Issues in Mental Health Nursing最新文献

Interprofessional communication is fundamental in healthcare, particularly where patient needs demand coordination and shared understanding. It fosters role clarity, care coordination, and team cohesion. However, unclear hierarchies, heavy workloads, and interpersonal conflicts can disrupt collaboration, affecting professional relationships and patient outcomes. This study explores experiences of and reflections on prerequisites for and barriers to interprofessional communication in psychiatric outpatient settings. While previous research has described barriers, few studies have examined how communication itself constitutes professional roles, boundaries, and collaborative practices. To address this gap, the study applies the Four Flows framework-membership negotiation, self-structuring, activity coordination, and institutional positioning-as an interpretive lens. Using vignettes and semi-structured interviews with 11 clinicians in psychiatric outpatient units, the study analyzed how communication shapes and is shaped by interprofessional collaboration. Analysis identified four key categories: systemic barriers and organizational challenges; social dynamics and interprofessional relationships; supportive leadership and team culture; and patient focus and involvement. These categories intersect across the Four Flows, illustrating how communication acts as a structuring process rather than a neutral tool. The overarching theme," From Separate Paths to Shared Care," highlights how clinicians enact person-centered collaboration through communicative practice in psychiatric outpatient settings.

Understanding the drivers of seclusion and physical restraint supports the work towards minimising their use in acute mental health units. However, evidence on their most important drivers remains limited and is focused mainly on individual-level features. Employing 249 days of 917 contemporaneous records of nurse de-escalation events in one adult inpatient unit in regional Australia, from January 2019 to March 2020, twenty-three features other than individual demographic, dispositional, and diagnostic factors were extracted. Bivariate statistics and supervised machine learning algorithms for feature selection (i.e. Boruta algorithm) and predictive modelling (i.e. random forest) were applied. Emerging top drivers include incidents in high observation beds, the assessed level of situational aggression before de-escalation, incidents directed towards nurses, verbal de-escalation, and distraction and redirection. These findings elevate the predictive value of contextual and interventional, rather than individual-level, features in understanding the likelihood of restrictive practices.

Stimulant use disorder (methamphetamine) represents a significant challenge in correctional settings, where over 40% of incarcerated individuals may be affected. Despite limited access to evidence-based treatments, psychiatric nurses are uniquely positioned to deliver psychosocial interventions. This randomized controlled trial evaluated an 8-week nurse-led cognitive behavioural therapy intervention among 72 incarcerated men with stimulant use disorder (methamphetamine) in Turkey. Participants were randomly assigned to receive either the nurse-led intervention consisting of eight sessions addressing cognitive restructuring, craving management, stress coping, and relapse prevention, or treatment as usual. The Substance Craving Scale and Stress Coping Scale were administered at baseline and post-intervention. Results demonstrated significant improvements in the experimental group, with a 38.5% reduction in craving intensity and 26.7% improvement in overall stress coping strategies. All three coping domains showed significant gains: social support seeking increased 34.1%, problem-focused coping 16.1%, and adaptive avoidance 33.7%. Effect sizes were large for stress coping and medium for craving reduction. These findings support the effectiveness of nurse-led psychosocial interventions in correctional settings and highlight the potential for psychiatric nurses to address substance use disorders among incarcerated populations, even in resource-limited environments.

Introduction: Recovery for people with lived experience (PLE) involves living a meaningful life within the community despite the limitations imposed by mental disorders. However, recovery can be hindered by factors beyond the symptoms themselves, including the stigmatising attitudes and behaviours of community members. Gaining a comprehensive understanding of these hindrances is essential for informing effective preventive strategies that can be implemented by caregivers and healthcare professionals. Despite its importance, limited research has explored the factors that impede recovery from a shared perspective of PLEs, caregivers, and nurses-highlighting a critical gap in the literature.

Aim: This study explores PLEs, caregivers and registered nurses' sharing perspectives on factors hindering recovery in the collectivist society of Saudi Arabia.

Method: An exploratory descriptive qualitative methodology was employed using in-depth semi-structured interviews with 16 PLEs, 10 caregivers and eight registered nurses and inductive thematic analysis of the data.

Findings: Society stigma, broken family bonding, unempathetic behaviours and toxic positivity were identified as factors hindering PLEs' recovery, leading them to adopt behaviours to protect their mental wellbeing.

Discussion: Regardless of the origins of stigma, resisting and protesting it may indicate that PLE overcame barriers to recovery.

Recommendations: Future research should investigate the implementation of recovery-oriented language. Studies should explore the concept of toxic positivity among PLE and their caregivers. Global mental healthcare systems should establish and sustain a trauma-informed care to mitigate negative effects of factors hindering recovery. The consolidated criteria for reporting qualitative studies' 32-item checklist was followed in this study.

