Screening for serious mental illness in a correctional setting.

BACKGROUND: Serious mental illness (SMI) is more common among adults in correctional settings than in the general population. No standard exists for SMI screening across correctional settings; SMI therefore often goes undetected in these facilities. Placing individuals with unidentified SMI who are incarcerated in general population cells increases their risk for self-harming behaviors, suicide, and for being victims or perpetrators of exploitation and violence. METHODS: This article describes a quantitative, descriptive study conducted to evaluate the use of the Brief Jail Mental Health Screen (BJMHS) tool to screen for possible SMI among individuals in a jail setting. RESULTS: A total of 89 individuals who were incarcerated in one jail setting were screened either with the facility's internally developed standard medical questionnaire (SMQ) or with the BJMHS. Findings showed that 28% screened positive for possible SMI using the BJMHS as compared with only 3% using the SMQ. CONCLUSION: The BJMHS flagged a higher number of possible instances of SMI than the jail's SMQ, potentially signifying its screening superiority. Identification of SMI leads to better care for individuals who are incarcerated, and it increases safety for the individual with SMI, the greater jail population, and jail staff. Findings from this study were shared with system leadership, which has replaced other screening tools with the BJMHS in at least 250 correctional facilities throughout the US.

Percepções da equipe de enfermagem sobre cuidados de crianças e adolescentes internados com transtornos mentais / Percepciones del equipo de enfermería sobre la atención a niños y adolescentes hospitalizados con trastornos mentales / Nursing team's perceptions on care for children and adolescents hospitalized with mental disorders

Resumo Objetivo conhecer as percepções da equipe de enfermagem ante o cuidado de crianças e adolescentes com transtornos mentais internados. Método estudo qualitativo fenomenológico social cuja coleta de dados foi realizada com 12 membros das equipes de enfermagem por meio de entrevista fenomenológica. Resultados "Motivos porque" descritos em duas categorias: a percepção da equipe de enfermagem em face dos cuidados prestados e ações e cuidados da equipe de enfermagem da criança com transtornos mentais. "Motivos para" expressos na categoria: a recuperação da criança com transtorno mental e o seu retorno para casa. Conclusões e Implicações para a prática a possibilidade do estabelecimento da relação face a face entre equipe, família e criança como forma de apreender a situação biográfica e o acervo de conhecimento dos sujeitos envolvidos e, então, entender as suas reais necessidades e demandas promovem um cuidado integral. Através da fenomenologia social de Alfred Schutz, traz-se como implicação para a prática a possibilidade de compreender a percepção da equipe de enfermagem sobre a relevância da relação face a face no cuidado de crianças e adolescentes com transtornos mentais.

Resumen Objetivo conocer las percepciones del equipo de enfermería sobre los cuidados prestados a los niños y adolescentes hospitalizados con trastornos mentales. Método estudio cualitativo fenomenológico social cuya recogida de datos se realizó con 12 miembros de los equipos de enfermería mediante entrevista fenomenológica. Resultados "Motivos-por qué" se describen en dos categorías: la percepción del equipo de enfermería ante los cuidados prestados y las acciones y cuidados del equipo de enfermería del niño con trastornos mentales. "Motivos-para" expresadas en la categoría: la recuperación del niño con trastorno mental y su regreso a casa. Conclusiones e Implicaciones para la práctica La posibilidad de establecer una relación cara a cara entre el equipo, la familia y el niño como una forma de aprehender la situación biográfica y el cuerpo de conocimiento de los sujetos involucrados y luego comprender sus necesidades y demandas reales, promueve la atención integral. A través de la fenomenología social de Alfred Schutz, aporta como implicaciones para la práctica la posibilidad de entender la percepción del equipo de enfermería sobre la relevancia de la relación cara a cara en el cuidado de niños y adolescentes con trastornos mentales.

Abstract Objective to know the perceptions of the nursing team about the care of hospitalized children and adolescents with mental disorders. Method social phenomenological qualitative study whose data collection was carried out with 12 members of the nursing teams by means of phenomenological interviews. Results "Reasons why" described in two categories: the perception of the nursing team in view of the care provided and actions and care of the nursing team of the child with mental disorders. "Reasons for" expressed in the category: the recovery of the child with mental disorder and his return home. Conclusions and Implications for practice The possibility of establishing a face-to-face relationship between the team, the family, and the child to apprehend the biographical situation and the body of knowledge of the subjects involved, and then understand their real needs and demands promotes comprehensive care. Through Alfred Schutz's social phenomenology, it brings as implications for practice the possibility of understanding the perception of the nursing staff about the relevance of the face-to-face relationship in caring for children and adolescents with mental disorders.

Percepção de gestores municipais diante da implementação da política de saúde mental / Percepción de los gestores municipales ante la implementación de la política de salud mental / Perception of municipal managers in the face of the implementation of the mental health policy

RESUMO Objetivo: apreender a percepção dos gestores de saúde sobre a implementação da Política de Saúde Mental nos municípios pertencentes a 5ª Regional de Saúde do Estado do Paraná. Métodos: estudo de abordagem qualitativa e caráter exploratório, realizado nos meses de fevereiro e março de 2015. Foram entrevistados 20 gestores de saúde da 5° Regional de Saúde, por meio de entrevistas semiestruturadas. A análise dos dados foi desenvolvida segundo o método de análise de conteúdo de Bardin, modalidade temática. Resultados: emergiram duas categorias: "A percepção dos gestores sobre aSM nos municípios" e "Dificuldades para a implementação da PNSM". Os gestores de saúde destacam a necessidade da melhor implementação da Política de Saúde Mental em seus municípios e a adequação da Rede de Atenção Psicossocial. As dificuldades enfrentadas são a falta de recursos financeiros, capacitação profissional e preconceitos. Considerações finais: é perceptível a falta de visibilidade entre os gestores em saúdesobre o papel dos serviços que compõem a Rede de Atenção àSaúde Mental, especialmente a atenção primária, pois é a principal responsável pelas ações de acolhimento e de promoção e prevenção aos transtornos mentais.

