Nursing observations are a critical component of psychiatric services, playing a key role in ensuring patient safety and maintaining high standards of care.
Aims
This study aims to examine the relationship between nursing observations and their impact on patient agitation and aggression in a psychiatric state hospital.
Methods
The study included 363 inpatients and was part of a broader investigation into the impact of nursing services on treatment processes during hospitalisation in a psychiatric hospital. The data were collected through observation forms completed by nurses and analysed statistically.
Results
Certain nursing interventions and observations were significantly associated with patient agitation and aggression. Weak to moderate correlations were found between various behaviours and restraint–isolation, excitation and agitation. Linear regression models revealed significant predictors for restraint, excitation and agitation based on observed behaviours.
Discussion
There remains uncertainty regarding which observation areas should be prioritised and how they should be evaluated. A structured, evidence-based psychiatric nursing observation guideline is urgently needed to address inconsistencies in care.
Limitations
Due to the lack of standardised assessment tools in this area, conclusions were based on electronically documented qualitative observations.
Implications
The findings suggest that targeted nursing interventions can effectively reduce agitation and aggression, thereby improving patient safety and care quality.
Recommendations
Enhancing the structure and quality of nursing observations could lead to significantly better outcomes for individuals with psychiatric disorders.
{"title":"Agitation and Aggression in Psychiatric Care: Insights From Nursing Observations in a Turkish Mental Health State Hospital","authors":"Metin Aslan, Seren Gunay, Huseyin Gulec","doi":"10.1111/jpm.70070","DOIUrl":"10.1111/jpm.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Nursing observations are a critical component of psychiatric services, playing a key role in ensuring patient safety and maintaining high standards of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aims to examine the relationship between nursing observations and their impact on patient agitation and aggression in a psychiatric state hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 363 inpatients and was part of a broader investigation into the impact of nursing services on treatment processes during hospitalisation in a psychiatric hospital. The data were collected through observation forms completed by nurses and analysed statistically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Certain nursing interventions and observations were significantly associated with patient agitation and aggression. Weak to moderate correlations were found between various behaviours and restraint–isolation, excitation and agitation. Linear regression models revealed significant predictors for restraint, excitation and agitation based on observed behaviours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>There remains uncertainty regarding which observation areas should be prioritised and how they should be evaluated. A structured, evidence-based psychiatric nursing observation guideline is urgently needed to address inconsistencies in care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Limitations</h3>\u0000 \u0000 <p>Due to the lack of standardised assessment tools in this area, conclusions were based on electronically documented qualitative observations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>The findings suggest that targeted nursing interventions can effectively reduce agitation and aggression, thereby improving patient safety and care quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Recommendations</h3>\u0000 \u0000 <p>Enhancing the structure and quality of nursing observations could lead to significantly better outcomes for individuals with psychiatric disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":"33 1","pages":"109-119"},"PeriodicalIF":2.9,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohamed Ali Zoromba, Atallah Alenezi, Ahmed Hashem El-Monshed, Ahmed Loutfy, Amira Mohammed Ali, Sameer A. Alkubati, Heba Emad El-Gazar
Background
Nurses caring for children with autism spectrum disorder (ASD) encounter unique challenges that can affect their psychological well-being and professional efficacy. Cognitive-Behavioural Strategies (CBS) are a promising approach to bolster the psychological resources of these nurses.
Objectives
This study sought to evaluate the effects of a structured CBS intervention on self-efficacy, sense of coherence (SOC) and psychological ownership among nurses caring for children with ASD.
Methods
This open-label, two-arm, parallel, randomised controlled trial was conducted from December 2024. A total of 131 registered nurses caring for children with ASD were randomly allocated to an intervention group (n = 65) or a control group (n = 66). The intervention group received a 6-week CBS programme. Outcomes were measured using the General Self-Efficacy Scale, SOC Scale and Psychological Ownership Questionnaire at baseline and post-intervention.
