Journal of the American Psychiatric Nurses Association最新文献

Background: Mothers of children with autism spectrum disorder (ASD) report significantly more depressive symptoms, lower maternal self-efficacy, and worse family functioning than mothers of neurotypical children and children with Down Syndrome. There is a need to describe what contributes to high self-efficacy and high family functioning among mothers of children with ASD.

Aim: To understand how mothers of children with ASD describe their emotions, maternal self-efficacy, and family functioning, comparing mothers who screen positive and negative for symptoms of depression.

Methods: In this second phase of a larger sequential explanatory mixed methods study, this qualitative descriptive study was conducted using semi-structured individual interviews with mothers of children with ASD. The data were analyzed by hybrid directed content analysis for a presentation of themes. Those themes were then compared across three groups: mothers who screened positive for depression, mothers who screened negative, and mothers whose screening results changed over time.

Results: Mothers in the group who screened positive for depression described more child behaviors perceived as problematic, higher caretaking demands, maternal self-efficacy dependent on child's progress and comparisons to others, more passive coping, and poor family communication.

Conclusion: Interventions to improve family processes and maternal self-efficacy may be an important complement to individual therapy for treating maternal depression. Intervening at the family level as soon as the child is diagnosed may also help mitigate maternal depressive symptoms. More research is necessary to understand and develop interventions that can improve the experiences of mothers of children with ASD.

Background: North Korean refugee women face significant psychological, economic, social, and cultural challenges when adapting to South Korean society. Understanding these challenges is essential for developing effective nursing interventions and health policies to support their successful adaptation.

Aims: This study aimed to identify the key challenges faced by North Korean refugee women during their adaptation to South Korean society and provide insights for nursing interventions and health policies to facilitate successful resettlement.

Methods: Using Walker and Avant's concept analysis framework, a systematic literature search on North Korean refugee women's adaptation to South Korean society was conducted to identify key attributes, antecedents, and consequences of adaptation.

Results: Four key attributes of adaptation to South Korean society were identified: psychological stability, economic independence, social relationship formation, and cultural acceptance. Psychological challenges, such as post-traumatic stress disorder (PTSD) and depression, significantly hinder adaptation. Economic independence and supportive social networks are essential for successful resettlement.

Conclusions: This study provides a comprehensive understanding of adaptation among North Korean refugee women and identifies defining attributes to inform psychiatric nursing practice and future research. However, the findings may be limited by the scarcity of recent literature and the specificity of the South Korean context.

Background: High-fidelity simulations are valuable for teaching mental health concepts in undergraduate nursing programs and are most effective when programs collaborate with stimulated participants (SPs) to maximize realism.

Aim: Examine the perceptions of student SPs in mental health nursing simulations.

Method: The pilot study was conducted at a rural mid-sized university in the Midwest with five pre-health students and seven theater majors or minors who served as SPs in undergraduate nursing mental health simulations. Utilizing a qualitative descriptive design, responses were analyzed thematically to identify patterns across participant perspectives.

Results: Seventy-five percent (n = 9) stated that this experience affected their own mental health. All five pre-health students reported gaining empathy for patients with mental health issues.

Conclusion: The mental health of student SPs may be affected by learning cases and portraying a mental health patient. Careful attention is needed to maintain the psychological safety of all SPs, and de-roling and debriefing are essential. SPs need to feel supported to opt out of potential triggering experiences and encouraged to reach out for support if they are having difficulty.

Objective: Therapeutic communication is essential to nursing practice, yet many pre-licensure nursing students report discomfort applying these skills in clinical settings. Standardized patient (SP) simulation offers a controlled environment for practicing communication, yet qualitative research describing students' perceptions of these experiences remains limited. This study explored undergraduate nursing students' perspectives on small-group, communication-focused SP simulations within a psychiatric-mental health nursing course.

Methods: As part of a larger program evaluation, six in-person focus groups were conducted with 47 Bachelor of Science in Nursing students following participation in two series of SP simulations across nine scenarios. Discussions were audio-recorded, transcribed, and analyzed using inductive thematic content analysis. An audit trail and team debriefing supported rigor and consistency.

Results: Three themes emerged. First, students reported that SP simulations increased their comfort and confidence in therapeutic communication, providing a safe space to practice navigating emotionally charged conversations and building rapport. Second, the simulations evoked ambiguity regarding the psychiatric-mental health nurse's role, as students struggled to differentiate therapeutic communication from psychotherapy and acknowledged real-world time constraints that limit such interactions. Third, students identified high-quality, instructive feedback, particularly during debriefing, as essential to learning and expressed a desire for more structured guidance from SPs and faculty.

Conclusions: Communication-focused SP simulations effectively enhance therapeutic communication skills among pre-licensure nursing students. To optimize learning, faculty should intentionally clarify nursing role boundaries and strengthen debriefing structures. Findings highlight the importance of targeted feedback and instructional support in maximizing the educational value of SP-based simulation.

Background: Suicide remains a leading global public health concern, and crisis hotlines are a critical preventive intervention. However, there is a paucity in studies about how population-level digital information-seeking behaviors for suicide and crisis hotlines evolve across time and countries.

Aims: This study aimed to (1) examine temporal trends and seasonality of global Google searches for "Suicide" and "Crisis Hotline," (2) analyze their temporal associations through cross-lagged correlations, and (3) identify country clusters based on all-time relative search volumes (RSVs).

