuable lessons on how to deal with the traumas of war. Using psychohistorical inquiry, this historian examined primary and secondary sources, beyond the facts and dates associated with historical events, to understand why and how psychiatric nurse pioneers developed therapeutic techniques to address the psychosocial and physical needs of combatants. Not only is the story told about the hardships endured as nurses ministered to soldiers, but their attitudes, beliefs, and emotions, that is, how they felt and what they thought about their circumstances, are explored. In this study the lived experiences of two psychiatric nurses, Votta and Peplau, are contrasted to explicate how knowledge development improved care and how this knowledge had an impact on the home front in nursing practice and education, as well as in mental institutions and society, long after the war was won.
Snyder, Melissa J.
The purpose of this action research study was two-fold. The first purpose was to examine the process of how nurses engaged in a professional development program that drew upon reading and creative writing related to their lives and work as nurses. Secondly, this study examined the nurses' perspectives on how their involvement in the process…
Pawlowski, Tomasz; Baranowski, Piotr
The aim of this study was to analyze the personality traits of nurses and the organizational climate in psychiatric wards affecting the frequency of the use of coercion. The study applied a descriptive, longitudinal design based on a 1-year prospective observation. The best predictor for the initiation of coercion by nursing personnel was a low score on the Creative Personality Factor Scale in Adjective Check List and the low score in the area of Leadership in Kolb's Organizing Climate Questionnaire (KOQC). The best predictor for decisions to use coercion was the low score in the area Requirements in the KOQC, whereas the best predictors for the participation in coercion were a high value for Leadership area and a low value for Requirements area in KOQC. The nursing personnel should be given frequent practical and theoretical training regarding the use of coercion. © 2017 Wiley Periodicals, Inc.
Kameg, Kirstyn M; Englert, Nadine Cozzo; Howard, Valerie M; Perozzi, Katherine J
High fidelity patient simulation (HFPS) has become an increasingly popular teaching methodology in nursing education. To date, there have not been any published studies investigating HFPS scenarios incorporating medical and psychiatric nursing content. This study utilized a quasi-experimental design to assess if HFPS improved student knowledge and retention of knowledge utilizing three parallel 30-item Elsevier HESI(TM) Custom Exams. A convenience sample of 37 senior level nursing students participated in the study. The results of the study revealed the mean HESI test scores decreased following the simulation intervention although an analysis of variance (ANOVA) determined the difference was not statistically significant (p = .297). Although this study did not reveal improved student knowledge following the HFPS experiences, the findings did provide preliminary evidence that HFPS may improve knowledge in students who are identified as "at-risk." Additionally, students responded favorably to the simulations and viewed them as a positive learning experience.
Zerach, Gad; Shalev, Tal Ben-Itzchak
This study examined posttraumatic stress disorder symptoms (PTSD), secondary traumatization (ST) and vicarious posttraumatic growth (VG) among Israeli psychiatric nurses (PN) who were compared to community nurses (CN). Furthermore, we examined the contribution of PN perceptions of the etiology of their patients' mental illness to their PTSD, ST and VG. Results show that PN reported higher levels of both PTSD and ST symptoms, but lower levels of VG, as compare to CN. While ST symptoms were positively related to VG among CN, PTSD and ST symptoms were negatively associated among PN. Finally, exposure to patients' violence, PTSD or ST symptoms, and illness attribution dimensions of 'powerful others', predicted nurses' VG. PN are an at-risk population for work-related stress residues. Copyright © 2015 Elsevier Inc. All rights reserved.
Capri, Charlotte; Buckle, Chanellé
Background: Migrating nursing labour inadvertently reinforces South Africa's care drain, contributes to a global care crisis and forces us to reconsider migration motivation. This paper highlights issues that complicate psychiatric intellectual disability nursing care and identifies loci for change in an attempt to redress this care challenge.…
Al-Zayyat, Abdulkarim Subhi; Al-Gamal, Ekhlas
Clinical practice in the psychiatric/mental health nursing (PMHN) field is considered a highly-stressful experience for nursing students. The purpose of the present study was to identify the degrees of stress, the types of stressors, and coping strategies perceived by undergraduate nursing students during their clinical practice in PMHN courses. A descriptive, longitudinal design was used. Sixty-five students registered in PMHN clinical courses were recruited from five Jordanian universities using a systematic random-sampling method. Data collection was conducted in the second semester of the 2012-2013 academic year at two points of time: pre-PMHN clinical training and post-PMHN training. The Basic Information Questionnaire, Perceived Stress Scale, and Coping Behavior Inventory were administered. Students' ages ranged from 20 to 25 years. The findings illustrate that the highest reported types of stressors at both data-collection times were taking care of patients, stress related to teachers and nursing staff, and from assignments and workloads. The most utilized coping strategy at both data-collection times was problem solving. The findings of the present study are useful for clinical educators in identifying nursing students' stressors, easing their learning in the clinical setting, and establishing an efficient PMHN course programme. © 2013 Australian College of Mental Health Nurses Inc.
Fujimoto, H; Hirota, M; Kodama, T; Greiner, C; Hashimoto, T
WHAT IS KNOWN ON THE SUBJECT?: There is a developing body of research on violence in healthcare workplaces. Although psychiatric visiting nurses (PVNs) are an important group of professionals who provide medical services for people with mental disorders live in the community, little is known about the experiences and characteristics of violence exposure among PVNs, or the characteristics and work situations of PVNs related to violence exposure. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: Approximately 40% of participants were exposed to violence during the previous 12 months; approximately 50% had been exposed during their PVN careers in PVN settings. The most frequent violence was verbal abuse. Longer career length as a PVN and greater number of visits per month were both positively associated with verbal abuse during the previous 12 months. Twenty-eight of the 34 participants (83%) who completed the IES-R-J survey had some residual psychological distress, and two (6%) had a potentially high risk of posttraumatic stress disorder. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: In devising policies and strategies against violence, PVN organizations and administrators should consider the characteristics of the violence, especially verbal abuse, as well as the characteristics and work situations of PVNs that are related to verbal abuse. Furthermore, they might provide relevant information on violence in PVN settings within their violence-prevention manuals or education. It would be important to provide support and to construct a safe workplace environment for PVNs who are experiencing residual psychological distress. Introduction Psychiatric visiting nurses (PVNs) play a crucial role by providing medical services for community-living individuals with mental disorders in Japan. However, little is known about violence towards PVNs. Aim This cross-sectional study investigated violence during visits and the resulting psychological effects for PVNs. Methods PVNs were assessed
Alzayyat, Abdulkarim; Al-Gamal, Ekhlas
Training in psychiatric settings is stressful for nursing students. The purpose of this study was to examine the correlations between the students' characteristics, their stress degrees, stressors and types of coping strategies they experience during training in psychiatric course. A descriptive, correlational, longitudinal design was used. Sixty-five undergraduate nursing students were recruited randomly from five Jordanian universities. Self-report questionnaires were administered at the second semester of the 2012-2013 academic year. The findings showed that students who utilized avoidance or transference strategies reported high stress degrees. Moreover, the results showed that those students who were in the fourth year, with a low family income, who avoid extracurricular activities, with a low academic grade or who registered in other clinical course(s) reported high stress degrees. These findings present a worthy data for the clinical instructors that facilitate students training in psychiatric settings and promote their psychosocial well-being. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.
Houlihan, G D
This paper explores the extent to which nurses can use statutory and common law provisions as lawful authority to detain informal psychiatric patients. The power of a nurse to detain informal psychiatric patients received statutory recognition for the first time in the Mental Health Act (1983). Section 5(4) of this Act, the 'Nurses Holding Power', provides for nurses of the 'prescribed class' to detain informal psychiatric patients for up to 6 hours. Further statutory authority that may be invoked with respect to the detention of patients is laid out in the Criminal Law Act (1967) and the Police and Criminal Evidence Act (1984). These statutes set out the circumstances whereby a nurse can use reasonable force to detain a patient. One of the most confusing areas in law is the extent to which common law powers can be used by nurses to detain or restrain informal psychiatric patients, including those who lack mental capacity. The detention of those patients who lack the mental capacity to express an informed desire to leave hospital has caused uncertainty and difficulties for nurses caring for them. These difficulties relate to whether it is lawful to detain and give treatment to informal patients who lack the capacity to express a choice. The principles derived from the case law are discussed in relation to detention, clinical practice and patients rights.
Full Text Available The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics—Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience—are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff’s perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment.
Settle, Peggy Doyle
Nurses working in a newborn intensive care unit report that treatment decision disagreements for infants in their care may lead to ethical dilemmas involving all health-care providers. Applying Rest's Four-Component Model of Moral Action as the theoretical framework, this study examined the responses of 224 newborn intensive care unit nurses to the Nurses Ethical Involvement Survey. The three most frequent actions selected were as follows: talking with other nurses, talking with doctors, and requesting a team meeting. The multiple regression analysis indicates that newborn intensive care unit nurses with greater concern for the ethical aspects of clinical practice (p = .001) and an increased perception of their ability to influence ethical decision making (p = .018) were more likely to display Nurse Activism. Future research is necessary to identify other factors leading to and inhibiting Nurse Activism as these findings explained just 8.5% of the variance.
Young, Sarah; Nixon, Eileen; Hinge, Denise; McFadyen, Jan; Wright, Vanessa; Lambert, Pauline; Pilkington, Carolyn; Newsome, Christine
This paper will discuss the process of action learning and the outcomes of using action learning as a tool to achieve a more strategic function from Nurse Consultant posts. It is documented that one of the most challenging aspect of Nurse Consultant roles, in terms of leadership, is the strategic contribution they make at a senior corporate Trust level, often across organizations and local health economies. A facilitated action learning set was established in Brighton, England, to support the strategic leadership development of eight nurse consultant posts across two NHS Trusts. Benefits to patient care, with regard to patient pathways and cross-organizational working, have been evident outcomes associated with the nurse consultant posts involved in the action learning set. Commitment by organizational nurse leaders is essential to address the challenges facing nurse consultants to implement change at strategic levels. The use of facilitated action learning had been a successful tool in developing the strategic skills of Nurse Consultant posts within this setting. Action learning sets may be successfully applied to a range of senior nursing posts with a strategic remit and may assist post holders in achieving better outcomes pertinent to their roles.
Trudel-Fitzgerald, Claudia; Chen, Ying; Singh, Ankura; Okereke, Olivia I; Kubzansky, Laura D
To review the contribution of the Nurses' Health Studies (NHS) on factors that influence mental and physical health. Narrative review of all published articles using data from the NHS, the NHS II, and the Growing Up Today Study focusing on mental health conditions (e.g., depression, posttraumatic stress disorder, anxiety) and psychosocial resources and stressors (e.g., job strain, interpersonal violence, social relationships, sexual orientation) between 1990 and 2016. Studies have considered a broad array of determinants (e.g., genes, biomarkers, air pollution) and consequent behavioral and disease-related outcomes (e.g., body weight, smoking, cardiometabolic diseases, cancer, autism). Findings suggest anxiety, posttraumatic stress disorder, childhood violence, caregiver burden, and job insecurity may increase the risk of coronary heart disease and diabetes, whereas findings with cancer are mixed. This work directly affects public health actions, as demonstrated by recent inclusion of a gender expression measure in state surveys. The NHS cohorts have produced novel and influential research on the interplay of psychological and social factors with health. Psychological and social variables are important contributors to the maintenance or decline of physical and mental health.
Leggat, Sandra G; Balding, Cathy; Schiftan, Dan
To determine whether a formal mentoring programme assists nurse practitioner candidates to develop competence in the clinical leadership competencies required in their advanced practice roles. Nurse practitioner candidates are required to show evidence of defined clinical leadership competencies when they apply for endorsement within the Australian health care system. Aiming to assist the candidates with the development or enhancement of these leadership skills, 18 nurse practitioner candidates participated in a mentoring programme that matched them with senior nurse mentors. A pre-postlongitudinal intervention study. Eighteen nurse practitioner candidates and 17 senior nurses participated in a voluntary mentoring programme that incorporated coaching and action learning over 18 months in 2012 and 2013. Participants completed a pen and paper questionnaire to document baseline measures of self-reported leadership practices prior to commencement of the programme and again at the end of the programme. The mentors and the nurse practitioner candidates qualitatively evaluated the programme as successful and quantitative data illustrated significant improvement in self-reported leadership practices among the nurse practitioner candidates. In particular, the nurse practitioner candidates reported greater competence in the transformational aspects of leadership, which is directly related to the nurse practitioner candidate clinical leadership standard. A formal, structured mentoring programme based on principles of action learning was successful in assisting Australian advanced practice nurses enhance their clinical leadership skills in preparation for formal endorsement as a nurse practitioner and for success in their advanced practice role. Mentoring can assist nurses to transition to new roles and develop knowledge and skills in clinical leadership essential for advanced practice roles. Nurse managers should make greater use of mentoring programmes to support nurses in
Virgolesi, Michele; Pucciarelli, Gianluca; Colantoni, Anna Maria; D'Andrea, Fabio; Di Donato, Barbara; Giorgi, Fabio; Landi, Lidia; Salustri, Eleonora; Turci, Carlo; Proietti, Maria Grazia
To observe the extent to which a nursing discharge plan is effective in promoting therapeutic adherence and improving patient satisfaction with their treatment based on information interventions provided by nursing staff, direct hospital medication distribution and follow-up telephone calls. Patient adherence is a fundamental requirement for the treatment of chronic diseases. Among psychiatric patients, adherence to the prescribed course of treatment allows patients to keep the symptoms of their disease under control, allowing for improvements in the management of their condition, minimising the risks of relapse and reducing the number of hospitalisations. This study uses a prospective correlational design. The Morisky Medication Adherence Scale, the Satisfaction with Information about Medicine Scale and the General Satisfaction Questionnaire were used. Of the 135 patients enrolled in the study, 57% of the sample was female, and, on average, patients were aged 33 years. About 72.9% were unmarried, and 88.1% were educated at less than high school level. This study showed that patients who received more information on their health status and on what would be done for them after their hospitalisation had a higher adherence to treatment. In addition, patients who were more satisfied with the nursing care provided had a higher rate of adherence to their treatment plan. The interpersonal and educational nursing intervention improves adherence to a treatment plan by allowing patients to express themselves not only as individuals who rely on health care but also as protagonists able to effectively manage their disease and to empower themselves by acquiring disease management skills. A patient-nurse communication programme could help to analyse the individual patient circumstances that might become barriers to adherence and to apply nursing interventions that promote better patient adherence. © 2017 John Wiley & Sons Ltd.
Klein, Tracy A; Graves, Janessa M
Nurse practitioners (NPs) are statutorily authorized to provide assessment and cognitive recommendations for concussion in most states. Their scope of practice includes assessment and management of concussion sequalae including anxiety, insomnia, and depression, as well as return to school and activity guidance. Analysis of symptom-based diagnosis of mild traumatic brain injury (TBI) in adolescents, including return to school and school workload recommendations comparing psychiatric and nonpsychiatric NPs. Cross-sectional Web-based survey with embedded videos using standardized actors and scripts randomized for patient sex and sport. A total of 4,849 NPs licensed in Oregon or Washington were invited by e-mail to view and respond to this study, with a response rate of 23%. Psychiatric mental health nurse practitioners (PMHNPs) were 44% less likely than family NPs to report using standardized concussion tools. 17% had completed continuing education on mild TBI compared to 54.5% of family NPs. Seven PMHNPs provided additional feedback related to discomfort in completing the survey due to lack of comfort or experience. Return to school recommendations and reduced workload advice did not significantly differ by NP type. PMHNPs may support individualized assessment through concussion evaluation, use of standardized tools, and differential consideration of TBI for mental health symptoms. More research is required related to the role and contribution of cognitive rest to full recovery.
Souza, Emilia Jales Simões de; Moreira, Lilian Hortale de Oliveira; Cardoso, Maria Manuela Vila Nova; Ferreira, Rosa Gomes dos Santos; Silva, Thuany Cristine Santos da
This is an exploratory and descriptive study of a qualitative nature. Its objective is to analyse the formation of strategies for social reintegration of the psychic suffering carrier in the practice of nurses working in hospital psychiatric institutions. For this study, we use, as a basis, the concepts and processes of the formation of strategies presented by Isabel Nicholau, 2001. Twelve nurses with health care experience in hospital psychiatric institutions participated in this study, and data collection occurred through semi-structured interviews in the year 2013. The data revealed that, in addition to human, material, and financial resources, institutional support is needed as is articulation and interaction among professionals and services. The importance of the social dimension and of the negotiation process depicts the development of conception of collective and integrated work. We conclude that strategies are emerging from the daily life of work and are not limited to a rational logic of cost and fundraising, but instead are developed through a negotiated process.
Liukka, Mari; Hupli, Markku; Turunen, Hannele
The aim of this study was to determine whether elements of transformational leadership are present in nursing managers' actions following adverse events. Transformational leadership exerts a positive influence on organisational culture and patient safety. Eleven nursing managers were interviewed individually using a semi-structured format. Data were analysed using inductive content analysis. Four themes emerged relating to nursing managers' actions following adverse events: patient-centredness as a principle for common action, courage to reform operational models to prevent future adverse events, nursing staff's encouragement of open and blame-free discussion, and challenge to recognize adverse events. Nursing managers must understand their responsibilities and the importance of making it clear to staff that patient-centredness should be evident in all health care actions. Nursing managers must also recognize the need to ensure that staff treat patients' interests as the top priority. If an adverse event occurs, the situation should be discussed with the nursing staff and any unique aspects of the event must be accounted for. Nursing managers must have the skill to motivate and empower staff to find new ways to work, to prevent adverse events and to promote patient safety. © 2017 John Wiley & Sons Ltd.
Maykut, Colleen A.; Lee, Andrew; Argueta, Nelson Garcia; Grant, Sean; Miller, Cole
Although women have made significant progress into traditionally male-dominated professions, such as medicine and engineering, the same cannot be said of men in the nursing profession. Utilizing a critical social theory perspective, an action research project was designed to encourage participants, current male nursing students and alumni of…
Taleghani, Fariba; Shahriari, Mohsen; Alimohammadi, Nasrollah
Chronic diseases such as cancer would lead to various health needs in patients and their families. To meet needs, developing new educational nursing courses is necessary. Therefore this study was conducted to empower nurses through designing and conducting short-term educational courses for training palliative care nurses. This study was a community-based action research which was conducted at Isfahan hospitals that provide services for cancer patients during 2015 at four stages (planning, acting, reflection, and evaluation). Participants (33 samples) included nurses, head nurses, managers of nursing services, nursing professors and professors of oncology department. Data were gathered through individual and group interviews and analyzed using content analysis. Data analysis resulted in 3 categories of "professional development of nursing in palliative care" which included subcategories of: knowledge-based performance and positive change in attitude, "obstacles to provide palliative care" with subcategories of: insufficient professional responsibility, insufficient ability in managing some of patients' symptoms and inappropriate interaction between nurses and physicians and "strategies for improving provision of palliative care" with subcategories of: improving the interactions between physicians and nurses, continuous trainings for palliative care and the necessity of developing palliative care in the country. To facilitate the process of providing palliative care to cancer patients, necessary actions and measures must be conducted including improvement of interaction between the members of health team, organizing continuing educational courses on palliative care and development of providing palliative care all over the country by managers of health centers.
Full Text Available Background: Chronic diseases such as cancer would lead to various health needs in patients and their families. To meet needs, developing new educational nursing courses is necessary. Therefore this study was conducted to empower nurses through designing and conducting short-term educational courses for training palliative care nurses. Materials and Methods: This study was a community-based action research which was conducted at Isfahan hospitals that provide services for cancer patients during 2015 at four stages (planning, acting, reflection, and evaluation. Participants (33 samples included nurses, head nurses, managers of nursing services, nursing professors and professors of oncology department. Data were gathered through individual and group interviews and analyzed using content analysis. Results: Data analysis resulted in 3 categories of "professional development of nursing in palliative care" which included subcategories of: knowledge-based performance and positive change in attitude, "obstacles to provide palliative care" with subcategories of: insufficient professional responsibility, insufficient ability in managing some of patients' symptoms and inappropriate interaction between nurses and physicians and "strategies for improving provision of palliative care" with subcategories of: improving the interactions between physicians and nurses, continuous trainings for palliative care and the necessity of developing palliative care in the country. Conclusions: To facilitate the process of providing palliative care to cancer patients, necessary actions and measures must be conducted including improvement of interaction between the members of health team, organizing continuing educational courses on palliative care and development of providing palliative care all over the country by managers of health centers.
Matney, Susan A; Staggers, Nancy; Clark, Lauren
Nurses seek to understand better what practicing with wisdom means and how to apply wisdom to practice; however, the experience of wisdom in nursing has not been well defined or researched. This study was designed to understand how emergency department (ED) nurses construct the meaning of wisdom within the culture of clinical nursing practice. Using Charmaz's constructivist grounded theory methodology, we developed a preliminary theory capturing the experience of wisdom in practice. The core theoretical model focuses on two juxtaposed processes, technical and affective, and is grounded in expertise. Significant findings were the recognition of affective categories, such as emotional intelligence, required to practice using wisdom. Results reinforce and extend the current wisdom literature and provide a new perspective on wisdom in practice in a nursing context.
Khorasani, Parvaneh; Rassouli, Maryam; Parvizy, Soroor; Zagheri-Tafreshi, Mansoureh; Nasr-Esfahani, Mahmood
Patient education is among the lowest met need of patients in Iran; therefore, expansion of that role can result in greater professional accountability. This study aimed to explain the practical science of the process, structure, and outcomes of a nurse-led action research project to expand the nurses' role in patient education in Iran. This study was part of a participatory action research. Daily communications and monthly joint meetings were held from January 2012 to February 2014 for planning and management. These were based on the research protocol, and the conceptual framework included the Mobilizing for Action through Planning and Partnerships process by means of Leadership for Change skills. Data were produced and gathered through participant observations. Administrative data included project records, official documents, artifacts, news, and reports, which were analyzed through qualitative content analysis. A participatory project was established with three groups of participants organized from both academic and clinical fields. These consisted of a "core research support team," "two steering committees," and community representatives of clients and professionals as "feedback groups." A seven-stage process, named the "Nurse Educators: Al-Zahra Role Expansion Action Research" (NEAREAR) process, resulted from the project, in which strategic issues were gradually developed and implemented through 32 action plans and quality improvement cycles of action research. Audits and supervision evaluations showed meaningful changes in capacity building components. A nurse-led ad hoc structure with academic-clinical partnerships and strategic management process was suggested as a possible practical model for expanding nurses' educational role in similar contexts. Implications and practical science introduced in this action research could also be applicable for top managers and health system policy makers in a wider range of practice.
Sørensen, Ann Lykkegaard; Nielsen, Lars Peter; Poulsen, Birgitte Klindt
nurses are the health professionals spending most time directly with the patient and very few studies investigate nurses’ role and potential in improving the appropriateness of medication. Therefore, the main objective of this study is to investigate the effect of educating nurses in general pharmacology...
To systematically analyse the Organizational Commitment model and Theory of Reasoned Action and determine concepts that can better explain nurses' intention to leave their job. The Organizational Commitment model and Theory of Reasoned Action have been proposed and applied to understand intention to leave and turnover behaviour, which are major contributors to nursing shortage. However, the appropriateness of applying these two models in nursing was not analysed. Three main criteria of a useful model were used for the analysis: consistency in the use of concepts, testability and predictability. Both theories use concepts consistently. Concepts in the Theory of Reasoned Action are defined broadly whereas they are operationally defined in the Organizational Commitment model. Predictability of the Theory of Reasoned Action is questionable whereas the Organizational Commitment model can be applied to predict intention to leave. A model was proposed based on this analysis. Organizational commitment, intention to leave, work experiences, job characteristics and personal characteristics can be concepts for predicting nurses' intention to leave. Nursing managers may consider nurses' personal characteristics and experiences to increase their organizational commitment and enhance their intention to stay. Empirical studies are needed to test and cross-validate the re-synthesized model for nurses' intention to leave their job.
Lusk, Pamela; Hart Abney, Beverly G; Melnyk, Bernadette Mazurek
Graduate faculty in advanced practice nursing programs seek to provide clinical training in psychotherapy for psychiatric mental health nurse practitioner (PMHNP) students and prepare them for practice with patients across the lifespan, including children and adolescents. To develop a clinical training model for child/adolescent cognitive behavior therapy (CBT) that is adaptable to all graduate nursing programs including online, classroom, and blended programs. Clinical training included a didactic 4-hour workshop and 7 small group practice sessions utilizing Creating Opportunities for Personal Empowerment (COPE), a manualized CBT program for teens. Students completed post-clinical training evaluations. Using qualitative design, responses to the open-ended questions were analyzed and common themes identified. One hundred seven PMHNP students completed evaluations. Four themes emerged from the data: (a) therapeutic understanding of adapting CBT for children and adolescents, (b) therapeutic skills and techniques for use with children/adolescents, (c) improved level of confidence through participation in the CBT program, and (d) therapeutic benefits of being in a group. Positive PMHNP student evaluations indicated that this clinical training model is feasible both online and face-to-face and acceptable for providing clinical training in CBT for children and adolescents.
Del Fabbro, Letitia; Mitchell, Creina; Shaw, Julie
It is imperative that nursing education addresses the issues arising from globalization. The adjustment challenges faced by international nursing students globally highlight the need to understand how nursing faculty experience and teach nursing classes with a mix of domestic and foreign students. This article reports on a participatory action research (PAR) study to examine and enhance the scholarly teaching of international nursing students. The overarching research question for this PAR was: How did participation in a PAR study contribute to shared learning and professional development of nursing faculty teaching international students? Five major themes were identified across the PAR: creating sharing spaces, recognizing and respecting diversity, developing and acknowledging teaching capabilities, utilizing precious time, and valuing the research. In summary, PAR was a useful approach to engage faculty in research by providing a process and a space to address concerns about the teaching and learning of international students. Copyright 2015, SLACK Incorporated.
Bakker, Ton J E M; Duivenvoorden, Hugo J; van der Lee, Jacqueline; Olde Rikkert, Marcel G M; Beekman, Aartjan T F; Ribbe, Miel W
To test the effectiveness of an integrative psychotherapeutic nursing home program (integrative reactivation and rehabilitation [IRR]) to reduce multiple neuropsychiatry symptoms (MNPS) of cognitively impaired patients and caregiver burden (CB). Randomized controlled trial. Psychiatric-skilled nursing home (IRR) and usual care (UC), consisting of different types of nursing home care at home or in an institution. N = 168 (81 IRR and 87 UC). Patients had to meet classification of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition for dementia, amnestic disorders, or other cognitive disorders. Further inclusion criteria: Neuropsychiatric Inventory (NPI) ≥3; Mini-Mental State Examination ≥18 and ≤27; and Barthel Index (BI) ≥5 and ≤19. IRR consisted of a person-oriented integrative psychotherapeutic nursing home program to reduce MNPS of the patient and CB. UC consisted of different types of nursing home care at home or in an institution, mostly emotion oriented. Primary outcome variable was MNPS (number and sum-severity of NPI). Furthermore, burden and competence of caregiver were also measured. T1 (inclusion), T2 (end of treatment), T3 (after 6 months of follow-up). Cohen's d (Cd) was calculated for mean differences (intention to treat). For confounding, repeated measurement modeling (random regression modeling [RRM]) was applied. In the short term from the perspective of the caregiver, IRR showed up to 34% surplus effects on MNPS of the patients; NPI symptoms: 1.31 lower (Cd, -0.53); and NPI sum- severity: 11.16 lower (Cd, -0.53). In follow-up, the effects were sustained. However, from the perspective of the nursing team, these effects were insignificant, although the trend was in the same direction and correlated significantly with the caregiver results over time (at T3: r = 0.48). In addition, IRR showed surplus effects (up to 36%) on burden and competence of caregiver: NPI emotional distress: 3.78 (Cd, -0.44); CB: 17.69 (Cd, -0
Chan, Roxane Raffin; Schaffrath, Michelle
Nurses, nursing educators and students support the inclusion of integrative health care (IHC) into nursing core curriculum as a way to create nurses who deliver nursing care to the full extent of their scope of practice and advance evidenced based IHC. Because of the holistic nature of IHC modalities, research to investigate appropriate teaching strategies and potential efficacy of learning IHC in the baccalaureate core curriculum requires a holistic approach. Therefore a phenomenological exploration using participatory action inquiry was conducted at a large Midwestern university. Eighteen first year nursing students were selected as co-researchers. Their experiences in learning and delivering three 15 min IHC interventions (foot reflexology, lavender aromatherapy and mindful breathing) in an acute care setting were captured using reflexive journaling and participation in structured and organic communicative spaces. Of the patients approached, 67% accepted to receive one or more IHC modalities (147/219). Using van Manen's model for holistic data reduction three themes emerged: The experience of presence, competency and unexpected results. Learning IHC modalities is best supported by a self-reflective process that is constructed and modeled by a nurse faculty member with experience in delivering IHC modalities. Copyright © 2016 Elsevier Ltd. All rights reserved.
Hagen, Julia; Knizek, Birthe Loa; Hjelmeland, Heidi
The purpose of the study is to investigate mental health nurses' experiences of recognizing and responding to suicidal behavior/self-harm and dealing with the emotional challenges in the care of potentially suicidal inpatients. Interview data of eight mental health nurses were analyzed by systematic text condensation. The participants reported alertness to patients' suicidal cues, relieving psychological pain and inspiring hope. Various emotions are evoked by suicidal behavior. Mental health nurses seem to regulate their emotions and emotional expressions, and balance involvement and distance to provide good care of patients and themselves. Mental health nurses have an important role and should receive sufficient formal support. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
performing psychotherapy. They found a positive correlation between educational level and openness to PCNS psychotherapists . Further, nurse educators were most...as a professional colleague on the mental health multidisciplinary team, setting standards for inpatient mental healtn nursing care, and educating...one behavior not identified to be characteristic of the PCNS role was, "serves as subordinate member of the mental nealth multidisciplinary team." .°I j
Renata Marques de Oliveira
Full Text Available ABSTRACT Objective: to develop a mobile app for research on the use of tobacco among psychiatric patients and the general population. Method: applied research with the technological development of an app for data collection on an Android tablet. For its development, we considered three criteria: data security, benefits for participants and optimization of the time of researchers. We performed tests with twenty fictitious participants and a final test with six pilots. Results: the app collects data, stores them in the database of the tablet and export then to an Excel spreadsheet. Resources: calculator, stopwatch, offline operation, branching logic, field validation and automatic tabulation. Conclusion: the app prevents human error, increases the quality of the data by validating them during the interview, allows the performing of automatic tabulation and makes the interviews less tiring. Its success may encourage the use of this and other computational resources by nurses as a research tool.
Full Text Available This one-year follow-up study determined the incidence and risk factors of workplace violence against nursing staff in a psychiatric hospital. The cohort members had a website to report events whenever they came across violence. A total of 971 events were reported. The incidence rates of physical violence, verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 1.7, 3.7, 0.2, 0.3, and 0 per staff-year, respectively. Young age, female sex, lower education, shorter duration of employment, and high level of anxiety of staff seemed to be the determinants of violence. Pre-placement education should focus on these staff to reduce workplace violence.
Bowers, Len; Allan, Teresa; Simpson, Alan; Nijman, Henk; Warren, Jonathan
Adverse incidents (violence, self-harm and absconding) can cause significant harm to patients and staff, are difficult to predict, and are driving an increase in security measures and defensive practice. To explore the relationship between adverse incidents on acute psychiatric wards, admissions and nursing workforce variables. A retrospective analysis of officially collected data covering a period of 30 months on 14 acute wards at three hospitals. This data included 69 serious untoward incidents. Adverse incidents were more likely during and after weeks of high numbers of male admissions, during weeks when other incidents also occurred, and during weeks of high regular staff absence through leave and vacancy. It may be possible to predict adverse incidents. Careful staff management and deployment may reduce the risks.
