Issues in Mental Health Nursing最新文献

Food insecurity is a critical social determinant of health among individuals with schizophrenia-spectrum psychotic disorders (SSPDs). While existing research emphasizes prevalence and clinical outcomes, less is known about how clients and case managers navigate chronic hunger relationally and emotionally. This qualitative descriptive study examined co-experiences and interpretations of food insecurity among individuals with SSPD and their case managers in a community mental health setting in the Southeastern United States. We conducted 10 semi-structured interviews with five clients diagnosed with SSPD and five case managers (30 minutes each). Reflexive thematic analysis, guided by Braun and Clarke's framework, identified five interconnected themes: structural tradeoffs that prioritize housing over food; the burden of shame and stigma when seeking help; invisible coping labor required to manage scarcity; physical health impacts, including malnutrition and chronic disease complications; and hunger as a potential catalyst for psychiatric distress and symptom relapse. Triangulation of client and case manager perspectives revealed shared and divergent understandings of these challenges. Findings from this small, single-site study suggest that food insecurity for individuals with SSPD extends beyond material deprivation and requires integrated, trauma-informed, stigma-reducing interventions that link food security with stable housing and mental health recovery in this community mental health context.

Despite the availability of evidence-based treatments, many United States veterans do not seek or complete mental healthcare when needed, which contributes to adverse outcomes such as chronic mental illness, substance misuse, and suicide. This integrative review aims to identify and synthesize the multidimensional factors that influence mental healthcare-seeking behaviours among veterans. A systematic search and synthesis of 43 peer-reviewed studies was conducted using an integrative review search. Studies were analysed to extract recurring patterns and themes related to veterans' engagement with mental health services. Five major themes emerged: military culture, need for care, barriers to care, facilitators to care, and veteran-specific care. A complex interaction of personal, cultural, and structural factors shapes veterans' mental healthcare-seeking behaviours. Addressing these barriers and enhancing facilitators through tailored interventions, culturally competent care models, and policy reforms is critical to improving access, engagement, and mental health outcomes among the veteran population.

Major Depressive Disorder (MDD) is a complex and debilitating condition influenced by biological, psychological, and social determinants. The biopsychosocial model has long guided mental health research and practice, yet it is often criticized for being conceptually broad and insufficiently operationalized. At the same time, interest in biomarkers, particularly hematological indices such as complete blood count (CBC) parameters, has grown, with the goal of providing objective tools to complement subjective assessments. This paper argues that integrating scientific realism with the biopsychosocial model offers a stronger conceptual and methodological foundation for biomarker research in depression. Scientific realism emphasizes the existence of causal mechanisms that can be approximated through measurable indicators, thereby addressing the limitations of the biopsychosocial model's vagueness. Using depression as an exemplar, this paper demonstrates how a scientifically realist approach can guide the operationalization of biological, psychological, and social constructs into testable models. Implications for nursing research, education, and clinical practice are discussed, with recommendations for developing rigorous biomarker studies and embedding biomarker literacy into mental health nursing curricula. This integration advances a more evidence-based, holistic, and clinically relevant understanding of depression.

In psychiatric nursing, patients often develop strong transference toward nurses due to intense psychological needs. How nurses managed this transference while maintaining professionalism remained an important issue. This study aimed to explore psychiatric nurses' experience in dealing with patients' transference. A qualitative design was employed. Fourteen psychiatric nurses from the psychiatric ward of Hospital were recruited. Data was collected through in-depth interviews and analyzed using thematic analysis to identify core concepts. Four themes were constructed; 1. Invisible boundaries, 2. self-reflection, 3. seeking help and responding, and 4. adjustment and relearning. Through self-reflection, nurses integrated personal experiences, individual characteristics, and professional skills, transforming explicit textbook knowledge into tacit clinical knowledge, which enhanced their understanding and learning in nurse-patient interactions. The study revealed that psychiatric nurses transformed the potential challenges of transference into resources that promoted therapeutic relationships. Nursing education was recommended to strengthen awareness, self-reflection, and boundary-setting skills. Role-playing and group discussions were suggested to guide nurses in establishing flexible and professional nurse-patient relationships.

The DSM-5 Cultural Formulation Interview (CFI) is a person-centred tool that systematically evaluates the influence of sociocultural factors in mental health assessment. It is practical, acceptable, and applicable across diverse clinical contexts. Patients and clinicians differing sociocultural views of illness can cause miscommunications that impact clinical communication, diagnosis, and the creation of culturally relevant treatment strategies. This single-case study used the CFI to explore the perspectives of a woman with schizophrenia and her caregiver, focusing on cultural influences. The patient, diagnosed per ICD-10 criteria at a tertiary care facility, underwent CFI and clinical interviews to assess cultural impacts on her illness experience. Her family attributed symptoms such as disrupted sleep, self-talk, and unusual behaviour to supernatural causes like black magic, reflecting community beliefs. Initially, they sought help from faith healers, with limited relief, before turning to psychiatric care, which improved her symptoms. Despite this, religious practices continued alongside treatment. The patient's limited understanding of her illness led to poor medication adherence. This case highlights the value of incorporating cultural perspectives into clinical practice to enhance adherence and outcomes. CFI aids in gaining a comprehensive understanding of illness and integrating cultural insights into care. Further research should explore its clinical relevance.