RESUMEN Objetivo: comprender la percepción de los gestores de salud sobre la implementación de la Política de Salud Mental en los municipios pertenecientes a la 5ª Regional de Salud del Estado de Paraná-Brasil. Método: estudio de enfoque cualitativo y carácter exploratorio, realizado en los meses de febrero y marzo de 2015. Se entrevistaron a 20 gestores de salud de la 5ª Regional de Salud, mediante entrevistas semiestructuradas. El análisis de datos se desarrolló según el método de análisis de contenido de Bardin, modalidad temática. Resultados: surgieron dos categorías: "La percepción de los gestores sobre la SM en los municipios" y "Dificultades para la implementación de la PNSM". Los gestores de salud señalan la necesidad de una mejor aplicación de la Política de Salud Mental en sus municipios y la adecuación de la Red de Atención Psicosocial. Las dificultades a las que se enfrentan son la falta de recursos financieros, la formación profesional y los prejuicios. Consideraciones finales: es perceptible la falta de visibilidad entre los gestores de salud sobre el rol de los servicios que componen la Red de Atención a la Salud Mental, especialmente la atención primaria, por ser la principal responsable de las acciones de acogida y de promoción y prevención de los trastornos mentales.

ABSTRACT Objective: to understand the perception of health managers about the implementation of the Mental Health Policy in municipalities belonging to the 5th Health Regional Unit of the State of Paraná. Methods: study with a qualitative approach and an exploratory nature, conducted in the months of February and March 2015. Twenty health managers from the 5th Health Regional Unit were interviewed, through semi-structured interviews. Data analysis was developed according to Bardin's content analysis method, thematic modality. Results: two categories emerged: "The perception of managers about MH in the municipalities" and "Difficulties in implementing PNSM". Health managers highlight the need for better implementation of the Mental Health Policy in their municipalities and the adequacy of the Psychosocial Care Network. The difficulties faced are the lack of financial resources, professional training and prejudice. Final considerations: the lack of visibility among health managers about the role of the services that make up the Mental Health Care Network is noticeable, especially primary care, as it is primarily responsible for the actions of welcoming and promotion/prevention of mental disorders.

Mental health problems among youth experiencing sex trafficking.

ABSTRACT: There are an estimated 4.8 million victims of sex trafficking (ST) globally, and 21% of these victims are children or adolescents. Victims of ST are at risk for mental health problems, and it is crucial for healthcare professionals to identify them and provide care.

Prazer-sofrimento de enfermeiros no cuidado à pessoa com transtorno mental e à família / Placer-sufrimiento de enfermeros en la atención de personas con trastornos mentales y familiares / Pleasure-suffering of nurses in caring for people with mental disorders and their families

RESUMO Objetivos: mensurar e comparar os indicadores de prazer-sofrimento em enfermeiros brasileiros e portugueses de cuidados primários à pessoa/família no contexto do transtorno mental. Método: estudo quantitativo, descritivo-correlacional, multicêntrico, com 500 enfermeiros de Portugal e Brasil. Coleta realizada via Google forms de abril a agosto de 2018, com questionário sociodemográfico e escala de indicadores de prazer-sofrimento no trabalho. Resultados: nos dois países, o domínio gratificação-realização profissional foi avaliado como satisfatório; insegurança/falta de reconhecimento e desgaste/esgotamento como graves. Os enfermeiros portugueses avaliaram a liberdade de expressão como satisfatória, os brasileiros como crítica. Em ambos os países houve correlação da liberdade de expressão com tempo de atuação no serviço, carga horária de trabalho e gênero; insegurança com tempo de formação, atuação no serviço e carga horária de trabalho; desgaste-esgotamento com tempo de atuação no atual serviço e tempo de formação. Conclusão: os enfermeiros de ambos os países apresentaram níveis críticos de sofrimento no trabalho. Avaliam com gratificação e com possibilidade de realização profissional a condução de cuidado à pessoa e famílias no contexto do transtorno mental, mas sua liberdade de expressão está comprometida.

RESUMEN Objetivos: medir y comparar los indicadores placer-sufrimiento en enfermeros de atención primaria brasileños y portugueses para la persona / familia en el contexto de trastorno mental. Método: estudio cuantitativo, descriptivo-correlacional, multicéntrico con 500 enfermeros de Portugal y Brasil. Recogida realizada a través de Google forms de abril a agosto de 2018, con cuestionario sociodemográfico y escala de indicadores placer-sufrimiento en el trabajo. Resultados: en ambos países, el dominio gratificación-realización profesional fue evaluado como satisfactorio; inseguridad / falta de reconocimiento y desgaste / agotamiento como graves. Los enfermeros portugueses evaluaron la libertad de expresión como satisfactoria, los enfermeros brasileños como crítica. En ambos países existía una correlación entre la libertad de expresión y el tiempo de servicio, la jornada laboral y el género; inseguridad con el tiempo de formación, el desempeño laboral y la carga de trabajo; desgaste-agotamiento con tiempo de trabajo en el servicio actual y tiempo de formación. Conclusión: enfermeros de ambos países tenían niveles críticos de sufrimiento en el trabajo. Evalúan, con gratificación y con posibilidad de realización profesional, la atención brindada a la persona y sus familias en el contexto de la enfermedad mental, pero su libertad de expresión se ve comprometida.

