Journal of the American Psychiatric Nurses Association最新文献

Objectives: Tobacco cessation remains a challenge for patients in psychiatric settings, with behavioral health care providers (BHCPs) often lacking training in mindfulness-based interventions. This gap may limit BHCPs' ability to offer holistic, evidence-based support to patients struggling with tobacco dependence. Experiential Learning Theory underpinned the mindfulness intervention, emphasizing hands-on learning. Through active participation, such as role-playing and discussion, BHCPs developed practical skills to incorporate mindfulness techniques into patient interactions. Incorporating mindfulness education may enhance tobacco treatment (TT) training, potentially improving outcomes for patients with psychiatric challenges.

Methods: A pilot evaluation was conducted on a brief 1-hr online training on mindfulness-based TT strategies. Pre- and post-intervention surveys were used to assess changes in knowledge scores. Post-surveys assessed confidence and intent to apply the learned skills in practice. Changes in knowledge scores were analyzed using paired-sample t-tests, and descriptive statistics were used to present results on confidence and intent to apply learned skills scores after the intervention.

Results: Of 28 BHCPs attending the training, 18 completed pre- and post-test surveys. Among these, there was an increase in knowledge scores (t = -2.496, p = .012) post-intervention. After the intervention, on a scale of 0 to 4, participants (n = 18) rated the intervention as highly effective in supporting their learning (M = 3.57, SD = 0.59) and also reported moderate levels of confidence (M = 2.87, SD = 1.06) and high intention (M = 3.70, SD = 0.55) scores to integrate mindfulness practices to support TT.

Conclusions: Our findings support the feasibility of a 1-hr mindfulness-based training to change BHCPs' knowledge and support confidence and intention to enhance TT efforts.

Background: Little is known about the palliative care needs of people living with a mental illness and a life-limiting illness.

Aims: To gain an understanding of palliative care need and service utilization in adult inpatients with mental health issues across a metropolitan area health service in Perth, Western Australia.

Methods: Data were collected at four sites from patient medical records. Adult patients who were admitted at study sites' mental health units were eligible for inclusion.

Results: In total, 192 patient records were reviewed. Almost one-third of patients (32%, n = 61) had at least one condition listed in the Gold Standards Framework, and 30% (n = 18) of these could have potentially benefited from palliative care. There was evidence of one patient receiving some form of palliative care.

Conclusions: In this cohort, there was unmet need for palliative care, especially among older adults. The majority of patients with potential palliative care needs were admitted to older adult mental health wards. There are missed opportunities to provide holistic care to adult inpatients with mental health issues experiencing life-limiting conditions, likely to result in poorer symptom control and reduced quality of life. Approaches to identify and respond to palliative care needs in mental health settings need to be adopted.

Background: Suicide represents a serious public health issue and lacks a singular, universally accepted definition, which complicates its study and comprehensive prevention. Its prevention requires a multidimensional framework encompassing individual, social, and structural factors, as the interaction among these elements significantly increases risk. Moreover, its impact varies across sociodemographic contexts, highlighting the need for tailored strategies that address the specific realities of each population.

Aims: This study aimed to examine suicidal behavior among young people and analyze its prevalence in relation to gender, sexual orientation, country of origin, education, employment status, and family relationships.

Methods: The sample consisted of 539 young individuals aged 15 to 30 years (M = 20.64, SD = 3.61). Participants completed the Suicide Behaviors Questionnaire-Revised to assess suicidal behavior and provided information on 11 independent variables grouped into sociodemographic, educational, occupational, personal, and familial domains. Descriptive and multivariate analyses were conducted using MANOVA.

Results: Most participants exhibited a low risk of suicide; however, nearly 20% showed moderate to high risk levels. Higher vulnerability was observed among women, migrants, and lesbian, gay, bisexual, transgender, intersex, queer, and questioning (LGBTIQ+) individuals. In addition, adverse family relationships and socioeconomic precarity were associated with increased susceptibility to suicidal behavior, as were personal, educational, occupational, and familial factors.

Conclusions: The findings enhance understanding of suicidal behavior among young people. The results underscore the urgent need for preventive strategies grounded in an intersectional perspective, integrating educational interventions, public welfare policies, and family support initiatives that address the structural inequalities affecting youth mental health.

Background: Suicide rates have risen disproportionately in Black youth, yet little is known about risk factors specific to this population.

Aims: We sought to identify proximal risk factors for suicide-related behavior (SRB) in a sample of Black youth at high risk for mood disorders.

Methods: The sample, drawn from a longitudinal study, included 156 Black youth aged 17 years or younger at baseline. Participants underwent baseline diagnostic and clinical assessment, including suicidal ideation and SRB, and yearly assessments for new SRB. Observations were censored at the time point closest to the first episode of SRB or the last observation for those without SRB. Chi-square, Fisher's exact test, t-tests, and Firth logistic regression were used.

Results: Twelve participants experienced SRB during follow-up. The average age of participants at baseline was 12.6 years (SD = 2.7). Participants were 44% female and 10% identified as Hispanic. Self-reported irritability, aggression, suicidal ideation, and a depression diagnosis were significant at the univariate level. Medium to large effect sizes were found for self-reported impulsive aggression, parental substance use disorder, and childhood abuse, all consistent with prior reports to be associated with SRB in youth. Using Firth logistic regression, younger age (β = -.60; p = .001) and depression diagnosis (β = 2.32, p = .006) were proximal risk indicators of SRB.

