International Journal of Mental Health Nursing最新文献

The education of mental health nurses has long remained a contentious topic in the UK and internationally. This research seeks to gather the perspectives of those directly affected by mental health nurse education. To investigate what knowledge, skills and values current mental health nursing students, graduate mental health nurses and people with lived experience of accessing mental health services believe should be paramount within pre-registration education. Data was gathered through focus groups involving a mix of pre- and post-qualified mental health nurses and people with lived experience of accessing mental health services. Data was collected through audio recordings, which were transcribed and subjected to thematic analysis. The analysis generated four themes of: (i) Values and ethics-based education, (ii) Self-awareness, (iii) Understanding and therapeutically being with others and (iv) Specialism versus Genericism. The findings speak to the special nature of mental health nursing and the need for students to develop specialist mental health knowledge and skills, alongside self-knowledge. The findings provide a unique insight into the aspects of pre-registration nursing felt to be most valuable by the three participant groups in this study. The findings reiterate the importance nurse education celebrating the specialism of mental health nursing and adds to the growing weight of literature for increased specialism with future education standard reviews.

Suicide is a major public health concern, and university students are at higher risk of suicide than any other age group. The purpose of this study was to examine the prediction power of loneliness, academic anxiety, and academic procrastination on suicidality among university students. A cross-sectional, correlational design was used to recruit 403 university students using the electronic survey format in Jordan. Data were collected regarding loneliness, academic anxiety, academic procrastination, and suicidality. A two-step multiple hierarchical regression analysis was performed. Only 17.1% (n = 69) of students were at risk of suicide, low to moderate level of loneliness, moderate level and moderate to high level of academic procrastination of academic anxiety. The model that included the sociodemographic and the psychological factors was significant (F_18,390 = 12.3, p < 0.001) where the total variance in suicidality was 37.3% (R² = 0.373). Being a working student, being on psychotropic medication, romantic and family relationships domains of loneliness, and academic anxiety were found to be predictors of suicidality (p < 0.05). Suicide is a significant problem among university students. Mental health professionals and policymakers need to enhance the use and access to mental health services and seek psychological counselling to combat the increasingly observed phenomenon of suicide among young people.

Emergency department (ED) presentations for mental health (MH) help-seeking have been rising rapidly in recent years. This research aims to identify the service usage demographic for people seeking MH care in the ED, specifically in this case, to understand the usage by First Nation people. This retrospective cohort study examined the sociodemographic and presentation characteristics of individuals seeking MH care in two EDs between 2016 and 2021. Data were collected using existing records and analysed using descriptive univariate analysis with statistical significance between the two sites determined using chi-squared test, p < 0.05. The overall data presented in this analysis show an overall ED mental health presentation rate of 12.02% for those who identified as ‘Aboriginal but not Torres Strait Islander origin’, 0.36% as ‘Both Aboriginal and Torres Strait Islander’ and 0.27% as ‘Torres Strait Islander’ totalling 12.63%. This is an overrepresentation compared to the regional population of 4.9%. One site recorded 14.1% of ED presentations that identified as Aboriginal and/or Torres Strait Islander, over double the site's demographic of 6.3%. Given the disproportionately high representation of First Nation people in MH-related ED presentations, further research is required to prioritise a First Nation research perspective that draws on First Nation research methods, such as yarning and storytelling to understand the unique cultural needs and challenges experienced by First Nation people accessing MH care via ED. Understanding the demographic is but one step in supporting the Cultural Safety needs of First Nation people. Additionally, research should be designed, governed and led by First Nation researchers.