According to the literature consulted, the biomedical approach continues dominating the ways in which nurses think, work and inform. In order to study whether this situation also occurs in our context, this research proposes to 1) describe the value or weight nurses give to the different instrumental, strategic and communicative actions, according to Habermas' Theory of the Communicative Action; as well as 2) analyse its possible relationship with the type of unit in which nurses work. It is a descriptive study including 89 nurses, conducted in medical, surgical and onco-haematological hospital wards in the Hospital Reina Sofia of Cordoba. For the data collection, a questionnaire was created specifically for the study, made up of 4 instrumental actions, 4 strategic actions and 4 communicative actions that were scored 1-5 according to their value or importance. The questionnaire was self-administered and collected after one week. The instrumental actions obtain the highest scores in the area of thoughts (19.49) and practice (18.9), followed by the communicative actions. Nevertheless, the strategic actions exceeded the communicative actions in the record (17.27 vs 14.49). Only in the onco-haematology units, communicative actions maintained high scores (17.26). The results from the present study emphasise the hegemony of the biomedical model, represented by instrumental and strategic actions, and draw a difficult situation for the communicative action, which has to find its place in the professional speech. Copyright © 2010 Elsevier España, S.L. All rights reserved.
Jasovsky, Deborah A; Morrow, Mary R; Clementi, Pamela S; Hindle, Paula A
Rogers' theoretical framework of diffusion of innovation guided the successful infusion of the educational training and implementation of the Magis model of care at a 570 bed hospital in the Chicagoland area. The Magis model of care was derived from several nursing theories along with information from the Institute of Family-Centered Care. By incorporating the components that relate to the institution's values and Magnet theme, the stages of innovation were readily adopted and sustained over the first year of implementation. The model has spread beyond the original and sister units as demonstrated by another department creating the Magnet poster with the various elements that they have incorporated into daily care delivery. What is so invigorating to the nursing administration is hearing how nursing staff articulates the care they give to the various components of the model and the theory that supports this practice.
Hsieh, Hsiu-Fen; Chang, Shu-Chen; Wang, Hsiu-Hung
The aim of the authors in this study was to identify factors associated with resilience that helped abused nurses face and cope with violent events. The data for this cross-sectional study were collected from June 2013 to December 2013; 272 participants were recruited from emergency rooms and psychiatric wards in four hospitals in central Taiwan. Among these participants, 230 (84.6%) met the inclusion criterion and completed all questionnaires; 69 (30%) of them reported having experienced only verbal violence; 46 (20%) reported having experienced only physical violence, and 115 (50%) reported having experienced a combination of verbal and physical violence. The following were positively associated with resilience score: having a college education or greater (exp((β)()) = 1.045, p = .018), extraversion (exp((β)()) = 1.012 per unit increase in the score, p support (exp((β)()) = 1.004 per unit increase in the score, p = .031), peer support (exp((β)()) = 1.008 per unit increase in the score, p = .006), and lower level of neuroticism (exp((β)()) = 0.983 per unit increase in the score, p resilience was explained by the variables assessed. Adequate support and advanced education are important for abused nurses to enhance their resilience.
The purpose of this study was to gain an insight into nurses' experiences of incorporating aromatherapy into the care of residents suffering from dementia, anxiety and disturbed sleep patterns. Twenty-four residents and twelve nurses from four nursing homes participated in an action research study. The use of lavender augustofolia essential oil diffused nightly was perceived as an effective care modality reducing insomnia and anxiety in this patient cohort. Nurses experienced some negative attitudes among colleagues because they considered aromatherapy as not evidence based. Nurses require greater access to evidence based use of Aromatherapy. Further research is needed to study how smell can enhance dementia care. Copyright © 2013 Elsevier Ltd. All rights reserved.
Friberg, Febe; Lyckhage, Elisabeth Dahlborg
This article describes the development of literature-based models for bachelor degree essays in Swedish undergraduate nursing education. Students' experiences in a course with literature-based models for bachelor degree essays are discussed. The ever-growing body of nursing research and specialized and complex health care practices make great demands on nursing education in terms of preparing students to be both skilled practitioners and users of research. Teaching to help students understand evidence-based practice is a challenge for nursing education. Action research was used to generate knowledge of and practical solutions to problems in everyday locations. Six models were developed: concept analysis, contributing to evidence-based nursing by means of quantitative research, contributing to evidence-based nursing by means of qualitative research, discourse analysis, analysis of narratives, and literature review. Action research was found to be a relevant procedure for changing ways of working with literature-based, bachelor degree essays. The models that were developed increased students' confidence in writing essays and preparedness for the nursing role.
Ellis, Horace; Alexander, Vinette
There has been renewed, global interest in developing new and transformative models of facilitating access to high-quality, cost-effective, and individually-centered health care for severe mentally-ill (SMI) persons of diverse racial/ethnic, cultural and socioeconomic backgrounds. However, in our present-day health-service delivery systems, scholars have identified layers of barriers to widespread dispersal of well-needed mental health care both nationally and internationally. It is crucial that contemporary models directed at eradicating barriers to mental health services are interdisciplinary in context, design, scope, sequence, and best-practice standards. Contextually, nurses are well-positioned to influence the incorporation and integration of new concepts into operationally interdisciplinary, evidence-based care models with measurable outcomes. The aim of this concept paper is to use the available evidence to contextually explicate how the blended roles of psychiatric mental health (PMH) nursing can be influential in eradicating barriers to care and services for SMI persons through the integrated principles of collaboration, integration and service expansion across health, socioeconomic, and community systems. A large body of literature proposes that any best-practice standards aimed at eliminating barriers to the health care needs of SMI persons require systematic, well-coordinated interdisciplinary partnerships through evidence-based, high-quality, person-centered, and outcome-driven processes. Transforming the conceptual models of collaboration, integration and service expansion could be revolutionary in how care and services are coordinated and dispersed to populations across disadvantaged communities. Building on their longstanding commitment to individual and community care approaches, and their pivotal roles in research, education, leadership, practice, and legislative processes; PMH nurses are well-positioned to be both influential and instrumental in
Löhr, M; Sauter, D; Nienaber, A; Heuft, G; Ahrens, R; Oppermann, G; Heinz, A; Schulz, M
The Psychiatry Personnel Act (Psych-PV) as the basis for personnel assessment in psychiatry becomes invalid on 1 January 2019. Because the Psych-PV previously coupled the personnel quota with the intensity of services provided, current efforts are required to develop an instrument to adapt the extent of financed personnel resources to the manifold new legal requirements and advances in treatment in terms of guideline-based care. Based on a literature search and the additional use of a databank of routine data, an example of a calculation was made to estimate the additional personnel resources which would be necessary for psychoeducation and fulfill the legal requirements from 2019 onwards. An investigation was also carried out to identify which psychiatry guidelines contain time values which can be used for calculation of personnel requirements. A three-step approach was used: (1) screening of the current guidelines and determination of the average intervention times with respect to nursing staff, (2) exemplary comparison between the times for guideline-based psychoeducation for patients in the diagnosis groups F32-F33 with the times allocated by the Psych-PV and (3) determination of times between education measures prescribed by law and necessary training for which no (sufficient) time contingents are provided in the Psych-PV. Times for individual activities (e.g. psychoeducation), which are also appropriate for nursing personnel can be found in the primary literature on guidelines; however, these include only a small proportion of tasks undertaken by nursing personnel. For psychoeducation it could be shown that additional time contingents would be necessary in the Psych-PV. Furthermore, there are new mandatory but disregarded schooling measures and instructions for nursing staff, the duration of which can be conservatively calculated as 21 min per case per hospital stay. The empirical approach presented in this study shows the possibility to identify time
Mendes, Davidson Passos; Moraes, Geraldo Fabiano de Souza; Mendes, Juliana Cristina de Lima
Our objective in this study, the analysis of potential fields of risk management in nursing work in psychiatric care to adolescents and children, while settings that go from the relationship between technical and organizational determinants of work activity and the skills of operators. It was established focus on the work process of the Technical and Nursing Assistants to seek for response elements in an attempt to understand the health-disease process experienced by these workers. It was used for analysis and data collection, through the method of Ergonomic Work Analysis (EWA), fifteen workers of nursing staff - T&NA, between effectives and contractors, and the strategies of action and regulation of these workers in relation to the interface that they deal with. The results show that the workers are exposed to all charges in an intense and specific way, causing physical and mental wear, as it approaches the psychological distress, exposure to the psychic pressure, not only through contact with the object of work, but the complexity of these relationships that are involved in nursing staff.
Henly, Susan J; Wyman, Jean F; Gaugler, Joseph E
The focus of health trajectory research is study of health over time for individual persons, families, or communities. The person-focused, time-based perspective reflects health as it is experienced over the life course and maps directly onto processes of care, contributing to ease in translation of results to practice. The agenda focuses on theoretical and empirical components needed to (a) build health trajectory science; (b) develop the scientific workforce to conduct health trajectory research; (c) integrate health trajectory research with other critical, emerging areas of nursing science (genomics and genetics, informatics, dynamic systems and communication); and (d) apply health trajectory research across the life span and continuum of care. Agenda items point the way toward a reorientation of nursing research that incorporates and emphasizes understanding of individual health trajectories.
Taylor, Bev; Bulmer, Beth; Hill, Loretta; Luxford, Catherine; McFarlane, Jenny; Reed, Juanne; Stirling, Kate
This article describes a qualitative research project using a combination of action research and reflective practice. Six experienced registered nurses identified their tendency towards idealism in their palliative nursing practice, which they defined as the tendency to expect to be 100% effective all of the time in their work. Participants collaborated in generating and evaluating an action plan to recognize and manage the negative effects of idealism in their work expectations and behaviours. Participants expressed positive changes in their practice, based on adjusting their responses to their idealistic tendencies towards perfectionism.
Mar 13, 2012 ... recommendations for nursing education, nursing research and nursing practice, with the aim of reducing the readmission of ... impairment of memory, concentration, motivation, self- esteem, relationships with others and ..... at increasing nursing students' and psychiatric nurses' insight about psychiatric ...
Machin, Alison I; Pearson, Pauline
Action learning sets (ALS) are used widely for organisational and workforce development, including in nursing (Anderson and Thorpe, 2004; Pounder, 2009; Young et al., 2010). In the United Kingdom, a multi-faceted educational Pilot programme for new nurses and midwives was implemented to accelerate their clinical practice and leadership development (NHS Education Scotland, 2010). Action Learning Sets were provided for peer support and personal development. The Realistic Evaluation study reported in this paper explored issues of context, mechanism and outcome (Pawson and Tilley, 1997) influencing the action learning experiences of: programme participants (recently qualified nurses and midwives, from different practice settings); and programme supporters. A range of data were collected via: online questionnaires from 66 participants and 29 supporters; three focus groups, each comprising between eight and 10 programme participants; and one focus group with three action learning facilitators. The qualitative data pertaining to the ALS are presented in this paper. Thematic data analysis of context, mechanism and outcome configurations, generated five themes: creating and sustaining a collective learning environment; challenging constructively; collective support; the role of feedback; and effectiveness of ALS. Study outcomes suggest nursing and midwifery action learning should (a) be facilitated positively to improve participants' experience; (b) be renamed to avoid learning methodology confusion; and (c) be outcome focused to evidence impact on practice. Copyright © 2014 Elsevier Ltd. All rights reserved.
Numminen, Olivia; Meretoja, Riitta; Isoaho, Hannu; Leino-Kilpi, Helena
To compare nurse competence in terms of its quality and frequency of action in medical, surgical, paediatric/obstetric/gynaecological and psychiatric clinical fields. One challenge of current health care is to target practising nurses' competencies to optimal use. Therefore, a systematic assessment of nurse competence is justified. Studies using the Nurse Competence Scale have found that nurses' competence is on a good or very good level and it increases with age and work experience. A cross-sectional comparative survey using the Nurse Competence Scale. A purposive sample of 2083 nurses in a major University Hospital in Finland participated in this study in 2007-2008. Descriptive statistics and inferential statistics' anova with Bonferroni correction, and Pearson/Spearman correlation coefficients were used to analyse the data. The overall level of competence of nurses was good, and the quality of action correlated positively with the frequency of action. Nurses in the psychiatric field reached somewhat higher overall mean scores than nurses in other clinical fields. On item level, nurses seemed to be the most competent in actions related to immediate individualised patient care, the maintenance of their own professional competence and commitment to nursing ethics. Age and particularly work experience were positively correlated with the competence. Findings from this large data corroborate previous study results on the category level assessment of nurse competence using the Nurse Competence Scale indicating a good level of competence. On item level, findings revealed more detailed themes of nurse competence, which complements earlier knowledge retrieved from the category level analysis and could be used to target nurses' competencies to even more optimal use. Competence assessment and targeted interventions are recommended as tools for the management for planning nurses' career development and continuing education to ensure competent and motivated work force and
Voogt, L Amar; Nugter, Annet; Goossens, Peter J J; van Achterberg, Theo
The focus is on a nursing intervention called "providing structure" (PS). This label does not exist in the Nursing Interventions Classification. The following three questions were asked: (a) How is PS defined? (b) What are the goals of PS? and (c) What is the evidence regarding the effectiveness of PS? A systematic literature review. Forty articles, predominantly qualitative studies of PS, were selected for review. Regarding PS, three elements were mentioned: to impose and maintain rules and limits; to assess the condition of the patient; and to interact with the patient. The goals for PS related to patient security, making expectations explicit, and recovering from illness. Major findings were reviewed, but little was found about the effectiveness of PS. © 2013 Wiley Periodicals, Inc.
Loft, Mia I; Poulsen, Ingrid; Esbensen, Bente A
AIMS AND OBJECTIVES: To explore nurses' and nurse assistants' beliefs, attitudes and actions related to their function in an inpatient stroke rehabilitation unit. BACKGROUND: Several attempts have been made to describe nurses' roles and functions in inpatient neurorehabilitation. However, current...... understandings of the contributions that nurses and nurse assistants make to neurorehabilitation remain sparse. DESIGN: Descriptive, interpretive qualitative study. METHODS: Participant observations were conducted during 1 month in a stroke rehabilitation unit at a university hospital in the Capital Region...... stroke rehabilitation. We obtained insights into nursing staff's beliefs and attitudes about rehabilitation-as well as their own role and function-and furthermore how the latter affects their actions in daily practice. RELEVANCE TO CLINICAL PRACTICE: The nursing role and function are still not clearly...
Thompson, Nadine; Murphy, Margaret; Robinson, John; Buckley, Thomas
Due to increasing demands on hospital Emergency Departments (EDs), the role of registered nurses, with additional training, has been extended to include requesting X-ray examinations. The aim of this study was to evaluate nurse practice guidelines for requesting X-rays in the ED setting and to utilise inter-professional learning and change management theory to promote practice improvements. Three hundred and one nurse initiated X-ray (NIX) requests were randomly selected between January and March 2012, and reviewed for observance of local department guidelines and quality of clinical history. The results of this preliminary review were used to inform the investigating team in order to improve and support practice. A collaborative educational intervention utilising inter-professional learning and change management theory was implemented with an aim of improving the clinical history provided in NIX requests and development of a new policy to support clinical practice. A second review was repeated from February to April 2014 to evaluate the success of the educational intervention. Observance of NIX guidelines improved from pre-intervention to post-intervention (48% vs. 90%, P > 0.001). Quality of clinical history also significantly improved in all four essential variable criteria: (1) mechanism of injury; (2) injury location; (3) side of injury; and (4) clinical question. This study demonstrates that utilising inter-professional learning and change management theory can contribute to significant improvements in and support clinical practice of NIX in the emergency setting. © 2016 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.
FitzPatrick, Kate; Doucette, Jeffrey N; Cotton, Amy; Arnow, Debra; Pipe, Teri
In this second installment of a three-part series on mindfulness, we describe the process of producing video vignettes to illustrate how clinical nurses draw on the power of mindfulness to build their own resiliency while delivering compassionate care.
A skills teaching programme for first year nursing students is being developed as an action research project with the participation of lecturers, practitioners of three NHS trusts and first year students. All branches of nursing are equally represented. During the first part of the action research cycle the skills to be taught were decided upon using anonymous questionnaires and branch specific group interviews. The selected skills related to aspects of communication, observation, care planning and nursing activities as well as health care and information technology. The professional and personal development of students was also considered. All branches were able to agree on a common skills teaching programme. During this first part of the action research cycle concerns about the organizational possibility of teaching skills to an ever-increasing number of nursing students and the necessary participation of many lecturers were raised. Nevertheless, all participants emphasized the need to continue the project, requesting the development, implementation and evaluation of a new curriculum based on this research as soon as possible. This research demonstrates how small schools of nursing without the resources of large metropolitan-based medical schools and teaching hospitals can improve or design and implement skills teaching programmes for their students in a logical and research based fashion. Copyright 2001 Harcourt Publishers Ltd.
Morano-Báez, Rocío; Albar-Marín, María Jesús; García-Ramírez, Manuel; Prieto-Guerrero, María Milagros; García-Nieto, Alejandro Antonio
To describe a collaborative practice focused on coping with the occupational stress among nursing staff in a hospital setting. These practices focus on the contextualization of the problems and the design and implementation of actions using the psychopolitical model and the participatory action research (PAR) methodology. Participants were the nurses of 4 units of internal medicine at the public hospital "Virgen Macarena" in Seville. We have used the ISTAS questionnaire, interviews and discussion groups through which nurses and researchers have assessed, defined, proposed and implemented different actions in order to improve their work conditions. Problematic situations detected by the questionnaires are associated to psychological demands, role conflicts and esteem. The main cause of stress in healthcare professionals is the lack of staff, according to the opinion laid by supervisors. In the discussion groups, nurses accorded to get involved in three situations: a) the need of the continuous presence of an orderly to move patients which aren't autonomous; b) the need of controlling visit hours and the number of accompanying people with each patient; and c) the need to improve the registration of the activities assigned to nursing staff. Among the strength of the psychopolitical model and PAR in a hospital context we must emphasize on the mobilization of professionals and the development of a critical consciousness. Among the weakness, those derived from bureaucratic processes. These barriers imply a challenge for change and organizational development.
Jensen, Mary E; Pease, Elizabeth A; Lambert, Kris; Hickman, Diane R; Robinson, Ora; McCoy, Kathleen T; Barut, Jennifer K; Musker, Kathleen M; Olive, Dana; Noll, Connie; Ramirez, Jeffery; Cogliser, Dawn; King, Joan Kenerson
At the heart of recovery-oriented psychiatric mental health care are the dignity and respect of each person and the ways in which helping professionals convey a person's uniqueness, strengths, abilities, and needs. "Person-first language" is a form of linguistic expression relying on words that reflect awareness, a sense of dignity, and positive attitudes about people with disabilities. As such, person-first language places emphasis on the person first rather than the disability (e.g., "person with schizophrenia" rather than "a schizophrenic"). This article champions the use of person-first language as a foundation for recovery-oriented practice and enhanced collaborative treatment environments that foster respect, human dignity, and hope.
Holter, I M; Schwartz-Barcott, D
Action research has enjoyed increasing popularity across a wide variety of disciplines including nursing. Action research was designed specifically to bridge the gap between theory, research and practice and incorporates both humanistic and naturalistic scientific methods. As such, action research is a highly compelling method for nursing. However, action research does not easily lend itself to definition. A variety of approaches, definitions and uses have emerged since it was created by Kurt Lewin and have given rise to much debate within social and behavioural sciences. This confusion has carried over into nursing literature without any systematic identification of or debate about the core characteristics of action research or the multitude of approaches or uses that have come to be associated with this method. Thus this paper addresses the central characteristics, three major approaches to action research that exist today and how action research has been used and can be used in nursing.
Faizi, Fakhrudin; Tavallaee, Abbas; Rahimi, Abolfazl; Saghafinia, Masoud
Lifestyle modification has a significant role in chronic daily headache (CDH) management. Participatory action research (PAR) can play an important role in managing chronic medical conditions. However, it has been scarcely used in CDH management. This study aimed to empower patients with CDH to modify their lifestyle in order to reduce both their headache and related psychiatric co-morbidities in a multidisciplinary headache clinic at Baqiyatallah hospital, Tehran, IR Iran. In the PAR plan, 37 patients (27 females) diagnosed with CDH were selected using purposeful sampling. Along with face-to-face group sessions, all available communication means such as phone calls, emails, short message system (SMS), and social media (Telegram) were used to facilitate the process. Questionnaires of health promotion lifestyle profile (HPLPІІ), visual analog scale (VAS), and depression-anxiety-stress scale (DASS21) were used to collect data. The data were analyzed using SPSS software. Mean age of the patients was 38.33 (± 9.7) years. Both "general pain" and "the worst imaginable pain" reduced (mean of reduction: 2.56 ± 2.7 and 2.3 ± 2.9, respectively, P 50% of pain reduction occurred in "the worst imaginable pain" category (-1.45 ± 2.02, P stress (P stress management" (17.73 ± 2.8 vs. 25.53 ± 3.9, P social media are recommended for action research to be more applicable.
Jenkins, Emrys R; Mabbett, Gaynor M; Surridge, Andrea G; Warring, Joanna; Gwynn, Elizabeth D
As nurse lecturers we investigated practice development and action learning approaches aimed at enabling postregistration bachelor's- and master's-level nursing students (Community Health Studies, Nursing in the Home) to advance practice in the context of policy and professional developments. A patchwork text was used to assess summatively what students achieved (practice change/development) and how this was informed critically, via an extended epistemology. First-person inquiry supplemented by cooperative inquiry postcourse completion (including reflective discussions with 16 students and 16 practice mentors) were used to assist coresearcher constructions of meaning. A relational, tripartite approach to learning and assessment (students', teachers', and practice mentors' collective contributions) depends on continuing reflective attention. Action learning enhances interrelation of experience with dialectic thinking. The patchwork text functions to promote creative writing, evaluative thinking, and praxis development. Role modeling by all, being genuine and not just "talking" genuine, is challenging yet crucial if people are to function as mutual resources for learning.
Full Text Available Background and purpose: A learning contract is defined as a written agreement between teacher and student which makes explicit what a learner will do to achieve specified learning outcomes.Learning contracts have been used as a teaching and learning strategy for both undergraduate and graduate nursing students in many countries.Methods : This research is a quasi-experimental study that compares effect of two different teaching methods , Contract learning and traditional on clinical skills for a group of nursing students who were in fourth year of study in a pre-registration bachelor of nursing degree program in Tehran . A learning contract was implemented as a learning tool in the students clinical placement in psychiatric nursing .Data were connected from questionnaires , interviews and clinical evaluation papers with students .Results : The results showed that students agreed that there was an increase in students autonomy and motivation in learning with the use of learning contract . It also increased the sharing between students and clinical instructors.Conclusion : According to the findings of this study , contract learning is considered beneficial to students learning and has the potential to be used in clinical learning .Key words : NURSING STUDENTS, LEARNING CONTRACTS , TRADITIONAL METHOD , MOTIVATION , AUTONOMY, PSYCHIATRIC WARDS .
Su, Tung-Ping; Lien, Te-Cheng; Yang, Chih-Yi; Su, Yiet Ling; Wang, Jia-Horng; Tsai, Sing-Ling; Yin, Jeo-Chen
To assess the rapidly changing psychological status of nurses during the acute phase of the 2003 SARS outbreak, we conducted a prospective and periodic evaluation of psychiatric morbidity and psychological adaptation among nurses in SARS units and non-SARS units. Nurse participants were from two SARS units (regular SARS [N=44] and SARS ICU [N=26]) and two non-SARS units (Neurology [N=15] and CCU [N=17]). Participants periodically self-evaluated their depression, anxiety, post-traumatic stress symptoms, sleep disturbance, attitude towards SARS and family support. Results showed that depression (38.5% vs. 3.1%) and insomnia (37% vs. 9.7%) were, respectively, greater in the SARS unit nurses than the non-SARS unit nurses. No difference between these two groups was found in the prevalence of post-traumatic stress symptoms (33% vs. 18.7%), yet, three unit subjects (SARS ICU, SARS regular and Neurology) had significantly higher rate than those in CCU (29.7% vs. 11.8%, respectively) (pregular SARS unit. Occurrence of psychiatric symptoms was linked to direct exposure to SARS patient care, previous mood disorder history, younger age and perceived negative feelings. Positive coping attitude and strong social and family support may have protected against acute stress. In conclusion, the psychological impact on the caring staffs facing future bio-disaster will be minimized with lowered risk factors and a safer and more structured work environment.
Grady, Christine; Danis, Marion; Soeken, Karen L.; O’Donnell, Patricia; Taylor, Carol; Farrar, Adrienne; Ulrich, Connie M.
Purpose/methods This study investigated the relationship between ethics education and training, and the use and usefulness of ethics resources, confidence in moral decisions, and moral action/activism through a survey of practicing nurses and social workers from four United States (US) census regions. Findings The sample (n = 1215) was primarily Caucasian (83%), female (85%), well educated (57% with a master’s degree). no ethics education at all was reported by 14% of study participants (8% of social workers had no ethics education, versus 23% of nurses), and only 57% of participants had ethics education in their professional educational program. Those with both professional ethics education and in-service or continuing education were more confident in their moral judgments and more likely to use ethics resources and to take moral action. Social workers had more overall education, more ethics education, and higher confidence and moral action scores, and were more likely to use ethics resources than nurses. Conclusion Ethics education has a significant positive influence on moral confidence, moral action, and use of ethics resources by nurses and social workers. PMID:18576241
Grady, Christine; Danis, Marion; Soeken, Karen L; O'Donnell, Patricia; Taylor, Carol; Farrar, Adrienne; Ulrich, Connie M
This study investigated the relationship between ethics education and training, and the use and usefulness of ethics resources, confidence in moral decisions, and moral action/activism through a survey of practicing nurses and social workers from four United States (US) census regions. The sample (n = 1215) was primarily Caucasian (83%), female (85%), well educated (57% with a master's degree). no ethics education at all was reported by 14% of study participants (8% of social workers had no ethics education, versus 23% of nurses), and only 57% of participants had ethics education in their professional educational program. Those with both professional ethics education and in-service or continuing education were more confident in their moral judgments and more likely to use ethics resources and to take moral action. Social workers had more overall education, more ethics education, and higher confidence and moral action scores, and were more likely to use ethics resources than nurses. Ethics education has a significant positive influence on moral confidence, moral action, and use of ethics resources by nurses and social workers.
Flatus problems are not uncommon among gastroenterological clients and those in other care settings. Yet what clients and nurses do productively about those problems in regard to their actions and interactions and why they do so has not previously been the focus of research. Holistic health management requires trustworthy qualitative evidence to guide best practice in this regard. This study systematically developed a substantive grounded theory that details and explains the trajectory of the basic social process: seeking relief from being discommoded (inconvenienced, troubled) by flatus in the situational context of client-nurse interactions. In the theory, there is also a focus on the context of nursing care situations, possible constraints, and likely outcomes. Grounded theory method was applied. Data were collected through semistructured individual interviews, nonparticipant observation, and document analysis regarding incidents and situations involving 38 participants-clients and registered nurses. The results show that clients, when trying to do something about the situation, can be severely discommoded by flatus problems and are hampered by embarrassment and the social taboo about admitting that one is bothered by flatus. The individual may or may not disclose the problem to a nurse, and nurses may or may not be attuned to these problems. There are ways for nurses to be helpful in these situations and possible remedies are identified in this article.
Bulman, C; Forde-Johnson, C; Griffiths, A; Hallworth, S; Kerry, A; Khan, S; Mills, K; Sharp, P
This action research study developed the use of peer reflective supervision (PRS) amongst eight nurse educators contributing to an undergraduate Adult Nursing programme at a UK University. During the academic year (2013-14), nurse educator co-researchers met for an introductory workshop and then met regularly in pairs to facilitate each other's reflection. This provided an opportunity for nurse educators to reflect on identified issues linked to their role with a facilitative peer. Educators met three additional times in a Reflexive Learning Group (RLG), to gather data on their use of PRS. Audio-recordings from the RLGs were transcribed and analysed using Norton's (2009) thematic analysis framework. Co-researchers iteratively validated the data and an external validation group critically viewed the evidence. Overall, seven themes were generated from the three research cycles. These were: PRS as a Valuable Affirming Experience; Time Issues; Facilitation- Support, Trust and Challenge; Developing a Flexible 'Toolbox'; To Write or Not to Write; Drawing on Literature; and Requirement for Action. Findings add new evidence regarding use of a flexible toolbox of resources to develop reflection and offer practical guidance on the development of PRS. Nurse educators often experienced similar concerns, and a facilitative supervision structure allowed co-researchers to positively explore these. Recognition of work pressures and requirement for time and space for reflection was highlighted, particularly regarding writing, and exploring the literature, to develop critical analysis of experiences. The importance of action as part of the reflective process was emphasised. Co-researchers reported positive personal change as well as the opportunity to highlight issues through their reflection for further action within the organisation. The study adds constructive evidence for the use of reflection to explore professional work, make sense of experiences and develop positive action
Chien, Wai-Tong; Bressington, Daniel
This study aimed to test the effectiveness of a nurse-led structured psychosocial intervention program in Chinese patients with first-onset mental illness. A single-blind, parallel group, randomized controlled trial design was used. The study involved 180 participants with mild to moderate-severe symptoms of psychotic or mood disorders who were newly referred to two psychiatric outpatient clinics in Hong Kong. Patients were randomly assigned to either an eight-session nurse-led psychosocial intervention program (plus usual care) or usual psychiatric outpatient care (both n=90). The primary outcome was psychiatric symptoms. Outcomes were measured at recruitment, one week and 12 months post-intervention. Patients in the psychosocial intervention group reported statistically significant improvements in symptoms compared to treatment as usual. There were also significant improvements in illness insight and perceived quality of life and reduction in length of re-hospitalizations over the 12-month follow-up. The findings provide evidence that the nurse-led psychosocial intervention program resulted in improved health outcomes in Chinese patients with first-onset mental illness. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
de Oliveira, Saionara Nunes; do Prado, Marta Lenise; Kempfer, Silvana Silveira; Martini, Jussara Gue; Caravaca-Morera, Jaime Alonso; Bernardi, Mariely Carmelina
This was an action research study conducted during an undergraduate nursing course. The objective was to propose and implement experiential learning for nursing consultation education using clinical simulation with actors. The 4 steps of action research were followed: planning, action, observation and reflection. Three nursing undergraduate students participated in the study. Data were collected in May and July 2013 via participant comments and interviews and were analyzed in accordance with the operative proposal for qualitative data analysis. Planning included constructing and validating the clinical guides, selecting and training the actors, organizing and preparing the scenario and the issuing invitations to the participants. The action was carried out according to Kolb's (1984) 4 stages of learning cycles: Concrete Experience, Reflective Observation, Abstract Conceptualization and Active Experimentation. Clinical simulation involves different subjects' participation in all stages, and action research is a method that enables the clinical stimulation to be implemented. It must be guided by clear learning objectives and by a critical pedagogy that encourages critical thinking in students. Using actors and a real scenario facilitated psychological fidelity, and debriefing was the key moment of the reflective process that facilitated the integral training of students through experiential learning. Copyright © 2014 Elsevier Ltd. All rights reserved.
Johansson, Catrin; Åström, Sture; Kauffeldt, Anders; Helldin, Lars; Carlström, Eric
It is well known that a conservative organizational culture can hinder the implementation of new organizational models. Prior to introducing something new it is important to identify the culture within the organization. This paper sets out to detect the feasibility of reform in a psychiatric clinic in a Swedish hospital prior to implementation of a new working method - a structured tool based on the International Classification of Functioning Disability and Health. A survey consisting of two instruments - an organizational values questionnaire (OVQ) and a resistance to change scale (RTC) - was distributed to registered and assistant nurses at the clinic. The association between the organizational subcultures and resistance to change was investigated with regression analysis. The results revealed that the dominating cultures in the outpatient centers and hospital wards were characterized by human relation properties such as flexibility, cohesion, belongingness, and trust. The mean resistance to change was low, but the subscale of cognitive rigidity was dominant, reflecting a tendency to avoid alternative ideas and perspectives. An instrument like the one employed in the study could be a useful tool for diagnosing the likelihood of extensive and costly interventions. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Cleary, Michelle; Hungerford, Catherine; Lopez, Violeta; Cutcliffe, John R
Micromanagement refers to a management style that involves managers exercising control over team members, teams, and also organizations, particularly in relation to the minutiae or minor details of day-to-day operations. While there is no single reason why some managers may choose to micromanage, many micromanagers exhibit similar behavioral traits, a consequence of perfectionism and/or underlying insecurities. In the culture of high performance that characterizes many contemporary mental health contexts, micromanagement also provides one way by which teams can be driven to achieve targets. However, over time, micromanagement leads to reductions in staff morale, creativity, and productivity; and increases in staff turnover. This paper provides an overview of micromanagement, including points of consideration for managers interested in reflecting on their management styles, and strategies for mental health nurses who find themselves working for a micromanager.
