Clinical effectiveness in nursing最新文献

There have been few investigations conducted into the relationship of gender to affective disturbance in clients with a primary diagnosis of schizophrenia. The current study sought to determine if there was a significant difference between male and female clients in this clinical group (N = 100) on self-report measures of anxiety and depression. No significant gender differences were observed on Hospital Anxiety and Depression Scale (HADS) scores; effect sizes were, however, small. Gender differences were observed in the proportion of clients classified as possible cases on HADS anxiety (HADS-A) and depression (HADS-D) sub-scale scores. Further research is recommended to investigate the role of gender in the presentation of affective disturbance in this often neglected and socially marginalised clinical group.

Objective

To examine factors in the work environment that are linked to the suicidal process among female street sex workers (FSSWs) in order to suggest interventions that would be appropriate among this marginalized group.

Design

Cross-sectional survey of female street sex workers in Hong Kong. The questionnaire contained questions regarding quality of life, health status, working environment, suicide ideation, mental health, as well as other personal and family characteristics. A number of statistical models were used to analyze this rich set of cross-sectional data.

Results

More than a quarter of the women surveyed reported to have considered or attempted suicide, nevertheless the specific timing of their suicide attempts was unclear. Accounting for background characteristics, factors that were inherent to the sex industry were significantly associated with poor psychological health and suicidality. Experience of stigma and previous employment experience prior to involvement in sex work were also highly correlated with increased incidence of suicide attempts. On the other hand, the presence of dependents and experience of social support were associated with lower probability of suicidality.

Conclusion

Our study suggests that a number of areas (e.g., increased emphasis on health education and promotion, self-esteem building, assertiveness training and client advocacy) warrant attention among health professionals practicing in the Asian region, particularly among mental health nurses.

A review of the literature on gender differences in people who experience schizophrenia identifies some interesting differences between women and men in terms of age of onset, premorbid functioning, level of symptomology and outcomes all are favourable towards women. If those differences are analysed using a psychosocial model of schizophrenia this provides a much richer analysis and a deeper understanding and potential explanation of these differences. Which in turn provides a clearer idea of the implications for Mental Health Nurses and other practitioners.

Postnatal depression (PND) follows 13% of deliveries and has an adverse impact on child development and well being. It is therefore a major public health problem but the evidence base for its treatment remains limited. There is a substantial literature on the views of adults about the treatment of depression but relatively little is known about what women with PND think about treatments. In addition there has been a rise in the use of complementary therapies. This paper reviews the literature in this area and discusses the implications for health professionals.

Objectives

To investigate everyday memory and related processes in patients with eating disorders and to consider how problems with these processes may impact upon their psychosocial functioning and ability to engage in cognitively demanding aspects of treatment programmes.

Design

Two case-control studies.

Setting

Regional Eating Disorders Service in the North East of England.

Participants

Patients with Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Eating Disorder Not Otherwise Specified (EDNOS) [DSM-IV, 1994] attending an Eating Disorder Unit, and healthy volunteers.

Main Outcome Measures

Self-report and objective measures of everyday memory and related processes; self-report and objective measures relating to state of illness; self-report measures of attendant anxiety and depression.

Results

Patients were found to be impaired on all measures of memory and related processes. Degree of impairment correlated variously with state of illness measures and depression/anxiety measures.

Conclusions

These data suggest that patients with eating disorders are impaired in their ability to engage in day-to-day and more directed activities that depend upon memory and related processes. Helping patients develop strategies to overcome these difficulties may be a useful nursing addition to existing treatment packages and may improve treatment efficacy.

Despite much research in recent years there still remains much doubt as to what causes CFS, and the role that mental health disorders play in its aetiology and perpetuation. The purpose of this study was to assess the illness experiences of a cohort of women who had recovered from Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (ME) in order to examine the extent to which the diagnoses they were given took a mental health perspective, and whether or not it was accepted that they were suffering a genuine illness. This was a qualitative study using Grounded Theory, with a sample of 14 female participants who had previously had CFS but considered themselves to be substantially or totally recovered from this illness. It was found that the participants experienced substantial problems with regard to diagnosis, with health care professionals often ignoring their physical symptoms. Similarly they encountered problems of acceptance and belief in terms of having a genuine illness. The findings are further discussed in terms of concomitant stigma and bias towards mental health diagnoses for women generally.

This paper presents a comprehensive review of the literature surrounding women’s psychological health in pregnancy, childbirth and the postnatal periods. The content will provide clinically useful information to midwives and health care professionals involved in caring for women during the antenatal, intranatal and postnatal periods. The impact of psychological health status in pregnancy on clinical outcomes such as preterm labour, pre-eclampsia, epidural use, caesarean section, instrumental deliveries and increased rates of admission to neonatal intensive care, alongside the cognitive and social development of the infant and child are well documented. Less research to date has considered the impact of psychological well-being on the mother throughout pregnancy, the peripartum, postpartum and beyond. Psychological status for these women has traditionally been characterised by anxiety and depression, largely ignoring the complex psychological interrelations that characterise pregnancy. Psychological status in pregnancy cannot be defined within a unidimensional framework but must include a comprehensive assessment of all the dimensions that attribute to mood and emotional status for women during pregnancy, childbirth and the postnatal period. This paper intends to address the constructs of anxiety and depression, worry, control, quality of life, sleep and self-esteem. Screening for, and identification of, maternal psychological distress from a multidimensional perspective enables healthcare professionals to recognise and acknowledge normal and abnormal adjustment and offer interventions, strategies and support to facilitate a woman’s transition to motherhood.

In this short report, some recent statistics of mental disorder prevalence in young people are presented and discussed from a gender perspective. It is suggested that girls with mental health problems might experience difficulty in having their needs met within services which may still embody significant elements of paternalism and where psychodynamic phenomena may impact on care delivery. Findings may have implications for practitioners involved in child and adolescent mental health care.