International journal of mental health nursing最新文献

Migrant nurses face many challenges as they adapt and assimilate into their new working environments. The aim of this cross-sectional study was to investigate the perceptions of work-related strain, sense of coherence and intercultural sensitivity among nurses who were employed at a public mental health facility in Qatar. We used three self-report questionnaires: the work-related strain inventory, sense of coherence scale and an intercultural sensitivity scale. A cohort of 136 nurses voluntarily engaged in the study. The majority of participants were male, migrated from South Asia and were in their mid-30s. The study found that both sense of coherence and intercultural sensitivity were inversely proportional to work-related strain. Work-related strain was found to be lower than expected; the factors that appear to protect against work-related strain include longer clinical experience, a high sense of coherence, and intercultural sensitivity. Additionally, greater age and extended clinical experience, combined with a history of work in three or more countries, associated with higher scores on the sense of coherence scale. Lastly, being female, having a postgraduate degree and holding a senior-level position were associated with increased intercultural sensitivity. As nurses' migration across national and international borders increases in response to global demand, this study has important implications for nursing administrators, educators and policymakers in relation to the development and implementation of strategies to enhance nurses' sense of coherence and intercultural sensitivity and prevent work-related strain. Trial Registration number: NCT04196751.

Eating disorders encompass a spectrum of mental health conditions that are characterised by a preoccupation with eating, exercise, body weight or shape. The trajectory of eating disorders can result in hospitalisation for medical complications, such as electrolyte imbalance, extremely low weight and other medical issues that require urgent inpatient attention. Typically, care for adolescents with medically compromised eating disorders occurs in general medical settings, with most care provided by nurses who may or may not have the training and experience to provide quality care for this complex mental health condition. The aim of this scoping review is to examine literature surrounding the experience of nurses caring for adolescents admitted to general medical wards (non-mental health settings) with medically compromised eating disorders. We used Arksey and O'Malley's (2005) five-step scoping review process to conduct this review. A systematic search of the literature located 476 relevant papers, and after screening, 10 were included in the final review. Most included papers were qualitative in methodology, with one using a mixed-methods design. The papers examined in this scoping review found common themes among nurses who were providing care for adolescents with medically compromised eating disorders being cared for in medical wards (non-mental health settings): a lack of preparation to care for individuals with eating disorders, a high emotional and psychological toll on nurses providing care and a degree of stigma towards adolescents with eating disorders, including a belief that eating disorders were a 'choice.' This review indicates that to provide quality and safe care for adolescents with eating disorders admitted to general medical wards, nurses require specialised training. In addition, the care of adolescents with medically compromised eating disorders requires the support of trained mental health nurses, especially where nurses on general medical wards are novice or have limited mental health training. We recommend further research into support structures to prevent burnout and turnover that is prevalent when providing care to individuals with eating disorders.

Nursing students in undergraduate programmes exhibit comparable, sometimes higher, levels of poor mental health and substance use compared to the general population; however, this area remains under-researched in New Zealand. The study involved 172 nursing students enrolled in the Bachelor of Nursing programme at one tertiary institution in Auckland, New Zealand. Employing a mixed-methodology approach, a 29-question survey comprising both open and closed questions was administered to explore the students' experiences with mental health and substance use, as well as their access to support services. Quantitative data were analysed using SPSS version 29 descriptive statistics, while a general inductive approach guided the qualitative analysis. A significant proportion of participants (75%) reported experiencing emotional distress during their studies, with anxiety being the most prevalent (78.5%). A smaller percentage disclosed substance use (8.1%) including excessive alcohol use, cannabis use, nicotine use, vaping cannabis and some refusal to reveal substance use. Surprisingly, less than 1% (n = 0.6) utilised institutional support services. Three qualitative themes were identified including emotional distress and associated effects, emotional and psychological impacts on nursing students' academic journey and tertiary support systems. The findings highlight the urgent need to address the mental health and addiction challenges experienced by nursing students, given their potential adverse effects on academic success and overall well-being. Urgent action is needed to integrate mental health training into the curriculum and provide faculty support. In this study, the underutilisation and inadequacy of institutional support services signal a need for institutional reforms to provide access and personalised mental health support to nursing students. Providing essential skills and support for student success contributes to the overall well-being of the nursing workforce.

