Journal of the American Psychiatric Nurses Association最新文献

Introduction: Psychiatric hospitalization is an opportunity to provide evidence-based tobacco treatment to optimize cessation efforts among people living with mental illnesses (MI). The purpose of this study was to examine the effectiveness of nurse-driven initiatives to enhance tobacco treatment within an inpatient psychiatric setting.

Aims: We assessed the 4-year impact of implementing a nurse-led tobacco treatment service offered to 11,314 inpatients at admissions in a tobacco-free psychiatric facility in Kentucky.

Method: Through a time-series design, we compared the differences in rates of screening for tobacco use and providing treatment from September to December 2015 (prior to implementing the nurse-led tobacco treatment services) to each subsequent year in a 4-year period (2016-2019).

Results: Approximately 60.0% of inpatients were persons using tobacco during the assessment period. Although there were no changes in tobacco use prevalence over the 4-year evaluation duration, there were significant increases in the provision of practical counseling and Food and Drug Administration-approved nicotine replacement therapies for persons using tobacco.

Conclusions: Our findings support the effectiveness of implementing tobacco treatment programs at the organizational level. Psychiatric hospitalizations provide an opportunity to optimize nurse-driven efforts to deliver tobacco treatment to people with MI. Similar models of nurse-led tobacco treatment services can be adopted within inpatient and other mental and behavioral health settings.

Objective: Prior psychiatric simulation experiences required our nursing students to role-play in an unknown area of nursing. Students confidence, clinical satisfaction, and use of clinical skills were negatively impacted leading to unmet course objectives. The aim of this pilot study was to strengthen our baccalaureate senior nursing students' simulation experience in their psychiatric nursing course with the use of standardized patients (SPs) instead of student role-play and measure the impact of this strategy on students' learning, satisfaction, and confidence in an unfamiliar area of nursing.

Methods: A mixed method explanatory sequential design was used. Participants consisted of a convenience sample of senior nursing students enrolled in their psychiatric nursing course. A quantitative simulation tool and a four-item questionnaire were analyzed after completion of the simulations (n = 47).

Results: Findings of this study identified greater than 80% of students had increased level of learning, confidence, and satisfaction with the SP simulation experience. Nurse faculty were able to overcome simulation barriers, that is, a patient hearing voices, non-verbal signs of depression, and evaluate students meeting course learning outcomes.

Conclusions: Findings from this study highlight students' positive simulation experiences. Using SPs as an educational strategy can be effective for students to reach competency, achieve higher knowledge, and improve confidence. It is believed the use of SPs as a simulation strategy in psychiatric nursing will assist students with clinical judgment and better prepare them to meet the needs of vulnerable persons with psychiatric conditions.

Background: Negative attitudes toward mental disorders are not only an interpersonal issue but also a concern of mental health care. Given that nursing students are future health care providers, it is pivotal to improve their attitudes toward individuals with mental disorders prior to their transition into clinical practice. However, research on nursing students' attitudes in relation to schizophrenia in Taiwan remains unexplored.

Aim: The aim of this article is to examine the correlates of attitudes toward individuals with schizophrenia among Taiwanese undergraduate nursing students.

Method: A descriptive, correlational, and cross-sectional study was adopted. Self-reported questionnaires were conducted with a convenience sample of 306 Taiwanese undergraduate nursing students. Descriptive statistics, independent t tests, one-way analysis of variance, Pearson's correlations, and a stepwise regression analysis were performed.

Results: Nursing students expressed negative attitudes toward individuals with schizophrenia. Nursing students, who were female, had contact with individuals with mental disorders, and expressed greater empathy and personality traits held more favorable attitudes toward individuals with schizophrenia. The study found that empathy, personality traits, and academic year were the most crucial attributes contributing to attitudes of nursing students toward individuals with schizophrenia.

Conclusion: Findings suggest that nursing education programs with empathy- and personality-tailored modules in mental health are pivotal to provide humanistic approaches with supportive attitudes regarding schizophrenia.

Background: Adolescent ineffective stress management has been associated with negative health outcomes, such as anxiety and depression. Comprehensively evaluating the effects of stress management interventions is needed.

Aims: The aim of this study was to quantitatively evaluate the effects of stress management interventions on mental health outcomes (stress, anxiety, depression, and positive and negative affect) and perform moderation analysis to identify moderators of intervention effects on stress, anxiety, and depression among U.S. high school adolescents.

Methods: Four databases (CINAHL, ERIC, PubMed, and PsycINFO) were searched. After literature screening, 24 articles describing 25 studies were retained. Hedge's g was calculated using random-effects models. Exploratory moderation analyses were performed to identify moderators.

Results: The pooled effects on reducing stress were -0.36. The interventions had small effects on decreasing anxiety (g = -0.31) and depression (g = -0.23). Long-term follow-up effects were -0.77 on perceived stress, -0.08 on anxiety, and -0.19 on depression. Mind-body and cognitive-behavioral interventions had moderate effects on reducing anxiety (g = -0.51). Interventions with longer duration (>8 weeks) were more effective in reducing anxiety (-0.39 vs. -0.26) and depression (-0.36 vs. -0.17).

Conclusions: These findings support the short-term effectiveness of stress management interventions in improving mental health among high school adolescents in the United States. Subsequent research efforts should focus on sustaining long-term effects.

Introduction: Behavioral crises are increasingly prevalent in health care settings. Existing programs, however, include procedures that lack adaptability, omit critical components, and deviate from clinical best-practice recommendations. Health care employees also continue to report lacking confidence for safely managing behavioral crises.

