Issues in Mental Health Nursing最新文献

Introduction: Recovery-oriented approaches in mental health emphasize personal growth, agency, and meaningful community integration. While endorsed by policies and reforms, the practical implementation of such approaches remains challenging, particularly in settings like Denmark, where structural fragmentation, professional hierarchies, and resource constraints may limit the adoption of holistic recovery principles.

Methods: This qualitative study employed focus group interviews with 21 health professionals from inpatient units and Assertive Community Treatment (ACT) teams in Danish mental health services. Using inductive content analysis, we examined participants' perceptions, understandings, and experiences in implementing personal recovery-oriented practices.

Results: Four categories emerged: (1) "Creating New Control in Recovery" highlighted the importance of personal agency and collaborative care involving patients, families, and community stakeholders; (2) "Recovery-Oriented Practice within Professional Parameters" underscored efforts to balance patient preferences with clinical responsibilities; (3) "Barriers to Implementing Recovery-Oriented Practice" revealed systemic constraints, resource limitations, and emotional strain on staff; and (4) "Advocating for a Paradigm Shift towards Recovery-Oriented Approaches" emphasized the desire for interprofessional collaboration, the inclusion of peer workers, and structural reforms.

Discussion/conclusion: The findings demonstrate that while Danish health professionals recognize the value of personal recovery-oriented care, their capacity to realize this approach is constrained by organizational structures, professional hierarchies, and limited resources. Strengthening systemic support, enhancing interprofessional collaboration, and integrating peer expertise are critical to fostering more equitable, person-centered mental health services. These insights contribute to a nuanced understanding of recovery-oriented implementation in European contexts and may inform strategies that better support professionals and service users in achieving sustained, meaningful recovery.

While the connection between risk factors and suicidality (suicide attempts and ideation) and physical self-harm is well established, the preventive roles of social bonding and dietary patterns remain underexplored. This study, based on the 2021 National Ungdata Surveys in Norway among middle and high school students (N = 15,430), can provide novel and context-specific insights into comparable environments. The results indicated a 5% suicide attempt rate, 18.3% prevalence of physical self-harm, and 26.7% suicidal ideation in the sample. The prevalence was higher among girls, students with low socioeconomic status, middle schoolers, and non-religious individuals. Logistic regression models for suicide attempts showed that substance use and victimization (sexual harassment and bullying) were significant predictors of suicide attempts. Elevated depressive symptoms and the use of pain relievers increased the risk. For suicidal ideation, victimization and depressive symptoms were significant predictors. Concerning physical self-harming behavior, substance use and risky behaviors increased odds, whereas binge drinking had varying effects. Victimization variables and health measures were also significant predictors. Dietary patterns, social bonding measures, and self-motivation were found to be protective factors, as they decreased the likelihood of suicidal and self-harming behaviors, highlighting the critical role of strong social connections, healthy dietary habits, and well-being.

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.

Patient-Initiated Brief Admission (PIBA) is perceived as a constructive intervention. It remains uncertain whether PIBA contributes to healthier behaviors among its users. To comprehend patients' motivation to engage in health-promoting behaviors, it is essential to understand how various nursing interventions influence the behavior-specific thoughts and feelings that lead to healthy behaviors. By integrating the theoretical concepts within the health promotion model, we can gain a better understanding of how PIBA as an intervention impacts health-promoting behaviors. Thus, the aim of this study is to describe PIBA users' perspectives on health-promoting behaviors based on Pender's health promotion model. Data were collected through semi-structured interviews with 20 PIBA users, and analyzed through directed content analysis based on Pender's health promotion model. The results illustrate that PIBA users experienced that access to and confidence in PIBA, interpersonal support, and help building self-efficacy promoted health-related behaviors. Deficiencies in PIBA's environmental impact and high internal and external demands were conditions counteracting health-related behaviors. Thus, PIBA has the potential to promote health-related behaviors among its users. However, health professionals need to be mindful of factors that counteract health-related behaviors and should strive to minimize these for PIBA to function fully and guide patients toward healthier behaviors.

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.

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.