Issues in Mental Health Nursing最新文献

Contrary to the expectations and intentions of inpatient mental healthcare, reports of adverse experiences by people admitted to inpatient settings are common and on the rise. Such experiences negatively impact individuals' mental health and recovery and incur costs to their networks, mental health providers, the healthcare system, and society at large. Research indicates ongoing challenges in understanding and addressing the complex interplay of factors that contribute to a diverse range of adverse experiences, from seclusion, restraint, and coercion, to boredom, loneliness, and lack of therapeutic relationships. There is a pressing need to better understand the mechanisms of adverse inpatient mental health experiences and identify frameworks to aid in more efficient and effective translation of knowledge into practice. This paper proposes self-determination theory (SDT) as a framework that can assist nurse researchers and practitioners elucidate the nature of adverse experiences and guide developments to mitigate adverse outcomes. Critically, SDT prioritises human psychological needs and wellbeing, and thus has potential to inform rights-based, person-centred, recovery-oriented research and development. This paper provides an overview of recent literature on adverse experiences before introducing SDT. It then considers adverse inpatient mental health experiences through the lens of SDT, providing actionable guidance for nursing research and development.

Workplace stressors can negatively impact the well-being and nurse-patient empathy among nurses working in psychiatric wards. This controlled trial investigated the impact of mindfulness-based stress reduction (MBSR) on workplace well-being and empathy levels among these nurses. In this study, 80 clinical nurses from the psychiatric wards of Ibn-e-Sina psychiatric hospital, affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, completed a demographics form, the Eudaimonic Workplace Well-being Scale, and the Clinical Interpersonal Reactivity Index. Subsequently, participants were allocated to either the MBSR group (n = 40) or the control group (n = 40). The MBSR group received an eight-week program consisting of weekly two-hour sessions based on the MBSR principles developed by Kabat-Zinn. The participants in both the MBSR and control groups completed the data collection tools immediately after the intervention and one month later. The mean scores of workplace well-being and its intrapersonal dimension increased significantly more in the MBSR group than in the control group over time. Similarly, empathy and its perspective-taking subscale improved significantly more in the MBSR group than in the control group over time. The MBSR intervention can be a beneficial tool to improve workplace well-being and nurse-patient empathy levels among nurses working in psychiatric wards.

A significant proportion of frontline nurses developed post-traumatic stress disorder (PTSD) symptoms as a result of working during the COVID-19 pandemic. This study aimed to determine the efficacy of a mindfulness- and acceptance-based smartphone app intervention among nurses traumatized by the COVID-19 pandemic. This was a two-arm, randomized controlled trial. We randomly assigned 60 frontline nurses working in various clinical settings in the United States during the pandemic to either the intervention group (i.e. participants used the mindfulness app for 6 wk) or the wait-list control group. We assessed the app's efficacy through outcome measures of PTSD symptom severity, experiential avoidance, rumination, mindfulness, and resilience, measured at pre-, mid-, and post-intervention periods and a 1-month follow-up. Intervention satisfaction and perceived usability of the app were assessed within the intervention group. There was strong evidence of within-between interaction for PTSD, experiential avoidance, and rumination, implying significant improvement of these outcomes for the intervention group as compared to the control group. We only found a within-group interaction effect for mindfulness, indicating significant improvement of mindfulness within the intervention group only. Participants in the intervention group reported high satisfaction levels and perceived usability with the app. Findings highlight that mindfulness- and acceptance-based smartphone apps can improve PTSD symptoms of nurses traumatized by the pandemic. Healthcare organizations should provide nurses with accessible interventions (e.g. mindfulness apps) to treat and prevent secondary behavioral consequences of the pandemic, such as PTSD.

Stigma is a form of injustice that contributes to the worsening course of the symptoms associated with mental health problems. The paper discusses the conceptualization and development of a contemporary theoretical model of stigma. Building on the findings of an initial scoping review, the author developed a theoretical model after thoroughly analyzing and redefining the key concepts of interest. This article proposes that stigmatized individuals are impacted by the religiocultural and structural violence perspectives embedded within social spaces, leading to stigma perception appraisal and subsequent coping mechanisms, which could be adaptive or maladaptive. Current models of mental illness stigma have gaps. It is time to relook at existing stigma frameworks and fill these gaps that have existed for many years for effective anti-stigma strategies.

The current documented nursing faculty shortage is an important factor affecting our ability to address the nationwide nursing shortage. Occupational burnout is a common phenomenon among nurses that may negatively impact retention of nursing faculty. While research suggests that promoting resilience moderates occupational burnout and relates to occupational satisfaction in practicing nurses, very few investigations have examined resilience among nursing faculty. The purpose of this integrative review is to describe the current state of the science on resilience in nursing faculty and includes an analysis of 14 studies. Three major foci were identified in the literature: 1) descriptions of resilience levels in nursing faculty, 2) examinations of resilience based upon demographic factors, and 3) resilience and related concepts. Existing research indicates there may be demographic differences in resilience levels of nursing faculty, but additional investigation is necessary to confirm these relationships. There is evidence that quality of life (QOL), components of QOL, and support are correlated with resilience in nursing faculty but more rigorous research on these relationships is needed. Understanding more about the relationship between resilience, demographics, and associated factors will guide future development and choice of interventions tailored to promote resilience among nursing faculty.

HIV post-exposure prophylaxis (PEP) can reduce the risk of acquiring HIV infection following sexual assault. However, only about half of people offered HIV PEP will initiate the medication. Factors associated with patient readiness for HIV PEP following sexual assault have been attributed to structural and clinical barriers. This study utilized the Theory of Reasoned Action and Planned Behavior to better understand how personal factors, cognitive factors, mental health, barriers and facilitators that could influence a patient's decision to start HIV PEP post sexual assault. A web-based cross sectional survey was conducted from October 2017 to January 2020 and a total of 228 responses were included from participants that had experienced sexual assault in the previous 3 months. Using linear regression modeling fear of HIV, post-traumatic stress symptoms, validating social responses to disclosure, and having someone else pay for HIV PEP were all associated with feeling better prepared for HIV PEP decision making. Results indicate that structural, social, and individual factors impact patient decision making. These findings highlight opportunities for health systems and providers to improve HIV education and the importance of initiating HIV PEP following sexual assault.