ABSTRACT Objectives: to measure and compare the pleasure-suffering indicators in Brazilian and Portuguese primary care nurses for the person/family in a mental disorder context. Method: this is a quantitative, descriptive-correlational, multicenter study with 500 nurses from Portugal and Brazil. Data collection was carried out via Google forms from April to August 2018, with a sociodemographic questionnaire and a scale of pleasure-suffering indicators at work. Results: In both countries, the reward-professional fulfillment domain was evaluated as satisfactory; insecurity/lack of recognition and wear/depletion as serious. Portuguese nurses assessed freedom of expression as satisfactory, Brazilian nurses as critical. In both countries there was a correlation between freedom of expression and length of service, working hours and gender; insecurity with training time, work performance, and workload; wear-depletion with working time in the current service and training time. Conclusion: nurses from both countries had critical levels of suffering at work. They assess, with reward and with the possibility of professional fulfillment, the care provided to the person and families in a mental disorder context, but their freedom of expression is compromised.

Oficina musical participativa para o Bem-Estar Subjetivo e Psicológico de usuários em internação psiquiátrica / Taller musical participativo para el Bienestar Subjetivo y Psicológico de usuarios en hospitalización psiquiátrica / Participatory music workshop for the Subjective and Psychological Well-being of users in psychiatric hospitalization

Resumo Objetivo identificar as contribuições de uma intervenção musical participativa sobre o Bem-Estar Psicológico e Subjetivo na assistência da enfermagem de usuários com transtorno mental grave e persistente durante a internação. Método pesquisa quase-experimental, do tipo antes e depois, realizada em uma instituição hospitalar do estado de São Paulo. Dez usuários em internação psiquiátrica participaram das quatro oficinas musicais. O repertório atendeu às suas preferências e foram distribuídos instrumentos musicais para promover a participação. Aplicou-se a escala de Bem-Estar Psicológico e dos Afetos Positivos e Negativos ao início e ao término de cada oficina. Os dados foram analisados considerando Intervalo de Confiança de 95%. Resultados não foram identificadas diferenças estatísticas entre os valores encontrados antes e depois das oficinas musicais para as variáveis do Bem-Estar e Afetos Positivos e Negativos. Os desfechos do Bem-Estar Subjetivo foram mais lineares quando comparados ao Bem-Estar Psicológico, observando-se aumento nos afetos positivos e diminuição dos afetos negativos. Conclusão e implicações para a prática a oficina musical participativa favorece o bem-estar subjetivo de usuários com transtornos mentais graves e persistentes. Essa intervenção correspondeu a uma tecnologia leve potencial para a enfermagem atuar de modo autônomo e qualificado no cuidado psicoemocional do usuário na internação psiquiátrica.

Resumen Objetivo identificar los aportes de una intervención musical participativa sobre el Bienestar Psicológico y Afectos Positivos y Negativos en el cuidado de enfermería de usuarios con trastorno mental severo y persistente durante la hospitalización. Método investigación cuasi experimental, del tipo antes y después, realizada en un hospital del estado de São Paulo. Diez usuarios en hospitalización psiquiátrica participaron en los cuatro talleres de música. El repertorio cumplió con sus preferencias y se distribuyeron instrumentos musicales para promover la participación. La escala de Bienestar Psicológico y Afectos Positivos y Negativos se aplicó al inicio y al final de cada taller. Los datos se analizaron considerando un intervalo de confianza del 95%. Resultados no se identificaron diferencias estadísticas entre los valores encontrados antes y después de los talleres musicales para las variables de bienestar y afectos positivos y negativos. Los resultados del Bienestar Subjetivo se comportaron de forma más lineal en comparación con el Bienestar Psicológico, con un aumento de los afectos positivos y una disminución de los afectos negativos. Conclusión e implicaciones para la práctica el taller de música participativa favorece el bienestar subjetivo de los usuarios con trastornos mentales graves y persistentes. Esta intervención correspondió a una potencial tecnología de luz para que Enfermería actuara de manera autónoma y calificada en la atención psicoemocional del usuario durante la hospitalización psiquiátrica.

Abstract Objective to identify the contributions of a participatory musical intervention on Psychological and Subjective Well-Being in nursing care for users with severe and persistent mental disorder during hospitalization. Method this is a quasi-experimental before-and-after research, carried out in a hospital in the state of São Paulo. Ten users in psychiatric hospitalization participated in the four music workshops. The repertoire catered to their preferences and musical instruments were distributed to promote participation. Psychological Well-Being and the Positive and Negative Affect Schedule were applied at the beginning and at the end of each workshop. Data were analyzed considering a confidence interval of 95%. Results no statistical differences were identified between the values found before and after the music workshops for the variables Well-Being and Positive and Negative Affects. The outcomes of Subjective Well-Being behaved more linear when compared to Psychological Well-Being, with an increase in positive affects and a decrease in negative affects. Conclusion and implications for practice participatory music workshops favor the subjective well-being of users with severe and persistent mental disorders. This intervention corresponded to a potential light technology for nursing to act autonomously and qualified in the psycho-emotional care of users in psychiatric hospitalization.