In addiction treatment, harm reduction is a philosophy that aims to reduce the harms from ongoing alcohol and other drug use. Although abstinence may be the 'gold standard' in reducing harm from ongoing alcohol and other drug use, harm reduction recognises that abstinence may not be achievable for certain individuals. Accordingly, harm reduction is used to enable medical or mental health treatment for individuals who continue to use alcohol and other drugs, providing a form of care which meets individuals where they present to healthcare facilities. Harm reduction accepts ongoing alcohol and other drug use, while providing a traditionally marginalised cohort of individuals access to healthcare services. In this perspective paper, we argue that the role of nurses in promoting and utilising harm reduction as part of their regular practice is essential to both reducing harm from alcohol and other drug use, engaging individuals who use alcohol and other drugs in healthcare services, and providing a means to accept individuals as they are to build trust and rapport for engagement in addiction treatment when they are ready, and at their own pace. Nurses, by virtue of their role and number in the healthcare landscape (approximately 28 million globally), are ideally placed to implement harm reduction in their practice to achieve better outcomes for individuals who use alcohol and other drugs.

Mental health (MH) differences remain an issue in contemporary Chinese society, with various factors influencing individuals' well-being. This study investigates the complex connection between results related to psychological wellness and social issues, integrating cultural, psychological and technological perspectives. Through a quantitative research methodology, data were collected from 1000 individuals using a questionnaire survey and analysed using SPSS software. The study's findings shed light on the impact of socioeconomic status (SES) on MH stigma, help-seeking behaviour and overall well-being. The findings identify that lower SES was associated with heightened levels of MH stigma and decreased the search for assistance actions. Cultural beliefs emphasising MH stigma and societal expectations were identified as mediators in the connection involve SES and MH outcomes. Digital technology use emerged as a moderator, indicating that higher levels of technology utilisation were linked to reduced disparities in accessing MH resources. The novelty of this study lies in its comprehensive examination of the multifaceted factors influencing MH disparities within Chinese society. Additionally, psychological factors such as resilience and social support were observed to mitigate the negative lower SES's effect on MH consequences. The interaction between SES and cultural factors was found to predict MH outcomes, with lower SES exacerbating the effects of MH stigma and cultural barriers.

The aim of this study is to investigate the factors related to post-traumatic stress disorder (PTSD), depression and anxiety mental disorders, as well as the quality of life of Syrian refugees and to examine the relationships between mental health disorders and the quality of life of Syrian refugees. Data were collected via face-to-face surveys with 613 adult Syrian refugees in an urban setting. Brislin's methodology was used for translating scale items, involving initial translation, back-translation and review by another professional translator. The study utilised the PTSD Scale, Beck Anxiety Scale, Depression Scale and Quality of Life Scale (QOLS). Descriptive, correlational and multivariate regression analysis were applied. Findings of correlational analysis indicate that PTSD levels among Syrian refugees are significantly related to gender, income level and employment. Depression levels are significantly associated with trauma history, healthcare service use, marital status and employment. Anxiety levels are significantly related to gender, trauma history, healthcare service use, employment and income. According to the findings of the regression analyses, the relationships between depression, quality of life and PTSD are complex. Meanwhile, anxiety decreases quality of life and increases PTSD. Quality of life moderates the relationship between depression and PTSD, as well as between anxiety and PTSD. The study concludes that the mental disorder levels of Syrian refugees, in terms of PTSD, depression and anxiety, are linked to their socio-demographic characteristics. These results highlight the importance of social, economic and cultural factors, healthcare and social services and the socio-demographic characteristics of the region where refugees have settled after displacement.

The COVID-19 pandemic continues to cause nurses stress and trauma, with alcohol potentially being used to manage this stress. Prior studies of nurses' alcohol consumption during the COVID-19 pandemic have shown increases in alcohol consumption to manage stress associated with the pandemic. The aim of this paper is to explore perceptions of alcohol consumption and stress among nurses, particularly since the declared end of the COVID-19 pandemic. We used semi-structured interviews with Australian nurses (n = 55), using a qualitative-descriptive study design, conducted between October 2023 and January 2024. Data were analysed using structural coding and reported in accordance with CORE-Q guidelines. Four key themes emerged from the data: (1) Alcohol consumption in response to ongoing role stress, (2) Alcohol consumption in response to incidents, (3) The lasting impact of the COVID-19 pandemic and (4) Do nurses feel comfortable seeking help for alcohol use? High-risk alcohol consumption has persisted beyond the end of the COVID-19 pandemic to manage the stress associated with clinical environments. Alcohol was also used in response to incidents, and the ongoing trauma and impact of the pandemic was described as a significant source of stress and anxiety. Not all nurses in our study felt comfortable seeking help for alcohol use, with participants describing concern for their nursing registration if they self-reported their alcohol consumption. Participants reported stronger links between stressful working environments and increased alcohol consumption. Nurses in our study do not feel safe seeking help or self-reporting alcohol consumption for fear of the regulatory body instituting sanctions that lead to loss or suspension of their registration. These factors require urgent attention to ensure workforce wellbeing and sustainability.