Method: Monthly global RSVs (2004-2025) and country-level all-time RSVs were extracted from Google Trends. Time-series analyses included Seasonal and Trend decomposition using Loess (STL) decomposition, Kruskal-Wallis tests for seasonality, Autoregressive Integrated Moving Average (ARIMA) forecasting, Pearson correlations, and cross-lagged correlations of raw and detrended series. K-means clustering was applied to country-level data.

Results: Suicide searches showed persistent baseline levels with spikes in 2009-2010, 2014, 2017-2018, and 2020-2021. Crisis hotline searches rose sharply from the late 2010s, accelerating during the COVID-19 period. Seasonality was significant for suicide but not for hotlines. Cross-lagged analysis showed a +22-month raw lag (r = .22) that disappeared after detrending, leaving only a contemporaneous association (r = .31). Four global clusters highlighted disparities in suicide versus crisis hotline interest.

Conclusion: Google Trends can serve as a proxy for real-time public demand for suicide prevention resources. Findings emphasize the need for agile, context-sensitive strategies to strengthen hotline visibility and accessibility globally.

Background: This manuscript explores the silent yet urgent crisis of suicidal ideation and suicide within the nursing profession. Despite being one of the most trusted and essential health care roles, nurses face disproportionately high risks for psychological distress, moral injury, and suicide.

Aims: The paper aims to synthesize existing evidence on prevalence, risk factors, and theoretical frameworks to guide prevention and intervention efforts, while emphasizing the critical need for trauma-informed, organizational, and policy-level responses.

Methods: Using Joiner's Interpersonal Theory of Suicide, the Job Demand-Control-Support (JDCS) model, and trauma-informed care (TIC) principles, the manuscript illustrates how feelings of burdensomeness, thwarted belonging, and exposure to trauma converge to elevate suicide risk.

Results: Key contributing factors to nurse suicide include chronic occupational stress, compassion fatigue, workplace bullying, moral distress, and limited autonomy, all compounded by a pervasive stigma around mental health help-seeking. A poignant case study underscores how institutional silence and lack of systemic support following medical errors can lead to devastating outcomes. Barriers such as fear of licensure consequences and lack of confidential services further discourage early intervention.

Conclusions: The suicide crisis among nurses necessitates a comprehensive, multi-level response. Nurse leaders must foster psychologically safe environments, promote peer support, and integrate mental health education into all levels of practice. System-level changes-such as confidential reporting systems, national suicide surveillance, licensure reform, and culturally competent outreach-are essential to prevent further loss. Future research must examine longitudinal risk trajectories, intervention efficacy, and artificial intelligence (AI)-driven early warning tools tailored to the nursing workforce.

BACKGROUNDThere are a number of effective treatment options available to women with postpartum depression (PPD). However, women often do not receive information about such options to help them make an informed choice. Aims. To determine the treatment preferences of women with PPD in Spain, to explore how exposure to evidence-based information influences these preferences, and to analyze whether these preferences are attended to by health professionals.METHODSA quasi-experimental pre-post survey study was designed, using an online questionnaire including the Edinburgh Postnatal Depression Scale (EPDS) and questions on treatment preferences, depression history, and access to therapeutic information. The sample consisted of 1146 women aged 19-52 years who had given birth in the last year, selected by nonprobability sampling. They were randomly assigned to an experimental group (with access to evidence-based information on treatments for PPD) and a control group (no information). Most participants preferred psychotherapy.RESULTSAccess to information did not change the preference for psychotherapy but increased the inclination toward antidepressants. The severity of PPD did not influence the choice of combined treatment. More than half of the diagnosed patients did not receive detailed information from the National Health Service (NHS), and their preferences were not taken into account.CONCLUSIONSThe results suggest a need for improved primary care training, increased psychotherapeutic resources, and the development of digital tools to improve access to PPD treatment.

Introduction: Transgender and gender diverse (TGD) youth disproportionately experience suicidality and acute psychiatric visits. However, research on affirming care in this setting is severely limited.

Aims: This mixed-methods study aimed to (1) assess pediatric acute psychiatric professionals' knowledge, attitudes, and comfort working with TGD youth and (2) examine pediatric acute psychiatric professionals' experiences and perceptions of providing affirming care to TGD youth.

Methods: This study used a mixed-methods approach to assess pediatric acute psychiatric health professionals' knowledge, attitudes, and comfort working with TGD youth and examine their experiences and perceptions of providing affirming care. Participants completed an online questionnaire consisting of demographic and professional characteristics, transgender-related attitudes and beliefs, and a series of true/false knowledge questions.

Results: Among participants (N = 31), most (n = 22, 71%) reported prior specific training and/or education on TGD youth, while less than a quarter (n = 7, 23%) reported the amount to be adequate. The mean knowledge score was 94.4% (SD = 7.1; range: 73%-100%). Optional interviews (n = 9) yielded nine inductive themes: five describing experiences of TGD youth care and four describing perceptions of affirming care.

Conclusions: Acute psychiatric settings provide crucial care for youth in crisis. Given starkly high rates of suicidality among TGD youth, there is a pressing need for targeted training to enhance healthcare workers' abilities to intervene effectively. Competency training should emphasize gender identity and expression, use of preferred pronouns, and understanding healthcare needs like hormone therapy and gender-affirming surgeries.