Research and Future Challenges for Disseminating Strengths-Based Nursing and Healthcare in Japan.

Strengths-Based Nursing and Healthcare (SBNH) has garnered attention in the field of psychiatric nursing in Japan, yet its adoption in other nursing sectors remains limited. Japan is currently facing the formidable challenge of a rapidly aging population and growing demand for healthcare and welfare services. To address these issues, a shift from hospital-based care to comprehensive community care is underway, underscoring the importance of nurses in community settings, where focusing on client strengths is essential. Therefore, this paper aims to present research and practical examples to advocate for the broader dissemination of SBNH in Japan.

Monitoring Persons' Rights to Equal Care: Registered Nurses' Experiences of Caring for People with Mental Ill-Health and Somatic Comorbidity in Psychiatric Outpatient Care.

Persons with severe mental ill-health die early from preventable physical ill-health. Registered nurses in psychiatric outpatient care play a key role in improving persons' physical health, and it is important to examine how they view their responsibility, their experiences of care, and the obstacles they meet in providing person-centred care. The purpose of this study was to explore registered nurses' experiences of caring for persons with mental ill-health and somatic comorbidity in psychiatric outpatient care, using qualitative content analysis to analyze data from semi-structured interviews. The results show that these nurses monitored the person's right to equal care, embraced the whole of the persons suffering, and dealt with unclear boundaries in care. This highlights the unique role that registered nurses play in psychiatric outpatient care via their ability to interpret symptoms and find ways to adapt care based on persons' needs. Registered nurses consider physical health in all care and provide a link between psychiatric and somatic care. Together with mental health nurses at primary health care centers, they are key in reducing persons' suffering. There is a need for structural and functional changes in line with person-centred care including collaboration both within and outside healthcare organizations.

RETRACTED: Reduced self-harm on acute mental health wards following the implementation of a vision-based patient monitoring system: Evidence from five NHS trusts.

WHAT IS KNOWN ON THE SUBJECT?: Inpatient mental health settings pose unique challenges for patient safety, in part because psychiatric disorders are well-known risk factors for self-harm and suicide. Ward staff follow protocols to try and keep patients safe including carrying out in-person safety checks, usually every 15 min, but patients unfortunately still find opportunities to harm themselves. A vision-based patient monitoring system (VBPMS) is a contact-free technology that can help mental health nurses to monitor patients in hospital more effectively. For example, the tool alerts staff to situations where a patient might need assistance, like when they spend a long period of time in their ensuite bathroom. Research has shown that the VBPMS can support staff to prevent safety incidents from occurring and a recent study found a decrease in self-harm after the tool was implemented at one NHS mental health trust. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: This paper presents data from five NHS mental health trusts and suggests that the VBPMS can consistently help staff to prevent self-harm on acute mental health wards. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Managing self-harm behaviours is a challenge for mental health nursing staff. Standard safety protocols are not effective enough - staff need new ways to monitor patients. In general hospitals, technology is used every day to support care. This research shows that the VBPMS can be used to improve patient safety in mental health hospitals. ABSTRACT: Introduction Self-harm is sadly relatively common in mental health inpatient settings, and the effectiveness and appropriateness of strategies used to prevent it have long been disputed. The use of vision-based patient monitoring systems (VBPMS) has been shown to improve various safety outcomes. Their potential to support staff in preventing inpatient self-harm warrants further exploration. Aim This research investigated whether implementing a VBPMS-as an adjunct to existing clinical practice-within acute inpatient services at five NHS England mental health trusts led to reductions in self-harm. Method Five quasi-experimental studies assessed the number of bedroom self-harm incidents, across 12 adult wards, before and 5-12 months after a VBPMS was deployed. Percentage changes were calculated. Four studies used control groups and were included in a fixed-effect meta-analysis. Results In the meta-analysis, a significant inverse-weighted average relative risk percentage change of -38.9% was recorded. For the study with no control groups, reductions in self-harm were seen across all wards (range: -9.1% to -29.8%). Discussion This research demonstrates that VBPMS can support clinicians to create safer ward environments by preventing incidents of self-harm from occurring. Implications for Practice The results provide preliminary support for wider rollout of the technology on acute mental health wards.

