Development of a Personalized Tobacco Cessation Intervention Package (PTCIP) for Persons with Schizophrenia in India.

Background: Among persons with schizophrenia (PwS), tobacco use is higher in comparison to the general population, contributing to greater morbidity and mortality. Pharmacological interventions combined with psychosocial interventions are effective in tobacco cessation. While the effectiveness of extant psychosocial interventions-when used in isolation-seems limited, developing better combinations of interventions could help treatment providers deliver tobacco cessation services to PwS at different stages of motivation to quit. We aimed to develop a personalized tobacco cessation intervention package (PTCIP) for PwS. Methods: The stage-based intervention package was developed through a systematic review of interventions for tobacco cessation, the authors' clinical experience, and expert validation. The components of the intervention package, developed for PwS visiting the outpatient psychiatric department, were retained, removed, or added based on the content validity ratio (CVR). Results: The final components included brief advice, principles of motivational interviewing, psychoeducation, decisional balance matrix, positive reinforcement, offering various treatment options, personalized feedback using a smoking-risk calculator, and prediction of cardiovascular risk using the WHO package of essential noncommunicable disease (PEN). The delivery of the intervention package was refined based on pilot testing in eight participants. Conclusion: The tailored package was designed to be delivered by a mental health professional as a single comprehensive 40 min to 45 min face-to-face session, integrated with routine follow-up visits, followed by two telephonic conversations in the second and third week of the initial session. The package needs to be tested in a randomized controlled trial for its effectiveness.

Effectiveness of personalized tobacco cessation intervention package among patients with schizophrenia and related psychotic disorders - A two-group experimental study.

INTRODUCTION: Persons with schizophrenia and related psychotic disorders (PwS) smoke more, and have twice the rate of mortality, with 10-25 years lower life expectancy than the general population. Evidence-based tobacco cessation interventions would help in quitting. AIM: To evaluate the effectiveness of a personalized tobacco cessation intervention package for patients attending the outpatient psychiatry department. METHODS: The study adopted a two-group experimental design in PwS, using a simple randomization method. Eligible participants were randomly allocated to either the intervention group (n = 85) receiving the intervention package or the control group (n = 85) receiving brief advice to stop tobacco. The study outcomes were measured at baseline, 1, 3, and 6 months. SPSS 23 was used for data analysis. Intention-to-treat analysis was used to manage missing data. The p-value of < 0.05 is considered statistically significant. RESULTS: At 6 months, there was a significant difference (p < 0.001) in 7 days point-prevalence abstinence (28 % vs 10.8 %), reduction of tobacco by at least 50 % (62.4 % vs 40.9 %) with an attrition rate of 15.3 % vs 30.5 % in intervention and control group respectively. Reduction in nicotine dependence and tobacco craving, an increase in motivation level, quit attempts and clinical improvement favored the intervention group. 16.5 % of participants expressed interest in pharmacotherapy for tobacco cessation, 3.5 % were referred to a specialized tobacco cessation center, two control group participants were hospitalized for drug default, and withdrawal symptoms reported were mild. CONCLUSION: Implementing a tobacco cessation intervention based on the stage of motivation aids in abstinence and reduction of tobacco use in PwS.

'Unheard voices': Perceptions of women with mental illness on nurses screening routinely for domestic violence: A qualitative analysis / "Voces no escuchadas": Percepciones de las mujeres con enfermedades mentales sobre el cribado rutinario de la violencia doméstica por parte de las enfermeras. Un análisis cualitativo / "Vozes não ouvidas": percepções de mulheres com transtorno mental sobre o rastreamento cotidiano da violência doméstica por enfermeiras. Uma análise qualitativa

Objective. To explore women's experiences of violence and their opinion on routine screening for domestic violence by nursing professionals in mental health care settings. Methods. This qualitative narrative research design was carried out among 20 asymptomatic women with mental illness at a tertiary care centre in Bangalore, India. Results. Narrative content analysis was performed, and five dominant themes have emerged: 1. Understanding the nature and signs of violence (subtheme: Meaning of violence), 2. Abusive experiences of women with mental illness (subthemes: Physical violence, psychological violence, social violence, sexual violence and financial violence), 3. Experiences on disclosure of violence (subthemes: Identification of violence by nursing professionals, Experiences of disclosure of violence), 4. Barriers for disclosure of abuse(subthemes: Fear of consequences, the hectic schedule of nursing staff, helplessness and hopelessness, perceived poor family support). 5.Routine screening for violence by nursing professionals (subthemes: reasons for routine inquiry of violence, nature of inquiry by the nursing professionals). Conclusion. Women with mental illness were undergoing more than one form of violence, and most of the participants supported routine screening by nursing professionals. Nurses play an essential role in identifying and supporting abused women in mental health care settings.

