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Reasons Explaining High Emergency Department Use in Patients With Mental Illnesses: Different Staff Perspectives 精神疾病患者频繁使用急诊科的原因:不同工作人员的观点。
IF 3.6 2区 医学 Q1 NURSING Pub Date : 2024-09-27 DOI: 10.1111/inm.13442
Marie-Josée Fleury, Francine Ferland, Lambert Farand, Guy Grenier, Armelle Imboua, Firas Gaida

For patients with mental illnesses (MIs), emergency departments (EDs) are often the entry point into the healthcare system, or their only resort for quickly accessing mental health treatment. A better understanding of the various barriers justifying high ED use among patients with MIs may help recommend targeted interventions that better meet their needs. This explorative qualitative study aimed to identify such barriers and the solutions brought forth to reduce ED use based on the perspectives of clinicians and managers working in EDs, other hospital departments or the community sector. Interviews were conducted between April 2021 and February 2022; 86 mental health professionals (22% were nurses) from four large urban ED sites in Quebec (Canada) were interviewed. Barriers were identified in relation to patient profiles, healthcare system and organisational features and professional characteristics. The key barriers that were found to explain high ED use were patients having serious MIs (e.g., psychotic disorders) or social issues (e.g., poverty), lack of coordination and patient referrals between EDs and other health services, insufficient access to mental health and addiction services and inadequacy of care. Very few solutions were implemented to improve care for high ED users. Better deployment of ED interventions in collaboration with outpatient care may be prioritised to reduce high ED use for patients with MIs. Improvements to the referral and transfer processes to outpatient care, particularly through care plans and case management programs, may be implemented to reduce high ED use and improve outpatient care among patients with multiple health and social needs.

对于精神疾病(MIs)患者来说,急诊室(EDs)往往是进入医疗系统的入口,也是他们快速获得精神健康治疗的唯一途径。更好地了解导致精神疾病患者大量使用急诊室的各种障碍,有助于推荐更能满足其需求的针对性干预措施。这项探索性定性研究旨在根据急诊室、其他医院部门或社区部门的临床医生和管理人员的观点,找出这些障碍以及为减少急诊室使用而提出的解决方案。访谈于 2021 年 4 月至 2022 年 2 月期间进行;来自加拿大魁北克省四个大型城市急诊室的 86 名精神卫生专业人员(22% 为护士)接受了访谈。研究发现了与患者概况、医疗保健系统和组织特征以及专业特点有关的障碍。研究发现,导致急诊室使用率高的主要障碍包括:患者患有严重的心肌梗塞(如精神障碍)或社会问题(如贫困)、急诊室与其他医疗服务机构之间缺乏协调和患者转诊、无法获得足够的心理健康和成瘾服务以及护理不足。为改善急诊室高就诊率患者的护理而实施的解决方案寥寥无几。可以优先考虑与门诊护理合作,更好地部署急诊室干预措施,以减少急诊室对心肌梗死患者的高使用率。可通过改善门诊护理的转诊和转院流程,特别是通过护理计划和个案管理计划,减少急诊室的高使用率,并改善有多种健康和社会需求的患者的门诊护理。
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引用次数: 0
Young People Transitioning From Child and Adolescent to Adult Mental Health Services: A Qualitative Systematic Review 从儿童和青少年向成人心理健康服务过渡的年轻人:定性系统回顾。
IF 3.6 2区 医学 Q1 NURSING Pub Date : 2024-09-27 DOI: 10.1111/inm.13439
Robyn Rosina, Rose McMaster, Victoria Lovecchio, Chiung-Jung Wu, Jo

