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Mental health care for transgender and gender diverse youth 跨性别和性别多样化青年的精神卫生保健：国际精神病学-精神卫生护士协会声明。

IF 2.2 4区医学 Q1 NURSING

Archives of Psychiatric Nursing

Pub Date : 2025-09-23 DOI: 10.1016/j.apnu.2025.151980

Elizabeth Bonham, Andrea Kwasky, Avery Anderson, Cynthia Paidipati, Linda Jo Volness, Patrice Wade-Olson

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IF 2.2 4区医学 Q1 NURSING

Archives of Psychiatric Nursing

Pub Date : 2025-09-06 DOI: 10.1016/S0883-9417(25)00144-X

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Archives of Psychiatric Nursing

Pub Date : 2025-09-06 DOI: 10.1016/S0883-9417(25)00147-5

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Archives of Psychiatric Nursing

Pub Date : 2025-09-06 DOI: 10.1016/S0883-9417(25)00145-1

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Archives of Psychiatric Nursing

Pub Date : 2025-09-06 DOI: 10.1016/S0883-9417(25)00146-3

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IF 2.2 4区医学 Q1 NURSING

Archives of Psychiatric Nursing

Pub Date : 2025-09-06 DOI: 10.1016/S0883-9417(25)00143-8

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Using motivational spirited cognitive behavioral change communication to increase acceptance/utilization of the CBT-I Coach for improved quality of sleep in adult psychiatric patients 使用激励性的认知行为改变交流来提高CBT-I教练对成人精神病患者睡眠质量的接受/利用

IF 2.2 4区医学 Q1 NURSING

Archives of Psychiatric Nursing

Pub Date : 2025-09-03 DOI: 10.1016/j.apnu.2025.151969

Todd B. Allen , Kimberly A. Williams , Jason L. Anderson , Kathleen T. McCoy

Low sleep quality (LSQ) affects up to 80% of individuals with a mental illness, leading to worsening of symptoms and an increased risk of suicide. Cognitive behavioral therapy for insomnia (CBT-I) is the first line of treatment for LSQ and is underutilized. Common barriers include lack of access, patient motivation, and engagement. Digital CBT-I, such as the CBT-I Coach smartphone application may be used as an alternative to traditional forms to deliver CBT-I strategies. Along with CBT-I Coach, motivational spirited cognitive behavioral change (MIS-CBC) communication is a novel model that aims to improve patient motivation and engagement of cognitive behavioral therapy (CBT).

Purpose

This project incorporated MIS-CBC communication to enhance acceptance and utilization of the CBT-I Coach to improve LSQ among patients 18 and older receiving treatment at the outpatient psychiatric clinic (OPC) over a period of 8 weeks.

Project design

This was a quality improvement project conducted at an outpatient psychiatry clinic (OPC) in a western state. Participants submitted an initial Pittsburgh Sleep Quality Index (PSQI) questionnaire, were introduced to the CBT-I Coach, and received weekly MIS-CBC sessions. At the conclusion of the eight-weeks, participants completed another PSQI, and scores were compared to determine improvement in sleep quality.

Findings

Adoption and use of the CBT-I Coach application was very high among the project participants indicating that MIS-CBC may be a useful strategy to increase patient engagement with the application. The aggregate PSQI score of all participants pre-post project implementation had a decrease from 13.11 to 8.5 (35%) indicating that sleep quality improved.

高达80%的精神疾病患者受到睡眠质量低下的影响，导致症状恶化，自杀风险增加。失眠的认知行为疗法（CBT-I）是LSQ的一线治疗方法，但尚未得到充分利用。常见的障碍包括缺乏获取、患者动机和参与。数字CBT-I，如CBT-I Coach智能手机应用程序可以作为传统形式的替代方案来提供CBT-I策略。激励性认知行为改变（MIS-CBC）沟通与CBT- i Coach一样，是一种旨在提高患者对认知行为治疗（CBT）的积极性和参与度的新模式。目的：本项目采用MIS-CBC沟通，提高18岁及以上在门诊精神病诊所（OPC）接受治疗的患者对CBT-I教练的接受和利用，以改善LSQ。项目设计这是一个在西部州的门诊精神病学诊所（OPC）进行的质量改进项目。参与者提交了最初的匹兹堡睡眠质量指数（PSQI）问卷，被介绍给CBT-I教练，并接受每周MIS-CBC会议。在八周结束时，参与者完成了另一项PSQI测试，并将得分进行比较，以确定睡眠质量的改善程度。研究结果：在项目参与者中，CBT-I教练应用程序的采用率和使用率非常高，这表明MIS-CBC可能是一种有效的策略，可以提高患者对应用程序的参与度。所有参与者在项目实施前的PSQI总分从13.11降至8.5(35%)，表明睡眠质量得到改善。