Objetivo. Explorar las experiencias de violencia que sufren las mujeres y su opinión sobre el cribado rutinario de la violencia doméstica por parte de los profesionales de enfermería en los centros de salud mental. Métodos. Esta investigación narrativa cualitativa se llevó a cabo con 20 mujeres asintomáticas con enfermedades mentales en un centro de atención terciaria en Bangalore, India. Resultados. Se realizó un análisis de contenido narrativo y surgieron cinco temas dominantes: 1. Comprensión de la naturaleza y los signos de la violencia (subtema: Significado de la violencia), 2. Experiencias abusivas de las mujeres con enfermedades mentales (subtemas: Violencia física, violencia psicológica, violencia social, violencia sexual y violencia económica), 3. Experiencias sobre la revelación de la violencia (subtemas: Identificación de la violencia por parte de los profesionales de enfermería, Experiencias de revelación de la violencia), 4. Barreras para la revelación del abuso (subtemas: Miedo a las consecuencias, el agitado horario del personal de enfermería, impotencia y desesperanza, percepción de un escaso apoyo familiar). 5. Indagación rutinaria de la violencia por parte de los profesionales de enfermería (subtemas: razones para la indagación rutinaria de la violencia, naturaleza de la indagación por parte de los profesionales de enfermería). Conclusión. Las mujeres con enfermedades mentales sufrieron más de una forma de violencia y la mayoría de las participantes apoyó el cribado rutinario por parte de los profesionales de enfermería. Las enfermeras desempeñan un papel esencial en la identificación y en el apoyo a las mujeres maltratadas en los entornos de atención en la salud mental.

Objetivo. Explorar as experiências de violência sofrida por mulheres e sua opinião sobre o rastreamento rotineiro de violência doméstica por profissionais de enfermagem em centros de saúde mental. Métodos. Esta pesquisa narrativa qualitativa foi realizada com 20 mulheres assintomáticas com doença mental em um estabelecimento de cuidados terciários em Bangalore, Índia. Resultados. Realizou-se uma análise de conteúdo narrativo e emergiram cinco temas dominantes: 1. Compreendendo a natureza e os sinais da violência (subtópico: Significado da violência), 2. Experiências abusivas de mulheres com transtorno mental (subtópicos: Violência física, violência psicológica, violência social, violência sexual e violência econômica), 3. Experiências sobre a divulgação da violência (subtópicos: Identificação da violência por profissionais de enfermagem, Experiências da divulgação da violência), 4. Barreiras para a divulgação do abuso (subtópicos: medo das consequências, enfermagem ocupada horas de trabalho, desamparo e desesperança, percepção de pouco apoio familiar) 5. Inquérito de rotina sobre violência por profissionais de enfermagem (subtópicos: motivos de inquérito de rotina sobre violência, natureza do inquérito por profissionais de enfermagem). Conclusão. Mulheres com doença mental sofreram mais de uma forma de violência e a maioria das participantes apoiava o rastreamento de rotina pelos profissionais de enfermagem. Os enfermeiros desempenham um papel essencial na identificação e apoio às mulheres agredidas em ambientes de cuidados de saúde mental.

Non-pharmacological interventions for smoking in persons with schizophrenia spectrum disorders - A systematic review.

INTRODUCTION: The rates and intensity of tobacco use are higher in persons with schizophrenia spectrum disorders (PwS) compared to the general population, contributing to increased morbidity and mortality. We aimed to systematically review randomised control trials (RCTs) that used non-pharmacological interventions to reduce or cease tobacco use in PwS. METHODS: We searched PubMed, EBSCO, ProQuest and PsycINFO for RCTs, published between January 2004 and December 2019, which included adult PwS. Studies providing self-reported or biochemically measured reduction of tobacco use and cessation after a minimum follow-up period of 6 months were included. We used the Cochrane Risk of Bias (ROB) tool for assessing the quality of selected studies. RESULTS: Of the six included trials, two compared non-pharmacological interventions alone while four compared combinations with pharmacological interventions with routine care. The non-pharmacological interventions varied widely. Continuous abstinence and seven days point-prevalence abstinence (7 PPA) were reported in 2 and 4 studies respectively, with one study assessing both. All six trials measured reduction in the number of cigarettes smoked, but only two trials reported significant reductions in intervention groups. No worsening of psychiatric symptoms was reported. CONCLUSIONS: Two trials were rated as "low risk", and 4 trials as "some concerns" on the ROB tool. Heterogeneity among trials precluded meta-analysis. Abstinence was significantly higher among groups who were given combination interventions, and intervention groups in studies showed significantly greater or a trend towards reduction in the number of cigarettes smoked than controls. No specific method of non-pharmacological management was conclusively favoured. IMPLICATIONS: Reduction in cigarettes smoked seemed to significantly favour or show non-significant trends favouring intervention groups over controls, while abstinence was significantly higher among groups in studies that used specific combination interventions. Combinations of pharmacological and non-pharmacological treatment were better than non-pharmacological interventions used in isolation, for facilitating abstinence and reduction in cigarettes smoked. Specific interventions such as home visits and contingent reinforcement merit further study. Trials included in this study were conducted in high-income and upper-middle-income countries. Thus, the application of these interventions to low and middle-income countries (LAMICs) needs to be further studied.

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.

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.

Social media use and health promoting lifestyle: an exploration among Indian nursing students

Objective. To evaluate the use of social media and the health promoting lifestyle profile of indian nursing students. Methods. A cross-sectional study was carried out with 125 students (89 undergraduate and 36 graduate) from various Nursing universities in India, who provided information on their sociodemographic data, the Bergen Social Media Addiction Scale (BSMAS) and the Health Promoting Lifestyle Profile (HPLP-II). Results. Regarding the BSMAS, the participants had an average of 12.8 (maximum possible = 30); 42% reported they frequently delayed their sleep due to using social media; 9% had excessive use of social media; by gender, men had higher total score than women. With respect to the health promoting lifestyle profile, the total average was 126.9 (maximum possible = 208); no difference was observed by gender in the total score and men scored better in the domain of physical activity; students living with their families had higher scores in the domain of health responsibility than those living alone; and graduate students had better scores than undergraduate students in the scale total and in the domains of health responsibility, spiritual relations, and interpersonal relations. Conclusion. There is excessive use of social media, especially among male students. This study also revealed lower scores than those desired in the domains of Health Promoting Lifestyle, especially for physical activity, health responsibility, stress management, and nutrition. Thereby, the findings may be used to improve health literacy on social media, as well as promote a positive lifestyle among nursing students.