Results
After the intervention, the intervention group demonstrated significant improvements compared to the control group in self-efficacy (t = 2.506, p < 0.05), SOC (t = 3.936, p < 0.001) and psychological ownership (t = 2.110, p < 0.05). Within-group analyses indicated significant pre–post improvements in the intervention group across all measures, with large effect sizes for SOC and self-efficacy, and a moderate effect size for psychological ownership.
Conclusions
The CBS intervention significantly improved self-efficacy, SOC and psychological ownership among nurses caring for children with ASD. These findings highlight CBS as a valuable strategy for supporting nurses in specialised care settings, with potential benefits for both nurse well-being and patient care quality.
{"title":"Effect of Cognitive-Behavioural Strategies on Self-Efficacy, Sense of Coherence and Psychological Ownership Among Nurses Caring for Children With Autism Spectrum Disorder: A Randomised Control Trial","authors":"Mohamed Ali Zoromba, Atallah Alenezi, Ahmed Hashem El-Monshed, Ahmed Loutfy, Amira Mohammed Ali, Sameer A. Alkubati, Heba Emad El-Gazar","doi":"10.1111/jpm.70066","DOIUrl":"10.1111/jpm.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nurses caring for children with autism spectrum disorder (ASD) encounter unique challenges that can affect their psychological well-being and professional efficacy. Cognitive-Behavioural Strategies (CBS) are a promising approach to bolster the psychological resources of these nurses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study sought to evaluate the effects of a structured CBS intervention on self-efficacy, sense of coherence (SOC) and psychological ownership among nurses caring for children with ASD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This open-label, two-arm, parallel, randomised controlled trial was conducted from December 2024. A total of 131 registered nurses caring for children with ASD were randomly allocated to an intervention group (<i>n</i> = 65) or a control group (<i>n</i> = 66). The intervention group received a 6-week CBS programme. Outcomes were measured using the General Self-Efficacy Scale, SOC Scale and Psychological Ownership Questionnaire at baseline and post-intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After the intervention, the intervention group demonstrated significant improvements compared to the control group in self-efficacy (<i>t</i> = 2.506, <i>p</i> < 0.05), SOC (<i>t</i> = 3.936, <i>p</i> < 0.001) and psychological ownership (<i>t</i> = 2.110, <i>p</i> < 0.05). Within-group analyses indicated significant pre–post improvements in the intervention group across all measures, with large effect sizes for SOC and self-efficacy, and a moderate effect size for psychological ownership.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The CBS intervention significantly improved self-efficacy, SOC and psychological ownership among nurses caring for children with ASD. These findings highlight CBS as a valuable strategy for supporting nurses in specialised care settings, with potential benefits for both nurse well-being and patient care quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT06929858</p>\u0000 </section>\u0000 </div>","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":"33 1","pages":"97-108"},"PeriodicalIF":2.9,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuanyuan Zhang, Mengmeng Lyu, Juli Yang, Conghong Li
Background
Personal recovery, a dynamic process of rebuilding identity and purpose beyond mental illness, remains underexplored within China's mental health system, which predominantly prioritizes clinical recovery.
Aim
To assess personal recovery among Chinese urban community-dwelling individuals with mental illness and to identify its predictors, including socio-demographic factors, self-stigma, and heterogeneous clinical recovery patterns.
Method
Cross-sectional study was conducted. 227 participants diagnosed with schizophrenia or mood disorders were recruited from community mental health outpatient services in Shanghai, China. Participants were invited to complete the questionnaire, which included items on personal recovery, clinical recovery, and self-stigma. Latent Profile Analysis was applied to identify heterogeneous clinical recovery patterns, and hierarchical regression analysis was subsequently used to examine predictors of personal recovery.
Results
Results indicated moderate personal recovery among participants with mental illness. Latent Profile Analysis identified four distinct clinical recovery profiles: Stable, Interpersonal-Emotion, Interpersonal-Abuse, and High-Risk. Regression revealed higher education, full self-awareness ability, and membership in the Stable Class of clinical recovery significantly predicted better personal recovery.