This article uses narrative analysis to understand how mental health professionals working in a pilot experiment in community psychiatry in France between 1960 and 1980 made sense of their work experiences. Based on a collection of essays written by these professionals as part of their training as well as on other archival materials, the article explores writing practices in post-war French psychiatry as ways of constructing and negotiating moral commitments to work. The first three sections of the article give some background on mental health nursing in France in the immediate post-war period. The subsequent three sections examine how the professionals elaborated on their experiences in their writings, focusing on three different levels: first, the narrative voice used in the essays; second, the learning processes described by trainees; and finally, the ways in which they negotiated discursively the requirement to do emotionally well at work.
Full Text Available In this article the authors present findings from a qualitative research study carried out with Ugandan nurses from September 2003 until June 2004. They highlight the process and philosophical basis of participatory action research (PAR by reflecting on the challenges, opportunities, outcomes, and ethical issues encountered during the conduct of the research. In this study PAR fostered a climate in which nurses could engage in collective reflection on their practice, make sense of their experiences, and thereby change their understanding of their work.
Green, J K; Huntington, A D
Professional development opportunities for nurses are increasingly being offered in the online environment and therefore it is imperative that learning designers, nurse educators and healthcare organisations consider how best to support staff to enable Registered Nurses to capitalise on the resources available. Research participants explored educational strategies to support digitally differentiated nurses' engagement with professional development activities in an online environment through a participatory action research project that collected data over a 16 month period through six focus groups before being analysed thematically. The reality of work-based, e-learning while managing clinical workloads can be problematic however specific measures, such as having a quiet space and computer away from the clinical floor, access to professional development resources from anywhere and at any time, can be effective. A 'one-size-fits-all' approach to resources offered will not meet the needs of diverse staffing groups whereas heutagogical learning offers tangible benefits to Registered Nurses seeking professional development opportunities in this context. Apparent proficiency with technological skills may not reflect a Registered Nurse's actual ability in this environment and face-to-face support offered regularly, rather than remedially, can be beneficial for some staff. Implementing specific strategies can result in successful transition to the online environment. Copyright © 2016 Elsevier Ltd. All rights reserved.
Westra, Bonnie L; Latimer, Gail E; Matney, Susan A; Park, Jung In; Sensmeier, Joyce; Simpson, Roy L; Swanson, Mary Jo; Warren, Judith J; Delaney, Connie W
There is wide recognition that, with the rapid implementation of electronic health records (EHRs), large data sets are available for research. However, essential standardized nursing data are seldom integrated into EHRs and clinical data repositories. There are many diverse activities that exist to implement standardized nursing languages in EHRs; however, these activities are not coordinated, resulting in duplicate efforts rather than building a shared learning environment and resources. The purpose of this paper is to describe the historical context of nursing terminologies, challenges to the use of nursing data for purposes other than documentation of care, and a national action plan for implementing and using sharable and comparable nursing data for quality reporting and translational research. In 2013 and 2014, the University of Minnesota School of Nursing hosted a diverse group of nurses to participate in the Nursing Knowledge: Big Data and Science to Transform Health Care consensus conferences. This consensus conference was held to develop a national action plan and harmonize existing and new efforts of multiple individuals and organizations to expedite integration of standardized nursing data within EHRs and ensure their availability in clinical data repositories for secondary use. This harmonization will address the implementation of standardized nursing terminologies and subsequent access to and use of clinical nursing data. Foundational to integrating nursing data into clinical data repositories for big data and science, is the implementation of standardized nursing terminologies, common data models, and information structures within EHRs. The 2014 National Action Plan for Sharable and Comparable Nursing Data for Transforming Health and Healthcare builds on and leverages existing, but separate long standing efforts of many individuals and organizations. The plan is action focused, with accountability for coordinating and tracking progress designated
Sarikoc, Gamze; Ozcan, Celale Tangul; Elcin, Melih
The use of standardized patients is not very common in psychiatric nursing education and there has been no study conducted in Turkey. This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students. This manuscript addressed the quantitative aspect of a doctoral thesis study in which both quantitative and qualitative methods were used. A pre-test and post-test were employed in the quantitative analysis in a randomized and controlled study design. The motivation scores, and interim and post-test scores for perceived learning were higher in the experimental group compared to pre-test scores and the scores of the control group. The students in the experimental group reported that they felt more competent about practical training in clinical psychiatry, as well as in performing interviews with patients having mental problems, and reported less anxiety about performing an interview when compared to students in the control group. It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Evidence from several sub-Saharan countries support nurse-initiated antiretroviral treatment as a feasible alternative to doctor-led models characteristic of early responses to the HIV epidemic. However, service delivery models shown to be effective in one country may not be readily adopted in another. This study used an implementation research approach to assist policy makers and other stakeholders to assess the acceptability and feasibility of task shifting in the Namibian context.The Namibian Ministry of Health and Social Services implemented a Task Shifting Demonstration Project (TSDP at 9 sites at different levels of the health system. Six months after implementation, a mixed methods evaluation was conducted. Seventy semi-structured interviews were conducted with patients, managers, doctors and nurses directly involved with the TSDP. Physician-evaluators observed and compared health service provision between doctors and nurses for 40 patients (80 observations, documenting performance in agreement with the national guidelines on 13 clinical care indicators.Doctors, nurses, and patients interviewed believed task shifting would improve access to and quality of HIV services. Doctors and nurses both reported an increase in nurses' skills as a result of the project. Observation data showed doctors and nurses were in considerable agreement (>80% with each other on all dimensions of HIV care and ≥90% on eight dimensions. To ensure success of national scale-up of the task shifting model, challenges involving infrastructure, on-going mentoring, and nursing scope of practice should be anticipated and addressed.In combination with findings from other studies in the region, data from the TSDP provided critical and timely information to the Namibian Ministry of Health and Social Services, thus helping to move evidence into action. Small-scale implementation research projects enable stakeholders to learn by doing, and provide an opportunity to test and
McCoy, Kathleen T
Radical changes in role, education, and practice have affected how education of advance practice nurses and practice deliverables occur. This article examines the effects of distance education upon the teaching/learning of psychotherapy in integrating Web-based technology and platforms. With the advent and proliferation of online programs of study, the question begs: How do distance-linked programs successfully introduce, practice, and supervise one-to-one and group psychotherapy training? By employing evidence-based education strategies, technology, and strong interpersonal skills and evidence-based therapies, a charter Psychiatric Mental Health Nurse Practitioner Doctor of Nursing Practice program paved an innovative and successful path. In that program, they prepared their students for full scope of practice, upon graduation, inclusive of psychotherapy as well as the other highly demanding and compressed requirements of the 3-year program. This article explores that journey and its recommendations for application derived from this 2010 cohort. © 2017 Wiley Periodicals, Inc.
Hewison, Alistair; Badger, Frances; Swani, Tina
If the end-of-life care needs of people living in nursing homes are to be met, effective leadership is necessary. This in turn requires that appropriate training and support are provided for nursing home managers. To meet this need, an action learning set (ALS) involving nursing home managers was developed, and as a result of the continuous process of learning and reflection that characterizes ALS work the managers brought about a number of improvements in end-of-life care. These included more consistent use of care plans, increased involvement of clients and their families in planning end-of-life care, more training for staff, and the use of events and techniques to create opportunities for discussing the end of life. The managers set specific individual objectives focused on improving end-of-life care and were supported in meeting them through their membership of the set.
Full Text Available Background: Low independent nurse actions leads to poor health care quality. Therefore, understanding the factors affecting independent nursing action is necessity. Objectives: This study aims to analysis the independent nurse actions and its related and predicting factors. Methods: This study used a cross-sectional design with observational technique for data collection. There were 165 nurses recruited using simple random sampling in 14 inpatient wards. Spearman Rank Correlation and multiple regressions were used for data analysis. Results: Results of this study showed that there were significant relationships of age, gender, education, employment time, family burden, working experience, knowledge, workload, and nurse ability with independent nursing action with p-value <0.05. Nurse knowledge is the most dominant factor predicting independent nursing action with R-value 0.450. Conclusions: Independent nurse actions in daily living activities, caring & support, and rehabilitation were influenced by multiple factors such as nurse knowledge, ability, education and gender. Nurse knowledge is the most predicting factors affecting independent nursing action. Therefore, hospital and nurse managers need to well manage these predicting variables in order to improve independent nurse action that leads to the better quality of health service in the Dr. M. Haulussy Ambon Hospital.
Lauvrud, Christian; Nonstad, Kåre; Palmstierna, Tom
Violence is frequent towards nurses in forensic mental health hospitals. Implications of this high risk environment have not been systematically explored. This paper explores occurrence of symptoms on post traumatic stress and their relationship to professional quality of life. Self report questionnaires assessing symptoms of post traumatic stress and professional quality of life were distributed among psychiatric nurses in a high security forensic psychiatric unit with high frequency of violent behaviour. Relationships between post traumatic stress symptoms, forensic nursing experience, type of ward and compassion satisfaction, burnout and compassion fatigue were explored. The prevalence of post traumatic stress symptoms was low. Low scores were found on compassion satisfaction. Length of psychiatric nursing experience and low scores on compassion satisfaction were correlated to increased post traumatic stress symptoms. Although high violence frequency, low rate of post traumatic stress symptoms and low compassion satisfaction scores was found. High staff/patient ratio and emotional distance between staff and patients are discussed as protective factors.
Savaşan, Ayşegül; Çam, Olcay
People with alcohol dependency have lower self-esteem than controls and when their alcohol use increases, their self-esteem decreases. Coping skills in alcohol related issues are predicted to reduce vulnerability to relapse. It is important to adapt care to individual needs so as to prevent a return to the cycle of alcohol use. The Tidal Model focuses on providing support and services to people who need to live a constructive life. The aim of the randomized study was to determine the effect of the psychiatric nursing approach based on the Tidal Model on coping and self-esteem in people with alcohol dependency. The study was semi-experimental in design with a control group, and was conducted on 36 individuals (18 experimental, 18 control). An experimental and a control group were formed by assigning persons to each group using the stratified randomization technique in the order in which they were admitted to hospital. The Coping Inventory (COPE) and the Coopersmith Self-Esteem Inventory (CSEI) were used as measurement instruments. The measurement instruments were applied before the application and three months after the application. In addition to routine treatment and follow-up, the psychiatric nursing approach based on the Tidal Model was applied to the experimental group in the One-to-One Sessions. The psychiatric nursing approach based on the Tidal Model is an approach which is effective in increasing the scores of people with alcohol dependency in positive reinterpretation and growth, active coping, restraint, emotional social support and planning and reducing their scores in behavioral disengagement. It was seen that self-esteem rose, but the difference from the control group did not reach significance. The psychiatric nursing approach based on the Tidal Model has an effect on people with alcohol dependency in maintaining their abstinence. The results of the study may provide practices on a theoretical basis for improving coping behaviors and self-esteem and
Steinert, Tilman; Goebel, Rita; Rieger, Wolfgang
In three psychiatric hospitals in Baden-Wuerttemberg, Germany, a physician-nurse shared leadership model was implemented in 1997 by the hospital management. The whole hospital, departments, and single wards are led each by a leadership team consisting of a physician, psychologist or social worker and a nurse, being responsible for organization, staff, and budgets. The consequences for staff opinion in leadership positions were evaluated. All 165 leading staff members of all professional groups were anonymously interviewed with a questionnaire containing 45 items regarding their satisfaction with this new leadership model. The response rate was 79.4%. Overall, the leading staff members were satisfied with the shared leadership model both in their own clinical practice and in general. Non-medical staff members were significantly more in favour of several aspects of shared leadership than physicians, but even the latter reported to be generally satisfied. However, both professional groups estimated leading positions to be only modestly attractive. The results yield some evidence that the change from traditional leadership models to the physician-nurse shared leadership model may have advantages in the management of psychiatric hospitals.
Nancy P. Hanrahan
Full Text Available Individuals with serious mental illness have greater risk for contracting HIV, multiple morbidities, and die 25 years younger than the general population. This high need and high cost subgroup face unique barriers to accessing required health care in the current health care system. The effectiveness of an advanced practice nurse model of care management was assessed in a four-year random controlled trial. Results are reported in this paper. In a four-year random controlled trial, a total of 238 community-dwelling individuals with HIV and serious mental illness (SMI were randomly assigned to an intervention group (n=128 or to a control group (n=110. Over 12 months, the intervention group received care management from advanced practice psychiatric nurse, and the control group received usual care. The intervention group showed significant improvement in depression (P=.012 and the physical component of health-related quality of life (P=.03 from baseline to 12 months. The advanced practice psychiatric nurse intervention is a model of care that holds promise for a higher quality of care and outcomes for this vulnerable population.
Sandra van der Loo; Gerrie Bours; Anna Beurskens; Albine Moser; Jolanda Friesen-Storms
Aims and objectives: To describe the process of implementing evidence-based practice (EBP) in a clinical nursing setting. Background: EBP has become a major issue in nursing, it is insufficiently integrated in daily practice and its implementation is complex. Design: Participatory action
Taylor, Bev; Roberts, Sue; Smyth, Therese; Tulloch, Moira
To raise nurse managers' critical awareness of practice problems; uncover practice constraints and improve work effectiveness. Nurse management requires skills and knowledge, underscored by emotional intelligence. The research improved participants' practice and personal insights. Purposive sampling targeted nurse managers interested in improving their practice. Three experienced female nurse managers met fortnightly in a group, for 1 hour, for 10 meetings. The methods included: writing and sharing de-identified journal reflections; critically analysing practice stories; identifying a thematic concern; generating action strategies; and instituting and revising the action plan. Phase One resulted in the identification of the issue of 'being drained by the intensity of nurse managers' work'. The participants adopted five strategies: debriefing problematic situations; deflecting multiple requests; diffusing issues; naming dysfunctional behaviours; and regrouping. In Phase Two, participants implemented and revised the action plan strategies, which resulted in them feeling less drained by their work. Strategies can lessen nurse managers' sense of personal depletion. However, strategies cannot guarantee success every time because the emotional intelligence is integral to nurse management. Action research and reflection assist nurse managers to improve their practice and develop their emotional intelligence. © 2014 John Wiley & Sons Ltd.
Itzhaki, Michal; Bluvstein, Irit; Raz, Shai; Barnoy, Sivia
The Internet is a preferred source of information for nursing students. The purpose of the research was to identify teachers' reactions towards students who present them with information retrieved from the Internet. A total of 137 nursing teachers from 15 nursing schools in Israel were surveyed by a questionnaire. The dependent variable was nursing teachers' actions following encounters with students who present them with information from the Internet. Independent variables were: teacher's emotional reactions, teachers' Internet efficacy, Internet anxiety, and perceived student Internet efficacy. The intensity of positive emotional reactions was the only predictor of teachers' actions towards Internet information retrieved by students. When teachers perceived students as having higher Internet efficacy, their emotional reactions were more positive and they took more actions. Teachers' Internet anxiety was negatively correlated with their positive emotional reactions and actions. No correlation was found between nursing teachers' Internet self efficacy and their reactions or actions following an encounter with students presenting Internet information. Positive emotional reactions mediated correlations between teachers' Internet anxiety, perceived student Internet efficacy, and teachers' actions. Nursing teachers' positive emotions foster openness and acceptance of Internet information retrieved by students. Copyright © 2012 Elsevier Ltd. All rights reserved.
Liu, Wen-I; Rong, Jiin-Ru; Liu, Chieh-Yu
E-learning is a flexible strategy to improve nurses' knowledge of case management, but there are methodological limitations in previous research into the effectiveness of such programs. To describe the development and effectiveness of an evidence-integrated e-learning program in case management continuing education for Taiwanese psychiatric nurses. Multiple methods were adopted to develop the program and a randomised controlled trial with repeated measures was employed to evaluate it. The e-learning program was developed in four stages: (1) systematic review of literature; (2) needs assessment through a national survey and focus group; (3) development of learning materials; and (4) pilot test. Following program development, psychiatric nurses were recruited and randomly allocated into an experimental or comparison group. The experimental group participated in an e-learning continuing education program. The case management knowledge index with sufficient reliability and validity and a satisfaction survey were used to determine the outcomes. A generalised estimating equation was used to assess the difference between the 2 groups before, after, and at 3 months follow-up. The learning material comprised 5 simulated learning modules, self-assessment questions, learning cases, sharing experiences, and learning resources. A total of 200 participants completed the 3 measurements. Knowledge scores in the experimental group significantly exceeded those in the comparison group after the program and at the 3-month follow-up. Participants reported positive learning perceptions. The program provides an evidence-based educational resource for nursing continuing education in case management. Copyright © 2014 Elsevier Ltd. All rights reserved.
Patricia de Oliveira Furukawa
Full Text Available ABSTRACT Objectives: to verify the correlation between the characteristics of professionals and the practice of sustainable actions in the medication processes in an ICU, and to determine if interventions such as training and awareness can promote sustainable practices performed by nursing staff in the hospital. Methods: before-and-after design study using Lean Six Sigma methodology, applied in an intensive care unit. Nursing staff were observed regarding the practice of ecologically sustainable actions during medication processes (n = 324 cases for each group (pre and post-intervention through a data collection instrument. The processes analyzed involved 99 professionals in the pre-intervention phase and 97 in the post-intervention phase. Data were analyzed quantitatively and the association of variables was accomplished by means of statistical inference, according to the nature of the related variables. Results: the education level was the only characteristic that showed to be relevant to an increase in sustainable practices, with a statistically significant difference (p = 0.002. When comparing before and after the intervention, there was an increase in environmentally friendly actions with statistically significant differences (p = 0.001. Conclusions: the results suggest that institutions should encourage and invest in formal education, as well as training of health professionals to promote sustainable practices in the hospital.
Barros, Edaiane Joana Lima; Santos, Silvana Sidney Costa; Gomes, Giovana Calcagno; Erdmann, Alacoque Lorenzini; Pelzer, Marlene Teda; Gautério, Daiane Porto
The goal was to identify the ecosystem and gerontogeriatric technological actions to be done in a complex nursing care for the elderly patients of ostomy. To do so, a qualitative and descriptive research was made on a Case Study. The data were collected through interviews. The elderly were classified due to the Functioning, Disability and Health. They also went through physical exams and systematic observation. Ten people from the Estomatherapy Service of the south of Brazil took part in the research along the period of June to August of 2012. A theoretical model was developed and the data were compared with a protocol. The ecosystem actions identified the construction of a therapeutic environment, the guaranty of physical access and environmental adaptation. The gerontogeriatric technological actions identified a health educative process, the routing to the support group and the material and necessary equipment distribution for self-care. Being the nursing care primordial for the elderly patients of ostomy, they are able to face their limitations, demystifying their deficiency/ disability /health.
Natan, Merav Ben; Beyil, Valery; Neta, Okev
A correlational design was used to examine nursing staff attitudes and subjective norms manifested in intended and actual care of drug users based on the Theory of Reasoned Action. One hundred and thirty-five nursing staff from three central Israeli hospitals completed a questionnaire examining theory-based variables as well as sociodemographic and professional characteristics. Most respondents reported a high to very high level of actual or intended care of drug users. Nurses' stronger intentions to provide quality care to drug users were associated with more positive attitudes. Nursing staff members had moderately negative attitudes towards drug users. Nurses were found to hold negative stereotypes of drug addict patients and most considered the management of this group difficult. Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality care to hospitalized patients addicted to drugs.
The purpose of this study was to explore and describe the perceptions of psychiatric patients with regard to marijuana use in Potchefstroom, North West Province, as well as to formulate recommendations for nursing education, nursing research and nursing practice, with the aim of reducing the readmission of psychiatric ...
Débora Cherchiglia de Moraes
Full Text Available Abstract OBJECTIVE To identify opportunistic screening actions for breast cancer performed by nurses working in primary health care units in Ribeirão Preto, São Paulo. METHOD Cross-sectional study with 60 nurses from 28 units, who had been working for at least one year in the public municipal health care network. Data were collected between December 2013 and March 2014, by means of a questionnaire, using descriptive analysis and the software IBM SPSS version 20 and Microsoft Excel 2010. RESULTS The results showed that 71.7% of the participants questioned their female patients as for risk factors for breast cancer, mainly during nursing consultation; 70.0% oriented users about the age to perform clinical breast exam, whereas 30.0% did not due to lack of knowledge and time; 60.0% explained about the age to perform mammogram; 73.3% did not refer patients with suspicious breast exam results to the referral department, citing scheduling as the main obstacle to referral. Educational activities were not performed by 78.3% of participants. CONCLUSION Investment is needed in professional training and management of breast cancer screening.
Camila Aparecida Pinheiro Landim Almeida
Full Text Available Educational actionswith people living with chronic conditions, especially Diabetes mellitus, are a challenge and a necessary strategy in Primary Care, in view of the glycemic balance, the prevention of complications and the improvement of the quality of life. This study aimed to analyze nurse training in educational actions developed in Primary Care with people living with Diabetes mellitus. A qualitative research was conducted with 28 nurses of Primary Care, in Teresina, state of Piauí, Brazil. Data were collected from April to June 2015 through interviews and analyzed by the collective subject discourse technique. The construction of the results was based on four sequential questions made in the interviews, from which emerged 15 central ideas: lectures, group orientation, nursing consultation and home care; theoretical knowledge, practical knowledge, technical knowledge and expertise knowledge; few materials and infrastructure in the basic unit, lack of professional teamwork, reduced workload and little awareness of teachers; and promotion of care and and self-care, family support and prevention of complications. In the analysis of the discourses, it was possible to conclude about the need for Permanent Health Education in Primary Care.
Oliveira, Renata Marques de; Duarte, Alexandre Freitas; Alves, Domingos; Furegato, Antonia Regina Ferreira
to develop a mobile app for research on the use of tobacco among psychiatric patients and the general population. applied research with the technological development of an app for data collection on an Android tablet. For its development, we considered three criteria: data security, benefits for participants and optimization of the time of researchers. We performed tests with twenty fictitious participants and a final test with six pilots. the app collects data, stores them in the database of the tablet and export then to an Excel spreadsheet. calculator, stopwatch, offline operation, branching logic, field validation and automatic tabulation. the app prevents human error, increases the quality of the data by validating them during the interview, allows the performing of automatic tabulation and makes the interviews less tiring. Its success may encourage the use of this and other computational resources by nurses as a research tool. desenvolver aplicativo mobile para pesquisa sobre o uso de tabaco entre pacientes psiquiátricos e a população geral. pesquisa aplicada com o desenvolvimento tecnológico de um aplicativo para coleta de dados em tablet Android. Para seu desenvolvimento, consideraram-se três critérios: segurança dos dados, benefícios para os participantes e otimização do tempo dos pesquisadores. Testes com 20 participantes fictícios e teste final com seis pilotos. o aplicativo coleta os dados, armazena-os no banco de dados do tablet e os exporta para planilha Excel. Recursos: calculadora; cronômetro; funcionamento off-line, lógica de ramificação, validação de campos e tabulação automática. o aplicativo previne erros humanos e aumenta a qualidade dos dados ao validá-los durante a entrevista, permite realizar tabulação automática e torna as entrevistas menos cansativas. Seu sucesso poderá incentivar o uso desse e outros recursos computacionais pelos enfermeiros, como ferramenta de pesquisa. desarrollar aplicativo móvil para hacer
Silvana, Salerno; Laura, Forcella; Ursula, Di Fabio; Irene, Figà Talamanca; Paolo, Boscolo
Patient's aggressive behavior is one of the major problem in the psychiatric ward. Here we present the preliminary results of a psychiatric ward case-study, of a public hospital in the Chieti province, in order to plan ergonomic improvement. We applied the Method of Organizational Congruencies in the psychiatric ward in order to study the relationship between organized hospital work and nurses wellbeing in a 24 hour shifts. We observed 58 main phases in the three work shifts. The technical actions are mainly those of any hospital wards (shift briefing, preparing and administering drugs, recording data on clinical charts, etc.). We found important differences mainly due to the nurses overcontrol activities on the patients behavior (preventing suicides or self destructive behavior), the occurrence of restraint procedure towards patients, the pollution due to patient's cigarette smoke. The fear of patient's self destructive behavior or other aggressive behaviour are the main cognitive and social aspects of this hospital ward. Nurses working in this psychiatric ward have to accept: locked doors, poor and polluted environment, restraint procedure with high risk of aggression and no availability of mental health care programs. A new interdisciplinary concept for ergonomics in psychiatry setting may represent a challenge for both nurses and patients and the community.
Bakker, T.J.; Duivenvoorden, H.J.; Lee, J. van der; Olde Rikkert, M.G.M.; Beekman, A.T.; Ribbe, M.W.
OBJECTIVE: To test the effectiveness of an integrative psychotherapeutic nursing home program (integrative reactivation and rehabilitation [IRR]) to reduce multiple neuropsychiatry symptoms (MNPS) of cognitively impaired patients and caregiver burden (CB). DESIGN: Randomized controlled trial.
Kvarme, Lisbeth Gravdal; Monsen, Karen A; Eboh, Winifred Oluchukwu
Cyberbullying is a global phenomenon. The experiences of bullied children are the same across cultures and languages, and psychiatric nursing interventions are known to be effective. It is critical to widely disseminate effective interventions to identify and address cyberbullying. Therefore, evidence-based care plans addressing cyberbullying at the individual and community levels were developed using the Omaha System, a terminology that is used internationally to guide and document care. This article presents a case study in which an evidence-based intervention was used to help a bullied child arrive at a solution, and demonstrates the use of the Omaha System to document evidence-based cyberbullying interventions with individuals and communities. Copyright 2014, SLACK Incorporated.
Luciana Regina Ferreira da Mata
Full Text Available Objective. To identify nursing actions in the perioperative period and in preparing prostatectomy patients for discharge. Methodology. Cross-sectional, retrospective study. Data were collected from medical record of patients who underwent partial or total prostatectomy between August 2009 and August 2010 at hospitals in Divinopolis, Minas Gerais, Brazil. Results. A total of 121 patients were identified; the mean age was 67 years. The most frequent diagnosis was prostate cancer (70%. Main preoperative activities were measuring vital signs (55%, administering drugs (52%, educating patients about fasting (50%, and managing edema (45%. After surgery, the most frequent tasks were measuring vital signs (100%, measuring urine and emptying the urinary bag (100% for each, facilitating the healing of surgical wounds (77%, and evaluating Penrose drain discharge (48%. Among the 25 types of care observed, the activity that nurses performed most often for patients about to be discharged was providing education about urinary catheter manipulation (16%. Conclusion. This study identified weaknesses in care delivery for prostatectomy patients, particularly regarding home care education.
Vabo, Grete; Slettebø, Åshild; Fossum, Mariann
The aim of this study is to describe healthcare professionals' experiences and perceptions of an intervention implemented in an action research project conducted to improve nursing documentation practices in four municipalities in Norway. Documentation of individualized patient care is a continuing concern in healthcare services and could impacts the quality and safety of healthcare. Use of electronic systems has made some aspects of documentation more comprehensive, but creation of an individualized care plan remains a pressing issue. A qualitative descriptive design was used. An action research project was conducted between 2010-2012 to improve the content and quality of nursing documentation in community healthcare services in four municipalities. One year after the project was completed four focus group interviews were conducted with healthcare professionals, one for each involved municipality. Two unit managers were interviewed individually. Qualitative content analysis was used. Three themes emerged: healthcare professionals perceived competing interest; they experienced that they had to manage complexity and changes; and they highlighted a clear and visible leader as important for success. Quality improvement activities are essential. Healthcare professionals experience a complicated situation when electronic health record systems do not support workflow. Further research is recommended to focus on the functionality and user interface of electronic health record systems, and on the role of leadership when implementing changes in clinical practice. Stronger cooperation among policymakers, electronic health record system vendors, and healthcare professionals is essential for improving electronic health record systems and documentation practices. Involvement of end-users in these improvements can make a difference in the way the systems are perceived in the clinical workflow. © 2016 John Wiley & Sons Ltd.
Frequent disconfirmation behaviors have been documented in psychiatric clients. Individuals who demonstrate maladaptive patterns of disconfirmation can learn to understand and modify this dysfunctional sequence. Through one to one interactions and group discussions, psychiatric nurses can help clients learn more positive communication behaviors. This accomplishment will positively affect the client's interpersonal responsiveness and self-esteem.
... personnel, psychological services, social work services, psychiatric nursing, and therapeutic activities. (c... of assessment/diagnostic data. Medical records must stress the psychiatric components of the record... health nursing, or its equivalent, from a school of nursing accredited by the National League for Nursing...
An, Feng-Rong; Qi, Yun-Ke; Zeng, Jiao-Ying; Ding, Yan-Ming; Chiu, Helen F K; Ungvari, Gabor S; Newhouse, Robin; Yu, Doris S F; Lai, Kelly Y C; Xiang, Yu-Tao
To determine the prevalence of insomnia and its socio-demographic correlates in Chinese nurses. Up to 799 nurses were examined. Demographic data, total sleep time (TST), and insomnia were collected. The mean expected and actual TST were 8.3 ± 1.5 and 6.1 ± 1.1 hr, respectively. The prevalence of at least one type of reported sleep disturbance was 69.7%; the rates of difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening were 54.6%, 54.7%, and 55.9%, respectively. There is a large discrepancy of actual and expected sleep duration, and insomnia is common among nurses in China. © 2015 Wiley Periodicals, Inc.
Mackoff, Barbara L; Glassman, Kimberly; Budin, Wendy
The aim of the pilot study was to design an innovative model of leadership development, Leadership Laboratory (LL), grounded in the lived experiences and peer best practices of 43 cross-disciplinary nurse managers. The Institute of Medicine/Robert Wood Johnson Foundation study, The Future of Nursing, reinforces the need to prepare nurses for leadership positions. A 1-year participatory action research study was designed to develop 3 LLs involving nurse managers as participants, co-creators, and evaluators of the unique learning format. Analysis of qualitative and quantitative data revealed consistent and significantly positive results in leadership skill areas in all 3 LLs. Participants identified elements that distinguished LLs from traditional seminars and trainings sessions, including opportunities to gain from peer-to peer consultation, strategies, and support. Participants in the 1-year pilot demonstrated significant learning based on postsession and postproject assessments of the LLs. Data also described the unique attributes of a peer-driven approach to leadership development.
Penney, Wendy; Meyer, Julienne; Cash, Penny; Clinnick, Lisa; Martin, Louise
The implementation of action learning workshops in three nursing homes in rural Victoria, Australia has been critical in the re-visioning of how care can be enhanced for residents. The workshops were designed with the intent of improving quality of care for residents by providing health care staff with opportunities to learn together and effect…
Werner, P; Mendelsson, G
To examine nursing staff members' attitudes, subjective norms, moral obligations and intentions to use physical restraints, using the Theory of Reasoned Action (TRA). During the last two decades an extensive body of research has examined nurses' attitudes as one of the main factors affecting the decision to use or not to use physical restraints with older persons. However, no studies have examined empirically the antecedents to nurses' intentions to use physical restraints within a theoretically based framework. A correlational design was used with 303 nursing staff members from an 800-bed elder care hospital in central Israel. Participants completed a questionnaire including questions based on the TRA as well as socio-demographic and professional characteristics. Regression analyses found attitudes, subjective norms and moral considerations to be significantly associated to intention to use physical restraints with older people. The TRA explained 48% of the variance in nurses' intentions. The TRA proved to be a useful framework for examining nurses' intentions to use physical restraints. Nurses' attitudes, beliefs and expectations of significant others should be examined before implementing educational programmes regarding the use of physical restraints.
