'Clinical Is the Pinnacle': Nurse Academics' Perspectives and Opinions of Their Students Undertaking Mental Health Clinical Placements.

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.

'I Can't See Myself Seeking Help': The Influence of Clinical Placements on Nursing Students' Stigmatising Beliefs and Intentions to Seek Help for Their Own Mental Health Issues: A Prospective Cohort Study.

Mental health conditions such as anxiety, depression and psychosis represent a global health challenge. Stigma surrounding mental health continues to hinder help-seeking behaviours for people with mental illness and as this study demonstrates, nursing students as well. However, if student nurses are reluctant to seek help for mental health issues, how can others be expected to do so? This reluctance poses challenges in mental health nursing, impacting both care provision and nursing education. The present study seeks to explore the influence of traditional versus non-traditional mental health clinical placements on second-year nursing students' stigmatising beliefs and intentions to seek help for mental health issues. Employing a prospective cohort design using the TREND checklist, the study sampled second-year nursing students assigned to either traditional hospital-based or non-traditional recovery-focused mental health clinical placements. Using validated scales, stigmatising beliefs and help-seeking intentions were measured before and after the placements. Statistical analyses were conducted to assess changes in these variables over time and across placement settings. A significant impact of placement setting on help-seeking intentions was observed, with students in non-traditional placements showing an increased willingness to seek help. Additionally, non-traditional placements were found to significantly reduce stigmatising beliefs in all measured domains, suggesting that these settings may provide a more conducive environment for fostering positive attitudes towards mental health. Recovery-focused placements appear to offer experiences that can diminish stigma and encourage more positive perceptions and intentions related to mental health support.

"This should be a compulsory placement for all nursing students": An evaluation of pre-registration nursing students' perceptions of learning on a mental health clinical placement.

AIM: To conduct a longitudinal exploration of pre-registration nursing students' perceptions of their learning on an immersive mental health clinical placement grounded in learning from people with a lived experience of mental illness (otherwise known as consumers). BACKGROUND: Enriching mental health clinical learning environments are crucial for positive mental health nursing outcomes. Though non-traditional clinical placement (i.e. non-hospital-based) models effectively increase student learning in a range of domains, little is known about the specific features of contemporary non-traditional placement settings that may be supporting student learning over time. DESIGN: A survey design in the form of a standardised evaluation tool with additional qualitative response questions was used to examine nursing students' perceptions of learning whilst on a non-traditional clinical placement over a 5-year period. Non-traditional placement settings are alternative placement options to traditional inpatient/community mental health settings. The TREND Statement Checklist was adhered to. METHODS: Second- and third-year students studying a Bachelor of Nursing (N = 753) from eight Australian Universities completed a Student Placement Feedback Survey between 2019 and 2023. Data were collected via an evaluation survey including 7-items (rated on a 5-point agreement scale) and three free-response questions. Quantitative and qualitative responses were analysed over all observations and compared between the five years of student evaluations. RESULTS: Across five years, the immersive mental health placement was consistently rated by students as a highly valuable learning experience. Utilizing a Multivariate Analysis-of-variance (MANOVA) for the quantitative component revealed that student 'learning from lived experience' remained uniformly high and steady throughout 2020-2023. This was despite disrupted learning that ceased face-to-face tuition caused by the COVID-19 pandemic. An increase in 'student enthusiasm for nursing' was identified after the return to face-to-face learning. Qualitative analysis identified a greater need for preparedness prior to attending the placement and wellbeing support amongst students. CONCLUSIONS: Over the five years, pre-registration nursing students report clinical skill improvement and enhanced knowledge following the immersive mental health placement alongside an increased desire for further skill development. Learning from people's lived experience of mental illness and specialised facilitators was valuable for student learning outcomes. Increased support is needed for student mental health vulnerabilities and wellbeing ahead of clinical placements. Further research is recommended on the aspects of non-traditional clinical placements that may be protective for student learning.

Non-traditional mental health clinical placements: An effective means for reducing self-stigma in pre-registration nursing students.