To critically synthesise the literature on the lived experience of young adults about their transition to adult mental health services including the perspectives of key people in their world: parents, carers and clinicians. Young people within child and adolescent mental health services are usually required to transition to adult mental health services at the age of 18, despite evidence showing cognitive and emotional development impacted by childhood trauma, illness and adverse life events. This qualitative systematic review searched relevant electronic databases, policy documents, grey literature and theses examining original qualitative peer-reviewed studies published from 2009 to 2022 in English. The process utilised the PRISMA guidelines and the quality of papers assessed by the JBI critical appraisal tool. Nine papers met the criteria for inclusion in the review. The results indicate that qualitative research listening to the voices of young people transitioning to adult mental health services is a rarity. Even fewer papers examine the perspectives of key people in their lives: this review has critically synthesised the literature on the lived experience of young adults about their transition to adult mental health services including the perspectives of key people in their world: parents, carers and clinicians. The main themes identified include: age 18 is not a helpful trigger to transition; young people want more individualised planning; parents want more involvement and clinicians open up about a challenging nexus with adult mental health services.

批判性地归纳有关青少年向成人心理健康服务过渡的生活经验的文献,包括他们世界中的关键人物:父母、照护者和临床医生的观点。尽管有证据表明认知和情感的发展会受到童年创伤、疾病和不良生活事件的影响,但儿童和青少年心理健康服务机构通常要求青少年在 18 岁时过渡到成人心理健康服务机构。本定性系统性综述检索了相关的电子数据库、政策文件、灰色文献和论文,审查了 2009 年至 2022 年期间发表的原创性定性同行评审研究的英文版。该过程采用了 PRISMA 指南,并通过 JBI 关键评估工具对论文质量进行了评估。九篇论文符合纳入综述的标准。结果表明,倾听过渡到成人精神健康服务的年轻人心声的定性研究非常罕见。本综述批判性地综合了有关年轻人过渡到成人精神健康服务的生活经历的文献,包括他们世界中的关键人物:父母、照顾者和临床医生的观点。所发现的主要主题包括:18 岁并不是过渡的触发点;年轻人希望有更多的个性化规划;父母希望有更多的参与;临床医生公开了他们与成人精神健康服务之间具有挑战性的关系。
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引用次数: 0
Nurses' Perspectives on Fostering Therapeutic Relationships While Working With Clients Who Display Conflict Behaviour 护士在与有冲突行为的客户共事时促进治疗关系的观点。
IF 3.6 2区 医学 Q1 NURSING Pub Date : 2024-09-27 DOI: 10.1111/inm.13441
Nick Overpelt, Nienke Kool-Goudzwaard, Barbara Stringer, Berno van Meijel

Therapeutic relationships are critical in the treatment of mental health disorders. Some clients experiencing mental health disorders display conflict behaviour—for example, suicidal or self-harming behaviour, threats of or actual aggression, and various psychotic behaviours—which presents significant challenges for care professionals. In inpatient mental health units, where interactions with mental health nurses are frequent, managing conflict behaviour is crucial to maintaining care quality and fostering therapeutic progress. This study aims to describe nurses' perspectives on fostering therapeutic relationships while working with clients who display conflict behaviour. Qualitative research was conducted in a specialised treatment setting for such clients by means of individual semi-structured interviews and a focus group interview with nurses. The results show that the nurses' primary focus is on cooperating with clients and colleagues. Regardless of conflict behaviour, nurses consistently invite clients to cooperate. To do so, they must manage their own emotions and expectations, emphasise the clients' responsibility and reduce the opportunities for conflict behaviour. The unit structure helps nurses by reducing ambiguity regarding treatment policies and inconsistencies in nurse–client interactions and allows nurses and clients to experience feelings of safety. To work with conflict behaviour, nurses need to feel valued and supported by their colleagues and have adequate time and resources. In conclusion, this study shows how nurses foster therapeutic relationships with clients who display conflict behaviour by focusing on cooperation, structure and safety.

