Issues in Mental Health Nursing最新文献

Purpose: As primary care (PC) clinics seek to integrate behavioral health (BH) services into patient care, it is crucial to understand the experiences of the clinic team and the impact on workflow and well-being. This study was designed to identify perspectives and experiences of nurse practitioner-led PC teams as they implemented a behavioral health integration (BHI) model into their Federally Qualified Health Center PC practices.

Methods: We conducted in-depth qualitative interviews with staff members at three clinic sites that implemented BHI. Interviewees were asked questions about the benefits and challenges encountered in the new BHI workflow, the dynamics of the warm hand-off, the tools and resources they used and desired, and the changes they would like to see to promote efficient workflows.

Results: We interviewed 21 staff members during May and June of 2020. An analysis of the qualitative data showed the most frequently reported experiences and attitudes focused on (a) the availability of behavioral health consultants (BHC); (b) procedural uses of the warm hand-off; (c) the organization's productivity goals; and (d) desired tools and resources that are generally unavailable to the clinicians but could make a difference to patient care.

Conclusion: Our results can assist FQHCs and similar organizations to achieve both BHI and the Quintuple aim. Integrating BH services into PC clinics is valuable and may mitigate clinician-staff burnout. However, PC organizations desiring to integrate new sustainable care models should consider involving staff in every phase of the transitional process phase to increase staff buy-in and staff rapport.

The social movements of #metoo and #notokay illuminated the extent of sexual violence. By providing a safe platform the movement enabled victims/survivors opportunity to share their own experiences of victimization, often in a delayed disclosure, years after the violence occurred. With new disclosures of sexual violence, also comes a growing awareness of the lasting impact and the requirement to take steps to improve responses to sexual violence across the social and clinical spectrum to address and respond to victims/survivors' holistic needs. The primary research question is, what is the retrospective life experience of individuals marginalized by gender who encounter sexual violence in post-secondary education? The authors of this manuscript used trauma- informed qualitative individual interviews with a feminist perspective to explore the retrospective experience of 10 victim/survivors, a decade or more after their experience of sexual violence. The inquiry discovered the themes of recognizing the wrong, the internal struggle, forging new relationships, and the lasting trauma of sexual violence. Learning from those that lived it legitimizes victims/survivors' experiences and deepens clinical knowledge of these impacts and associated needs.

Violence by patients against healthcare workers is of global concern among both producers and consumers of health care. The US is among the countries with the highest reports of workplace violence, and the majority of the violent incidents occur in healthcare settings. The purpose of this integrative review is to identify, analyze and appraise the best interventions for reducing violence by patients against healthcare workers in adult acute psychiatric hospitals. Additionally, findings from the review inform our recommendations designed to contribute to violence reduction in these settings. We explored the PsycINFO, PubMed, CINAHL and Cochrane Library databases and launched an integrative review using the Johns Hopkins Nursing Evidence-Based Practice Model as a framework and the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. Fifteen records were included in this review using specific inclusion and exclusion criteria. Four themes were identified from the review as providing evidence-based interventions to reduce and mitigate violence against healthcare providers in acute psychiatric hospitals. These were staff attributes, patient characteristics, environmental factors, and staff-patient relationships. These factors interact in a dynamic and complex manner in optimizing the nurse-patient relationship to decrease violence by patients against healthcare workers in inpatient psychiatric settings. The implications of this review are that a multifactorial approach is needed in devising effective strategies to reduce violence in psychiatric settings. The strategies should involve all stakeholders including providers, administrators, and patients.

Mental health and quality of life may be negatively impacted among earthquake survivors. This pilot study evaluates the use of and reports on the preliminary effects of participating in a 1-minute Laughie (Laugh Intentionally Everyday) Laughter Prescription on well-being in earthquake survivors in Türkiye. A Group Laughie intervention was delivered using a within-subject (n = 20; M age = 34.78 ± 6.65; 14 female) pretest-posttest design. Group Laughies were delivered once a day over 2 weeks with participants prescribed to further laugh with the Group Laughie recording twice a day, resulting in 3 minutes of intentional laughter daily. Data were collected using a range of questionnaires to track feasibility, reach-out, acceptability, fidelity, and efficacy, including Laughie Checklists, a Post-Intervention Perceived Impact Measure (PIPIM) in the form of the Positive Psychology One-off Post-intervention measure (PPOP), and the World Health Organization (WHO-5) well-being index. Results indicated high intervention fidelity using Laughie Checklists and positive post-intervention perceived impact using the 11-point Likert-scaled PPOP (x = 7.62 ± 1.44). After the intervention, a statistically significant difference (p < 0.001) was found between WHO-5 well-being index pretest scores (x = 2.16 ± 1.00) and post-test (x = 4.08 ± 0.24). This study demonstrated beneficial effects of the Laughie prescription on earthquake survivors. This is the first intervention to explore an online Group Laughie intervention. Health professionals and especially nurses can use the 1-minute Laughie prescription in the form of a Group Laughie intervention to increase the well-being of individuals and improve perceived mental health.

