International journal of mental health nursing最新文献

Since 2002, National Outcomes and Casemix Collection of clinician-rated and consumer-rated outcome measures has become part of routine care within Australian clinical mental health services, aiming to ensure that services understand, improve and are accountable for effectiveness of treatment and care provision. Consumer-rated outcome measures, implemented well, support basic human rights of consumers to be asked, heard and included equally in their own care. However, their use has lagged due to clinician inertia, uncertainty about their value to clinical care, assumptions about consumers' capacity to complete the measures and organisational cultural issues that have hampered more holistic assessment, consumer inclusion and care collaboration. Much is known about negative, largely tokenistic use of such measures, poor uptake and dominance of clinical approaches to measurement that privilege clinical expertise; however, little is known about consumers' positive experiences of using consumer-rated measures, Therefore, our aims were as follows: to seek the views and experiences of mental health consumers of using consumer-rated measures in their encounters with clinicians; to understand better whether there were benefits (and if so what) of consumer-rated measures being used in routine mental health practice; to understand how feedback on the use of consumer-rated measures can inform training for mental health staff; and to promote their wider use within mental health services. In-depth interviews conducted with 10 Australian mental health consumers used interview questions co-designed with lived experience and clinical advocates. Descriptive thematic analyses produced four themes emphasising consumers' preferences for completing the measures, the importance of explaining their purpose, how the process validated their feelings and was an opportunity for self-reflection, sense-making, trust-building, and transparency in the encounter and empowerment. This research offers recommendations about the value of effective implementation of consumer-rated measures.

Nurses routinely face psychological challenges as part of their work, acutely so during times of crises when nurses may treat many severely injured and dying patients. While the need for such support is well documented in the literature, mental health support programmes aimed at healthcare workers, even when available, are often underutilised, especially by nurses. To gain insights about needed mental health supports for nurses and programme implementation, this study examines a programme launched following a surprise attack on Israel on 7 October, 2023, resulting in thousands of deaths and injuries and precipitating a war. The programme deployed 30 volunteer nurses trained in cognitive behavioural therapy, trauma support and mental health first aid to offer up to three, anonymous, 30-min online therapy sessions to nurses around Israel in December 2023. Using a qualitative descriptive design, we engaged 22 of these volunteers in one of the three focus groups lasting 60-90 min each. Our findings highlight a range of mental health issues-among both the volunteers and therapy recipients-as well as barriers to providing mental health support to nurses. The importance of normalising the pursuit of mental health support in nursing education and ensuring the availability of support in healthcare organisations was emphasised.

The Dynamic Appraisal of Situational Aggression: Youth Version (DASA:YV) is a brief instrument, most often used by nurses and was specifically designed to assess risk of imminent violence in youth settings. To date, it has been recommended that DASA:YV scores are interpreted in a linear manner, with high scores indicating a greater level of risk and therefore need more assertive and immediate intervention. This study re-analyses an existing data set using contemporary robust data analytic procedures to examine the predictive validity of the DASA:YV, and to determine appropriate risk bands. Mixed effect logistic regression models were used to determine whether the DASA:YV predicted aggression when the observations are correlated. Two approaches were employed to identify and test novel DASA:YV risk bands, where (1) three risk bands as previously generated for the adult DASA were used as a starting point to consider recategorising the DASA:YV into three risk bands, and (2) using a decision tree analysis method known as Chi-square automated interaction detection to produce risk bands. There was no statistically significant difference between a four and three category of risk band. AUC values were 0.85 for the four- and three-category options. A three-category approach is recommended for the DASA:YV. The new risk bands may assist nursing staff by providing more accurate categorisation of risk state. Identification of escalation in risk state may prompt early intervention, which may also prevent reliance on the use of restrictive practices when young people are at risk of acting aggressively.