WHAT IS KNOWN ON THE SUBJECT: Pre-registration nursing students report high rates of stigma, leading to low help-seeking attitudes when seeking help for mental health issues. Traditional mental health clinical placements can improve stigma related to attitudes and social distance for pre-registration nursing students. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: There are nil recorded clinical placement interventions that have decreased self-stigma for pre-registration nursing students, with this study highlighting a clinical placement model that is effective in significantly decreasing self-stigma. IMPLICATIONS FOR PRACTICE: The knowledge around the mental health struggles experienced by pre-registration nursing students, and the effect of a non-traditional mental health placement in decreasing self-stigmatizing attitudes in this population, is important for the future of retaining mental health nurses. There is an opportunity to use the clinical placement model presented, and design interventions for nursing students that aims to promote help-seeking behaviours. ABSTRACT: INTRODUCTION: Traditional mental health clinical placements can improve pre-registration nurse stigma toward mental illness, particularly in measures of attitudes and social distance. However, they have not yet been shown to improve self-stigma, which affects mental health disclosure and help-seeking behaviour. AIM: The present study investigates nursing students' stigma following a non-traditional mental health placement immersed alongside people living with mental illness. METHODS: Three stigma subtypes were measured using the Opening Minds Scale for Healthcare Providers: Attitudes, Social Distance, and Disclosure/Help-seeking. RESULTS: Pre-registration nurses (N = 848) completed the instrument pre- and post-placement. A multivariate analysis of variance (MANOVA) identified a large effect of placement on stigma (p < .001, η p 2 $$ {\eta}_p^2 $$ = .101). Post hoc pairwise comparisons revealed all three types of stigma decreased after the non-traditional placement (Attitudes: p < .001, η p 2 $$ {\eta}_p^2 $$ = 0.09, Social Distance: p < .001, η p 2 $$ {\eta}_p^2 $$ = 0.07, Disclosure/Help-seeking: p < .001, η p 2 $$ {\eta}_p^2 $$ = 0.04). DISCUSSION: These findings emphasize that attending a non-traditional mental health clinical placement can effectively reduce multiple types of nursing student stigma. LIMITATIONS: Further research in this area could focus on which attributes of the clinical placement setting foster positive help-seeking. IMPLICATIONS: These results are noteworthy for stigma surrounding disclosure/help-seeking, as traditional (i.e. hospital-based) mental-health clinical placements have been found ineffective in reducing nursing student stigma in this domain. RECOMMENDATIONS: Further research into the effectiveness of non-traditional clinical placements in reducing nursing students' stigma regarding mental health disclosure and help-seeking, is required.

Enhancing nurse practitioner research through reflexivity.

ABSTRACT: This article highlights the essential role of reflexivity in research, using a qualitative project involving interviews with nurse practitioners during the COVID-19 pandemic as an example. It discusses the potential biases inherent in research, particularly when the researcher's experiences closely align with those of the participants. Drawing on the perspective of a nurse practitioner engaged in both research and health care provision, this article explores the importance of reflexivity in addressing these biases. Examining the lead author's experiences conducting interviews with fellow nurse practitioners, the article illustrates how reflexivity was used, particularly in data collection and analysis, to enhance transparency and minimize subjectivity. By advocating for the integration of reflexivity in qualitative research, this article emphasizes the significance of shared experiences between nurse practitioner researchers and participants in reducing biases and improving research outcomes. It demonstrates how reflexivity contributes to a more authentic and comprehensive methodology, especially when researchers share similar experiences with participants. Furthermore, this article offers practical suggestions to assist nurse practitioners in enhancing reflexivity throughout the research process, thereby contributing to ongoing discussion and strategy development in the field.

Experiences of Respite Care Among Carers or Relatives Who are Responsible for Caring for Individuals With a Mental Illness: An Integrative Literature Review.

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.

Under Prepared for Practice: A Qualitative Study of Mental Health Nurse Undergraduate Workforce Preparation in Australia.

Internationally there are both current and looming mental health workforce shortages. Mental health nurses who have received specialist education are a vital component to respond to these challenges. AIM: This qualitative study aimed to better understand the efficacy and product quality of mental health nurse workforce preparation through pre-registration nurse education in Australia. METHOD: To meet this aim 19 educators representing 13 different universities were qualitatively interviewed. RESULTS: Thematic analysis found four themes (1) Graduates are under-prepared for safe mental health nurse practice; (2) Essential mental health nurse capabilities are missing in graduates; (3) Barriers to graduate preparation, and (4) Negative impacts of inadequate graduate preparation. DISCUSSION: Findings from this study suggest future workforce shortages would be best addressed through direct undergraduate entry for mental health nursing Implications for Practice: All nurse undergraduate training needs significantly enhanced mental health theory and placement within the course.