Psychotherapeutic nursing as Advanced Clinical Practice for the promotion of mental health in Spain.

OBJECTIVE: To contribute to the recognition of psychotherapeutic nursing (PTN) as a regulated advanced clinical practice (ACP) in Spain, as is the case in other countries. BACKGROUND: Nurses are continually evolving to improve overall health outcomes. PTN has become a reality, with several authors describing it as an ACP. In Spain, psychotherapy is not officially regulated, which has led to a significant number of psychiatric nurses adopting an important ACP in this area without recognition. SOURCES OF EVIDENCE: Evidence confirms that PTN possesses the attributes necessary to be considered an ACP. Nurses, like psychotherapists, independently address the complex needs of individuals and families within the context of therapeutic relationships, and there is a pressing need to advance formal processes of regulation and certification. DISCUSSION: PTN has evolved at different rates depending on local initiatives, policies and various professional interests. In Spain, it is crucial to evaluate its outcomes, recognise it as an ACP and develop training plans for its regulation and accreditation. CONCLUSIONS: Mental health nurses in Spain have a strong interest in PTN being recognised as an ACP. To this end, they should join forces with other partners, scientific associations and international bodies such as the International Council of Nurses (ICN) to make PTN an internationally recognised ACP. IMPLICATIONS FOR NURSING PRACTICE: Psychotherapeutic nurses could contribute to improving mental health outcomes, client satisfaction and health system efficiency, and their formal recognition is an opportunity to enhance their professional identity, competence and autonomy. IMPLICATIONS FOR NURSING POLICY: Nursing policy needs to be reoriented towards strengthening psychotherapy as an ACP. Synergies and alliances between international nursing associations and the ICN can promote its development and implementation, while research, education and leadership are essential to achieving official regulation and accreditation.

Development of the clinical competency assessment scale in child and adolescent mental health nursing.

WHAT IS KNOWN ON THE SUBJECT?: Children and adolescents' mental health problems, such as autism spectrum disorder, anxiety disorder and attention-deficit hyperactivity disorder, are a global public health concern, and nurses require advanced expertise and skills to properly care for this population. There is a gap between the required competencies and the actual skills and knowledge of CAMHN practitioners. Previous studies suggest that educational interventions for nurses are necessary to enhance the quality of care for children and adolescents with mental health problems. However, the corresponding evaluation indicators have not been verified, making it difficult to determine the most effective methods. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The present study developed the two-factor (direct care for children and their family members and approach to the care environment) Clinical Competency Assessment Scale in Child and Adolescent Mental Health Nursing (CCAS-CAMHN). We demonstrated that the assessment scale was reliable and valid, based on its adequate internal consistency and temporal stability, the acceptable range of its model-fit indexes, and its good concurrent and divergent validity. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The newly developed scale is useful for assessing nurses' competency and could help them identify their difficulties in CAMHN. The scale could contribute to the development of effective educational interventions to enhance the quality of care for children and adolescents with mental health problems. ABSTRACT: INTRODUCTION: Caring for children and adolescents with mental health problems, such as autism spectrum disorder, anxiety disorder and attention-deficit hyperactivity disorder, requires expertise and skills. A quantitative clinical competency measurement tool in child and adolescent mental health nursing (CAMHN) is needed to evaluate the indicators of advanced expertise. AIM: The aim of this study was to develop a clinical competency assessment scale in CAMHN and evaluate its psychometric properties. METHOD: Scale items were derived from previous studies and adjusted based on cognitive interviews with five CAMHN experts. In total, 505 nurses in CAMHN from 29 hospitals in Japan participated in the self-administered survey. The scale's construct validity, criterion-related validity, internal consistency and test-retest reliability were assessed. RESULTS: A two-factor (direct care for children and their family members and approach to the care environment) scale was constructed. A secondary structural model showed that a two-factor model fits best. The total score was significantly and positively correlated with excellence in nursing practice, amount of clinical experience and mental status. The overall scale exhibited good validity and reliability. DISCUSSION: The scale is reliable and valid for assessing CAMHN clinical competency. IMPLICATIONS FOR PRACTICE: The scale is useful for assessing nurses' competency and evaluating educational interventions' effectiveness for nurses.