Objetivo. Evaluar el uso de las redes sociales y el estilo de vida promotores de salud los estudiantes de enfermería hindúes. Métodos. Se hizo un estudio de corte transversal con la participación de 125 estudiantes (89 de pregrado y 36 de posgrado) de varias universidades de enfermería en India brindaron información sobre datos sociodemográficos, la Escala de adicción a las redes sociales de Bergen (BSMAS) y el Perfil de estilos de vida promotores de salud (HPLP-II). Resultados. Con respecto al BSMAS los participantes tuvieron un promedio de 12.8 (máximo posible = 30); un 42% reportó que con frecuencia tenía retraso en el sueño debido al uso de las redes sociales; un 9% tiene uso excesivo de las redes sociales; por sexo, los hombres tuvieron mayor puntaje total que las mujeres. Pasando al Perfil de estilos de vida promotores de salud -HPLP-II- el promedio total fue de 126.9 (Máximo posible = 208); no se observó diferencia por sexo en el puntaje total y los hombres tuvieron mejor puntaje en el dominio de actividad física; los estudiantes que residen con su familia tienen mayor puntaje en el dominio de responsabilidad en salud que los que viven solos; y los estudiantes de posgrado tienen mejores puntajes que los de pregrado en el total de la escala y en los dominios de responsabilidad de salud, las relaciones espirituales y las relaciones interpersonales. Conclusión. Hay un uso excesivo de las redes sociales, especialmente entre los estudiantes varones. Este estudio también reveló puntuaciones más bajas de las deseadas en los dominios de estilos de vida promotores de la salud, especialmente para la actividad física, la responsabilidad de la salud, el manejo del estrés y la nutrición. Por lo tanto, los hallazgos se pueden utilizar para mejorar la alfabetización en salud en las redes sociales, así como para promover un estilo de vida positivo entre los estudiantes de enfermería.

Objetivo. Avaliar o uso de redes sociais e promotores de saúde no estilo de vida de estudantes de enfermagem hindus. Métodos. Foi realizado um estudo transversal com a participação de 125 estudantes (89 de graduação e 36 de pós-graduação) de várias universidades de enfermagem da Índia, que forneceram informações sobre dados sociodemográficos, a Escala de Adição de redes sociais Bergen (BSMAS) e o Perfil dos promotores de saúde no estilo de vida (HPLP-II). Resultados. Em relação à Escala de Dependência em Redes Sociais - BSMAS - os participantes tiveram uma média de 12.8 (máximo possível = 30); 42% relataram que frequentemente tiveram atraso no sono devido ao uso de redes sociais; 9% fazem uso excessivo de redes sociais; por sexo, os homens tiveram uma pontuação total mais alta que as mulheres. Indo para o Perfil de Estilo de Vida dos Promotores de Saúde - HPLP-II -, a média total foi de 126.9 (Máximo possível = 208); nenhuma diferença foi observada por sexo na pontuação total e os homens tiveram melhor pontuação no domínio da atividade física; os estudantes que residem com suas famílias obtêm pontuação mais alta no domínio da responsabilidade em saúde do que os que moram sozinhos; e os estudantes de pós-graduação obtêm uma pontuação melhor do que os graduados na escala geral e nos domínios de responsabilidade com a saúde, relacionamentos espirituais e relacionamentos interpessoais. Conclusão. Há um uso excessivo de redes sociais, especialmente entre estudantes do sexo masculino. Este estudo também revelou pontuações mais baixas do que o desejado nos domínios do estilo de vida que promovem a saúde, especialmente em atividade física, responsabilidade em saúde, controle do estresse e nutrição. Portanto, os resultados podem ser usados para melhorar a alfabetização em saúde nas redes sociais, bem como para promover um estilo de vida positivo entre os estudantes de enfermagem.

Perceived stress and resilience and their relationship with the use of mobile phone among nursing students

Objective. The study sought to explore the relationship between levels of stress and resilience with the use of the mobile phone in nursing students. Methods. Cross-sectional study conducted with 102 nursing students from several Nursing schools in India who were invited to participate in the research. The data were gathered by using the following instruments: Perceived Stress Scale (PSS) by Cohen, The Connor-Davidson Resilience scale (CD-RISC), and Mobile Phone Involvement Questionnaire (MPIQ) by Walsh. Results. Most of the participants were women (94.1%), studying in the undergraduate (70.6%), with a mean age of 25.2 years. In all, 77.5% of the students had stress perception between moderate and high, 20.6% had high resilience capacity, and 25.5% were frequent mobile phone users. Perceived stress was correlated significantly and negatively with age and resilience capacity. Graduate students had greater capacity to recover than undergraduate students. Conclusion. This study indicates the negative relation of resilience capacity with stress and the use of mobile phones among nursing students. Hence, it is necessary for institutions preparing nurses to develop intervention strategies to enhance the resilience capacity, improve skills to manage stress, and healthy use of the mobile phone.

