Violence Against Women with Mental Illness and Social Norms and Beliefs: Nursing Professional Perspective.

Violence against women is a priority public health issue globally and women with mental illness are at double disadvantage. While social norms and beliefs play a critical role in influencing violence among women, limited or no research is available from India. To explore nurses and nursing students' views on social norms and beliefs that support Violence against women with mental illness. A descriptive cross-sectional survey was carried out among randomly selected registered nurses and nursing students (N = 209) using self-reported questionnaires. Majority of the participants confronted norms (76.7%) and situations that justify (67.7%) abuse among women with mental illness. Nurses reported more negative attitudes than nursing students with regard to norms and beliefs (t = - 2.714, p < 0.007) and justifiability of abuse (t = - 3.089, p < 0.002). The findings suggest suitable academic programs to extinguish the prevailing cultural beliefs that support abuse in women with mental illness.

Empowerment of nurses' knowledge and skills on violence against women with mental illness: A randomized controlled trail.

BACKGROUND: Nurses play a key role in identifying and supporting women with abusive experiences. However, research that evaluated the effectiveness of educational interventions on violence against women is sparse from India. AIM: To evaluate the effectiveness of a training program in improving nurses' knowledge and skills related to the identification and management of abused Women with Mental Illness (WMI). METHODS: A randomized controlled trial design was adopted for the present study. A total of 68 nurses were randomly assigned to either the experimental or control group (34 in each group). The experimental group was provided eight interactive sessions based on a Nursing Module on abuse among women with mental illness. The assessments were done in both groups at baseline, after the intervention, at three months and six months. The data was collected using a self-rated questionnaire and case vignettes. RESULTS: The mean knowledge score increased significantly in the experimental group after the intervention from 12.26 (SD, 2.03) to 23.60 (SD,1.24) and sustained at three months (23.07 ± 0.94) and six months (23.13 ± 1.61). Similarly, there were significant differences in nurses' skills after the training program (t = 13.17, p < 0.001) and at different time points of assessment (p < 0.001). CONCLUSIONS: Results showed that training had a positive impact on nurses' knowledge and skills related to violence against women with mental illness. Therefore, it is necessary to provide continuous training on this issue to help nurses in providing holistic care to this vulnerable population.

Effectiveness of nurses training in routine screening of violence against women with mental illness: A randomized controlled trail.

BACKGROUND: Globally, people with mental illness are highly vulnerable to various forms of abuse. Yet, research on routine screening of violence by mental health professionals is limited. AIM: The aim of this study was to evaluate the impact of training on nurses' attitudes towards routine screening and confidence in implementing routine screening of violence among women with mental illness. METHODS: A randomized controlled trial design was adopted for the present study. The participants of this study were 68 nurses randomly assigned to either experimental or control group (34 in each group). The experimental group was provided eight interactive sessions based on a Nursing Module on abuse among women with mental illness. The assessments were done in both groups at baseline, after the intervention, at three months and at six months. All assessments were self-rated questionnaires to assess nurses' attitudes and confidence in implementing routine screening of violence attitudes. RESULTS: The experimental group showed a statistically significant improvement in the attitudes and confidence in implementing routine screening of abuse in women with mental illness (p < 0.05) than the control group. Repeated measures of analysis also revealed statistically significant differences related to attitude and confidence in implementing routine screening of abuse between the groups and within the experimental group at different time points of assessment (p < 0.001). CONCLUSION: This study concluded that training based on a nursing module improved nurses' attitudes and confidence to conduct routine screening of violence among women with mental illness. However, further studies are necessary to clarify whether the training is effective in implementing in nursing practice.

Violence against women with mental illness and routine screening: Nurses' knowledge, confidence, barriers and learning needs.