Barriers and Needs of Mental Health Nursing Practitioners toward the Provision of Physical Health Care for Individuals with Severe Mental Illness: Findings from a Cross-Sectional Survey in India.

Despite the potential and opportunity for nurses in mental health settings to deliver comprehensive care to individuals with severe mental illnesses, existing evidence indicates inadequacy in providing physical health care. To understand this gap, we examined the mental health nurse's attitudes, practices, training needs, and barriers toward physical healthcare of individuals with severe mental illness and explored the associated socio-demographic differences. All mental health nurses working in an apex mental health care center in India were assessed using a self-administered questionnaire, which included a socio-demographic profile and the Physical Health Attitude Scale (PHASe). Overall, the nurses held positive attitudes, with items related to smoking and confidence toward physical health care delivery showing more positive ratings than those items related to attitude and perceived barriers. Lack of motivation from patients and nurse's workload in provision of psychiatric care were perceived as major barriers. Nurses with lesser years of experience had a slightly more positive attitude. The findings have important implications for mental health nursing practice and training toward strengthening holistic nursing care for individuals with severe mental illness, specifically in countries with limited resources.

The role of the dually certified primary care/psychiatric mental health nurse practitioner in treating high-needs/high-cost patients.

ABSTRACT: National nursing organizations have called for nurses to provide leadership in care solutions for high-cost/high-needs vulnerable populations. In response to this call, important modifications are emerging in Doctor of Nursing Practice programs, including an increasing number of nurses pursuing dual certification in primary care and psychiatric mental health or primary care nurse practitioners returning for a postgraduate certificate in psychiatric mental health. This innovative role warrants examination, particularly because it relates to high-needs/high-cost patients such as those with serious mental illness (SMI). This article highlights two aspects of the role of the primary care/psychiatric mental health nurse practitioner (PC/PMHNP): one, to provide a vision of the PC/PMHNP as a unique solution for optimal care of vulnerable patients and two, to demonstrate potential contributions of the PC/PMHNP to the larger health care system. A case exemplar is used to illustrate role contributions of the PC/PMHNP in a high-needs/high-cost patient with SMI and complex co-occurring physical illness. Three capacities of the PC/PMHNP are discussed: depth and breath, expert engagement and rapport building, and full patient-centered care and flexibility. The case exemplar emphasizes the PC/PMHNP value through transitions across care settings and where gaps in service frequently occur. The impact of the PC/PMHNP on improved patient outcomes, patient and provider satisfaction, and cost savings are explored.

The Future of the Psychiatric Mental Health Nursing Workforce: Using Our Skill Set to Address Incongruities in Mental Health Care Delivery.

The USA is dealing with well-documented issues around mental health and its treatment. The Psychiatric Mental Health (PMH) workforce is growing and practicing in a variety of roles within the mental health system. How will PMH nurses address instances when the structure of services does not meet the mental health needs of the population? In this piece, I argue that to some degree the future of the PMH workforce will be determined by how well we use our capacity and capabilities to address incongruities in service structure and population needs. Five areas of concern with mental health services are outlined; they all involve factors that can be addressed with innovative approaches and optimum utilization of the PMH workforce. Included are suggestions on how PMH nurses might direct efforts toward these service issues, particularly by using their skill set and presence in the mental health system. Strategies include forging a tighter connection between the work of advanced practice and registered nurses in delivering care. Broadly, these efforts should be directed at building models of patient-centered care that address the needs of populations, reducing disparities, and demonstrating how engagement is a critical lever of effective inpatient and community-based care.