治疗关系对于治疗精神疾病至关重要。一些患有精神障碍的病人会表现出冲突行为--例如,自杀或自残行为、威胁或实际的攻击行为以及各种精神病行为--这给护理专业人员带来了巨大的挑战。在与精神科护士互动频繁的住院精神健康病房中,管理冲突行为对于保持护理质量和促进治疗进展至关重要。本研究旨在描述护士在与表现出冲突行为的客户共事时,对促进治疗关系的看法。本研究在一家专门治疗此类客户的机构中,通过对护士进行个人半结构化访谈和焦点小组访谈的方式,开展了定性研究。结果表明,护士的主要工作重点是与客户和同事合作。无论冲突行为如何,护士都会始终如一地邀请客户合作。为此,她们必须管理好自己的情绪和期望,强调服务对象的责任,减少冲突行为发生的机会。科室结构有助于护士减少治疗政策的模糊性和护士与服务对象互动的不一致性,并使护士和服务对象体验到安全感。要解决工作中的冲突行为,护士需要感受到同事的重视和支持,并拥有充足的时间和资源。总之,本研究展示了护士如何通过关注合作、结构和安全来促进与有冲突行为的服务对象之间的治疗关系。
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引用次数: 0
Recovery From Severe Mental Illnesses: The Influence of Personal and Psychosocial Factors in Community Settings 从严重精神疾病中康复:社区环境中个人和社会心理因素的影响》。
IF 3.6 2区 医学 Q1 NURSING Pub Date : 2024-09-27 DOI: 10.1111/inm.13440
Jie Fu, Jianwen Zhu, Jiajia Dong, Yang Wang, Sizhe Wang, Xia Zhang, Lu Wen, Hong Fan

Severe mental illnesses (SMIs) represent a significant public health challenge with substantial personal, economic and societal burdens. Despite treatment advances, recovery outcomes for SMI patients remain variable. This study aimed to investigate the influence of personal and psychosocial factors on recovery among SMI patients in community health settings. This cross-sectional study was conducted in 23 community health service centres in Nanjing, China. We recruited 924 participants diagnosed with SMIs, using a random sampling method. The relationships between individual, psychosocial factors and patients' recovery status were analysed by multiple linear regression. The mediation effect of medication adherence was further tested by the Sobel test with bootstrapping. The mean score of the Morningside Rehabilitation Status Scale (MRSS) of 924 patients with SMIs was 49.82 ± 41.52. The main influencing personal factors of recovery status were age, marital status, education, average annual income and duration of illness. Patients who were accepted by their families tended to have better recovery outcomes, while stigma and social impairment may hinder recovery. Medication adherence played a mediating role between psychosocial factors and recovery status. This study highlights the crucial role of psychosocial factors in the treatment and recovery of SMI patients. Furthermore, medication adherence emerged as a mediating factor. Implementing targeted interventions and policies addressing identified psychosocial barriers can offer promising avenues for improving recovery outcomes for SMI patients in community settings.

严重精神疾病(SMI)是一项重大的公共卫生挑战,给个人、经济和社会带来沉重负担。尽管在治疗方面取得了进步,但 SMI 患者的康复效果仍然参差不齐。本研究旨在调查社区卫生环境中个人和社会心理因素对 SMI 患者康复的影响。这项横断面研究在中国南京的 23 个社区卫生服务中心进行。我们采用随机抽样的方法,招募了924名确诊为SMI的参与者。通过多元线性回归分析了个体因素、社会心理因素与患者康复状况之间的关系。通过自引导的 Sobel 检验进一步检验了服药依从性的中介效应。924名SMI患者的晨兴康复状况量表(MRSS)平均得分为(49.82±41.52)分。影响康复状况的主要个人因素是年龄、婚姻状况、教育程度、平均年收入和病程。被家人接受的患者往往有更好的康复结果,而耻辱感和社会障碍可能会阻碍康复。用药依从性在社会心理因素和康复状况之间起着中介作用。这项研究强调了社会心理因素在 SMI 患者的治疗和康复中的关键作用。此外,坚持服药也是一个中介因素。实施有针对性的干预措施和政策,消除已识别的社会心理障碍,可为改善社区环境中 SMI 患者的康复结果提供有希望的途径。
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引用次数: 0
Harm Reduction as a Form of ‘Wrap-Around’ Care: The Nursing Role 减低伤害是一种 "全方位 "护理:护理角色。
IF 3.6 2区 医学 Q1 NURSING Pub Date : 2024-09-20 DOI: 10.1111/inm.13436
Marissa D. Abram, Adrian Jugdoyal, Paulo Seabra, Dana Murphy-Parker, Adam Searby

