Issues in Mental Health Nursing最新文献

A review of the existing literature shows that although numerous factors influence the quality of care, only a few have been thoroughly investigated as potential mediators impacting mental health professionals' perceptions of quality in psychiatric inpatient care. This study aimed to explore how burnout mediates the relationship between individual characteristics, ward environment conditions and professionals' perceptions of the quality of psychiatric care patients receive. A total of 117 professionals from two Norwegian health trusts participated in the study. Data were collected through an online questionnaire comprising validated instruments measuring quality of care, job satisfaction, perceived stress and burnout while collecting background information on sociodemographic and work-related factors. The relationships between these variables were analyzed using univariate and multiple regression analyses. The results showed that professionals who were open for developing quality work, found their work stimulating, had sufficient time for tasks and were satisfied with their job reported lower levels of burnout. In turn, burnout was associated with lower perceived quality of participation and secure environment. Overall, professionals generally rated the quality of care as high. These findings provide insights for designing interventions to improve workplace conditions, reduce risk of burnout and enhance the quality in psychiatric inpatients settings.

Community Mental Health Centers (CMHCs) are designed to promote rehabilitation, social integration, and functionality for individuals living with chronic mental disorders. Understanding how service users perceive these services is crucial for improving psychiatric care that is both sustainable and centered on human experience. This qualitative study aimed to explore the perceptions of CMHC service users through their metaphorical expressions. Data were collected from 104 participants, with 80 valid metaphors analyzed. Using metaphor analysis, the expressions were thematically categorized through independent and collaborative coding processes. The analysis revealed six main metaphor categories, including emotional supportive entity, providing closeness and interest in relationships, healing and supportive services, building bridges to life, learning and development, and maintaining balance. The majority of the metaphors conveyed positive experiences, emphasizing emotional support, personal growth, social connectedness, and recovery. These findings suggest that CMHCs are experienced by users as therapeutic, empowering, and meaningful in their everyday lives. The metaphorical insights highlight the importance of integrating user experiences into service design and emphasize the key role of psychiatric nurses in delivering effective community-based mental health care.

The stepped care model aims to dynamically align the intensity of care with the patients' needs, adjusting mental health interventions accordingly. While stepped up care for mental illness has been widely researched, there is limited evidence on how stepped down care supports recovery after acute mental illness. This JBI qualitative systematic review sought to understand stakeholders' perspectives of stepped care in supporting patients' transitions from acute mental healthcare to community settings. CINAHL, Medline, Embase, PsycINFO and Web of Science were searched, and data were synthesized using the JBI meta-aggregation method. Fourteen studies were included. Themes were patient preference, emotional support, information and education, coordination, access to care, family and friends, continuity and transition, physical comfort, service delivery, health sector, and community setting. Patients expressed the importance of autonomy, with many stakeholders making assumptions about their care. Challenges with existing stepped care programs, include a lack of resources, strained patient relationships with providers, a lack of standardized care, and limited communication. Enhancing the design and delivery of stepped care following acute mental illness could support mental health recovery.

This paper explores competing meanings which may arise through receiving a diagnosis of "borderline personality disorder," discussing how this may impact a person's treatment and their sense of self. This paper is informed by qualitative case study research, which utilized interviews to explore experiences of crisis and crisis intervention for people diagnosed with borderline personality disorder, their family and friends, and professionals who work with them. Utilizing this qualitative research data, alongside wider literature, the conceptualization of "borderline personality disorder" and the actual and potential real-world consequences of receiving this label are explored. Potential meanings are mapped onto a "black hole" model where potential competing meanings exist in the same place at the same time, and harm a persons sense of self. "Borderline personality disorder" is the most controversial personality disorder diagnosis. People may conceptualize their distress through four different labels for borderline personality disorder, be seen as "not real mental illness," "borderline of what?", not personality disorder, only personality disorder, and too unstable for therapy. Spaghettification, a term from astrophysics, is used as a metaphor to explain how a persons sense of self can fragment as they are pulled into the confusion of this black hole.

This paper explores compassion and connection through a biophilic lens, examining how human-animal relationships reflect the moral and cultural foundations of nursing. Drawing on Edward O. Wilson's biophilia hypothesis, it considers examples from animal-assisted care with ducks in Tennessee and urban animal interaction spaces in Japan. Across these diverse settings, engagement with animals fostered emotional well-being, reduced anxiety, and reawakened empathy. The analysis situates biophilia within nursing's ethical commitment to compassionate care, proposing that intentional human-animal connection offers a universal pathway to empathy, healing, and quality of life across cultural contexts.

Asian Americans and immigrants (AAIs) faced unprecedented challenges during the pandemic due to anti-Asian racist acts fueled by COVID19 rhetoric and the resulting racial trauma. This study explored AAIs' perceptions of these anti-Asian acts and their impact on psychosocial and mental health in the state of New Mexico (NM). Meyer's Minority Stress Theory provided the conceptual framework for the study. Sixty AAIs were conveniently recruited through various social networks in NM. Semi-structured interviews were conducted remotely, primarily in English. All interviews were transcribed verbatim. Thematic content analysis was used to identify codes, categories, and patterns across the transcripts. Most participants viewed anti-Asian racism as an inseparable part of their lives, describing direct or vicarious experiences of racism as surreal and emotionally torturous. Many reported feelings trapped in a "rabbit hole," alienated from mainstream society, and on the verge of emotional eruption. AAIs employed both unhealthy and healthy coping strategies for survival. The findings highlight the profound, life-altering distress-defined as suffering that disrupts the ability to cope with daily life-experienced by NM AAIs, underscoring the urgent need for long-lasting, tailored resilience programs (e.g. culture-specific counseling) to support their psychosocial and emotional well-being and foster a renewed sense of community-belonging.

Limited lesbian, gay, bisexual, transgender, and queer (LGBTQ) health research exists in many countries, including Thailand. Understanding LGBTQ outness is a key determinant in developing targeted and impactful mental health strategies. Outness among LGBTQ individuals, once safe from potential discrimination, brings significant benefits of acceptance, affirmation, and adequate healthcare access. This study examined outness patterns among 388 Thai LGBTQ adults, using a secondary analysis of a larger cross-sectional descriptive survey on minority stressors and mental health. The Outness Inventory measured identity disclosure and responses to those disclosures in three categories: the World, Family, and Religious Community. Descriptive and bivariate analyses were conducted. Participants reported higher levels of outness to the world (M = 5.55, SD = 1.88) and to their family (M = 5.39, SD = 2.03) compared to their religious communities (M = 3.92, SD = 2.58). Acceptance rates following LGBTQ disclosure were highest in the 'World' category, followed by 'Family' and then 'Religious Communities.' Percentage acceptance ranged from 30.15% for members of religious communities to 64.69% for their heterosexual friends. Overall, less acceptance among family members and religious communities was associated with participants being gay, feminine, and at an older age when first disclosing their LGBTQ identity. Outness has important implications for LGBTQ mental health nursing research. Interventions to support the coming-out process and promote positive attitudes toward LGBTQ individuals are most needed for their families and religious institutions.