Objetivo. Explorar la relación entre los niveles de estrés y resiliencia con el uso del teléfono móvil en estudiantes hindúes de enfermería. Métodos. Estudio de corte transversal realizado con 102 estudiantes de enfermería de varias escuelas de enfermería en la India a quienes se invitó a participar en la investigación. Los datos se recopilaron con la ayuda de los siguientes instrumentos: Percibed Stress Scale (PSS) de Cohen, The Connor-Davidson Resilience scale (CD-RISC) y Mobile Phone Involvement Questionnaire (MPIQ) de Walsh. Resultados La mayoría de los participantes fueron mujeres (94.1%), estudiaban pregrado (70.6%) y tenían un promedio de edad de 25.2 años. El 77.5% de los estudiantes tenía una percepción de estrés entre moderada y alta; el 20.6% tenía alta capacidad de resiliencia y el 25.5% eran usuarios frecuentes de teléfonos móviles. El estrés percibido se correlacionó significativamente y de manera negativa con la edad y la capacidad de resiliencia. Los estudiantes de posgrado tuvieron mayor capacidad de recuperación que los estudiantes de pregrado. Conclusión. El presente estudio indica la relación negativa de la capacidad de resiliencia con el estrés y el uso de teléfonos móviles entre los estudiantes hindúes de enfermería. Por lo tanto, es necesario que las instituciones formadoras de enfermeros desarrollen estrategias de intervención para fortalecer la capacidad de resiliencia, mejorando las habilidades para manejar el estrés y el uso saludable del teléfono móvil.

Objetivo. Explorar a relação entre os níveis de estresse e resiliência com o uso do telefone móbil em estudantes de enfermagem. Métodos. Estudo de corte transversal realizado com 102 estudantes de enfermagem de várias escolas de enfermagem na Índia que foram convidados a participar na investigação. Os dados se recopilaram utilizando os seguintes instrumentos: Percibed Stress Scale (PSS) de Cohen, The Connor-Davidson Resilience scale (CD-RISC) e Mobile Phone Involvement Questionnaire (MPIQ) de Walsh. Resultados A maioria dos participantes eram mulheres (94.1%), estudavam graduação (70.6%)e tinham uma média de idade de 25.2 anos. 77.5% dos estudantes tinham uma percepção de estresse entre moderada e alta, 20.6% tinha alta capacidade de resiliência e 25.5% eram usuários frequentes de telefones móbeis. O estresse percebido se correlacionou significativamente e de maneira negativa com a idade e a capacidade de resiliência. Os estudantes de pós-graduação tiveram maior capacidade de recuperação que os estudantes de graduação. Conclusão. O presente estudo indica a relação negativa da capacidade de resiliência com o estresse e o uso de telefones móbeis entre os estudantes de enfermagem. Por tanto, é necessário que as instituições formadoras de enfermeiros desenvolvem estratégias de intervenção para fortalecer a capacidade de resiliência, melhorando as habilidades para manejar o estresse e o uso saudável do telefone móbil.

Knowledge and perceptions of Indian primary care nurses towards mental illness

Objective. To assess nurses' knowledge and perceptions towards mental illness. Methods. This was a crosssectional descriptive study conducted among 126 randomly selected nurses those are working under District Mental Health program in Karnataka (India). The data was collected through self-reported questionnaires Using the modified version of Public perception of mental illness questionnaire and Attitude Scale for Mental Illness. Results. The findings revealed that majority of the subjects were women (74.4%), Hindus (92.1%) and were from rural background (69.8%). The mean Knowledge score 10.8±1.6 adequate knowledge (maximum possible =12) among 91% of the subjects, and 52% of them hold negative attitudes towards people with mental illness (88.9±13.6). While majority of the subjects hold negative attitudes in 'Separatism' (53.5%), 'Stereotyping' (73%), 'Benevolence' (54%), 'Pessimistic prediction' (53%) domains, they hold positive attitudes in 'Restrictiveness'(88%) and 'Stigmatization' (72%) domains. Women than men endorsed positive attitudes towards persons with mental illness in Stereotyping' (p<0.001), 'Restrictiveness' (p<0.01), 'Benevolence' (p<0.001) and 'Pessimistic prediction' (t= 2.22, p<0.05) domains. Similarly, Auxiliary Nursing Midwifery found to be less restrictive (p<0.05), more benevolent (p<0.001) and less pessimistic (p<0.05) compared to nurses with higher education (General Nursing and Midwifery and Bachelor of Science in Nursing). Conclusion. The present study showed adequate knowledge on mental illness among nurses. Yet they hold stigmatizing and negative attitudes towards mental illness. Hence, it is an urgent priority to develop andimplement educational programs to inculcate positive attitudes towards people with mental illness to provide optimal care to this vulnerable population.