This case study explores the multifaceted roles of a nurse with lived experience of mental illness in facilitating peer support for mental health recovery in China. Drawing on qualitative interviews with the nurse, four service users, and four family caregivers, as well as non-participant observations, the study highlights how the nurse enacted four interrelated roles: wounded healer, educator, coordinator, and advocate. Through shared narratives and empathetic engagement, the nurse fostered emotional resonance and challenged internalized stigma among participants. Her integration of family caregivers and mobilization of external resources further strengthened the recovery environment. The study applies the "wounded healer" framework to examine three stages of role transformation-trauma recognition, pain transformation, and transcendence-within a culturally collectivist setting. Findings suggest that even a single nurse with lived experience can play a transformative role in recovery-oriented care, promoting both individual healing and broader social inclusion. By highlighting the therapeutic potential of integrating experiential knowledge into nursing practice, this study offers practical insights for expanding peer support models in under-resourced mental health systems. It also provides culturally relevant implications for the training and inclusion of nurses with lived experience in recovery-oriented mental health care in China and beyond.

Sexting is associated with adolescent depression. This study aimed to expand provider assessment in Family Medicine and specialty settings in Appalachian Upstate South Carolina (AUSC) to include sexting and depression screening. AUSC depression rates are among the highest in the nation, highlighting disparities in the region. This nurse-led mixed-method, exploratory descriptive study included adolescents 11 to 18 years old and providers from an AUSC healthcare system, including nurse researchers, nurse practitioners, and physicians. Following education on sexting, depression, and screening, providers in Family Medicine and specialty settings administered the Intimate Images Diffusion Scale and PHQ-2 to adolescents at episodic visits. Concurrently, providers completed a survey on the barriers and facilitators to talking with parents/guardians (P/G) and adolescents about sexting with each participant, including provider comments. Providers also gave P/G a sexting education notebook to take with them. Surveys were analysed using SPSSv24 statistical software, and comments were analysed using thematic analysis. Over 50% screened positive for sexting, and over 40% of those who sexted screened positive for depression. Providers reported few barriers, with P/G (71.9%) and adolescents (81.3%) talking about sexting. The themes were P/G openness to conversations about sexting, P/G awareness of sexting risks, P/G concerns about sexting, adolescent openness to conversations about sexting, and provider facilitators and barriers to discussing sexting. Provider education and screening is a crucial first step in identifying adolescent sexting and depression. Screening in Family Medicine and specialty settings in rural, underserved areas may lead to earlier diagnosis and treatment and improved patient outcomes.

The aim of this study was to explore individuals' perspectives on the person-centred nursing care they received during a recent mental health inpatient hospitalization. Eight individuals who were admitted to an inpatient unit in the previous 12 months participated in the study. The study was guided by the Person-centred Practice Framework and used the methodology of Interpretive Description. The constant comparative method supported the analysis resulting in three themes: 1) The rare, but precious, moments of person-centred care, 2) The relationship with my nurse: A fluctuating connection, and 3) The pearls and perils of the care environment. Those interviewed described few person-centred experiences. The fragile relationships between participants and their nurses and the fear experienced in the care environment may have contributed to this finding. Our findings are consistent with existing evidence, as the challenges of implementing person-centred care are broad in scope and not easily managed. Study results may encourage nurses to critically reflect on their own practice and consider meaningful changes in how they work. Further, health organizations may consider how they can better support nurses in the delivery of person-centred care through policy development, staff training, and creating environments that foster shared decision-making, safety, and meaningful engagement.

Engaging in hobbies can contribute to personal growth, reduce stress, and foster social connections through community involvement and active participation. If hobbies are to be promoted as a mental health and well-being measure, it is important to provide strong evidence by synthesising the existing research. This scoping review identifies and maps primary research reporting the impact of hobbies on mental health and well-being. In August 2024, a detailed search was performed using PubMed, CINAHL and Scopus electronic databases. Following the screening, 12 articles from 11 studies met the inclusion criteria. Three themes emerged from the data: (1) Depression, anxiety and stress; (2) Quality of life and well-being; and (3) Social interaction and support. Hobbies help connect people, build relationships, and promote a sense of community. Several studies noted lower levels of depression, anxiety or stress as one of the benefits of participating in hobbies. Additionally, hobbies facilitate relaxation and pleasure, playing a crucial role in mitigating anxiety, stress and depression and promoting overall life satisfaction. This review highlights the benefits of hobbies for mental health and well-being. Mental health professionals are well-positioned through their therapeutic relationships with service users to advocate for and promote their engagement in accessible hobbies that support mental health and well-being. Whilst this review identified the therapeutic benefits of hobbies, we suggest that further research is warranted among population groups.