International journal of mental health nursing最新文献

To improve mental health, diverse mobile applications (apps) have been developed to target those who actively use smartphones and in-phone apps. In this vein, this study developed a mobile app, eRAPPORT, to prevent suicide using ecological momentary assessment and intervention. A brief literature review and mobile app market search were conducted to determine the app's content and modality. The design and contents of eRAPPORT were developed through consulting with contextual and methodological experts for end-users' need assessment and technician review. For implementation, an experienced mobile app developer collaborated with the research team to create the app, which includes a safety plan, a feature to track suicidal risk and mental health status, evidence-based information from international and national authorised organisations, an outreach service with online/offline counselling and pop-ups displaying emergency contacts. Twenty-five general adults participated in the feasibility study. After using eRAPPORT for a month, they completed a self-reported questionnaire, followed by an in-depth interview of functionality, acceptability and safety. Both quantitative and qualitative evaluations assured the moderate level of usability and acceptability due to some features that should be improved before applying those with a high risk of suicide. No critical adverse event was reported. Thus, this eRAPPORT feasibility study provides fundamental information to describe the patient-centred processes on how to develop a mobile app for suicide prevention. Further study will be conducted to test the app's effectiveness and determine the application in clinical practice for monitoring and preventing suicide risk by collecting real-time and longitudinal data.

PNDA are complex health conditions affecting up to one in five women. The causes of PNDA are not well understood and no proven prevention exists. This study aimed: (1) to understand health professionals' perspectives of the common drivers contributing to PNDA amongst women from regional and rural areas in Australia; (2) to identify clinical practice related to PNDA-associated challenges; (3) to identify and inform areas for intervention. We conducted four online Group Model Building (GMB) workshops with health professionals from the southwest of Victoria, Australia. Informed by local data, participants built a model that progressed from connection circles to causal loop diagrams (CLD) to capture a shared understanding of the key drivers of PNDA rates within the region. The CLD was thematically analysed and common drivers were grouped. The GMB transcripts were thematically analysed inductively identifying emergent themes about PNDA drivers and intervention ideas. The CLD revealed 28 drivers and four key themes that stakeholders perceived to be driving the increasing rates of PNDA. An additional three major themes were identified from the GMB transcripts: (1) Social determinants of women's health; (2) Health system issues; (3) Negative birth experiences. Three key intervention themes were proposed, to improve collaboration between health services and departments, increase training availability, and increase continuity of care. Our findings suggest that dedicated training and pathways for collaboration between large regional and smaller rural services are necessary to address the rising rates of PNDA in the region.

Severe mental illnesses (SMIs) represent a significant public health challenge with substantial personal, economic and societal burdens. Despite treatment advances, recovery outcomes for SMI patients remain variable. This study aimed to investigate the influence of personal and psychosocial factors on recovery among SMI patients in community health settings. This cross-sectional study was conducted in 23 community health service centres in Nanjing, China. We recruited 924 participants diagnosed with SMIs, using a random sampling method. The relationships between individual, psychosocial factors and patients' recovery status were analysed by multiple linear regression. The mediation effect of medication adherence was further tested by the Sobel test with bootstrapping. The mean score of the Morningside Rehabilitation Status Scale (MRSS) of 924 patients with SMIs was 49.82 ± 41.52. The main influencing personal factors of recovery status were age, marital status, education, average annual income and duration of illness. Patients who were accepted by their families tended to have better recovery outcomes, while stigma and social impairment may hinder recovery. Medication adherence played a mediating role between psychosocial factors and recovery status. This study highlights the crucial role of psychosocial factors in the treatment and recovery of SMI patients. Furthermore, medication adherence emerged as a mediating factor. Implementing targeted interventions and policies addressing identified psychosocial barriers can offer promising avenues for improving recovery outcomes for SMI patients in community settings.

The therapeutic relationship plays a crucial role in nursing care for people with mental illness. Adopting a systemic and person-centred approach that considers the individual experiences and needs of the person is paramount. However, no instruments were found in the literature designed to evaluate the nurse-patient therapeutic relationship from the perspective of a person with mental illness. This study aimed to develop and evaluate the psychometric properties of an instrument for assessing the quality of the nurse-patient therapeutic relationship from the patient's perspective. An e-Delphi study was conducted to develop the assessment tool, and a psychometric study was carried out to examine its psychometric properties. The sample comprised 240 adults with mental illness. Internal consistency was assessed using Cronbach's alpha and the Omega coefficient. The final structure of the assessment instrument included 24 items distributed across two factors, explaining 64.2% of the variance. Cronbach's alpha was 0.94, and the Omega coefficient was 0.96. The intraclass correlation coefficient was 0.84 (95% CI: 0.66-0.92). The therapeutic relationship assessment scale (TRAS-Patient) shows good psychometric properties. This is a relevant tool for assessing the quality of the nurse-patient therapeutic relationship from the patient's perspective, thus promoting a patient-centred approach and responding to the patient's needs. Mental health nurses can access a tool for evaluating the nurse-patient therapeutic relationship centred on disciplinary knowledge. This enables patient involvement in care, enhanced care and person-centred practice.

