Issues in Mental Health Nursing最新文献

Little is known about the role of acculturation in preventing depressive symptoms among sexual minority youth. This study examined the impact of bidimensional acculturation (i.e. Americanism-adherence to mainstream cultural values and Hispanicism-adherence to heritage cultural values) on the trajectory of adolescent depressive symptoms and differences among Hispanic sexual minority youth (HSMY) and Hispanic non-SMY. We examined the trajectories of adolescent depressive symptoms and parent and adolescent acculturation across 36-months and regressed the slope of the trajectory of depressive symptoms on the slope of the trajectory of parent and adolescent Hispanicism and Americanism among the overall sample (N = 456), HSMY (n = 85; 20%), and Hispanic non-SMY (n = 339; 80.0%). For the overall sample and Hispanic non-SMY, adolescents' own Hispanicism and Americanism and parent Americanism buffered adolescent depressive symptoms. There were no significant associations between adolescent or parent Hispanicism or Americanism and HSMY depressive symptoms, however, the effect sizes for HSMY were larger than those of the overall sample and Hispanic non-SMY, suggesting that the study was underpowered to detect statistical significance with the limited sample size. Americanism and Hispanicism may mitigate depressive symptoms among Hispanic youth, speaking to the importance of biculturalism in Hispanic families.

Seclusion is a restrictive intervention used in forensic mental health care to manage service user risk of harm. It has been associated with harmful effects for service users and consensus is that its use needs to be reduced. Research has identified that factors related to nursing staff influence the use of seclusion. However, to date no research has considered staff decision-making as it relates to the seclusion process, from initiation to termination. The current aim was to address this gap in the literature. Thirteen senior nurses were recruited from a UK-based service which provided care to men and women in low and medium secure wards. Constructivist Grounded Theory was used to analyse semi-structured interviews that were conducted with participants. Analysis revealed a complex model consisting of numerous overlapping categories that contributed to seclusion decision-making. There were four main categories: cognitive, emotional, relational, and organisational, each with numerous sub-categories. Practice could be improved through using structured assessments to inform seclusion decision-making, providing consistent emotional support for staff who implement seclusion, and focusing on relational approaches to care to build effective therapeutic relationships. There were implications for the importance of organisational policy and leadership and incorporating staff-related factors into seclusion recording processes.

The stigma surrounding drug use adversely affects the health and wellbeing of people who use drugs. With projected increases in drug use in Africa over the next decade, understanding public perceptions of drug use is critical. This study explores perceptions and attitudes toward illicit drug use from the viewpoint of the families of women who use drugs. In March 2019, we conducted semi-structured interviews with 19 family members of women who use drugs in Dar es Salaam, Tanzania. The interviews included a closed-ended survey and open-ended questions about drug use attitudes. We thematically analyzed open-ended responses and summarized survey response frequencies. Three key themes emerged: (1) disapproval and stigma regarding drug use, (2) increased stigma and social consequences for women who use drugs, and (3) empathy and a call for support and intervention. Participants viewed people who use drugs negatively, associating them with danger and criminality. Women faced harsher judgment due to cultural expectations of femininity and motherhood. Despite these negative perceptions and attitudes, participants wanted to support people who use drugs, advocating for better access to treatment. Culturally tailored, gender-sensitive interventions are essential to reduce stigma and improve outcomes for these women and their families.

Background: People living with schizophrenia or schizoaffective disorder are at heightened risk for experiencing loneliness, which is associated with negative health, quality of life, and symptom-specific outcomes.

Aims: This study aimed to better understand the experience of loneliness among adults living with schizophrenia or schizoaffective disorder.

Methods: Using a semi-structured interview guide, researchers interviewed twelve participants living with schizophrenia or schizoaffective disorder. Interview topics included the contexts of loneliness, hopes related to living a life less impacted by loneliness, and coping strategies. Researchers used conventional content analysis to analyze interview data and generate themes.

Results: The research team identified four themes from the interview data: emotional disconnection, social anxiety leading to loneliness, unmet needs within social networks, and lacking companionship. Participants had a variety of hopes for the future, including increasing the quality of their relationships and improving their sense of self-efficacy. Participants described a variety of coping strategies, ranging from individual (e.g. leveraging technology, using cognitive reframing techniques) to systems-level (e.g. local clubhouses and walkable neighborhoods).

Conclusions: Participants have identified several priorities and coping strategies to reduce loneliness that can be integrated with current models of loneliness to develop interventions that are meaningful and effective for this population.

To decrease the high rates of mental health-related maternal morbidity and mortality among rural-dwelling women, it is critical to identify those experiencing postpartum depression (PPD) and provide necessary follow-up care. To effectively screen for PPD, clinicians must utilize instruments which account for context-specific factors and maintain validity across diverse populations. The Edinburgh Postnatal Depression Scale (EPDS) is the most commonly used depression screening tool in perinatal settings, but has not been validated for use within rural American settings. The aim of this study was to establish the psychometric properties of the EPDS and assess its validity for clinical use within a rural American context. In regards to construct validity, we found that a single-factor structure representing depression status was psychometrically sound and well explained by the items of the EPDS. The scale demonstrated strong criterion-related validity, where EPDS screening results were significantly correlated with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria used by providers to make differential depression diagnoses. The EPDS yielded acceptable reliability and internal consistency (Cronbach's alpha = 0.90) in measuring depression status among our rural-dwelling sample. This is the first study establishing validity of a PPD screening tool within a rural U.S. population.

Background: Mental illness is among the most common health conditions in the U.S., yet clients needing mental health services such as psychotherapy may not be able to receive these services because of mental health providers such as psychiatric/mental health nurse practitioners (PMHNPs). PMHNP students could be used as future clinicians to address this gap. However, little is known about PMHNP students' attitudes, knowledge, and modality preferences for providing psychotherapy.

Aims: The purpose of this study was to qualitatively assess how PMHNP students' attitudes, knowledge, and modality preferences may change after educational exposure to this content in theories and modalities of psychotherapy course in a post-master's PMHNP program.

Methods: A qualitative description design was used to collect data from formal writing assignments of 33 PMHNP students at the beginning and end of a one-semester course on theories and psychotherapy modalities. Responses were analyzed to form themes and categories while maintaining qualitative rigor.

Results: Attitudes, knowledge, and preferred psychotherapeutic modalities changed from the beginning of the course when compared to the end. An increase in comfort, knowledge, and the preferred number of modalities increased both qualitatively and quantitatively throughout the course.

Conclusions: Providing psychotherapy is an essential skill that is an important component of PMHNP education. More research is needed to learn the most efficient ways to increase attitudes, knowledge, and preferred modality. PMHNP faculty should encourage students to develop and refine beginning competency in psychotherapy during PMHNP educational programs.

Nursing students, faculty, and community partners report a gap in the preparation of nurses to work collaboratively with persons living with mental health conditions in a variety of healthcare settings. Engaging the expertise from lived experience within undergraduate nursing education promotes a holistic approach to care that aligns with clients' real-world needs. This paper describes the steps we followed to create a virtual simulation in partnership with persons living with mental health conditions. In 4 months, a team with diverse expertise worked together to develop an open-access virtual simulation module. The process resulted in a quality product that was worth the time invested. Of importance to our team, this development project resulted in a meaningful and authentic person-centred simulation. This virtual simulation is a tool to provide scalable and meaningful experiential learning in a safe environment for students and nurses.