In addiction treatment, harm reduction is a philosophy that aims to reduce the harms from ongoing alcohol and other drug use. Although abstinence may be the ‘gold standard’ in reducing harm from ongoing alcohol and other drug use, harm reduction recognises that abstinence may not be achievable for certain individuals. Accordingly, harm reduction is used to enable medical or mental health treatment for individuals who continue to use alcohol and other drugs, providing a form of care which meets individuals where they present to healthcare facilities. Harm reduction accepts ongoing alcohol and other drug use, while providing a traditionally marginalised cohort of individuals access to healthcare services. In this perspective paper, we argue that the role of nurses in promoting and utilising harm reduction as part of their regular practice is essential to both reducing harm from alcohol and other drug use, engaging individuals who use alcohol and other drugs in healthcare services, and providing a means to accept individuals as they are to build trust and rapport for engagement in addiction treatment when they are ready, and at their own pace. Nurses, by virtue of their role and number in the healthcare landscape (approximately 28 million globally), are ideally placed to implement harm reduction in their practice to achieve better outcomes for individuals who use alcohol and other drugs.

在戒毒治疗中,减低伤害是一种旨在减少持续酗酒和使用其他药物所造成伤害的理念。虽然禁欲可能是减少持续酗酒和使用其他药物所造成伤害的 "黄金标准",但减低伤害认识到,对某些人来说,禁欲可能无法实现。因此,减低危害疗法被用来为继续使用酒精和其他药物的人提供医疗或心理健康治疗,提供一种在他们来到医疗机构时就能满足他们需求的护理方式。减低危害的做法接受了继续酗酒和使用其他毒品的行为,同时为传统上被边缘化的人群提供了获得医疗保健服务的机会。在这篇视角论文中,我们认为,护士在促进和利用减低伤害作为其常规实践的一部分方面所扮演的角色,对于减少酒精和其他药物的使用所造成的伤害、让使用酒精和其他药物的个人参与医疗保健服务,以及提供一种接受个人现状的方法,以建立信任和融洽关系,从而在他们准备好时,按照他们自己的节奏参与成瘾治疗,都是至关重要的。护士在医疗保健领域的作用和人数(全球约 2800 万),使其成为在实践中实施减低伤害的理想场所,从而为酗酒和使用其他药物的个人带来更好的结果。
{"title":"Harm Reduction as a Form of ‘Wrap-Around’ Care: The Nursing Role","authors":"Marissa D. Abram,&nbsp;Adrian Jugdoyal,&nbsp;Paulo Seabra,&nbsp;Dana Murphy-Parker,&nbsp;Adam Searby","doi":"10.1111/inm.13436","DOIUrl":"10.1111/inm.13436","url":null,"abstract":"<p>In addiction treatment, harm reduction is a philosophy that aims to reduce the harms from ongoing alcohol and other drug use. Although abstinence may be the ‘gold standard’ in reducing harm from ongoing alcohol and other drug use, harm reduction recognises that abstinence may not be achievable for certain individuals. Accordingly, harm reduction is used to enable medical or mental health treatment for individuals who continue to use alcohol and other drugs, providing a form of care which meets individuals where they present to healthcare facilities. Harm reduction accepts ongoing alcohol and other drug use, while providing a traditionally marginalised cohort of individuals access to healthcare services. In this perspective paper, we argue that the role of nurses in promoting and utilising harm reduction as part of their regular practice is essential to both reducing harm from alcohol and other drug use, engaging individuals who use alcohol and other drugs in healthcare services, and providing a means to accept individuals as they are to build trust and rapport for engagement in addiction treatment when they are ready, and at their own pace. Nurses, by virtue of their role and number in the healthcare landscape (approximately 28 million globally), are ideally placed to implement harm reduction in their practice to achieve better outcomes for individuals who use alcohol and other drugs.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
‘I Can't See Myself Seeking Help’: The Influence of Clinical Placements on Nursing Students' Stigmatising Beliefs and Intentions to Seek Help for Their Own Mental Health Issues: A Prospective Cohort Study 我看不到自己会寻求帮助":临床实习对护理专业学生的污名化信念以及为自身心理健康问题寻求帮助的意愿的影响:一项前瞻性队列研究。
IF 3.6 2区 医学 Q1 NURSING Pub Date : 2024-09-20 DOI: 10.1111/inm.13429
Lorna Moxham, Michelle Roberts, Taylor Yousiph, Elissa-Kate Jay, Kelly Lewer, Georgia Robson, Peta Drury, Joanne Cordina, Suzi Villeneuve-Smith, Christopher Patterson