Aims: We described the development and acceptability of a comprehensive crisis prevention program and its modification for a large pediatric health care system to help remediate the limitations of existing programs.

Method: Chi-square analyses evaluated the acceptability of the crisis prevention program pre- versus post-training and at 3- and 6-month follow-up times. For insignificant outcomes, logistical regressions identify whether responses differed between emergency-department and nonemergency-department employees.

Results: Chi-square analyses were significant for 10 of 15 questions suggesting that employees were more confident in managing and communicating during behavioral crises post-training, and that this confidence was maintained. Logistic regressions found that emergency-department employees differed in some responses to the acceptability questionnaire than nonemergency-department employees over time.

Conclusion: The present crisis prevention program is adaptable to various settings and patients, and it is well received overall by employees. The safety of patients and employees is integral to the delivery of quality care and improving patient-provider relations.

Background: Urban, ethnically/racially diverse, impoverished men are predisposed to experience unaddressed depression and anxiety. The overlap of these factors creates significant mental health inequity.

Aims: This study sought to capture men's impressions of the factors that contributed to their experience of depression and anxiety as well as barriers that they experienced in pursuing intervention.

Methods: Using community-based participatory research, in the context of long-term partnerships between a department of nursing and three urban, racially/ethnically diverse, and impoverished neighborhoods, the researchers recruited 50 men ages 23-83 years. Data were collected via six homogeneous, Zoom-based focus groups composed of Black, Hispanic, and White men, respectively.

Results: The men identified multiple themes pertaining to modifiable and non-modifiable contributing factors that played a role in their development of depression and anxiety as well as barriers related to stigma, resource issues, and a lack of knowledge of mental illness that they faced when seeking intervention.

Conclusions: Understanding men's perspectives on the contributing factors and barriers to mental health intervention can provide an evidence base with which to address mental health inequity via tailored care, policy, and research agendas.

Background: African American women have an elevated risk for experiencing depressive symptoms, and discrimination, stress, and coping contribute to symptoms of depression.

Aims: We aimed to examine the associations between discrimination, stress, and coping on symptoms of depression among young African American mothers.

Methods: In this retrospective study, we utilized a hierarchical linear regression to explore the effects of perceived racial discrimination, stress, and general and discrimination-related coping responses on depressive symptoms in a sample of African American mothers (N = 250). The data were drawn from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure study (InterGEN), a study conducted between 2014 and 2019 and based in Connecticut.

Results: After accounting for maternal age, level of education, and income, greater perceived racial discrimination (p = .03), higher levels of stress (p < .001), greater engagement in avoidance coping (p < .001), and use of passive coping responses to discrimination (p = .04) were uniquely associated with increased depressive symptoms. Other forms of coping, specifically, problem-solving and support seeking, did not appear to influence depressive symptoms in this sample.

Conclusion: The findings highlight the negative impact of discrimination, heightened stress, and maladaptive coping on the emotional health of young African American mothers.

Background: Parents of children with autism spectrum disorder (ASD) face unique challenges in raising their children, and they are at higher risk for depression compared to parents of children with typical development (TD) and other disabilities.

Aims: (1) To compare prevalence of depressive symptoms among mothers of children with ASD (n = 101), Down syndrome (DS, n = 101), and TD (n = 43) and (2) to describe the relationships among depression, self-efficacy, and family functioning, and describe the mediating role of maternal child care self-efficacy between depressive symptoms and child behavior.

Methods: In this cross-sectional study, mothers completed the Social Communication Questionnaire, Aberrant Behavior Checklist, Patient Health Questionnaire-9 (PHQ-9), Family Assessment Device General Functioning Scale, and Maternal Self-Efficacy Scale.

Results: Mothers of children with ASD had significantly higher mean PHQ-9 scores (p < .001), higher proportion of positive depression screening (p < .001), and lower family functioning (p < .001). Better family functioning is associated with less depression, better self-efficacy, and less severe ASD symptoms and behaviors. Self-efficacy mediated the relationship between depression and child ASD symptoms, and problematic behavior.

Conclusions: The rates of reported history of depression and low family functioning in mothers of children with ASD are twice the rate in mothers of children with DS and TD. Maternal child care self-efficacy is protective against maternal depression, even in the presence of severe child problematic behaviors and ASD symptoms. Interventions that increase child care self-efficacy and family functioning may be helpful in addressing depression in mothers of children with ASD.

Objective: The use of sexual activity to self-injure has been proposed in research literature but remains underexplored. The purpose of this pilot study was to determine the feasibility of identifying sexual activity as self-injury in a U.S. college-based sample and to provide a preliminary examination of sexual activity as self-injury to inform future study on this topic.

Method: A cross-sectional descriptive pilot study was conducted to assess for recognition of and attitudes toward sexual behavior as self-injury and to identify participant-reported experiences of sexual activity to self-injure.

Results: A total of 50 participants completed the online survey. Thirteen (26%) participants reported they had heard of the concept of "sex as self-injury." Six (12%) participants reported ever having used sexual activity to cause physical or psychological harm to themselves. Participants reported intentions for engaging in sexual activity to self-injure, including causing physical pain, reliving past self-harm or trauma, showing vulnerability, proving self-worth, pleasing or wanting to feel needed by their partner, and suicidal ideation.

Conclusion: Sexual activities have been used by some college students as a means of self-harm. Further research is needed to understand this phenomenon and clinicians should consider screening for this in patients who participate in dangerous sexual behaviors or self-injurious behaviors.