Factors influencing suicidal ideation among Chinese patients with stomach cancer: qualitative study.

AIM: The aim of this qualitative descriptive study was to explore the influencing factors of suicidal ideation in Chinese patients diagnosed with stomach cancer. INTRODUCTION: More recently, links have been made between suicide and cancer. For inpatients with cancer, nurses are at the front line to cope with suicidal issues in clinical settings. METHOD: This study was part of a larger study that investigated psychological strains and related factors associated with suicidal ideation. Thirty-two patients with stomach cancer participated in a face-to-face interview. Thematic analysis was used to analyse the qualitative data. FINDINGS: Four themes were identified as protective factors against suicidal ideation: suicidal denial and fears of stigmatization; positive coping skills; family connectedness; and desire to live well and longer. DISCUSSION: Consistent with previous research, these four protective factors may encourage participants to think more positively about life and cancer. CONCLUSION: Our findings suggest four protective factors for targeted suicide prevention, which may play an important role in future suicide-prevention programmes for Chinese patients diagnosed with stomach cancer. IMPLICATIONS FOR NURSING: Nurses may help reduce patients' risk for suicidal ideation more effectively by discussing beliefs, family and meaning in life perspectives, as well as offering health education about positive coping skills. IMPLICATIONS FOR HEALTHY POLICY: Clinical nurses, hospitals and the government should work collaboratively with each other. It is suggested that Chinese national guidelines for working with the high-risk suicide populations should be considered within a future mental health working plan.

A qualitative inquiry into consumer beliefs about the causes of mental illness.

This paper examines consumer or service user beliefs about the causes of mental illness. It presents a qualitative, participatory action research study involving semi-structured in-depth interviews with 16 people who had been diagnosed with a mental illness and attended a community mental health centre in metropolitan South Australia. Inductive thematic analysis was undertaken, with a range of beliefs about the possible cause of mental illness identified. Findings are organized within two key areas: social or environmental factors and physical or biological factors. The social or environmental category included varied situations, clustered under the subcategories of: stress during childhood, events in adulthood and religious beliefs. Physical or biological factors included beliefs that mental illness was inherited, caused by brain malfunction or chemical imbalance. Of note, one-third of consumer participants who discussed possible causes of mental illness identified multiple potential causes. Implications for service delivery, specifically related to therapeutic trust and engagement, are also considered.

Management of a complex wound in a person with spinal cord injury and mental illness.

This paper highlights the important nexus between physical and mental health by examining a case concerning a patient with a lower spinal cord injury and mental illness who subsequently developed two pressure ulcers. It examines how clinicians can benefit from looking beyond typical assumptions when caring for an individual with complex needs in the community setting. In such circumstances, the need for a holistic and collaborative approach to wound care is vital. This involves taking into account the individual's mental health care needs, which can be overlooked in the first instance. Recommendations for clinical practice centre on involving the patient in his or her dietary, psychological and physical care, thereby helping to build resilience to any mental health problems and promoting a positive physical recovery.

How definition of mental health problems can influence help seeking in rural and remote communities.

The present study sought to understand the rural and remote influences on people's identification of, and response to, mental health problems. Twenty-two key informants living in northern and western South Australia were interviewed. They included mental health and generalist health professionals, other human service workers and mental health consumers. Three themes are reported here: reluctance to acknowledge mental health problems and the avoidance of appropriate help; stigma and the avoidance of mental health services; and the influence of rural and remote circumstances. Most informants considered that many mental health problems were amenable to help from generalist workers, with backup support from mental health specialists. Informants thought this intervention to be appropriate because a common view of mental health problems as 'insanity' and a culture of self-reliance created a reluctance to seek help from a mental health specialist. These themes need to be taken into account when designing mental health interventions for rural and remote communities.

Cultural affirmation and the protection of emotional well-being.