Violence against women is a major public health issue and women with mental illness (WMI) are at a double disadvantage. While nurses play a key role in identifying and responding to abused women, research is limited on this issue from India. This qualitative study was aimed to explore nurses' knowledge, confidence, and learning needs in the identification and responding to disclosure of abuse in women with mental illness. The focus group discussions were conducted among nurses (N = 21) working in psychiatry units at a tertiary care center. An interview guide with semi-structured questions was used to collect the data. Five dominant themes and fifteen sub-themes have emerged from qualitative analysis. The dominant themes include; Awareness of abuse among women with mental illness (AWMI), Experiences of recognizing and responding to abuse, Barriers for routine screening for abuse, Educational preparedness, and learning needs, and Prevention of abuse in women with mental illness. The identified barriers include personal related (personal discomfort, lack of knowledge, etc.), job related (Time consuming, not a nurse's job, lack of time, etc.) and organizational (lack of policies and administrative support, etc.). Most of the participants expressed that they lack confidence in the routine screening of women for abuse due to inadequate training. Therefore, it is critical to include a topic on domestic violence in the nursing curriculum and provide ongoing learning opportunities to the nurses through CNE programs, workshops, and conferences.

Misconceptions about traumatic brain injury among nursing students in India: implications for nursing care and curriculum.

BACKGROUND: Despite the devastating consequences of Traumatic brain injuries (TBIs), TBI misconceptions are common among healthcare professionals. As an essential member of multi-professional team providing TBI care, it is important that nurses have correct information and adequate skills to achieve the best possible outcomes for TBI. For example, some common misconceptions about TBIs are that a second blow to the head can improve memory functioning and wearing seatbelts can cause as many brain injuries as it prevents. In India, perhaps such misconceptions towards TBI among nursing professionals were not yet documented. As nursing students form the future health workforce, understanding TBI misconceptions among nursing students in resource-limited settings like India will provide useful information for strengthening the nursing curricula for improved care and rehabilitation of TBIs. METHODS: We used a cross-sectional survey to study the TBI misconceptions among nursing students in India. A Common Misconceptions about Traumatic Brain Injury (CM-TBI) questionnaire was administered to 154 nursing students from a nursing college of a tertiary care neuro-centre in India. The mean percentage of misconceptions were calculated for 7-domains of CM-TBI. T-test for independent samples and ANOVA were used to study the association of misconception with socio-demographic variables using total score for each respondent. RESULTS: Of the 143 nursing students who completed the survey, majority of them were female (97%) and in the 19-20 year age-group (95.1%). Domain on brain damage (81.1%) had highest rate, while amnesia domain (42.0%) had lowest rate of misconception. The overall mean-score was 22.73 (Standard Deviation: 4.69) which was significantly higher than the median score of 19.5. The study did not show significant differences on overall misconceptions about TBI for any of the socio-demographic characteristics. CONCLUSIONS: Misconceptions about TBIs were common among nursing students and it was pervasive irrespective of age, gender, place of residence and year of education. A need to strengthen nursing curriculum in the area of TBIs has been emphasized for improved care and management of TBIs. The study findings also suggest the need for understanding such misconceptions among other healthcare professionals involved in TBI care.

Eating Attitudes, Weight Control Behaviors, Body Image Satisfaction and Depression Level Among Indian Medical and Nursing Undergraduate Students.

This was a cross sectional descriptive study carried out among Medical and Nursing students to assess the presence of eating disorders. Data was collected using self administered 'Sick, Control, One, Fat, Food' (SCOFF) and 'Eating Attitudes Test (EAT-26)' questionnaires. It was found that 34.1% and 10.4% of the participants were at high risk to suffer from eating disorders on SCOFF and EAT-26 scales. Further, age, gender and education found to have significant association on SCOFF and EAT-26 scores (p < 0.05). Thus, the findings suggest the need for effective interventions to prevent depression and eating disorders among the future health professionals.

Indian novice nurses' perceptions of their role in caring for women who have experienced intimate partner violence.