Effectiveness of advanced nursing care (ANC) on bone cancer pain, psychological disorders and quality of life in patients with primary bone cancers: A protocol for a PRISMA-compliant meta-analysis.

BACKGROUND: Advanced nursing care (ANC) has been reported to effectively relieve bone cancer pain, prevent psychological disorders and improve the quality of life (QoL) in patients with primary bone cancers (PBC) during the treatment. However, the exact effect of ANC remains controversial. This systematic review will aimed to assess the effectiveness of ANC on bone cancer pain, psychological disorders and QoL in patients with PBC. METHODS: Eligible randomized controlled trials (RCTs) and high-quality prospective cohort studies were searched from Excerpt Medica Database (Embase), PubMed, Google Scholar, Medline, Cochrane Library, Web of Science (WOS), China National Knowledge Infrastructure (CNKI), Chinese Bio Medical Database (CBM), China Scientific Journal Database (CSJD), and Wanfang Database. Papers in English or Chinese published from January 2000 to July 2020 will be included without any restrictions. The clinical outcomes including bone cancer pain, psychological disorders, QoL, and adverse events of ANC in patients with PBC were systematically evaluated.Two reviewers will separately carry out study selection and data extraction. Stata 14.0 and Review Manager 5.3 were used for data analysis. Methodological quality for each eligible clinical trial will be assessed by using Cochrane risk of bias tool. Subgroup and meta-regression analysis will be carried out depending on the availability of sufficient data. RESULTS: This study will comprehensively summarize all potential evidence to systematically investigate the effects and safety of ANC on bone cancer pain, psychological disorders and QoL in patients with PBC. CONCLUSION: The findings of this study will help to determine whether ANC is effective or not on bone cancer pain, psychological disorders and QoL in patients with PBC. INPLASY REGISTRATION NUMBER: INPLASY202090037.

Mental health nurse psychotherapists are well situated to improve service shortfalls in Australia: findings from a qualitative study.

OBJECTIVE: This paper reports the capabilities of mental health nurse (MHN) psychotherapists in Australia and their perceptions on how to best utilize their skills. METHOD: An MHN is a registered nurse with recognized specialist qualifications in mental health nursing. One hundred and fifty three MHNs completed an online survey; 12 were interviewed. RESULTS: Three themes were derived from a qualitative analysis of the aggregated data: psychotherapy skills of MHN psychotherapists are under-utilized; these nurses bridge gaps between biomedical and psychosocial service provision; and equitable access to rebates in the primary care sector is an obstacle to enabling access to services. CONCLUSIONS: MHN psychotherapists are a potentially valuable resource to patients in tertiary and primary health care. They offer capacity to increase access to specialist psychotherapy services for complex and high risk groups, while being additionally capable of meeting patients' physical and social needs. Equitable access to current funding streams including Medicare rebates can enable these outcomes.

Effect of high-quality nursing intervention on the psychological disorder in patients with gastric cancer during perioperative period: A protocol of systematic review and meta-analysis.

BACKGROUND: This study will be proposed for investigating the effects of high-quality nursing intervention (HQNI) on the psychological disorder in patients with gastric cancer during perioperative period (GC-PPP). METHODS: A cumulative search from inception up to the March 31, 2020 will be performed in the following databases: Cochrane Library, MEDLINE, EMBASE, Web of Science, VIP database, and China National Knowledge Infrastructure. We will search all potential studies from those electronic databases regardless their language and publication status. We will only consider randomized controlled trials (RCTs) for inclusion, which explores the effect of HQNI on the psychological disorder in patients with GC-PPP. Study identification, information extraction, and study quality appraisal will be independently and respectively done by 2 researchers. Any different opinions between 2 researchers will be disentangled by a third researcher after discussion. Cochrane risk of bias tool will be used for study quality assessment, and RevMan 5.3 software will be utilized for statistical analysis. RESULTS: This study will provide a high-quality synthesis of psychological disorder outcomes to evaluate the effects and safety of HQNI for patients with GC-PPP. CONCLUSION: The findings of this study will provide reference and evidence to appraise whether HQNI is an effective on the psychological disorder in patients with GC-PPP STUDY REGISTRATION NUMBER:: INPLASY202040080.

O cuidado ao idoso com transtorno mental em uma instituição de longa permanência no Sudoeste de Minas Gerais: relatos de cuidadores e equipe de enfermagem / The care of the elderly with mental disorder in a long permanent institution in Southeast Minas Gerais: reports of caregivers and nursing staff

Objetivo: identificar o cuidado ao idoso institucionalizado com transtorno mental, as principais dificuldades e percepções da equipe diante do cuidado e de seu impacto na relação profissional-paciente. Métodos: estudo transversal e descritivo, de abordagem qualitativa. A amostra foi constituída de oito profissionais, entre membros da equipe de enfermagem e cuidadores de idosos, em uma instituição de longa permanência para idosos de um município do sudoeste mineiro. A coleta de dados foi realizada na própria instituição, por meio de gravação das verbalizações (depoimentos) dos participantes, mediante roteiro padronizado de entrevista individual, contendo variáveis sociodemográficas e profissionais para a caracterização da amostra, bem como três questões disparadoras concernentes ao objetivo do estudo. Para a interpretação dos dados, utilizou-se a técnica da análise temática de conteúdo. Resultados: entre os entrevistados, houve predomínio de profissionais do sexo feminino, com nível médio de escolaridade e curto tempo de formação e de atuação em instituições de longa permanência para idosos. Ao investigar o cuidado ao idoso com transtorno mental, evidenciaram-se duas categorias temáticas: lidando com as reações de agressividade do idoso e seu impacto no cuidado; despreparo/ insegurança do profissional e a falta de recursos. Conclusão: os achados reiteram a necessidade de capacitação de recursos humanos na área de Gerontologia, com ênfase em Saúde Mental, assim como a atuação de uma equipe multidisciplinar junto aos idosos institucionalizados.