Objetivo. Evaluar los conocimientos y percepciones de las enfermeras de atención primaria hacia la enfermedad mental. Métodos. Se realizó un estudio descriptivo transversal con 126 enfermeras que trabajan en el programa de Salud Mental del Distrito en Karnataka (India). Los datos se recolectaron a partir de cuestionarios contestados por autorreporte, empleando la versión modificada del cuestionario Percepción pública de la enfermedad mental y la Escala de Actitudes hacia la enfemedad mental. Resultados. Los hallazgos revelaron que la mayoría de los participantes eran mujeres (74.4%), hindúes (92.1%) y de origen rural (69.8%). El puntaje promedio de conocimiento fue de 10.8±1.6, que indica un conocimiento adecuado (máximo posible = 12). El 52% de los participantes tienen actitudes negativas hacia las personas con enfermedades mentales, siendo mayor este porcentaje en los dominios 'Estereotipos' (73%), 'Benevolencia' (54%), 'Separatismo' (53.5%), 'Predicción pesimista' (53%); mientras que tienen actitudes positivas en 'Restricción' (88%) y 'Estigmatización '(72%). Las mujeres, en mayor porcentaje que los hombres, tuvieron actitudes positivas hacia las personas con enfermedades mentales en los dominios 'Estereotipos' (p<0.001), 'Restricción' (p<0.01), 'Benevolencia' (p<0.001) y 'Predicción pesimista' (p<0.05). Del mismo modo, las enfermeras parteras auxiliares fueron menos restrictivas (p<0.05), más benévolas (p<0.001) y menos pesimista (p<0.05) en comparación con las enfermeras con mayor educación (enfermeras parteras generales y licenciadas en ciencias de la enfermería). Conclusión. El presente estudio mostró un conocimiento adecuado sobre las enfermedades mentales entre las enfermeras. Sin embargo, tienen actitudes estigmatizantes y negativas hacia la enfermedad mental. Por lo tanto, es una prioridad implementar programas educativos para la adquisición de actitudes positivas hacia las personas con enfermedades mentales con el fin de brindar una atención integral a esta población vulnerable.

Objetivo. Avaliar os conhecimentos e percepções à doença mental das enfermeiras de atenção primária. Métodos. Se realizou um estudo descritivo transversal com 126 enfermeiras que trabalham no programa de Saúde Mental do Distrito em Karnataka (Índia). Os dados foram recolhidos a través de questionários respondidos por autorreporte, empregando a versão modificada do questionário Percepção pública da doença mental e a Escala de Atitudes à doença mental. Resultados. As descobertas revelaram que a maioria dos participantes eram mulheres (74.4%), hindus (92.1%) e de origem rural (69.8%). A pontuação média de conhecimento foi de 10.8±1.6 indicando conhecimento adequado (máximo possível = 12). 52% dos participantes têm atitudes negativas às pessoas com doenças mentais, sendo maior esta porcentagem nos domínios 'Estereótipos' (73%), 'Benevolência' (54%), 'Separatismo' (53.5%), 'Predição pessimista' (53%); enquanto que têm atitudes positivas em 'Restrição' (88%) e 'Estigmas'(72%). As mulheres, em maior porcentagem que os homens, tiveram atitudes positivas às pessoas com doenças mentais nos domínios 'Estereótipos' (p<0.001), 'Restrição' (p<0.01), 'Benevolência' (p<0.001) e 'Predição pessimista' (p<0.05). Do mesmo modo, as enfermeiras parteiras auxiliares formam menos restritivas (p<0.05), mais benévolas (p<0.001) e menos pessimista (p<0.05) em comparação com as enfermeiras com maior educação (enfermeiras parteiras gerais e licenciadas em ciências da enfermagem). Conclusão. O presente estudo mostrou um conhecimento adequado sobre as doenças mentais entre as enfermeiras. Porém, tem atitudes de estigmas e negativas à doença mental. Por tanto, é uma prioridade implementar programas educativos para o melhoramento das atitudes positivas às pessoas com doenças mentais com o fim de brindar uma atenção integral a esta população vulnerável.

Exercise, diet and educational interventions for metabolic syndrome in persons with schizophrenia: A systematic review.

INTRODUCTION: Individuals with major psychotic disorders such as schizophrenia are at increased risk for developing metabolic syndrome due to lifestyle- and treatment-related factors. Numerous interventions have been tested in inpatient and outpatient mental health settings to decrease risk factors. Diet and exercise represent the mainstay of weight loss treatment. With this background the review aimed to evaluate the effects of psychoeducation, diet and physical activity interventions on reduction of metabolic syndrome risk factors such as BMI, Body weight, biochemical profiles in schizophrenia. METHODS: The authors conducted database searches of PsychINFO, MEDLINE, Pubmed, Proquest, EBSCO and the Cochrane Database of Systematic Reviews, and manual searches from 1968 to 2017. Search indentified 11 studies that met the inclusion criteria. Study quality was critically appraised by 2 reviewers using established criteria. The outcome measures were body mass index, body weight, waist circumference, lipid profile, fasting glucose. RESULTS: Interventions led to significant weight reduction (8 studies), reduced body mass index (5 studies), decreased waist circumference (4 studies) and lower blood glucose levels (5 studies). Dietician and nurse led interventions (6 studies). The studies showed non pharmacological interventions were effective in reducing risk factors. CONCLUSION: This review was able to demonstrate effectiveness of peychoeducation, diet and physical activity interventions were helpful to decrease and manage antipsychotic-induced weight gain. Results showed lifestyle interventions are safer and effective for promoting decrease or maintenance of weight and it can be delivered at low cost, safe and improves quality of life.