The aim of this paper is to identify barriers to quality mental health nurse education in the United Kingdom and show these through the sharing of personal experiences of working as a mental health nurse academic. Since the Nursing and Midwifery Council introduced their 'future nurse' education standards in 2018, mental health content for mental health nurses has been argued to have been marginalised. The sense of a diluted mental health nurse education was supported by an open letter, signed by over 100 mental health nurses, with representation across 33 universities. Nonetheless, the approach taken by the NMC has been defended. Meanwhile, mental health nurse academics all over the United Kingdom are having varying experiences, some of incredible discomfort and invalidation. The movement 'mental health deserves better' arose through many of these mental health nurses feeling they had no representation or channel to voice their concerns. This is a personal position paper which outlines barriers to autonomy for mental health nurse academics, and shares personal opinion on experiences which have impacted the ability to deliver a depth of knowledge, skill and critical thinking to students, impacting the quality of new mental health nurse graduates. The issue is discussed using contemporary literature to support lines of argument, which are augmented by personal experiences of working in nurse education. There are complex interconnected issues within nurse education which can hinder the autonomy of mental health nursing to decide its own future. This paper recounts a personal journey. Often we cannot understand the failings of a system until we try to navigate it from the inside.

The aim of this experimental research is to assess the impact of a mindfulness-based empowerment program applied to women who have experienced violence on their levels of self-compassion, self-esteem and coping with stress. The study was a randomised controlled trial with a control group. Participants were randomly assigned to the experimental group (EG, n₁ = 27) and the control group (CG, n₂ = 26) from women who had experienced violence. Descriptive statistical methods and t-tests for dependent and independent groups were employed in data analysis. After the mindfulness-based empowerment program, the intervention group exhibited a statistically significant high effect size in post-intervention measurements compared to the control group for the Self-Compassion Scale, Coopersmith Self-Esteem Inventory and Coping Styles Scale total and subscale mean scores (p < 0.001). The mindfulness-based empowerment program has been found to enhance self-compassion, self-esteem and coping levels in women who have experienced violence. Therefore, it is recommended to promote the widespread adoption of mindfulness-based interventions for individuals who have undergone trauma, such as violence, to facilitate their re-empowerment and functional recovery. Trial Registration: ClinicalTrials.gov identifier: NCT05310656.

Diagnostic overshadowing refers to a phenomenon whereby people with mental health conditions encounter inadequate or delayed medical attention and misdiagnosis. This occurs when physical symptoms are mistakenly attributed to their mental health condition. This paper presents a scoping review focusing on direct causes and background factors of diagnostic overshadowing in the context of hepatitis C infection in people who inject drugs and have concurrent mental health conditions. Despite significant strides in hepatitis C treatment with direct-acting antiviral drugs, the complex interplay of mental health conditions and physical symptoms necessitates a nuanced approach for accurate diagnosis and effective screening. This review was conducted using Joanna Briggs Institute's methodology for scoping reviews. The databases searched included Medline, Embase, PsycInfo, Global Health, CINAHL and Scopus. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search strategies identified 1995 records. Overall, 166 studies were excluded. Forty-two (42) studies met the inclusion criteria. Three (n = 3) studies represented direct causes, and 39 (n = 39) with background factors related to diagnostic overshadowing. Studies highlighted six key themes encompassing diagnostic overshadowing, with communication barriers, stigma and knowledge deficiencies being the most prominent. Recognising and addressing diagnostic overshadowing in chronic hepatitis C will lead to increased screening, diagnosis and timely administration of life-saving antiviral therapy, resulting in profound enhancements in well-being and health outcomes. Moreover, this proactive approach will play a pivotal role in advancing the global effort towards eliminating hepatitis C by 2030.

