International Journal of Mental Health Nursing最新文献

The aim of this study is to investigate the factors related to post-traumatic stress disorder (PTSD), depression and anxiety mental disorders, as well as the quality of life of Syrian refugees and to examine the relationships between mental health disorders and the quality of life of Syrian refugees. Data were collected via face-to-face surveys with 613 adult Syrian refugees in an urban setting. Brislin's methodology was used for translating scale items, involving initial translation, back-translation and review by another professional translator. The study utilised the PTSD Scale, Beck Anxiety Scale, Depression Scale and Quality of Life Scale (QOLS). Descriptive, correlational and multivariate regression analysis were applied. Findings of correlational analysis indicate that PTSD levels among Syrian refugees are significantly related to gender, income level and employment. Depression levels are significantly associated with trauma history, healthcare service use, marital status and employment. Anxiety levels are significantly related to gender, trauma history, healthcare service use, employment and income. According to the findings of the regression analyses, the relationships between depression, quality of life and PTSD are complex. Meanwhile, anxiety decreases quality of life and increases PTSD. Quality of life moderates the relationship between depression and PTSD, as well as between anxiety and PTSD. The study concludes that the mental disorder levels of Syrian refugees, in terms of PTSD, depression and anxiety, are linked to their socio-demographic characteristics. These results highlight the importance of social, economic and cultural factors, healthcare and social services and the socio-demographic characteristics of the region where refugees have settled after displacement.

Countries around the world are experiencing both a growing need for mental health services and major gaps in the delivery of mental healthcare. The World Health Organisation's 2022 report on mental health emphasised co-designed and systems-level innovations responsive to the voice of those with lived experience. However, evidence for implementing such methodologies is sparse. Group model building (GMB), a participatory systems-based approach, has been used in various fields, but its application is limited within mental healthcare settings. It is recognised as a valuable tool for engaging stakeholders, including those with lived experience, in understanding and redesigning health systems and services. The participatory approach aligns with the mental health sector's shift towards co-design and person-centred care. This study assessed the acceptability of GMB as a method for co-design within mental healthcare, aiming to explore its potential for meaningful collaborative improvement and systems-level insights. Participants from a regional Mental Health and Drug and Alcohol Service (MHDAS) engaged in GMB workshops and focus groups. Eighteen individuals, including lived experience workers and healthcare professionals, provided feedback that informed adjustments to the workshops' design, language, timing and facilitation techniques, enhancing GMB's relevance for mental health co-design. The findings demonstrate the value and acceptability of the adapted GMB process in acute mental healthcare, marking a significant step towards evidence-based, person-centred service improvement. This study highlights the potential effectiveness of participatory methods in identifying and addressing systemic challenges, paving the way for future mental health reforms. Future work will focus on implementing and evaluating co-designed interventions, aiming for more inclusive and effective mental healthcare and advancing innovation and reform in the field.

Clinical placements form an integral and important part of preregistration nursing student learning. The theory–practice gap has been identified as problematic, with clinical experience being a key strategy to address this. Despite this, the perceptions of nurse academics teaching preregistration mental health nursing regarding clinical placements have not been widely explored. To garner perspectives and experiences of mental health clinical placements from nurse academics teaching mental health nursing to preregistration nursing students. A descriptive qualitative study involving 19 nurse academics from 13 metropolitan and regional Australian universities, who were involved in the design and delivery of preregistration mental health nursing content. Data were analysed thematically. The study adhered to the Standards for Reporting Qualitative Research (SRQR). Participants reported that inappropriate clinical placements generate negative student experiences. Furthermore, mental health placements in nonspecialist settings such as medical-surgical or aged care compromised student learning and posed a barrier to linking theory to practice. Increasing meaningful and appropriate mental health clinical placements in nurse education requires investment and support from multiple stakeholders. Nurse academics are crucial stakeholders in terms of understanding the impact of mental health clinical placements. Appropriate mental health clinical placements are central to effective comprehensive nurse education. Academics teaching mental health in preregistration curricula are significant stakeholders, and their informed perceptions are central to compel change.

Mental health service integration currently has no consensus definition and exists in a variety of settings, including primary care, addiction treatment and chronic disease management, and mental health nurses have often experienced efforts at service integration with varying degrees of success. The intent of mental health service integration is to enable collaboration between mental health services and other healthcare providers to improve service access and the care provided to individuals with mental health issues or mental illness. This scoping review aimed to explore service integration between mental health services and with a specific focus on those evaluated in peer-reviewed, primary literature, to determine facilitators and barriers to service integration. Using the Arksey and O'Malley's framework for scoping reviews, we located 3148 studies, with screening narrowing final papers for inclusion to 18. Facilitators to service integration included clinician education, adequate resourcing and an interdisciplinary approach, while barriers included staff factors such as a reluctance to work with individuals with mental illness, consumer level barriers such as poor mental health literacy, ‘territorialism’ among staff and organisational climate. Research indicates that service integration is an effective means to detect and treat mental health issues in settings that do not traditionally provide mental health care, lowering the costs of providing healthcare and providing improved care for mental health needs; however, there are several barriers to be addressed to achieve full implementation of integration models.