Conocimientos, actitudes y prácticas de las enfermeras hindúes sobre el uso de restricciones físicas en pacientes psiquiátricos / Conhecimentos, atitudes e práticas das enfermeiras hindus sobre o uso de restrições físicas em pacientes psiquiátricos / Indian nurses' Knowledge, Attitude and Practice towards use of physical restraints in psychiatric patients

Objective. To assess nurses' knowledge, attitude and practice towards using physical restraints among psychiatric patients. Methods. A descriptive cross sectional survey was carried out among conveniently selected sample of nurses working in psychiatry departments at a tertiary care center. The data was collected using self reported questionnaires of Suen. Results. The findings revealed that nurses had good knowledge (7.2±1.7, maximum posible=11), favorable attitudes 30.8± 3.3 (maximum posible=48) and good practice 31.2±6.2 (maximun posible=42) about use of physical restraints in psychiatric patients. Females had better knowledge (p<0.001), attitudes (p<0.05) than males towards use of physical restraints. Nurses those had more than ten years of experience found to have more favorable attitudes towards using physical restraints than nurses with less experience (p<0.05) and nurses with higher education differed significantly on practice score than nurses with basic education in nursing (p<0.05). Conclusion. This study revealed good knowledge, positive attitudes and good practices among nurses about using physical restraints in mental health services. However there is need to improve even more nurses practice through continuing education programs on this topic.(AU)

Objetivo. Evaluar los conocimientos, las actitudes y las prácticas de las enfermeras hacia el uso de restricciones físicas en los pacientes psiquiátricos. Métodos. Se realizó un estudio descriptivo de corte transversal en una muestra por conveniencia de enfermeras que laboraban en departamentos de psiquiatría de un hospital de atención terciaria al sur de la India. Los datos se recolectaron utilizando el cuestionario de Suen, el cual fue contestado por autorreporte. Resultados. Los hallazgos revelaron que en cuanto al uso de restricciones físicas en pacientes psiquiátricos las enfermeras tenían buen conocimiento (media =7.2±1.7, máximo posible=11), actitudes favorables (media=30.8±3.3, máximo posible=48) y buenas prácticas (media=31.2 ± 6.2, máximo posible=42). Las mujeres tenían mejores conocimientos (p<0.001) y actitudes (p<0.05) que los varones hacia el uso de restricciones físicas. Las enfermeras con más de diez años de experiencia tuvieron actitudes más favorables hacia el uso de estas restricciones que las de menor experiencia (p<0.05) y las enfermeras con educación superior difirieron significativamente en el puntaje de la práctica comparadas con aquellas con educación básica en enfermería (p<0.05). Conclusión. Este estudio reveló buenos conocimientos, actitudes positivas y buenas prácticas de las enfermeras sobre el uso de restricciones físicas en los servicios de salud mental. Sin embargo, es necesario mejorar aún más las prácticas de las enfermeras a partir de programas de educación continua sobre este tema (AU)

Objetivo. Avaliar os conhecimentos, as atitudes e as práticas das enfermeiras para o uso de restrições físicas nos pacientes psiquiátricos. Métodos. Se realizou um estudo descritivo de corte transversal numa amostra por conveniência de enfermeiras que trabalhavam em departamentos de psiquiatria de um hospital de atenção terciaria no sul da Índia. Os dados foram recolhidos utilizando o questionário de Suen, o qual foi contestado por auto-reporte. Resultados. As descobertas revelaram que em quanto ao uso de restrições físicas em pacientes psiquiátricos as enfermeiras tinham bom conhecimento (media =7.2±1.7, máximo possível=11), atitudes favoráveis (media=30.8±3.3, máximo possível=48) e boas práticas (média=31.2 ± 6.2, máximo possíveis=42). As mulheres tinham melhores conhecimentos (p<0.001) e atitudes (p<0.05) que os homens para o uso de restrições físicas. As enfermeiras com mais de dez anos de experiência tiveram atitudes mais favoráveis para o uso destas restrições que as de menor experiência (p<0.05) e as enfermeiras com educação superior deferiram significativamente na pontuação da prática comparadas com aquelas com educação básica na enfermagem (p<0.05). Conclusão. Este estudo revelou bons conhecimentos, atitudes positivas e boas práticas das enfermeiras sobre o uso de restrições físicas nos serviços de saúde mental. Embora, seja necessário melhorar ainda mais as práticas das enfermeiras através de programas de educação continua sobre este assunto. (AU)

Diferencias por sexo en el índice de masa corporal, percepción del peso corporal, satisfacción con el peso, desórdenes de la alimentación y estrategias para el control de peso en estudiantes de medicina y enfermería de la India / Diferenças por sexo no índice de massa corporal, percepção do peso corporal, satisfação com o peso, desordens da alimentação e estratégias para o controle de peso em estudantes de medicina e enfermagem da Índia / Gender Differences in Body Mass Index, Body Weight Perception, weight satisfaction, disordered eating and Weight control strategies among Indian Medical and Nursing Undergraduates

Objective. To assess gender disparity in body weight perception, Body Mass Index (BMI), weight satisfaction and role of depression among undergraduate Medical and Nursing students. Methods. A descriptive cross sectional descriptive study was conducted in conveniently selected medical (n=241) and nursing (n=213) students of Bangalore, South India. Data was collected using self-administered SCOFF questionnaires. Results. Our findings revealed that men had a significantly higher BMI than women (t=5.403, p<0.001). More number of women compared to men, perceived themselves as over weight (74.8%) and not satisfied with their weight status (81.6%). More men than women scored positively for disordered eating behaviors on SCOFF (45.4% vs. 31.1%) and EAT scale (16.5% vs. 8.7%). While, 48.2% of the women practice binge eating, 41.2% of the men practice it (p<0.004); more men (47.4%) than women (25.4%) exercised for more than sixty minutes (p<0.001) to control their weight. Conclusion. Findings indicate small differences between the genders that have to be taken in consideration in planning interventional programs to prevent eating disorders in this population. (AU)

