Journal of the American Psychiatric Nurses Association最新文献

Background: Depression is a growing concern among university students. Chatbots provide flexible, accessible, personalized psychosocial support. Delivering Mindfulness-Based Stress Reduction (MBSR) sessions via chatbots may reduce depressive symptoms in university students.

Aim: This study aims to evaluate the feasibility, acceptability, safety, and preliminary efficacy of a chatbot-based MBSR intervention for university students with depressive symptoms.

Methods: A rule-based MBSR chatbot was developed and evaluated with a single-group pretest-posttest study for university students in Hong Kong (N = 30) reporting depressive symptoms, followed by the collection of their subjective feedback. The intervention lasted eight weeks. The primary clinical outcome was depression levels, with a range of secondary outcomes.

Results: The chatbot-based MBSR program demonstrated satisfying recruitment, retention, and adherence rates. The safety of the program was confirmed by the absence of any adverse events directly related to the intervention, tracked from the onset of the intervention to the completion of data assessment. Significant improvements were observed in both primary and secondary outcomes. Participant feedback highlighted the benefits of the program and its effects on depressive symptoms.

Conclusions: The program has shown feasibility, acceptability, safety, and preliminary efficacy in reducing depressive symptoms among 30 university students in Hong Kong. The intervention should now be evaluated in a randomized controlled trial with follow-up. This study highlights the potential role of chatbot-based interventions in mental health promotion, nursing, and clinical practice and will inform the subsequent development of innovative digital interventions to address mental health challenges faced by university students.

Background: About 115,000 young people in the United States experience a first episode of psychosis (FEP) annually. FEP is associated with functional decline and long-term executive functioning impairment. Schizophrenia is a risk factor for homelessness with up to 20% of individuals diagnosed experiencing homelessness. Homelessness conveys many burdens including higher rates of victimization, incarceration, and substance use. The intersection of homelessness and FEP represents a uniquely vulnerable population undergoing the compounding effects of two highly stigmatizing burdensome experiences that negatively impact health outcomes, treatment engagement, and life expectancy.

Aims: This study reviews the literature to explore what is currently known about the impacts of homelessness on individuals with FEP, knowledge gaps, directions for research, and recommendations for action.

Methods: An integrative review was conducted in April 2023 with APAPsychInfo, APAPsychArticle, Medline, and CINAHL.

Results: This is the first known review to examine available literature on homelessness and FEP. Current literature examines aspects of FEP and homelessness, but not the likely compounding and interacting relationships between multiple variables. Although the associations among variables such as FEP, homelessness, substance use, legal involvement, family involvement, and treatment engagement have not been studied, the literature available may be suggestive of a compounding negative effect on FEP outcomes.

Conclusion: FEP programs should define homelessness, report rates of homelessness, and conduct research examining the compounding effects of homelessness and FEP as well as other factors like race and ethnicity. Research and policy should support housing interventions for homeless individuals to improve treatment engagement and health outcomes.

Background: One of the most crucial objectives in the education and treatment of young children with autism spectrum disorder (ASD) is independence in daily living skills (DLS). Therefore, as a child with ASD condition grows, measures of everyday functioning including adaptive behaviors should be more regularly monitored and regulated.

Aim: The primary aim of this study was to evaluate the feasibility of a developed theory-based training program and its preliminary effectiveness on the acquisition of DLS among school-age children with ASD.

Methods: A preliminary experimental research design (pre- and post-evaluation) was conducted from the beginning of May to the end of July 2023 on 31 children with ASD. The socio-economic status scale, Vineland Adaptive Behavior Scale, and Gilliam Autism Rating Scale were administered before and after a theory-based DLS training program.

Results: There was a significant difference in the DLS and motor functioning before and after the implementation of the training program (p < .001 and p = .021, respectively). In addition, there was a significant difference in the total score of autistic severity before and after the implementation of the training program (p < .001).

Conclusion: The promising outcomes of the study indicate the need for further testing and expansion of this intervention. These findings contribute to the growing body of evidence highlighting the significance of DLS training program in the comprehensive treatment approach for children with ASD. Consequently, proposing DLS training programs as a cost-effective and efficient nursing intervention is warranted.

INTRODUCTION: Treatment for eating disorders (EDs) after hospitalization requires structured environments such as residential care programs where treatment options such as meal support therapy can help manage the physical and psychological effects of their illness. The residential center for this project follows a multidisciplinary approach that uses cognitive behavior therapy (CBT) as a treatment modality for ED. Structured meal support is an essential part of implementing the center's CBT program. AIM: The project aimed to determine if one-on-one mealtime support training for staff can help increase oral nutrition intake in adolescents with EDs. METHODS: Meal consumption data for five residents of the ED center was used for this project. First, 2 weeks of meal consumption data were collected (210 meals). Then residential center staff were trained on using meal support strategies adapted from the Auckland Eating Disorder Manual. After training the staff and having them implement the strategies with ED clients for a week, another 2 weeks of meal consumption data were collected (210 meals). The preimplementation and postimplementation data were compared to determine if the intervention had an impact on the overall meal intake by residents of the ED center. RESULTS: Before implementing the project, patients completed 122 meals in 2 weeks, representing 58.1% of their meals and after the intervention, patients completed 141 meals representing 67.14% of their meals. CONCLUSION: Project findings show that the use of mealtime support strategies while providing one-on-one support for patients with EDs led to an increase in the overall oral intake.

