Issues in Mental Health Nursing最新文献

Cardiovascular conditions are the leading cause of pregnancy-related death among African American women (AAW). Stress is a risk factor for cardiovascular conditions that negatively impacts maternal health; however, research on stress management interventions for pregnant AAW is currently limited. Thus, we conducted a scoping review to explore the state of the science on this topic to better understand what types of methods, measures, and components have been utilized in stress management interventions for pregnant AAW. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) framework was used to conduct a systematic literature search. Eight studies using quantitative (n = 4), qualitative (n = 2), and mixed methods (n = 2) were identified. Common intervention components were education, social support, mind-body exercises, and reflection. Studies additionally measured physiological stress, anxiety, and depression. Results for stress reduction were mixed; while two studies reported post-intervention decreases in stress, others found no significant changes, highlighting the preliminary nature of existing evidence. The qualitative studies provided information on intervention benefits and barriers to participation. Future intervention studies that are community-based, culturally-relevant, and target contextualized stressors are necessary to build confirmatory evidence on methods of stress management for pregnant AAW.

Unhealthy alcohol use includes a range of drinking behaviors that pose health risks. Among gay, bisexual, and other men who have sex with men (GBMSM), factors including minority stress exacerbate these risks. However, inconsistencies in defining unhealthy alcohol use in research hinder effective screening and intervention. A clearer conceptual understanding is essential for improving nursing care and public health strategies. This article aims to clarify the concept of unhealthy alcohol use among GBMSM using the Norris method of concept clarification. A selective literature review identified 20 sources. The Norris framework was applied to examine unhealthy alcohol use through its antecedents, attributes, and consequences. Findings were synthesized to develop an operational definition and a conceptual model. Unhealthy alcohol use among GBMSM is defined as a pattern of drinking that exceeds established low-risk guidelines and/or causes harm, often influenced by stigma, discrimination, and permissive social norms, thereby increasing vulnerability to adverse health outcomes, including co-occurring substance use, HIV risk, and chronic conditions. Nurses are well-positioned to address unhealthy alcohol use in GBMSM communities through culturally competent screening, education, and interventions. Conceptual clarity supports research, policy, and practice by integrating quantitative thresholds with sociocultural influences and guiding targeted strategies to improve GBMSM health outcomes.

Introduction: Psychiatric inpatient care is often characterized by brief admissions and an orientation toward acute treatments. Persons with dissociative identity disorder have been recognized as a vulnerable group within psychiatric inpatient care and are at risk of not receiving correct support in psychiatric inpatient care. Research within the area is limited and includes no overview of how persons with dissociative identity disorder are cared for in psychiatric inpatient care.

Aim: The aim was to map the area of knowledge on psychiatric inpatient care for persons with dissociative identity disorder.

Method: This scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews. The search strategy included both peer reviewed papers indexed in PubMed, Cinahl and PsycINFO, and grey literature.

Results and conclusions: The review identified eight studies, revealing a small base of knowledge on psychiatric inpatient care for persons with dissociative identity disorder, showing the importance of further research exploring the significance of trauma awareness in this area. Further research should include persons with lived experience, both as participants and as partners in the research process. Nurses are in a position to prevent retraumatisation and promote person-centered approaches to care by valuing the patients' perspectives.

Caring for women in compulsory psychiatric inpatient care entails having to make a number of different moral considerations. Using coercive measures leads to difficulties in creating a caring relationship and the care given to the women thus needs to be as ethical as possible. The aim was to describe healthcare staff's experiences of caring for women in compulsory psychiatric inpatient care. Eleven healthcare staff were interviewed, and the material was analyzed with a Reflective Lifeworld Research approach. The results show that healthcare staff move between self-examination and examining their colleagues closely and are also careful about protecting the women's privacy. An emotional rollercoaster is set in motion when the women's life situation affects the healthcare staff. Bridges are built, both with the next of kin but also with other authorities. It can be challenging to include the next of kin in the care for women in compulsory care since they may have a different view to that of the healthcare staff. Providing the healthcare staff with professional support and a supportive care environment may enhance their ability to provide a personalized care for the women in compulsory care.

The beginning of poor physical health trajectory for young people with early psychosis is found to occur prior to the onset of psychosis. Promotion of physical health requires sustainable positive health behaviour change. This study is aimed at exploring the views of carers on the physical health of young people with early psychosis, the physical health care young people receive and carers' perspectives on important elements in promoting sustainable positive lifestyle changes. The outcome of this study will help inform the development of a co-designed lifestyle intervention for young people with early psychosis. Semi-structured interviews were conducted with 12 carers using an exploratory descriptive approach. Three main themes were identified using thematic analysis: (i) Physical health - what makes them worry and seek help; (ii) Disconnected physical health care; (iii) Key to sustainability - "Nothing succeeds like success". Carers are at the forefront of physical health promotion for young people. The findings of this study emphasised that a lifestyle intervention designed for young people should be tailored to the needs and preferences of not only young people but also their carers, with incorporation of elements of health literacy, psychosocial wellbeing and self-determination in the drive for sustainable positive health behaviour change.

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.

Suicide risk is often reflective and nonverbal, transmitted through the affective field of the clinician-patient relationship. This discussion paper advances a defense-informed framework showing how splitting, projection, and denial may be enacted interpersonally and registered as countertransference-guilt, detachment, or affective "whiplash"-that signals unspoken suicidal disintegration. Integrating psychodynamic and intersubjective theory with emerging suicidology (e.g. Suicide Crisis Syndrome), the approach formalizes countertransference as clinical attunement rather than interference. It augments standardized assessment by adding relational and embodied data, particularly when communication is fragmented, symbolic, or defended. Practice implications include routine affect check-ins, reflective supervision, and deliberate use of relational cues in formulation and safety planning. Although examples derive from youth and high-acuity services, the framework is transdiagnostic and portable across inpatient, community, and emergency settings. The aim is a more responsive, person-centered model of suicide prevention grounded in containment, co-regulation, and therapeutic presence.

Global migration has heightened due to various factors ranging from economic instability, political tension in many countries, escape from human rights abuse, search for better education and quality of life, as well as other involuntary reasons. Immigrants, irrespective of their immigration status, are often confronted by various challenges such as systemic inequities, identity conflict, community fragmentation, cultural and sociopolitical marginalization, including acculturation stress in their host countries that undermine their mental health. Current sociopolitical situations, particularly in the United States, further exacerbate these stressors. In light of this, mental health nurses must provide care that transcends borders, race, sexuality, or immigration status. Drawing on existing evidence, practice-based gaps, and emerging frameworks of culturally attuned care positions presence-centered care as a critical care approach in mental health care for vulnerable populations. There is transformative power in caring presence practice, particularly for immigrants who are confronted with various cultural and sociocultural stressors that exacerbate mental health issues among the population, inviting new discourse in this care dimension. Additionally, culturally attuned and presence-centered care are approaches that are culturally congruent to better prepare mental health nurses in the delivery of holistic care for improved mental health and overall well-being of the immigrant population.