Objetivo. Evaluar la disparidad por sexo en el índice de masa corporal, la percepción del peso corporal, la satisfacción con el peso, los desórdenes de la alimentación y estrategias para el control de peso en estudiantes de medicina y enfermería de la India. Métodos. Se realizó un estudio descriptivo de corte transversal con una muestra tomada a conveniencia de estudiantes de Medicina (n=241) y de Enfermería (n=213) de Bangalore, en el sur de India. Los datos se recolectaron usando los instrumentos auto-administrados SCOFF y EAT-26. Resultados. Los hombres tenían un IMC significativamente mayor que las mujeres (t=5.403, p<0.001); un mayor porcentaje de mujeres, en comparación con los hombres, percibía que pesaba más (74.8%), sin embargo, no estaban satisfechas con su peso (81.6%). Los hombres y las mujeres tuvieron puntajes que mostraban riesgo de tener trastornos de conductas alimentarias en el SCOFF (45.4% vs. 31.1%) y en el EAT (16.5% vs. 8.7%). Mientras que el 48.2% de las mujeres practicaba el atracón, el 41.2% de los hombres lo tenía (p <0.004); más hombres (47.4%) que mujeres (25.4%) se ejercitaban por más de sesenta minutos (p<0.001) para controlar su peso. Conclusión. Los hallazgos indican pequeñas diferencias por sexo que deben ser tenidas en cuenta en la planeación de programas de intervención para prevenir los trastornos en la alimentación en esta población. (AU)

Objetivo. Avaliar a disparidade por sexo no índice de massa corporal, percepção do peso corporal, satisfação com o peso, desordens da alimentação e estratégias para o controle de peso em estudantes de medicina e enfermagem da Índia. Métodos. Se realizou um estudo descritivo de corte transversal com uma amostra tomada a conveniência de estudantes de Medicina (n=241) e de Enfermagem (n=213) de Bangalore, no sul da Índia. Os dados foram coletados usando os instrumentos auto-administrados SCOFF e EAT-26. Resultados. Os homens tinham um IMC significativamente maior que as mulheres (t=5.403, p<0.001), mas um maior número de mulheres em comparação com os homens, percebiam que pesavam mais (74.8%) e não estavam satisfeitas com seu peso (81.6%). Os homens e as mulheres tiveram pontuações que mostravam risco de ter transtornos de condutas alimentar no SCOFF (45.4% vs. 31.1%) e no EAT (16.5% vs. 8.7%). Enquanto que 48.2% das mulheres praticavam o excesso, já os homens 41.2% (p <0.004); mais homens (47.4%) do que mulheres (25.4%) se exercitavam por mais de sessenta minutos (p<0.001) para controlar seu peso. Conclusão. As descobertas indicam pequenas diferenças por sexo que devem ser tidas em conta no planejamento de programas de intervenção para prevenir os transtornos na alimentação nesta população. (AU)

Attitudes toward consumer involvement in mental health services: a cross-sectional survey of Indian medical and nursing undergraduates / Actitudes hacia la participación de los consumidores de los servicios de salud mental: un estudio transversal en estudiantes de medicina y enfermería de la India / Atitudes para a participação dos consumidores dos serviços de saúde mental: um estudo transversal em estudantes de medicina e enfermagem da Índia

Objective.To understand the views of medical and nursing undergraduates regarding consumer involvement in mental health services. Methods. A descriptive cross sectional survey was conducted in Bangalore, South India, among medical (n=155) and nursing (n=116) undergraduates using self-reported the Mental Health Consumer Participation Questionnaire of Happell et al. ''Mental health consumer'' or ''consumer'' is defined as a person who is currently using mental health services as either an in-patient or out-patient. Results. The overall mean score on Mental Health Consumer Participation Questionnaire (54.1±6.7) implies that 64% of the participants hold positive attitudes towards consumer involvement in mental health services. Medical students possessed more positive attitudes than nursing in: consumer capacity (p<0.001), consumer as staff (p< 0.001) and overall score on mental health consumer participation questionnaire (t=6.892, p<0.001). Conclusion. The findings suggest that majority of the participants hold positive attitudes towards mental health consumer involvement in health care services. However, additional research is urgently required from developing countries to understand the effectiveness of involving mental health consumers in academic programs at undergraduate level.

Objetivo.Describir las actitudes de los estudiantes de medicina y de enfermería con respecto a su participación como consumidores de los servicios de salud mental. Métodos. Se realizó un estudio descriptivo de corte transversal en Bangalore, sur de la India, en estudiantes de medicina (n=116) y de enfermería (n=155) utilizando el Mental Health Consumer Participation Questionnaire de Happell et al. contestado por autorreporte. Se definió ''consumidor de salud mental'' o ''consumidor'' como aquella persona que estaba utilizando los servicios de salud mental pero no era paciente hospitalizado ni de consulta externa. Resultados. La puntuación media global en la salud mental, cuestionario de participación de los consumidores (54.1±6.7), implica que el 64% de los participantes tiene actitudes positivas hacia la participación como consumidores de los servicios de salud mental. Los estudiantes de medicina poseían una actitud más positiva que los de enfermería en: la capacidad de consumo (p<0.001), consumidor como parte del staff (p<0.001) y la puntuación global del cuestionario (p<0.001). Conclusión. Los hallazgos sugieren que la mayoría de los participantes tienen una actitud positiva hacia su participación como consumidores en los servicios de salud. Sin embargo, se requiere con urgencia una investigación adicional para comprender la efectividad de la participación de los consumidores de programas académicos a nivel de pregrado.