Transcultural adaptation and assessment of psychometric properties of the Spanish version of the Scale for the Evaluation of Staff-Patient Interactions in Progress Notes.

PURPOSE: To adapt the Scale for the Evaluation of Staff Patient Interactions in Progress Notes to Spanish and to test the psychometric properties. DESIGN AND METHODS: The study was conducted in two phases: (1) Adaptation of the instrument to Spanish following the Standards for Educational and Psychological Testing. (2) Psychometric study in a sample of mental health nurses. FINDINGS: The Cronbach's alpha values were 0.97 for the total scale and 0.83 to 0.81 for each dimension. The inter-rater reliability values were between 0.94 and 0.97. PRACTICE IMPLICATIONS: The scale is a reliable tool for assessing nurses' clinical notes in relation to the quality of nurse-patient interactions.

Assistência à saúde mental nos serviços médicos de emergência: revisão integrativa / Asistencia a la salud mental en los servicios médicos de emergencia: revisión integrativa / Mental health care in emergency medical services: an integrative review

Objetivos: conhecer as características da assistência à saúde mental dispensada por profissionais de enfermagem nos serviços médicos de emergência. Método: revisão integrativa de literatura nas bases de dados Literatura Latino-Americano e do Caribe em Ciências da Saúde (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) e Cumulative Index to Nursing and Allied Health Literature (CINAHL), no período de março a junho de 2023, utilizando-se critérios de inclusão e exclusão previamente definidos. Resultados: obteve-se uma amostra final de 59 artigos os quais foram agrupados nas seguintes categorias temáticas: concepções em saúde mental, comunicação, intervenções, atendimento em rede, competência em cuidado em saúde mental e barreiras durante os atendimentos. Conclusão: o cuidado é feito de forma incipiente e permeado por elementos dificultadores. Os achados do presente estudo servem para rever e repensar práticas e políticas de cuidado em saúde mental e promover estratégias de aperfeiçoamento dos processos de trabalho.

Objetivos: conocer las características de la asistencia a la salud mental dispensada por profesionales de enfermería en los servicios médicos de emergencia. Método: revisión integrativa de literatura en las bases de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) y Cumulative Index to Nursing and Allied Health Literature (CINAHL), en el período de marzo a junio de 2023, utilizando criterios de inclusión y exclusión previamente definidos. Resultados: se obtuvo una muestra final de 59 artículos los cuales fueron agrupados en las siguientes categorías temáticas: concepciones en salud mental, comunicación, intervenciones, atención en red, competencia en atención en salud mental y barreras durante los atendimientos. Conclusión: el cuidado es hecho de forma incipiente y permeado por elementos difíciles. Los hallazgos del presente estudio sirven para revisar y repensar prácticas y políticas de cuidado en salud mental y promover estrategias de perfeccionamiento de los procesos de trabajo.

Objective: to know the characteristics of mental health care provided by nursing professionals in emergency medical services. Method: integrative literature review in the databases Latin American and Caribbean Health Sciences Literature (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) and Cumulative Index to Nursing and Allied Health Literature (CINAHL), from March to June 2023, using previously defined inclusion and exclusion criteria. Results: the final sample included 59 articles, which were grouped into the following thematic categories: conceptions in mental health, communication, interventions, network care, competence in mental health care and barriers during care. Conclusion: care is done incipient and permeated by difficult elements. The findings of this study serve to review and rethink mental health care practices and policies and promote strategies for improving work processes.