BACKGROUND: intimate partner violence (IPV) is a significant health problem and a gross violation of the human rights of women. Nurses play an important role in providing support for these women. There is limited research on nurses' understanding and perceptions of their role in caring for women with IPV issues in India. AIM: to assess novice nurses' perceptions of self-efficacy, educational preparedness and their role in this area. METHODS: this was a cross-sectional descriptive survey carried out among a convenience sample of novice nurses (n=83) at a tertiary care centre using self-reported questionnaires. RESULTS: a majority of the subjects were confident and had adequate knowledge in dealing with women who have experienced IPV. A significantly positive relationship was found between educational preparedness and self-efficacy and attitudes towards nurses' roles in caring for these women. CONCLUSION: novice nurses were confident and held positive attitudes towards women who experienced IPV. Yet their self-efficacy in caring for these patients could be improved through continuing education and there is an urgent need to integrate comprehensive training on IPV to improve clinical competencies, including how to refer women for further support.

Knowledge, attitude and behaviour of the general population towards organ donation: An Indian perspective.

BACKGROUND: The rate of organ donation in India is low and research on organ donation among the general population is limited. We assessed the knowledge, attitude and willingness to donate organs among the general population. METHODS: We carried out a cross-sectional descriptive study among 193 randomly selected relatives of patients (not of those seeking organ donation) attending the outpatient department at a tertiary care centre. We used a structured questionnaire to collect data through face-to-face interviews. RESULTS: We found that 52.8% of the participants had adequate knowledge and 67% had a positive attitude towards organ donation. While 181 (93.8%) participants were aware of and 147 (76.2%) supported organ donation, only 120 (62.2%) were willing to donate organs after death. Further, there were significant associations between age, gender, education, economic status and background of the participants with their intention to donate organs. CONCLUSION: Our study advocates for public education programmes to increase awareness among the general population about the legislation related to organ donation.

Gender Differences Related to Attitudes Toward Suicide and Suicidal Behavior.

This descriptive study examined gender differences related to attitudes toward suicide among randomly selected urban residents. Data was collected using a standardized questionnaire through face-to-face interview. Our findings revealed that men hold more pro preventive attitudes to help persons with suicidal thoughts (80.3 %, p = 0.05) and agreed that suicidal attempts are impulsive (78.6 %, p = 0.01). However, they hold permissive attitude to help persons with incurable diseases and expressing death wishes to die (66 %, p = 0.05). A majority of men (78.6 %) than women agreed that "suicidal attempt is essentially a cry for help" (χ (2) = 11.798, p = 0.05). These gender differences need to be taken into consideration when developing appropriate programs to prevent suicide. Further, decriminalizing the law, high-quality research and raising awareness about suicide prevention among the general population is crucial in developing countries like India.

Nursing Students Attitudes and Understanding of Complementary and Alternative Therapies: An Indian Perspective.

UNLABELLED: AIM The purpose of the present study was to explore Indian nursing students' knowledge and attitudes regarding complementary and alternative medicine (CAM). BACKGROUND: Research on nursing students' knowledge of complementary and alternative therapies is limited in India. METHOD: This was a cross-sectional exploratory study carried out in a convenience sample of nursing students (N = 122) using self-administered questionnaires. RESULTS: A majority of the participants (89.3 percent) felt that Ayurveda is highly/moderately effective. A majority of participants agreed with most items, indicating positive attitudes toward CAM therapies. Lack of evidence, lack of staff training, unavailability of credentialed providers, and lack of appropriate equipment were seen as the main barriers to practicing CAM therapies. CONCLUSION: The findings suggest that introducing CAM in the nursing curriculum is needed to prepare future nurses. Continuing education/training in CAM is needed by nurses to provide holistic care.

Nursing students' knowledge of child abuse and neglect in India.