Discussion
Culturally tailored interventions should integrate psychosocial support with clinical care, particularly targeting on populations with low educational attainment, those with suboptimal clinical recovery outcomes, and individuals experiencing self-stigma.
Relevance to Mental Health Nursing
Personal recovery plays a pivotal role in facilitating the social reintegration of individuals with mental illnesses who remain concealed within community settings. These findings offer scientific evidence to inform mental healthcare professionals in developing targeted rehabilitation support interventions.
{"title":"Predictors of Personal Recovery Among People With Mental Illness in the Chinese Community: A Cross-Sectional Study","authors":"Yuanyuan Zhang, Mengmeng Lyu, Juli Yang, Conghong Li","doi":"10.1111/jpm.70068","DOIUrl":"10.1111/jpm.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Personal recovery, a dynamic process of rebuilding identity and purpose beyond mental illness, remains underexplored within China's mental health system, which predominantly prioritizes clinical recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess personal recovery among Chinese urban community-dwelling individuals with mental illness and to identify its predictors, including socio-demographic factors, self-stigma, and heterogeneous clinical recovery patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Cross-sectional study was conducted. 227 participants diagnosed with schizophrenia or mood disorders were recruited from community mental health outpatient services in Shanghai, China. Participants were invited to complete the questionnaire, which included items on personal recovery, clinical recovery, and self-stigma. Latent Profile Analysis was applied to identify heterogeneous clinical recovery patterns, and hierarchical regression analysis was subsequently used to examine predictors of personal recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results indicated moderate personal recovery among participants with mental illness. Latent Profile Analysis identified four distinct clinical recovery profiles: Stable, Interpersonal-Emotion, Interpersonal-Abuse, and High-Risk. Regression revealed higher education, full self-awareness ability, and membership in the Stable Class of clinical recovery significantly predicted better personal recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Culturally tailored interventions should integrate psychosocial support with clinical care, particularly targeting on populations with low educational attainment, those with suboptimal clinical recovery outcomes, and individuals experiencing self-stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Relevance to Mental Health Nursing</h3>\u0000 \u0000 <p>Personal recovery plays a pivotal role in facilitating the social reintegration of individuals with mental illnesses who remain concealed within community settings. These findings offer scientific evidence to inform mental healthcare professionals in developing targeted rehabilitation support interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":"33 1","pages":"86-96"},"PeriodicalIF":2.9,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael Nash, Floraidh Rolf, Andrew Grundy, Timothy Frawley, Mark Pearson, Jessica MacLaren, Fiona Nolan