BackgroundNursing presence is a core relational phenomenon in nursing. It is the process of devoting attention to being with and connecting with another, requisite to providing quality, holistic, person-centered care. Presence has been incorporated in the newly revised scope and standards of nursing, as an intervention. There is a paucity of research on the experience of nurses practicing in mental health settings who employ presence to provide unique, relational care.AimsThe aim of this research is to understand the lived experience of nurses providing nursing care and engaging with presence in the mental health setting.MethodsThe tenets of hermeneutic phenomenology proposed by Heidegger and Gadamer were used to guide this inquiry. Twelve nurses practicing mental health were interviewed on Zoom using a semistructured interview guide and the interview time ranged from 45 min to 1 hr. Data were analyzed using the interpretative phenomenological analysis (IPA) process outlined by Smith et al.ResultsFour themes are identified: A powerful intervention which fuels healing, Building the bridge, Transcending barriers, and Preserving the well.ConclusionsNursing presence is implicated as essential to improving the quality of holistic health care, positively impacting patients and nurses. These findings may influence nursing leaders, educators, and administrators to incorporate nursing presence in nursing curricula, develop policies respecting presence, and alter the culture of the health care environment.

Objective: In 2023, over 20 million individuals in the United States experienced a mental health condition and a co-occurring substance use disorder. As many as 42% of individuals with a mental health condition report past-year illicit drug use, and as many as 6% report past-year opioid use. Given the high rates of psychiatric comorbidity and mortality associated with opioid use disorder, it is imperative that psychiatric mental health nurses not only view opioid use disorder as a brain-based, chronic remitting-relapsing disease but also leverage non-stigmatizing clinical approaches to improve patient outcomes. Harm reduction is a practical and transformative approach that seeks to empower people who use drugs with the choice to live healthy, self-directed, and purpose-filled lives. This article provides an overview of theoretical harm reduction approaches and tangible harm reduction interventions to inform psychiatric mental health nursing practice.

Methods: Relevant literature was reviewed related to harm reduction and its role in psychiatric mental health nursing practice.

Results: Harm reduction as an ethos is discussed, in addition to practical harm reduction strategies such as opioid antagonists for overdose reversal, fentanyl test strips, syringe service programs, and supervised consumption sites. The importance of patient engagement is highlighted as necessary in improving health outcomes among those who use substances.

Conclusions: Given the conclusive evidence that a harm reduction approach and associated interventions are lifesaving, it is the ethical duty of psychiatric mental health nurses to implement and advocate for harm reduction across the healthcare continuum.

BackgroundEarthquakes cause significant psychological and physical trauma in children, especially when leading to amputations, as they disrupt physical, emotional, and social well-being.AimThis study was conducted phenomenologically to explore the experiences of children amputated in the Kahramanmaraş earthquake and their parents/caregivers.MethodThis study was conducted as a phenomenological study with children who were amputated in the Kahramanmaraş earthquake and their parents/caregivers between August and October 2023. The sample of the study consisted of seven children and their parents/caregivers who met the inclusion criteria and volunteered to participate in the study through purposive sampling method. Data were collected through in-depth interviews using an introductory information form and a semistructured interview form developed by the researcher.ResultsIt was found that 57.2% of the children who participated in our study were male and their mean age was 11.25 ± 4.02 years. It was found that all the children's houses were destroyed in the earthquake, they were trapped under the debris, and they experienced losses in their family members and relatives. As a result of data analysis, nine themes were identified as apocalypse, pain, fear, and hopelessness for children and apocalypse, helplessness, pain, anger, and hopelessness for parents/caregivers.Conclusions:This study found that earthquake-affected amputee children perceived the earthquake as an apocalypse, experienced prolonged pain during hospitalization, continued to fear the earthquake, and felt hopeless about the future. The children's parents/caregivers also reported that they perceived the earthquake as an apocalypse, that they felt helpless and hopeless for themselves and the children, and that the children had angry/irritable behavior with pain after the disaster.

Background: Nurses enrolled in certified registered nurse anesthetist programs are taught to be experts in complex pharmaceutical agents, often under high stakes conditions. Such conditions may create maladaptive coping mechanisms, such as substance use. However, exploration of student registered nurse anesthetists' (SRNAs) perceptions of substance use and drug diversion have only been minimally described in the literature.

Aims: The study aims were to (a) investigate SRNAs' ratings of the American Association of Nurse Anesthesiology's (AANA) recommended strategies to reduce drug diversion and (b) analyze qualitative responses to open-ended items related to the use of substances.

Methods: Approximately 400 students responded to an online survey in March 2021. The survey was randomly sent to 3,000 SNRAs who were members of the AANA (return rate of 13%). Descriptive statistics and paired t-tests were calculated to determine differences between strategies viewed as effective and strategies that have been implemented. A descriptive content analysis was conducted to derive themes from four open-ended questions.

Results: For all 11 AANA strategies, the means for effectiveness were significantly higher than means for strategies that were implemented, indicating that strategies were seen as effective, but were not being implemented. The highest scored perceived effectiveness strategy was "Creating a safe environment for prompt reporting." Themes captured a high-pressured, high-stakes educational environment, characterized by rigidity and incivility.

Conclusions: Policies to support a safe environment to encourage students to self-report substance use, an awareness of alternative-to-discipline programs, and reintegration into educational programs should be formulated and implemented by educational institutions.