Issues in Mental Health Nursing最新文献

Mental health, encompassing self-esteem, confidence, physical activity, and social interaction, is essential for the well-being of children and adolescents and supports executive functions crucial for school performance. Mental ill health among young people is increasing in Sweden, with rising rates of self-reported problems, psychiatric diagnoses, and prescriptions of psychotropic medication. The aim of this study was to explore the experiences of equine-assisted interventions (EAI) among children and adolescents with anxiety-related mental ill health in southern Sweden. A qualitative design using reflexive thematic analysis was employed. Participation in an equine-assisted intervention was experienced as fostering a sense of "being good enough." The findings were presented through three interrelated themes. Participants described how a non-demanding, stress-free environment promoted relaxation and emotional safety. Interaction with the horse supported experiences of inner harmony, emotional regulation, and increased confidence. Participants also reported feeling more competent and authentic in managing everyday situations. These experiences developed gradually through interconnected aspects of the intervention rather than as a single outcome. Participation in EAI was experienced as providing a safe and supportive environment that promoted emotional regulation, confidence, and a sense of competence among youth.

Suicide prevention represents a critical opportunity for nursing practice, policy, and research to advance a more cohesive and proactive model of care. Many individuals who attempt or die by suicide have had recent contact with healthcare services but were not adequately assessed for suicide risk, underscoring the importance of early identification through brief, validated screening tools such as the ASQ and C-SSRS. Implementing universal screening promotes consistent assessment across clinical settings, reducing missed opportunities for intervention in emergency, inpatient, and outpatient care. However, national data reveal substantial variability in screening practices, driven by workflow constraints, limited training, and unclear policy guidance, highlighting the need for greater standardization. As the largest and most patient-facing segment of the healthcare workforce, nurses are uniquely positioned to lead suicide prevention efforts. Through strong nursing leadership, screening protocols can be integrated into routine care, documentation processes streamlined, and clear pathways for escalation and follow-up established. Standardized approaches support both clinicians and patients by supporting shared responsibility for suicide care across healthcare systems while honouring patient autonomy, lived experience, and the complex role that suicidal thoughts may play in coping with psychological pain. Aligning policy, practice, and research is essential to advancing a cohesive, preventative framework that strengthens patient safety and ensures individuals at risk are identified and supported before reaching crisis points.

To investigate factors associated with medication adherence among young patients experiencing their first episode of major depressive disorder (MDD). A total of 512 patients were prospectively enrolled and tracked by adherence for 30 days using the Medication Event Monitoring System (MEMS). Socio-demographic factors, clinical variables, and patient-reported rating scores were analyzed using a binary logistic regression model. About 69.3% of cases achieved MEMS adherence. Patients with ≥1 hospital readmission for exacerbation, drug concentration beyond the recommended therapeutic range, and severe side effects had an increased risk of low adherence. Older age, higher self-stigma scores, and negative drug attitude were the positive predictors. A prognostic index > 0.800 was at high-risk of developing low adherence. A formula was established for evaluating clinical risk to improve medication adherence among young MDDs.

Eating disorders have the highest mortality risks compared to other psychiatric disorders. Since the Covid-19 pandemic, the number of young people diagnosed with an eating disorder has rapidly increased and has led to increased referrals and longer admissions to inpatient services. To improve treatment success and rates of remission it is vital to undertake further qualitative exploration of patient journeys to understand their experience. This study co-designed and conducted semi-structured interviews with YP with EDs and their parents/carers to explore the key factors driving referrals to inpatient services to help inform future research and impact on admission rates. This study conducted a thematic analysis utilising Braun and Clarke's six stage model exploring why some young people are referred for admission to inpatient services across three sites across England, comprising two NHS trusts. In total, 13 interviews were conducted (n = 7 parents, n = 6 young people). A wide range of multifaceted factors contributing to inpatient admission referral were identified. The most prominent being 'Preceding and Precipitating Factors', 'Start of Treatment Journey', 'Eating Disorder Symptoms', 'Impact', 'Community CAMHS Support', 'Hospital Admissions' and 'Resilience'. These encompassed various significant subthemes. Although inpatient services can be life‑saving for young people with eating disorders, they are also frequently described as traumatic and associated with lasting consequences, making it essential to understand the factors that contribute to requiring inpatient care in the first place. Findings suggest reasons for referral to an inpatient unit are multifaceted and that we must collaborate with those with lived experience to create system wide change to improve treatment journeys.

Moral distress (MD) and moral injury (MI) are potential consequences of military service among veterans. They can be manifested as deep emotional, psychological, and spiritual wounds that are difficult to heal. These deep wounds can go unrecognized because managing specific psychological symptoms can obscure the broader moral and spiritual wounds veterans carry after serving in combat. This paper discusses MD and MI clinical implications for nurses in all specialties and levels or care, but especially for mental health nurses. This paper also explores veterans' psychological and behavioral manifestations of MD and MIy, examines the impact of these conditions, and identifies nursing strategies that foster moral repair. Additionally, it calls for policy initiatives to empower nurses in delivering holistic, veteran-centered care and promote moral healing.

