International Journal of Mental Health Nursing最新文献

Evidence suggests that moving from specialist to generic nurse education, as is proposed in the United Kingdom and as has already happened in countries such as Australia, leads to a reduction in the quality of mental health nurse education and a weakening of mental health nurse professional identity. Meanwhile, research has found that mental health nurse professional identity is already complex because of the discipline's multifaceted but objectively ambiguous role. The present qualitative systematic review aimed to explore mental health nurses' perceptions of their professional identity. It was conducted in the form of a thematic analysis of qualitative data and was compliant with PRISMA reporting guidelines. Six databases (CINAHL Ultimate, EBSCO Medline, APA PsycInfo, APA PsycArticles, PubMed and SCOPUS) were searched in April and May 2024. The literature search yielded a total of n = 3710 studies. Following a process of screening using Covidence and quality appraisal using the CASP tool, a total of n = 23 peer-reviewed qualitative studies were selected for inclusion. Five themes emerged: (1) Professional identity formation, (2) The attributes of mental health nurses, (3) The mental health nurse role, (4) The unique skills and knowledge of mental health nurses and (5) Professional identity and the future of mental health nursing. This systematic review concluded that mental health nurses recognise their profession as being complex and difficult to describe; however, they remain positive and committed to their roles, recognising that the uniqueness of mental health nursing may become its defining strength.

Interventions to prevent aggression and reduce use of restrictive practices are essential for recovery-oriented mental health nursing care. This study explored how nurses can best enhance employment of a structured risk assessment instrument paired with an aggression prevention protocol. Fourteen nurses with responsibilities for reducing restrictive practices attended focus groups, and three consumer consultants working with mental health nursing staff participated in one-to-one interviews. The focus groups and interviews were designed to elicit recommendations to assist nurses use of the violence risk assessment instrument and apply the protocol interventions. Thematic analysis was used to analyse the data. Four themes were interpreted from the data. Theme one: The nurses are experiencing incredible difficulty talking about how they can be supported. Theme two: ‘calming the farm’: The need to self-regulate, with the subthemes: (1) some nurses may need support to ‘calm the farm’ and (2) if you can't ‘calm the farm’ another nurse may need to step in. Theme three was the need for robust training and education and the final theme was: The need for ‘decompressing’ before leaving the shift. Participants suggested while some nurses were very skilled at regulating their emotions while intervening to prevent violence, some had difficulty, or were not aware of their emotional state, and may need support from colleagues when intervening. Suggestions for enhancing the application of aggression prevention interventions include use of mental wellness check-in forms, engaging in clinical supervision and safety huddles at the end of the shift to assist nurses to decompress before leaving.

In 2018 the UK's Nursing and Midwifery Council (NMC) moved from field-specific to generic standards of proficiency in training all four fields of nursing practice. Some educators claim these proficiencies exclude field-specific content, but there is a lack of comparative evidence on student feedback across each field. This study examined student nurses experiences of being assessed against these generic proficiencies to identify whether there are any differences between the fields of nursing in the United Kingdom. In a cross-sectional study employing a mixed-methods anonymous online survey, 531 nursing students in the final 3 months of training were surveyed across UK universities in 10 regions of the United Kingdom. Significant differences between nursing fields were observed in students' feedback on the NMC proficiencies (p = 0.000). Mental health nursing students reported the lowest levels of practice confidence; significant barriers to achieving proficiencies; and exclusion of field-specific knowledge and skills, which devalued and threatened their professional identity. Adult nursing students reported high levels of practice confidence; fewer barriers to achieving proficiencies; variable experiences of placement support; and a preference for more focus on communication skills. Feedback indicates that students experience the generic proficiencies as a list of medical procedures that exclude communication and relationship management skills. The findings suggest that further evaluation and guidance are required to ensure that mental health proficiencies are included in practice assessment documentation.

Suicide crisis is a considerable health concern for Australian adolescents. Parents provide suicidal adolescents with support and access to life-saving care, such as the emergency department (ED). The aim of this study was to explore, from a parent perspective, what supports parents had received or would have found helpful when they attended the ED for their adolescents' suicide crisis. A cross-sectional sample of 163 parents who had attended an Australian ED with their adolescent child (aged 12–18 years) completed an online survey, which explored the support participants have received during an ED presentation, what support is important to receive and factors which inform participants' preference for adolescent support. A binary logistic regression was conducted to determine which factors informed the likelihood of parents' preference type (adolescent support over parent support). Parents reported wanting information that would help them to support their adolescent after discharge. Ninety percent of parents indicated that they would prefer receiving adolescent-focused support over parent-focused support, with parents of younger adolescents significantly more likely to endorse wanting adolescent-focused support during the ED presentation. This is the first study that examines the support parents receive from EDs when presenting for a suicide crisis. It demonstrates a large gap between what parents would consider helpful to receive and what support they are receiving in Australian EDs. These findings should be used to help guide ED reform and to develop resources that support parents to care for their adolescent during and immediately following a suicide crisis.