Sobre dias em que me senti sem ar: desassossegos do pesquisar / On days when i felt breathless: unrest of search / Sobre días que me sentí sin aliento: disurbios de investigación

Resumo Conceitos como o de alteridade, encontro de saberes, polifasia cognitiva, o princípio de familiaridade e de representações sociais operaram na complexa tarefa de compreender como os encontros entre profissionais e usuários sustentavam e/ou transformavam as práticas de acolhimento. Entretanto, a experiência da minha pesquisa de doutorado me levou a questionar os próprios conceitos utilizados da Teoria das Representações Sociais. Ao final do ensaio, após discutir aspectos teórico-metodológicos, o princípio de familiaridade e a questão da tensão e dos afetos nas representações sociais, espero evidenciar como o movimento provocado pelo encontro com usuários e profissionais de uma Rede de Atenção Psicossocial levou-me a questionar pontos essenciais da teoria: o papel domesticador das representações, a forma ainda estática de evidenciar os fenômenos, a separação entre um sujeito que representa e o objeto representado e a dificuldade em usar suas ferramentas conceituais para acompanhar processos me fazem repensar meu lugar e minha função de pesquisador.

Abstract Concepts such as alterity, encounter of knowledge, cognitive polyphasia, the principle of familiarity and the very concept of social representations operated in the complex task of understanding how the encounters between professionals and users supported and / or transformed user embracement practices. However, the experience of my doctoral research led me to question the very concepts used in the Theory of Social Representations. At the end of the essay, after discussing theoretical and methodological aspects, the principle of familiarity and the issue of tension and affects in social representations, I hope to show how the movement caused by the encounter with users and professionals of a Psychosocial Care Network, led me to question essential points of the theory: the domesticating role of representations, the still static way of showing phenomena, the separation between a subject that represents and the object represented and the difficulty in using their conceptual tools to accompany processes makes me rethink my place and role as a researcher.

Resumen Conceptos como la alteridad, el encuentro de saberes, la polifasia cognitiva, el principio de familiaridad y el concepto mismo de representaciones sociales operaron en la compleja tarea de comprender cómo los encuentros entre profesionales y usuarios apoyaron y / o transformaron las prácticas de acogimiento. Sin embargo, la experiencia de mi investigación doctoral me llevó a cuestionar los propios conceptos utilizados en la Teoría de las Representaciones Sociales. Al final del ensayo, después de discutir aspectos teóricos y metodológicos, el principio de familiaridad y el tema de tensión y afectos en las representaciones sociales, Espero mostrar cómo el movimiento provocado por el encuentro con usuarios y profesionales de una Red de Atención Psicosocial, me llevó a cuestionar puntos esenciales de la teoría: el rol domesticador de las representaciones, la forma todavía estática de mostrar los fenómenos, la separación entre un sujeto que representa y el objeto representado y la dificultad para utilizar sus herramientas conceptuales para acompañar procesos, me hace repensar mi lugar y rol como investigador.

Honoring the past and charting the future: The International Society of Psychiatric Mental Health Nurses' commitment to advance diversity and equity in mental health care.

For more than two decades, the International Society of Psychiatric Nurses has dedicated its efforts to improving mental health care services worldwide, focusing on leveraging the psychiatric nursing workforce and advocating to eradicate systemic health disparities. Part of this labor included creating a culturally centered initiative, the Position Statement on Diversity, Cultural Competence and Access to Mental Health Care to fortify the cultural awareness of ISPN members to improve health-care quality delivered to diverse individuals, families, and communities across the life span and to improve these populations' access to mental health care.

Recovery Ecosystems: A Whole Health Approach to Substance Use Prevention and Treatment.

A recovery ecosystem is an evidence-based approach that creates the environment that individuals and families need by providing all the necessary tools, services, and supports for recovery to occur. Several models have been proposed in the literature, including the recovery-oriented systems of care model and Recovery Ready Ecosystems Model. A major concern with previous models is lack of focus on how the individual with substance use disorder (SUD) is a partner in the recovery process and interacts with the recovery ecosystem to optimize recovery wrap-around services and supports. Therefore, we propose the SUD Holistic Recovery Ecosystem Model (HREM), which uses a whole health approach to substance use prevention and treatment and builds on prior work by other researchers. The HREM has four domains: health support, social welfare support, occupational support, and legal and legislative support. [Journal of Psychosocial Nursing and Mental Health Services, 60(9), 10-14.].