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Using Motivational Interviewing to promote medication adherence in patients with major depressive disorder 运用动机性访谈促进重度抑郁症患者的药物依从性

IF 2.2 4区医学 Q1 NURSING

Archives of Psychiatric Nursing

Pub Date : 2025-09-02 DOI: 10.1016/j.apnu.2025.151968

Ololade Bello , Kelly Kearney

Background

Medication non-adherence is common in patients with major depressive disorder (MDD) and leads to high relapse rates. Motivational Interviewing (MI), a patient-centered psychotherapy technique, can improve adherence and has been effective in various psychiatric diagnoses.

Local problem

Despite integrated pharmacotherapy and psychotherapy, high readmission rates persist due to medication non-adherence.

Method

The project, conducted at an outpatient psychiatric center in the United State, involved patients with MDD. The project employed a pretest-posttest design to evaluate the effect of MI.

Implementation

Nurses, nurse practitioners, physicians, and licensed counselors are the key stakeholders in the QI project. MDD patients received four MI sessions, with data collected using the Medication Adherence Rating Scale (MARS).

Results

The post-intervention report showed an average increase of 50 % in the participants' MARS score.

Conclusion

Incorporating MI reduced relapse rates, improved medication adherence, and enhanced communication between patients and providers.

背景：药物不依从性在重度抑郁症（MDD）患者中很常见，并导致高复发率。动机访谈（MI）是一种以患者为中心的心理治疗技术，可以提高依从性，并在各种精神病诊断中有效。局部问题尽管综合药物治疗和心理治疗，但由于药物依从性不高，再入院率仍然很高。该项目在美国一家精神病门诊中心进行，涉及重度抑郁症患者。该项目采用了前测后测设计来评估mi的效果。实施护士、护士从业人员、医生和执业咨询师是QI项目的关键利益相关者。重度抑郁症患者接受四次MI治疗，使用药物依从性评定量表（MARS）收集数据。结果干预后报告显示，参与者的MARS评分平均提高了50%。结论：合并心肌梗死可降低复发率，提高药物依从性，并加强患者与医护人员之间的沟通。

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Enhancing mental health nursing education through virtual reality simulation: A focus on bipolar disorder 通过虚拟现实模拟加强心理健康护理教育：以双相情感障碍为重点

IF 2.2 4区医学 Q1 NURSING

Archives of Psychiatric Nursing

Pub Date : 2025-08-22 DOI: 10.1016/j.apnu.2025.151967

Pamela R. Short , William Stuart Pope , Chih-hsuan Wang , Karol Renfroe , Leora Wright , Tiffani Chidume

This study investigates the integration of Virtual Reality Simulation (VRS) in undergraduate mental health nursing education. Utilizing SPSS, data from Qualtrics were analyzed for reliability and research questions. Results demonstrate that VRS significantly enhances students' self-efficacy, clinical judgment, and therapeutic communication skills. Over 88 % of students reported increased confidence and learning, while 90 % found debriefing sessions valuable. However, the limited diversity of the sample suggests the need for broader research to generalize findings. The study underscores VRS as a transformative tool in nursing education, fostering a workforce equipped for complex psychiatric care.