Objective: to identify the care for institutionalized elderly person with mental disorders, the main difficulties and perceptions of the team regarding the care and its impact on the professional-patient relationship. Methods: cross-sectional and descriptive study with a qualitative approach. The sample consisted of eight professionals, including members of the nursing team and elderly caregivers, in a long-term care institution for the elderly in a southwestern Minas Gerais municipality. Data collection was carried out in the institution itself, by recording participants' verbalizations (statements), through a standardized individual interview script, containing socio-demographic and professional variables to characterize the sample, as well as three triggering questions concerning the purpose of the study. For data interpretation, the technique of thematic content analysis was used. Results: among the interviewees, there was a predominance of female professionals, with a medium level of education and short time of training and working in long-term care institutions for the elderly. When investigating the care to the elderly with mental disorders, two thematic categories were highlighted: dealing with the aggressive reactions of the elderly and their impact in the care; unpreparedness / insecurity of the professional and the lack of resources. Conclusion: the findings reiterate the need for training human resources in the area of Gerontology, with emphasis on Mental Health, as well as the performance of a multidisciplinary team with institutionalized elderly.

Initial psychometric evaluation of the physical health attitude scale and a survey of mental health nurses.

WHAT IS KNOWN ON THE SUBJECT?: A clear association exists between serious mental illness (SMI) and poor physical health. Individuals with SMI have markedly higher risks for mortality and morbidity. Mental health nurses play an important role in enhancing service users' mental and physical well-being. The attitudes of mental health nurses towards physical health care have been explored in the western part of the world. However, cross-country differences should be determined to reveal the importance of this global issue. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study adds new data to the literature on the Physical Health Attitude Scale's (PHASe) validity and nurses' attitudes when working in acute mental health services in different cultures. Nurses in acute mental health wards mostly focus on the basic physiological indicators of patients' existing physical health problems, so health promotion practices such as sexual health and eye/dental examinations are neglected for individuals with SMI. Nurses' higher level of confidence about their delivery of physical health care is due to their familiarity with basic nursing practices (e.g. monitoring blood pressure and checking blood glucose levels). Differences that exist between countries in relation to smoking habits are probably due to different regulations. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: To improve patients' physical healthcare outcomes, nurses should be provided with additional training and supervision to strengthen their skills and confidence. Nurses' perceived need for additional training reflects the importance of physical health care in mental health settings, in which training could substantially improve patient outcomes. Authors believe that standard protocols must be established in acute psychiatric care to eliminate obstacles to holistic patient care. Training needs of mental health nurses on health promotion practices should be considered by administrators of mental health settings. Abstract Introduction Nurses play an important role in improving the physical health of individuals with serious mental illnesses. The literature on the attitudes of mental health nurses towards physical health care provides a small amount of data. Assessing trends in nurses' attitudes through suitable surveys is important to ensure holistic care. Aim/Question This study sought to examine the Turkish version of the Physical Health Attitude Scale's (PHASe) validity and reliability and to survey Turkish mental health nurses' attitudes towards physical health care. Method The sample consisted of 174 nurses working in acute psychiatric wards. Firstly, the psychometric properties of the scale were analysed using factor analysis and measures of internal consistency and reliability. Then, the survey results of the attitudes of mental health nurses towards the physical health of patients with serious mental illnesses were determined using the Physical Health Attitude Scale (PHASe). Results The translated PHASe functioned best as a 24-item version and 4-factor solution that explains 51.3% of the variance. The internal consistency value was 0.83. The respondents' attitudes were generally positive about their role. There was less agreement for the involvement of nurses in practices of health promotion, such as sexual health, eye and/or dental examinations. The nurses surveyed also tended to use smoking for therapeutic purposes. Implications for practice Mental health nurses' knowledge and attitudes should be enhanced by additional training in the ways of meeting patients' biopsychosocial needs. Obstacles to physical health care can be removed by implementing standard protocols nationwide.

Clarity, confidence and complexity: Learning from mental health nurses' experiences of events involving physiological deterioration of consumers in acute inpatient mental health settings.

AIMS AND OBJECTIVE: To capture the experiences of nurses in relation to the acutely physiologically deteriorating consumer. BACKGROUND: Improving the physical health care of consumers with mental illness has been widely adopted as a priority for mental health nursing. Much of the effort thus far has focused on routine screening, prevention and treatment of common comorbidities including cardiovascular disease, diabetes mellitus and cancer. There has been less focus on the acutely physiologically deteriorating consumer in the mental health setting. Further study is warranted since this issue poses a set of highly complex challenges for nurses within the inpatient setting. METHOD: An exploratory, descriptive study was employed using focus groups to gather narrative data, which was then subject to qualitative analysis. Eleven mental health inpatient wards within a local health district in Sydney, Australia, were studied, comprising ward-based nurses (n = 64) and nurse unit managers (n = 8). This paper follows the COREQ guidelines for reporting qualitative health research. RESULTS: Qualitative data analysis revealed three themes central to the nurses' experience: (a) lack of clarity (subthemes: procedures and leadership accountability); (b) confidence in the workforce (subthemes: knowledge and skills, training needs, relevant experience, collaboration with emergency and medical teams, stigmatising attitudes); and (c) complexity (subthemes: complexity as the new norm and suitability of the mental health environment). CONCLUSION: The themes found in this study can be used to guide and inform healthcare policy, protocols, education and processes around building a more confident nurse workforce for the acutely physiologically deteriorating consumer. RELEVANCE TO CLINICAL PRACTICE: Findings provide a rich data set for the generation of measurement tools and protocols to guide physical health care and evaluate performance.

