The mediating role of psychological flexibility in the relationship between psychotic symptom severity and depression in individuals diagnosed with schizophrenia.

WHAT IS KNOWN ABOUT THE SUBJECT?: Psychotic symptoms and depression are common problems in people diagnosed with schizophrenia. Psychological flexibility is a skill that facilitates coping with difficulties. There is limited research on the role of psychological flexibility in the relationship between psychotic symptoms and depression in people diagnosed with schizophrenia. WHAT DOES THE ARTICLE ADD TO EXISTING KNOWLEDGE?: This article investigates the role of psychological flexibility in the link between psychotic symptom severity and depression in people diagnosed with schizophrenia. The article shows that psychological flexibility partially mediates the relationship between psychotic symptom severity and depression. The article suggests that interventions aimed at improving psychological flexibility may be beneficial in reducing depressive symptoms in people diagnosed with schizophrenia. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses should consider psychotic symptom severity and psychological flexibility when assessing and intervening for depressive symptoms in people diagnosed with schizophrenia. Mental health nurses should receive training to improve psychological flexibility and pass this skill on to their patients. Mental health nurses should continue to research the effectiveness and outcomes of interventions aimed at improving psychological flexibility. ABSTRACT: INTRODUCTION: Psychological flexibility may help people diagnosed with schizophrenia (PWS) cope with their psychotic symptoms and reduce their depressive symptoms, but the mechanism of this effect is unclear. AIM: To investigate whether psychological flexibility mediates the relationship between psychotic symptom severity and depression in PWS. METHOD: A cross-sectional study was conducted, in which a total of 111 PWS were assessed with DSM-5 Clinician-Rated Dimensions of Psychosis Symptom Severity, Calgary Depression Scale for Schizophrenia and Acceptance and Action Questionnaire. Data analysis was performed using SPSS 25 and PROCESS macro. RESULTS: Significant correlations were found between psychotic symptoms, depression and psychological flexibility. Psychological flexibility partially mediated the relationship between psychotic symptom severity and depression. DISCUSSION: Psychological flexibility could weaken the impact of psychotic symptom severity on depression in PWS. Higher psychotic symptoms were associated with lower psychological flexibility and higher depression. IMPLICATIONS FOR PRACTICE: Interventions to improve psychological flexibility may prevent depressive symptoms in PWS. Psychiatric nurses can use psychological flexibility as a goal for evaluation and intervention.

Associations between Psychological Resilience and Social Support with Posttraumatic Growth in Breast Cancer Patients: A Cross-Sectional Study.

This cross-sectional study examined the associations of psychological resilience, perceived social support, and posttraumatic growth (PTG) in breast cancer (BC) patients (N = 203). The participants' mean age was 43.14 ± 9.06, 80.3% were married, 40.9% had a university degree, 61.6% were unemployed, and 72.4% reported a moderate economic status. No significant correlation was found between PTG and psychological resilience, while a moderate and positive correlation was observed between PTG and perceived social support. A weak and positive correlation was also detected between perceived social support and psychological resilience. Professionals working in the field of psycho-oncology and social work can make attempts to increase psychological resilience, perceived social support, and PTG in BC patients.

The effects of psychoeducation and motivational interviewing on treatment adherence and functionality in individuals with bipolar disorder.

BACKGROUND: Individuals diagnosed with bipolar disorder (BD) encounter difficulties in adherence to treatment and functionality. Although it is known that psychosocial interventions such as motivational interviewing (MI) and psychoeducation are important in regard to improving adherence to treatment and functionality, the content and nature of these interventions remain uncertain. OBJECTIVE: This study was conducted to determine the effects of psychoeducation and MI on treatment adherence and functionality in individuals diagnosed with BD. METHOD: In this study, a quasi-experimental pretest-posttest design with three groups was adopted. The study was completed with 119 participants in the MI (n = 32), psychoeducation (n = 31), and control (n = 56) groups. RESULTS: There was a statistically significant improvement in the psychoeducation and MI groups in terms of treatment adherence compared to the control group (F = 32.672, p = 0.001, Partial η2 = 0.364). Similarly, the psychoeducation and MI groups had significantly higher functionality levels compared to the control group, and significant differences were observed between the groups regarding the degree of improvement in functionality dimensions including the feeling of stigmatization (F = 8.433, p = 0.001, Partial η2 = 0.129) and participation in social activities (F = 7.038, p = 0.001, Partial η2 = 0.110). CONCLUSION: It can be stated that psychoeducation and MI have positive effects in terms of improvement in treatment adherence and functionality in individuals diagnosed with BD.

The relationship between COVID-19 fear levels and healthy lifestyle behaviors of elderly individuals: a cross-sectional study.