<p>Ethical review of research proposals involving human subjects is a fundamental aspect of research governance. The purpose of Research Ethics Committees (RECs) is to ensure that research conforms to ethical and legal standards, particularly that participants' rights are protected (Tusino and Furfaro <span>2022</span>). Protecting participants may require RECs to adopt a paternalist stance. Paternalism in healthcare, is a process of professional decision-making based on what is felt to be in the patient's best interest (Sandman and Munthe <span>2010</span>). In research, paternalism concerns RECs making decisions based on what they consider to be in the research participant's best interest. Paternalism contrasts with autonomy, which is usually expressed as the right of competent adults to make informed decisions about their own medical care (Pons et al. <span>2020</span>). However, as essential as protecting participants in research is Cook et al. (<span>2022</span>) ask: when does protection become paternalism, and who gets to decide this?</p><p>Mental Health Nurse Academics UK (MHNAUK) is a professional interest group with members from over 120 organisations in the UK and international Higher Education Institutions (HEI), NHS mental health providers and government and voluntary organisations. MHNAUK serves as a forum for discussion, collaboration and raising awareness around issues relating to mental health, in particular education, research, and policy development.</p><p>In one meeting, some members decided to conduct research on student mental health nurses' experiences of self-harm during clinical practice. The overall aim of the study was to develop a framework of support sessions to help students cope with these events. Their initial ethics application was rejected due to the perceived vulnerability of the sample (nursing students) but was eventually approved following extensive edits to the application. The researchers felt that the REC had been unduly paternalistic as the threshold of risk seemed elevated due to the subject matter and perceived vulnerability of the sample.</p><p>A special meeting was arranged to explore members' experiences of perceived paternalism in RECs, and it happened to be a common experience from both University/Faculty (HEI) RECs and NHS RECs (if a clinical aspect of the research was required). What we, as MHNAUK researchers, have encountered is a tension between the need for RECs to protect research participants and the requirement for more recovery-focused and lived experience research with service users, families and carers.</p><p>The concept of recovery is embedded in mental healthcare and service provision (Slade et al. <span>2014</span>). Recovery philosophy recognises the inherent individual experience of illness but supposes that hope and a contributing life, even with limitations caused by symptoms, can lead to service users having new meaning and purpose (Anthony <span>1993</span>). In mental healthcar
对涉及人类受试者的研究计划进行伦理审查是研究治理的一个基本方面。研究伦理委员会（rec）的目的是确保研究符合道德和法律标准，特别是参与者的权利得到保护（Tusino和Furfaro 2022）。保护参与者可能需要RECs采取家长式的立场。医疗保健中的家长式作风是一种专业决策过程，基于患者的最佳利益（Sandman和Munthe 2010）。在研究中，家长式作风涉及rec根据他们认为符合研究参与者的最佳利益做出决策。家长式作风与自主权形成对比，自主权通常表现为有能力的成年人有权就自己的医疗保健做出知情决定（Pons等人，2020年）。然而，与保护研究参与者同样重要的是Cook等人（2022）提出的问题：保护何时成为家长式作风，谁来决定这一点？英国心理健康护士学会（MHNAUK）是一个专业兴趣小组，成员来自英国和国际高等教育机构（HEI）、NHS心理健康提供者以及政府和志愿组织的120多个组织。MHNAUK是一个讨论、合作和提高对与精神卫生有关的问题，特别是教育、研究和政策制定的认识的论坛。在一次会议上，一些成员决定对学生心理健康护士在临床实践中自残的经历进行研究。这项研究的总体目标是建立一个支持会议的框架，以帮助学生应对这些事件。他们最初的伦理申请由于样本（护生）的脆弱性而被拒绝，但最终在对申请进行广泛编辑后获得批准。研究人员认为，REC过于家长式，因为风险阈值似乎因样本的主题和感知脆弱性而升高。安排了一次特别会议，探讨成员在RECs中感知家长式作风的经历，这恰好是大学/学院（HEI） RECs和NHS RECs的共同经历（如果需要临床方面的研究）。作为MHNAUK的研究人员，我们遇到的是一种紧张关系，一方面需要RECs来保护研究参与者，另一方面需要更多以康复为重点的、与服务用户、家庭和护理人员一起进行的生活体验研究。康复的概念嵌入到心理保健和服务提供中（Slade et al. 2014）。康复哲学承认个人对疾病的固有体验，但假设希望和有贡献的生活，即使有症状造成的限制，也能使服务使用者有新的意义和目的（Anthony 1993）。在精神卫生保健实践中，促进康复需要增加服务使用者的自主权和治疗风险。这包括授权服务用户做出有关自身安全的决策，并承担风险以实现个人发展（Felton et al. 2017）。促进自主和选择被认为是恢复概念的核心（Slade et al. 2014），这可能会给RECs带来挑战，在RECs中，保护研究参与者免受伤害的家长式作风可能会导致服务用户声音的压制。健康研究中的伦理批准问题不仅限于心理健康，而且在几个领域都有报道，例如，Pickering（2018）在物质使用研究中以及Monaghan等人（2012）在哮喘儿童中。在精神卫生领域，家长式作风的一个突出问题源于这样一种假设，即服务使用者都是脆弱的。在伦理审查过程中，研究人员经常被要求表明他们的研究是否包括来自“弱势”群体的参与者。