The assessment of interprofessional practice in mental health nursing with ethnographic observation and social network analysis: a confirmatory and bibliometric network study using VOSviewer.

INTRODUCTION: Despite numerous techniques for assessing mental health nursing abilities and accomplishments, most practice in psychiatric wards is based on observable clinical behaviours and actions. VOSviewer can perform bibliographic network analysis (BNA), extracting all central topics that identify core behavioural skills in mental health nursing and essential elements in interprofessional practice (IPP). AIM: The current study captures the critical concepts in mental health nursing assessment by performing a BNA of essential topics on ethnography, social network analysis, and interprofessional care. METHODS: A qualitative BNA with a VOSviewer extracted relevant topics from a total of 542 articles obtained from Microsoft API. A subsequent confirmatory quantitative analysis with NVIVO weighed the percentages of the relevant issues and words extracted by the VOSviewer. Boolean keywords searched were 'ethnography,' 'social network analysis,' 'interprofessional', 'psychiatry' and 'hospital'. RESULTS: Major themes identified in ethnography, IPP, and social network analysis for nursing assessment were those of 'communication' (11.63%), 'whole' (9.29%), 'knowledge' (7.66%), 'person' (7.52%), 'activity' (6.31%) and 'collaboration' (6.10%). DISCUSSION: The current study has proven the value of BNA in extracting relevant topics in target literature. VOSviewer captured salient issues in mental health nursing assessment, including ethnographic observations, social network analysis, and IPP. The results confirmed the value of focusing on collaborative care, reciprocity, knowledge management, and information sharing in assessing mental health nursing performances.

The development of nurse prescribing in mental health services: Outcomes from five national surveys 2004-2019.

AIM: This study aimed to explore data from national surveys of nurse prescribing in England's National Health Service mental health services. BACKGROUND: Nurse prescribing is increasing worldwide. Reports describing long-term developments after implementation are rare. METHODS: Five surveys were distributed to all mental health organisations between 2004 and 2019. RESULTS: Response rates increased from 54% (n = 45/83) in 2004 to 79% (n = 42/53) in 2019. The estimated proportion of mental health nurses who were prescribers increased to 4.3% by 2019. Distribution between clinical practice areas did not change significantly over time, with the largest numbers in community mental health teams. The proportion of nurse prescribers actively prescribing increased from 76.4% in 2014 to 87.8% in 2019. Independent prescribing became the predominant approach, with supplementary prescribing rarely used as the sole model within organisations. The scale of implementation varied markedly between organisations. CONCLUSIONS: Although nurse prescribing in mental health services has grown over time, growth has slowed and is variable at local level. IMPLICATIONS FOR NURSING MANAGEMENT: Organisations considering the introduction or growth of nurse prescribing should note the evidenced preference for an independent prescribing model to date and consider how to avoid unwarranted variation in nurse prescriber role distribution.

The Psychiatric Nurse Care Coordinator on a Multi-disciplinary, Community Mental Health Treatment Team.

Community mental health nurses sometimes join multi-disciplinary teams, but the role has not been defined and studied carefully. This article describes the psychiatric Nurse Care Coordinator (NCC)-a unique position created to support care management, facilitate systematic medication management, and coordinate medical care in the Social Security Administration's 30-site Supported Employment Demonstration. The authors reviewed the study's NCC manual, supervised and consulted with the NCCs weekly over nearly three years, and reviewed data on NCC activities. Although the 984 participants assigned to NCCs experienced numerous mental health, substance use, and chronic medical conditions, only 59% completed intake assessments and engaged over time with NCCs. For those 581 participants, NCCs spent approximately 51% of their time helping with mental health issues, 35% on medical care, and 12% on substance use conditions. The NCC was critically important for complex, high-need individuals.

An Update on Billing and Coding for the Psychiatric-Mental Health Nurse Practitioner.