Managing health changes for people with a learning disability in a residential care home setting.

BACKGROUND: People with learning disability (LD) have complex comorbidities that develop at an earlier age than the general population and with which they are now living longer. Identification, assessment and management of these conditions is important but challenging. AIM: To develop resources with care staff to enable them to recognise and manage changes and decline in the health of a person with a LD. METHODS: Two resources (PIP-LD and CIRC) were developed through undertaking a literature review; networking with experts; and collaborating with staff in the care homes for people with a LD. Care staff then used these resourcesto review their residents. FINDINGS: The PIP-LD and CIRC were used in 39 care homes. The PIP-LD empowered staff to meet people's immediate health needs, and the CIRC helped them to recognise changes or a decline. CONCLUSIONS: The combined use of the PIP-LD and the CIRC enabled care staff to recognise the signs and symptoms of each person's comorbidities early, and to identify and manage changes when their health declined.

Prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders.

AIMS AND OBJECTIVES: This study aimed to analyse the prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders. BACKGROUND: Studies conducted with family caregivers of people with dementia and cancer point out a high prevalence of suicidal ideation among these subjects; however, this aspect has not yet been investigated among family caregivers of people with mental disorders. DESIGN: This is a cross-sectional study, conducted with 537 family caregivers of patients from 16 Psychosocial Care Centers (CAPS) of the 21st Health Region of the state of Rio Grande do Sul, Brazil. METHODS: Question 17 of the Self-Reporting Questionnaire (SRQ-20) was used for suicidal ideation screening. The prevalence of suicidal ideation was calculated according to sociodemographic and care variables, with confidence interval estimate (95% CI). Crude and adjusted odds ratios were calculated by logistic regression. The Guidelines to Reporting of Observational Studies in Epidemiology (STROBE Statement) was adhered in this study (See File S1). RESULTS: The prevalence of suicidal ideation found in this study for the 30 days preceding the interview was 12.5% (95% CI: 10-15). The factors associated with the outcome were lower age, lower schooling, feeling of burden, self-report of stress problem and dissatisfaction with family relationships. CONCLUSION: The prevalence of suicidal ideation among the studied family caregivers was high and strongly associated with issues regarding care, showing the need for interventions that provide support. RELEVANCE FOR CLINICAL PRACTICE: Nurses are a large part of the workforce of the community mental health services. The careful characterisation of the subjects who show suicidal ideation, as performed in this study, may reveal specificities capable of refining the diagnostic potential for establishment of action plans in a timely manner, avoiding possible attempts or even the consummation of suicide.

Perceptions, Knowledge, and Use of Electronic Cigarettes: A Survey of Mental Health Patients.

Tobacco smoking is the leading cause of preventable illness and death in the United States. Smoking and mental illness are often comorbid, yet little is known about mental health patients' perceptions, knowledge, and use of electronic nicotine delivery systems (ENDS). ENDS may be a beneficial short-term intervention to help this group quit smoking. A survey was administered to a sample of patients at an adult outpatient mental health office (N = 109, 45% male, mean age 33). The majority of participants had tried ENDS. Most used ENDS to quit smoking, and believed it was less harmful than smoking. Participants had variable knowledge about ENDS, but few had asked providers for recommendations. They reported providers were not very knowledgeable about ENDS, and were not asking providers for recommendations. ENDS may help mental health patients who have been unable to quit tobacco, but should not be recommended outside of smoking cessation. This survey provides needed information about how ENDS are being used by mental health patients to help guide future recommendations by their healthcare providers when screening for tobacco use.

Review and analysis of the Mental Health Nurse Incentive Program.

Objective The aim of the present study was to review and synthesise research on the Mental Health Nurse Incentive Program (MHNIP) to ascertain the benefits and limitations of this initiative for people with mental illness, general practitioners, mental health nurses and the wider community. Methods An electronic and manual search was made of the research literature for MHNIP in May 2017. Features of studies, including cohorts and findings, were tabulated and cross-study patterns in program processes and outcomes were closely compared. Results Seventeen reports of primary research data have been released. Triangulation of data from different cohorts, regions and design show that the program has been successful on the primary objectives of increased access to primary mental health care, and has received positive feedback from all major stakeholders. Although the program has been broadly beneficial to consumer health, there are inequities in access for people with mental illness. Conclusions The MHNIP greatly benefits the health of people with mental illness. Larger and more representative sampling of consumers is needed, as well as intensive case studies to provide a more comprehensive and effective understanding of the benefits and limitations of the program as it evolves with the establishment of primary health networks. What is known about the topic? The MHNIP is designed to increase access to mental health care in primary care settings such as general practice clinics. Studies have reported favourable views about the program. However, research is limited and further investigation is required to demonstrate the strengths and limitations of the program. What does this paper add? All studies reviewed reported that the MHNIP had positive implications for people with severe and persistent mental illness. Qualitative research has been most prevalent for mental health nurse views and research on Health of the Nation Outcome Scale scores for recipients of the program. There is more research on system dimensions than on person-centred care. Mental health consumers, carers and families have been neglected in the establishment, engagement and evaluation of the MHNIP. What are the implications for practitioners? A more systematic, national-level research program into the MHNIP is required that is centred more on the experiences of people with mental illness.