Schroeder等人（2024）发现，在57项研究伦理规范和指导方针中，精神疾病患者与囚犯、学生、难民和未成年人等其他群体一起被归类为弱势群体。自动归因于“弱势群体”可能反映了与决策能力（DMC）相关的感知问题，DMC被定义为做出决策和沟通决策的心理能力（Sleeman和Saunders 2014）。在精神健康方面，在某些情况下，DMC可能会受损，例如精神分裂症或双相情感障碍、痴呆等病症（NHS 2022）。然而，并不是所有的精神疾病都会损害个人在参与研究时提供知情同意的能力（美国精神病学协会研究伦理工作组2006）。Spencer等人（2018）表明，即使在严重不适的情况下，住院的精神分裂症和相关精神病患者尽管缺乏用于治疗的DMC (DMC- t)，也可以保留用于研究的DMC （DMC- r）。 MHNAUK的研究人员还指出，全面采用脆弱性意味着他们在RECs中面临更高的诚实标准。Bracken-Roche等人（2016）注意到，将脆弱性等同于受损的DMC将其降低为静态特征，仅由参与者的诊断定义。这可能是rec的直觉判断，可能会受到认知偏差的影响（Rid et al. 2010）。例如，锚定偏差发生在过分重视某一患者特征时（Nash et al. 2024）。对于rec来说，精神疾病可能是一种锚定偏见，他们会自动假设自己的脆弱性，降低DMC，从而导致更高的伦理审查标准。对脆弱的笼统概念也可能是一种歧视。Perlin和Dorfman（1993:51）将Sanism定义为“一种非理性偏见，与其他非理性偏见具有相同的性质和特征，例如种族主义、性别歧视、同性恋恐惧症，这些偏见导致了普遍的社会偏见态度……Sanism主要基于刻板印象、神话、迷信和去个性化”。RECs的规则可能暗示，保护主义是一种有意识的倾向于保护“脆弱的”服务用户。当然，危险在于服务用户的声音在研究中被压制了，我们对生活经验的了解也被削弱了。过度保护导致自主权和参与研究以及塑造心理健康实践和经验格局的权利受到侵蚀（Marsh和Kelly， 2018）。一些与会者报告说，卫生服务RECs似乎没有很好地理解定性方法，一位与会者评论说，涉及非结构化或参与性观察的研究似乎容易受到越来越多的审查和评论，因为REC成员无法想象这些方法是如何工作的。他们举了一个人种学住院病人研究的例子，REC主席问他们的第一个问题是“你希望有人从你的窗户往里看吗？”其他与会者报告说，家长作风的问题影响了攻读硕士学位的学生，而硕士学位的毕业论文是其中的一个组成部分。预见到rec可能面临的挑战的学生通过选择进行系统审查而不是研究项目来避免这些挑战。有趣的是，与会者报告说，学生追求的定性和定量系统评论的数量明显增加。事实上，Revel（2023）在博士阶段也指出了类似的挑战，由于需要花费时间来获得伦理批准，学生们尽量减少了他们收集的NHS患者数据的类型。然而，最消极的遭遇涉及一位从事博士后研究的生活体验研究员。他们回忆起REC的一次经历，在那里，一个小组成员问有严重和持久精神病经历的人是否有能力处理同意和患者数据。这个例子与之前提到的认知偏见和sanism有关，即REC成员锚定在研究人员的“诊断”上，而不是他们作为拥有博士学位的研究人员的能力。我们承认所有的研究都应该受到严格的伦理审查。一些与会者报告说，区域经济委员会对决定的讨论是开放的，在这种交流和澄清之后，批准得到了批准。RECs是研究的重要和基本组成部分，申请RECs的过程是新手研究人员的必经之路。然而，如果家长作风和风险厌恶在RECs中是不可动摇的目标，而自主和冒险在精神卫生保健中是不可阻挡的力量，那么就需要妥协。家长作风需要与恢复原则相平衡，在恢复原则中，自治和自决保护服务用户的发言权。压制这些声音可能是一种结构性的认知不公正，必须得到研究界的承认和挑战（Revel 2023）。事实上，正如Cook等人（2022）指出的那样，如果对参与者的伤害是不道德的，那么排除在研究之外是否也会被认为是不道德的和认知上的伤害？RECs可能缺乏有生活经验的人的代表；因此，可以探索增加REC过程中的代表性。RECs可能没有意识到可能维持风险厌恶的复苏理念。自主、能力和同意并不是RECs需要考虑的唯一伦理原则。以恢
{"title":"Recovery Philosophy, Mental Health Nursing Research and the Challenge of Paternalism in Research Ethics Committees","authors":"Michael Nash, Floraidh Rolf, Andrew Grundy, Timothy Frawley, Mark Pearson, Jessica MacLaren, Fiona Nolan","doi":"10.1111/jpm.70064","DOIUrl":"10.1111/jpm.70064","url":null,"abstract":"<p>Ethical review of research proposals involving human subjects is a fundamental aspect of research governance. The purpose of Research Ethics Committees (RECs) is to ensure that research conforms to ethical and legal standards, particularly that participants' rights are protected (Tusino and Furfaro <span>2022</span>). Protecting participants may require RECs to adopt a paternalist stance. Paternalism in healthcare, is a process of professional decision-making based on what is felt to be in the patient's best interest (Sandman and Munthe <span>2010</span>). In research, paternalism concerns RECs making decisions based on what they consider to be in the research participant's best interest. Paternalism contrasts with autonomy, which is usually expressed as the right of competent adults to make informed decisions about their own medical care (Pons et al. <span>2020</span>). However, as essential as protecting participants in research is Cook et al. (<span>2022</span>) ask: when does protection become paternalism, and who gets to decide this?</p><p>Mental Health Nurse Academics UK (MHNAUK) is a professional interest group with members from over 120 organisations in the UK and international Higher Education Institutions (HEI), NHS mental health providers and government and voluntary organisations. MHNAUK serves as a forum for discussion, collaboration and raising awareness around issues relating to mental health, in particular education, research, and policy development.