For patients with mental illnesses (MIs), emergency departments (EDs) are often the entry point into the healthcare system, or their only resort for quickly accessing mental health treatment. A better understanding of the various barriers justifying high ED use among patients with MIs may help recommend targeted interventions that better meet their needs. This explorative qualitative study aimed to identify such barriers and the solutions brought forth to reduce ED use based on the perspectives of clinicians and managers working in EDs, other hospital departments or the community sector. Interviews were conducted between April 2021 and February 2022; 86 mental health professionals (22% were nurses) from four large urban ED sites in Quebec (Canada) were interviewed. Barriers were identified in relation to patient profiles, healthcare system and organisational features and professional characteristics. The key barriers that were found to explain high ED use were patients having serious MIs (e.g., psychotic disorders) or social issues (e.g., poverty), lack of coordination and patient referrals between EDs and other health services, insufficient access to mental health and addiction services and inadequacy of care. Very few solutions were implemented to improve care for high ED users. Better deployment of ED interventions in collaboration with outpatient care may be prioritised to reduce high ED use for patients with MIs. Improvements to the referral and transfer processes to outpatient care, particularly through care plans and case management programs, may be implemented to reduce high ED use and improve outpatient care among patients with multiple health and social needs.

Substance use disorder is a public health crisis that is a financial strain to many healthcare systems and communities, but more importantly, it costs lives. Nurses interact with people experiencing substance use disorders and their families in many settings. Nurses can provide insights into the experiences of working with this population. This descriptive qualitative study aimed to examine nurses' experiences and perspectives on caring for people with substance use disorder and their families. After receiving institutional review approval, purposive sampling was used to recruit registered nurses (n = 16) who worked in a variety of settings, and interviews were conducted. Constant comparison analysis was conducted concurrently with data collection until saturation was reached. Code development and refinement was an iterative process. Three themes were generated from the data. Personal Experiences Affect Professional Practice represented participants varied personal experiences and included two subthemes: Reflecting on Personal Experiences and Seeing the Person Beyond the Substance Use Disorder. A second theme is Professional Experiences Affect Professional Practice, which included two subthemes: Professional Experiences are Stressful and Rewarding and Substance Use Disorder Education Increases Confidence. Finally, Stigma Affects Substance Use Disorder Care is the third theme. Future implications range from the individual engaging in self-reflection, to nursing leadership establishing a framework to incorporate reflection and creating a culture that supports and reinforces these activities. The findings of this study support the need for stigma awareness/reduction education starting in undergraduate nursing programmes, throughout practice, with extension to inter-professional groups and the community.

Emergency Department (ED) presentations for Mental Health (MH) help-seeking have been rising rapidly, with EDs as the main entry point for most individuals in Australia. The objective of this retrospective cohort study was to analyse the sociodemographic and presentation features of people who sought mental healthcare in two EDs located in a regional coastal setting in New South Wales (NSW), Australia from 2016 to 2021. This article is a part of a broader research study on the utilisation of machine learning in MH. The objective of this study is to identify the factors that lead to the admission of individuals to an MH inpatient facility when they seek MH care in an ED. Data were collected using existing records and analysed using descriptive univariate analysis with statistical significance between the two sites was determined using Chi squared test, p < 0.05. Two main themes characterise dominant help-seeking dynamics for MH conditions in ED, suicidal ideation, and access and egress pathways. The main findings indicate that suicidal ideation was the most common presenting problem (38.19%). People presenting to ED who 'Did not wait' or 'Left at own risk' accounted for 10.20% of departures from ED. A large number of presentations arrived via the ambulance, accounting for 45.91%. A large proportion of presentations are related to a potentially life-threatening condition (suicidal ideation). The largest proportion of triage code 1 'Resuscitation' was for people with presenting problem of 'Behavioural Disturbance'. Departure and arrival dynamics need to be better understood in consultation with community and lived experience groups to improve future service alignment with the access and egress pathways for emergency MH care.