Full Text Available Introduction: In a four-year undergraduate level , the nursing students have to get prepared in the patients education, designing care plans, applying nursing processes and exercise the clinical decisions, in addition to learning practical skills. Therefore, multiple clinical teaching strategies in nursing must be applied. In this study the sheets for the mentioned fields were designed and used. Methods: In this action research in Tabriz University of Medical Sciences, 64 nursing senior students and related instructors participated. Clinical written assignment included the patient’s health condition sheet, tables showing the used medicines and the precautions, the clinical and paraclinical tests and the results, identifying the patient problems, designing and implementing care plan and writing nursing reports with SOAPIE method. The instructors’ viewpoints were achieved through the group discussions and their notes taken. The perceived competency of the students was obtained through a questionnaire. The qualitative data was analyzed by the content analysis and quantitative using SPSS. Results: Both the students and the instructors agreed with the clinical written assignment. The desired care competency of the students before and after assignment was statistically significant (p<0.05. According to the instructors, intervention was useful for the senior students who have passed the courses needed for completing and using the different parts of these forms. Conclusion: Since a need is always felt in the trends of the nursing clinical teaching, the researchers recommend the clinical written assignment and their application along with other strategies for senior nursing students in clinical teaching.
Koukia, Evmorfia; Giannouli, Eleni; Gonis, Nikolaos; Douzenis, Athanassios
Mental health nurses play a key role in maintaining the safety of patients, themselves, and others during hospitalization. The aim of the research was to evaluate the safety measures that are taken by mental health nurses to identify the security policies that exist in acute mental health wards. The Ward Safety and Security Rules Survey was used as a method of data collection. Descriptive analysis and content analysis were carried out in order to identify nurses' practices. The total sample consisted of 172 mental health nurses and nurses' assistants who worked in 14 acute inpatient psychiatric wards in three psychiatric hospitals in the greater area of Athens, Greece. The results show a minimum number of security features existing in the wards. Only one of the 14 wards had an intercom system. In only nine wards, there was a panic alarm in the office, and in eight, an emergency response telephone extension. A wide range of practices were noted concerning banned items and patient searches upon admission and return from leave. The results indicate the significant lack of protocols and specific safety rules to guide nurses' actions across psychiatric acute admission wards in Athens. © 2010 The Authors. International Journal of Mental Health Nursing © 2010 Australian College of Mental Health Nurses Inc.
The Rise of Mental Health Nursing onderzoekt de tegenstrijdigheden in de op het ziekenhuis georiënteerde inrichtingszorg, die rond 1900 opkwam. Bovendien illustreert het boek de sociale complexiteit van de psychiatrische zorg. Op basis van archiefmateriaal uit vier Nederlandse psychiatrische
Conradie, Maria; Erwee, Danelle; Serfontein, Isabel; Visser, Maré; Calitz, Frikkie J W; Joubert, Gina
Nursing staff working with intellectually disabled in-patients experience unique stress factors that can influence their personal well-being and work performance. To compile a profile of stress factors experienced by nursing staff working with intellectually disabled in-patients at the Free State Psychiatric Complex (FSPC). This descriptive study included 89 nursing staff members from this environment. A questionnaire was used to collect socio-demographic information and determine personal and occupational stressors. The data were summarised by frequencies and percentages (categorical variables) and means or percentiles (numerical variables). Most participants were aged between 46 and 55 (41.2%), female (93.2%) and black (93.2%), and 76.7% had children or dependant minors. The main stressors among participants were pressure providing financially for their children and dependant minors (71.2%), caring for them (39.4%) and fearing them moving away (25.8%). Occupational stressors included high workload (66.3%), lack of decision-making by superiors (58.1%), underpayment (53.5%), endangerment of physical health (52.3%) and safety (50.0%), working hours (51.2%), pressure of expectations from superiors (48.8%), uncertainty of employment (48.8%), work responsibilities (47.7%) and perceiving that skills and training were not appreciated. They experienced stress regarding health issues such as hyper- and hypotension (35.3%). Because of stress 34.5% of participants took leave, 34.5% developed depression and 14.3% had panic attacks. Most of the respondents experienced personal and occupational stress that influenced their health, which poses serious challenges for the management of the FSPC. Security should be upgraded, medical and psychological support for the staff and care facilities for their dependants should be provided, and financial problems experienced by these staff members should be addressed. The workload of the nursing staff at FSPC needs urgent attention. This
Full Text Available Introduction: Nursing staff working with intellectually disabled in-patients experience unique stress factors that can influence their personal well-being and work performance. Objectives: To compile a profile of stress factors experienced by nursing staff working with intellectually disabled in-patients at the Free State Psychiatric Complex (FSPC. Methods: This descriptive study included 89 nursing staff members from this environment. A questionnaire was used to collect socio-demographic information and determine personal and occupational stressors. The data were summarised by frequencies and percentages (categorical variables and means or percentiles (numerical variables. Results: Most participants were aged between 46 and 55 (41.2%, female (93.2% and black (93.2%, and 76.7% had children or dependant minors. The main stressors among participants were pressure providing financially for their children and dependant minors (71.2%, caring for them (39.4% and fearing them moving away (25.8%. Occupational stressors included high workload (66.3%, lack of decision-making by superiors (58.1%, underpayment (53.5%, endangerment of physical health (52.3% and safety (50.0%, working hours (51.2%, pressure of expectations from superiors (48.8%, uncertainty of employment (48.8%, work responsibilities (47.7% and perceiving that skills and training were not appreciated. They experienced stress regarding health issues such as hyper- and hypotension (35.3%. Because of stress 34.5% of participants took leave, 34.5% developed depression and 14.3% had panic attacks. Conclusion: Most of the respondents experienced personal and occupational stress that influenced their health, which poses serious challenges for the management of the FSPC. Security should be upgraded, medical and psychological support for the staff and care facilities for their dependants should be provided, and financial problems experienced by these staff members should be addressed. The workload of
Friesen-Storms, Jolanda H H M; Moser, Albine; van der Loo, Sandra; Beurskens, Anna J H M; Bours, Gerrie J J W
To describe the process of implementing evidence-based practice in a clinical nursing setting. Evidence-based practice has become a major issue in nursing, it is insufficiently integrated into daily practice and its implementation is complex. Participatory action research. The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases. Data were continuously gathered during a 24-month period from 2010 to 2012, and analysed using an interpretive constant comparative approach. Patients were consulted to incorporate their perspective. A best-practice mode of working was prevalent on the ward. The main barriers to the implementation of evidence-based practice were that nurses had little knowledge of evidence-based practice and a rather negative attitude towards it, and that their English reading proficiency was poor. The main facilitators were that nurses wanted to deliver high-quality care and were enthusiastic and open to innovation. Implementation strategies included a tailored interactive outreach training and the development and implementation of an evidence-based discharge protocol. The academic model of evidence-based practice was adapted. Nurses worked according to the evidence-based practice discharge protocol but barely recorded their activities. Nurses favourably evaluated the participatory action research process. Action research provides an opportunity to empower nurses and to tailor evidence-based practice to the practice context. Applying and implementing evidence-based practice is difficult for front-line nurses with limited evidence-based practice competencies. Adaptation of the academic model of evidence-based practice to a more pragmatic approach seems necessary to introduce evidence-based practice into clinical practice. The use of scientific evidence can be facilitated by using pre-appraised evidence. For clinical practice
The aim of this study was to describe how the limitation of patients is being practiced in psychiatric intensive care units. A focused ethnographic methodology was applied. To gather data, the author conducted fieldwork involving participant observation. The results of the study are presented in two categories, which describe the limited access patients had to items and in the ward environments. It is advisable for practitioners to critically reflect upon local regulations and policies related to the practice of limiting patients during the worst phase of their mental illness. © 2014 Wiley Periodicals, Inc.
At the 6th Congress of the World Psychiatric Association, held at Honolulu in August 1977, its participants accepted by acclamation a--so called--"Hawaiian Declaration" and a Resolution of the Royal College of Psychiatrists. The Declaration condemned all kinds of abuse in psychiatry, and the Resolution condemned the abuses in the Soviet psychiatry in particular. The Congress of Honolulu carried out, at last, the action initiated at the Congress of Mexico City six years earlier. But by then there was a lack of courage yet to take these measures, and the counter-action of the Soviet authorities proved to be effective. Aware of the fact that this time the pressure to condemn the misuses practiced in the Soviet psychiatry would be ever stronger, the KGB and the Ministry of Health of the USSR began their "preparations" for the next Congress as early as in 1976. This article describes the tactics of action promoted by the Soviet authorities in order to prevent the condemnation. The Author made a proper use of some documents that he had recovered at the Moscow "Centre for Storing the Contemporary Archives".
Full Text Available Abstract Background Violence is frequent towards nurses in forensic mental health hospitals. Implications of this high risk environment have not been systematically explored. This paper explores occurrence of symptoms on post traumatic stress and their relationship to professional quality of life. Methods Self report questionnaires assessing symptoms of post traumatic stress and professional quality of life were distributed among psychiatric nurses in a high security forensic psychiatric unit with high frequency of violent behaviour. Relationships between post traumatic stress symptoms, forensic nursing experience, type of ward and compassion satisfaction, burnout and compassion fatigue were explored. Results The prevalence of post traumatic stress symptoms was low. Low scores were found on compassion satisfaction. Length of psychiatric nursing experience and low scores on compassion satisfaction were correlated to increased post traumatic stress symptoms. Conclusion Although high violence frequency, low rate of post traumatic stress symptoms and low compassion satisfaction scores was found. High staff/patient ratio and emotional distance between staff and patients are discussed as protective factors.
Jeffreys, Marianne R
Nursing student persistence, retention, and success are universally desired outcomes yet remain elusive and challenging worldwide. The aim of this study is to provide nurse educators with an organizing framework and action ideas for optimizing student outcomes. Jeffreys's Nursing Universal Retention and Success (NURS) model presents a globally-applicable framework for examining the multidimensional factors that affect undergraduate and graduate nursing student retention and success in order to make a positive difference. This article presents a brief overview of the empirically-based NURS model and indicates that retention decisions, persistence, and optimal outcomes will be based on the interaction of student profile characteristics, student affective factors, academic factors, environmental factors, academic outcomes, psychological outcomes, outside surrounding factors, and professional integration factors. An A-Z list of action ideas provides nurse educators with a springboard for further developing ideas tailored to individual program and student needs. Recommendations for global collaborative partnerships and networks are presented. Copyright © 2014 Elsevier Ltd. All rights reserved.
Full Text Available Objective. To examine psychiatric patients’ experience of mechanical restraints and to describe the care the patients received. Background. All around the world, threats and violence perpetrated by patients in psychiatric emergency inpatient units are quite common and are a prevalent factor concerning the application of mechanical restraints, although psychiatric patients’ experiences of mechanical restraints are still moderately unknown. Method. A qualitative design with an inductive approach were used, based on interviews with patients who once been in restraints. Results. This study resulted in an overbridging theme: Physical Presence, Instruction and Composed Behaviour Can Reduce Discontent and Trauma, including five categories. These findings implicated the following: information must be given in a calm and sensitive way, staff must be physically present during the whole procedure, and debriefing after the incident must be conducted. Conclusions. When mechanical restraints were unavoidable, the presence of committed staff during mechanical restraint was important, demonstrating the significance of training acute psychiatric nurses correctly so that their presence is meaningful. Nurses in acute psychiatric settings should be required to be genuinely committed, aware of their actions, and fully present in coercive situations where patients are vulnerable.
McAllister, M; Higson, D; McIntosh, W; O'Leary, S; Hargreaves, L; Murrell, L; Mullen, V; Lovell, F; Kearney, J; Sammon, D; Woelders, S; Adams, T; Davies-Cotter, D; Wilson, J; O'Brien, J
This paper presents the results of an action research study into the acute care experience of Dissociative Identity Disorder. The study, which was grounded in principles of critical social science, utilized focus group interviews and narrative construction. Nurses and patients are under-represented in all clinical evaluation and their voices need to be heard if services are to be truly collaborative. Findings of the study extend intrapsychic theories of trauma to emphasize the interpersonal relationship between nurse and person who can work together to facilitate recovery from trauma, make connections both intra and interpersonally and build resilience.
Mills, Jane; Felton-Busch, Catrina; Park, Tanya; Maza, Karen; Mills, Frances; Ghee, McCauley; Hitchins, Marnie; Chamberlain-Salaun, Jennifer; Neuendorf, Nalisa
Attempts to recruit Aboriginal and Torres Strait Islander students into nursing degrees have made minimal impact on the number of registered nurses working in Australia's healthcare sector. Yet increasing the number of Indigenous nurses remains one of the most important objectives in strategies to close the health gap between Indigenous and…
Maaitah, Rowaida Al; AbuAlRub, Raeda Fawzi
to explore priority actions for strengthening the role of Advanced Practice Nurses (APNs) towards the achievement of Universal Health Converge (UHC) as perceived by health key informants in Jordan. an exploratory qualitative design, using a semi-structured survey, was utilized. A purposive sample of seventeen key informants from various nursing and health care sectors was recruited for the purpose of the study. Content analysis utilizing the five-stage framework approach was used for data analysis. the findings revealed that policy and regulation, nursing education, research, and workforce were identified as the main elements that influence the role of APNs in contributing to the achievement of UHC. Priority actions were identified by the participants for the main four elements. study findings confirm the need to strengthen the role of APNs to achieve UHC through a major transformation in nursing education, practice, research, leadership, and regulatory system. Nurses should unite to come up with solid nursing competencies related to APNs, PHC, UHC, leadership and policy making to strengthen their position as main actors in influencing the health care system and evidence creation. analisar as ações prioritárias para o fortalecimento do papel da enfermeira em prática avançada na Cobertura Universal de Saúde , segundo a percepção dos informantes-chave na Jordânia. foi utilizado desenho qualitativo exploratório, com um questionário semiestruturado. A amostra intencional de dezessete informantes-chave de vários setores de enfermagem e de saúde foi recrutado para o propósito do estudo. A análise de conteúdo utilizando a abordagem do quadro de cinco estágios foi utilizada para a análise de dados. os resultados revelaram que as políticas e regulações, educação em enfermagem, pesquisa e força de trabalho foram identificados como os principais elementos que influenciam o papel da enfermeira em prática avançada em contribuir para a realização da
A paucity of nursing literature is available on disaster-related community resilience. Using a nursing method for analyzing concepts, this article attempts to clarify the meaning of this novel concept to encourage nursing research and practice. This concept analysis provides an introduction to the phenomenon of disaster-related community resilience for nurses and consumers of nursing research. The article proposes the definition, antecedents, attributes, consequences, and empirical referents of disaster-related community resilience and provides suggestions for nursing research and practice. It also provides nurses a foundation for participating in resilience-building activities that may save lives and allow communities to recover more rapidly postdisaster. © 2016 Wiley Periodicals, Inc.
Frauenfelder, F.; Muller-Staub, M.; Needham, I.; Achterberg, T. van
Little is known about the question if the nursing diagnosis classification of North American Nursing Association-International (NANDA-I) describes the adult inpatient psychiatric nursing care. The present study aimed to identify nursing phenomena mentioned in journal articles about the psychiatric
Brownie, Sharon; Oywer, Elizabeth
This paper highlights the extent of the brain drain in relation to human resources for health (HRH) that is currently challenging Kenya, and suggests strategies that have the potential to change current working environments and improve HRH retention rates. Governments in partnership with health professional bodies and regulators could improve the working conditions for psychiatrists and mental health nurses: by promoting career choices in mental health; by providing accessible professional development opportunities; and by easing workload pressures by expanding service reach through thoughtfully planned and delivered task-shifting to primary care. While these strategies have the potential to make a significant difference, the evidence suggests a brain drain will continue as long as working conditions remain sub-optimal and global HRH shortages persist.
Ogbolu, Yolanda; Ford, Jodi; Cohn, Elizabeth; Gillespie, Gordon Lee
Medical care alone cannot adequately improve population health or eliminate inequities; social determinants of health (SDH) must be addressed. This study's purpose was to describe the research, teaching, service, and clinical practice activities implemented by RWJF Nurse Faculty Scholars to act on the SDH. A cross-sectional survey design was used with a sample of RWJF Nurse Faculty Scholars, chosen because they were provided specialized mentoring, grants, and other support that allowed them to explore SDH. Respondents (n = 57) addressed SDH in their research (86.0%), teaching (68.4%), service (66.7%), and clinical practice (33.3%). Leading research foci were quality of health care (56.1%), social and physical environmental stressors (54.4%), and access to health care services (49.1%). Leading SDH areas in teaching were discrimination in society against vulnerable populations (54.4%), quality of health care received by vulnerable populations (50.9%), and vulnerable populations' access to health care services (50.9%). Service activities included addressing discrimination against diverse populations. Leading SDH areas in clinical practice were quality of health care received by vulnerable populations (28.1%), vulnerable populations' access to health care services (22.8%), and discrimination in society against vulnerable populations (19.3%). Respondents also addressed SDH through personal mentoring (71.9%); efforts to recruit and/or retain underrepresented faculty (59.6%); developing a diverse pipeline of nurses (59.6%); and participation on a diversity committee (40.4%). The RWJF Nurse Faculty Scholars were able to leverage their awards to address SDH; however, further research is needed to assess the impact of the SDH work conducted. Knowledge from this study can be used as a road map for SDH elements and areas of professional work that nurses and other health professionals could address SDH in research, teaching, service, and practice.
Sabrina da Costa Machado
Full Text Available O processo de liderança em enfermagem psiquiátrica é uma temática que deve ser cuidadosamente abordada e amplamente discutida. Contudo, poucas são as fontes científicas acerca do assunto. Assim sendo, buscou-se através deste ensaio refletir a liderança e as suas várias formas de abordagem em psiquiatria ao longo dos tempos, sendo possível certificar sua evolução. A assistência de qualidade deve ser o objetivo único e primordial e a liderança na enfermagem psquiátrica deve estar baseada no reconhecimento das necessidades desta clientela e nas qualidades de sua equipe. Este muitas vezes constitui um desafio para os profissionais enfermeiros, permitindo um maior crescimento profissional. E é justamente o preparo do profissional que auxiliará no bom andamento do tratamento do paciente psiquiátrico, alcançando um resultado satisfatórioEl proceso de liderazgo en enfermería psiquiátrica es un tema que debe ser cuidadosamente abordado y extensamente discutido. Sin embargo, pocas son las fuentes científicas referentes al tema. De esta manera, hubo una búsqueda a través de este trabajo sobre el liderazgo y sus varias formas de abordaje en psiquiatría a través de los tiempos, siendo posible certificar su evolución. La ayuda de calidad debe ser el único y primordial objetivo y el liderazgo del enfermero debe estar basada en el reconocimiento de las necesidades de la clientela y en las calidades del equipo. Tal reflexión muchas veces constituye un desafío para los enfermeros profesionales, permitiendole un crecimiento profesional mayor. Es exactamente la preparación del profesional que ayudará al buen curso del tratamiento del paciente psiquiátrico, alcanzando un resultado satisfactorio.The process of leadership in psychiatric nursing is a thematic that must be carefully boarded and be widely argued. However, few are the scientific sources concerning the subject. In this way, it was seek through this work reflecting the
Frauenfelder, F.; Muller-Staub, M.; Needham, I.; Achterberg, T. van
The successful application of the Nursing Interventions Classification (NIC) in inpatient psychiatry depends on whether the classification adequately describes nursing care in this setting. The present study aimed to identify nursing interventions mentioned in journal articles on psychiatric
Full Text Available Background: A lack of authentic learning opportunities influence the quality of emergency training of nursing students. The purpose of this article is to describe how the step-up action research model was used to improve the quality of trauma-related educational practice of undergraduate nursing students.Objectives: To reduce deaths caused by trauma, healthcare workers should be competent to provide emergency care and collaborate effectively with one another.Method: A simulated mass casualty incident, structured to support the integration of theory into practice, became a more rigorous action research activity which focused on the quality improvement of the mass casualty incident.Results: The results indicated improved student learning; partnership appreciation; improved student coping mechanisms, and increased student exposure. Quality emergency training thus results in better real-life collaboration in emergency contexts.Conclusion: The step-up action research model proved to be a collaborative and flexible process. To improve the quality and rigour of educational programmes it is therefore recommended that the step-up action research model be routinely used in the execution of educational practices.
Seale, Ielse; De Villiers, Johanna C
A lack of authentic learning opportunities influence the quality of emergency training of nursing students. The purpose of this article is to describe how the step-up action research model was used to improve the quality of trauma-related educational practice of undergraduate nursing students. To reduce deaths caused by trauma, healthcare workers should be competent to provide emergency care and collaborate effectively with one another. A simulated mass casualty incident, structured to support the integration of theory into practice, became a more rigorous action research activity which focused on the quality improvement of the mass casualty incident. The results indicated improved student learning; partnership appreciation; improved student coping mechanisms, and increased student exposure. Quality emergency training thus results in better real-life collaboration in emergency contexts. The step-up action research model proved to be a collaborative and flexible process. To improve the quality and rigour of educational programmes it is therefore recommended that the step-up action research model be routinely used in the execution of educational practices.
Gonen, Ayala; Sharon, Dganit; Lev-Ari, Lilac
Today, in the digital age, we are committed to prepare the future nurse for the information technology-rich workplace, and to help them reducing the "shock reality" upon arriving at the clinical setting. The main aim of the study is to promote the knowledge of Information Competencies Technology among nurses' educators and student. The…
Fernanda Lima de Paula
Full Text Available Goal: to analyze the possibilities and limits of multiprofessional care in the attention to psychiatric emergencies. Method: it is an analytical study of the type integrative review of the comprehensive literature. Searches were conducted in the Latin American and Caribbean Literature (LILACS and Nursing Database (BDENF databases and in the ScieLo Virtual Library, with the use of Descriptors in Health Sciences (DECs: “Emergency Services, Psychiatric”, “Forensic Psychiatry”, “Psychiatric Rehabilitation”, in the period from 2007 to 2017. Results: after data analysis, two thematic categories emerged: “Possibilities and limits in multiprofessional care for patients in crisis” and “The continuity of care to the patient in crisis by the multiprofessional team”. The studies point out fragility in the management of the multiprofessional team of care to the patients in psychiatric crisis. Therefore, in the substitutive services to the psychiatric hospital, it is necessary to strengthen the care and bonding tools for continuity of treatment after the cases of psychiatric emergency of these patients. Conclusion: this research provided a deepening of the knowledge regarding the challenges of the multiprofessional team in the care of analytical psychiatric emergencies and in relation to the patient in crisis, considering the main multiprofessional actions, understanding how this approach is done and patient follow-up. Descriptors: Emergency Services, Psychiatric. Forensic Psychiatry. Psychiatric Rehabilitation.
Kurt Lewin, the originator of action research, proposed that it was valuable not only for innovating change, but also the process of change could lead to new insights into the nature of the problem that was being tackled. This action research project developed and evaluated a teaching model that aimed to help RGN (registered general nurse) students to bridge the theory-practice gap. During the course of this work, the possible reasons for a theory-practice gap started to become clear. This paper provides a discussion of these factors. The viewpoint for this discussion is that of the student nurse. The student is assumed to 'own' the problem and it is from her perspective that the theory-practice gap is analysed. The paper includes a critical examination of books, lectures, the school curriculum and ward nursing practice. Finally, possible solutions to the theory-practice problem are discussed and it is hoped that these will provide a rational basis for tackling the problem.
Rantz, Marilyn J; Birtley, Nancy M; Flesner, Marcia; Crecelius, Charles; Murray, Cathy
Centers for Medicare and Medicaid Innovation Center sponsored the initiative to reduce avoidable hospitalizations among nursing facility residents. Missouri Quality Initiative (MOQI) designed inter-professional model in nursing homes with advanced practice registered nurses (APRNs). MOQI APRN model was implemented for 4 years in 16 nursing homes in a metro area of the Midwest. Hospitalizations were reduced (40% all-cause, 58% potentially avoidable), emergency room visits (54% all-cause, 65% potentially avoidable), Medicare expenditures for hospitalizations (34% all-cause, 45% potentially avoidable), and Medicare expenditures for emergency room visits (50% all-cause, 60% potentially avoidable) for long-stay nursing home residents. Success of the MOQI model reinforces decades of research demonstrating that care provided by APRNs is cost-effective, safe, and associated with positive health outcomes and patient satisfaction. Nursing homes can implement and benefit by hiring APRNs. However, changes in the Code of Federal Regulation (CFR 483.40) are necessary to improve patient access to care and encourage hiring APRNs in US nursing homes. Copyright © 2017 Elsevier Inc. All rights reserved.
Furukawa, Patricia de Oliveira; Cunha, Isabel Cristina Kowal Olm; Pedreira, Mavilde da Luz Gonçalves; Marck, Patricia Beryl
to verify the correlation between the characteristics of professionals and the practice of sustainable actions in the medication processes in an ICU, and to determine if interventions such as training and awareness can promote sustainable practices performed by nursing staff in the hospital. before-and-after design study using Lean Six Sigma methodology, applied in an intensive care unit. Nursing staff were observed regarding the practice of ecologically sustainable actions during medication processes (n = 324 cases for each group (pre and post-intervention)) through a data collection instrument. The processes analyzed involved 99 professionals in the pre-intervention phase and 97 in the post-intervention phase. Data were analyzed quantitatively and the association of variables was accomplished by means of statistical inference, according to the nature of the related variables. the education level was the only characteristic that showed to be relevant to an increase in sustainable practices, with a statistically significant difference (p = 0.002). When comparing before and after the intervention, there was an increase in environmentally friendly actions with statistically significant differences (p = 0.001). the results suggest that institutions should encourage and invest in formal education, as well as training of health professionals to promote sustainable practices in the hospital. verificar la correlación entre las características de los profesionales y la práctica de acciones sustentables en los procesos de medicación en una UTI y determinar si intervenciones como capacitación y concientización logran promover la práctica de acciones sustentables por el equipo de enfermería en el hospital. estudio antes y después usando la metodología Lean Seis Sigma, aplicada en una unidad de terapia intensiva. El equipo de enfermería fue observado referente a la práctica de acciones ecológicamente sustentables durante los procesos de medicación (n = 324 casos
Bükki, Johannes; Neuhaus, Petra M; Paal, Piret
Therapeutic options for nursing home residents focus on functional improvement, while inadequate hospital admissions in the dying phase are frequent. The aim of this study was to explore views, attitudes, and concerns among staff and to embark on a process that facilitates end-of-life care on an institutional level. Three focus group interviews were conducted with nursing home staff (nurses, care managers, physicians). The discussants (22) expressed the following issues: workload; ethical conflicts; additional resources; "living palliative care"; deleterious effect of restorative aims; lack of training; fear; knowledge and skills; rituals; lack of attachment, frustration, and abuse; team; discouragement; resilience enhanced by good care; style of communication; avoidance; the "palliative status"; legal concerns and hospital admissions. Nursing home staff expressed willingness to care for the dying. Providing good end of life care may promote professional resilience and personal integrity. Therefore, team issues, fears, and avoidance should be addressed. Copyright © 2016 Elsevier Inc. All rights reserved.
Karen LeGrow; Karen Campbell; Nancy Elford; Krista L McLaughlin; Alliah Over
.... The relevance of person-centredness to postgraduate student learning is immense, as new graduate nurses are expected to assume leadership and advocacy roles in healthcare environments and engage...
Full Text Available Background: Person-centredness is an approach that views each individual as a unique being, and is supported by the values of mutual respect and individual right to self-determination. This approach is currently a prevailing principle in policy, education and practice settings globally. The relevance of person-centredness to postgraduate student learning is immense, as new graduate nurses are expected to assume leadership and advocacy roles in healthcare environments and engage with key stakeholders in the exchange of knowledge to inform practice. The application of person-centred practices by faculty within postgraduate nursing programmes is therefore instrumental in providing students with the necessary supportive environments to acquire the skills for person-centred care. Method: Practice development was used as a foundation for implementing innovative teaching methods for postgraduate nursing students. Nurses enrolled in the advancement of professional nursing practice seminars and practicum, participating in various active learning and critical reflection activities throughout the semester. Implications for practice: Practice development provides an innovative foundation for postgraduate nursing education Educators should consider this unique and person-centred approach as an alternative to the typical pedagogical approach
Poremski, Daniel; Lim, Xin Ya; Kunjithapatham, Ganesh; Koh, Doris; Alexander, Mark; Cheng, Lee
The way service seekers interact with the staff at emergency services has been shown to influence the standard of care, especially in the case of certain psychiatric manifestations. Staff reactions to psychiatric complaints have been linked to their comfort dealing with these types of service users as well as their competencies understanding the illness. It is therefore vital to understand which skills increase confidence in treating psychiatric emergencies. Twenty-six open-ended convergent interviews were conducted with staff working in a psychiatric emergency department. Thematic analysis was used to analyze the data. Participants reported several non-technical skills which developed from exclusively serving people with psychiatric emergencies: 1) Vigilance allowed staff to be sensitive to minor changes in behavior which precede psychiatric emergencies. 2) The ability to negotiate and find tangible solutions was particularly important when dealing with psychiatric complaints which may not have tangible resolutions. 3) The ability to appraise social support networks allowed staff to plan follow-up actions and ensure continuity of care when support was available. 4) The ability to self-reflect allowed participants to learn from their experience and avoid burnout, frustration, and fatigue. Participants also reported several other clinical skills which they gained during training, including teamwork, de-escalating techniques and risk assessment. Tentatively speaking, these skills improve staff's confidence when treating psychiatric emergencies. Certain skills may be generalized to staff working in medical emergency departments who frequently encounter psychiatric complaints. © 2016 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd on behalf of Australian College of Mental Health Nurses Inc.
Knowledge of nurses at a psychiatric hospitalization unit of a teaching hospital Saberes de los enfermeros en una unidad de internación psiquiátrica en un hospital universitario Saberes dos enfermeiros em uma unidade de internação psiquiátrica de um hospital universitário
Full Text Available This study aims to identify the knowledge of the nurses in a psychiatric hospitalization unit at a university hospital. It is an exploratory, descriptive research with a qualitative approach, utilizing semistructured interviews. The nurses refer to a change in the assisting care, starting from their experience in the asylum mode and making references to the concepts of the psychosocial mode: integrality, welcoming, interdisciplinarity and interpersonal relationship. Integral and individual care, knowledge of the psychiatric syndromes and their treatment as well as the consideration of the subjectivity of the subject under psychiatric suffering are part of the knowledge that guides nursing actions in mental health.Este estudio tiene por objetivo identificar los saberes de los enfermeros en una unidad de internación psiquiátrica en un hospital universitario. Se trata de una investigación exploratoria, descriptiva, con aproximación cualitativa, utilizando la entrevista semi-estructurada. Los enfermeros refieren una transformación en el cuidado asistencial a partir de su experiencia en el modo asilar, haciendo referencias a las concepciones del modo psicosocial: integralidad, acogida, interdisciplinaridad y relación interpersonal. El cuidado integral e individual, el conocimiento de los síndromes psiquiátricos y su tratamiento y la consideración de la subjetividad del individuo bajo sufrimiento psíquico son formas del saber que orientan las acciones de la enfermería en salud mental.Este estudo tem o objetivo de identificar os saberes dos enfermeiros em uma unidade de internação psiquiátrica em um hospital universitário. Trata-se de pesquisa exploratório-descritiva, com abordagem qualitativa, utilizando a entrevista semi-estruturada. Os enfermeiros relatam transformação no cuidado assistencial a partir de sua experiência no modo asilar, fazendo referências às concepções do modo psicossocial: integralidade, acolhimento
Aranda, Kay; McGreevy, Debbie
Obesity is now commonly recognised to be a significant public health issue worldwide with its increasing prevalence frequently described as a global epidemic. In the United Kingdom, primary care nurses are responsible for weight management through the provision of healthy eating advice and support with lifestyle change. However, nurses themselves are not immune to the persistent and pervasive global levels of weight gain. Drawing on a Gadamerian informed phenomenological study of female primary care nurses in England, this paper considers the complex gendered understandings and experiences of being overweight, and of food and eating. The nurses' emotional and injurious experiences of being large is found to be capable of producing embodied caring practices, involving a fusion of horizons with patients over how it feels to inhabit a large body. Yet, even though subjected to similar derogatory stereotypes as patients, they simultaneously reinforce the dominant and damaging individualising psychopathology inherent to anti-obesity discourses. This suggests an urgent need to expose and challenge harmful discourses surrounding women's body size and weight in order to avoid nursing practices that unthinkingly reproduce culturally dominant and gendered understandings of weight, body size, food and eating. © 2012 John Wiley & Sons Ltd.