</p><p>In one meeting, some members decided to conduct research on student mental health nurses' experiences of self-harm during clinical practice. The overall aim of the study was to develop a framework of support sessions to help students cope with these events. Their initial ethics application was rejected due to the perceived vulnerability of the sample (nursing students) but was eventually approved following extensive edits to the application. The researchers felt that the REC had been unduly paternalistic as the threshold of risk seemed elevated due to the subject matter and perceived vulnerability of the sample.</p><p>A special meeting was arranged to explore members' experiences of perceived paternalism in RECs, and it happened to be a common experience from both University/Faculty (HEI) RECs and NHS RECs (if a clinical aspect of the research was required). What we, as MHNAUK researchers, have encountered is a tension between the need for RECs to protect research participants and the requirement for more recovery-focused and lived experience research with service users, families and carers.</p><p>The concept of recovery is embedded in mental healthcare and service provision (Slade et al. <span>2014</span>). Recovery philosophy recognises the inherent individual experience of illness but supposes that hope and a contributing life, even with limitations caused by symptoms, can lead to service users having new meaning and purpose (Anthony <span>1993</span>). In mental healthcar","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":"33 1","pages":"82-85"},"PeriodicalIF":2.9,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpm.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dominikus David Biondi Situmorang, Muqaffi, Hendrik Tuaputimain, M Solehuddin
{"title":"Artificial Intelligence and Mental Health: Toward a Pancasila-Based Ethical Foundation for AI-Counselling Practice in Indonesia.","authors":"Dominikus David Biondi Situmorang, Muqaffi, Hendrik Tuaputimain, M Solehuddin","doi":"10.1111/jpm.70063","DOIUrl":"https://doi.org/10.1111/jpm.70063","url":null,"abstract":"","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dominikus David Biondi Situmorang, Nisa Anindita, Sarah Kusumah Bakti
{"title":"Verbal Violence and Character Assassination: The Silent Epidemic in Mental Health Issues.","authors":"Dominikus David Biondi Situmorang, Nisa Anindita, Sarah Kusumah Bakti","doi":"10.1111/jpm.70053","DOIUrl":"https://doi.org/10.1111/jpm.70053","url":null,"abstract":"","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dominikus David Biondi Situmorang, Clara Ika Sari Budhayanti, Ivan Stevanus, Yohanna Claudia Dhian Ariani Harbelubun
{"title":"'I Hate Myself and I Want to Die': Untreated Psychosis, Self-Stigma, and the Ethical Imperative for Early Therapeutic Engagement in Schizophrenia.","authors":"Dominikus David Biondi Situmorang, Clara Ika Sari Budhayanti, Ivan Stevanus, Yohanna Claudia Dhian Ariani Harbelubun","doi":"10.1111/jpm.70058","DOIUrl":"https://doi.org/10.1111/jpm.70058","url":null,"abstract":"","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dominikus David Biondi Situmorang, Rose Mini Agoes Salim, Mulawarman, Sunawan
{"title":"Single-Session Therapy as a Preventive Follow-Up After the House-Tree-Person Drawing Test: Expanding Interventions for Suicide-Risk Children Affected by HIV/AIDS.","authors":"Dominikus David Biondi Situmorang, Rose Mini Agoes Salim, Mulawarman, Sunawan","doi":"10.1111/jpm.70054","DOIUrl":"https://doi.org/10.1111/jpm.70054","url":null,"abstract":"","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jie Wang, Nan Yao, Caifeng Li, Yifan Chen, Meiqi Wang, Long Sun
Introduction
Better mental health service engagement (MHSE) was identified to be an effective way to prevent relapse and worsening of the severe mental disorders (SMDs). There is a lack of evidence on the relationships between family function and MHSE among people with SMD.