Contributing to 'a sense of purpose' - Evaluating consumer recovery progress after attending a therapeutic-recreation intervention programme: A quantitative analysis.

INTRODUCTION: The recommended objective for mental health plans and policies is the adoption of recovery approaches to mental healthcare. Mental health recovery is no longer defined by symptom resolution but as a journey towards a meaningful life from the consumer's own perspective. Recovery approaches focus on consumers' strengths, feelings of well-being and the achievement of personal goals. Designing recovery-oriented interventions is crucial for supporting people in their personal recovery journey. AIM: This study sought to evaluate how attending a recovery-oriented intervention impacts the recovery of attending people living with serious mental illness. METHODS: A quasi-experimental approach was utilised to examine changes in self-reported recovery progress in a purposive sample of consumers living with enduring mental illness (N = 105). Recovery progress was evaluated via the Recovery Assessment Scale - Domains and Stages (RAS-DS). Data were collected at entry and exit to a therapeutic recreation programme grounded in principles of recovery-oriented care and social contact theory. Pre-post scores were analysed via a repeated-measures multivariate analysis of variance (RM-MANOVA) per the four RAS-DS recovery domains. RESULTS: After attending the therapeutic recreation programme, consumer recovery scores significantly increased in the functional, personal, and social recovery RAS-DS domains as measured by 'Doing Things I Value', 'Looking Forward', and 'Connecting and Belonging' (respectively). No changes were observed to consumers' clinical recovery progress, as assessed via the recovery domain 'Mastering my Illness'. CONCLUSION: The results of this study demonstrate that therapeutic recreation camps can provide a recovery-based approach to mental healthcare, with positive effects on the three areas of: a purposeful life; connection and belonging; and optimism and hope. Recovery Camp has been previously identified by the Productivity Commission as having potential person-centred recovery benefits for mental health consumers. The results of this study now establish these benefits as evidence based and can be used to guide mental health practice and policy for the implementation of therapeutic recreation camps for mental health recovery.

It takes it out of the textbook: Benefits of and barriers to expert by experience involvement in pre-registration mental health nursing education.

WHAT IS KNOWN ON THE SUBJECT?: Service user involvement in mental health nursing education is beneficial in terms of attitudinal change to reduce stigma, clinical skill development and enhancing understandings of recovery-oriented practice. Service users as experts by experience have not been embedded within pre-registration nursing programs. Consequently, they remain limited in number, ad hoc and frequently tokenistic. Nurse academics responsible for the design and delivery of pre-registration mental health nursing curricula have a potentially important role in facilitating expert by experience involvement in mental health nursing education. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE: Nurse academics teaching mental health nursing have generally favourable views about the importance of expert by experience involvement. Nurse academics experience significant barriers in supporting the implementation of academic positions for experts by experience, particularly in obtaining funding. The experts by experience could contribute to mental health nursing education does not appear to be clearly understood by nurse academics. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health services aspire to adopt a recovery-oriented approach to practice. Involving experts by experience in mental health nursing education can facilitate increased understanding and appreciation of recovery-oriented practice. Nurse academics could play an important role in supporting the implementation of experts by experience positions in nursing academia. To do so, they require an understanding of the benefits of EBE involvement in academia and the barriers that can be encountered when attempting to facilitate the implementation of such positions. Experts by experience contribute unique expertise, essential to the development of quality mental health services. Conveying this expertise through the educating the future nursing workforce in mental health is essential. ABSTRACT: INTRODUCTION: Involving service users in mental health nursing education is ad hoc and minimal, despite growing evidence of its benefits. Insights and experiences of nurse academics teaching mental health to pre-registration students have been underrepresented in the research to date. AIM: To seek insights and experiences of nurse academics involved in designing and delivering pre-registration mental health nursing education in Australian universities regarding involving service users in mental health nursing education. METHODS: A descriptive qualitative study involving 19 nurse academics from 13 Australian universities, involved in pre-registration mental health nursing education. Data were analysed thematically. RESULTS: Participants reported minimal service user involvement. Most sought an increase and identified barriers. Data analysis resulted in five identified themes: (1) value-rich, (2) resource-poor, (3) imperfect processes, (4) 'part, but not all' and (5) unrecognised worth. CONCLUSIONS: Increasing meaningful involvement of service-users in mental health nursing education requires support and investment from multiple stakeholders. Nurse academics are crucial stakeholders in understanding the unique expertise service users bring. IMPLICATIONS FOR PRACTICE: Service users being central to all aspects of mental health services requires their active participation in the education of health professionals. Nurse academics have an important role in realising this goal.