A. Schene; A. Smit; A. Kaasenbrood; B. van Meijel; G. Hutschemaekers; Bauke van Koekkoek
In psychiatric care professionals perceive some patients as ‘difficult’, especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the authors. It
A. Smit; A. Schene; A. Kaasenbrood; G. Hutschemaekers; prof Berno van Meijel; B. Koekkoek
In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the authors. It
Koekkoek, B.W.; Meijel, B.K.G. van; Schene, A.H.; Smit, A.; Kaasenbrood, A.J.A.; Hutschemaekers, G.J.M.
Background: In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the
Yanicki, Sharon M; Kushner, Kaysi E; Reutter, Linda
Social inclusion/exclusion involves just/unjust social relations and social structures enabling or constraining opportunities for participation and health. In this paper, social inclusion/exclusion is explored as a dialectic. Three discourses--discourses on recognition, capabilities, and equality and citizenship--are identified within Canadian literature. Each discourse highlights a different view of the injustices leading to social exclusion and the conditions supporting inclusion and social justice. An Integrated Framework for Social Justice that incorporates the three discourses is developed and used to critique the dominant focus on distributive justice within foundational Canadian nursing documents. We propose a broader conceptualization of social (in)justice that includes both relational and structural dimensions. Opportunities for multilevel interventions to promote social justice are identified. This framework is congruent with nursing's moral imperative to promote health equity and with the multiple roles played by nurses to promote social justice in everyday practice. © 2014 John Wiley & Sons Ltd.
Adenícia Custodia Silva Souza
Full Text Available The inappropriate disposal of infectious waste generates occupational and environmental risks, representing the main cause of accidents with biological material. The aim of the present study was to verify the knowledge and the practice regarding the disposal of infectious waste among nursing and medical undergraduate students at a public university in the state of Goiás. Data were collected with the application of a questionnaire. The respondent students were observed in their practice and data were recorded in a checklist. Nursing students presented greater knowledge than medical students on the disposal of contaminated gloves (x²; p<0.001, as well as on the disposal of sharp cutting instruments (p=0.001. Contaminated gloves were disposed of into bags for common waste both by the nursing and the medical students. Results evidenced that the knowledge of students on the disposal of infectious waste was poor and insufficient to ensure its application to practice.
Pesquisa em enfermagem psiquiátrica: concepções e expectativas de enfermeiros que atuam em instituições psiquiátricas Investigación en enfermeria psiquiátrica: concepciónes y expectativas de los enfermeros que trabajan en instituciones psiquiátricas Psychiatric nursing research: conceptions and expectations of nurses in psychiatric institutions
encontraban en servicio en el periodo previsto para la realización de la colecta de datos, quienes emitieron sus opiniones a través de guía de entrevista semi-estructurada. Los resultados fueron cualitativamente analizados y se apoyaron en los principios teórico-metodológicos de las Representaciones Sociales, permitindo concluir que la mayoría de los enfermeros entrevistados refirió no tener acceso a las investigaciones específicas del área, y demostró dificultad en establecer relación e influencia desas investigaciones en sus servicios aunque admitieron su importancia en le desarrollo personal y profesional, lo que repercutiría sobremanera en la asistencia prestada por los enfermeros.This research has as objects of study the conceptions and expectations of the clinical nurses in psychiatric institutions about the research developed in this area. It has the purpose to identify conceptions and expectations, enabling the identification of the process of dissemination and utilization of the research in the attention and administration of psychiatric nursing care. It was developed with nurses that work in psychiatric instituitions at Salvador, in March, 1997. 25 nurses who worked in the period were interviewed expressing their opinions concerning the theme in study, through semi-structured interview. Results were quantitatively analised, based on the theoretical-methodological design of the Social Representations. It was possible to conclude that the great part of the nurses interviewed mentioned that they did not have acess to research in this area, as well as demonstrated difficulty to find the relations and influence of these research in their service, however they admit its importance to personal and professional development, that certainly, reflects on nursing care.
de Niet, G. J. (Gerrit); Tiemens, B. G. (Bea); Lendemeijer, H. H. G. M. (Bert); Hutschemaekers, G. J. M. (Giel)
This paper aims at acquiring knowledge about the quality of sleep of adult and elderly psychiatric patients who receive clinical or outpatient nursing care, and identifying key factors in perceiving a sleep problem. To do so, a sample of 1699 psychiatric patients were asked whether they perceived a
Mar 13, 2012 ... of reducing the readmission of psychiatric patients following marijuana-induced psychosis. A qualitative ... The findings of this study include perceptions of psychiatric patients on the use of marijuana, the negative effects of marijuana .... to the nursing body of knowledge that cannot be obtained by any other ...
Sitvast, J.E.; Widdershoven, G.G.A.M.; Abma, T.A.
The purpose of this article is to illustrate moral learning in persons with a psychiatric disability who participated in a nursing intervention, called the photo-instrument. This intervention is a form of hermeneutic photography. The findings are based on a multiple case study of 42 patients and
Andressa de Oliveira; Ana Paula Rigon Francischetti Garcia; Vanessa Pellegrino Toledo
Abstract Objective: To know how the nurse provides care in the first psychotic outbreak of patients, and to identify the Barbara Carper patterns of knowing used for this action. Methods: A qualitative study using a phenomenological approach was performed in four Psychosocial Care Centers and in a psychiatric ward of a university hospital. Data collection was carried out with ten nurses participating in semi-structured interviews using the following guiding question: "Tell me your experience...
McKinlay, A; Couston, M; Cowan, S
The incidence of self-poisoning is on the increase. Most patients who self-poison are dealt with initially in the general hospital. Therefore, the type and quality of care self-poisoning patients receive will depend, in part, on how they are viewed by nursing staff within the general hospital setting. A knowledge and understanding of the attitudes held by nurses towards self-poisoning patients is therefore important to those involved in the planning and delivery of care towards this client group. Previous studies have examined health care professionals' attitudes towards people who self-poison. Usually, however, these have not focused specifically on nurses' attitudes, and they have ignored the relationship between the attitudes expressed by staff and their intentions to engage in subsequent caring behaviour of one sort or another. It is hence unclear how the findings of such studies are relevant or applicable to nursing policy and practice. The present study aims to address these limitations using a methodology informed by the theory of reasoned action. The study aims to separate out the distinctive roles played by nurses' own attitudes, and the social pressures represented by other people's attitudes, in determining the types of caring behaviour in which nurses intend to engage when dealing with self-poisoning patients. The study adopts a questionnaire-based approach incorporating two specially designed vignettes. The results show that nurses' own attitudes, and what they believe about the attitudes of others, predict their behavioural intentions towards self-poisoning patients. The study also shows that nurses with a more positive orientation towards self-poisoning patients differ in behavioural and normative beliefs from nurses who have a less positive orientation. The implications for future attempts to explore the relationship between nurses' attitudes and subsequent caring behaviour are considered, along with implications for nursing policy and practice.
Sullivan, Patrick F; Agrawal, Arpana; Bulik, Cynthia M
into biologically, clinically, and therapeutically meaningful insights. The emerging findings suggest that we are entering a phase of accelerated genetic discovery for multiple psychiatric disorders. These findings are likely to elucidate the genetic portions of these truly complex traits, and this knowledge can...... then be mined for its relevance for improved therapeutics and its impact on psychiatric practice within a precision medicine framework. [AJP at 175: Remembering Our Past As We Envision Our Future November 1946: The Genetic Theory of Schizophrenia Franz Kallmann's influential twin study of schizophrenia in 691...
Loth, Christien; Schippers, Gerard M.; Hart, Harm't; van de Wijngaart, Goof
AIM: This paper is a report of a study to answer the research question: can participative action research help to halt the deterioration in methadone substitution treatment and develop new care strategies which are better geared toward the patients' needs? BACKGROUND: In the Netherlands, methadone
Crider, Mark C; McNiesh, Susan G
In this article, we present a theory-based application of clinical simulation in psychiatric-mental health nursing education. As described by Benner, Sutphen, Leonard, and Day, a three-pronged apprenticeship that integrates intellectual, practical, and ethical aspects of the professional role is critical in the development of practical reasoning in nursing education and training. Clinical encounters are often fraught with ambiguity and uncertainty. Therefore, educating for a practice discipline requires experiential and situated learning. Using the three-pronged experiential model in simulated psychiatric-mental health nursing practice supports the development of critical nursing skills, ethics, and theoretical concepts. A clinical scenario is presented that demonstrates the application of this model of professional apprenticeship in psychiatric-mental health education. Applications of the concept presented may be used in training nurses new to the practice of psychiatric-mental health nursing. Copyright 2011, SLACK Incorporated.
Rossetti, Jeanette; King, Camille
The use of animal-assisted therapy (AAT) as an adjunct treatment approach in psychiatric settings has received much attention in the literature. This article explores the use of AAT with psychiatric patients. The authors performed a literature review and found that AAT can have a significant effect on the improvement of psychiatric patients' socialization and provides a variety of psychological benefits. Nurses can benefit from learning about the potential benefits of AAT for psychiatric patients.
Elliott, Rohan A; Lee, Cik Yin; Beanland, Christine; Goeman, Dianne P; Petrie, Neil; Petrie, Barbara; Vise, Felicity; Gray, June
To develop a collaborative, person-centred model of clinical pharmacy support for community nurses and their medication management clients. Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and other stakeholders. A large, non-profit home nursing service in Melbourne, Australia. Older people referred to the home nursing service for medication management, their carers, community nurses, general practitioners (GPs) and pharmacists, a multidisciplinary stakeholder reference group (including consumer representation) and the project team. Feedback and reflections from minutes, notes and transcripts from: project team meetings, clinical pharmacists' reflective diaries and interviews, meetings with community nurses, reference group meetings and interviews and focus groups with 27 older people, 18 carers, 53 nurses, 15 GPs and seven community pharmacists. The model was based on best practice medication management standards and designed to address key medication management issues raised by stakeholders. Pharmacist roles included direct client care and indirect care. Direct care included home visits, medication reconciliation, medication review, medication regimen simplification, preparation of medication lists for clients and nurses, liaison and information sharing with prescribers and pharmacies and patient/carer education. Indirect care included providing medicines information and education for nurses and assisting with review and implementation of organisational medication policies and procedures. The model allowed nurses to refer directly to the pharmacist, enabling timely resolution of medication issues. Direct care was provided to 84 older people over a 15-month implementation period. Ongoing feedback and consultation, in line with participatory action research principles, informed the development and refinement of the model and identification of enablers and challenges. A collaborative
Parker, Vicki; Lieschke, Gena; Giles, Michelle
Improving health, patient and system outcomes through a practice-based research agenda requires infrastructural supports, leadership and capacity building approaches, at both the individual and organisational levels. Embedding research as normal nursing and midwifery practice requires a flexible approach that is responsive to the diverse clinical contexts within which care is delivered and the variable research skills and interest of clinicians. This paper reports the study protocol for research being undertaken in a Local Health District (LHD) in New South Wales (NSW) Australia. The study aims to evaluate existing nursing and midwifery research activity, culture, capacity and capability across the LHD. This information, in addition to input from key stakeholders will be used to develop a responsive, productive and sustainable research capacity building framework aimed at enculturating practice-based research activities within and across diverse clinical settings of the LHD. A three-phased, sequential mixed-methods action research design underpinned by Normalization Process Theory (NPT). Participants will be nursing and midwifery clinicians and managers across rural and metropolitan services. A combination of survey, focus group, individual interviews and peer supported action-learning groups will be used to gather data. Quantitative data will be analysed using descriptive statistics, correlation and regression, together with thematic analysis of qualitative data to produce an integrated report. Understanding the current research activity and capacity of nurses and midwives, together with organisational supports and culture is essential to developing a productive and sustainable research environment. However, knowledge alone will not bring about change. This study will move beyond description of barriers to research participation for nurses and midwives and the promulgation of various capacity building frameworks to employ a theory driven action-oriented approach
Forchuk, C; Tweedell, D
1. There is a risk of losing important parts of our psychiatric nursing history as a result of the rapid rate of mental health reform and the closing or changing of governance of major psychiatric facilities. 2. Hamilton Psychiatric Hospital provided leadership in psychiatric nursing in Canada for more than a century and is now changing governance from being a provincial psychiatric hospital to part of a community general hospital. 3. The hospital's tradition includes nonrestrictive care policies that have been in place for more than a century, a humanistic approach to care, being the first facility in Canada to require theory-based nursing care from all nursing staff, innovative practice models, and achieving authorship or co-authorship from more than 17% of the RN staff.
Benedict, S; Kuhla, J
During the Nazi era, so-called euthanasia programs were established for handicapped and mentally ill children and adults. Organized killings of an estimated 70,000 German citizens took place at killing centers and in psychiatric institutions. Nurses were active participants; they intentionally killed more than 10,000 people in these involuntary euthanasia programs. After the war was over, most of the nurses were never punished for these crimes against humanity--although some nurses were tried along with the physicians they assisted. One such trial was of 14 nurses and was held in Munich in 1965. Although some of these nurses reported that they struggled with a guilty conscience, others did not see anything wrong with their actions, and they believed that they were releasing these patients from their suffering.
Laird, Elizabeth A; McGurk, Phyllis; Reid, Bernie; Ryan, Assumpta
This study explored the experiences and perspectives of community psychiatric nurses, day centre managers and social workers about supporting clients living with and without dementia attending a generic day care service. The purpose of the study was to elucidate approaches that enable clients living with dementia to access and derive benefit from the service. In the light of international ageing demographics and strategy towards social inclusion, it is anticipated that demand for generic day care services for clients living with and without dementia will increase. A descriptive qualitative design utilised three focus groups for data collection. Community psychiatric nurses (n = 4), day centre mangers (n = 4) and social workers (n = 12) participated in the study. Data analysis informed a narrative description of the approaches that support adults living with dementia in day care. An exhaustive description is encapsulated in five key themes. These are "easing the transition to day care," "proactively managing supervision and complexity of need," "sustaining the person and family carer," making the best of what we have" and "encountering a need for change," The data conveyed a sensitivity to the life story and needs of clients with dementia. Whilst the data revealed deficits in the physical environment of the centres, there were indications of the generation of a positive social environment. A generic day care service that provides an integrated blend of care and treatment and social and recreational support to older adults, irrespective of whether they have or have not dementia, is realistic and manageable. The routine of day centre attendance may have value in sustaining clients with dementia and family care-giving relationships. Approaches to support the attendance of clients with dementia at day care include home visits, life story work, proactive supervision and careful planning of social groupings and recreational activities. © 2017 John Wiley & Sons Ltd.
Sitvast, J E; Widdershoven, G A M; Abma, T A
The purpose of this article is to illustrate moral learning in persons with a psychiatric disability who participated in a nursing intervention, called the photo-instrument. This intervention is a form of hermeneutic photography. The findings are based on a multiple case study of 42 patients and additional interviews with eight of them. Photo groups were organized within three settings of psychiatric services: ambulatory as well as clinical, all situated in the Netherlands. Data were analysed according to hermeneutic and semiotic principles. Two cases are presented. Findings show that voice and face are concepts that help to identify elements of moral learning in the rehabilitation process of persons with a psychiatric disability. During the process patients become more aware of their responsibilities towards themselves and others.
Goldstone, Lisa W; Cooley, Janet
To create an interprofessional psychiatry advanced pharmacy practice experience (APPE) and assess the initial outcomes. An elective psychiatry APPE was developed in a setting of interdisciplinary practice. Preceptor responsibilities were shared between a psychiatric pharmacist and an attending psychiatrist or psychiatric nurse practitioner. Students were also given the opportunity to shadow and work with other health care professionals such as nurses, social workers, therapists, family nurse practitioners, and utilization review staff members. Midpoint and final evaluations demonstrated student advancement throughout the experience as well as the development of communication skills with patients and an increased ability to work collaboratively with other health care providers. Students rated this practice experience highly and their comments reflected achievement of the established learning objectives. An interdisciplinary elective practice experience in psychiatry at a local teaching hospital was effective in teaching psychiatric care and interprofessional interaction. This teaching model can be adapted for use in other practice settings or specialty areas.
Enfermeiros assistenciais das instituições psiquiátricas de Ribeirão Preto: caracterização, formação e atuação Enfermeros asistenciales de las instituciones psiquiátricas de Ribeirão Preto: caracterización, formación y actuación Clinical nurses working in psychiatric institutions at the city of Ribeirão Preto: characteristics, education and performance
Maria Conceição B.Mello e Souza
su formación/actualización.This is a quanti-qualitative study that had the purpose to characterize nurses who work in psychiatric institutions at the city of Ribeirão Preto, focussing on their education, identifying nursing actions that those professionals perform daily and finding out about practice and knowledge that they consider specific to their area. The discussions on the results were based on authors who study psychiatric nursing teaching and research. Data evidenced a sample mainly formed by adult women, with a reasonable period of service in the area. The majority of the professionals did not search for specialization or continuing education courses and did not participate in training courses and scientific events. Among the actions that nurses perform daily, the bureaucratic-administrative ones are emphasized. They mentioned some themes such as specific knowledge on psychiatric nursing, especially therapeutic relationship. They also pointed out some difficulties and facilities they found regarding their professional education and knowledge updating.
Wertenberger, Sydney; Chapman, Kathleen M; Wright-Brown, Salena
The Department of Veterans Health Administration Office of Nursing Service has embarked on a multiyear transformational process, an example of which is the development of an organization-wide nursing handbook. The development of this handbook offered the opportunity to improve collaboration, redefine expectations and behavior, as well as prepare for the future of Nursing within the Veterans Health Administration. The lessons learned from this process have revolved around the themes of leadership skills for managing high-level change often in a virtual environment; constant collaboration; that the practice of nursing will continue to evolve on the basis of new evidence, technology, customer expectations, and resources; and that the process to accomplish this goal is powerful.
Lea, Emma J; Andrews, Sharon; Stronach, Megan; Marlow, Annette; Robinson, Andrew L
To describe whether an action research approach can be used to build capacity of residential aged care facility staff to support undergraduate nursing students' clinical placements in residential aged care facilities, using development of an orientation programme as an exemplar. Aged care facilities are unpopular sites for nursing students' clinical placements. A contributing factor is the limited capacity of staff to provide students with a positive placement experience. Strategies to build mentor capability to shape student placements and support learning and teaching are critical if nursing students are to have positive placements that attract them to aged care after graduation, an imperative given the increasing care needs of the ageing population worldwide. Action research approach employing mixed-methods data collection (primarily qualitative with a quantitative component). Aged care facility staff (n = 32) formed a mentor group at each of two Tasmanian facilities and met regularly to support undergraduate nursing students (n = 40) during placements. Group members planned, enacted, reviewed and reflected on orientation procedures to welcome students, familiarise them with the facility and prepare them for their placement. Data comprised transcripts from these and parallel student meetings, and orientation data from student questionnaires from two successive placement periods (2011/2012). Problems were identified in the orientation processes for the initial student placements. Mentors implemented a revised orientation programme. Evaluation demonstrated improved programme outcomes for students regarding knowledge of facility operations, their responsibilities and emergency procedures. Action research provides an effective approach to engage aged care facility staff to build their capacity to support clinical placements. Building capacity in the aged care workforce is vital to provide appropriate care for residents with increasing care needs. © 2016 John
Use of force preferences and perceived effectiveness of actions among Crisis Intervention Team (CIT) police officers and non-CIT officers in an escalating psychiatric crisis involving a subject with schizophrenia.
Compton, Michael T; Demir Neubert, Berivan N; Broussard, Beth; McGriff, Joanne A; Morgan, Rhiannon; Oliva, Janet R
Few studies have examined police officers' use of force toward individuals with schizophrenia, despite the widely disseminated Crisis Intervention Team (CIT) model of partnership between mental health and law enforcement that seeks to reduce use of force and enhance safety of officers and individuals with mental illnesses. This study tested the hypotheses that CIT-trained officers would select a lower level of force, identify nonphysical actions as more effective, and perceive physical force as less effective in an escalating psychiatric crisis, compared with non-CIT-trained officers. Police officers (n = 135)-48 CIT trained and 87 non-CIT trained-completed a survey containing 3 scenario-based vignettes depicting an escalating situation involving a subject with psychosis. Data were analyzed using repeated-measures analyses of variance. Officers escalated their preferred actions across the scenarios. A significant scenario by group interaction indicated that CIT-trained officers chose less escalation (ie, opting for less force at the third scenario) than non-CIT-trained officers. Officers reported decreasing perceived effectiveness of nonphysical action across the 3 scenarios. A significant scenario by group interaction indicated that CIT-trained officers reported a lesser decline in perceived effectiveness of nonphysical actions at the third scenario. CIT-trained officers consistently endorsed lower perceived effectiveness of physical force. Efforts are needed to reduce use of force toward individuals with psychotic disorders. These findings suggest that CIT may be an effective approach. In addition to clinical and programmatic implications, such findings demonstrate a role for clinicians, advocates, and schizophrenia researchers in promoting social justice through partnerships with diverse social sectors.
Cohen, Benita E; Reutter, Linda
The purpose of this paper is to invite dialogue about how public health nurses could best address child and family poverty. Their current role is reviewed and a framework for expanding this role is presented. The negative health consequences of poverty for children are well-documented worldwide. The high levels of children living in poverty in wealthy industrialized countries such as Canada should be of concern to the health sector. What role(s) can public health nurses play in addressing child and family poverty? A review of scholarly literature from Canada, the United States of America and the United Kingdom was conducted to ascertain support for public health nurses' roles in reducing poverty and its effects. We then reviewed professional standards and competencies for nursing practice in Canada. The data were collected between 2005 and 2006. Numerous nursing scholars have called for public health nurses to address the causes and consequences of poverty through policy advocacy. However, this role was less likely to be identified in professional standards and competencies, and we found little empirical evidence documenting Canadian public health nurses' efforts to engage in this role. Public health nurses' roles in relation to poverty focus primarily on assisting families living in poverty to access appropriate services rather than directing efforts at the policy level. Factors associated with this limited involvement are identified. We suggest that the conceptual framework developed by Blackburn in the United Kingdom offers direction for a more fully developed public health nursing role. Prerequisites to engaging in the strategies articulated in the framework are discussed. Given more organizational support and enhanced knowledge and skills, public health nurses could be playing a greater role in working with others to make child and family poverty history.
Stress among Mansoura (Egypt) baccalaureate nursing students. ... On average each student reported a mean of 4.6 stressors and academic pressures were the ... programs and psychiatric care into nursing health services of the University.
Testa, A; Giannuzzi, R; Sollazzo, F; Petrongolo, L; Bernardini, L; Dain, S
In this Part II psychiatric disorders coexisting with organic diseases are discussed. "Comorbidity phenomenon" defines the not univocal interrelation between medical illnesses and psychiatric disorders, each other negatively influencing morbidity and mortality. Most severe psychiatric disorders, such as schizophrenia, bipolar disorder and depression, show increased prevalence of cardiovascular disease, related to poverty, use of psychotropic medication, and higher rate of preventable risk factors such as smoking, addiction, poor diet and lack of exercise. Moreover, psychiatric and organic disorders can develop together in different conditions of toxic substance and prescription drug use or abuse, especially in the emergency setting population. Different combinations with mutual interaction of psychiatric disorders and substance use disorders are defined by the so called "dual diagnosis". The hypotheses that attempt to explain the psychiatric disorders and substance abuse relationship are examined: (1) common risk factors; (2) psychiatric disorders precipitated by substance use; (3) psychiatric disorders precipitating substance use (self-medication hypothesis); and (4) synergistic interaction. Diagnostic and therapeutic difficulty concerning the problem of dual diagnosis, and legal implications, are also discussed. Substance induced psychiatric and organic symptoms can occur both in the intoxication and withdrawal state. Since ancient history, humans selected indigene psychotropic plants for recreational, medicinal, doping or spiritual purpose. After the isolation of active principles or their chemical synthesis, higher blood concentrations reached predispose to substance use, abuse and dependence. Abuse substances have specific molecular targets and very different acute mechanisms of action, mainly involving dopaminergic and serotoninergic systems, but finally converging on the brain's reward pathways, increasing dopamine in nucleus accumbens. The most common
Laschinger, H K; Goldenberg, D
The purpose of this descriptive correlational study was to examine practicing nurses' attitudes, subjective norms, and intentions to care for HIV positive patients, using the Theory of Reasoned Action. One hundred and forty-one subjects completed a questionnaire developed according to guidelines described by Ajzen and Fishbein (1980). Consistent with the theory, nurses' attitudes and subjective norms were found to be significant predictors of intentions to care for persons who are HIV positive (R2 = 0.27). Personal beliefs found to discriminate between intenders and nonintenders were those related to possible consequences for self, family, and friends, but not job-related consequences. Normative beliefs which discriminated between groups were also related to nonprofessional referents' expectations. In addition, qualitative data showed persistent concerns about occupational risk for contracting AIDS. Based on the results of this research, it is recommended that nurse educators in both clinical and academic settings, target specific educational/training interventions to include transmission, prevention, as well as exploration of feelings, attitudes, beliefs, and behavioral intentions about HIV-related topics. Further theory-based research and testing of interventions to change practicing nurses' attitudes and beliefs about HIV disease are advocated.
Goldenberg, D; Laschinger, H
Few investigators have studied nurses' or nursing students' responses to caring for AIDS patients. The purpose of this exploratory study was to test the Ajzen-Fishbein (1980) Theory of Reasoned Action in a student nurse population about AIDS patient care. This theory offers an approach to explaining individuals' intentions to engage in certain behaviors as determined by two components: attitudes toward the behavior and subjective norms. Forty-six second-year baccalaureate nursing students completed a questionnaire developed according to guidelines described by Ajzen and Fishbein (alpha reliability range was .69-.85) prior to and following an instructional unit on caring for AIDS patients. Consistent with the theory, students' attitudes and subjective norms were found to be significant predictors of intentions to care for AIDS patients in their clinical experience (R2 = .29, F[1, 43] = 6.63, p less than .003). In addition, qualitative data resembled those in previous reports of fear of contagion among health professionals. The effects of the instructional unit about caring for AIDS patients resulted in significant changes in both attitudes and subjective norms.
Reflection on action is widely accepted as a means of developing an individual's experience and professional and scientific knowledge [Accident and Emergency Nursing 4 (1996) 135]. Reflection can occur when a nursing event is examined and explored which may lead to the individual acquiring new perspectives and new knowledge regarding the event. This paper contends that the exploration of an event in practice can be better understood if viewed in the context of previous similar experiences. A five stage structured process is suggested whereby the nurse intentionally returns to former places and recreates previously experienced affective states with the purpose of accessing context and state dependent memories. These rediscovered remembrances can then serve as the raw material for reflection on nursing problems and dilemmas. A comparison of the current problem with the past experience may lead to new learning and a deepening of the reflective process. The seminal work of Marcel Proust is referred to in order to illustrate the process and examples from practice are also identified.
Full Text Available RESUMO No atual contexto de transformações no campo da assistência à saúde mental no Brasil, a Universidade tem a responsabilidade de redirecionar a qualificação profissional da força de trabalho em saúde. Este artigo versa sobre a experiência de um Programa de Integração Docente-Assistencial envolvendo a Secretaria de Estado de Saúde e a Universidade de São Paulo. Particulariza a experiência de estudantes de enfermagem cursando a disciplina de enfermagem psiquiátrica. A análise da avaliação dos alunos do programa teórico-prático desenvolvido na unidade, ancorado nos pressupostos da Reabilitação Psicossocial indica, ao mesmo tempo, que o modelo de atenção interfere diretamente na qualificação das práticas e, simultaneamente, desenvolve nos alunos atitudes e conhecimentos que os qualificam para desempenhar de forma coerente suas funções.ABSTRACT In the context of recent changes that are taking place in the field of mental health care in Brazil, the University has the responsibility to redimensioning human, resources qualification of mental health workers: At the Mental Health Care and Educational Program of the University of São Paulo and São Paulo Health Office (São Paulo/Brazil, an experience still in course, the nursing students attending to psychiatric nurse training evaluated that theoretical practical education, dealing with health care issues in the field of Psychosocial Rehabilitation purpose, at the same time that directly interferes in the qualification of practices, simultaneously develops the students attitudes and knowledge that qualify them to perform coherent practices in accordance with rehabilitation models of care.
Schwartz, Richard H; O'Laughlen, Mary C; Kim, Joshua
There is an ongoing shortage of child mental health professionals. Nurse practitioners (NPs) who completed behavioral and mental health training have proven that they can diagnose and manage many pediatric problems. To ask the training directors of both child/adolescent psychiatry (CAP) and developmental/behavioral pediatric (DBP) programs about their receptivity and willingness to give additional training for NPs who provide care to children with behavioral and mental health issues and examine the main obstacles to the development of such programs. A survey was sent to 151 CAP and DBP training directors in the United States. The return rate was 67% (N = 101). Only 12% expressed objection to the concept of additional NP training in CAP or DBP, but only 53% of training directors currently reported having sufficient faculty to do so. Some training directors reported already having advanced behavioral and mental health training programs for NPs (31%) and most (82%) would consider expanding, if funded. There is support for advanced training for NPs, but funding is needed to make this a reality. Expansion of such programs might rapidly improve accessibility and reduce waiting time of mental health providers for children and adolescents. ©2017 American Association of Nurse Practitioners.
Ensino da enfermagem psiquiátrica/saúde mental: sua interface com a Reforma Psiquiátrica e diretrizes curriculares nacionais La enseñanza de la enfermería psiquiátrica/salud mental: su conexión con la Reforma Psiquiátrica y las directrices curriculares nacionales Teaching psychiatric nursing/mental health: its interface with the Brazilian Psychiatric Reform and national curriculum guidelines
Josicelia Dumêt Fernandes
étodos y técnicas pedagógicas; es necesario superar desafíos e implementar los cambios, guiándose por una nueva perspectiva, y osando colocar en cuestión la naturaleza del saber y de las prácticas institucionales psiquiátricas.This theoretical study addresses the education system for Psychiatric Nursing in an increasingly changing world of accelerated scientific and technological modernization. The objective is to discuss the pedagogy in Psychiatric Nursing, and its interface with the principles of the Brazilian psychiatric reform and national curriculum guidelines of nursing undergraduate courses. The theoretical foundation of the study consisted of constructs of the Brazilian psychiatric reform and national curriculum guidelines of nursing undergraduate courses and their relationship to factors constituting the pedagogy in psychiatric nursing. The study shows that it is not enough to identify technical issues regarding contents and teaching, didactic procedures, methods and pedagogical techniques; it is necessary to implement changes, using a new perspective and by daring to question the nature of knowledge and institutional psychiatric practices.
Howard, J S
In reviewing my efforts to clarify the role of the nurse clinician as a psychiatric consultant in a hospital setting, I came away with many impressions. Inherent in my search was a desire to experiment with various means of providing nursing service and much of my time was spent examining the collaborative aspects of the nursing role that would add greater depth to patient care. This involved role experimentation and allowed me the opportunity to develop my role within the context of the guidelines of community organization and consultation in a hospital setting. Although much of the time I found that the liaison role has been aimed at the supportive level, I have also discovered that as I developed security in the role wherein I could function in new and more independent ways--the parameters of the role expanded. Whereas initially I envisioned working only with nursing staff, I have found myself collaborating with many disciplines and many levels of care givers and I have also been able to function collaboratively with other psychiatric liaison team members. Thus, at this time I see the liaison nurse functioning basically as a coordinator, who, at any time, may assume one or more of the following roles: 1) Integrator; 2) Provider of direct services; 3) Educator and consultant; 4) Change agent.