The therapeutic relationship plays a crucial role in nursing care for people with mental illness. Adopting a systemic and person-centred approach that considers the individual experiences and needs of the person is paramount. However, no instruments were found in the literature designed to evaluate the nurse–patient therapeutic relationship from the perspective of a person with mental illness. This study aimed to develop and evaluate the psychometric properties of an instrument for assessing the quality of the nurse–patient therapeutic relationship from the patient's perspective. An e-Delphi study was conducted to develop the assessment tool, and a psychometric study was carried out to examine its psychometric properties. The sample comprised 240 adults with mental illness. Internal consistency was assessed using Cronbach's alpha and the Omega coefficient. The final structure of the assessment instrument included 24 items distributed across two factors, explaining 64.2% of the variance. Cronbach's alpha was 0.94, and the Omega coefficient was 0.96. The intraclass correlation coefficient was 0.84 (95% CI: 0.66–0.92). The therapeutic relationship assessment scale (TRAS-Patient) shows good psychometric properties. This is a relevant tool for assessing the quality of the nurse–patient therapeutic relationship from the patient's perspective, thus promoting a patient-centred approach and responding to the patient's needs. Mental health nurses can access a tool for evaluating the nurse–patient therapeutic relationship centred on disciplinary knowledge. This enables patient involvement in care, enhanced care and person-centred practice.

Despite the therapeutic benefits of sensory approaches being well documented, little research has focused on improving their implementation in acute mental health units. The use of implementation frameworks to improve the use of evidence-based practices has shown promising results in healthcare; however, there is little evidence for their use in acute mental health units. A pre–post comparison design was used to determine the effect of an 11-month co-designed theory-informed multifaceted implementation strategy on the use of sensory approaches and the use of seclusion/restraint in one acute mental health ward. This study was guided by Integrated Knowledge Translation (IKT) and informed by the Behaviour Change Wheel (BCW) approach. Implementation strategies were co-designed and included provision of sensory materials/resources; education/training; prompts/reminders; modelling; audit and feedback; workplace coalition; and facilitation. Data were collected through pre- and post-project questionnaires (pre- n = 37, post- n = 40) and routine clinical data. Data were analysed using SPSS and thematic analysis. Data for matched pairs (n = 19) revealed significant improvements between pre- and post-perceived levels of knowledge and confidence in using sensory approaches. Significant increases were found in the use of sensory kits, weighted modalities and sensory assessment/plans. Post participants' recommendations to sustain the use of sensory approaches in their unit included ongoing training; funding; maintenance and supply of sensory equipment; increased staffing; and support from colleagues. This is the first study to use the IKT and BCW to design, facilitate and evaluate a co-designed, theory-informed implementation strategy to improve the use of sensory approaches in an acute mental health unit.

Substance use disorder is a public health crisis that is a financial strain to many healthcare systems and communities, but more importantly, it costs lives. Nurses interact with people experiencing substance use disorders and their families in many settings. Nurses can provide insights into the experiences of working with this population. This descriptive qualitative study aimed to examine nurses' experiences and perspectives on caring for people with substance use disorder and their families. After receiving institutional review approval, purposive sampling was used to recruit registered nurses (n = 16) who worked in a variety of settings, and interviews were conducted. Constant comparison analysis was conducted concurrently with data collection until saturation was reached. Code development and refinement was an iterative process. Three themes were generated from the data. Personal Experiences Affect Professional Practice represented participants varied personal experiences and included two subthemes: Reflecting on Personal Experiences and Seeing the Person Beyond the Substance Use Disorder. A second theme is Professional Experiences Affect Professional Practice, which included two subthemes: Professional Experiences are Stressful and Rewarding and Substance Use Disorder Education Increases Confidence. Finally, Stigma Affects Substance Use Disorder Care is the third theme. Future implications range from the individual engaging in self-reflection, to nursing leadership establishing a framework to incorporate reflection and creating a culture that supports and reinforces these activities. The findings of this study support the need for stigma awareness/reduction education starting in undergraduate nursing programmes, throughout practice, with extension to inter-professional groups and the community.