Aim
To understand the current status of family function and MHSE among people with SMD and to explore the associations between family function and MHSE.
Methods
A cross-sectional study involving 486 people with SMD was conducted in Shandong province, China. Family function (the family adaptation, partnership, growth, affection, resolve [APGAR] scale) and MHSE (service engagement scale [SES]) were measured.
Results
The results indicated that the family function of the study sample was good, and the MHSE was low. Family function was negatively associated with the SES scores (β = −0.36, p = 0.002), indicating that better family function was associated with high engagement levels (since higher SES scores indicate lower engagement).
Discussion
The findings of this study provided epidemiological evidence for the association between family function and MHSE, and helped us further understand the significance of family in mental disease management.
Implications for Practice
Some interventions for family function are helpful to improve MHSE among people with SMD, and some family-oriented policies may be useful to promote MHSE.
提高精神卫生服务参与度（MHSE）被认为是预防重度精神障碍（SMDs）复发和恶化的有效途径。SMD患者的家庭功能与MHSE之间的关系缺乏证据。目的：了解SMD患者家庭功能与MHSE的现状，探讨家庭功能与MHSE的关系。方法：在中国山东省对486例SMD患者进行横断面研究。测量家庭功能（家庭适应、伙伴关系、成长、情感、决心量表[APGAR]）和服务投入量表（MHSE）。结果：研究样本的家族功能良好，MHSE较低。家庭功能与社会经济地位得分呈负相关（β = -0.36, p = 0.002），表明家庭功能越好，参与程度越高（因为社会经济地位得分越高，参与程度越低）。讨论：本研究结果为家庭功能与MHSE之间的关系提供了流行病学证据，并有助于我们进一步了解家庭在精神疾病管理中的意义。对实践的启示：一些家庭功能干预措施有助于改善SMD患者的MHSE，一些以家庭为导向的政策可能有助于促进MHSE。
{"title":"Associations Between Family Function and Mental Health Service Engagement Among Severe Mental Disorders in China","authors":"Jie Wang, Nan Yao, Caifeng Li, Yifan Chen, Meiqi Wang, Long Sun","doi":"10.1111/jpm.70065","DOIUrl":"10.1111/jpm.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Better mental health service engagement (MHSE) was identified to be an effective way to prevent relapse and worsening of the severe mental disorders (SMDs). There is a lack of evidence on the relationships between family function and MHSE among people with SMD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To understand the current status of family function and MHSE among people with SMD and to explore the associations between family function and MHSE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study involving 486 people with SMD was conducted in Shandong province, China. Family function (the family adaptation, partnership, growth, affection, resolve [APGAR] scale) and MHSE (service engagement scale [SES]) were measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results indicated that the family function of the study sample was good, and the MHSE was low. Family function was negatively associated with the SES scores (<i>β</i> = −0.36, <i>p</i> = 0.002), indicating that better family function was associated with high engagement levels (since higher SES scores indicate lower engagement).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The findings of this study provided epidemiological evidence for the association between family function and MHSE, and helped us further understand the significance of family in mental disease management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Practice</h3>\u0000 \u0000 <p>Some interventions for family function are helpful to improve MHSE among people with SMD, and some family-oriented policies may be useful to promote MHSE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":"33 1","pages":"68-81"},"PeriodicalIF":2.9,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kim Foster, Michael Roche, Jane Shakespeare-Finch, Ian Shochet, Darryl Maybery, Kathleen L. Bagot
Introduction