Imai, H; Nakao, H; Tsuchiya, M; Kuroda, Y; Katoh, T
(1) To examine whether prevalence of burnout is higher among community psychiatric nurses working under recently introduced job specific work systems than among public health nurses (PHNs) engaged in other public health services. (2) To identify work environment factors potentially contributing to burnout. Two groups were examined. The psychiatric group comprised 525 PHNs primarily engaged in public mental health services at public health centres (PHCs) that had adopted the job specific work system. The control group comprised 525 PHNs primarily engaged in other health services. Pines' Burnout Scale was used to measure burnout. Respondents were classified by burnout score into three groups: A (mentally stable, no burnout); B (positive signs, risk of burnout); and C (burnout present, action required). Groups B and C were considered representative of "burnout". A questionnaire was also prepared to investigate systems for supporting PHNs working at PHCs and to define emergency mental health service factors contributing to burnout. Final respondents comprised 785 PHNs. Prevalence of burnout was significantly higher in the psychiatric group (59.2%) than in the control group (51.5%). Responses indicating lack of job control and increased annual frequency of emergency overtime services were significantly correlated with prevalence of burnout in the psychiatric group, but not in the control group. Prevalence of burnout is significantly higher for community psychiatric nurses than for PHNs engaged in other services. Overwork in emergency services and lack of job control appear to represent work environment factors contributing to burnout.
Andressa de Oliveira
Full Text Available Abstract Objective: To know how the nurse provides care in the first psychotic outbreak of patients, and to identify the Barbara Carper patterns of knowing used for this action. Methods: A qualitative study using a phenomenological approach was performed in four Psychosocial Care Centers and in a psychiatric ward of a university hospital. Data collection was carried out with ten nurses participating in semi-structured interviews using the following guiding question: "Tell me your experience in caring for a patient in their first psychotic outbreak". Results: Carper's fundamental ways of knowing (empirical, aesthetic, ethical and personal were identified in the caring of the patient in their first psychotic outbreak. Conclusion and Implications: A fragmented practice is implied when patterns of knowledge are taken in isolation. This reflects on specific actions of nursing work, such as the nursing practice and its stages.
Elioenai Dornelles Alves
Full Text Available This philosophical reflection search to build some guide elements that can subsidize the discussions on the teaching methodologies in health and nursing, while philosophical referencial to rethink the pedagogic political projects used in the qualification of human resources in health and of the implications with the offers of courses, projects, researches and activities related to extension action the permanent education in health. This study search to rescue a critical and creative approach of the educators in health, contributing to a new look interdisciplinar focused philosophically of way multiprofissional, to rethink our praxis in the different acting forms.
Cope, D; Cox, S
The organization of the way in which hospitals and hospital staff provide a service to patients is obviously of critical importance to their effectiveness, yet it is clear that rigidities and inappropriate and ineffective procedures frequently intrude. It is commonly held that changing hospitals as organizations is difficult to acomplish, and indeed, reported attempts at such change reflect this. The project reported here was a successful attempt at changing a number of different aspects of the culture of a psychiatric hospital which included managerial practices and structure, aspects of patient care, multidisciplinary team work, and staff development. The present paper concentrates on some specific outcomes at ward level. The general pattern for bringing about change involves the collection of (valid) data and then feeding this back to the staff involved so that they can take appropriate action. The data discussed here concerned ward nursing staff's attitude to the 'climate' of the hospital, their job satisfaction and aspects of patient care. This was fed back to nursing, managerial and medical staff, and action plans were agreed to overcome the difficulties highlighted. Outcomes have included the production of ward and unit objectives and changes in treatment programmes and aspects of patient care on the wards.
Frederiksen, Julie Elisabeth Nordgaard; Sass, Louis A; Parnas, Josef
that are historically rooted in logical positivism and behaviorism. These theoretical approaches marked decisively the so-called "operational revolution in psychiatry" leading to the creation of DSM-III. This paper attempts to examine the theoretical assumptions that underlie the use of a fully structured psychiatric...... person), actionable format, used for classification, treatment, and research. Our central thesis is that psychiatry targets the phenomena of consciousness, which, unlike somatic symptoms and signs, cannot be grasped on the analogy with material thing-like objects. We claim that in order to perform...... faithful distinctions in this particular domain, we need a more adequate approach, that is, an approach that is guided by phenomenologically informed considerations. Our theoretical discussion draws upon clinical examples derived from structured and semi-structured interviews. We conclude that fully...
Our report describes the evolution of the outpatients' psychiatry in Lausanne. Here is mentioned the constant increase of consultations for new and former cases, and it is statistically shown that this augmentation is not only the result of the increasing population in the "Vaud District" (Canton de Vaud) but rather the consequence of the increasing number of patients with deeper investigations and treatments. It is true that the psychotherapeutic training was the most important in our outpatients' department, but the coming of psychotropic drugs has changed the treatment in certain cases and has developed mixed treatments. The creation of the Psycho-Social Center in the Psychiatric outpatients' department was the beginning of the social action in the institution, with the creation of an emergency department, consultations at the patients' home and treatment made by a team including doctors-outpatients' nurses-social assistants. We have checked that for many outpatients, very often in hard or psycho-reactive situations, there was no opposition between pharmaco-therapy or psychotherapy. So pharmaco-therapy and psychotherapy are often used separately or together in the outpatients' department through individual analytic psychotherapies, group or brief psychotherapies, relaxation, emergency treatments with perfusion of psychotropic and neuroleptic drugs.
Ensino de enfermagempsiquiátrica / saúde mental na Faculdade de Enfermagem da Universidade Federal de Goiás Enseñanza de enfermería psiquiátrica y de salud mental en la Facultad de Enfermería de la Universidad Federal de Goiás - Brasil Psychiatric nursing and mental health education in nursing college of the Federal University of Goiás - Brazil
Denize Bouttelet Munari
Full Text Available Este artigo descreve a experiência do ensino em Enfermagem Psiquiátrica/Saúde Mental na Faculdade de Enfermagem/Universidade Federal de Goiás, pontuando potencialidades e fragilidades na busca de novos caminhos para atenção em enfermagem de saúde mental e psiquiatria. Destacamos aspectos relevantes como facilidade de integração entre as disciplinas da área com outras áreas, a contribuição na formação geral do enfermeiro no desenvolvimento de competências relacionais, de gestão, de capacitação para compreender, planejar e desenvolver ações de resgate da humanização nos serviços de saúde, com destaque especial ao cuidado do cuidador. Como fator limitante, pontuamos a fragilidade da rede de serviços de atenção psicossocial que constitui um obstáculo e grande desafio a ser superado para a implementação de mudanças na assistência e ensino.Este artículo describe la experiencia de enseñanza en Enfermería Psiquiátrica/Salud Mental en la Escuela de Enfermería de la Universidad Federal de Goiás puntuando potencialidades y fragilidades en la búsqueda de nuevas maneras de atención en enfermería de salud mental y psiquiatría. Enfatizamos aspectos importantes como facilidad de integración entre varias disciplinas de áreas diferentes, la contribución en la formación general del enfermero en el desarrollo de habilidades de relacionar, la administración, de calificación para entender, planear y desarrollar acciones para rescatar ayuda humanística en servicios de salud, con destaque especial al cuidado de aquel que cuida. Como factor limitante puntuamos la fragilidad de la red de servicios de atención psicosocial que constituye un obstáculo y gran desafío de ser superados para la implementación de cambios en el cuidado y enseñanzaThis article describes the experience of education in Mental Health and Psychiatric Nursing in the Nursing College of Federal University of Goiás, marking potentialities and
Maddison, Charlotte; Strang, Gus
The aim of this study was to investigate if by participating in action learning sets, Graduate Entry Pre-registration Nursing (GEN) students were able to engage in collaborative and deliberative learning. A single focus group interview involving eleven participants was used to collect data. Data analysis identified five themes; collaborative learning; reflection; learning through case study and problem-solving; communication, and rejection of codified learning. The themes are discussed and further analysed in the context of collaborative and deliberative learning. The evidence from this small scale study suggests that action learning sets do provide an environment where collaborative and deliberative learning can occur. However, students perceived some of them, particularly during year one, to be too 'teacher lead', which stifled learning. Copyright © 2017 Elsevier Ltd. All rights reserved.
Referencial de cuidar em enfermagem psiquiátrica: um processo de reflexão de um grupo de enfermeiras Referencial de Cuidar en Enfermería Psiquiátrica: un proceso de reflexión de un grupo de enfermeras Psychiatric nursing care reference: a reflective process of a group of nurses
Anna Cristina Cardoso Fontes dos Santos
Humano, Cuidado Profesional de Enfermería; Cuidador profesional; Proceso Educativo; Institucional y des-cuidado que permitieron formular una propuesta de referencia para la práctica del Cuidar en Enfermería a pacientes psiquiátricos institucionalizados de larga permanencia.Qualitative research that had as purpose to construct in conjunction with six head nurses, of a public Psychiatric Institution located in Rio de Janeiro, a theoretical-philosophical reference to be implemented by themselves, in the development of the psychiatric patients' care process. It was made a reflexion process on group dynamics looking for self-knowledge and maturity. This occurred during the development of master thesis (1, advised by Dr. Eloita Pereira Neves. It was used concepts of Humanistic (2 and Bureaucratic Care Theories (3, directives of the Psychiatric Reform and Politics of Mental Health. The data collected were recorded, transcribed, and analyzed according to the content analysis (4. The results pointed to categories of Conceptions related to: Human Being; Professional Nursing Care; Care of the Professional Caregiver; Caring as an Educational Process; Institutional and Carelessness. These allowed formulating a reference proposal for the Nursing Care practice in institutionalized psychiatric patients of long permanence.
Currie, Kay; Biggam, John; Palmer, Janette; Corcoran, Terry
Professional role development in nursing is occurring at a rapid pace in the UK as elsewhere. Internationally, finding relevant, flexible, sustainable educational solutions to support the preparation of nurses for new roles presents significant challenges for Higher Education Institutions, health service managers and the clinical practitioners who are would-be students. The use of on-line learning is frequently advocated as one means of resolving these difficulties. This paper discusses participants' engagement with, and reactions to, the use of on-line Action Learning Sets (ALS) as part of a national pilot development pathway for Advanced Nursing Practice in Scotland. Data collection included: survey of participants' views of on-line ALS; survey comparing perceptions of ALS with other educational experiences within the pathway; in-depth interviews with case-site participants. A range of benefits and limitations of on-line ALS was identified. The benefit of flexible access and sharing experiences with others was emphasised. Conversely, multiple commitments and lack of group cohesiveness significantly interfered with the effectiveness of this process. Key recommendations for future implementation acknowledge participants' preference for a blended approach, with face-to-face sessions to provide 'getting-to-know-you' opportunities, enhancing commitment to the group process. Copyright © 2011 Elsevier Ltd. All rights reserved.
Full Text Available Objective: To translate the English work-related acceptance and action questionnaire (WAAQ, make cross-cultural adaptations, and examine its psychometric properties when used by Chinese oncology nurses. Methods: After translation, the psychometric properties of the Chinese WAAQ were analyzed among 417 nurses, and content validity was determined by six experts. Results: Item-level content validity index (CVI values were between 0.83 and 1.00; scale-level CVI/universal agreement (S-CVI/UA and S-CVI/average were 0.86 and 0.98, respectively, which implicated a good content validity. The correlation of the Chinese WAAQ with AAQ-II (rs= −0.247, P < 0.001 suggested criterion validity, and those with General Health Questionnaire-12 (−0.250, <0.001 and general self-efficacy scale (0.491, <0.001 and Utrecht work engagement scale (UWES (0.439, <0.001 suggested convergent validity. Exploratory factor analysis identified a seven-item, one-factor structure of WAAQ. The Chinese version of WAAQ had high internal consistency (Cronbach's α = 0.920, with an item-total correlation coefficient of 0.702–0.828 (P < 0.05, split-half reliability of 0.933, and test-retest reliability of 0.772. Conclusions: The Chinese WAAQ is a reliable and valid tool for assessing psychological flexibility in Chinese oncology nurses.
Weisman de Mamani, A; Gurak, K; Maura, J; Martinez de Andino, A; Weintraub, M J; Mejia, M
WHAT IS KNOWN ON THE SUBJECT?: Some research suggests that holding a free will perspective may offer mental health and physical health benefits. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study is the first to examine links between free will perceptions and psychiatric symptoms in patients diagnosed with schizophrenia. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Study results suggest that helping people with a diagnosis of schizophrenia to recognize situations where they do have some freedom of choice over their actions and emotional reactions (free will) may assist them in improving their experiences and better managing their symptoms. Introduction Some research indicates that having a strong sense that one possesses free will may be associated with better psychological and physical health. This study is the first to examine the relationship between free will perceptions and psychiatric symptoms in patients with a diagnosis of schizophrenia. Method Thirty-two participants were interviewed using the Brief Psychiatric Rating Scale to assess symptom severity and the Free Will Subscale of the Free Will and Determinism Scale to assess free will perceptions. Results As hypothesized, a negative association was found between free will perceptions and total symptom severity, though it appears that this was mainly accounted for by positive symptoms. A content analysis was also conducted to qualitatively examine how patients conceptualize the construct of free will and its role in coping with their own mental illness. Discussion Study results suggest that holding a free will perspective may mitigate psychiatric symptoms in patients with a diagnosis of schizophrenia. Thus, psychiatric nurses and other mental health clinicians may improve current treatments for schizophrenia by helping patients recognize situations where they do have some freedom of choice over their actions and emotional reactions (free will) to stressful life events. © 2016 John Wiley & Sons Ltd.
Stewart, D; Bowers, L
Nursing staff on psychiatric wards often attribute patient violence and aggression to substance use. This study examined incidents of alcohol and illicit drug use among acute psychiatric inpatients and associations between substance use and violence or other forms of aggression. A sample of 522 adult psychiatric inpatients was recruited from 84 acute psychiatric wards in England. Data were collected from nursing and medical records for the first 2 weeks of admission. Only a small proportion of the sample was reported to have used or been under the influence of alcohol (5%) or drugs (3%). There was no physical violence during a shift when a patient had used alcohol or drugs. Substance using patients were also no more likely than others to behave violently at any point during the study period. However, incidents of substance use were sometimes followed by verbal aggression. Beliefs that substance using patients are likely to be violent were not supported by this study, and could impact negatively on therapeutic relationships between nurses and this patient group. Future studies are needed to examine how staff intervene and interact with intoxicated patients. © 2014 John Wiley & Sons Ltd.
Jaqueline Santos de Andrade Martins
entendimiento trae contribuciones para la mejor caracterización de los entornos, personas y su relaciones en la internet.This study is about interaction of nursing on virtual environments and their importance for nursing care and learning this profession. Objectives: To propose a categorization for participating actions in messages produced by virtual identity of the nursing community; and to verify the distribution of the participating actions, to correlate with the process of interaction in a nursing virtual community. Methods: This is an exploratory study of quantitative approach, with descriptive statistics. Held inspectional reading email messages and through the nine categories were proposed for the participating actions. Results: Commentary, questioning and answer were prevalent categories. These actions were named "triad for conversation". We made the test of kappa, obtaining result in a moderate agreement that guided the discussion to two possible hypotheses for future studies. Conclusion: Believed that exist a possibility to take the participating actions as basics elements that indicate interaction and transaction in the systemic perspective applied in nursing. This comprehension contributes for the better characterization of ambient, individual and his connections on the virtual space in the internet.
Mahone, Irma H.; Farrell, Sarah P.; Hinton, Ivora; Johnson, Robert; Moody, David; Rifkin, Karen; Moore, Kenneth; Becker, Marcia; Barker, Margaret
An academic-community partnership between a school of nursing (SON) at a public university (the University of Virginia, or UVA) and a public mental health clinic developed around a shared goal of finding an acceptable shared decision making (SDM) intervention targeting medication use by persons with serious mental illness. The planning meetings of the academic-community partnership were recorded and analyzed. Issues under the partnership process included 1) clinic values and priorities, 2) re...
Krystal, Andrew D.
SYNOPSIS Psychiatric disorders and sleep are related in important ways. In contrast to the longstanding view of this relationship which viewed sleep problems as symptoms of psychiatric disorders, there is growing experimental evidence that the relationship between psychiatric disorders and sleep is complex and includes bi-directional causation. In this article we provide the evidence that supports this point of view, reviewing the data on the sleep disturbances seen in patients with psychiatric disorders but also reviewing the data on the impact of sleep disturbances on psychiatric conditions. Although much has been learned about the psychiatric disorders-sleep relationship, additional research is needed to better understand these relationships. This work promises to improve our ability to understand both of these phenomena and to allow us to better treat the many patients with sleep disorders and with psychiatric disorders. PMID:23099143
Shires, B; Tappan, T
As managed care continues to flourish, the psychiatric clinical nurse specialist may function as a case manager for a managed care company or as a utilization review nurse for a hospital, community provider, or administrator. Stressing the strengths of the psychiatric clinical nurse specialist as brief therapist, the author reviews elements of the brief treatment model, including assessment, focus of treatment, knowledge of community resources, patient education, group skills, crisis intervention, and treatment planning.
Full Text Available Background. Action-oriented study circles (AOSC have been found to improve nutrition in 24 nursing homes in Sweden. Little, however, is known about the conceptual use of knowledge (changes in staffs’ knowledge and behaviours. Methods. Qualitative and quantitative methods, structured questionnaires for evaluating participants’ (working in nursing homes experiences from study circles (n=592, 71 AOSC and for comparisons between AOSC participants (n=74 and nonparticipants (n=115. Finally, a focus group interview was conducted with AOSC participants (in total n=12. Statistical, conventional, and directed content analyses were used. Results. Participants experienced a statistically significant increase in their knowledge about eating and nutrition, when retrospectively comparing before participating and after, as well as in comparison to non-participants, and they felt that the management was engaged in and took care of ideas regarding food and mealtimes to a significantly greater extent than non-participants. The use of AOSC was successful judging from how staff members had changed their attitudes and behaviours toward feeding residents. Conclusions. AOSC facilitates professional development, better system performance, and, as shown in previous studies, better patient outcome. Based on a collaborative learning perspective, AOSC manages to integrate evidence, context, and facilitation in the efforts to achieve knowledge translation in a learning organisation. This study has implications also for other care settings implementing AOSC.
Renata Curi Labate
Full Text Available A visita domiciliária é tema de interesse em diversas áreas da enfermagem. Em psiquiatria, com a implantação de serviços psiquiátricos na comunidade, a necessidade de realizar visita domiciliaria tornou-se evidente. Por um período de um ano estivemos envolvidos com esta atividade, solicitando-a ou realizando-a para pacientes atendidos no Núcleo de Saúde Mental. O objetivo deste trabalho é relatar esta experiência, destacando os seguintes aspectos: O Espaço Público e o Privado da família e a articulação entre visitadores e os recursos da comunidade. A visita domiciliaria aproxima a equipe do contexto do doente e favorece a articulação entre o doente, sua família, o serviço de saúde e os recursos da comunidade.La visita domiciliaria es tema de interés en diversas áreas de enfermería. En psiquiatría, con la implantación de servicios psiquiátricos en la comunidad, la necesidad para las visitas ha llegado a ser evidente. Durante un año hemos estado involucrados en esta actividad, realizándola o solicitándola para pacientes atendidos en el Núcleo de Salud Mental. El objetivo de este trabajo es describir nuestra experiencia, detallando los siguientes aspectos: La Vida Pública y Privada de la Familia y la colaboración entre los profesionales y los recursos en la comunidad. Las visitas domiciliarias reúnen al equipo desde el contexto del enfermo y favorece la articulación entre el enfermo, su familia, el servicio de salud y los recursos de la comunidad.The home visit is a matter of concern in diverse areas of nursing. With the implementation of psychiatric services in the community, the need for visits has become evident. For one year, we were involved with this activity, requesting it or providing it for patients assisted in the Núcleo de Saúde Mental (Mental Health Center. The aim of this paper is to describe our experience, detailing the following aspects: the public and private life of the family and the
Frauenfelder, F.; Achterberg, T. van; Needham, I.; Staub, M. Muller
PURPOSE: This study explored how well NANDA-I covers the reality of adult inpatient psychiatric nursing care. METHODS: Patient observations documented by registered nurses in records were analyzed using content analysis and mapped with the classification NANDA-I. FINDINGS: A total of 1,818 notes
The purpose of this study was to explore how community-based case managers interface with their clients' healthcare providers and other community organizations as a function within their advocacy efforts. Case managers previously defined advocacy as occurring at individual, organizational, and community levels. The relationships they attempt to develop and maintain are consistent with case management ideology, yet this is a complex process to ensure care for vulnerable populations with many medical and socioeconomic needs. Community-based case management settings. In-depth qualitative interviews with a total of 20 nurse and social work case managers working in public housing, university-affiliated community nursing centers, local parishes, and community ministry. The case managers in this study reflected on how they interface with their clients, other healthcare providers, and community organizations on behalf of their clients. They reflect on the importance of trust and communication to facilitate this process. The advocacy work of case managers is influenced by the setting, others' perceptions of their knowledge and expertise, and power dynamics. Their ability to effectively advocate is greatly influenced by the strength of the relationships they forge. Advocacy for vulnerable clients is influenced by the existing relationship between case managers and their clients' healthcare providers. Case managers need to be persistent in their interactions with other providers to ensure that their clients have access to valuable community resources. Clear lines of communication should be established between case managers so that there is clarity around roles and expectations in service provision. Case managers should also participate in the mentoring of future health professions students so they may learn the application of advocacy work in community settings.
The paper describes the current provision of psychiatric services in Algeria - in particular, in-patient and out-patient facilities, child psychiatry and human resources. Education, training, associations and research in the field of mental health are also briefly presented. The challenges that must dealt with to improve psychiatric care and to comply with international standards are listed, by way of conclusion.
Full Text Available Psychiatric disorders are common in women during their childbearing years. Special considerations are needed when psychotic disorders present during pregnancy. Early identification and treatment of psychiatric disorders in pregnancy can prevent morbidity in pregnancy and in postpartum with the concomitant risks to mother and baby. Nevertheless, diagnosis of psychiatric illnesses during pregnancy is made more difficult by the overlap between symptoms of the disorders and symptoms of pregnancy. In majority of cases both psychotherapy and pharmacotherapy should be considered. However, psychiatric disorders in pregnancy are often under treated because of concerns about potential harmful effects of medication. This paper reviews findings about the presentation and course of major psychiatric disorders during pregnancy.
Full Text Available The etiology of these dermatological diseases is entirely psychiatric origin. These patients show overconcern to their skin or self inflicted dermatoses unconsciously instead of facing with their real problems. In this group, delusions, dermatitis artefacta, trichotillomania, body dysmorphic disorder can be seen. They use denial as defence mechanism to their real psychiatric problems and prefer to apply dermatology instead of psychiatry. Dermatologist should be very careful before asking psychiatric consultation. Denial mechanism help patients to overcome agressive impulses like suicide or prevent further psychiatric damage like psychosis. Dermatologist should see these patients with short and frequent intervals with a good empathic approach. This will help to progress a powerful patient doctor relationship which will lead to a psychiatric evaluation.
Munk-Olsen, Trine; Maegbaek, M L; Johannsen, B M
and childbirth, which suggests differences in the underlying etiology. We further speculate varying treatment incidence and prevalence in pregnancy vs postpartum may indicate that the current Diagnostic and Statistical Manual of Mental Disorders-5 peripartum specifier not adequately describes at-risk periods......Perinatal psychiatric episodes comprise various disorders and symptom severity, which are diagnosed and treated in multiple treatment settings. To date, no studies have quantified the incidence and prevalence of perinatal psychiatric episodes treated in primary and secondary care, which we aimed...... psychiatric facilities, 2.5 births were followed by an episode treated at outpatient psychiatric facility and 12 births by GP-provided pharmacological treatment. We interpret our results the following way: treated severe and moderate psychiatric disorders have different risk patterns in relation to pregnancy...
O conhecimento produzido no Programa de Pós-Graduação em Enfermagem: a enfermagem psiquiátrica El conocimiento producido en el programa de post-graduación en enfermería: la enfermería psiquiátrica The knowledge produced in the graduate program in nursing: psychiatric nursing
producir conocimientos a partir de las prácticas concretas de los trabajadores en los campos de la asistencia, la gestión y la enseñanza de Salud Mental.After almost 30 years since the creation of the Psychiatric Nursing Concentration Area in the Graduate Program of the University of São Paulo Nursing School, it is important to take a look at its scientific production in order to substantiate reflection about teaching. This is a descriptive-exploratory study. It used as sources the registers of the Graduate Service, abstracts from theses and dissertations, and memoranda and official correspondence. The data collected were analyzed in the light of the transformations occurred in this structure that has graduated 60 students, of which 50 obtained a Master's Degree and 10 a PhD, and that has been restructuring its disciplines, research lines and projects with the objective of responding to internal and external evaluations and adjusting to the guidelines of the country's fostering agencies. Current scientific production points out to an alignment with the guidelines of the Psychiatric Reform, and a tendency to produce knowledge through the concrete practice of the workers in the assistance field, the management and the teaching of Mental Health.
Gokce Nur Say
Full Text Available Oxytocin is a neuropeptide that plays critical role in mother-infant bonding, pair bonding and prosocial behaviors. Several neuropsychiatric disorders such as autism, schizophrenia, affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, alcohol/substance addiction, aggression, suicide, eating disorders and personality disorders show abnormalities of oxytocin system. These findings have given rise to the studies searching therapeutic use of oxytocin for psychi-atric disorders. The studies of oxytocin interventions in psychiatric disorders yielded potentially promising findings. This paper reviews the role of oxytocin in emotions, behavior and its effects in psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 102-113
Understanding the management of people seeking voluntary psychiatric hospitalization who do not meet the criteria for inpatient admission: a qualitative study of mental health liaison nurses working in accident and emergency departments in the north of England.
Hepworth, Iain; McGowan, Linda
Mental health liaison nurses assess people who self-present at accident and emergency departments seeking inpatient admission, however not all presentations meet the criteria for admission. Little is known about how liaison nurses manage this client group. This qualitative study explored how liaison nurses manage this client group. This study used the think aloud technique to recreate clinical scenarios of clients requesting admission who do not meet the criteria for such admission. Participants were then subsequently interviewed. Eighteen liaison nurses working in hospitals across the North of England participated. Data were analysed using framework analysis methods. Findings indicate that the liaison nurses use a variety of therapeutic skills and methods in managing this client group. Liaison nurses were found to 'sell' crisis and home-based treatment as an equivalent, or superior in quality, to hospital care. However, the existing evidence base does not fully support this assertion. Liaison nurses face numerous difficulties in this role. In the absence of any formalized training, liaison nurses rely on their own clinical knowledge and expertise. Implications for future service provision and further research are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.
I was horrified to read mental health nurse Tony Leiba's assertion that racism might be a psychiatric condition (features October 3). However abhorrent and misinformed, racism remains opinion, thoughts and assumptions. To suggest that these attitudes are in some way psychiatric is a step towards totalitarianism.
lisorders (4%) and no anxiety disorders. A number of drug. ;ombinations and usages for the ... psychiatric care provided by the PS in the Mhala district of. Northern Transvaal. The PS in Mhala. Mhala district is ... nurse (CPN) being responsible for the continuing care of all patients discharged from the hospital's psychiatric ...
Kousloglou, Sa; Mouzas, Od; Bonotis, K; Roupa, Z; Vasilopoulos, A; Angelopoulos, Nv
.... The purpose of the study was to investigate the prevalence of insomnia and its relation with burnout levels in a group of nurses working in psychiatric, pediatric, internal medicine and surgery...
Alexander, J W
The organizational development process was evaluated on psychiatric units. Using a model of technostructural fit suggested by Alexander and Bauerschmidt, structural interventions were implemented. Insights on the use of organizational development in nursing are presented.
... Guide - Table of Contents Facts For Families Guide - View by Topic Chinese Facts for Families Guide ... Psychiatric Evaluation No. 52; Updated October 2017 Evaluation by a child and adolescent psychiatrist is appropriate for any child or adolescent ...
Lewis-Fernández, Roberto; Aggarwal, Neil Krishan
Since the publication of DSM-IV in 1994, a number of components related to psychiatric diagnosis have come under criticism for their inaccuracies and inadequacies. Neurobiologists and anthropologists have particularly criticized the rigidity of DSM-IV diagnostic criteria that appear to exclude whole classes of alternate illness presentations as well as the lack of attention in contemporary psychiatric nosology to the role of contextual factors in the emergence and characteristics of psychopat...
Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind
Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity.......Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....
Carolina Luiza Bernardes
Full Text Available Objective: To identify the issues occurred with nursing workers through a Health Monitoring System for Nursing Workers (SIMOSTE and to describe the consequences of those problems. Method: This is a quantitative, exploratory and descriptive study realized in a teaching hospital in the west region of the city of São Paulo. Results: From the SIMOSTE, 1.847 occurrences were registered in a six month period. Within the main occurrences, medical licenses, work related accidents with and without removals; psychiatric consultations and psychotherapy were highlighted. Conclusion: The data points out to the need for the development of new health vigilance actions to notify accidents and illness related to work, besides the prevention of issues.
Sutton, Eliza L
Sleep issues are common in people with psychiatric disorders, and the interaction is complex. Sleep disorders, particularly insomnia, can precede and predispose to psychiatric disorders, can be comorbid with and exacerbate psychiatric disorders, and can occur as part of psychiatric disorders. Sleep disorders can mimic psychiatric disorders or result from medication given for psychiatric disorders. Impairment of sleep and of mental health may be different manifestations of the same underlying neurobiological processes. For the primary care physician, key tools include recognition of potential sleep effects of psychiatric medications and familiarity with treatment approaches for insomnia in depression and anxiety. Copyright © 2014 Elsevier Inc. All rights reserved.
Kagan, Sarah H; Melendez-Torres, G J
Ageism in health care delivery and nursing poses a fundamental threat to health and society. In this commentary, implications of age discrimination are presented to generate an agenda for action in nursing management. In nations like the United States and the United Kingdom, nursing is an ageing profession caring for an ageing society where age discrimination takes many forms and has broad impact. This commentary critically synthesizes the literature on ageism and relevant data on ageing societies for nurse managers and other leaders. Investigations of ageism suggest that discrimination negatively affects health and results in poor health care experiences. Age discrimination is present in nursing, exacerbating workforce shortages and limiting the use of expertise within the profession. Nursing faces a future for which understanding ageing societies and ageism is essential. An agenda for the future is proposed. Nurse managers possess the power to enact an agenda for combating ageism in health care and nursing. © 2013 John Wiley & Sons Ltd.
Mazhindu, Deborah M; Griffiths, Lauren; Pook, Carol; Erskine, Allen; Ellis, Roger; Smith, Fleur
From April 1st 2015 it will be mandatory for Higher Education Institutions (HEI) in the United Kingdom (UK) providing pre-qualifying health care higher education to use a Values Based Recruitment (VBR) tool, to ensure only the candidates with the "right" personal identity and values commensurate with the Professional Identity of Nursing (PIN) are accepted for nurse education. "Nurse Match" instrument was developed to enhance the recruitment and selection of candidates for pre-qualifying nursing. Action Research into PIN commenced with voluntary, purposive, convenience samples of qualified nurses (n = 30), Service Users (N = 10), postgraduate diploma nurses in mental health (N = 25), third year mental health branch students (N = 20) and adult and child student nurses in years 2 and 3 (N = 20) in Focus Groups. Data collection and analysis occurred concomitantly between July 2013 and October 2014, aided by NVivo 10 software and revealed Key Quality Indicators (KQIs) of the social construction of PIN. Construct development included a literature review spanning the last fifteen years, which identified four main themes; 1. Nursing's ethics and values. 2. Nursing's professional identity and caring. 3. Nursing's emotional intelligence. 4. Nursing's professionalism. Nurse Match offers an evidence-based enhancement to VBR, for future nurse recruitment locally, nationally and internationally. Copyright © 2016 Elsevier Ltd. All rights reserved.