BACKGROUND: It is known that fear of COVID-19 is associated with many lifestyle behaviours including delays in access to healthcare services and smoking status. However, the relationship between healthy lifestyle behaviours and fear of COVID-19 in older individuals remains unclear. Therefore, there is a need for research that examines the relationship between healthy lifestyle behaviours and fear of COVID-19 in elderly individuals. The purpose of this study is to investigate the relationship between the COVID-19 fear levels of elderly individuals and their healthy lifestyle behaviours. METHODS: This cross-sectional study was carried out with individuals at or over the age of 65 registered at a public health centre located in eastern Turkey (N = 494). Data collection tools included a form for descriptive variables and two scales, the Fear of COVID-19 Scale (FCV-19 S) and the Healthy Lifestyle Behaviours Scale-II (HLSBS-II). Descriptive statistics, independent-samples t-test, ANOVA, correlation analyses, and hierarchical linear regression analyses were used in the analysis of the data. RESULTS: The mean HLSBS-II and FCV-19 S scores of the participants were 127.61 ± 24.76 and 20.96 ± 7.29, respectively. While fear of COVID-19 alone, as indicated by the FCV-19 S score, explained 2.4% of the total variance in healthy lifestyle behaviours, fear of COVID-19, having a university degree, and high economic status together explained 7.5% of the total variance in healthy lifestyle behaviours indicated by scores on the HLSBS-II. CONCLUSIONS: The results of this study showed that fear of COVID-19 and healthy lifestyle behaviours were dynamics that are positively related, albeit to a small extent, to each other for elderly individuals. Additionally, it was revealed that elderly individuals have moderate levels of fear of COVID-19 and healthy lifestyle behaviours.

Psychopathological Factors Associated With Burnout in Intensive Care Nurses: A Cross-Sectional Study.

BACKGROUND: Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses. AIMS: To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses. METHODS: A cross-sectional study was conducted with ICU nurses (N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis. RESULTS: The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment. CONCLUSIONS: While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.

Perceived social support associated with posttraumatic growth in liver transplant recipients: A cross-sectional study.

INTRODUCTION: There is almost no information about the role of perceived social support, one of the main variables facilitating posttraumatic growth, in liver transplant. For this reason, the issue requires further clarity. The aim of this study was to investigate the relationship between perceived social support and posttraumatic growth in individuals receiving liver transplants. METHOD: This cross-sectional study was carried out with liver transplant recipients at a hospital in eastern Turkey (N = 117). The data collection instruments included a Descriptive Characteristics Form, the Posttraumatic Growth Inventory and the Multidimensional Scale of Perceived Social Support. The data were analyzed using descriptive statistics, correlation analysis and hierarchical linear regression analysis. RESULTS: It was revealed that the participants had high levels of posttraumatic growth (73.05 ±â€¯16.82) and perceived social support (67.75 ±â€¯14.33). A moderate and positive relationship was determined between the mean perceived social support total score and the mean posttraumatic growth total score of the participants (p < 0.01). Perceived social support explained 25.6% of the variance in posttraumatic growth (F = 39.600; p < 0.05; Adjusted R2=0.256), while perceived social support together with primary school-level education and low economic status explained 32.3% of the variance in posttraumatic growth (F = 17.954; p < 0.05; Adjusted R2=0.323). CONCLUSION: The results on perceived social support revealed that liver transplant recipients had a subjective feeling of being understood, respected and supported by their families more than friends and significant other in a social environment. This study showed that high perceived social support contributes to posttraumatic growth in liver transplant recipients. Apart from perceived social support, other factors affecting posttraumatic growth included individuals' perceptions of their education level and economic situation.

Posttraumatic growth and positive determinants in nursing students after COVID-19 alarm status: A descriptive cross-sectional study.

PURPOSE: To determine the relationship between posttraumatic growth (PTG), psychological flexibility, and psychological resilience of nursing students after the COVID-19 alarm status. DESIGN AND METHODS: This descriptive cross-sectional study was conducted with nursing students (N = 292) studying at a nursing school of a university. The data collection instruments included a form on descriptive variables, and the PTG, psychological flexibility, and psychological resilience scales. Descriptive statistics, independent-samples t test, ANOVA, correlation, simple, and hierarchical linear regression analyses were used to analyze the data. FINDINGS: The mean scores regarding psychological flexibility, psychological resilience, and PTG were 27.56 ± 11.06, 18.10 ± 5.75, and 63.49 ± 20.64, respectively. While psychological flexibility explained 36.7% of the total variance in psychological resilience, the predictive effect of seven descriptive variables, including psychological flexibility and psychological resilience, on PTG was determined as 13.4%. PRACTICE IMPLICATIONS: PTG, psychological flexibility, and psychological resilience may help nursing students prepare for their transition to the profession.