This study examined how sibling dyads in families with a parent diagnosed with bipolar disorder navigate shared adversity and develop interconnected lived experience orientations toward parental mental illness. A qualitative secondary analysis of narrative inquiry data was conducted using semi-structured interviews with four sibling dyads (seven females and one male, aged 20-32). Guided by narrative inquiry principles and the SHARE framework, the analysis examined seven dimensions: life focus, emotions toward family, coping with parental mental illness, supporting family, perceived gains and losses, perceptions of siblings, and perceptions of sibling relationships. Two interrelated orientations were identified. Family-oriented experiences involved emotional closeness, caregiving engagement, and active illness management, whereas individual-oriented experiences emphasized autonomy, self-protection, and career development, often expressed through financial or practical support. Across families, siblings assumed complementary roles and dynamically negotiated closeness and distance to sustain family balance and personal adaptation, reflecting an interplay between emotional connection and independence. These findings underscore the importance of assessing sibling dynamics in psychiatric settings, particularly how differentiated orientations shape caregiving roles, emotional regulation, and relational boundaries among adult children of parents with bipolar disorder. They further suggest that family-centered psychoeducation should address sibling-specific roles to support adaptive communication and role negotiation. For mental health nurses, integrating sibling- and family-oriented perspectives into assessment and care planning may facilitate more relationally attuned, developmentally sensitive support. By foregrounding sibling dyads as an underexamined unit of analysis, this study advances nursing practice and identifies directions for future sibling-focused research across diverse family and cultural contexts.

Bullying, harassment, and other negative workplace behaviours are unfortunately all too common in nursing. In this discursive paper, we illuminate the darker side of nursing by summarising prominent negative behaviours in nursing academia, exploring their causes, and considering the weaponisation of complaints as a covert form of bullying. Informed by published peer-reviewed literature on bullying in nursing, bullying in academia, organisational justice, workplace fairness, complaints processes, and weaponisation, as well as specific negative workplace behaviours, we report on how nursing academia shapes professional culture and patient care, yet negative workplace behaviours persist. Weaponised complaints perpetuate bullying in nursing academia, harming academics' wellbeing and reputations while undermining universities' credibility. Such practices damage organisational culture and risk graduating nurses into environments where harm is normalised, ultimately undermining the profession's commitment to safe practice. Addressing weaponised complaints is important to protect nurse wellbeing, foster collegiality and ensure nursing students inherit cultures grounded in procedural fairness, integrity and safe practice. Recognising and preventing misuse is important to safeguarding wellbeing, integrity and collegiality in nursing academia and beyond.

Introduction: In compulsory psychiatric care and forensic psychiatric care, supportive functions with independent roles have been instituted to uphold patient rights, preserve self-determination and personal integrity, work toward recovery and fulfill the obligation to ensure that individuals remain at the center of decision making. In Sweden, independent support persons (ISP) provide personal support and companionship to patients during and shortly after involuntary care. Knowledge about the ISPs experiences of the role is needed to expand and further develop the ISP role. This study aimed to illuminate ISPs experiences of their role regarding patients treated in compulsory psychiatric care and forensic psychiatric care.

Methods: The study used a qualitative design with semi structured interviews and inductive qualitative content analysis. Nine ISPs participated.

Results: ISPs experiences were reflected in the main theme Managing boundaries in a borderland, interpreted through the themes Balancing personal and professional approaches, Serving as social support and Being in the hands of staff.

Discussion: Findings highlights the important role of ISPs in mental health recovery through supportive, friendship-like relationships that promote reciprocity. ISPs help bridge social gaps, especially for those lacking networks. However, misunderstandings about their role can limit their impact.

Depression among professional truck drivers may be driven by isolation, irregular schedules, and high job demands. This systematic review identified occupational and psychosocial risk factors for depression in adult truck, heavy goods vehicle (HGV), or lorry drivers. PubMed, PsycINFO, Web of Science, and Embase were searched for observational studies assessing work or psychosocial exposures and depression via validated measures or clinical diagnosis. Screening was conducted in duplicate; data extraction was verified by a second reviewer; risk of bias was assessed using the JBI cross-sectional checklist. Because heterogeneity precluded meta-analysis, we used direction-of-effect vote counting. Seven cross-sectional studies (n = 1,591) from six countries were included; reported prevalence ranged from 13.6% to 59.1%. Consistent positive associations were found for high work demands (longer hours, tight deadlines), safety hazards in driving conditions (e.g., poor roads, accident history, distraction), and lock of occupational support (job dissatisfaction, limited supervisor support, wage-earning vs. self-employment). Psychosocial isolation (loneliness, low engagement) showed strong links to depressive symptoms. Poor sleep quality and stimulant use were associated with higher risks, while better self-rated health was protective; evidence for age and substance use was mixed. Findings highlight modifiable work and social conditions and the need for longitudinal and interventional research.