Journal of the American Psychiatric Nurses Association最新文献

Background: Trends in perinatal anxiety (PNA) and perinatal depression (PND) have been increasing among pregnant and parenting adolescents (PPAs). We examined the state of research on perinatal mental health focused on PPAs experiencing PND or PNA, including knowledge and perceptions of PNA and PND, mental health needs, care preferences, and access to perinatal mental health care among PPAs.

Aims: Our goal was to improve our understanding of PND and PNA among PPAs to enable the development of culturally relevant perinatal mental health interventions, reduce maternal morbidity and mortality, and enhance health outcomes for mothers and infants.

Methods: We used the Whittemore and Knafl (2005) five-stage methodology to search five electronic databases and the Mixed Methods Appraisal Tool to rate the methodological quality of the selected articles.

Results: Our search yielded 26 studies with various designs that assessed PNA and PND. Although we found limited research on PNA, quantitative studies reported PND rates ranging from 16% to 40% among PPAs. PPAs and their families often struggle to differentiate between PND and PNA. Research on PPA's preventive practices for PND and PNA is limited, though coping strategies for PND have been identified. PPAs expressed diverse perspectives on their mental health needs, expecting services to address a broad range of psychosocial issues. Factors influencing PPA's access and engagement with perinatal mental health services should be considered in future interventions to improve adherence and uptake. Tailored web-based interventions, combining professional support with online flexibility, are needed to enhance engagement among PPAs.

Conclusion: Perinatal mental health research for PPAs is evolving. The findings emphasize the need for increased support and adaptive care for PND and PNA in this vulnerable group, particularly in resource-limited settings requiring self-management.

BackgroundThe Philippines is a significant supplier of nurses worldwide despite facing a considerable nursing shortage of about 127,000 in its healthcare system. Given the challenging socioeconomic conditions that can heighten their risk for various mental health issues in the country, it is crucial to explore the rate and factors of depression among Filipino nurses to support them in their roles better.AimsThis systematic review explores the rate and associated factors of depression among Filipino nurses.MethodsAfter screening and assessing 56 studies from three databases, data from three studies were extracted, described, compared, and synthesized.ResultsThe proportion of nurses who self-reported experiencing depressive symptoms among the eligible studies ranged from 19.5% to 45%, with 11.2% to 19.9% of participants indicating mild symptoms, 5.8% to 18.2% reporting moderate symptoms, and 2.5% to 6.8% reporting severe to extremely severe depressive symptoms. Depression rates were higher among nurses intending to migrate (31%) than those not intending to migrate (23%). Depression was positively associated with disengagement, exhaustion, and overall occupational burnout, while it was negatively associated with personal faith, spiritual contentment, and religious practice.ConclusionThese findings highlight the need for community-based and hospital-based mental wellness programs for nurses that enhance their motivation, engagement, self-efficacy, and spirituality. Future research should explore longitudinal studies and broader sampling methods to enhance generalizability. Research can also focus on interventions, such as the different religious and spiritual practices, as well as policies addressing depression and its implications.

ObjectivesThis paper describes the different modalities of Coordinated Specialty Care (CSC) in first-episode psychosis and illustrates how psychiatric nurse practitioners can fulfill important roles in the team-based effort of individualized treatment and therefore increase access to specialized care for those suffering from early serious mental illness.MethodsReview of published literature and other online resources on first-episode psychosis (FEP) and CSC, shortage of psychiatric providers, and the role of the Psychiatric Mental Health Nurse Practitioner.ResultsResults are extracted from published literature on young persons experiencing FEP within current CSC models, as well as other online resources evaluating the increasing psychiatrist shortage throughout the United States.ConclusionThis article explores the potential roles and benefits of integrating psychiatric nurse practitioners into first-episode care and advocates that their involvement improves access to timely and effective interventions for young persons experiencing new-onset psychosis.

BackgroundAdverse childhood experiences (ACEs) are associated with both increased depressive symptomatology and nicotine dependence (ND) in the general population. However, the relationship between ACEs, depressive symptoms, and ND among people with mental illness (MI) remains unexplored.AimsIn this study, we examined (a) depressive symptoms mediating the relationship between ACEs and ND and (b) ND severity mediating the relationship between ACEs and depressive symptoms.MethodA cross-sectional design was used to recruit participants online and from community mental health settings. Data analysis was conducted using IBM SPSS version 29.ResultsResponses from 194 individuals were included in the analysis. ND intensity mediated the relationship between ACEs and depressive symptom severity. The indirect variance of the effects of this mediation was 10.9%, 6.9%, and 10.6% among the total sample, females, and males, respectively. In addition, depressive symptoms mediated the relationship between ACEs and ND intensity, and the indirect variance of the effect of this mediation was 7.9%, 3.6%, and 8.8% in the total sample, females, and males, respectively.ConclusionsAmong people living with MI, ND mediates the impact of ACEs on depression, with varying degrees of influence between genders. In addition, depressive symptoms mediate the effect of ACEs on ND intensity. Further research is needed to investigate effective depressive treatment modalities to be integrated into tobacco treatment plans among people living with MI. In addition, nurse clinicians should assess for childhood adversity and depressive symptoms among tobacco users while treating ND.