Nursing students' attitudes towards mental illness: A multi-national comparison.

Accessible Summary What is known on the subject Health professionals, including nurses, are shown to have stigmatizing attitudes towards mental illness. For nursing students who are in their formative years of professional development, mental illness stigma can severely impact the care they provide. Little research has investigated multi-national comparisons of nursing students' attitudes towards mental illness. What this paper adds to existing knowledge This study shows that between countries, there were substantial differences amongst nursing students in stigmatizing attitudes towards mental illness. Cultural perspectives may explain some of these differences. What are the implications for practice Regardless of location, stigmatizing attitudes are present at varying levels. Each nation can take steps to reduce these by acknowledging the presence of stigmatizing attitudes amongst nurses, educating nurses regarding the negative impacts of stigma on patient outcomes, and decrease stigmatizing attitudes by facilitating opportunities for nurses (particularly student nurses) to have direct contact with people with lived experiences of mental illness. ABSTRACT: INTRODUCTION: Stigmatizing attitudes perpetuated by nursing professionals are a pervasive problem for people experiencing mental health issues. This global issue has detrimental consequences; inhibiting one's life chances and help-seeking behaviours. To date, few studies have compared nursing students' attitudes towards mental illness from a multi-national perspective. AIM: To compare undergraduate nursing students' attitudes towards mental illness across six countries: Australia, India, Jordan, Saudi Arabia, Taiwan and USA. METHOD: In a cross-sectional design, data were collected from undergraduate nursing students (N = 426) using the Social Distance Scale. A one-way analysis of variance was used to compare differences between countries. RESULTS: Nursing students' attitudes to mental illness differed between countries. Social Distance Scores were highest amongst nursing students from Jordan and Saudi Arabia. Students from Taiwan and India possessed moderate stigma scores. Social Distance Scores from the USA and Australia were lowest. DISCUSSION: Clear differences in stigmatizing attitudes emerged between countries; these are discussed in relation to possible cultural influences. IMPLICATIONS FOR PRACTICE: It is suggested that educating nurses, combined with direct contact with people with lived experiences of mental illness, can reduce stigmatizing attitudes regardless of country, location or educational institution.

Connection and recovery in the COVID-19 age: An analysis of changes in goal-setting throughout the pandemic by consumers living with enduring mental illness.

Goal-setting is a tool that empowers consumer recovery. Though the pandemic has affected consumer goal-setting, the nature and extent of this impact have not been examined in a recovery setting. The aim of this study is to assess whether the recovery goals of individuals with serious mental illness changed in association with the COVID-19 pandemic. In this mixed-methods design, data were collected from a purposeful sample of consumers (nTOTAL = 355) aged 19-67 years (MAGE = 44.56, SD = 13.05) attending Recovery Camp, a 5-day therapeutic-recreation programme for individuals living with severe mental illness (e.g., PTSD, schizophrenia). Consumer-set goals were examined across 5 programmes prior to March 2020 (nPRE = 126) and 11 following (nPOST = 229). Goals were set on day one, with attainment self-scored on day five. Chi-squared goodness-of-fit tests compared goal proportions per domain; tests of independence assessed changes in goals pre- and post-pandemic. Six goal domains were identified: Approach-Based Recovery, Avoidance-based Recovery, Novel Physical Activities, Relationships, Health, and Recreation/Relaxation. Irrespective of the pandemic, goal attainment was consistently high across all programmes (86.56%). Approach-based Recovery goals were predominant pre-pandemic, but were significantly reduced post-pandemic (p = 0.040). Goals related to Relationships and Novel Physical Activities took precedence throughout the pandemic. Post-COVID-19, consumer recovery goals reveal increased desire for connection, novelty-seeking, and positive behavioural change.