Mental health conditions such as anxiety, depression and psychosis represent a global health challenge. Stigma surrounding mental health continues to hinder help-seeking behaviours for people with mental illness and as this study demonstrates, nursing students as well. However, if student nurses are reluctant to seek help for mental health issues, how can others be expected to do so? This reluctance poses challenges in mental health nursing, impacting both care provision and nursing education. The present study seeks to explore the influence of traditional versus non-traditional mental health clinical placements on second-year nursing students' stigmatising beliefs and intentions to seek help for mental health issues. Employing a prospective cohort design using the TREND checklist, the study sampled second-year nursing students assigned to either traditional hospital-based or non-traditional recovery-focused mental health clinical placements. Using validated scales, stigmatising beliefs and help-seeking intentions were measured before and after the placements. Statistical analyses were conducted to assess changes in these variables over time and across placement settings. A significant impact of placement setting on help-seeking intentions was observed, with students in non-traditional placements showing an increased willingness to seek help. Additionally, non-traditional placements were found to significantly reduce stigmatising beliefs in all measured domains, suggesting that these settings may provide a more conducive environment for fostering positive attitudes towards mental health. Recovery-focused placements appear to offer experiences that can diminish stigma and encourage more positive perceptions and intentions related to mental health support.

焦虑、抑郁和精神病等精神疾病是一项全球性的健康挑战。围绕心理健康的耻辱感继续阻碍着心理疾病患者的求助行为,正如本研究所示,也阻碍着护理专业学生的求助行为。然而,如果护士学生不愿意为心理健康问题寻求帮助,又怎能指望其他人会这样做呢?这种不情愿给心理健康护理工作带来了挑战,对护理服务的提供和护理教育都产生了影响。本研究旨在探讨传统与非传统心理健康临床实习对护理专业二年级学生的污名化信念和心理健康问题求助意愿的影响。本研究采用前瞻性队列设计,使用 TREND 检查表,抽样调查了被分配到传统的以医院为基础或非传统的以康复为重点的心理健康临床实习的二年级护理学生。使用经过验证的量表,对实习前后的鄙视信念和求助意向进行了测量。我们进行了统计分析,以评估这些变量随时间和安置环境的变化。观察发现,实习环境对求助意愿有重大影响,在非传统实习环境中,学生的求助意愿有所提高。此外,研究还发现,非传统性实习能显著减少所有测量领域中的鄙视信念,这表明这些实习环境能为培养学生对心理健康的积极态度提供更有利的环境。以康复为重点的安置似乎提供了可以减少污名化的体验,并鼓励与心理健康支持相关的更积极的观念和意向。
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引用次数: 0
‘I Don't Know How to Live Real Life Sober’—Identifying Needed Supports Through the Voices of Pregnant and Parenting People Seeking Recovery 我不知道如何清醒地过真正的生活"--通过寻求康复的孕妇和为人父母者的声音确定所需的支持。
IF 3.6 2区 医学 Q1 NURSING Pub Date : 2024-09-20 DOI: 10.1111/inm.13426
Phyllis Raynor, Cynthia F. Corbett, Delia West, Constance Guille, Kacey Eichelberger, Alain Litwin, Ronald Prinz