Nurse practitioners (NPs) possess expert clinical knowledge that can be optimized to ensure delivery of high-quality care. In the United States, NP scope of practice is generally expanding. With expanding scope of practice comes increased revenue potential, and in some cases, entrepreneurial opportunities for NPs. Therefore, NPs must be familiar with current procedural terminology codes to ensure appropriate billing and maximize reimbursement from payers. [Journal of Psychosocial Nursing and Mental Health Services, 60(2), 11-13.].

Development and psychometric properties of the Therapeutic Relationship Assessment Scale-Nurse.

WHAT IS KNOWN ON THE SUBJECT?: The literature shows a clear relationship between a good therapeutic relationship (TR) and the efficacy of nursing interventions. For the implementation of nursing psychotherapeutic interventions, the initial establishment of a good TR is essential. Several instruments assess the relationship established between the therapist and the patient in psychotherapy. However, no tool has been found to assess the quality of the TR established between the nurse and the patient. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study allowed the development and evaluation of the psychometric properties of a scale to assess the TR between the nurse and the patient in a sample of mental health nurses. The developed scale (Therapeutic Relationship Assessment Scale-Nurse) has psychometric properties that attest its reliability (internal consistency and test-retest) and construct validity as an instrument to assess the quality of the TR established between the nurse and the patient from the nurse's perspective. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: As the TR is crucial for providing nursing care and, in particular, for implementing nursing psychotherapeutic interventions, the scale developed is a valid tool to assess the quality of the TR established between the nurse and the patient in the perspective of the mental health nurse. The use of instruments to assess the quality of the nurse-patient TR facilitates the identification of the relationship's gaps, which can serve as a basis for improving the relationship itself and the nursing care provision. ABSTRACT: Introduction The therapeutic relationship (TR) is essential to providing psychiatric and mental health nursing care. Nevertheless, no assessment tools exclusive for assessing nursing TR were found in the literature. Aim To describe and evaluate the psychometric properties (reliability and construct validity) of a scale that allows assessing the quality of TR established between the nurse and the patient. Method A survey method was adopted, using a convenience sample of 356 mental health nurses. Internal consistency was assessed by Cronbach's alpha and Omega index. Results A total of 221 mental health nurses participated in the study (response rate = 62.08%). The scale's final structure has 25 items. Cronbach's alpha was 0.93, ranging from 0.78 to 0.88 for each of the factors. The cumulative variance explained in a four-factor structure was 71.12%. Discussion The Therapeutic Relationship Assessment Scale (TRAS)-Nurse presents good psychometric properties. In the light of Benner's theory, it can be an useful tool for novice nurses to better understand what aspects they should pay attention to for establishing a successful TR. Implications for Practice Mental health nurses can use the TRAS-Nurse, thus having a scale available that allows them to self-assess the quality of TR they establish with their patients.

The role and activities of the Traveller mental health liaison nurse: Findings from a multi-stakeholder evaluation.

Irish Travellers are a minority ethnic group within the Irish state with a distinct culture and set of traditions. Travellers experience mental health inequalities, high rates of mental ill health, and structural and individual barriers to mental health supports. A Traveller Mental Health Liaison Nurse (TMHLN) was introduced in a healthcare region in Ireland to provide greater mental health-related support to Travellers. This paper presents a description of the TMHLN role following a multi-stakeholder evaluation. The research design was descriptive qualitative and the findings are reported using COREQ criteria. Thirty-four key stakeholders were interviewed individually or as part of focus groups. Thematic analysis generated two broad themes: the role context, and the specific activities of the role. Mental health nursing experience and understanding of local issues and services were key, as was use of language, building trusting relations, creating the metaphorical, and having the physical, space for working. Specific activities involved in-reach and outreach work, including one-to-one mental health support provision, delivery of education/training sessions to Travellers and service providers, (re)establishing links to specialist services, integrated and interagency working, and promoting cultural competency. The findings set out a role with a greater emphasis on the use of recovery technologies, having an emphasis on psychosocial interventions and self-care, and less focus on biomedical technologies, signs and symptoms, and clinical outcomes. This study contributes to knowledge on the role of a MHLN as this relates to working with marginalized minority groups.