BACKGROUND: Child abuse and neglect are global phenomena. Research on knowledge of and attitudes towards child abuse and neglect among nursing students in India is limited. AIM: To investigate undergraduate nursing students' knowledge of and attitudes towards child abuse and neglect. METHODS: A descriptive design was adopted for the study, in which 158 nursing students participated by responding to a standardised questionnaire. RESULTS: The findings revealed that students' knowledge of child abuse and neglect is inadequate, as the total mean (M) score was 13.84±4.35 (M±standard deviation (SD)). The total attitude score of 50.37±6.196 (M±SD) indicated participants' positive attitudes towards prevention of child abuse and neglect. However, there was a negative relation between age and attitudes towards and knowledge of child abuse. Older students scored higher on the total attitude and knowledge scale compared with younger students. CONCLUSION: The study findings support the hypothesis that nursing education programmes need to improve the curricular content related to the assessment and reporting of suspected child abuse and neglect, and prevention strategies to improve the wellbeing of children. Curricular changes have the potential to provide nurses with an opportunity to reduce the prevalence of child abuse and neglect in India.

The Question is the Answer: concerns and queries raised by patients and caregivers referred to rehabilitation services.

BACKGROUND: The philosophy of recovery emphasises consumer participation and engagement in developing effective rehabilitation services. Assessment of consumer perspectives and concerns lies at the heart of responsive and relevant rehabilitation frameworks. AIM: The study aimed to document and examine patient and caregiver queries, at their first contact with Rehabilitation Services. METHODS: The sample consisted of 124 consecutive inpatients and their accompanying caregiver/s, referred to Psychiatric Rehabilitation Services, within a tertiary care psychiatric hospital in India. The data were collected using the semi-structured Inpatient Intake proforma during the intake session. The spontaneous queries raised by patients and/or caregivers were documented and content analysis identified themes, separately for patients and caregivers. RESULTS: The results indicated both similarities and differences in the frequency of themes that emerged from questions asked by patients and their caregivers. Two prominent themes centered on specific queries about rehabilitation services and the treatment and prognosis of the psychiatric illness. CONCLUSIONS: The findings have implications for training, practice and research in the field of psychosocial rehabilitation. Recommendations are made for training and practice frameworks to facilitate consumer-service provider communication towards the development of responsive recovery-oriented services.

Smoking cessation support: Indian nursing students' practices, attitudes and perceived barriers.

BACKGROUND: Tobacco use is a significant global health issue. Studies that examined nursing students' attitudes towards smoking cessation support were limited from India. AIM: To assess undergraduate nursing students' practices, beliefs, attitudes and perceived barriers towards smoking cessation support. METHODS: A cross-sectional descriptive design was adopted among undergraduate nursing students (n=178) using self-reported questionnaires. RESULTS: Findings revealed that a majority (68.5%) of the students inquire about their clients' smoking habits and 78.1% of them advise patients who are smokers about the health effects of smoking. Although student nurses hold positive attitudes in the enthusiasm domain (28.8 ± 7.29), the majority of them lack self-efficacy towards smoking cessation support (14.2 ± 4.70). 'Patient's lack of motivation' (89.3%), 'lack of training/knowledge' (88.2%) and 'lack of communication skills' (77.5%) were the major barriers encountered by the participants during tobacco counselling. CONCLUSION: The findings suggest that there is an urgent need to include a tobacco-control curriculum at undergraduate level to improve their competency in giving smoking cessation support.

Effect of Uoncept Mapping in Improving Nursing Students' Knowledge and Attitudes Related to Care of HIV/AIDS Patients.

This one group pre- and post-test study evaluated the effectiveness of concept mapping and lecture method of teaching among 73 under graduate nursing students. One group was exposed to concept mapping technique and the other group was exposed to lecture method of teaching about HIV/AIDS. Findings indicated a statistically significant increase in the knowledge and attitude of students towards HIV/ AIDS among students exposed to concept mapping than students who underwent lecture method. The results of this study indicated that moden teaching strategies may enhance learning among nursing students. However further evaluation is needed.

Stakeholders' perspectives on adverse effects of ECT: A qualitative thematic analysis.