Significant and widespread changes to the education of the psychiatric nursing workforce in Victoria, Australia are resulting in serious problems in the recruitment of new nursing staff. In reviewing the available literature, it is evident that undergraduate nursing students do not commence their educational program with a strong interest in pursuing a career in psychiatric nursing. In light of this knowledge, the role of education in providing a comprehensive view of the nursing profession becomes paramount. Research investigating the impact of education on the attitudes of students to psychiatric nursing as a career option has produced mixed and often inconclusive results. A longitudinal study was undertaken in Victoria, Australia. Students of the majority of universities in which undergraduate nursing programs were operating participated in this study. The participants were asked to rank nine areas of nursing specialty in order of preference at the commencement and immediately prior to the completion of the nursing program. Despite a significant improvement in the popularity of psychiatric nursing as a career choice, this area was ranked at number 8 at both pre- and post-program test. The analysis of open-ended questions demonstrated a marked change in the overall attitudes towards the mentally ill and psychiatric nursing.
Full Text Available Infertility can be defined as a crisis with cultural, religious, and class related aspects, which coexists with medical, psychiatric, psychological, and social problems. Relation between psychiatric and psychological factors stem from a mutual interaction of both. Family is an important institution in maintaining human existence and raising individuals in line with society's expectations. Fertility and reproduction are seen as universal functions unique to women with raising children as the expected result of the family institution. Incidence of infertility has increased recently and can become a life crisis for a couple. Even though not being able to have a child affects both sexes emotionally, women feel greater amounts of stress, pressure, anxiety, and depression.Consequences of infertility arise from short and long-term devastating effects on both individual's physical and mental health, and marital system. Many studies focus on infertility related psychological and psychiatric disorders (depression, anxiety, grief, marital conflict, gender differences, relation between the causes of infertility and psychopathology, the effects of psychiatric evaluation and intervention -when necessaryon the course of infertility treatment, pregnancy rates, and childbirth. The most important underlying causes of high levels of stress and anxiety that infertile women experience are the loss of maternity, reproduction, sense of self, and genetic continuity. In this review article is to investigate the relationship between medically unexplained symptoms and psychiatric symptoms. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 165-185
Nurse transformational leaders can serve in academic settings and at local, national, international professional nursing organizations and community-based groups. As a transformational leader, nurses can lead in any workplace. According to a study by Stanley (2012), clinical leaders are not sought for their capacity to outline a vision, but for their values and beliefs on display that are easily recognized in their actions. This encompasses the moral component of transformational leadership. It is the APRNs duty to continue to strive towards a better vision for the well-being of all nurses, patients, and colleagues. Autonomous APRNs are happier, healthier, and better prepared to provide the best patient care to their patients. We should not be happy to sit back and let others fight this fight. APRNs need to be on the frontline, leading the way. This is only an insight that I have gained after many frustrating years of cheering our profession and then being made to feel inferior at the same time. Only nurses, who have that nurturing spirit, would hold back if they felt it might hurt others. Don't back off or hold back! It might hurt those that follow!
Joginder Pal Attri
Full Text Available Many patients with psychiatric illnesses are prescribed long-term drug treatment, and the anaesthesiologist must be aware of potential interactions with anaesthetic agents. Psychotropic drugs often given in combination with each other or with other non-psychiatric drugs generally exert profound effects on the central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anaesthesia and surgery. This article highlights the effects of anaesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors and lithium carbonate. The risk that should be considered in the perioperative period are the extent of surgery, the patient′s physical state, anaesthesia, the direct and indirect effects of psychotropics, risk of withdrawal symptoms and risk of psychiatric recurrence and relapse.
The inter-play between facilitation and context in the promoting action on research implementation in health services framework: A qualitative exploratory implementation study embedded in a cluster randomized controlled trial to reduce restraint in nursing homes.
Mekki, Tone Elin; Øye, Christine; Kristensen, Bodil; Dahl, Helen; Haaland, Astrid; Nordin, Kristin Aas; Strandos, Marta; Terum, Toril Marie; Ydstebø, Arnt Egil; McCormack, Brendan
To explore the inter-play between external facilitation and nursing home contexts relative to intervention outcomes. The Promoting Action on Research Implementation in Health Services framework is frequently used to theoretically inform implementation and research in nursing and recent reviews indicate high face validity for health services. However, the inter-play and relationship between framework sub-elements of evidence, context and facilitation and the prospective utility in non-English speaking contexts warrant further illumination. In an overarching single-blind cluster-randomized controlled trial, we applied participatory action research and ethnography from August 2011-June 2015 to evaluate a standardized education intervention to reduce restraint and agitation in nursing home residents living with dementia. The trial results are published elsewhere. Prospectively informed by the PARIHS framework, a research team and eight facilitators participating in dual roles as action researchers designed, implemented, and evaluated the intervention. How contextual factors influenced the facilitation processes were explored in focus group interviews (1), reflection notes (84) written by the facilitators' after each education session, ethnographic field studies (6 homes), and co-analysis workshops (5). Directed content analysis was used to analyse data. Clinical leaders taking roles of internal facilitator influenced the success of implementation, while complex and fluctuating context elements determined whether restraint use was reduced- or not. The PARIHS framework was found to be relevant in a non-English nursing home setting, albeit some elements merit further conceptualization. Our findings confirm the prospective utility of the PARIHS framework for implementation in a non-English context, particularly the notion of implementation processes as dynamic and multifaceted. © 2017 John Wiley & Sons Ltd.
Educação continuada em enfermagem psiquiátrica: reflexão sobre conceitos Educación continua en enfermería psiquiátrica: reflexión sobre conceptos Continuing education in psychiatric nursing: a reflection on concepts
Maria da Graça Girade
continuing education programs that prepare nurses to work in psychiatric nursing led us to conduct this study, the first one on the "development of psychiatric and mental health nursing personnel" research line. Its objective is to make a reflection on the concepts of continuing education, in-service and permanent, found in recent nursing education literature. To carry out the literature review of the concepts we reviewed the MEDLINE and LILACS data bases, theses and dissertations and a number of classical titles on the theme. After the analysis of the concepts and discussions with experts, we concluded that the continuing in-service education denomination is the one that presents more consonance with the authors and experts that were consulted, as well as the one that better meets the demands of knowledge in the area of psychiatric nursing towards the quality of assistance.
Sistema de classificação de pacientesna enfermagem psiquiátrica: validação clínica Sistema de clasificación de pacientes en la enfermería psiquiátrica: validación clínica Patient classification system in psychiatric nursing: clinical validation
Paula Andréa Shinzato Ferreira Martins
de Dependencia en la Enfermería Psiquiátrica fue considerado confiable con índices satisfactorios de concordancia y el constructo fue validado, de-terminando el grado de dependencia del paciente portador de trastornos mentales.The scarcity of publications about personnel dimensioning in psychiatric nursing motivated the development of an Instrument to Classify the Level of Dependence in Psychiatric Nursing, the initial stage for the establishment of the ideal number of professionals in the nursing crew of the specialty. The purpose of this study was to look for the clinical validation through reliability and construct validity tests, as well as to verify its applicability in the management practice of nurses. Two samples were used, of which n=40 pairs of instruments filled in Stage 1 of data collection and n=100 instruments filled in Stage 3 of the study, with different statistical criteria being applied, among them the Kappa coefficient and the Spearman correlation. The Instrument to Classify the Level of Dependence in Psychiatric Nursing was considered reliable, with good indicators of agreement, and the construct was validated, determining the degree of dependence of mental disorder patients.
Tobiano, Georgia; Bucknall, Tracey; Marshall, Andrea; Guinane, Jessica; Chaboyer, Wendy
To explore nurses' views of patient participation in nursing care on medical wards. Nurses have frequent contact with patients, highlighting their potential role in enabling patient participation. However, some nurses' actions and attitudes act as barriers, failing to achieve core requirements of patient participation. Discovering nurses' views may assist in developing strategies to encourage patient participation in hospitals. Interpretive study. Twenty nurses were recruited from four medical wards, located in two Australian hospitals. In-depth semi-structured interviews were conducted between November 2013-March 2014 and analysed using content analysis. Five categories emerged from the nurses' views. The first category, acknowledging patients as partners, showed nurses respected patients as legitimate participants. In the second category, managing risk, nurses emphasized the need to monitor participation to ensure rules and patient safety were maintained. Enabling participation was the third category, which demonstrated nurses' strategies that enhanced patients' participation. The fourth category was hindering participation; encapsulating nurses' difficulty in engaging patients with certain characteristics. In the final category, realizing participation, nurses believed patients could be involved in physical activities or clinical communication. Nurses have a crucial role in promoting patient participation. Through acknowledging and enabling participation, nurses may facilitate patient participation in a range of nursing activities. The nurse's role in enacting participation is complex, having to accommodate each patient's risks and characteristics, highlighting the need for good assessment skills. Education, policy and research strategies are essential to foster nurses' pivotal role in patient participation. © 2015 John Wiley & Sons Ltd.
Pedrini, Laura; Magni, Laura Rosa; Giovannini, Caterina; Panetta, Valentina; Zacchi, Valeria; Rossi, Giuseppe; Placentino, Anna
This study evaluated levels and risk factors of burnout in a sample of mental health professionals employed in nonhospital psychiatric residential facilities of northern Italy. Nurses, nurse assistants, and educators completed a questionnaire evaluating demographic variables, burnout (Maslach Burnout Inventory), job characteristics (Job Diagnostic Survey), workload, relationships with colleagues, and support from supervising coordinators. A total of 202 (83% response rate) questionnaires were analyzed. Logistic linear regressions were used to estimate predictors of burnout dimensions. Burnout risk was widespread. Low feedback about job performance, poor support from coordinators, and young age predicted emotional exhaustion. Low feedback about job performance predicted feelings of depersonalization. Low task identity and young age predicted reduced feelings of personal accomplishment. Interventions to prevent burnout among employees should be developed. These include providing feedback about performance, clearly identifying the tasks of the job, and providing support.
Wang, A G
A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service......, and an outpatient service. The number of chronic patients has not decreased, due to an influx of unruly senile patients. The close proximity of the service to the community has increased the pressure with regard to the care of such patients. Other services, such as outpatient treatment of alcoholics and neurotics...
Wang, A G
, and an outpatient service. The number of chronic patients has not decreased, due to an influx of unruly senile patients. The close proximity of the service to the community has increased the pressure with regard to the care of such patients. Other services, such as outpatient treatment of alcoholics and neurotics......A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service...
Rotter, Iwona; Kemicer-Chmielewska, Ewa; Lipa, Paweł; Kotwas, Artur; Jurczak, Anna; Laszczyńska, Maria; Karakiewicz, Beata
.... The purpose of the work was the assessment of psychosocial working conditions of nurses. The research included 388 nurses working at surgical wards, medical treatment wards, and psychiatric wards...
Tabolli, S; Ianni, A; Renzi, C; Di Pietro, C; Puddu, P
The job satisfaction and psychological well-being of health care workers may significantly influence the quality of care they provide. The aim of this study was to assess burnout and psychiatric disorders, such as anxiety and depression, as well as evaluate job satisfaction among nurses working at the IDI-Sanità in Rome. Nurses (n = 545) were invited to answer an anonymous, self-administered questionnaire, which consisted of the Maslach Burnout Inventory (MBI), the General Health Questionnaire (GHQ-12), and a validated questionnaire to examine job satisfaction. Descriptive analyses and multiple logistic regression analysis were performed. The section designed to evaluate job satisfaction was specifically examined by means of principal component factor analysis. Two hundred and forty-two nurses answered the questionnaire (response rate: 44%). Emotional exhaustion was observed in 38% of respondents. No significant difference was detected between mean values ( standard deviation) at each of the three MBI subscales and Italian normative data. About 33% of respondents showed a GHQ-12 score typical for disorders such as anxiety or depression. High levels of job satisfaction were found to be associated to a lower likelihood both of emotional exhaustion at MBI and psychiatric morbidity at GHQ-12. Factor analysis on items investigating job satisfaction identified 4 factors that globally accounted for 61% of the total variance. The factors obtained could represent possible targets for action aimed at improving nurse satisfaction.
Fereidooni Moghadam, Malek; Fallahi Khoshknab, Masoud; Pazargadi, Mehrnoosh
Background: The use of physical restraint as an intervention in the care of psychiatric patients dates back to the beginning of psychiatry. Although it is a challenging question, it is still one of the common procedures in psychiatry. Considering that very little research has been done in Iran in relation to physical restraint, this qualitative study aimed to investigate the experiences of nurses working in psychiatric wards regarding physical restraint. Methods: This qualitative study was done on 14 nurses working in the psychiatric hospitals of Ahvaz city, southern Iran, during 2011-2012. The participants were selected by purposive sampling. Semi-structured interviews were used for data collection, which were continued until data saturation and emergence of themes. Inductive content analysis was used to analyze the data. Results: Four categories emerged: (1) Restraint as a multi-purpose procedure, (2) Processing of physical restraint, (3) Restraint as a challenging subject and (4) The effects of restraint on the spectrum. Each category has several different sub-categories. Conclusion: The participants described using physical restraint as one of the main strategies to control psychiatric patients, and despite having negative consequences, it is extensively used. Given the risks and challenges of using physical restraint, nursing education should find alternative methods. PMID:25349842
Dec 3, 2002 ... Impairment and disability assessment on psychiatric grounds has always been subjective, controversial ... informed medical advisors doing their disability assessments. Many of these advisors have expressed ..... that will empower the affected employee and that is non- stigma- tising. In order to do so it is ...
Hvidhjelm, Jacob; Sestoft, Dorte; Skovgaard, Lene Theil
Health care workers are often exposed to violence and aggression in psychiatric settings. Short-term risk assessments, such as the Brøset Violence Checklist (BVC), are strong predictors of such aggression and may enable staff to take preventive measures against aggression. This study evaluated wh...
their caregivers in South Africa. The heritability of the majority of the psychiatric disorders is ... linkage analyses in a cohort of Bantu-speaking black South. Africans.17-22 Areas of implied linkage to schizophrenia ... one of the studies of a Bantu-speaking schizophrenia cohort. Table I. Glossary of genetic terminology. Allele.
Baldaçara,Leonardo; Borgio,João Guilherme Fiorani; Lacerda,Acioly Luiz Tavares de; Jackowski,Andrea Parolin
OBJECTIVE: The objective of this update article is to report structural and functional neuroimaging studies exploring the potential role of cerebellum in the pathophysiology of psychiatric disorders. METHOD: A non-systematic literature review was conducted by means of Medline using the following terms as a parameter: "cerebellum", "cerebellar vermis", "schizophrenia", "bipolar disorder", "depression", "anxiety disorders", "dementia" and "attention deficit hyperactivity disorder". The electron...
The article analyzes some ethical problems in psychiatry that have been emerging in recent years. It deals with the ongoing intensive debates about the DSM-5 before its publication, and with some of the criticisms of the DSM-5 itself. Then it goes on to analyze the use of placebo. This is followed by the ethical problems of the treatment of ADHD with stimulant drugs, among which one is the question of authenticity, namely whether the pre-treatment or the post-treatment personality is the real, authentic self of the patient. This question has been raised not only in the case of the ADHD, but also in relation with the antidepressant treatment of depression earlier, and in relation with deep brain stimulation and dopamine replacement therapy now, all of which causes changes in the treated patient's personality and motivations. Finally the article describes some ethical problems of informed consent in the case of antidepressant medication, together with the necessity to involve psychiatric nurses and rating scales in the assessment of the patient's decision making capacity.
Nurses can become demoralized and hostile toward frequent visitors in psychiatric emergency rooms because of the number of visits. The aim of this study was to develop more knowledge about the ways in which nurses categorize frequent visitors. Eleven nurses were interviewed, and their categorizing...... through the emergency room and/or there was poor rapport with the nurses....... practices were examined from a social constructionist perspective. The results showed that the nurses did not categorize frequent visitors as particularly unlikeable or difficult to treat. Like other visitors, they could be categorized as difficult if they obstructed a smooth flow of successful referrals...
Cuidado de enfermagem ao paciente com comorbidade clínico-psiquiátrica em um pronto atendimento hospitalar Atención de enfermería a pacientes con comorbilidad clínica psiquiátrica en un Pronto Socorro hospitalar Nursing care to patients with comorbidity clinical and psychiatric in hospital Emergency Service
Marcio Roberto Paes
de locales de capacitación en salud mental y la sensibilización del personal de enfermería sobre la atención a la clientela.Qualitative descriptive, exploratory research developed in 2009, in the emergency service of a general hospital in Curitiba, Paraná, Brazil. Aim to investigate how developed the nursing care of patients with clinical and psychiatric comorbidity. Participated six nurses, seven nursing technicians and 14 nursing assistants. We obtained data through semi-structured interviews and submitted to analysis of thematic content. The categories that emerged from the data were: Care is the technical and without specificity; Safety and protection of patient and Physical restraint and chemical as protective measures. Nursing care developed for patients with clinical and psychiatric comorbidity are without specificity, with emphasis on basic care, physical and chemical restraint. It was concluded that there is need for the establishment of local training in mental health and awareness of nurses about the care to this clientele.
Sullivan, Patrick F; Agrawal, Arpana; Bulik, Cynthia M; Andreassen, Ole A; Børglum, Anders D; Breen, Gerome; Cichon, Sven; Edenberg, Howard J; Faraone, Stephen V; Gelernter, Joel; Mathews, Carol A; Nievergelt, Caroline M; Smoller, Jordan W; O'Donovan, Michael C
The Psychiatric Genomics Consortium (PGC) is the largest consortium in the history of psychiatry. This global effort is dedicated to rapid progress and open science, and in the past decade it has delivered an increasing flow of new knowledge about the fundamental basis of common psychiatric disorders. The PGC has recently commenced a program of research designed to deliver "actionable" findings-genomic results that 1) reveal fundamental biology, 2) inform clinical practice, and 3) deliver new therapeutic targets. The central idea of the PGC is to convert the family history risk factor into biologically, clinically, and therapeutically meaningful insights. The emerging findings suggest that we are entering a phase of accelerated genetic discovery for multiple psychiatric disorders. These findings are likely to elucidate the genetic portions of these truly complex traits, and this knowledge can then be mined for its relevance for improved therapeutics and its impact on psychiatric practice within a precision medicine framework. [AJP at 175: Remembering Our Past As We Envision Our Future November 1946: The Genetic Theory of Schizophrenia Franz Kallmann's influential twin study of schizophrenia in 691 twin pairs was the largest in the field for nearly four decades. (Am J Psychiatry 1946; 103:309-322 )].
Yadav, B L
Social skills training, a psychological approach, is used to ameliorate the deficits in social skills among patients with a severe mental illness. For the efficacy of social skills training in schizophrenia, the literature in other core psychiatric disciplines (i.e. psychology, psychiatry, etc) indicates some conflicting evidences and a limited quality of evidence in psychiatric nursing. With the exemption of a few individual nursing studies, no systematic review is available to date in psychiatric nursing literature. This systematic review of literature was undertaken to explore the efficacy of social skills training in schizophrenia.
Croft, Rhonda Kathleen; Cash, Penelope Anne
Bullying and lateral violence is a reality in the workplace for many nurses and has been explored in nursing literature for at least three decades. Using a postcolonial feminist approach this paper examines what contributes to bullying and lateral violence in the nursing workplace by deconstructing the findings from a British Columbia Nurses Union and Union of Psychiatric Nurses study. Theories of oppression and organizational context which have appeared in the literature serve to inform the discussion. A postcolonial lens provides an opportunity to come to grips with the insidiousness of bullying and lateral violence. An adaption of Phillips, Lawrence, and Hardy's (2004) framework is used to unpack discourses, actions, texts, and organizational practices to challenge taken-for-granted hegemonies in the workplace. Taking this different view has enabled new prisms of understanding to emerge from the contributing factors identified in the study. Based on this analysis it is clear that bullying and lateral violence is deeply institutionalized. Nurses, managers, and organizations need to interrupt and interrogate the embeddedness of bullying and lateral violence in order to create a civil workplace.
Sarró Alvarez, S
Rheumatic fibromyalgia, also known as fibrositis or myofascial pain, is a common syndrome whose diagnoses, founded mainly on physical examination, usually delays due to symptom unspecificity, amount of complementary tests requested and intercourse with psychiatric disorders. Psychyatrists and psychologists get often involved in fibromyalgia treatment. Its proper knowledge prevents not only physicians and patients' psychological discourage but also development of depression and mental health expenses, as well as allows designing a treatment plan according to the main symptoms which may offer improvement chances to fibromyalgia patients. This article intends to offer an up-to-date and complete information about this entity, focused on psychiatric aspects, to better identify and manage such a puzzling disease.
Cookson, Amy; Daffern, Michael; Foley, Fiona
Aggression during psychiatric hospitalization is frequent, problematic, and a major challenge for nurses and mental health services more generally. The strength of the therapeutic alliance between nursing staff and patients has been posited as an important protective factor that can limit the likelihood of aggression. This study examined the relationship between interpersonal style, perceived coercion, and psychiatric symptoms on the therapeutic alliance between patients and staff, and how each, in turn, is related to aggression. Participants in this study were 79 patients admitted to an acute psychiatric hospital. Each participant was interviewed to determine perceived coercion, symptoms of psychiatric illness, interpersonal style, and therapeutic alliance. Incidents of aggression were recorded at discharge through a review of incident forms, file review, and interviews with unit nursing staff. The results showed that a hostile-dominant interpersonal style and symptoms of paranoia predicted poor therapeutic alliance, contributing 14% of the variance in therapeutic alliance scores. A dominant interpersonal style predicted aggression towards staff. Therapeutic alliance, perceived coercion, and symptoms of psychiatric illness did not predict aggression. Implications for engagement in treatment and the prevention of aggression are discussed. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
Lewis-Fernández, Roberto; Aggarwal, Neil Krishan
Since the publication of DSM-IV in 1994, neurobiologists and anthropologists have criticized the rigidity of its diagnostic criteria that appear to exclude whole classes of alternate illness presentations, as well as the lack of attention in contemporary psychiatric nosology to the role of contextual factors in the emergence and characteristics of psychopathology. Experts in culture and mental health have responded to these criticisms by revising the very process of diagnosis for DSM-5. Specifically, the DSM-5 Cultural Issues Subgroup has recommended that concepts of culture be included more prominently in several areas: an introductory chapter on Cultural Aspects of Psychiatric Diagnosis - composed of a conceptual introduction, a revised Outline for Cultural Formulation, a Cultural Formulation Interview that operationalizes this Outline, and a glossary on cultural concepts of distress - as well as material directly related to culture that is incorporated into the description of each disorder. This chapter surveys these recommendations to demonstrate how culture and context interact with psychiatric diagnosis at multiple levels. A greater appreciation of the interplay between culture, context, and biology can help clinicians improve diagnostic and treatment planning. Copyright © 2013 APA*
Servodidio, C A
Based on the nursing literature and my own ophthalmic nursing experience, there appears to be some confusion about how the general public, our colleagues, and physicians view the duties and responsibilities of the profession of nursing. We, as nurses, can serve as advocates for our own profession and educate the public about who we are, how we have achieved our current status and goals, and where we expect to be in the future.
Shakya, D R; Lama, S; Shyangwa, P M
A high prevalence of psychological/ mental disorders has frequently been reported among nursing staff. However, there is a scarcity of data about 'psychological, mental and behavioural problems' among Nepalese nurses. Current study aimed to measure the prevalence of psychiatric problems among nursing staff in a tertiary care hosital. All nursing staffs working in the hospital during one year were the subjects of this study. With the informed written consent, the responses to semi-structured proforma and the questionnaire General Health Questionnaire 28 were collected. A semi-structured proforma was used to record socio-demographic, clinical profiles and other information. The GHQ 28 was used to screen major psychiatric disorders. The GHQ 28 gives 'psychiatric caseness' to the subjects with score of 4 or more. Overwhelming majority of nursing staff in BPKIHS is female certificate level staff nurses. Majority were from urban and semi urban settings. Some had job and institute related stressors. Most common among the reported health complaints were low back pain and headache. Few staff revealed psychiatric diagnosis. Among the enrolled 337 subjects, 'psychiatric caseness' was present in 34.72%. Some departments (e.g. dialysis, eye, medical, gynecology ward) had proportionately higher 'psychiatric caseness' rates than other (e.g. ENT, psychiatry ward, emergency OT, CSSD). A great proportion of nursing staff suffer from mental and behavioral problems.
Sleeper, Justin A; Thompson, Cesarina
Nursing students entering psychiatric settings for clinical practice need a solid foundation of therapeutic communication skills. This article presents an innovative strategy for nursing students to practice therapeutic communication skills with psychiatric patients by using hi fidelity simulation with Laerdal SimMan. Using the SimMan vocal function enabled nurse educators to develop communication algorithms that allowed students to interact with SimMan as they would with psychiatric patients. The SimMan algorithms can be designed to mimic many scenarios typically found in psychiatric settings. Nursing students can use this technology to take the therapeutic communication skills they have learned in the classroom and practice them in a safe laboratory environment before entering actual psychiatric settings. The ability of students to practice communication skills prior to entering psychiatric settings can promote effective therapeutic communication skills and decrease student anxiety.
Pai, Daiane Dal; Lautert, Liana; Souza, Sônia Beatriz Cocaro de; Marziale, Maria Helena Palucci; Tavares, Juliana Petri
Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001), among nursing auxiliaries/technicians (p=0.014) and was associated with minor psychiatric disorders (pBurnout dimensions were also associated to violence at work (pworkers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders.
Daiane Dal Pai
Full Text Available OBJECTIVE Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. METHODS Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. RESULTS Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001, among nursing auxiliaries/technicians (p=0.014 and was associated with minor psychiatric disorders (p<0.05, as exposure to different forms of violence increased the chances of these disorders by 60% (CI 95%: 1.2-2.1. The three Burnout dimensions were also associated to violence at work (p<0.05. CONCLUSION Health workers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders.
Daiane Dal Pai
Full Text Available OBJECTIVE Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. METHODS Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. RESULTS Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001, among nursing auxiliaries/technicians (p=0.014 and was associated with minor psychiatric disorders (p<0.05, as exposure to different forms of violence increased the chances of these disorders by 60% (CI 95%: 1.2-2.1. The three Burnout dimensions were also associated to violence at work (p<0.05. CONCLUSION Health workers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders.
Larsen, Tina Gram; Valbak, Lone; Perto, Gurli; Reinert, Kjeld
In Denmark the number of forensic psychiatric patients is increasing. The objective of this study was to explore whether the increased number of forensic psychiatric patients has been reflected in the use of psychiatric inpatient facilities. Furthermore, we wanted to investigate differences in the treatment of various diagnostic groups of forensic patients and of forensic and non-forensic patients with schizophrenia. Information about admissions and outpatient contact was extracted from the Danish Psychiatric Central Research Register for all Danish patients sentenced to psychiatric treatment in the period 1994-2003. Furthermore, a group of first-admission forensic patients suffering from schizophrenia was compared to a control group of first-admission non-forensic patients with schizophrenia, matched for sex, age and time of admission. The number of forensic psychiatric patients increased markedly in the period 1994-2003; at the same time, the use of inpatient facilities for this group of patients did not increase to a similar degree but actually decreased. Forensic patients in the group F20-F29 spent more time in hospital than did forensic patients with affective disorders and personality disorders. Forensic psychiatric patients with schizophrenia had significantly longer periods of hospitalization than did non-forensic patients with schizophrenia. Forensic psychiatric patients' use of psychiatric inpatient facilities during the last 10 years did not increase to the extent expected relative to the increasing number of forensic psychiatric patients. This raises the question of whether these patients are receiving necessary and sufficient treatment.
Ana Karine Ramos Brum
enfrentamiento de la situación vivida. El estudio permitió señalar algunas contribuciones para las áreas del cuidado, la atención, la docencia y la investigación, contemplando la actitud del enfermero como instrumento de acción en el cuidado del anciano.This study approaches nursing care as related to the aged. The studied situation involved health care needs of hospitalized persons, using the following central question: which is the meaning of nurses' actions when attending hospitalized aged patients without expectation of recovery and when technology is no longer that important? We aimed to reflect about hospitalized elders' needs in nursing reality. Comprehensive Sociology was used as a theoretical-methodological framework. The study was carried out at an Intensive Care Service of a Municipal Hospital in the city of Rio de Janeiro - Brazil. The subjects were nurses who attend hospitalized aged persons without any expectation of recovery, who were approached through a phenomenological interview. Through a comprehensive analysis, we identified care by being together, providing at the same time physical comfort and well-being to cope with the situation as typical of nursing actions. This study indicates some contributions for nursing care, assistance, teaching and research, aimed at strengthening nurses' attitude as an action tool in care for aged patients.
Shakya, D. R.; S Lama; P M Shyangwa
Introduction: A high prevalence of psychological/ mental disorders has frequently been reported among nursing staff. However, there is a scarcity of data about ‘psychological, mental and behavioural problems’ among Nepalese nurses. Current study aimed to measure the prevalence of psychiatric problems among nursing staff in a tertiary care hosital. Methods: All nursing staffs working in the hospital during one year were the subjects of this study. With the informed written consent...
Fredriksson, Lennart; Lindström, Unni A
The aim of this study was to increase and deepen the understanding of how psychiatric patients in conversations with nurses narrate their experience of suffering. Data were obtained in the years 2001-2002 by audio recording of 20 individual caring conversations between eight patients and three psychiatric nurses at a psychiatric outpatient unit in Sweden. Before the data were gathered the study was approved by a local research ethics committee. The methodology is inspired by the hermeneutics of Paul Ricoeur. The data is given a naïve reading which is followed by two structural analyses which explain the text. Finally, the structural analyses and the pre-understanding are confronted in a critical reflection. In the patients' narratives, suffering was at first concealed under a façade that helps the patient to cope with suffering and with shame. As they moved along to a turning point, something happened that made them able to risk everything, i.e. their very selves, but also gave them the possibility of regaining vital parts of themselves that where lost when the façade was constructed. As they took the suffering upon themselves, they grew to be fully visible as human beings and healing was possible as a re-establishment of the interpersonal bridge. This not only meant that the sufferer became open for relationships with others or an abstract other, but also that an opening in the relationship with themselves occurred. If psychiatric patients are allowed to narrate freely they develop different plot structures, which can either hide or reveal suffering. Patients who could establish an answer to the why-question of suffering could also interpret their suffering in a way that enabled growth and reconciliation. In order to do so, they had to abandon the shelter of the façade and confront suffering and shame. This turning point opened them up to life-sustaining relationships with themselves as well as with abstract and concrete others.
Hein, Laura C; Matthews, Alicia K
Reparative therapy aims to modify the sexual orientation of lesbian, gay, and bisexual (LGB) people into that of heterosexuals. Although denounced as harmful by most professional organizations, these treatments continue-youth may be particularly vulnerable to the negative consequences. The purpose of this article is to discuss reparative therapies, the potential harm LGB youth may experience, clinical and practice issues for psychiatric nurses, and the ethical issues surrounding nurse involvement in reparative therapy. Reparative therapy for adolescents raises important clinical and ethical issues for psychiatric nursing. Further discussion of nurse involvement in these treatments is needed.
Sørensen, Ann Lykkegaard; Nielsen, Lars Peter; Poulsen, Birgitte Klindt
Background: Medication errors continue to challenge patient safety across health sectors, including psychiatry. Nurses are integral safeguards in the medication process and a growing body of research demonstrates that nurse’s ability to ensure medication safety also depend on organizational factors...... such as hierarchical medical teams and the nurse-physician relationship (NPR). To date, there are no studies of how psychiatric nurses perceive the importance of the NPR in relation to medication issues. Objectives: The objective of this study was to explore psychiatric nurses’ perception of the NPR in relation...... to medication safety and medication management. Methods: A qualitative design using a semi-structured interview guide. The interviews took place in two focus groups consisting of psychiatric nurses (Group 1 (n= 9) and group 2 (n=8)) from two bedwards in a Danish University Hospital. The interviews were carried...
