Recovery-oriented daily care practice for community-based mental health service consumers in Japan: A grounded theory approach.

Recovery, which is a non-linear, unique process allowing mental health service consumers to live autonomously, has become a prominent concept. However, adapting recovery-oriented practice to daily care is challenging. We explored recovery-oriented practice among mental health professionals in Japan via semi-structured interviews including nurses, occupational therapists, and psychiatric social workers (17 professionals in total). Data were analysed using grounded theory. Six categories emerged. The core category was 'Continuing to adjust care to meet consumers' needs for their unique lives'. The professionals stated that they practised in accordance with the service consumers' sincere hopes based on an equitable relationship because they believed that this approach would enhance consumers' personal agency, proactive behaviour, and self-choice. Despite negative consequences, the professionals did not view the consumers' choices as 'failures' and instead helped them to find meaning in their experiences. Although the therapeutic relationship tended to be paternalistic, participants described how concrete practices helped build an equitable relationship. In recovery-oriented practice, the provision of support centred on consumer values is important, without imposing own's own values. Care practices should also be aligned with consumers' hopes, needs and goals.

Differences in the risk of severe falls between patients aged <65 years and patients aged ≥65 years at a psychiatric hospital based on 12-year incident reports.

PURPOSE: This study compared age differences in risk factors for falls requiring treatment in psychiatric patients. DESIGN AND METHODS: An incident database was used to compare fall incidents in patients aged less than 65 years and those aged greater than or equal to 65 years. FINDINGS: Approximately 30% of fallers were less than 65 years. Mental status and medication were the main risk factors. Decreased activities of daily living were associated with the most falls in patients greater than or equal to 65 years. PRACTICE IMPLICATIONS: Fall risk differed between the two age groups. Medication may play a major role in falls among patients less than 65 years.

Effectiveness of ultrasound-guided peripheral intravenous cannulation in pediatric patients aged under three years: a systematic review protocol.

REVIEW QUESTION: The objective of this systematic review is to identify, evaluate and synthesize evidence of effectiveness on ultrasound-guided peripheral intravenous cannulation in pediatric patients aged under three years.Specially, the review question is: In pediatric patients aged under three years, what is the effect of ultrasound-guided peripheral intravenous cannulation on the first attempt and on the overall success rate, time to cannulation and number of attempts for successful cannulation compared with the traditional blind approach?

Analysis of inedible substance ingestion at a Japanese psychiatric hospital.

BACKGROUND: Inedible substance ingestion increases the risk of ileus, poisoning, and suffocation. Prevention is especially important in a psychiatric setting. This study aimed to analyze the incidence of inedible substance ingestion in a Japanese psychiatric hospital. METHODS: Inedible substance ingestion incidents were extracted from an incident report database spanning 2000-2012 at a 400-bed psychiatric hospital in Japan. We tabulated the frequencies of incidents in accordance with major diagnosis, ingested materials, incident levels, and time of occurrence. RESULTS: The incidence rate was 0.09/1000 patient days, and 149 cases in 105 patients were classified as having experienced inedible substance ingestion. The most common diagnosis was dementia (n = 58), followed by schizophrenia (n = 22). Materials ingested by dementia patients were nappies or gauze attached to the patient's body after medical procedures. Materials ingested by schizophrenic patients were liquid soap, detergent or shampoo, and cigarettes. Inedible substance ingestion among dementia patients occurred mostly before or during meals. Among schizophrenic patients, the peak period of incidents was in the evening. CONCLUSIONS: Dementia patients were overrepresented in the inedible substance ingestion incidents. Items they wore or applied to their bodies were often subject to ingestion, and such behaviours mostly occurred around meal time. Therefore, the nursing staff were able to discover them quickly and treat most of the cases free of serious consequences. In contrast, schizophrenic patients were underrepresented in the incidents, and most cases involved ingestion of detergent powder or cigarettes, resulting in more serious consequences and requiring treatment.

The effectiveness of psychoeducation programs following first episode psychosis: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to establish whether psychoeducational programs can lead to improved outcomes (reduced relapse or readmission) in patients with first-episode psychosis (FEP) compared with usual care. Specifically, the review question is: Are psychoeducational programs for patients with first-episode psychosis effective in improving outcomes compared with those receiving usual care?