Early mortality experienced by people living with mental health issues (hereon termed consumers) is largely preventable. Healthcare professionals perceive healthcare system inadequacies such as diagnostic overshadowing, stigma and fragmentation of physical and mental healthcare services can be resolved through effective integration approaches. Service- and individual-level integration approaches involve multidisciplinary teams collaborating and coordinating care to holistically meet consumers' physical and mental health needs. Evidence suggests appropriately trained healthcare professionals can deliver effective integrated treatment without financial or organisational restructuring. Specialist nursing positions such as Physical Health Nurse Consultants can support and integrate physical and mental health care. Consumers report the Physical Health Nurse Consultant as providing dedicated, integrated, coordinated and holistic mental and physical health care. This study aimed to explore the Physical Health Nurse Consultant role from the perspectives of healthcare professionals. A qualitative exploratory study design was used. Fourteen healthcare professionals participated in individual interviews or focus groups. Interview recordings were transcribed, and thematically analysed. Three themes were identified: (i) role functions, including integration of physical and mental health care, (ii) impact on consumer physical health outcomes and (iii) impact on service delivery. Healthcare professionals perceive the Physical Health Nurse Consultant effectively integrates physical and mental health care and subsequently support the continuation and embedding of the role in routine practice. Future research is required to explore healthcare professionals' experiences and perceptions of how these roles be translated to routine clinical practice. Examining the professional development requirements, service provider constraints and economic implication to achieve these outcomes also warrants attention.

Exposure to traumatic and/or violent events is an inherent part of the first responder role, which increases the risk of developing acute and chronic mental health symptoms and conditions. Suicidality for Australian first responders have recently increased with prevalence considered much higher compared with the general population. To inform specific recommendations for Australian first responders, there is a need to establish what evidence is available regarding these issues within the Australian context. The aim of this scoping review was to explore the impacts of trauma on the mental health of Australian first responders, the strategies recommended to address these issues and any unique needs in rural contexts. A scoping review was undertaken following PRISMA guidelines for scoping reviews. Peer-reviewed articles on Australian first responder mental health from seven databases were screened for inclusion. This review highlights that despite available evidence on the types of traumas and adverse mental health outcomes experienced, less evidence exists pertaining to intervention effectiveness. There are major gaps in evidence within rural and remote contexts which hinders effective planning and delivery of support for rural and regional first responders. Clinicians such as mental health nurses, particularly in rural areas, need to be aware of these gaps which impact planning and delivery of support and are in prime position to ensure screening, interventions and strategies are used and evaluated to determine their suitability for rural first responders.

Understanding the perspectives of regional people living with mental illness is crucial to adapting services, improving holistic care and meeting individual needs. This study explored people living with mental illness perceptions of physical health, mental health and well-being. A descriptive qualitative study design underpinned by empowerment theory was conducted. Qualitative data were collected verbally via semi-structured interviews, with demographic details provided verbally at the end of the interview. Thematic analysis was utilised to identify themes. The COREQ checklist was used for reporting. Fourteen participants admitted to regional mental health inpatient units aged between 25 and 84 years old were interviewed. Participants felt their overall well-being was good despite feeling their physical health or mental health was suboptimal, suggesting that their perceived well-being is influenced by factors beyond their physical and mental health. Most participants reported looking after their physical health, mental health and well-being and identified various behavioural lifestyle strategies they found helpful. Thematic analysis identified three themes: functioning well, feeling in control and meeting basic needs. Mental health services and clinicians play an important role in empowering people with mental illness to improve their physical health, mental health and well-being while admitted to inpatient services; however, it is acknowledged resources can be limited. Mental health services may consider referring people with mental illness to social prescribing programmes to meet their individualised needs on discharge.

An integrative review methodology was employed, following PRISMA guidelines and Whittemore and Knafi's method for integrative review. Thus, the review synthesised the findings of empirical literature published between 2005 and 2023 drawn from four databases: CINAHL, MEDLINE, PsycINFO and Scopus. From the seven studies that met the inclusion criteria, a number of themes emerged: (a) relief of carer burden; (b) benefits for individuals with Mental Illness (MI); (c) barriers to accessing respite care; and (d) inappropriate services model for respite care for individuals with MI. The review findings indicate that using respite care services can decrease a carer's burden and can positively impact both carers and individuals with MI. Conversely, respite care may cause an increase in carers' stress levels due to the lack of service availability, insufficient knowledge and understanding about respite care services for carers, respite accessibility challenges accessible for people with MI and the reluctance of people with MI to accept respite care.