Journal of the American Psychiatric Nurses Association最新文献

Background: High patient activation is associated with a variety of positive health outcomes. Although increasing patient activation in persons with opioid use disorder (OUD) in intensive outpatient treatment (IOT) programs may increase engagement and improve outcomes, little is known about how patient activation is manifested in these programs.

Aims: To describe types of instances in which persons play an active role in their IOT or show self-determination in their recovery generally (patient activation) and types of instances in which they play a passive role in their IOT or have recovery directed by others (patient nonactivation).

Methods: A qualitative descriptive study using data from a larger grounded theory study was conducted. Interviews were completed with 14 persons with OUD who attended an IOT program within a large health care system in the Midwest. Content analysis was used to create a typology of instances of patient activation or nonactivation in participants' IOT experiences.

Results: Six types of instances were identified: (1) making and enacting one's own treatment decisions, (2) actively collaborating with staff, (3) self-determining one's disclosure in groups, (4) making a commitment to treatment, (5) taking responsibility for one's recovery, and (6) taking actions to avoid return to use.

Conclusions: Patient activation is multidimensional and plays a salient role in IOT experiences. IOT staff should engage patients as active participants in their treatment and encourage mutual goal-setting and shared-decision but should be aware that some approaches used too early in treatment may impede recovery.

Introduction: Research suggests that persons diagnosed with behavioral health illnesses can benefit from shared decision-making. On an inpatient behavioral health unit, low Press Ganey scores related to satisfaction with involvement in care triggered a root cause analysis that identified patients did not feel engaged by nursing during their time together; and discharge meetings with the health care team were not required.

Aims: The purpose of this quality improvement project was to improve patient perception of involvement in their care as evidenced by increased Press Ganey scores and increased number of patients involved in discharge meetings.

Methods: Nurses used an evidence-based model for nurse-patient communication: the Seeking information, Engaging in conversation, Exploring options, and Deciding on treatment (SEED) and use of a Control Preferences Scale (CPS) to increase communication about treatment and discharge decisions.

Results: A total of 120 patients engaged in the intervention. Patient presence at discharge meetings increased from 39% to 82% (p < .001), and Press Ganey scores evidenced minimal change.

Conclusions: Use of the SEED model and CPS by nurses was effective in increasing patients' involvement in their treatment. Although findings were limited due to COVID-19, the study suggests that improving patient involvement from admission through discharge throughout hospitalization can improve patient experience scores.

Background: In 2018, one in six newly diagnosed individuals with HIV in the United States were adults aged 50 years and older, 24% were women, and 60% were Black/African American and Hispanic (42% and 18%, respectively).

Aims: This study aims to examine the factors associated with HIV psychosocial illness impact among Black/African American and Hispanic older women living with HIV.

Method: Guided by the socioecological model, a secondary data analysis design with cross-sectional data that included 138 Black/African American and Hispanic women aged 50 years and older was conducted.

Results: Higher levels of avoidant coping, depressive symptoms, negative self-perception of health, and decreased social support were significant factors associated with HIV psychosocial illness impact among this sample.

Conclusions: Findings from this study can contribute to identifying solutions to prevent and decrease these negative factors associated with HIV psychosocial illness impact among Black/African American and Hispanic older women.

Background: Adults with severe mental illnesses have mortality rates 2.5 to 3 times higher than the general population, largely due to medical illnesses. Those with the most profound mental illnesses are served by assertive community treatment (ACT) teams that provide intensive mental health care; however, there are no clearly established models to integrate physical health treatment into ACT and this is a critical gap in the literature.

Aims: To describe perceptions of ACT team members regarding services provided for their clients to treat physical health, how those services can be improved, and what implementation strategies would likely be needed to promote uptake and sustainability of those services on ACT teams.

Method: Qualitative interviews were conducted via Zoom using a semistructured interview guide with 19 employees from three ACT teams in a southeastern state. Interview transcripts were analyzed, using manifest content analysis, a form of qualitative analysis, to identify key themes in the interview transcripts.

Results: ACT team members described limited physical health services for their clients. They reported (1) system-level barriers to improving physical health care, such as inadequate tools and training; and (2) patient-level barriers, such as limited awareness of physical care needs. ACT team members reported the need for additional medical staff and strengthened relationships with primary care providers. They also recommended changes in policy, education, and quality monitoring to implement new physical health care services.

Conclusions: Findings suggest intervention components and implementation strategies for improving physical health care of ACT consumers.