What Do Nursing Students Tell Us About Their Communication With People With Mental Illness? A Qualitative Study.

BACKGROUND: Communication with individuals with mental disorder (IMDs) may often be a nonlinear, complex, and variable situation. In general, the first contact of nurses with IMDs occurs during training rotations at a psychiatric clinic. Psychiatric nursing students' initial communication experiences with IMDs may be critical to their thinking of psychiatric nursing as a career. AIM: To determine the communication experiences of psychiatric nursing students with IMDs. METHOD: A qualitative interview study was conducted with psychiatric nursing students studying at a nursing faculty in the east of Turkey in 2019 who completed the clinical practice. Semistructured interviews were conducted by an independent researcher. The data were analyzed using content analysis with an inductive approach. RESULTS: In this study, maximum effort was made for data saturation criteria, and data saturation was achieved with 26 students. As a result of the data analysis, four main themes and 11 categories were developed. The main themes were as follows: (1) restrictions caused by psychological barriers, (2) restrictions caused by thinking and perceptions, (3) restrictions caused by personal and behavioral barriers, and (4) effective communication and therapeutic environment. CONCLUSIONS: In this study, although it is seen that nursing students encounter many communication barriers with IMDs, it is an important development that they implement approaches to provide effective therapeutic communication. The results show the importance of effective nurse-patient communication skills as the first step in improving the clinical practice of nurses in psychiatry clinics.

How Counseling Based on Acceptance and Commitment Therapy and Supported With Motivational Interviewing Affects the Perceptions of Treatment Motivation in Patients Diagnosed With Schizophrenia: A Qualitative Study.

BACKGROUND: Lack of motivation is a common phenomenon in treatment of schizophrenia. Despite information that various psychosocial approaches may help overcome lack of motivation, their content and nature remain uncertain. However, in recent years, there is an increasing interest in psychosocial interventions such as acceptance and commitment therapy (ACT) and motivational interviewing (MI) techniques in approaching individuals diagnosed with schizophrenia (IDSs). In this study, the therapeutic models of ACT and MI were combined to create an innovative integrative approach to address the problem of lack of motivation in IDSs. AIMS: This study was conducted to determine how a counseling program based on ACT and supported with MI affected the perceptions of treatment motivation in IDSs. METHOD: This study addressed the qualitative aspects of a doctoral dissertation designed as a quasi-experimental study that gathered both quantitative and qualitative data. RESULTS: As a result of the content analysis, three main themes and 10 categories that motivated IDSs for compliance with regular treatment were developed. The participants in the experimental group expressed a focused treatment motivation to participate in daily life activities and social relations, acceptance of illness, satisfaction with life despite side effects and leading a value-oriented life in comparison with the control group. CONCLUSIONS: Counseling based on ACT and supported with the MI technique is effective in improving treatment motivation in IDSs. This counseling may be implemented as an effective psychiatric nursing intervention for IDSs.

How Counseling Based on Acceptance and Commitment Therapy and Supported with Motivational Interviewing Affects Levels of Functional Recovery in Patients Diagnosed with Schizophrenia: A Quasi-Experimental Study.

This study aimed to determine how counseling based on acceptance and commitment therapy (ACT) and supported with motivational interviewing (MIs) affected functional recovery in individuals diagnosed with schizophrenia (IDSs). A quasi-experimental design was used. The participants of this study were 87 individuals diagnosed with schizophrenia (36 in the experimental group and 51 in the control group). The experimental group received counseling based on ACT and supported with MIs. The data were collected between September 2018 and May 2019 using a Descriptive Information Form and the Functional Remission of General Schizophrenia Scale (FROGS). The participants in the experimental group were given a group counseling program of eight sessions at community mental health centers in downtown Malatya, Turkey. The results revealed a statistically significant difference in the mean scores on FROGS between those in the IDS experimental group and those in the control group. The scores increased on both groups.

The Relationship Between Anxiety and Intolerance of Uncertainty Levels in Individuals Who Received Liver Transplant: A Descriptive Cross-Sectional Study.

Studies have revealed that anxiety is associated with intolerance of uncertainty (IU); however, no study has examined the predictive effect of IU on anxiety in individuals with liver transplantation (LT). Therefore, this study aimed to identify the relationship between anxiety and IU levels in individuals who received LT. A descriptive cross-sectional study with a convenience sample (N = 118) was conducted at a center in eastern Turkey. The data were analyzed using descriptive statistics, correlation, and hierarchical linear regression analysis. The mean scores for the dimensions of IU, state anxiety and trait anxiety were 34.42 ± 8.35, 40.38 ± 10.07, and 41.88 ± 7.53, respectively. IU and anxiety in individuals with LT were identified as related dynamics. Present findings suggest that uncertainty and IU can be considered in the conceptualization and treatment of anxiety and related pathologies. Nurses may seriously consider these results in order to increase the quality of the treatment and care provided to patients.