The internalisation of stigma has adverse effects on the recovery and quality of life of people with severe mental illnesses. Studies have shown that life experiences in one's close environment are highly relevant in explaining the onset and development of self-stigma. Families play a critical role in the daily care of people with severe mental illness and have a profound impact on patient recovery. This qualitative study explored the influence of family on stigma internalisation among people with severe mental illness in the context of Chinese culture. A grounded theory design was used. Semi-structured interviews were conducted with 20 patients with severe mental illness and 10 family members, and observations were carried out among five of the families. The data analysis followed three steps (open, axial and selective coding) and involved the use of a constant comparative method and memo writing. The COREQ reporting checklist was used to report the results. Our findings revealed that families can facilitate and impede stigma internalisation in people with severe mental illness via negative or positive daily interactions. A theoretical framework was developed to present the potential effects of the identified family factors on stigma internalisation. Three major family factors influencing patients' internalised stigma were identified, namely, “beliefs of family members” at the individual level, “responses within the family” at the intrafamilial level and “differentiated family environment” at the level of the whole family system, in which “biased beliefs of family members” could bring about “negative responses within the family” and further result in patients' internalised stigma. Our findings suggested that mental health stigma internalised by ill people should be viewed within the broad context of the family. Family-based programs aimed at improving positive interactions and support within the family need to be developed and launched, with particular attention given to interventions for affiliate stigma, coping with stigma and families' negative responses towards people with severe mental illness to prevent the internalisation of stigma by patients.

Peer support is a collaborative practice where people with lived experience of mental health conditions engage in supporting like-minded. Peer support impacts on personal recovery and empowerment and creates value at an organisational level. However, the implementation of peer support into existing mental health services is often impeded by barriers embedded in organisational culture and support in role expectations. Non-peer professionals' recovery orientation and attitudes towards peer support workers (PSWs) are essential factors in the implementation of peer support, and this study explored non-peer professionals' understanding of recovery and their attitudes towards PSWs joining existing community mental health teams in one region of Denmark. In total, 17 non-peer professionals participated in three focus groups. Thematic analysis led to three themes: (1) Recovery is a process of “getting better” and balancing personal and clinical perspectives; (2) Realising recovery-oriented practice: a challenging task with conflicting values; and (3) Expectations and concerns about peer support workers joining the team. Recovery-oriented practice faces challenging conditions in contemporary mental health services due to a dominant focus on biomedical aspects in care and treatment. Implementation facilitators and barriers in the employment of PSWs point towards fundamental aspects that must be present when employing PSWs in an organisation. The issues described leading up to the employment of PSWs reflected in this study underpin the importance of preparing an organisation for the employment of PSWs based on the available knowledge.

Elimination of restrictive practices (physical/mechanical restraint and seclusion) from adult acute mental health care services has been demanded internationally for many decades. This study aimed to: (1) Identify priority issues in the elimination of and use of alternative approaches to restrictive practices (seclusion and physical/mechanical restraint) in rural/regional acute adult mental healthcare services, as told by mental healthcare service users and practitioners, (2) identify the community-based, system-level feedback loops that enhance or reduce the use of restrictive practices and viable alternatives and, (3) identify potential action areas to improve system structures to increase regional mental healthcare services' ability to eliminate restrictive practices and use alternative approaches. Group model building (GMB) workshops were held with a small group (n = 9) of mental healthcare practitioners and service users with lived experience of restrictive practice use. This participatory approach enables exploration and visual mapping of local structures causing behaviour patterns of practitioner and service user concern over time – in this case, the barriers, and enablers to alternative approaches to restrictive practices in adult acute mental healthcare services within the Geelong-Barwon region. This is the first study that specifically applies GMB in the discussion of the elimination of restrictive practices in mental health in the non-metropolitan regional/rural context. Participants identified four key priorities in relation to eliminating restrictive practices: (1) self-advocacy, (2) continuity of care, (3) early intervention, and (4) safety for all. The study findings were distilled into a novel preliminary set of mental healthcare practitioner and service user action ideas.

