Issues in Mental Health Nursing最新文献

Intimate partner violence (IPV) against women is widely recognized as a significant global problem, a major public health issue in the United States, and one of the most widespread violations of human rights. Recent research has noted that non-fatal strangulation (NFS) has been a significantly overlooked indicator and by-product for victims of IPV and often may be undisclosed or can be confounded with other mental health symptoms; for example, those that are common with conditions seen in psychiatric facilities. Traumatic brain injury (TBI) and nonfatal strangulation are often unrecognized forms of IPV and can lead to significant short and long-term neurologic sequelae. It is possible that some mental health disturbances and anxiety symptoms may be better explained as a medical consequence of TBI and repeated NFS-or a signal of homeostatic disruption. In such cases, providing psychopharmacological treatment might help the patient with the symptoms, but will not address the underlying cause. This reinforces the critical need for mental health nurses to not only assess for IPV, but simultaneously screen for TBI-related neurological disorders and injuries, including recent and/or past unconsciousness, and facilitate linkage to IPV interventions and mental health treatment.

Non-adherence to antipsychotic medications is a commonly recognized problem that can lead to lack of follow-up for patients with schizophrenia spectrum disorders, increasing risk for psychotic symptoms, hospitalizations, and decreased quality of life. We conducted a secondary data analysis of electronic health record data of patients with schizophrenia spectrum disorders (n = 1,341) in Central Florida to explore relationships between geographic access to mental healthcare facilities, socioeconomic factors, and follow-up visits, and whether these conditions contributed to adherence over 1 years' time. Using Geographic Information Systems among six mental health facilities, spatial analysis and logistic regression indicated that patients had 27.9% increased odds (p = 0.02) of adherence to treatment when travel time to facilities was 30 min or less. Spatial autocorrelation revealed significant positive clusters in areas with low travel time (15 min or less). Patients who had Medicaid, a case manager and/or a life skills coach, medication side effects, a substance use disorders history, and/or closer proximity to mental healthcare services, had an increased likelihood of attending four or more follow-up visits in 1 year. Identifying effects of spatial and non-spatial variables on non-adherence to treatment can provide useful insights for developing targeted interventions to improve treatment outcomes.

Transitioning from child to adult services is a significant event for young adults. The study aimed to explore the experiences of young adults who transitioned from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in Ireland. Semi-structured interviews were conducted with six young adults and analysed according to interpretative phenomenological analysis. Interpretations were subsequently viewed through the lens of transition theory. Findings indicate that the transition presents major challenges for young adults and can cause a deterioration in mental health, in the context of multiple concurrent life transitions, discontinuity of care, a dramatic culture shift in AMHS, and experiences of impersonal care. Participants expressed their view that AMHS clinicians did not know how to approach their treatment due to a lack of available options or diagnosis-specific expertise, leading these individuals to question the validity of their suffering; this is a novel finding in the context of previous transition research. The utility of transition theory in developing a CAMHS-AMHS transition framework is demonstrated.

Police officers are increasingly tasked with responding to people in crisis (PIC), often resulting in transfers to emergency departments (EDs) where they can encounter challenges like long wait times, safety concerns, and conflicting perspectives between the medical and legal systems. This qualitative study explores the experiences of police officers during the transfer of PIC to ED nurses and staff. Eleven police officers were recruited and interviewed, providing contextual information about ED transfers in the greater Montreal area. The findings revealed that police officers face varied challenges in transferring PIC to different EDs, influenced by each hospital's unique characteristics, staffing, security, and organizational issues. Relationships with nurses significantly impact these experiences, ranging from positive interactions to tension and conflict influenced by staff biases and differing perceptions of the PIC. Effective communication between police and ED nurses is critical for accurate clinical evaluation and decision-making, yet often hindered by inconsistent information transfer and procedural gaps. Role confusion, divergent philosophies between police officers and ED nurses, and 'grey zones' further complicate transfers, emphasizing the need for clear communication and mutual understanding to ensure safe and effective care. The results underscore the need to ameliorate ED transfers through enhanced joint training for police officers and nurses, establishing hospital-precinct committees, and other intersectoral initiatives to promote collaboration. Such measures are essential to ensure effective and compassionate care of people in crisis while prioritizing safety for all involved.