Objetivo.Descrever as atitudes dos estudantes de medicina e de enfermagem com respeito a sua participação como consumidores dos serviços de saúde mental. Métodos. Se realizou um estudo descritivo de corte transversal em Bangalore, sul da índia, em estudantes de medicina (n=116) e de enfermagem (n=155) utilizando o Mental Health Consumer Participation Questionnaire de Happell et al. contestado por auto-reporte. Se definiu ''consumidor de saúde mental'' ou ''consumidor'' como aquela pessoa que estava utilizando os serviços de saúde mental mas não era paciente hospitalizado nem de consulta externa. Resultados. A pontuação média global na saúde mental questionário de participação dos consumidores (54.1±6.7) implica que 64% dos participantes têm atitudes positivas à participação como consumidores dos serviços de saúde mental. Os estudantes de medicina possuíam uma atitude mais positiva que os de enfermagem em: a capacidade de consumo (p<0.001), consumidor como parte do staff (p<0.001) e a pontuação global do questionário (p<0.001). Conclusão. As descobertas sugerem que a maioria dos participantes têm uma atitude positiva a sua participação como consumidores nos serviços de saúde. Embora, se requere com urgência uma investigação adicional para compreender a efetividade da participação dos consumidores de programas acadêmicos a nível de graduação.

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.

Knowledge and attitudes of undergraduate nursing students toward dementia: An Indian perspective / Conocimientos y actitudes de los estudiantes de enfermería hacia la demencia: Una perspectiva hindú / Conhecimentos e atitudes dos estudantes de enfermagem para a demência: Uma perspectiva indiana

Objective.This work evaluated nursing students' knowledge and attitudes toward individuals with Alzheimer's disease and dementia. Methodology. This was a transversal, descriptive study carried out with a randomly selected group of nursing students (N = 122) from Bangalore, India, in 2013. The study used the Alzheimer's Disease Knowledge scale (30 questions with true-false options) and the Attitude toward Alzheimer's Disease and Related Dementias scale (20 questions scored with seven Likert-type options; the higher the score, the better the attitude). Results. The findings revealed that 56% of the questions were answered correctly and the average attitude score was 95 ± 1.5. A negative correlation was observed between age and knowledge of dementia (r = -0.323; p < 0.001). Conclusion. The participants have inadequate knowledge of dementia. However, they have positive attitudes towards patients with dementia, giving way to improving their knowledge related to this disease. Thereby, there is urgent need to enhance the undergraduate study plan with respect to the content of this theme and strengthen the attitudes of comprehensive care to individuals with dementia.

Evaluar en los estudiantes de enfermería el conocimiento y las actitudes hacia las personas con enfermedad de Alzheimer y demencia. Metodología. Estudio de descriptivo de tipo transversal llevado a cabo en un grupo seleccionado en forma aleatoria de estudiantes de enfermería (N=122) de Bangalore, India, en 2013. Se utilizaron las escalas: Alzheimer's Disease Knowledge Scale (30 preguntas con opciones verdadero/falso) y The Attitude toward Alzheimer's disease and Related Dementias Scale (20 preguntas calificadas con 7 opciones tipo Likert, a mayor puntaje mejor es la actitud). Resultados. Los hallazgos revelaron que el 56% de las preguntas fueron contestadas correctamente y el promedio puntaje de actitud fue 95±1.5 Se Observó una correlación negativa entre la edad y el conocimiento sobre la demencia (r=-0.323; p<0.001). Conclusion. Los participantes tienen un inadecuado conocimiento sobre la demencia. Sin embargo, que poseen actitudes alentadoras hacia los pacientes con demencia dando espacio a mejorar sus conocimientos relacionados con esta enfermedad. Por lo tanto, hay una necesidad urgente de fortalecer el plan de estudios de pregrado con respecto al contenido de este tema y fortalecer las actitudes el cuidado integral a las personas con demencia.

Objetivo.Avaliar nos estudantes de enfermagem o conhecimento e as atitudes para as pessoas com doença de Alzheimer e demência. Metodologia. Estudo de descritivo de tipo transversal levado a cabo num grupo selecionado em forma aleatória de estudantes de enfermagem (N=122) de Bangalore, índia, em 2013. Utilizaram-se as escalas: Alzheimer's Disease Knowledge Scale (30 perguntas com opções verdadeiro/falso) e The Attitude toward Alzheimer's disease and Related Dementias Scale (20 perguntas qualificadas com 7 opções tipo Likert, a maior pontuação, melhor é a atitude). Resultados. Os resultados revelaram que 56% das perguntas foram contestadas corretamente e a pontuação média de atitude foi 95±1.5 Se Observou uma correlação negativa entre a idade e o conhecimento sobre a demência (r=-0.323; p<0.001). Conclusão. Os participantes têm um inadequado conhecimento sobre a demência. No entanto, que possuem atitudes alentadoras para os pacientes com demência dando espaço a melhorar seus conhecimentos relacionados com esta doença. Portanto, há uma necessidade urgente de fortalecer o plano de estudos de graduação com respeito ao conteúdo deste tema e fortalecer as atitudes o cuidado integral às pessoas com demência.