Mental Health Issues and Substance Use in the United States: Pulling the Power Levers.

BACKGROUND: Promising treatment avenues have been developed and studied that align well with the skills of psychiatric-mental health (PMH) nurses. The treatments are relationship-driven, nimble and accessible, and recovery-guided. They emphasize a whole-person approach with care delivered by a team of experts working in a contextually coordinated way. AIMS: To describe the challenges facing the United States with regard to mental illness and substance use disorders and the ways in which PMH nurses can use their skills to mitigate these challenges. METHOD: Published research and government reports were reviewed to obtain current mental health and substance use data. RESULTS: The number of people not being treated for mental illnesses-particularly serious mental illness, major depressive episode, and suicidal thoughts-has not improved since 2009. Although inroads have been made in reducing the rate of smoking in the United States, we are facing an opioid crisis. There are limited data on marijuana use, but it is apparent that many Americans use cannabis routinely. According to the Substance Abuse and Mental Health Administration, approximately 44.7 million people need mental health treatment and 20.1 million Americans need substance use treatment, but only 10% to 30% receive it. CONCLUSIONS: PMH nurses must take a leading role in retooling the therapeutic relationship and partnering with clients, families, and caregivers to improve the quality of life and well-being of those dealing with mental illness and substance use disorders. To accomplish this essential task, the PMH nursing workforce must be robust and distributed throughout the United States.

Nursing actions for liberty deprived people: a scoping review / Acciones de enfermería para las personas privadas de libertad: una scoping review / Ações de enfermagem para as pessoas privadas de liberdade: uma scoping review

Abstract Objective: To identify and map the care practices carried out by the nursing team for the Liberty Deprived People. Method: Scoping review according to the JBI Institute Reviewer's Manual. In the initial search we used MESH: Nursing, Delivery of Health Care and Prisoners, to delimit the final search strategy, made up by a combination of twelve keywords, performed in scientific and gray databases, with no temporal limit. Information about publication year, country of origin, objective, aspects of the method, results and conclusions related to the scoping review, were extracted. Results: 59.310 texts were found, after reading the title and abstract, 55 were read in full and 15 articles composed the final selection. Among nursing actions there is preponderance of clinical practices, screening and qualified listening, which contribute to improving the health conditions of liberty deprived people and their families. Conclusions and implications for practice: The nursing actions carried out in prisons contribute to health for liberty deprived people. This paper elucidates the role of nursing in the penitentiaries, informing on the actions that this professional class performs, in order to highlight the gaps that are still perceived and contributing to the training of nurses for acting in the prison system health teams.

Resumen Objetivo: Identificar y mapear las prácticas asistenciales ejercidas por un equipo de enfermería para las Personas Privadas de Libertad. Método: Scoping review según el JBI Institute Reviewer's Manual. En la búsqueda inicial se utilizaron los MESH: Nursing, Delivery of Health Care y Prisoners, para delimitar la estrategia final de búsqueda, compuesta por una combinación de doce palabras claves, realizada en bases de datos científicas y grises, sin límite temporal. Se extrajeron informaciones sobre el año de publicación, el país de origen, el objetivo, los aspectos del método, los resultados y las conclusiones relacionados con la scoping review. Resultados: Se encontraron 59.310 textos, después de la lectura de títulos y resúmenes, de los cuales se leyeron 55 en su totalidad y 15 artículos compusieron la selección final. Entre las acciones de enfermería hay preponderancia de las prácticas clínicas, la selección y la escucha cualificada, que contribuyen a una mejora de las condiciones de la salud de las PPL y sus familias. Conclusiones e implicaciones para la práctica: Las acciones de enfermería realizadas en las cárceles han sido resolutivas y equiparadas a aquella suministrada extramuros. Este trabajo aclara el papel de la enfermería en las cárceles, informa sobre las acciones llevadas a cabo, y contribuye a la formación de enfermeros para su desempeño en el sistema penitenciario.

Resumo Objetivo: Identificar e mapear as práticas assistenciais exercidas pela equipe de enfermagem para as Pessoas Privadas de Liberdade. Método: Scoping review segundo o JBI Institute Reviewer's Manual. Na busca inicial foram utilizados os MESH: Nursing, Delivery of Health Care e Prisoners, para delimitar a estratégia final de busca, composta por uma combinação de doze palavas-chaves, realizada em bases de dados científicas e cinzentas, sem limite temporal. Foram extraídas informações sobre o ano, país de origem, objetivo da publicação, aspectos do método, resultados e conclusões relacionados a scoping review. Resultados: Foram encontrados 59.310 textos, após a leitura de título e resumo, 55 foram lidos na íntegra e 15 artigos compuseram a seleção final. Entre as ações de enfermagem há preponderância de práticas direcionadas para doenças infectocontagiosas e saúde mental, com ações clínicas, triagem e escuta qualificada, que melhoram as condições de saúde nos presídios. Conclusões e implicações para a prática: As ações de enfermagem nos presídios contribuem para o acesso à saúde entre privados de liberdade. Este trabalho elucida o papel da enfermagem nas penitenciárias, informa sobre as ações desempenhadas e contribui para a formação de enfermeiros para a atuação no sistema prisional.

