Issues in Mental Health Nursing最新文献

Staff members working in mental health settings may experience stigmatising attitudes towards individuals with a personality disorder diagnosis. Little is known about how such attitudes may be modified or improved. The purpose of the current study was to investigate the impact of a written psychological formulation on attitudes towards an individual with a diagnosis of personality disorder. The current study had an experimental, vignette-based, between-subjects design and utilised online survey approach. Multidisciplinary staff members (n = 141) from two large mental health trusts in the East of England took part in the study being randomly assigned to either the formulation or Non-formulation condition. Both groups read a short extract about the same fictitious patient. Participants in the formulation condition also read a psychological formulation regarding the patient's presenting difficulties. Attitudes and causal attributions were compared between the two groups. The results of the study suggest that the addition of a psychological formulation, at least one structured along the lines of the 5-P's framework, did not significantly alter participants' attitudes towards the individual within the vignette in most domains measured. One domain of the Causal Attributions measure ('Stability') showed a change in the direction of increased stigma.

Digital technologies are increasingly integrated into psychiatric nursing, yet a comprehensive understanding of their implementation and effectiveness remains limited. This bibliometric analysis explored the research landscape of digitally-supported interventions, focusing on models, effectiveness, and future directions. A systematic search of the Web of Science Core Collection (2019-2024) was conducted, combining bibliometric mapping with thematic analysis. Four thematic clusters emerged: (1) Digital Psychiatry and m-Health Applications, (2) Simulation and VR in Nursing Education, (3) Telemedicine and Mental Health in the COVID-19 Era, and (4) Foundational Concepts of Digital Mental Health. m-Health applications were central themes, while telemedicine's role was crucial during the pandemic. The study highlights the importance of digital technologies, especially m-health, in psychiatric nursing and underscores the need to enhance nurses' digital skills and develop effective nurse-led interventions. The analysis also identifies critical research gaps concerning clinically meaningful outcomes, cost-effectiveness, transferability, and patient/provider experiences. These findings provide a roadmap for future investigations to improve patient care.

Interprofessional communication is fundamental in healthcare, particularly where patient needs demand coordination and shared understanding. It fosters role clarity, care coordination, and team cohesion. However, unclear hierarchies, heavy workloads, and interpersonal conflicts can disrupt collaboration, affecting professional relationships and patient outcomes. This study explores experiences of and reflections on prerequisites for and barriers to interprofessional communication in psychiatric outpatient settings. While previous research has described barriers, few studies have examined how communication itself constitutes professional roles, boundaries, and collaborative practices. To address this gap, the study applies the Four Flows framework-membership negotiation, self-structuring, activity coordination, and institutional positioning-as an interpretive lens. Using vignettes and semi-structured interviews with 11 clinicians in psychiatric outpatient units, the study analyzed how communication shapes and is shaped by interprofessional collaboration. Analysis identified four key categories: systemic barriers and organizational challenges; social dynamics and interprofessional relationships; supportive leadership and team culture; and patient focus and involvement. These categories intersect across the Four Flows, illustrating how communication acts as a structuring process rather than a neutral tool. The overarching theme," From Separate Paths to Shared Care," highlights how clinicians enact person-centered collaboration through communicative practice in psychiatric outpatient settings.

Understanding the drivers of seclusion and physical restraint supports the work towards minimising their use in acute mental health units. However, evidence on their most important drivers remains limited and is focused mainly on individual-level features. Employing 249 days of 917 contemporaneous records of nurse de-escalation events in one adult inpatient unit in regional Australia, from January 2019 to March 2020, twenty-three features other than individual demographic, dispositional, and diagnostic factors were extracted. Bivariate statistics and supervised machine learning algorithms for feature selection (i.e. Boruta algorithm) and predictive modelling (i.e. random forest) were applied. Emerging top drivers include incidents in high observation beds, the assessed level of situational aggression before de-escalation, incidents directed towards nurses, verbal de-escalation, and distraction and redirection. These findings elevate the predictive value of contextual and interventional, rather than individual-level, features in understanding the likelihood of restrictive practices.

Stimulant use disorder (methamphetamine) represents a significant challenge in correctional settings, where over 40% of incarcerated individuals may be affected. Despite limited access to evidence-based treatments, psychiatric nurses are uniquely positioned to deliver psychosocial interventions. This randomized controlled trial evaluated an 8-week nurse-led cognitive behavioural therapy intervention among 72 incarcerated men with stimulant use disorder (methamphetamine) in Turkey. Participants were randomly assigned to receive either the nurse-led intervention consisting of eight sessions addressing cognitive restructuring, craving management, stress coping, and relapse prevention, or treatment as usual. The Substance Craving Scale and Stress Coping Scale were administered at baseline and post-intervention. Results demonstrated significant improvements in the experimental group, with a 38.5% reduction in craving intensity and 26.7% improvement in overall stress coping strategies. All three coping domains showed significant gains: social support seeking increased 34.1%, problem-focused coping 16.1%, and adaptive avoidance 33.7%. Effect sizes were large for stress coping and medium for craving reduction. These findings support the effectiveness of nurse-led psychosocial interventions in correctional settings and highlight the potential for psychiatric nurses to address substance use disorders among incarcerated populations, even in resource-limited environments.

Introduction: Recovery for people with lived experience (PLE) involves living a meaningful life within the community despite the limitations imposed by mental disorders. However, recovery can be hindered by factors beyond the symptoms themselves, including the stigmatising attitudes and behaviours of community members. Gaining a comprehensive understanding of these hindrances is essential for informing effective preventive strategies that can be implemented by caregivers and healthcare professionals. Despite its importance, limited research has explored the factors that impede recovery from a shared perspective of PLEs, caregivers, and nurses-highlighting a critical gap in the literature.

Aim: This study explores PLEs, caregivers and registered nurses' sharing perspectives on factors hindering recovery in the collectivist society of Saudi Arabia.

Method: An exploratory descriptive qualitative methodology was employed using in-depth semi-structured interviews with 16 PLEs, 10 caregivers and eight registered nurses and inductive thematic analysis of the data.

Findings: Society stigma, broken family bonding, unempathetic behaviours and toxic positivity were identified as factors hindering PLEs' recovery, leading them to adopt behaviours to protect their mental wellbeing.

Discussion: Regardless of the origins of stigma, resisting and protesting it may indicate that PLE overcame barriers to recovery.

Recommendations: Future research should investigate the implementation of recovery-oriented language. Studies should explore the concept of toxic positivity among PLE and their caregivers. Global mental healthcare systems should establish and sustain a trauma-informed care to mitigate negative effects of factors hindering recovery. The consolidated criteria for reporting qualitative studies' 32-item checklist was followed in this study.