Beyond satisfaction, what service users expect of inpatient mental health care: a literature review.

To provide efficient and effective inpatient mental health services, it is imperative to not only ascertain if service users are satisfied with the care received from nurses, but also the degree to which initial expectations are being met. Ten reports of primary research on service users' experiences, perceptions and expectations of inpatient mental health care were examined to understand what service users' expect of inpatient mental health care and the implications for nursing practice. The World Health Organization's description of responsiveness to service users' non-medical expectations of care was used as a framework for retrieving literature and organizing the research outcomes. Responsiveness includes seven categories of healthcare performance ranging from respect for the dignity of the person, to adequacy of amenities, and choice of provider. Service users expect to form interpersonal relationships with nurses; however, non-clinical responsibilities serve as barriers which consume considerable available nursing time that otherwise could be spent developing therapeutic relationships. In addition, inpatient programming ideas are identified for the provision of better services. Hospitals' expectations of mental health nurses will need to be reconsidered if these nurses are to provide the time and resources necessary to meet current service users' expectations.

Severe aplastic anaemia following the use of hair dye: report of two cases and review of literature.

We describe two female patients aged 31 and 62 y who developed severe aplastic anaemia following the use of hair dye containing para-toluenediamine. One received a bone marrow transplant but died after developing graft versus host disease and severe opportunistic infection. The second responded to treatment with methylprednisolone, oxymetholone and antithymocyte globulin and 3 y later she has a normal blood count apart from mild thrombocytopenia. In this paper we also review previously described case reports of aplastic anaemia apparently associated with the use of hair dye.