O cuidado à pessoa com comorbidade psiquiátrica em emergência geral: visão dos enfermeiros / Cuidado a la persona con comorbidad psiquiátrica en emergencia general: visión de los enfermeros / Care for people with psychiatric comorbidity in a general emergency unit: vision of the nurses

Resumo OBJETIVO Analisar dificuldades encontradas pelos enfermeiros no cuidado à pessoa com comorbidade psiquiátrica em uma emergência geral e suas sugestões para melhoria do cuidado à estas neste serviço. MÉTODO Estudo qualitativo, descritivo e exploratório, realizado com doze enfermeiros em hospital geral do sul do Brasil em 2016. Para a coleta de informações utilizou-se entrevista e os resultados foram avaliados por Análise de Conteúdo. RESULTADOS Emergiram duas categorias: Dificuldades encontradas pelos enfermeiros no cuidado à pessoa com comorbidade psiquiátrica e Sugestões dos enfermeiros para qualificar o cuidado à pessoa com comorbidade psiquiátrica. A primeira relacionada à estrutura física e recursos materiais; superlotação; falta de preparo da equipe e de consultoria psiquiátrica e a segunda indicou fluxograma de atendimento; consultoria psiquiátrica e capacitação para a equipe. CONCLUSÕES Deve-se transcender a fragmentação do cuidado desde a formação dos profissionais de saúde, trazendo a necessidade de capacitações e de maior investimento na formação acadêmica.

Resumen OBJETIVO Analizar dificultades encontradas por los enfermeros en el cuidado a la persona con comorbilidad psiquiátrica en una emergencia general y sus sugerencias para mejorar el cuidado a éstas en este servicio. MÉTODO Estudio cualitativo, descriptivo y exploratorio, realizado con doce enfermeros en hospital general del sur de Brasil en 2016. Para la recolección de informaciones se utilizó entrevista y los resultados fueron evaluados por Análisis de Contenido. RESULTADOS Emergieron dos categorías: Dificultades encontradas por los enfermeros en el cuidado a la persona con comorbilidad psiquiátrica y Sugerencias de los enfermeros para calificar el cuidado a la persona con comorbilidad psiquiátrica. La primera relacionada con la estructura física y los recursos materiales; hacinamiento; falta de preparación del equipo y de consultoría psiquiátrica y la segunda indicó diagrama de atención; consultoría psiquiátrica y capacitación para el equipo. CONCLUSIONES Se debe trascender la fragmentación del cuidado desde la formación de los profesionales de salud, trayendo la necesidad de capacitaciones y de mayor inversión en la formación académica.

Abstract OBJECTIVE To analyze the difficulties encountered by nurses when providing care to people with psychiatric comorbidity in the general emergency unit and their suggestions for improving the care of these patients. METHOD This is a qualitative, descriptive, and exploratory study conducted with twelve nurses at a general hospital in southern Brazil, in 2016. Information was collected during an interview and the results were evaluated using content analysis. RESULTS Data interpretation led to two categories: Difficulties of nurses when providing care to people with psychiatric comorbidity and Nurses' suggestions to improve care for people with psychiatric comorbidity. The first category is related to the physical structure and material resources of the service, overcrowding, and lack of preparation of the team and professionals who provide psychiatric consultations. In the second category, the workers suggested a care flow chart, psychiatric consultations, and team training. CONCLUSIONS We must transcend the fragmentation of care from the education years of health professionals, emphasize the need for training, and make greater investments in health education.

What causes medication administration errors in a mental health hospital? A qualitative study with nursing staff.

OBJECTIVE: Medication administration errors (MAEs) are a common risk to patient safety in mental health hospitals, but an absence of in-depth studies to understand the underlying causes of these errors limits the development of effective remedial interventions. This study aimed to investigate the causes of MAEs affecting inpatients in a mental health National Health Service (NHS) hospital in the North West of England. METHODS: Registered and student mental health nurses working in inpatient psychiatric units were identified using a combination of direct advertisement and incident reports and invited to participate in semi-structured interviews utilising the critical incident technique. Interviews were designed to capture the participants' experiences of inpatient MAEs. All interviews were transcribed verbatim and subject to framework analysis to illuminate the underlying active failures, error/violation-provoking conditions and latent failures according to Reason's model of accident causation. RESULTS: A total of 20 participants described 26 MAEs (including 5 near misses) during the interviews. The majority of MAEs were skill-based slips and lapses (n = 16) or mistakes (n = 5), and were caused by a variety of interconnecting error/violation-provoking conditions relating to the patient, medicines used, medicines administration task, health care team, individual nurse and working environment. Some of these local conditions had origins in wider organisational latent failures. Recurrent and influential themes included inadequate staffing levels, unbalanced staff skill mix, interruptions/distractions, concerns with how the medicines administration task was approached and problems with communication. CONCLUSIONS: To our knowledge this is the first published in-depth qualitative study to investigate the underlying causes of specific MAEs in a mental health hospital. Our findings revealed that MAEs may arise due to multiple interacting error and violation provoking conditions and latent 'system' failures, which emphasises the complexity of this everyday task facing practitioners in clinical practice. Future research should focus on developing and testing interventions which address key local and wider organisational 'systems' failures to reduce error.