Dobry, Yuriy; Braquehais, María Dolores; Sher, Leo
Bullying is a highly prevalent behavior which carries a significant social, medical and financial cost for its victims and perpetrators, with powerful and long-lasting psychological and social impact. Bullying has been defined as a specific form of intentional, repeated aggression, that involves a disparity of power between the victim(s) and perpetrator(s). The aggression can take physical, verbal or gestural forms. The behavior of bullying crosses sociodemographic categories of age, gender, ethnicity, level of academic achievement and professional environment. It has been abundantly observed by teachers and parents in elementary schools, but has also shown its negative presence in corporate boardrooms. The direct outcome of bullying, for both victims and perpetrators, is an increased risk of psychiatric disorders including depression, post-traumatic stress disorder, anxiety disorders, substance abuse and suicidal behavior. Cruelty (and bullying, as one of its manifestations) breaks the basis of morality. Mental health professionals usually treat the victims of those actions unfortunately long after they have been exposed to the harm. The evidence does not support the idea that the majority of cruel actions are intrinsically "pathological", in the sense of being motivated by "mental disorders". Therefore, only moral rules and legal actions - but not psychiatric or psychological interventions - may dissuade humans from this form of cruelty.
Gurpegui, Manuel; Jurado, Dolores
The psychiatric consequences of induced abortion continue to be the object of controversy. The reactions of women when they became aware of conception are very variable. Pregnancy, whether initially intended or unintended, may provoke stress; and miscarriage may bring about feelings of loss and grief reaction. Therefore, induced abortion, with its emotional implications (of relief, shame and guilt) not surprisingly is a stressful adverse life event. METHODOLOGICAL CONSIDERATIONS: There is agreement among researchers on the need to compare the mental health outcomes (or the psychiatric complications) with appropriate groups, including women with unintended pregnancies ending in live births and women with miscarriages. There is also agreement on the need to control for the potential confounding effects of multiple variables: demographic, contextual, personal development, previous or current traumatic experiences, and mental health prior to the obstetric event. Any psychiatric outcome is multi-factorial in origin and the impact of life events depend on how they are perceived, the psychological defence mechanisms (unconscious to a great extent) and the coping style. The fact of voluntarily aborting has an undeniable ethical dimension in which facts and values are interwoven. No research study has found that induced abortion is associated with a better mental health outcome, although the results of some studies are interpreted as or Some general population studies point out significant associations with alcohol or illegal drug dependence, mood disorders (including depression) and some anxiety disorders. Some of these associations have been confirmed, and nuanced, by longitudinal prospective studies which support causal relationships. With the available data, it is advisable to devote efforts to the mental health care of women who have had an induced abortion. Reasons of the woman's mental health by no means can be invoked, on empirical bases, for inducing an abortion.
Reid, Jennifer G; Gitlin, Michael J; Altshuler, Lori L
Owing to the prevalence of medication side effects and treatment resistance, prescribers often consider off-label uses of US Food and Drug Administration (FDA)-approved agents for the treatment of persistent symptoms. The authors review the available literature on the FDA-approved and non-FDA-approved uses of lamotrigine in adults with psychiatric disorders. We used PubMed, MEDLINE, and a hand search of relevant literature to find studies published between 1990 and 2012 and available in English language. The following keywords were searched: lamotrigine, psychiatric, mood disorders, depression, personality disorders, anxiety, schizophrenia, side effects, and rash. Data were selected from 29 randomized controlled trials (RCTs). When RCTs were not available, open-label trials (6), retrospective case reviews (10), and case series (4) were summarized. We extracted results of monotherapy and augmentation trials of lamotrigine on primary and secondary outcome measures. Lamotrigine is generally well tolerated, with the best evidence for the maintenance treatment of bipolar disorder, particularly in prevention of depressive episodes. In acute bipolar depression, meta-analyses suggested a modest benefit, especially for more severely depressed subjects, with switch rates similar to placebo. In unipolar depression, double-blind RCTs noted benefit on subsets of symptoms and improved response in more severely depressed subjects. Data are limited but promising in borderline personality disorder. Use of lamotrigine in schizophrenia and anxiety disorders has little supportive evidence. Lamotrigine is recommended in bipolar maintenance when depression is prominent. It also has a role in treating acute bipolar depression and unipolar depression, though the latter warrants more research. Data are too limited in other psychiatric disorders to recommend its use at this time. © Copyright 2013 Physicians Postgraduate Press, Inc.
Full Text Available INTRODUCTION Parricide is defined as a murder of parents by their children; the patricide is murder of father, while matricide is murder of mother. This entity is classified as homicide, but it differs in the fact that victims are parents and the killers are their children. Mostly, it is associated with psychiatric morbidity. OBJECTIVE To describe sociodemographic and psychopathological characteristics of parricide committers and to analyze circumstances of parricide and psychiatric morbidity in order to achieve better recognition and prevention of risks. METHOD This retrospective study included all homicide autopsy records (1991-2005 performed at the Institute of Forensic Medicine, Medical School, University of Belgrade. For further analyses, all parricide records were selected out. The study analyzed all available parameters, which concerned parricide committers, victims and the act itself. Methods of descriptive statistics were used. RESULTS Between 1991 and 2005, there were 948 cases of homicide; of these, 3.5% were parricides. The committers of parricide were on average 31.2±11.9 years old, 87.8% were males, 60.6% with psychiatric symptoms most commonly with schizophrenia, alcohol dependence, personality disorder etc. Victims were on average 63.7±11.9 years old, 54.5% males, and 21.2% had a diagnosed mental illness. CONCLUSION Parricide is a rare kind of homicide accounting for 3% of all homicides. Committers are mostly unemployed males in early adulthood who have mental disorder. The phenomenon of parricide deserves a detailed analysis of the committer (individual bio-psycho-social profile and the environ- mental factors (family, closely related circumstances to enable a precise prediction of the act and prevention of the fatal outcome, which logically imposes the need of further studies.
Brust, J S; Ford, C V; Rimoin, D L
Sixteen adult dwarfs - 11 with achondroplasia and 5 with hypopituitarism - were studied by means of psychiatric interviews and psychological tests. There were no significant differences between the two groups; in general, the subjects had achieved a satisfactory life adjustment despite the stress of having bodies uniquely different from those of the general population. They had secure identities as "little people" and successfully used coping mechanisms such as a sense of humor and a pleasant interpersonal style. Male dwarfs tended to experience more emotional distress than female dwarfs.
A self-management approach using self-initiated action plans for symptoms with ongoing nurse support in patients with Chronic Obstructive Pulmonary Disease (COPD) and comorbidities: the COPE-III study protocol.
Lenferink, Anke; Frith, Peter; van der Valk, Paul; Buckman, Julie; Sladek, Ruth; Cafarella, Paul; van der Palen, Job; Effing, Tanja
Chronic Obstructive Pulmonary Disease (COPD) frequently coexists with other diseases. Whereas COPD action plans are currently part of usual care, they are less suitable and potentially unsafe for use in the presence of comorbidities. This study evaluates whether an innovative treatment approach directed towards COPD and frequently existing comorbidities can reduce COPD exacerbation days. We hypothesise that this approach, which combines self-initiated action plans and nurse support, will accelerate proper treatment actions and lead to better control of deteriorating symptoms. In this multicenter randomised controlled trial we aim to include 300 patients with COPD (GOLD II-IV), and with at least one comorbidity (cardiovascular disease, diabetes, anxiety and/or depression). Patients will be recruited from hospitals in the Netherlands (n = 150) and Australia (n = 150) and will be assigned to an intervention or control group. All patients will learn to complete daily symptom diaries for 12-months. Intervention group patients will participate in self-management training sessions to learn the use of individualised action plans for COPD and comorbidities, linked to the diary. The primary outcome is the number of COPD exacerbation days. Secondary outcomes include hospitalisations, quality of life, self-efficacy, adherence, patient's satisfaction and confidence, health care use and cost data. Intention-to-treat analyses (random effect negative binomial regression and random effect mixed models) and cost-effectiveness analyses will be performed. Prudence should be employed before extrapolating the use of COPD specific action plans in patients with comorbidities. This study evaluates the efficacy of tailored action plans for both COPD and common comorbidities. Copyright © 2013 Elsevier Inc. All rights reserved.
História da enfermagem psiquiátrica e a dependência química no Brasil: atravessando a história para reflexão Historia de la enfermería psiquiátrica y la dependencia química en el Brasil: atravesando la historia para la reflexión History of the psychiatric nursing and chemical dependency in Brazil: crossing the history for reflection
Amanda Márcia dos Santos Reinaldo
ón del enfermero profesional. Ambas temáticas encuentran puntos de aproximación y alejamiento conforme el contexto en que son analizadas.The nursing education in psychiatric nursing and in the area of chemical dependency guides the discussion of this article towards the complexity of problems related to the nursing, mental health, psychiatric and alcohol and drugs teaching. It is a literature review where the authors compiled primary and secondary sources on the theme. Analyses and reflections on historical crossings that permeate the history of the psychiatric nursing and chemical dependency in Brazil were performed on the bibliographic material. The results point to an evolution of the theme alcohol and drugs given the magnitude of the problem in the contemporaneous society. Regarding the psychiatric nursing, the teaching presents changes due to the historical evolution of the psychiatry that must be considered during the education of the nursing professional. Both themes had common and distinctive points according to the context in which they were analyzed.
Introduction. An accused found unfit to stand trial and/or not criminally responsible for his/her actions because of mental illness, is declared a state patient by the court. Aim. The aim of the study was to analyse the biographical data and relevant particulars of forensic psychiatric inpatients who were admitted to the Free State ...
By understanding the constructions of knowledge we currently label nursing theories as nursing ontologies, nurses can perceive these conceptualizations differently. Paul Ricoeur and Stephen White offer a conceptualization of ontology that differs from traditional, realist perspectives because they assume that a person's experience of a phenomenon (e.g., nursing) will change, but also maintain some stability. Discussing nursing ontologies, rather than nursing theories, might increase philosophy's status in nursing and may also more accurately reflect the experience of being a nurse.
Baldaçara, Leonardo; Borgio, João Guilherme Fiorani; Lacerda, Acioly Luiz Tavares de; Jackowski, Andrea Parolin
The objective of this update article is to report structural and functional neuroimaging studies exploring the potential role of cerebellum in the pathophysiology of psychiatric disorders. A non-systematic literature review was conducted by means of Medline using the following terms as a parameter: "cerebellum", "cerebellar vermis", "schizophrenia", "bipolar disorder", "depression", "anxiety disorders", "dementia" and "attention deficit hyperactivity disorder". The electronic search was done up to April 2008. Structural and functional cerebellar abnormalities have been reported in many psychiatric disorders, namely schizophrenia, bipolar disorder, major depressive disorder, anxiety disorders, dementia and attention deficit hyperactivity disorder. Structural magnetic resonance imaging studies have reported smaller total cerebellar and vermal volumes in schizophrenia, mood disorders and attention deficit hyperactivity disorder. Functional magnetic resonance imaging studies using cognitive paradigms have shown alterations in cerebellar activity in schizophrenia, anxiety disorders and attention deficit hyperactivity disorder. In dementia, the cerebellum is affected in later stages of the disease. Contrasting with early theories, cerebellum appears to play a major role in different brain functions other than balance and motor control, including emotional regulation and cognition. Future studies are clearly needed to further elucidate the role of cerebellum in both normal and pathological behavior, mood regulation, and cognitive functioning.
Lay, B; Nordt, C; Rössler, W
The use of coercive measures in psychiatry is still poorly understood. Most empirical research has been limited to compulsory admission and to risk factors on an individual patient level. This study addresses three coercive measures and the role of predictive factors at both patient and institutional levels. Using the central psychiatric register that covers all psychiatric hospitals in Canton Zurich (1.3 million people), Switzerland, we traced all inpatients in 2007 aged 18-70 (n = 9698). We used GEE models to analyse variation in rates between psychiatric hospitals. Overall, we found quotas of 24.8% involuntary admissions, 6.4% seclusion/restraint and 4.2% coerced medication. Results suggest that the kind and severity of mental illness are the most important risk factors for being subjected to any form of coercion. Variation across the six psychiatric hospitals was high, even after accounting for risk factors on the patient level suggesting that centre effects are an important source of variability. However, effects of the hospital characteristics 'size of the hospital', 'length of inpatient stay', and 'work load of the nursing staff' were only weak ('bed occupancy rate' was not statistically significant). The significant variation in use of coercive measures across psychiatric hospitals needs further study. Copyright © 2010 Elsevier Masson SAS. All rights reserved.
Hess, Shmuel; Zemishlany, Zvi
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA) as a guide for diagnosing psychiatric diseases and enables the alignment of psychiatric diagnoses with those of the psychologists, the social workers, the nursing staff and other mental health professionals. In addition, it helps bring cohesion to research, public health policy, education, the field of insurance and compensation and the legal system. After 14 years of hard work, the updated version of the DSM, the DSM-5, was published on May 2013. The current review aims to update the readers on the essence of the DSM and the methods of psychiatric diagnosing and to present the main changes in the field, as expressed in the 5th edition of the guide. In addition to details of those changes we included discussions of the criticisms brought against them. We hope that the review will contribute to broadening the readers' knowledge, broaden exposure and familiarity with the psychiatric lingo and to strengthening the professional ties between psychiatrists and professionals in other, tangential, medical fields.
Full Text Available Background: Identifying and using the strengths of patients, in practice, is a new territory. Today, the need to educate nurses and psychiatric patients about positive psychology in practice and the importance of understanding and focusing on strengths is clear. However, little is known about the strengths the psychiatric patients use and experience. Thus, this study has been designed and conducted in order to understand how people with psychiatric disorders demonstrate their strengths. Materials and Methods: In the present study, 13 semi-structured, qualitative interviews with patients and 2 focus groups with nurses were carried out. In addition, a qualitative content analysis was used to identify significant strengths. Results: Based on the results, the four main strengths consisted of: Finding a meaning in daily living, work as enduring strength, entertaining activities, and positive relationship. Patients also reported that health care providers rarely focused on patients′ strengths, and experts confirmed these findings. Our findings indicate that patients′ own strengths are a pivotal factor in getting through their illness from their perspective. Conclusions: Despite the enduring legacy of pessimism regarding psychiatric patients, these people have a repertoire of strengths. Nurses should, therefore, have a greater focus on eliciting and nourishing psychiatric patients′ strengths in their care. It is suggested that the theoretical and practical aspects of patients′ strengths be incorporated in nursing school curricula.
1. Assault directed against psychiatric staff is emerging as a serious occupational health problem. Governmental regulatory agencies, unions, and academic research have identified workplace assault in the psychiatric setting as a serious workplace health issue. 2. Violence directed against psychiatric nursing personnel is increasing. Increases in assault are related to shorter hospitalizations, cutbacks in mental health services, and the increasing number of clients with criminal histories and personality disorders. 3. Reduction in staff assault can best be accomplished using an injury epidemiology occupational health focus. Identifying hazards, energy transfer mechanisms, and other environmental factors contributing to staff injuries can reduce or eliminate the morbidity associated with client assault.
The subject of this essay is chosen for the purpose of obtaining a deeper insight into various methodological aspects related to my forthcoming doctoral work; an historical biographical study of the Norwegian nursing pioneer, Bergljot Larsson (1883 – 1968). In the essay I claim that it is of great importance that the interpreter is explicit on the assumptions underlying his interpretations, and is aware of their influence on the theory developed. I further discuss how the Finnish philoso...
van Loo, Hanna; Romeijn, Johannes
The frequent occurrence of comorbidity has brought about an extensive theoretical debate in psychiatry. Why are the rates of psychiatric comorbidity so high and what are their implications for the ontological and epistemological status of comorbid psychiatric diseases? Current explanations focus
Singh, Delar K.
This paper focuses on college students with psychiatric disabilities. It defines and discusses various psychiatric conditions such as mood disorders, anxiety disorders, eating disorders, and personality disorders. It concludes with accommodations that a college professor can make to help these students succeed in higher education. (Contains 1…
Uma nova enfermagem psiquiátrica na universidade do Brasil nos anos 60 do século XX Una nueva enfermería psiquiátrica en la universidad del Brasil en los años 60 del siglo 20 A new psychiatric nursing in the university of Brazil in the 60’s of the 20th century
Maria Angélica de Almeida Peres
acumulación de cargos (educativo y assistencial La consolidación del nuevo modelo, prolongado para otras escuelas, volvió la EAN/IPUB centros de difusión de saber acerca de la enfermería psiquiátrica en Brasil.Historical-social study about the implementation of a model of psychiatric nursing, by the School Ana Nery (EAN, in the Institute of Psychiatry of the University of Brazil (IPUB. The initial landmark corresponds to the contracting of a professor of the school as the leader of the service of nursing of the IPUB, in 1962, and the final landmark to the enclosure of the nurses like members of the team of health of the IPUB, in 1963. Objective: describe the situation of the psychiatric nursing in the IPUB; analyze the strategies adopted in the reform of the nursing; discuss the importance of that know/ power about the nursing. Theoretical reference: concepts of Michel Foucault. Springs: documents writing, oral statements and bibliography. Results: the strategies utilized were of administrative, technical, and political nature; his conditions of possibility were given by the accumulation of charges (educational and assistencial The consolidation of the new model, extended for other schools, became the EAN/IPUB centers of diffusion of know about the psychiatric nursing in Brazil.
Matney, Susan A; Avant, Kay; Staggers, Nancy
As nurses, we seek to better understand how to gain nursing ‘wisdom’ and apply this wisdom in our daily practice. Yet the concept and experience of ‘wisdom in nursing practice’ has not been well defined. This article addresses wisdom-in-action for nursing practice. We briefly describe nursing theory, review the wisdom literature as presented in various disciplines, and identify characteristics of wisdom by analyzing four models of wisdom from other disciplines. We also present the ten antecedents of wisdom and the ten characteristics of wisdom identified in our analysis of the wisdom literature, discuss and summarize these antecedents, and conclude that understanding these ten antecedents and the ten characteristics of wisdom-in-action can both help nurses demonstrate wisdom as they provide nursing care and teach new nurses the process of becoming wise in nursing practice.
Gelfand, Yaroslav; Kaplitt, Michael G
Gene therapy has become of increasing interest in clinical neurosurgery with the completion of numerous clinical trials for Parkinson disease, Alzheimer disease, and pediatric genetic disorders. With improved understanding of the dysfunctional circuitry mediating various psychiatric disorders, deep brain stimulation for refractory psychiatric diseases is being increasingly explored in human patients. These factors are likely to facilitate development of gene therapy for psychiatric diseases. Because delivery of gene therapy agents would require the same surgical techniques currently being employed for deep brain stimulation, neurosurgeons are likely to lead the development of this field, as has occurred in other areas of clinical gene therapy for neurologic disorders. We review the current state of gene therapy for psychiatric disorders and focus specifically on particular areas of promising research that may translate into human trials for depression, drug addiction, obsessive-compulsive disorder, and schizophrenia. Issues that are relatively unique to psychiatric gene therapy are also discussed. Copyright © 2013. Published by Elsevier Inc.
Juliana Petri Tavares
Full Text Available This cross-sectional study addresses 130 nursing faculty members in federal universities from Rio Grande do Sul, Brazil. It investigated the psychological demands and decision latitude (the Demand-Control Model by Karasek and their association with Minor Psychological Disorders (MPDs. The Brazilian versions of the Self-Report-Questionnaire-20 and the Job Stress Scale were used. MPDs were prevalent in 20% of the studied individuals. After adjusting for potential confounders, the chances of participants presenting mental disorders were higher in the quadrant 'active strain jobs' (OR=14.23, 95% CI 1.55 to 130.73, followed by the 'high strain jobs' quadrant (OR=10.05, 95% CI 1.23 to 82.44, compared to nursing professors classified in the 'low strain jobs' quadrant. We conclude that high psychological demands and low control over work can cause disorders in nursing professors, among them, MPDs.Estudio epidemiológico seccional entre 130 enfermeros docentes de las universidades federales del estado de Rio Grande do Sul, en Brasil, que tuvo como objetivo investigar la demanda psicológica y el control del trabajo (Modelo Demanda-Control de Karasek y sus asociaciones con Disturbios Psíquicos Menores. Se utilizaron las versiones brasileñas del Self-Report-Questionnaire-20 y del Job Stress Scale. La prevalencia de Disturbios Psíquicos Menores fue del 20,1%. Después de ajustar los posibles factores de confusión, las posibilidades de trastornos psíquicos fueron mayores en el cuadrante Trabajo Activo (OR=14,13; IC95%=1,55-130,73, seguido del cuadrante Alta exigencia (OR=10,05; IC95%=1,23-82,44, en comparación con los enfermeros docentes del cuadrante Baja Exigencia. Se concluyó que la alta demanda psicológica y el bajo control del trabajo pueden provocar daños a la salud, entre ellos los Disturbios Psíquicos Menores en enfermeros docentes.Trata-se de estudo epidemiológico seccional, incluindo 130 enfermeiros docentes das Universidades Federais do
Westra, Bonnie L; Peterson, Jessica J
Big data are large volumes of digital data that can be collected from disparate sources and are challenging to analyze. These data are often described with the five "Vs": volume, velocity, variety, veracity, and value. Perioperative nurses contribute to big data through documentation in the electronic health record during routine surgical care, and these data have implications for clinical decision making, administrative decisions, quality improvement, and big data science. This article explores methods to improve the quality of perioperative nursing data and provides examples of how these data can be combined with broader nursing data for quality improvement. We also discuss a national action plan for nursing knowledge and big data science and how perioperative nurses can engage in collaborative actions to transform health care. Standardized perioperative nursing data has the potential to affect care far beyond the original patient. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Ball, Stephen; Cohen, Ann; Meyer, Margaret
Jump Into Action (JIA) is a school-based team-taught program to help fifth-grade students make healthy food choices and be more active. The JIA team (physical education teacher, classroom teacher, school nurse, and parent) work together to provide a supportive environment as students set goals to improve food choices and increase activity.…
Algumas considerações sobre a utilização de modalidades terapêuticas não tradicionais pelo enfermeiro na assistência de enfermagem psiquiátrica Algunas consideraciones sobre la utilización de modalidades terapeúticas no tradicionales por el enfermero en la atención de enfermería psiquiátrica Some considerations about nurses' use of non traditional therapies in psychiatric nursing care
Rubia Laine de Paula Andrade
ansiedad y la irritabilidad, promueve relajación y un mayor sentimiento de auto-dominio. Toda la actividad debe ser integrada a un plan terapéutico global para cada usuario y hacer parte de la programación diaria del servicio.In this work, a revision of the literature was carried out to identify articles that described non traditional therapeutic modalities psychiatric nurses can use in their daily practice. The described modalities were Music, Motor Activity, Therapeutic Accompaniment and Yoga. Music is able to reconstruct identities, integrate people, reduce anxiety and provide the construction of positive self-esteem. Motor Activity increases self-esteem, reduces inactivity and increases the participation of the psychiatric patient in other activities. In Therapeutic Accompaniment, nurses follow patients in daily routine with a view to their reintegration in the different situations they have to face. Yoga allows for improved memory, reduces emotional tension, depression, anxiety and irritability, and promotes relaxation and a greater feeling of self-control. All activities should be integrated in a global therapeutic plan for each user and be part of daily service programming.
R Delaney, Kathleen
Currently the United States health care system is responding to the Patient Protection and Affordable Care Act (PPACA) and the vision it contains for health care transformation. Along with sweeping changes in service delivery and payment structures, health care reform has championed concepts such as patient-centered care, integrated care, and wellness. Although these are not new ideas, their adaptation, in both ideology and service design has been accelerated in the context for reform. Indeed they are reaching a tipping point; the point where ideas gain wide acceptance and become influential trends. Although psychiatric mental health (PMH) nurses have been active in wellness, patient-centered care, and integrated care, at the current time they seem to be situated peripheral to these national trends. Increased presence of PMH nurses will facilitate their contribution to the development of these concepts within service structures and interventions. To increase knowledge and appreciation of PMH nurses' practice and unique perspective on these issues, leaders are needed who will connect and effectively communicate PMH nursing efforts to the broader health care arena. This article outlines the events that created a context for these three concepts (patient-centered care, wellness, and integrated care), and I suggest why they have reached a tipping point and discuss the need for greater PMH nursing presence in the American national dialog and the role of nursing leaders in facilitating these connections.
Frankle, W.G. [Columbia Univ., New York, NY, (United States). Coll. of Physicians and Surgeons; Laruelle, M. [Columbia Univ., New York, NY (United States). New York State Psychiatric Inst.
Molecular imaging, the study of receptors, transporters and enzymes, as well as other cellular processes, has grown in recent years to be one of the most active neuroimaging areas. The application of single photon emission tomography (SPECT) and positron emission tomography (PET) techniques to the study of psychiatric illness has lead to increased understanding of disease processes as well as validated, in vivo, theories of illness etiology. Within the field of psychiatry these techniques have been applied most widely to the study of schizophrenia. Studies within schizophrenia are largely limited to either the dopamine or serotonin system. This is due in large part to the availability of suitable radiotracers as well as the current theories on the etiology of the illness. Two basic study designs are used when studying schizophrenia using molecular imaging and make up the majority of studies reviewed in this manuscript. The first type, termed ''clinical studies'', compares the findings from PET and SPECT studies in those with schizophrenia to normal controls in an attempt to understand the pathophysiology of the illness. The second study design, termed ''occupancy studies'', uses these techniques to enhance the understanding of the mechanism of action of the medications used in treating this illness. This review will focus on the findings of molecular imaging studies in schizophrenia, focusing, for the most part, on the serotonin and dopamine systems. Emphasis will be placed on how these findings and techniques are currently being used to inform the development of novel treatments for schizophrenia. (author)
Kroska, Amy; Harkness, Sarah K; Brown, Ryan P; Thomas, Lauren S
We examine a key modified labeling theory proposition-that a psychiatric label increases vulnerability to competence-based criticism and rejection-within task- and collectively oriented dyads comprised of same-sex individuals with equivalent education. Drawing on empirical work that approximates these conditions, we expect the proposition to hold only among men. We also expect education, operationalized with college class standing, to moderate the effects of gender by reducing men's and increasing women's criticism and rejection. But, we also expect the effect of education to weaken when men work with a psychiatric patient. As predicted, men reject suggestions from teammates with a psychiatric history more frequently than they reject suggestions from other teammates, while women's resistance to influence is unaffected by their teammate's psychiatric status. Men also rate psychiatric patient teammates as less powerful but no lower in status than other teammates, while women's teammate assessments are unaffected by their teammate's psychiatric status. Also as predicted, education reduces men's resistance to influence when their teammate has no psychiatric history. Education also increases men's ratings of their teammate's power, as predicted, but has no effect on women's resistance to influence or teammate ratings. We discuss the implications of these findings for the modified labeling theory of mental illness and status characteristics theory. Copyright © 2015 Elsevier Inc. All rights reserved.
Gutierrez, Karen M
Nurses frequently experience conflict regarding healthcare decisions, yet are expected to implement actions which they perceive to be morally wrong. Research has described the deleterious effects of this moral incongruency, coined moral distress, on nurses' well being and has identified it as a causative agent in nursing turnover, burnout, and nurses leaving the profession. Thus, it is known that moral distress has significant consequences for nurses, but does moral distress affect nurses' provision of care, and if so, how?
Magnavita, Nicola; Heponiemi, Tarja
Nurses and nursing students are exposed to workplace violence. To compare the characteristics and effects of violence in nursing students and nurses in order to assess the phenomenon and take preventive action. A retrospective survey was conducted in three Italian university schools of nursing. At the end of a lecture, 346 of 349 students agreed to fill out a questionnaire that included domains on violence, mental health, job stress, and organizational justice. This group was compared with 275 nurses from a general hospital (94.2% participation rate). The prevalence of subjects reporting at least one upsetting episode of physical or verbal violence during their lifetime activity in clinical settings was 43% in nurses and 34% in nursing students. Nurses reported more physical assaults (odds ratio [OR] 2.89, 95% confidence interval [CI] 1.35-6.18), threats (OR 2.84, 95% CI 1.39-5.79), and sexual harassment (OR 2.3, 95% CI 1.15-5.54) during the previous 12 months than students. Nurses were mostly assaulted or harassed by patients or their relatives and friends ("external" violence), whereas students often reported verbal and also physical violence on the part of colleagues, staff, and others, including teachers, doctors, and supervisors ("internal" violence). Verbal violence was associated with high levels of psychological problems, as measured by the 12-item version of the General Health Questionnaire, in both students and nurses. Verbal violence was also associated with high job strain, low social support, and low organizational justice, but only among nursing students. Preventive action is urgently needed to control patient-to-worker and worker-to-worker violence in clinical settings. Not only nurses, but also nursing students, would benefit from multilevel programs of violence prevention. © 2011 Sigma Theta Tau International.
Hollander, S F; Allen, K E; Mechanic, J
By creating and promoting an "intrapreneurial climate" with appropriate "actions" within the department of nursing, nurses may exploit their creativity and commitment to health care without leaving the organization. This article discusses an approach to fostering nurse intrapreneurship and gives examples of success achieved at Stanford University Hospital.
Ancient Greek physicians as well as philosophers were fully cognizant of a human being's psychological function and used their particular art to influence individual or social behavior in accordance with their pursuit. This art or technique favorably compares with several of the methods currently called supportive psychotherapy. This psychotherapy was the first form of care for people with mental health problems. Nurses who base their practice on ancient Greek psychotherapy see the patient as a whole, a person who creates meaning in life. Applying the philosophical principles of ancient Greeks helps nurses understand the behavior of people with mental health problems and recognize and facilitate adaptive satisfaction of these psychological needs. In addition, psychiatric nurses are able to help distressed individuals understand their fears and anxieties, so they are freed from the causes of their symptoms that led them to seek therapy in the first place. Consequently, this understanding can make psychiatric nurses' work a living experience and add meaning to their work.
Kennedy, B; Covington, K; Evans, T; Williams, C A
As the world's population ages, increasing numbers of people can anticipate spending their latter years in long-term care settings. Many of these nursing home residents will also present psychiatric illnesses as primary or secondary diagnoses. The resulting behavioral problems may present challenges to nursing staff that they are ill-prepared to meet. This article illustrates the application of the Blake and Mouton consultation model to a Veterans Administration (VA) nursing home situation by a team of psychiatric mental health nurse specialists. The consultation is described and interpreted in terms of the Blake and Mouton model. The focal conflicts addressed in the consultation included issues of morale/cohesion, power/authority, and norms/standards. Interventions used were acceptant, prescriptive, confrontation, and theories/principles. The model provided a useful structure for conceptualizing and organizing assessment and intervention in the consultation situation.
Mariana Inés Ybarra
Full Text Available OBJECTIVE: To investigate the prevalence of psychiatric disorders in patients with myasthenia gravis (MG. METHOD: Forty-one patients with MG answered to a structured psychiatric interview (MINI-Plus. RESULTS: Eleven (26.1% patients were diagnosed with a depressive disorder and 19 (46.3% were diagnosed with an anxiety disorder. Patients with dysthymia were older (p=0.029 and had longer disease duration (p=0.006. Patients with social phobia also had longer disease duration (p=0.039. CONCLUSION: Psychiatric disorders in MG are common, especially depressive and anxiety disorders.
Full Text Available The cerebellum has been considered for a long time to play a role solely in motor coordination. However, studies over the past two decades have shown that the cerebellum also plays a key role in many motor, cognitive, and emotional processes. In addition, studies have also shown that the cerebellum is implicated in many psychiatric disorders including attention deficit hyperactivity disorder, autism spectrum disorders, schizophrenia, bipolar disorder, major depressive disorder and anxiety disorders. In this review, we discuss existing studies reporting cerebellar dysfunction in various psychiatric disorders. We will also discuss future directions for studies linking the cerebellum to psychiatric disorders.