Informing the development of a fit-for-purpose mental health nursing curriculum: A survey of mental health nurse academics in Australia.

Inadequate mental health nursing content in pre-registration nursing curricula has been the topic of debate and concern since the introduction of comprehensive nursing education in Australia. Government-initiated inquiries and the efforts of mental health professional organizations and leaders have not successfully addressed this problem. The aim of the current study was to garner the perspectives and experiences of mental health nurse academics regarding the adequacy of mental health content in producing graduates able to work effectively in mental health settings and identify barriers and enablers to implementing and sustaining sufficient mental health content in pre-registration programs. A survey was distributed to mental health academics in Australian universities offering pre-registration nursing degrees. In total, 44 complete responses were included in the analysis. The results demonstrated the following: Most participants considered the current mental health content, theory and clinical hours insufficient to prepare graduates for practice in mental health settings. They reported a scarcity of tenured mental health nurse academics to deliver content effectively. Most participants were dissatisfied with the comprehensive approach to nurse education and preferred a double degree (nursing and mental health nursing), or a direct entry mental health nursing program. These findings provide further evidence for the current crisis in mental health nursing education and highlight the need for urgent action. People accessing health services have the right to receive high-quality care from appropriately qualified nurses. The inadequacy of mental health content in these programs effectively denies vulnerable people the standard of care and treatment they should be entitled to.

Unveiling final-year students and new graduates' concerns, preparedness, and learning experiences during the pandemic in Qatar: A cross-sectional survey.

Background: The emergence of COVID-19 interrupted education worldwide and educational institutions were forced to switch to an online learning (E-learning) environment. Objectives: To explore the perceived educational experiences, worries, and preparedness to enter clinical practice among final-year nursing students and new graduate nurses after studying during the COVID-19 pandemic. Design: A cross-sectional survey design. Setting: and participants: An online survey of final-year undergraduate bachelor of nursing students at a single university in Qatar and new graduates across 14 health facilities in Qatar was undertaken between May 2022 and July 2022. Methods: Participant demographics, experiences of E-learning and perceptions of readiness for practice were collected using validated instruments and open-ended questions. Descriptive statistics and thematic exploration were used to analyze the data. Results: Fifty-nine final-year students and 23 new graduates with an average age of 23.95 years (SD = 3.89) responded to the survey. Face-to-face clinical placement learning was preferred by 50 % of students and 66.1 % of graduates. During COVID-19, the majority of the participants indicated that strategies like practice kits and online simulations were implemented. While 61 % of new graduates felt well-prepared in their nursing skills, and 87 % felt confident, less than half of the students still in their final year of education felt prepared or confident. Increased stress and a perceived impact on education quality were reported due to changes in learning modalities. Despite these challenges, 81.1 % of students and 95.7 % of graduates felt they had developed sufficient professional values, with most looking forward to becoming registered nurses. The qualitative themes that emerged related to 1) adjusting to online learning, 2) experiencing restrictions in clinical learning skills, 3) feeling less confident and 4) experiencing increased stress. Conclusions: Despite experiencing emotional and educational challenges, the participants in this study felt that their education prepared them for clinical practice. Innovative strategies and unique educational experiences used by educators enhanced participants' clinical skills and readiness for practice.

The experience of healthcare professionals implementing recovery-oriented practice in mental health inpatient units: A qualitative evidence synthesis.