Background: In the Indian context, published systematic research on the opinions of mental health professionals and other stakeholders (patients and caregivers) regarding the different adverse effects of electroconvulsive therapy (ECT) is not available. This type of study allows for an in-depth exploration of complex phenomena, such as the perspectives of mental health professionals, which can provide a rich understanding of their experiences regarding ECT and also helps to understand the views of mental health professionals regarding the adverse effects of ECT during the post-ECT recovery period and its management. Conversely, the perception of patients and caregivers regarding the adverse effects of ECT can provide a more comprehensive understanding of the treatment and its impact on the patients who receive it. Purpose: To explore the understanding of participants about the various adverse effects following ECT and their perception of managing different adverse effects of ECT during the post-ECT recovery period. Methods: A qualitative approach using focus group discussion (FGD) was used. A convenience sampling technique was followed for selecting the participants. FGDs were conducted with stakeholders including mental health professionals, patients, and caregivers. Five FGDs were conducted with psychiatry residents, nursing officers from the ECT suite, and different psychiatry wards at NIMHANS. Four FGDs were held separately for patients receiving ECT and their caregivers, admitted to various psychiatry wards at NIMHANS. A total of 28 mental health professionals, 20 patients, and 20 caregivers participated. The number of participants for FGDs was decided based on data saturation. The FGDs, lasting 30-40 minutes each, occurred between October 2022 and December 2022. The FGDs were audio-recorded with prior permission from the participants. All the participants were informed about the study. Written informed consent was obtained. All FGDs were transcribed. Thematic analysis was done using Atlas. ti software. Results: The broad categories identified were adverse events associated with ECT during the ECT procedure, adverse events associated with ECT after the ECT procedure, prevalence of different adverse effects according to mental health professionals, effects of adverse effects on the continuity of ECT, and difficulties encountered by mental health professionals throughout the management. Other broad categories were found after conducting FGDs with caregivers and patients, which were patients' experience as per the caregivers over the course of ECT, caregivers' and patients' willingness to continue ECT, unfavorable impacts of ECT experienced by the patients immediately after ECT sessions, and, later till the end of that day, suggestions of the caregivers and patients to improvise the management of ECT-related adverse effects and management of adverse effects by the treating team. Conclusion: The findings will develop a standard operating procedure that may help nursing officers monitor and identify the adverse effects immediately after ECT and minimize the complications during the post-ECT recovery period.

Effectiveness of Digital Learning in Community Mental Health Care Among Nurses in India.

Background: Digital learning is a cost-effective and time-saving approach in higher education. The present study aimed to check the impact of continuing nursing education programs through digital learning by connecting Indian nurses to NIMHANS Digital Academy (NDA). Materials and Methods: One group pre-test and post-test design was used for this study. Overall, 217 nurses registered for the course and 146 nurses were recruited on the basis of eligibility and their Expression of Interest (EoI) through the online registration portal. All the nurses who had access to the internet and enough internet literacy were included in the study. 64 nurses had not submitted the post-test due to various reasons within the stipulated time. Hence, the final sample achieved and calculated for the analysis was n = 82. The data for this study were collected through the retrospective chart review method. Result: The findings of this study reveal that most of the nurses in India had willingness and readiness for digital learning. All the nurses who joined the NDA learning program stated that they would like to improve their knowledge regarding mental health and illness, to identify and manage mentally ill patients efficiently. The results indicated that the training provided through NDA positively impacted the nurses' knowledge and fulfilled their learning needs. Statistical analysis showed a significant difference between knowledge, practice, and confidence score changes for the two-time point period, i.e. before and after the training. Conclusion: It can be concluded that conducting Continuing Nursing Education (CNE) through a digital learning program is an effective teaching-learning method in the nursing curriculum.

Effectiveness of lifestyle intervention on prevention/management of antipsychotic-induced weight gain among persons with severe mental illness: A systematic review and meta-analysis.