Pregnant and parenting people (PPP) experience complex challenges when seeking recovery from substance use disorders (SUD). Using a community-based participatory research approach, researchers partnered with PPP seeking recovery from SUD to explore supports needed in their communities. Findings are reported in adherence with the consolidated criteria for reporting qualitative research. Thirty PPP were recruited from a residential drug recovery facility in the Southeastern United States. Participant interviews were conducted in-person or virtually. PPP were asked to identify existing and needed parenting and recovery supports in their communities. Interviews were transcribed, verified for accuracy and coded using NVIVO software. Thematic analysis was framed by the Substance Abuse and Mental Health Services Administration (SAMHSA) eight dimensions of wellness, which reflect wellness standards across life domains. Participants identified internal and external challenges including feelings of guilt and shame, treatment access issues, lack of recovery support, grief and loss and inadequate instrumental support. Needed supports were broadly categorised as parenting resources, childcare resources, housing supports, recovery supports, occupational training and assistance and spirituality resources, and then evaluated and sorted based on appropriate fit within the SAMHSA's eight dimensions of wellness. Highest perceived needs fit within Intellectual, Emotional, Spiritual and Environmental wellness dimensions, respectively. Healthcare providers promoting recovery for PPP should focus on support needs within SAMHSA's dimensions of wellness and develop strategies that address the full range of these critical wellness dimensions. Intellectual, emotional and tangible environmental supports including parenting and recovery skills training, accessible mental health care and residential housing with childcare availability are essential for long-term recovery and positive parenting.

孕妇和养育子女者(PPP)在寻求从药物使用障碍(SUD)中康复时,会遇到复杂的挑战。研究人员采用以社区为基础的参与式研究方法,与寻求从药物滥用障碍 (SUD) 中康复的 PPP 合作,探索他们所在社区所需的支持。研究结果按照定性研究的综合报告标准进行报告。研究人员从美国东南部的一家住院戒毒机构招募了 30 名 PPP。对参与者的访谈以面对面或虚拟的方式进行。要求 PPP 确定其所在社区现有的和需要的育儿和康复支持。访谈内容通过 NVIVO 软件进行转录、准确性验证和编码。主题分析以美国药物滥用和心理健康服务管理局 (SAMHSA) 的八个健康维度为框架,这八个维度反映了各生活领域的健康标准。参与者指出了内部和外部的挑战,包括内疚感和羞耻感、治疗机会问题、缺乏康复支持、悲伤和失落以及工具支持不足。所需的支持大致分为养育资源、儿童保育资源、住房支持、康复支持、职业培训和援助以及精神资源,然后根据是否符合美国卫生与健康协会的八个健康维度进行评估和分类。感知到的最高需求分别符合智力、情感、精神和环境健康维度。促进 PPP 恢复的医疗服务提供者应重点关注 SAMHSA 健康维度中的支持需求,并制定策略来全面解决这些关键健康维度的问题。智力、情感和有形的环境支持,包括养育子女和康复技能培训、可获得的心理健康护理和提供托儿服务的住宅,对于长期康复和积极养育子女至关重要。
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引用次数: 0
National Implementation of a Crisis Resolution Home Treatment (CRHT) Team in Malta: Insights From the First Two Years of Operation 马耳他危机解决家庭治疗(CRHT)小组的全国性实施:马耳他危机解决家庭治疗小组的全国性实施:头两年运作的启示》。
IF 3.6 2区 医学 Q1 NURSING Pub Date : 2024-09-20 DOI: 10.1111/inm.13428
Francesca Sammut, Doreen Calleja, Manwel Abela, Giovanni Grech