This descriptive study examined the mental health literacy levels and attitudes towards seeking psychological help among university students. The study was conducted with 317 students from a university in Türkiye. Data were collected via an online platform using a Personal Information Form, the Mental Health Literacy Scale (MHLS) and the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPHS-SF). Participants, with an average age of 20 ± 1, were predominantly female (89%). Most had previously sought psychological support (75.1%) and believed the psychology information obtained online was accurate (61.2%). Significant differences were found between residential location (p = 0.034) and maternal education level (p = 0.017) with the Knowledge Subscale of MHLS, and between history of seeking psychological support (p = 0.010) with the Resource Subscale of MHLS. Additionally, there was a significant difference between seeking psychological support history and mean ATSPPHS-SF scores (p = 0.060). The scores on MHLS (13.15 ± 3.38) and ATSPPHS-SF (18.38 ± 3.77) indicated moderate levels, with a positive and significant relationship between the scales' total scores (p = 0.000). The study concluded that mental health literacy is crucial for increasing the rate of seeking psychological help. Addressing the lack of knowledge regarding mental health is essential for early diagnosis, prevention and maintenance of mental health. It is recommended incorporating mental health literacy content into university curricula, initiating efforts to provide information about psychological help resources and engaging psychiatric nurses in educational roles on campus through multidisciplinary planning.

Clinical placements form an integral and important part of preregistration nursing student learning. The theory-practice gap has been identified as problematic, with clinical experience being a key strategy to address this. Despite this, the perceptions of nurse academics teaching preregistration mental health nursing regarding clinical placements have not been widely explored. To garner perspectives and experiences of mental health clinical placements from nurse academics teaching mental health nursing to preregistration nursing students. A descriptive qualitative study involving 19 nurse academics from 13 metropolitan and regional Australian universities, who were involved in the design and delivery of preregistration mental health nursing content. Data were analysed thematically. The study adhered to the Standards for Reporting Qualitative Research (SRQR). Participants reported that inappropriate clinical placements generate negative student experiences. Furthermore, mental health placements in nonspecialist settings such as medical-surgical or aged care compromised student learning and posed a barrier to linking theory to practice. Increasing meaningful and appropriate mental health clinical placements in nurse education requires investment and support from multiple stakeholders. Nurse academics are crucial stakeholders in terms of understanding the impact of mental health clinical placements. Appropriate mental health clinical placements are central to effective comprehensive nurse education. Academics teaching mental health in preregistration curricula are significant stakeholders, and their informed perceptions are central to compel change.

Lesbian, gay, bisexual, transgender, queer and other diverse sexual orientations and gender identity groups (LGBTQ+) face high rates of poor mental health. In the most severe and emergent of instances, inpatient psychiatric care may be required. LGBTQ+ people report experiences of mistreatment in healthcare settings broadly, such as denial of healthcare services and harassment from healthcare providers and other patients. However, little is known about the experiences of LGBTQ+ people in inpatient psychiatric care settings, specifically. The purpose of this review was to assess the existing literature for descriptions of LGBTQ+ people's experiences within inpatient psychiatric care. We searched multiple databases (i.e., PubMed, PsychINFO, CINAHL, Web of Science and Google Scholar) for peer-reviewed articles that described the experiences of LGBTQ+ people within inpatient psychiatric care that were published in English. The included articles (N = 14) were analysed using a conceptual model of stigma and organised within those strata (structural, interpersonal and individual stigma) across the inpatient experience, (admission, inpatient unit, and discharge). Themes identified included: noninclusive intake tools and pervasive misgendering during the admission process; lack of healthcare infrastructure, inadequate training and lack of cultural humility, pervasive discrimination and victimization, silencing of LGBTQ+ patients, and feelings of fear and shame while on inpatient units, and lack of community resources during the discharge process. Clinicians should consider the perspectives and experiences of LGBTQ+ people to enact identity-affirming care practices that may increase mental healthcare engagement and improve long-term mental health outcomes.

To meet the aim of synthesising research on nurses' experiences of promoting personal recovery within psychiatric inpatient care, meta ethnography according to Noblit and Hare has been chosen as the method, which is a qualitative review of scientific literature that results in a synthesis. The focus is on interpretation and is expressed to be able to reduce a story, but at the same time keep what is unique using metaphors. Nine articles formed the basis of the synthesis. The analysis resulted in two levels of synthesis. The first level involved the translation of metaphors into one another, which proceeded in two directions, described as two principal headings. The second level produced five overarching metaphors. The first principal heading is that 'erected walls in psychiatric inpatient care impedes personal recovery.' It encompasses the overarching metaphors 'cultivating in exhausted soil' and 'nurses are gatekeeping watchdogs'. The second principal heading is 'torn-down walls in psychiatric inpatient care enable personal recovery'. It encompasses the overarching metaphors 'disarming and de-escalating', 'facing suffering together reveals treasures' and 'elevating the competent partner promotes recovery'. Conclusively, if the nurse is to be able to promote personal recovery in psychiatric inpatient care, bridges of cooperation and consensus need to be built to other professions in care. Otherwise, the obstacles to promoting personal recovery will be far too hard to overcome.