Individualized lifestyle interventions using motivational interviewing (MI) approach are recommended for persons with severe mental illness (SMI) for effective weight management. The aim of this meta-analysis was to assess the effectiveness of various lifestyle interventions that addressed obesity among persons with SMI. Twelve RCTs were assessed by individual reviewers using revised cochrane risk-of-bias tool (RoB 2). The standardized mean difference (SMD) was calculated with a 95% CI. The age of participants was between 18 and 70 years. Waist circumference showed an SMD of -0.09 (-0.22, 0.03), weight -0.03 (-0.10, 0.15) and BMI -0.07 (-0.07, 0.22). The findings in this meta-analysis revealed that though lifestyle interventions were statistically insignificant in reducing antipsychotic induced weight gain among persons with SMI, they show changes in intervention group. Psychosocial management along with lifestyle interventions, and MI are effective in the management of antipsychotic induced weight gain.

Perspectives of Community Nurses on Treatment Engagement of Persons with Severe Mental Illnesses (PwSMI): A Qualitative Study from South India.

Background: There is increasing evidence of the need for treatment engagement between Persons with Severe Mental Illnesses (PwSMIs) and Mental Health Professionals (MHPs). This therapeutic process involves collaborative work between patients and MHPs, which improves the condition. Community nurses are uniquely positioned to facilitate this process as they act as the focal point of interaction between patients and the health system. Methods: This qualitative study explored the community nurses' experiences in treatment engagement with PwSMI through eight group interviews of 35 community nurses from District Mental Health Programs (DMHPs) across Karnataka (South India) from February 2020 to March 2020. The audio recordings of the interviews were transcribed and coded to arrive at themes and subthemes. Results: The major themes identified were factors influencing treatment engagement, strategies to tackle treatment nonengagement, and challenges in dealing with nonengagement. The reasons for nonengagement were lack of insight and lack of knowledge of sociocultural, logistic, and treatment-related factors. The DMHP teams contacted patients through phone calls, home visits, and liaisons with health workers and intervened with them through education and depot injections. The major challenges were difficulty conducting home visits, distances, the unavailability of medications, and the need for adequate infrastructure and human resources. Conclusion: Community nurses address a few factors of nonengagement, such as insight, sociocultural factors, and treatment-related factors. Addressing the systemic challenges and adequate training of nurses in intervening in the dropped-out PwSMIs would help to reduce the treatment gap.

Nurses' perception about a DVD module on 'mental status examination demonstration'.

Computer-based multimedia can improve learning and retention of learnt material A video recorded DVD module on role play of mental status examination was visualised by 226 nursing students and 133 nursing teachers. Their opinion of the DVD on various parameters such as audibility, visibility, clarity, methodical, organisation of content, following the principles of psychiatric interview, symptom elicitation, therapist behaviour, therapist communication skill and ease in understanding revealed that the DVD module was of high quality and could be used as a teaching tool

Experiences of the Occupational Therapists During the COVID-19 Pandemic: A Scoping Review.

Occupational therapy has been impacted by the worldwide COVID-19 pandemic and has transitioned from a traditional face-to-face therapy method to an online one. In the wake of the pandemic, occupational therapist faced the challenge of providing online services to people with disabilities. The review aimed to identify and synthesize the best available evidence on the experience of occupational therapists in psychiatric rehabilitation settings during the COVID-19 pandemic. Additionally, the challenges posed by changes in the mode of training were examined. Electronic database search included PubMed, PsycINFO, PsycNET, Cochrane Library, Ovid, MEDLINE, CINAHL, SAGE Journals, Elsevier Science Direct, Springer, Wiley Online Library, JAMA Psychiatry, and Society E-Journals. Inclusion criteria were studies describing the experience of the occupational therapists during the COVID-19 pandemic in psychiatric rehabilitation settings. A systematic search identified 8 studies included quantitative, qualitative and mixed methodology conducted between 2020 and 2022. The findings from the reviewed articles revealed that the complexities and challenges faced by occupational therapists during the COVID-19 pandemic were professional, personal, and organizational; innovative practices were implemented in the psychiatric settings. The review findings expressed both positive (accepting a new mode of training, time saving) and negative experiences (problems with interaction & internet) perceived by the rehabilitation professionals. Enhancing the training of occupational therapists will help in easing the access and know-how of using telerehabilitation services for patients and coping with COVID-19-like situations in the future.