Crisis Resolution Home Treatment (CRHT) teams have become a widespread alternative to psychiatric hospitalisation. Despite their popularisation, Malta has only recently introduced a CRHT team. The aims of the current study were to investigate (i) patient characteristics, (ii) factors influencing patients' length of follow-up (LoFU) and (iii) predictors of clinical outcomes. Descriptive and quantitative non-identifiable data were collected and analysed for patients utilising the CRHT service within its first 2 years of operation (n = 643). One-way ANOVA tests investigated influencing factors for LoFU, whereas binary logistic regressions deduced predictive factors for clinical outcomes. Patients without acute psychiatric disorders had the shortest LoFU, indicating that the team received inappropriate referrals. Patients were most likely to have extended LoFU if they were diagnosed with OCD & related disorders and were most likely to be diagnosed with an underlying personality disorder if they were diagnosed with anxiety & phobic disorders. Continuity of care facilitates discharge planning. Patients receiving the CRHT service in Malta are most comparable with health systems that prefer to hospitalise patients with a higher risk profile. The high occurrence of personality disorders necessitates staff to have interdisciplinary knowledge and an appropriate skill mix.

危机解决家庭治疗(CRHT)小组已成为精神病住院治疗的一种普遍替代方式。尽管危机排解家庭治疗小组已得到普及,但马耳他直到最近才引入该小组。本研究旨在调查 (i) 患者特征,(ii) 影响患者随访时间(LoFU)的因素,以及 (iii) 临床结果的预测因素。研究收集并分析了在 CRHT 运营头两年内使用该服务的患者(n = 643)的描述性和不可识别的定量数据。单因素方差分析检验调查了影响LoFU的因素,而二元逻辑回归则推导出了临床结果的预测因素。没有急性精神障碍的患者的LoFU最短,这表明该团队收到了不适当的转诊。如果患者被诊断为强迫症及相关障碍,则最有可能延长LoFU;如果患者被诊断为焦虑症及恐惧症,则最有可能被诊断为潜在的人格障碍。持续护理有助于制定出院计划。在马耳他,接受 CRHT 服务的患者与那些更倾向于将风险较高的患者送入医院治疗的医疗系统最为相似。人格障碍的高发率要求工作人员具备跨学科知识和适当的技能组合。
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引用次数: 0
Being Open to a Process of Learning: The Meaning of Joint Activities With Patients as Narrated by Nursing Staff in Psychiatric Inpatient Care 对学习过程持开放态度:精神病住院护理中护理人员讲述的与患者共同活动的意义》。
IF 3.6 2区 医学 Q1 NURSING Pub Date : 2024-09-20 DOI: 10.1111/inm.13431
Andreas Glantz, Lena Wiklund Gustin, Ingeborg Nilsson, Anna Westerlund, Jenny Molin

Forming therapeutic relationships is considered important within psychiatric and mental health nursing. One way of achieving this is through social interaction when engaging in joint activities. However, introducing and using nursing interventions based on joint activities in psychiatric inpatient care has proven challenging. Since staff motivation is important, researching the meaning of engaging in joint activities from the nursing professional's point of view can provide information that is relevant in this area. This study aims to illuminate the meaning of participating in joint activities with patients as narrated by nursing professionals in psychiatric inpatient care. Narrative interviews with 14 nursing professionals with experience from psychiatric inpatient care were conducted. Data were analysed using phenomenological hermeneutics and reported following the consolidated criteria for reporting qualitative research (COREQ) guidelines. Results illuminate that engaging in joint activities means being open to a process of learning. Four themes contributed to this understanding: Struggling with uncertainty, discovering aspects of the other, unfolding paths to self-fulfilment and sharing personhood. Being open to a process of learning means being willing to face uncertainty when engaging in activities as well as being open to learning about oneself as well as the other. Through openness to this process of learning, a sharing of personhood can be achieved, where the nursing professional and the patient approach becoming two persons. Illuminating the meaning of joint activities from the nursing professionals' perspective may provide valuable insights related to introducing and using interventions focusing on joint activities.