Ageing in a non-native land brings numerous challenges that may complicate adaptation and health for older Latin American immigrants in Australia. While religiosity emerges as a protective factor for mental health, there is scarce research focused on exploring the multifaceted dimensions of religiosity in this population. As part of a broad Constructivist Grounded Theory study, the aim of this qualitative descriptive analysis was to explore and understand this population's religious practices and experiences, focusing on the impact on their mental health. Following ethical approval, 23 Spanish-speaking Latin American immigrants aged 60 and older living in Australia were interviewed. Data analysis was performed on a constant comparative basis and concurrent with data collection to understand the findings. Three key categories were identified: "Being involved in religious groups and communities," "Connecting with God," and "Changing how one lives one's faith." Regardless of their religious practices, all participants engaged in social activities that helped them integrate into their communities. Several barriers to religious practices were identified. The findings add to the field of religiosity as a protective factor in older Latin American immigrants' mental health. Future research should identify barriers to religious practices and targeted interventions.

First-episode psychosis is a significant mental health condition that can have a profound and lasting effect on an individual's functional abilities and overall quality of life. While music therapy has shown promise in improving these areas, there is a lack of research exploring the impact of music groups led by mental health professionals without formal music therapy training in the context of early intervention in psychosis. This study aimed to conduct a qualitative evaluation of a once-weekly, 12-week, nurse-led music group, offered as an adjunct to early intervention in young people with first-episode psychosis. The specific objectives were to explore social interaction and experiences of participants and instructors in relation to the music group and provide focus points for implementation in clinical practice. The study utilized Interpretive Description, collecting data through participant observation (6 sessions × 1.5 hrs; 9 hrs in total), key informant interviews (n = 1), and group (n = 4) and email-based (n = 2) interviews. The data was transcribed, thematized, and analyzed using NVivo12 and Interpretive Description inductive analysis resulting in three main themes: Practicalities of the music group, Restored identity, and Music as medicine reflecting the potential of the music group to contribute to a sense of non-patient identity, decreasing symptoms related to mental illness, foster social relationships and a feeling of belonging to a musical community. This study highligts how participation in music groups can be a possible promoter of recovery. However, sustainability appears contingent on the skills and resources of the facilitator (i.e., nurse). Suggestions for a program theory and clinical implications are presented and discussed.

Mental health professionals are at a heightened risk of secondary traumatic stress (STS) due to the higher prevalence of trauma-exposed individuals seeking clinical help compared to the general population. The aims of this study were as follows: (1) to explore the association between exposure to workplace violence (WPV) and secondary traumatic stress, and the potential mitigating effects of organizational support and (2) to examine how the workplace setting (inpatient vs outpatient) affects the experience of STS. The study was cross-sectional. Over 58 days, survey data was collected from mental health professionals working in both inpatient and outpatient settings. A total of 2,549 professionals responded. The overall prevalence of STS across settings was 87%. The highest reported secondary traumatic stress levels were among nurse practitioners/APRNs (49.29%), followed by nurses (47.94%) and psychiatrists (46.85%). Levels of STS occurred at slightly higher levels among professionals in outpatient settings (48.39%) than those in inpatient settings (45.11%). Increased exposure to WPV correlated with higher levels of STS, while higher levels of perceived organizational support (POS) had a moderating effect on STS levels. This study suggests that STS is a significant phenomenon and that mental health professionals are at risk for developing the condition. Organizational support can play a role in mitigating the effects of WPV and STS. Interventions aimed at improving organizational support and building psychological resilience may help reduce the prevalence of STS among this population.

The aim of this review was to identify and integrate evidence on suicide mortality among U.S. nurses. To the best of our knowledge, this represents the first review to focus exclusively on suicide among U.S. nurses. Electronic medical databases, reference lists, and supplementary files were searched to identify studies that examined suicide mortality among U.S. nurses. In total, n = 28 studies were included: n = 14 were cohort, n = 10 were epidemiological, and n = 4 utilized mixed methods. Many studies had unique aims, included different nurse groups and referent populations, and utilized a variety of statistical procedures. However, when taken together, four categories were assessed across these n = 28 cumulative studies: incidence of suicide, factors associated with suicide, circumstances preceding suicide, and methods of suicide among U.S. nurses. Taken together, continued surveillance of suicide incidence among U.S. nurses is important, as evidence largely suggests nurses experience elevated suicide incidence when compared to select referent groups. Additional research on factors associated with suicide and circumstances preceding suicide are also needed, particularly among male nurses. Finally, additional research regarding the leading method of suicide, leading substance implicated in self-poisoning, and sex-differentiated suicide methods are also important. Collectively, these data are needed to inform intervention and surveillance strategies.