Objective: Examine the advantages, disadvantages, and challenges of telehealth for the psychiatric mental health nurse practitioner (PMHNP) in practice and student education. Describe areas for future research and policy development regarding telehealth in PMHNP practice and training during and beyond the COVID-19 pandemic.

Methods: Review current evidence, standards of practice, and education for the PMHNP.

Results: Recent rapid pandemic-related shifts in utilization of telehealth for clinical practice and student education have highlighted the advantages, disadvantages, and areas in need of additional study.

Conclusions: Postpandemic telehealth care delivery will likely persist or expand. PMHNPs must advocate for high practice and education standards.

Background: Sexual health is a taboo issue in some societies. Limited assessments were conducted during nursing care in mental health services. It is unknown whether psychiatric nurses' competencies would be enhanced through short training courses.

Aims: The present study employed a quasi-experimental design to evaluate the effectiveness of an 8-hour sexual health care training for psychiatric nurses to improve sexual health knowledge, attitude, and self-efficacy in a teaching psychiatric hospital in southern Taiwan.

Method: Volunteered psychiatric nurses were randomly assigned to the experimental or control group. The 8-hour training program contained sexual health knowledge and attitudes, case discussion, role play, and sexual identity or harassment issues. Each nurse received a pretest and a posttest in the 1-month period between August and September 2019. Descriptive and multivariate statistical analyses were used to evaluate the effects.

Results: Among the 75 psychiatric nurses, 43 were in the control group and 32 were in the experimental group. The two groups were not significantly different in the working year, gender, education, marriage, and other psychosocial variables. After the training, the overall performance of sexual health care knowledge, attitudes, and self-efficacy of the experimental group improved significantly than the controls.

Conclusions: The sexual health care training program enhanced psychiatric nurses' confidence and generally improved their sexual knowledge and attitudes. It is suggested that sexual health care needs to be highlighted during in-job training to augment the well-being and life quality of psychiatric patients.

Background: Mental health problems are estimated to affect one in six individuals in the European Union. Fifty percent of mental disorders start in adolescence, around the age of 14. The stigma associated with having a mental health problem is one of the main barriers to seeking help for psychiatric and psychological disorders among adolescents and young adults. Interventions to reduce social stigma could contribute to increased help-seeking behavior in this population. AIMS: To assess the effectiveness of a direct contact intervention in the classroom by persons with lived experience to reduce vocational students' stigmatizing attitudes. METHOD: One person with lived experience and one first-degree relative implemented a classroom intervention lasting 90 min. Its effectiveness was measured using a quasi-experimental study with a pretest-posttest design and within-subject control. RESULTS: A total of 128 students from three different Vocational and Technical Schools from Spain participated in the study. After the intervention, statistically significant differences were observed in the scores of 11 of the 13 dimensions measured with the Spanish Mental Illness Stigma Attribution Questionnaire (AQ-27-E) and the Community Attitudes toward Mental Illness (CAMI) questionnaires. No differences associated with gender or familiarity with the mental disorder were observed. CONCLUSION: Vocational students' negative attitudes and emotions can be improved through a direct contact intervention in the classroom involving people who have experienced a mental disorder themselves. The age range for optimal results with this type of intervention appears to be 18 to 20 years.

Background: Patients with bipolar affective disorder (BPAD) have a suicide risk of up to 30 times higher than the general population. There is increasing interest in analyzing the effects of resilience in psychiatric diseases and its relationship to other factors such as suicide risk.

Aim: The main objective of this study was to analyze the relationship between psychological resilience and suicide attempts, along with other relevant clinical and sociodemographic variables in euthymic patients with BPAD.

Methods: Eighty six outpatients, more than 18 years old, mostly men (60.5%) with BPAD type 1, 2, mixed, and unspecified, in euthymic phase receiving antidepressant and/or euthimizing treatment, participated in the study. Sociodemographic and clinical variables were assessed by means of a questionnaire and psychological resilience by means of Connor-Davidson's 10-item Resilience Scale.

Results: Patients with previous autolytic attempts scored significantly lower in resilience than those who had not attempted suicide (T = 3.30; p ≤ .001; 20.61 ± 6.58 vs. 26.52 ± 7.29). Patients diagnosed with BPAD scored significantly lower than other samples of university participants, workers, and the unemployed. The number of depressive episodes experienced was negatively and significantly associated with resilience scores (r = -.28; p < .01).

Conclusions: Patients diagnosed with BPAD who had made autolytic attempts had lower resilience scores than those who had not made them and lower scores than other general nonpsychiatric samples. The promotion of resilience in patients diagnosed with BPAD would facilitate a more adaptive and positive coping with the disease and their recovery process.