Background: The complexity of health concerns associated with unregulated substance use has led to increased hospital utilization by people who use unregulated substances. Health care providers have described inadequate knowledge to adequately support this patient population during hospitalization.

Aims: The aim of this research was to explore health care providers' perspectives on harm reduction and substance use education in hospital settings.

Methods: A qualitative secondary analysis was conducted using an interpretive lens. The research was conducted across three hospitals in one city in Southwestern Ontario. To guide the research, 31 health care providers, the majority being nurses, participated in either focus groups or individual interviews based on preference. All focus group or interview data were analyzed using an ethnographic method of analysis focusing on the hospital environment and education.

Results: Health care providers described two interconnected states regarding harm reduction and substance use education: the current state and the desired state. Key themes which emerged in the current state and desired state include: (a) insufficient education, (b) lack of resources, (c) inconsistent policy, (d) culture of stigma and suboptimal care, (e) enhanced education, (f) resources, (g) policy change, and (h) culture shift and optimal care.

Conclusion: Findings of this study demonstrate the need for supportive policies, adequate resources, and enhanced harm reduction and substance use in hospital settings. Addressing these gaps is essential to transforming hospital culture and improving care for people who use unregulated substances. These insights can inform future policy, practice, education, and guide new research initiatives.

Background: Women Veterans are at increased risk for both substance use and suicidality, both of which can contribute to early morbidity and mortality.

Aims: This study aimed to examine the impact of substance use on suicidality among women Veterans compared to their peers, and how this relationship might be moderated by access to care.

Methods: This study utilized data from the 2015 to 2019 National Surveys on Drug Use and Health (NSDUH) administered by the Substance Abuse and Mental Health Services Administration (SAMHSA) (n = 131,344). A series of binary logistic regression analyses was used to examine the relationship between substance use and suicidality, adjusted for demographic factors and stratified by sex and Veteran status.

Results: Women Veterans were at increased odds of suicidality compared to their peers. In women Veterans, only lifetime non-prescribed prescription opioid use (aOR = 1.99 [1.04-3.79], p = .038) and lifetime cocaine use (aOR = 1.74 [1.10 = 2.74], p = .018) increased the odds of past-year suicidal ideation. Past-year cannabis use disorder, but not combined drug use disorders, increased the odds of suicidal ideation in women Veterans (aOR = 3.93 [1.21-13.81], p = .033). Lifetime cannabis use (aOR = 2.02 [1.03-3.96], p = .040), lifetime cocaine use (aOR=2.24, 1.20-4.05, p = .011), and lifetime stimulant use (aOR = 1.87 [1.05-3.33], p = .034) increased the odds of past-year suicide plans among women Veterans.

Conclusions: Women Veterans are at increased risk for suicidality, and substance use may predict suicidality in this population. Psychiatric nurses can be instrumental in ensuring timely access to care for women Veterans, underscoring this study's clinical relevance.

Objective: The diagnostic landscape in psychiatric practice has shifted significantly in recent years, particularly around neurodevelopmental and trauma-related conditions. Where diagnosis once functioned primarily as a medical tool to identify and treat functional impairment, it is increasingly used as a narrative framework to explain suffering, validate identity, and confer legitimacy within both clinical and social contexts. This conceptual article critically examines the cultural inflation of psychiatric diagnoses, especially autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and trauma-related conditions, and explores implications for psychiatric nursing practice.

Methods: We conducted an integrative review of literature on diagnostic inflation in psychiatry from 2010 to 2024, with particular attention to nursing implications. Literature findings are synthesized with composite case examples representing common clinical dilemmas-identity-based self-diagnosis, diagnostic ambiguity, and the pathologization of adaptive behavior-to illustrate key concepts.

Results: Diagnostic inflation impacts psychiatric nursing in areas including assessment validity, therapeutic alliance, resource allocation, ethical decision-making, and professional identity. Digital culture accelerates these challenges by promoting self-diagnosis and identity-based diagnostic frameworks, particularly among young adults seeking explanations for psychological distress and interpersonal difficulties.

Conclusion: Psychiatric nurses are increasingly called upon to discern between pathology and personhood. We propose a practice framework that maintains diagnostic integrity while honoring lived experience and the meaning that diagnostic narratives hold for individuals seeking understanding of their experiences.