Conclusions: Risk factors identified in this study are consistent with previous reports in majority White samples. A depression diagnosis was the strongest indicator, highlighting the importance of early identification of depression in Black youth, particularly in younger youth with a family history of mood disorder.

Objective: Burnout among correctional nurses is a growing concern, with 50% to 62% reporting symptoms and intent to leave their positions. This occupational phenomenon, marked by emotional, physical, and mental exhaustion, stems from chronic workplace stress and is exacerbated in correctional environments due to overcrowding, perceived threats of violence, and limited autonomy. This study aimed to assess environmental contributors to burnout among nurses located in a southeastern U.S. county correctional facility.

Methods: Using a cross-sectional design and the Maslach Burnout Inventory paired with the Areas of Work life Survey, the study evaluated six domains of workplace stressors.

Results: Of 22 eligible participants, 45% completed the survey. Contrary to prior findings, nurses reported feeling safe and having adequate time to complete tasks. However, low scores in workplace relationships, recognition, and fairness suggest systemic issues. These findings highlight the need for leadership training, improved reward systems, and policy reforms to foster healthier work environments.

Conclusion: Addressing organizational culture is critical to improving nurse well-being, retention, and patient outcomes. This study contributes to the limited literature on correctional nurse burnout and underscores the importance of targeted interventions to reduce stress and enhance job satisfaction in secure care settings.

Objectives: Missing outpatient psychiatric care could lead to decompensation and hospitalization. The purpose of this quality improvement project was to implement reminder phone calls in the outpatient psychiatric setting and measure the impact on appointment adherence.

Methods: Reminder phone calls were provided by three clinic staff to patients the day before their scheduled appointment during a 9-week intervention period. Due to seasonal appointment attendance variation, attendance during the 9-week period was compared to the same 9-week period the year prior.

Results: A total of 837 appointments were evaluated, and 16.25% resulted in missed appointments. In-person no-show percentages were different from 1 year to the next, while telehealth no-show percentages were not. The overall no-show rate for in-person visits was 21.39%, while telehealth was 12.63%.

Conclusion: There may be many reasons for a missed appointment, with forgetting an appointment being only one of them. Despite a reminder phone call, appointment attendance did not significantly improve. Providers may want to consider flexible scheduling from in-person to telehealth appointments as a way to improve attendance, given that telehealth appointment attendance is higher and may eliminate transportation concerns. Future studies should evaluate flexible scheduling as well as multi-pronged interventions that address several reasons for non-attendance.

Background: Depression and anxiety are among the most prevalent mental health disorders globally, often leading to significant impairments in daily functioning. While traditional treatments are practical, complementary approaches-such as nature-based and animal-assisted therapies-are gaining recognition, home aquariums may offer a safe, accessible, and underexplored therapeutic modality for individuals experiencing these conditions.

Purpose: This study aimed to explore the experiences of individuals with depression and/or anxiety who interact daily with fish in a home aquarium, using narrative inquiry to understand the therapeutic potential of fishkeeping.

Methods: A qualitative narrative inquiry design guided by Clandinin and Connelly's framework and Smith and Liehr's Story Theory was employed. Seven participants were recruited through social media and interviewed via Zoom. Data were analyzed through the dimensions of temporality, sociality, and spatiality to uncover patterns and meaning in participants' stories.

Results: Participants described fishkeeping as a source of emotional therapy, social connection, and personal growth. Themes included reconnecting with memories, finding purpose through caregiving, and experiencing calm and creativity through aquascaping. The aquarium served as a therapeutic environment that fostered resilience, reduced stress, and enhanced well-being.

Conclusion: Home aquariums offer a nature-based, person-centered approach to mental health, fostering comfort, creativity, and resilience. This study supports integrating animal-assisted therapies into holistic models. Future research is needed to explore broader applications, long-term outcomes, and comparative efficacy across diverse populations.

Background: Sexual health is a vital aspect of holistic nursing care, yet its integration into psychiatric practice remains limited, particularly among nursing students. Understanding how students approach sexual health in psychiatric settings is crucial for improving education and care quality.

Aims: This study aimed to investigate the factors influencing nursing students' provision of sexual health care to individuals with psychiatric disorders.

Methods: A descriptive qualitative design was used to explore the experiences of 28 undergraduate nursing students enrolled in a psychiatric nursing course in Sakarya, Turkey. Each student assessed the sexual health of individuals with psychiatric disorders during clinical practice with psychiatric patients. Data were collected through semi-structured interviews and were analyzed thematically.

Results: Four themes emerged: (1) inclusion of sexuality in the clinical process, (2) the empowering role of education, (3) uncertainty in sexual care, and (4) systemic invisibility. Facilitators of comprehensive assessment included recognizing diagnosis-related changes in sexual desire, understanding sexuality's role in psychological well-being, and receiving education that strengthened communication skills and confidence. Barriers included conflicts between personal values and professional roles, discomfort and potential misunderstandings in gender-based interactions, cultural norms surrounding sexuality, lack of counseling resources or standardized care plans, and insufficient privacy in psychiatric settings.

Conclusions: Nursing students face educational, cultural, and systemic barriers that complicate sexual health care in psychiatric settings. Targeted educational programs and institutional support are needed, with content addressing privacy, ethics, boundaries, and cultural sensitivity, supported by practice-based learning to better prepare students for sexual health discussions in clinical practice.