WHAT IS KNOWN ON THE SUBJECT?: The principles of personal recovery are primarily applied in outpatient and community settings as these settings provide continuity of care and recovery-based community programs supporting consumers' recovery journey. A range of healthcare professionals are involved in the care of people within mental health in-patient units, including nurses, psychiatrists, psychologists, occupational therapists and social workers. The integration of recovery-oriented care in mental health inpatient units may be impaired by a lack of confidence among mental health professionals. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Developing hope and a safe place is an integral part of recovery-oriented practice within mental health inpatient units. Instilling connectedness is a relevant recovery principle; however, there may be greater barriers in mental health settings which traditionally prioritise safety and risk mitigation practices to prevent perceived harmful behaviours. Staff workload and inadequate understanding of recovery concepts present challenges to promoting recovery-oriented care in everyday practice. Using strength-based practice is critical in promoting a safe space for consumers by providing psychosocial interventions and person-centred care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The provision of recovery-oriented practice requires adopting a collaborative approach that places a strong emphasis on the involvement of consumers and their families. Empowering mental health professionals to believe that recovery-oriented practice is possible in mental health inpatient units is crucial. Mental health professionals need to create a safe environment and positive relationships through respect and empathy for consumers and their family members. ABSTRACT: Introduction Recovery-oriented practice underpins an individual's personal recovery. Mental health nurses are required to adopt a recovery-oriented approach. Globally, a paucity of literature exists on mental health professionals' experience of recovery-oriented practice in mental health inpatient units. Aim The aim of this synthesis was to explore the experiences of healthcare professionals regarding recovery-oriented care in mental health inpatient units by appraising and synthesising existing qualitative research. Method Three databases, including MEDLINE, PsycINFO and CINAHL were searched between 2000 and 2021. Data were extracted and synthesised using thematic integrative analysis. The quality of included studies was assessed with the CASP Critical Appraisal Checklist. Results Ten qualitative research projects met the inclusion criteria. Four themes were identified (i) developing a safe and hopeful space, (ii) promoting a healing space, (iii) instilling connectedness and (iv) challenges to realising recovery-oriented care. Discussion Mental healthcare professionals perceived the principles of recovery-oriented care to be positive and include: therapeutic space, holistic care and person-centred care. Nevertheless, findings revealed limited knowledge and uncertainty of the recovery concept to be key barriers that may hinder implementation into practice. Implications for Practice Recovery-oriented practice must underpin consumer and family engagement, treatment choices and continuity of care to facilitate consumer's personal recovery.

The Role of Self-Determined Motivation and the Potential for Pre-registration Student Learning: A Comparative Study within a Mental Health Clinical Placement.

Developing therapeutic relationship skills as well as clinical skill confidence is critical for nursing students. While the nursing literature has examined multiple factors that influence student learning, little is known about the role of student motivation in skill development in non-traditional placement settings. Although therapeutic skills and clinical confidence are vital across a variety of contexts, here we focus on its development in mental health settings. The present study aimed to investigate whether the motivational profiles of nursing students varied with the learning associated with developing (1) a therapeutic relationship in mental health and (2) mental health clinical confidence. We examined students' self-determined motivation and skill development within an immersive, work-integrated learning experience. Undergraduate nursing students (n = 279) engaged in five-day mental health clinical placement, "Recovery Camp," as part of their studies. Data were collected via the Work Task Motivation Scale, Therapeutic Relationship Scale and the Mental Health Clinical Confidence Scale. Students were ranked into either high (top-third), moderate (mid-third) or low (bottom-third) motivation-level groups. These groups were compared for differences in Therapeutic Relationship and Mental Health Clinical Confidence scores. Students higher in motivation reported significantly higher therapeutic relationship skills (Positive Collaboration, p < .001; Emotional Difficulties, p < .01). Increased student motivation was also associated with greater clinical confidence compared to each lower-ranked motivation group (p ≤ .05). Our findings show that student motivation plays a meaningful role in pre-registration learning. Non-traditional learning environments may be uniquely placed to influence student motivation and enhance learning outcomes.

Suicide prevention program (SPP) in South Asian Countries: A protocol for systematic review.

Introduction: Every year, over 700,000 individuals lose their life by suicide and many individuals attempt suicide. Suicide occurs in all age groups and is the fourth major cause of death among 15-29-year-olds globally in 2019. A suicide prevention program (SPP) is a capacity-building program that helps gatekeepers to identify the risk of suicide. The objective of the review is to determine the effectiveness of SPP on the improvement of knowledge, attitude, and gatekeeper behaviour among gatekeepers in South Asian countries so that the number of suicide cases will be reduced among college students in South Asia countries. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) will be followed in this review. This review will include all interventional studies (controlled and uncontrolled) that provided a suicide prevention program to the gatekeepers as an intervention. The full-text articles will be included from the following databases, Scopus, PubMed (MEDLINE), Cochrane, PsycINFO, Web of Science, and CINAHL, published in peer-reviewed, and indexed journals from the date of inception to 2022. A grey literature search and hand-search of reference lists of the included studies will also be done. A search strategy will be developed using keywords and MeSH terms for each database. Cochrane ROB-2 tool, JBI Critical Appraisal Checklist will be used to evaluate the quality of individual studies. Analysis of the data will be done using narrative synthesis. Conclusions: This review will provide information on knowledge, attitude, and gatekeeper behaviour toward suicide prevention in college students and will be helpful for the prevention of suicide. Therefore, the authors plan to publish the review outcome through a peer-reviewed journal. Registration : The review is registered in PROSPERO (CRD42023387020).