在精神科和心理健康护理工作中,建立治疗关系非常重要。实现这一目标的方法之一是在开展联合活动时进行社交互动。然而,在精神病住院护理中引入和使用基于联合活动的护理干预措施已被证明具有挑战性。由于员工的积极性非常重要,因此从护理专业人员的角度研究参与联合活动的意义,可以为这一领域提供相关信息。本研究旨在通过精神病住院护理中护理专业人员的叙述,阐明与患者共同参与活动的意义。研究人员对 14 名具有精神病住院护理经验的护理专业人员进行了叙述式访谈。采用现象学诠释学对数据进行了分析,并根据定性研究报告综合标准(COREQ)指南进行了报告。结果表明,参与联合活动意味着对学习过程持开放态度。四个主题促成了这一认识:在不确定性中挣扎、发现他人的方方面面、展开自我实现之路和分享人格。对学习过程持开放态度意味着在参与活动时愿意面对不确定性,以及对学习自己和他人持开放态度。通过对这一学习过程的开放,可以实现人格共享,使护理专业人员和患者接近成为两个人。从护理专业人员的角度阐明共同活动的意义,可为引入和使用以共同活动为重点的干预措施提供有价值的见解。
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引用次数: 0
Sir Henry Parkes and the Relationships That Enabled Nightingale Nursing to Advance Mental Healthcare in Nineteenth Century Australia 亨利-帕克斯爵士和使南丁格尔护理学在十九世纪的澳大利亚推动心理保健的关系。
IF 3.6 2区 医学 Q1 NURSING Pub Date : 2024-09-20 DOI: 10.1111/inm.13430
Toby Raeburn, Paul McDonald, Sophie Schapiro, Rebecca O'Reilly

This position paper explores famous colonial Australian politician Sir Henry Parkes use of relationships to reform colonial Australian mental healthcare by facilitating the integration of Nightingale-trained nurses into hospitals for the insane in the late nineteenth century. A review of historical sources including primary documents reveals that Parkes exhibited astute political skill by developing relationships with influential healthcare leaders such as Florence Nightingale, Lucy Osburn and Dr. Frederic Norton Manning. As Parkes cultivated friendships with such people, he was able to sow seeds for the deployment of Nightingale nurses including two members from the original group of six nurses sent by Nightingale to Australia in 1868, as well as three nurses trained under their supervision (probationers) into hospitals for the insane. This historical account provides evidence that enables current-day nurses to understand ways in which events of the past have contributed to the development of present-day mental health services and systems. Parkes' legacy also encourages contemporary nurses who are interested in change to consider the importance of forging diverse strategic relationships to bring their own visions into reality.

本立场文件探讨了澳大利亚殖民地时期著名政治家亨利-帕克斯爵士(Sir Henry Parkes)如何利用各种关系来改革澳大利亚殖民地时期的精神医疗保健,在 19 世纪晚期推动将南丁格尔培训的护士纳入精神病院。对包括原始文件在内的历史资料的回顾显示,帕克斯通过与弗洛伦斯-南丁格尔、露西-奥斯本和弗雷德里克-诺顿-曼宁博士等有影响力的医疗保健领袖发展关系,展现了精明的政治技巧。由于 Parkes 与这些人建立了友谊,因此他能够为派遣南丁格尔护士播下种子,其中包括南丁格尔于 1868 年派往澳大利亚的最初六名护士中的两名成员,以及在他们的监督下培训到精神病院的三名护士(见习护士)。这段历史提供了证据,使当今的护士能够了解过去的事件如何促进了当今心理健康服务和系统的发展。帕克斯的遗产还鼓励当代有志于变革的护士考虑建立多元化战略关系的重要性,从而将自己的愿景变为现实。
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International Journal of Mental Health Nursing
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