This study explores the implementation of a lifestyle programme within municipal mental health services from the perspectives of staff working with housing support, focusing on the challenges and facilitators that shaped its delivery over time. Drawing on longitudinal data collected across three time points, the findings highlight the complexity of implementing lifestyle programmes in fragmented service environments. While early stages were marked by staff engagement and contextual adaptation, sustainability was hindered by staff turnover, limited organisational anchoring, and unclear responsibilities. The Consolidated Framework for Implementation Research was used to analyse how organisational context, leadership, and timing influenced outcomes. The study underscores the importance of shared responsibility, embedded support structures, and flexible implementation strategies. It also points to the potential of cross-sector collaboration, particularly with third sector organisations, as a means of sustaining preventive efforts when internal resources are constrained. Overall, the findings contribute to a deeper understanding of how complex interventions can be adapted and maintained in real-world mental health settings.

Self-with-other schemata, such as attachment style, partner rejection sensitivity, and intolerance of uncertainty in relationships, shape how people relate to intimate partners as well as mental health. The effects of these self-with-other schemata upon depression and life satisfaction, as well as the potential protective effects of identity resilience and social support were examined in a cross-sectional correlational survey study of 257 lesbian, gay, and bisexual people. Participants provided demographic information, and completed measures of attachment style, partner rejection sensitivity, intolerance of uncertainty in relationships, identity resilience, social support, depression, and life satisfaction. Data were analyzed using hierarchical multiple regression. Depression was associated positively with uncertainty intolerance, and negatively with income, identity resilience, and social support. Life satisfaction was associated positively with income, being partnered, identity resilience, and social support. When identity resilience and social support were inserted in the models, avoidant attachment ceased to be a significant predictor of depression, and anxious and avoidant attachment and partner rejection sensitivity ceased to be significant predictors of life satisfaction. Insecure attachment, partner rejection sensitivity, and uncertainty intolerance are risk factors for poor mental health but identity resilience and social support may have protective effects.

Visually dense social media platforms have reshaped how motherhood is portrayed. Idealized maternal depictions on platforms like Instagram contribute to heightened social expectations, impacting the well-being of working mothers. Nearly 74% of American mothers are in the workforce, and curated portrayals of motherhood online intensify the pressure to balance professional and family responsibilities. This study explored the impacts of idealized portrayals of motherhood online on maternal well-being. A 2 × 2 within-subjects factorial design examined how idealized portrayals and content sources influence maternal self-perception and well-being. Participants (n = 70), full-time working mothers with children three or younger, viewed 16 Instagram posts depicting motherhood before completing measures of perceived similarity, state anxiety (STAI-6), and unfavorable social comparisons. Self-esteem, employment guilt, and social media use were also assessed. Idealized portrayals significantly increased state anxiety and reduced perceived similarity. Effects were most pronounced when the source was a mommy influencer. Everyday mothers elicited stronger negative comparisons than influencers, especially with non-idealized portrayals. Maternal employment guilt and lower self-esteem amplified adverse responses, indicating risk-enriched subgroups. Exposure to idealized portrayals of motherhood, especially from online influencers, can acutely raise anxiety among working mothers. Guilt about employment further heightens maternal vulnerability.

Relapse prevention and function rehabilitation of major depressive disorder (MDD) are main issues faced by general public. This study aimed to explore association between pet attachment, sense of alienation, oxytocin (OT), and depressive symptoms in MDD rehabilitees for promoting MDD prevention and rehabilitation. A total of 284 pet dog owners served as study group and 284 non-pet owners as control group were assessed using Lexington Attachment to Pets Scale (LAPS), General Alienation Scale (GAS), and Patient Health Questionnaire-9 (PHQ-9). OT was detected using enzyme-linked immunosorbent assay. The results showed total LAPS score and OT were higher, and 4 dimensional scores of GAS and PHQ-9 were lower in study group. ROC curve, constructed using LAPS as testing variable, showed area under curve was 0.822. Scores of LAPS was higher and of PHQ-9 was lower in urban residents and females. LAPS, GAS, and OT could predict PHQ-9 and account for 74.60% of PHQ-9 variance in study group. Mediating effects of GAS and OT between LAPS and PHQ-9 were 28.46% and 11.09%, respectively. Taken together, pet attachment could alleviate depressive symptoms by reducing sense of alienation and increasing OT. Pet ownership has greater advantages for MDD prevention in females and urban residents.