Mental health nurses (MHNs) experience a range of stressors as part of their work, which can impact their well-being and turnover intention. There is no prior evidence, however, on MHNs' mental health, well-being, resilience, and turnover intention during the COVID-19 pandemic. The aims of this online survey-based cross-sectional study, conducted during the pandemic, were to explore the psychological distress, well-being, emotional intelligence, coping self-efficacy, resilience, posttraumatic growth, sense of workplace belonging, and turnover intention of n = 144 Australian mental health registered and enrolled nurses; and explore relationships between these variables, in particular, psychological distress, well-being, and turnover intention. There was a higher percentage of MHNs with high (27.78%) and very high psychological distress (9.72%) compared to population norms as measured by the K10. Emotional intelligence behaviours were significantly lower than the population mean (GENOS-EI Short). Coping self-efficacy was mid-range (CSES-Short). Resilience was moderate overall (Brief Resilience Scale), and posttraumatic growth was mid-range (Posttraumatic Growth Inventory; PTGI). Sense of workplace belonging was moderate, and turnover intention was low. Higher levels of psychological distress were associated with higher turnover intention, and lower workplace belonging, coping self-efficacy, well-being, resilience, and emotional intelligence behaviours. Despite the levels of psychological distress, nearly half the sample (n = 71) was ‘flourishing’ in terms of well-being (Mental Health Continuum Short-Form). To help prevent staff distress in the post-pandemic period, organisations need to proactively offer support and professional development to strengthen staff's psychological well-being, emotional intelligence, and resilience skills. These strategies and group clinical supervision may also support lower turnover.

Suicide management skills are essential for nursing students, as they are often the initial healthcare contact for individuals at risk of suicide. Recognising signs of suicidal ideation and behaviour is critical for initiating timely interventions. This study aimed to develop and access the psychometric evaluation of the Suicide Management Competency Scale (SMCS) for nursing students. A first draft of the SMCS was initially developed following literature and focus group, and a scale containing 28 items was constructed. We recruited 216 participants from two nursing schools. Construct validity was evaluated with exploratory factor analysis (EFA). Internal consistency reliability was determined with Cronbach's alpha, and test–retest reliability was examined with intra-class correlation. After four rounds of EFA and item analysis, we reduced the number of items to 16. We deleted 12 items, including 4 items for communalities less than 0.40, 3 items for cross-loading, 3 items for factor loading less than 0.40, and 2 items for low corrected item–total correlation. The final 16-item SMCS resulted in three subscales, which explained 55.813% of the total variance: emotional challenges in suicide risk assessment, delivering suicide interventions, and suicide risk nursing competence and confidence. Cronbach's alpha was 0.854 for the total score and 0.748 to 0.847 for the subscales. The newly developed SMCS was found to have good reliability and validity, suggesting that this scale could be used to evaluate nursing students' perceived competency in managing suicide, which might help cultivate competence in nurses' ability to effectively manage and prevent suicide, thus contributing to saving lives.

Mental state deterioration in patients poses significant challenges in healthcare, potentially resulting in adverse outcomes for patients and continued reliance on restrictive interventions. Implementing evidence-based approaches such as a rapid response system that prioritises early identification and intervention can effectively manage adverse outcomes. However, little is known regarding the effectiveness of these interventions. The objective of this synthesis was to test and refine initial programme theories by synthesising evidence to understand what works, for whom and under what circumstances. Based on the realist synthesis methodology, we searched EMBASE, CINAHL, MEDLINE, the Cochrane Library and grey literature for evidence to inform contexts, mechanisms and outcomes on the functioning of a rapid response model. We identified 28 relevant sources encompassing peer-reviewed journal articles and grey literature. This synthesis identified three important elements that contribute to the effectiveness of a rapid response system for managing mental state deterioration: care processes, therapeutic practices and organisational support. Essential elements include improving confidence and clinical skills through training, timely assessment and intervention, teamwork, communication and the creation of governance structures for monitoring and evaluation. To ensure the effectiveness, an organisation must adopt a comprehensive approach that incorporates organisational support, resource allocation, training, clear communication channels and commitment to continuous quality improvement. However, implementing interventions within a complex healthcare system requires thoughtful consideration of the organisational culture and governance structures. By taking a comprehensive and holistic approach to improvement initiatives, organisations can strive to achieve optimal outcomes in managing mental state deterioration and improving patient care.