本研究旨在探讨虚拟现实仿真（VRS）在大学生心理健康护理教育中的整合。利用SPSS对qualics的数据进行可靠性分析和研究问题分析。结果表明，VRS显著提高了学生的自我效能感、临床判断能力和治疗沟通能力。超过88%的学生表示自信心和学习能力都有所提高，而90%的学生认为汇报会议很有价值。然而，样本的有限多样性表明需要更广泛的研究来概括研究结果。该研究强调VRS是护理教育的变革工具，培养了一支具备复杂精神病学护理能力的劳动力队伍。

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Caregivers' perspectives on the healthcare experiences of children with autism spectrum disorder and associated family impacts in Ras Al Khaimah, UAE 在Ras Al Khaimah，阿联酋，照顾者对自闭症谱系障碍儿童的医疗保健经历和相关家庭影响的看法

IF 2.2 4区医学 Q1 NURSING

Archives of Psychiatric Nursing

Pub Date : 2025-08-15 DOI: 10.1016/j.apnu.2025.151966

Rasha Aziz Salama , Abeer Rahman Sharmin , Huda Hamouda , Fatima Al-Hashmi , Hesham Amin Hamdy , Nihal Amir Wadid

Background & objectives

The global rise in autism spectrum disorder (ASD) has highlighted the burden on healthcare systems and the significant impact on affected families. This study explored caregivers' perspectives on the healthcare experiences of children with ASD and the related challenges faced by families in Ras Al Khaimah, UAE.

Methods

A descriptive, cross-sectional study was conducted among caregivers of 38 children with confirmed ASD attending two autism centers. Children included had a formal diagnosis of ASD documented in their medical records. Data were collected using a semi-structured, interviewer-administered questionnaire developed through a comprehensive literature review. The tool was reviewed for content validity by three experts and was pre-tested with caregivers of children with special needs to assess clarity and feasibility. Informed consent and confidentiality were maintained.

Results

Barriers to healthcare access were reported by 52.7 % of caregivers, and 68.5 % experienced difficulties with family support services. Financial hardship affected 63.2 % of families, while 36.8 % reported psychological distress. Unmet healthcare needs were associated with younger child age (OR = 1.32), non-Emirati nationality (OR = 2.91), and lower caregiver education (OR = 1.74). Financial difficulties were linked to younger age (OR = 1.68), lower education (OR = 2.60), and single-mother households (OR = 1.22). Qualitative analysis revealed emotional distress, social stigma, and strained family dynamics, particularly among mothers. Recurring concerns included anxiety about the child's future, reluctance to have more children, and dissatisfaction with healthcare communication.

Conclusion

Caregivers of children with ASD face significant barriers to care and family well-being, highlighting the need for targeted, empathetic, and culturally sensitive interventions.

背景,自闭症谱系障碍（ASD）在全球范围内的上升凸显了卫生保健系统的负担和对受影响家庭的重大影响。本研究探讨了护理人员对阿联酋Ras Al Khaimah ASD儿童医疗保健经历的看法以及家庭面临的相关挑战。方法对两家自闭症中心的38名确诊ASD儿童的护理人员进行了一项描述性横断面研究。这些儿童在他们的医疗记录中有正式的自闭症诊断。数据收集使用半结构化，访谈者通过全面的文献综述制定的问卷调查。该工具的内容效度由三位专家进行了审查，并与有特殊需要的儿童的照顾者进行了预测试，以评估清晰度和可行性。保持知情同意和保密。结果52.7%的护理人员报告了获得医疗保健的障碍，68.5%的护理人员报告了家庭支持服务的困难。经济困难影响了63.2%的家庭，而36.8%的家庭报告了心理困扰。未满足的医疗保健需求与儿童年龄较小（OR = 1.32）、非阿联酋国籍（OR = 2.91）和照顾者受教育程度较低（OR = 1.74）相关。经济困难与年龄较小（OR = 1.68）、受教育程度较低（OR = 2.60）和单亲母亲家庭（OR = 1.22）有关。定性分析揭示了情绪困扰、社会耻辱和紧张的家庭动态，尤其是在母亲中。反复出现的担忧包括对孩子未来的焦虑、不愿生育更多孩子以及对医疗保健沟通的不满。结论自闭症儿童的照顾者在照顾和家庭幸福方面面临着重大障碍，这突出了有针对性、共情和文化敏感的干预措施的必要性。

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