Experiences of nurse practitioners working during the COVID-19 pandemic: A metasynthesis of qualitative studies.

BACKGROUND: The impact of the COVID-19 pandemic forced global changes to how nurses practice. Nurse practitioners adjusted their scope, changed how they delivered their service, and worked with limited resources. For some services, patient access was also compromised. OBJECTIVES: To synthesize, combine, and present current evidence on the experiences of nurse practitioners working during the COVID-19 pandemic. DATA SOURCES: CINAHL, Embase, and MEDLINE electronic databases were used to perform a structured search strategy. CONCLUSION: During the COVID-19 pandemic, health care services had to leverage their workforce skills to accelerate COVID-19 identification, treatment, and care. Nurse practitioners rapidly found themselves at the forefront and were concerned about infecting others. They also identified the need for support and were able to adapt to the changing environment. Nurse practitioners also recognized the impact on their well-being. Having insight into nurse practitioner's experiences during the pandemic is valuable for future health care workforce planning. Understanding how they coped will help with critical preparedness and response actions to other health care crises. IMPLICATIONS FOR PRACTICE: Having insight into nurse practitioner's experiences during the pandemic is valuable for future health care workforce planning because, as we know, the nurse practitioner workforce is one of the most rapidly growing professions in primary health care. Any future work in this space will help inform future nurse practitioner education and also help by informing critical preparedness and response actions to future health care crises, whether global or local or clinical or nonclinical.

Voice of persons with a life-limiting illness in conversation with healthcare professionals: systematic review and meta-synthesis.

BACKGROUND: Healthcare organisations are transforming the way care is delivered to people with a life-limiting illness with an increased focus on recognising the voice of the persons experiencing the illness and putting them in the centre of decision-making. However, the clinical practice remains largely based on the views of healthcare professionals and families or carers of the person with the illness. OBJECTIVES: To synthesise the best available evidence on the experience of persons living with a life-limiting illness about expressing their voice during communication with healthcare professionals. DESIGN: Systematic review and meta-synthesis. DATA SOURCES: CINAHL, Embase, Medline, PsycINFO, ProQuest Dissertations and Theses. REVIEW METHODS: A structured search was conducted to identify qualitative studies that reported on the experience of persons living with a life-limiting illness. The methodological quality of included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. The review was undertaken using the JBI and PRISMA guidelines. RESULTS: The expression of the voice of persons living with a life-limiting illness is influenced by: (1) the uncertain future surrounding illness trajectory and prognosis; (2) what is known from experience, media, family and friends; (3) emotional and psychological factors and (4) control and personal autonomy. CONCLUSIONS: In the early stages of a life-limiting illness, the voice of those experiencing the disease is not always audible. Instead, this voice is potentially present but silent and carried and promoted within healthcare professionals' values of accountability, professionalism, respect, altruism, equality, integrity and morality.

Nursing students' attitudes, behaviour, and knowledge toward smoking cessation: Results from a descriptive survey at a regional university.