This article examines the impact of the Balkan conflict on the culture and emotional health of a community of Serbian Australians. It discusses how an intimate reconnection with their cultural identity, Serbian Australians, without formal mental health service supports, managed the complex and dynamic interplay between homeland events, mainstream media reports, ethnonational bonds, and mental health issues in Australia. Ethnographic techniques revealed that although the Balkan conflict bared a multitude of potent health and emotional concerns for Serbian Australians, their coping was enhanced by an intimate sense of belonging and reassociation with their historical, religious, cultural, and national identities. By engaging in spiritual connections with their culture and ethnicity, the transglobal effects of the Balkan war on Serbians in Australia revealed that mental health and healing could no longer be seen as a localized phenomenon. It must also be seen as something that transcends the nations and communities in which people live.

Nursing practice and ethnography: a mental health nursing response to threatened violence in ethnographic fieldwork.

This paper reverses the usual argument about the relationship between research and nursing by showing how mental health nursing knowledge can be used to facilitate ethnographic research. It focuses on the use of mental health nursing in ethnographic data generation from Serbian Australian participants living in the shadow of the Balkan war 1991-96. Beginning with a fieldwork episode at the scene of property damage, it traces the main features of participants' distress, and describes a mental health nursing response to a threat of violence against the author. A background in mental health nursing facilitated a productive and safe interaction under difficult and extremely emotionally charged circumstances.

Violent ethnic wars and world-wide people movement: implications for mental health nursing practice.

In recent years, the world has been subjected to violent ethnic wars for autonomy and secession. Violent conflicts over national and international territorial boundaries are marked by a murderous mistrust, hatred and a perpetual life-and-death struggle in the present. For the mental health nurse, the world-wide persistent global circumstance of international catastrophe and increasing nationalism mediated through war is inextricably linked to practice as well as the significant health and lifestyle concerns of displaced people. Central to the discussion in this paper will be the mechanisms used by the mental health nurse to maintain empathy and clinical excellence during highly sensitive practice issues; in particular, the management of feelings of frustration, anger, guilt, loneliness and sleeplessness, and repeated mental images of suffering and human butchering, because these issues intersect with national and cultural identity. In rising to the challenges these issues present, mental health nursing must co-exist with critical world events and the globalisation of national identity in cultural diversity.

Identifying and responding to the needs of refugees: a global nursing concern.

Worldwide catastrophic events such as civil war have forced 1 in every 130 people in the world to flee her or his home and become a refugee or displaced person. The article draws upon contemporary refugee experiences from Afghanistan, the Sudan, and the former Yugoslavia to introduce the role of nursing during the refugee journey from flight to asylum seeking. It is hoped that the article will provide nurses with a beginning awareness of the nurse's role in the care and comfort of refugees and displaced people. Central to this role is the gathering of humanitarian, sociocultural, and personal information to enable extensive networking and relationship building with refugees for ongoing empowerment and increased problem-solving capabilities.

Student nurses' attitudes to psychiatry: the influence of training and personality.

Fifty-one second-year students completed the Attitudes to Treatment Questionnaire (ATQ), the Conservatism Scale (CS), the Defence Style Questionnaire (DSQ) and an open-ended questionnaire before and after components of their psychiatric training programme, which included a 1-week placement in a psychiatric hospital. CS scores indicated that the nurses were moderately conservative. ATQ scores and CS scores correlated significantly, with the more conservative nurses reporting more traditional attitudes to psychiatric nursing. ATQ scores fell significantly after psychiatric hospital placement, indicating more progressive attitudes. Mean scores on the DSQ were within normal limits, although men scored significantly higher than women on the Immature Defences Scale immediately after placement. The open-ended questionnaire revealed mainly positive comments about the psychiatric hospital placement. Almost half the nurses expressed surprise at the relaxed, informal atmosphere on the wards, and as many stated that personal interaction with the patients rapidly removed any stereotyped attitudes that they held previously. Over 40% of nurses stated that the patients were much less aggressive or dangerous than they had expected, although nearly 20% said they were concerned about the levels of aggression that they observed.

Operating characteristics of the Dynaray 18 linear accelerator.

The operating system of a Dynaray 18 linear accelerator is described. Central axis depth dose data for the 10 MV roentgen ray beam are given and compared with published data. The alignment of the roentgen ray beam and the modifications required to obtain satisfactory uniformity and reliable dosimetry are described. The characteristics of the electron beams are also described, central axis depth dose data are given and the derived estimates of energy are discussed.