Mental health nurses can experience trauma in their personal and work lives; however there is no prior qualitative research describing these experiences.
Aim
Describe mental health nurses' experience of potentially traumatic events in their personal and professional lives.
Method
Qualitative descriptive study of mental health nurses describing traumatic events in a survey. Content analysis conducted using Foli's trauma framework.
Results
Eighty-two mental health nurses described potentially traumatic events. Most (65%) were personal events, including deaths and suicides of family members, domestic and family violence, and adverse childhood experiences. Workplace events included violence, consumer and colleague deaths, second-victim trauma, and trauma from insufficient workplace resources.
Discussion
Due to their trauma experiences, nurses are at risk of poorer psychological health and re-traumatisation through their work.
Limitations
Findings are limited to one group of mental health nurses in one setting.
Implications
Organisations need to place nurses and other staff at the centre of approaches for addressing trauma, and support nurses' trauma-informed self-care.
Recommendations
Organisations have a duty of care to staff. Organisation-wide trauma-informed approaches in mental health services are recommended, that are staff-centred as well as consumer-centred. Continued efforts to reduce avoidable sources of trauma at work, such as violence and lack of workplace resources, are needed.
{"title":"Mental Health Nurses' Experience of Trauma: A Qualitative Descriptive Study","authors":"Kim Foster, Michael Roche, Jane Shakespeare-Finch, Ian Shochet, Darryl Maybery, Kathleen L. Bagot","doi":"10.1111/jpm.70060","DOIUrl":"10.1111/jpm.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Mental health nurses can experience trauma in their personal and work lives; however there is no prior qualitative research describing these experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Describe mental health nurses' experience of potentially traumatic events in their personal and professional lives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Qualitative descriptive study of mental health nurses describing traumatic events in a survey. Content analysis conducted using Foli's trauma framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-two mental health nurses described potentially traumatic events. Most (65%) were personal events, including deaths and suicides of family members, domestic and family violence, and adverse childhood experiences. Workplace events included violence, consumer and colleague deaths, second-victim trauma, and trauma from insufficient workplace resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Due to their trauma experiences, nurses are at risk of poorer psychological health and re-traumatisation through their work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Limitations</h3>\u0000 \u0000 <p>Findings are limited to one group of mental health nurses in one setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Organisations need to place nurses and other staff at the centre of approaches for addressing trauma, and support nurses' trauma-informed self-care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Recommendations</h3>\u0000 \u0000 <p>Organisations have a duty of care to staff. Organisation-wide trauma-informed approaches in mental health services are recommended, that are staff-centred as well as consumer-centred. Continued efforts to reduce avoidable sources of trauma at work, such as violence and lack of workplace resources, are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":"33 1","pages":"57-67"},"PeriodicalIF":2.9,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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