Issues in Mental Health Nursing最新文献

Loneliness is a multifaceted phenomenon linked to adverse mental and physical health outcomes, increasingly understood as a relationally embedded experience shaped by sociocultural, cognitive, and emotional factors. While previous research has predominantly relied on surveys and clinical tools, emerging approaches recognize the value of unsolicited narratives shared on digital platforms. This snapshot study examines 498 Reddit posts from the subforums r/lonely and r/offmychest, using a publicly available annotated dataset to examine perceived causes and intensities of loneliness. Each post was annotated for types of loneliness cause and rated for intensity on a five-point scale. Descriptive statistics characterized the annotated dataset, and inferential analyses examined relationships among labels within this sample. Lack of friends emerged as the most frequently identified cause, whereas lack of family contact was associated with the highest perceived intensity. Co-occurring deficits across relational domains were common, particularly between lack of friends and lack of social support. Differences by subreddit and annotation batch were observed descriptively but were not statistically significant. These findings underscore the contextual, multi-causal nature of loneliness and support the value of Reddit as a site for accessing emotionally rich, real-time disclosures. Implications for mental health nursing include allocating space within assessments to explore relational complexity, drawing on patients' digital narratives when they emerge.

This study examined the effect of a self-compassion-oriented mindfulness-based psychoeducation program on internalized stigma in individuals diagnosed with schizophrenia. This single-blind, randomized controlled experimental study was conducted with individuals with schizophrenia who were receiving follow-up care at a Community Mental Health Center in a province in northern Türkiye between June and August 2024. Following the administration of pretest assessments, the sample was randomly allocated into an experimental group (n = 21) and a control group (n = 21) through simple randomization. The psychoeducation program, adapted to the specific needs of this population, was administered to the experimental group. Data were collected using the Internalized Stigma of Mental Illness (ISMI) scale and the Descriptive Characteristics Form. Posttest measurements revealed a statistically significant difference between the experimental and control groups in the total score and the subdimensions of Alienation, Stereotype Endorsement, Perceived Discrimination, and Social Withdrawal (p < 0.05). However, no significant difference was observed between the groups in the Stigma Resistance subdimension scores (p > 0.05). The psychoeducation program significantly reduced the total scores on the ISMI among individuals diagnosed with schizophrenia, demonstrating a large effect size of 17.3% (η2 = 0.173; p = 0.006). These findings suggest that a self-compassion-oriented mindfulness-based psychoeducation program, adapted specifically for individuals with schizophrenia, is an effective intervention for reducing internalized stigma in this population.

Suicide remains a leading cause of death among adolescents in the United States, and instances of death by suicide continue to increase in this population. To mitigate this public health crisis, effective and accessible suicide prevention programming is critical; however, suicide prevention programming is often developed and implemented without input from the adolescents engaged in the training. This study developed themes that emerged from student feedback as to how a school-based suicide prevention training, delivered to adolescents by either their peers or school personnel, could be improved. Data was collected from 2,480 adolescents who completed pre-training and post-training surveys between March 2022 and June 2023. Thematic analysis was used to explore participant responses to an open-ended question included in the post-training survey, which asked whether students had suggestions for improving the training. Four themes were generated: empowerment, self-care, increased sensitivity and discretion, and enhanced interactive learning and engagement. These themes highlight the need to incorporate a flexible, trauma-informed approach into school-based suicide prevention training. Given their role and expertise, nurses are well-suited to implement these strategies. Student perspectives should consistently be sought and integrated into curricula as communities strive to decrease death by suicide among adolescents.

We aimed to explore the effect of cognitive behavior intervention on violent behavior in female patients with schizophrenia (SP). A total of 86 female SP patients who were treated in Fuyang Third People's Hospital from January 2021 to January 2023 were included, and they were randomly divided into control and cognitive behavior intervention groups (n = 43). Patients in the control group received routine psychiatric nursing measures, including basic nursing, drug guidance, safety management, and psychological nursing. Those in the cognitive behavior intervention group received cognitive behavioral intervention based on routine nursing measures, including evaluating the condition and establishing a treatment alliance in the first week, knowledge training in the second week, cognitive reconstruction in the third week, and cognitive behavior training in the fourth week. The number of violent incidents after intervention was compared between the two groups. The Brief Psychiatric Rating Scale (BPRS) was used to compare the nursing effects. The incidence of violent behavior after nursing in the cognitive behavior intervention group was 13.9% (6/43), which was lower than that in the control group (39.5%, 17/43). There was no significant difference in BPRS between the two groups before nursing intervention (p > 0.05). After intervention, BPRS was notably decreased in the two groups than before intervention (p < 0.05), and the BPRS factor scores in the cognitive behavior intervention group were significantly lower than those in the control group (p < 0.05). This study provides preliminary evidence that CBI may reduce the incidence of violent behaviors in female patients with schizophrenia, with the intervention group demonstrating a lower rate of violent incidents compared to the control group. While these findings suggest the potential clinical utility of CBI for managing violence risk in this population, several important limitations must be acknowledged, including the restricted sample size and the exclusion of male patients.

Dramatic increases in adolescent social media use have occurred alongside worsening adolescent mental and behavioral health and associated risk factors, including adverse childhood experiences (ACEs). Understanding these relationships is important for mental health nurses working with adversity-impacted adolescents. This study examined the association between ACEs exposure and problematic social media use (PSMU), and the moderating role of emotional and behavioral dysregulation among a diverse sample of young United States' (US) adolescents (10-14 years old). A secondary analysis using mixed-effects linear modeling was used to analyze adolescent and parent self-report data collected from baseline through 3-year follow-up in the Adolescent Brain Cognitive Development Study (ABCD Study^®). After adjusting for socio-demographic covariates, a significant positive association was found between adolescent cumulative ACEs score at 10-12 years and higher PSMU at 12-14 years: relative to adolescents with low (< 2) ACEs, those with high ($\ge 4$) ACEs reported higher PSMU (β = 1.5, p < 0.001). Adolescent emotional and behavioral dysregulation did not moderate this association. Findings underscore the importance of ACEs and mental health screening, as well as trauma-informed, developmentally appropriate preventative interventions to promote healthy social media use and reduce risk for PSMU among adversity-impacted adolescents.

Background: Mental health disorders are prevalent and often treated with psychotropic drugs; however, concerns remain regarding their efficacy and long-term benefits. Likewise, there has been increasing attention on limiting psychotropic drug use to the minimum necessary level. Several studies have focused on deprescribing, often supported by various non-pharmacological interventions (NPIs). This study aimed to explore recent literature on the use of NPIs to support psychotropic drug deprescribing in adults.

Methods: We conducted a narrative review and performed literature search in major electronic databases, including Embase, Medline, PsycInfo, and CINAHL, covering a period of 6 years. The results were screened and selected based on pre-defined eligibility criteria.

Results: We identified eight studies; the majority explored deprescribing of antidepressant medication and benzodiazepines for mood and anxiety disorder. One study focused on deprescribing of antipsychotics. Shared Decision Making, Mindfulness-Based Cognitive Therapy, Cognitive Behavioral Therapy and personal tapering strips for gradual drug reduction were identified as strategies aiming at supporting deprescribing.

Conclusion: This review identified research on NPIs supporting deprescribing in mental health disorders. It highlights the need for individual approaches and strong clinician-patient collaboration. Further rigorous and well-designed research is needed to better understand the benefits, challenges, and role of NPIs in deprescribing.