BACKGROUND: Smoking is the largest single cause of lifestyle-related preventable morbidity and mortality. Nurses form the largest cohort of health professionals and are strategically placed to implement smoking cessation interventions. However their capacity is underutilised, particularly in rural and remote areas in countries such as Australia where the incidence of smoking in is higher than average and access to healthcare is limited. One strategy to address the underutilisation of nurses in smoking cessation interventions is to include training in the university/college nursing curriculum. To effectively implement this training, it is vital to have an in-depth knowledge of student nurses' attitudes towards smoking including the role of healthcare professionals in smoking cessation, their smoking behaviour and that of their peers, and knowledge regarding smoking cessation techniques and resources. OBJECTIVES: Investigate nursing students' attitudes, behaviour, and knowledge towards smoking cessation, determine the impact of demographics and educational experienced on these, and develop recommendations for future research and educational practice. DESIGN: Descriptive survey. PARTICIPANTS: Non-probability sample of undergraduate nursing students (n = 247) from a regional Australian university. RESULTS: Significantly more participants had tried smoking cigarettes than had not (p = 0.026). There were no significant relationships between gender and smoking (p = 0.169) or e-cigarette use (p = 0.200), but a significant relationship was found between age and smoking status where older participants (48-57 years) were more likely to smoke (p < 0.001). Most participants (70 %) were supportive of public health measures to reduce cigarette smoking but felt that they lacked specific knowledge to assist their patients to cease smoking. CONCLUSIONS: Within education there needs to be an emphasis on the central role that nurses play in smoking cessation with a greater focus on training nursing students about smoking cessation strategies and resources. There is also a need to ensure that students know it falls within their duty of care to address smoking cessation with patients.

Exploring the benefits and challenges of being a consumer educator in nursing education: A scoping review.

WHAT IS KNOWN ON THE SUBJECT?: The mental health needs of individuals are increasing following the COVID-19 pandemic, with a need to focus on the education of nurses to be equipped to respond. Stigma around mental health still exists for nursing students, with the implementation of mental health education by an individual with lived experience having a known positive effect on stigmatizing attitudes. Research on consumer involvement in nursing education identifies that the consumer role is often varied and casual, with no existing review on the consumer experience. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The study emphasizes the importance of consumer involvement in nursing education. Alongside the literature focussing on the student benefits, this review highlights both the benefits of being an educator, and the challenges of being an educator from the consumer's perspective. WHAT ARE THE IMPLICATIONS FOR PRACTICE: The knowledge around the consumer perspective mapped in this review has the potential to impact and transform education protocols for consumer involvement in education. This can maximize on the meaningful contribution that lived experience has within mental health nursing education. This review enforces the need for an awareness of the challenges consumers face in their role as an educator, and highlights the need for further understanding of how to overcome these challenges. There is also an opportunity to capitalize on the benefits identified by consumers in their role within nursing education and sharing their lived experience. ABSTRACT: Introduction While the mental health needs of populations are increasing, the targeted training of mental health professionals, specifically nurses, is required. Stigma surrounding mental health from nursing students exists, highlighting educational gaps. To address this, the involvement of consumers in undergraduate education has resulted in a positive effect on the stigmatizing attitudes of nursing students. There is still a limited understanding, however, of the consumers experience in this process. Aim To explore the experiences of individuals living with mental illness in educating nursing students. Methods The Joanna Brigg's Institute's (JBI) methodology for scoping reviews was used to search CINAHL, Medline, PsychInfo, Web of Science and Scopus including grey literature. The eligibility criteria for participants included individuals (a) diagnosed with a mental illness; (b) over 18 years of age; and (c) who participated in the educating of nursing students surrounding mental health in any context. Articles were only considered that were in the English language, and no time constraint was enforced during the search strategy for article selection. The search yielded 2640 results, of which 26 articles were included. Results Results found two prominent categories, including both benefits and challenges of being the educator from the consumer perspective. The benefits included: (a) the person behind the diagnosis; (b) reciprocal relationships; (c) positive effects on well-being; (d) unique contribution; and (e) purpose in storytelling. Challenges identified included: (a) vulnerability; (b) voyeuristic; (c) lack of preparation; (d) negative effects on well-being; (e) support; (f) not a real consumer; (g) variation of involvement; and (h) acknowledging consumer perspective. Discussion As consumer-led education for mental health nursing curriculum becomes mandated, amplifying the voice of the consumer in nursing education is crucial. While the benefits and challenges voiced by consumers in their involvement in mental health nursing education have been outlined here, further knowledge focussed on the consumer's experience as an educator outside the classroom setting, and in clinical practicum, alongside consumer involvement in specialized mental health education sessions, could aid in transforming consumer involvement. Implications for practice This review offers an incentive for nurse educators to capitalize on the benefits of educating for consumers to promote a meaningful contribution, while also practicing with an awareness of voiced challenges.