Despite a global drive to improve staff well-being in healthcare, distress and absenteeism continue to persist, posing consequences for patient care and organisational functioning. Current research and subsequent strategies implemented to remediate such problems have primarily focused on occupational experiences, disregarding the contribution of problems occurring outside of the workplace. The current study sought to establish the prevalence of work and non-work problems, and their respective impacts on several well-being outcomes, in this occupational group. Secondary analysis of data from a cross-sectional survey of 323 staff in a secure UK mental healthcare organisation was conducted. Exposure to non-work problems was pervasive across the sample (79.3%). Demographic discrepancies in exposure to types of problems were apparent, though number of problems reported was comparable across the sample. Number of non-work problems was a significant predictor of depression, anxiety, functional impairment, and complex post-traumatic stress disorder symptoms, when controlling for exposure to work problems. The findings implicate the need for a broader conceptualisation of distress in secure mental healthcare staff, who typically report exposure to several non-work problems, in the context of occupational challenges. Policy, practice and service implications are discussed, with consideration for the availability and modality of support offered to staff.

Aim: To determine the acceptability of targeted apps and provide recommendations for the implementation of and app addressing high risk alcohol use to nurses.

Design: A qualitative descriptive study design, using the Behavioural Change Wheel implementation framework.

Methods: Semi-structured interviews with 42 Australian nurses were subject to structural coding using the Capability, Opportunity, and Motivation (COM-B) model linked to the Behaviour Change Wheel. Qualitative data has been reported using the COREQ framework.

Results: Most participants agreed that targeted apps would appeal to nurses, provided specific design considerations were included. These considerations related to privacy and confidentiality, strategies to target the app to nurses across wide age and experience ranges and identified the need for a considered campaign to both launch the app and position it with existing interventions for high-risk alcohol use.

Conclusions: Our findings indicate that a targeted app to reduce high-risk alcohol consumption could be acceptable to nurses, however the needs to include specific components suitable for nurses. We recommend further research into specific components of a targeted app, leading to a co-design process where nurses can determine app components and function. Summary of relevanceHigh-risk alcohol consumption has been shown to be an issue amongst nurses.Targeted apps have been shown to have an effect in addressing high-risk alcohol consumption among specific groups.However, consideration for privacy of data provided to the app must be considered, especially given the link between disciplinary action, loss of role identity, and nurse suicide.This paper indicates that nurses would accept a targeted app, subject to specific design considerations, particularly related to confidentiality.

Autistic children and adolescents experience a range of co-morbidities, including diagnoses of mental illness. Animal-assisted therapies have advanced rapidly over recent years as an effective and accessible intervention for autistic children and adolescents with various health issues. Horses offer a unique opportunity for interaction as the young person can physically ride the animal, thus creating a therapy with different physical interactions from other animals. This qualitative study had two main aims: first, to understand parents' experiences of their autistic child's involvement with horse-based therapies; and second, to understand the experiences of the staff of organisations offering horse-based therapies to those on the autism spectrum. Twelve interviews were conducted with six parents across four interviews (four mothers and two fathers), and eight staff of equine therapy services in eight individual interviews, to understand their perceptions of the child's experience with horse riding and the perceived mental health impacts. Three emergent themes were prominent among parents and service providers alike: physical and social benefits, including health, self-management skills and social skills; protecting mental health; and recommendations for improvements and accessibility of horse-based therapies. Specifically, service providers with long-standing associations with horse-based therapies saw the actual and potential benefits of horse-based therapies for autistic children, particularly in promoting happiness, calm, resilience, and good mental health.

Among adolescents, loneliness is common. One kind of loneliness, existential loneliness, is understood as a painful part of the human condition. During adolescence, existential loneliness has been shown to be challenging to navigate independently. Therefore, this study aimed to explore Swedish adolescents' experiences of existential loneliness regarding receiving and providing support. This study had an exploratory qualitative design based on focus group discussions (n = 9) comprising 30 Swedish adolescents (median age 18). The data was analysed inductively using thematic analysis. The adolescents' experiences of existential loneliness regarding receiving and providing support were represented in four themes: Wanting to face existential loneliness alone, but seeking relief and support when needed; Wanting to share the experiences, but not knowing how or being afraid to bare the vulnerability; Wanting to share the experiences, but nobody is there; Supporting friends by trying to be there, but feeling insecure. In conclusion, knowledge of existential loneliness and a sensitivity to adolescents' personal needs is crucial. Supporting and being there for adolescents may increase their ability to encounter ̶ their own or others' ̶ experiences of existential loneliness, which could be promotive for their well-being and personal growth.