The effects of acceptance and commitment therapy on lifestyle and behavioral changes: A systematic review of randomized controlled trials.

PURPOSE: To determine, evaluate, and synthesize the best available evidence about the evidence-based pragmatic effects of acceptance and commitment therapy (ACT) on lifestyle and behavioral changes (LBCs). DESIGN AND METHODS: The PICOS formulations were used to improve the search strategy of this systematic review with the aim to find the right evidence and ask the right questions. The assessed articles were subjected to quality assessment using the PRISMA checklist and the Joanna Briggs Institute's standardized critical assessment and data extraction tools. FINDINGS: This study involved 30 randomized controlled trials (RCTs) which met the research criteria. Although the included RCTs have several limitations in themselves, the results of this study suggested that the ACT will help maintain long-term LBCs (eg, weight management, effective coping with substance-related and addictive problems, eating and physical activity). PRACTICE IMPLICATIONS: Given that ACT is a trandiagnostic approach that promotes health-related LBCs in many diseases and populations, it seems reasonable for clinicians to use and test ACT to achieve pragmatic results.

The effects of acceptance and commitment therapy in psychosis treatment: A systematic review of randomized controlled trials.

PURPOSE: To identify, evaluate, and synthesize existing randomized controlled trials (RCTs) that examine the effect of acceptance and commitment therapy (ACT) in the treatment of psychotic disorders and to integrate this knowledge and experience into the nursing literature. DESIGN AND METHODS: This systematic review is based on the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. FINDINGS: This study was completed with 11 RCTs meeting the research criteria. It has been determined that the vast majority (82%) of the assessed studies were published after 2010. There is evidence that ACT is effective on depression, anxiety, and hallucinations seen in psychotic disorders. PRACTICE IMPLICATIONS: ACT is seen as a reasonable approach to be used and tested by nurses and other clinicians because it provides an explanatory and pragmatic approach to psychotic disorders.

Ethics in nursing: A systematic review of the framework of evidence perspective.

AIM: To determine the current state of knowledge on nursing and ethics and to assess the knowledge and experience based on the evidence in this regard. BACKGROUND: Although ethics is at the center of the nursing profession and the ethical issues affecting nurses are given much importance, few studies have focused on professional ethics in nursing. In this respect, ethics has become a concept that contains controversial and ambiguous situations. DESIGN: The Preferred Reporting Items for Systematic Reviews and Meta-analyses guide, a basic search algorithm, was taken. DATA SOURCES: Cochrane, PubMed, CINAHL Complete, PsycINFO, and ULAKBIM from 2012 to 2016. REVIEW METHODS: Following a systematic search strategy, all papers were assessed in relation to inclusion criteria and type of study. When sufficient information was not available in the title and summary of the works, the necessary data were evaluated in full texts. RESULTS: This review was completed with 27 articles meeting the research criteria. The evaluation identified six themes: (1) ethics and nursing, (2) ethical difficulties/ethical dilemmas and nursing, (3) ethical competence and nursing, (4) professional ethics and nursing, (5) ethics, education, and nursing, and (6) ethics in health research. CONCLUSION: As a result of the review, a synthesis of high evidence-level research relating to nursing ethics was obtained. The emphasis was on the importance of further research and education so that the ethical aspects of nursing can be better understood throughout the studies. Nursing researchers' level of evidence on ethics and their orientation to high research design will shed light on uncertain and controversial aspects of the subject. ETHICAL CONSIDERATION: Since this was a systematic review, no ethical approval was required. There is no conflict of interest in this literature review.

Suicide in sexual minority populations: A systematic review of evidence-based studies.

Sexual minority populations are exposed to more forms of distress than heterosexual individuals, thereby increasing the risk of suicidal behavior. It therefore seems surprising that suicidal behavior in sexual minorities is not sufficiently addressed in the nursing literature.The aim of this review was to integrate evidence-based knowledge and experiences related to suicide in sexual minorities into the nursing literature. This study has been conducted according to PRISMA guidelines, which contains a basic systematic screening process. Fourteen articles met the research criteria. The evaluation encompassed 4 themes: 1) Suicide attempts; 2) Thoughts of suicide; 3) Suicide attempts and completed suicide; 4) Suicidal thoughts and suicide attempts. Most studies focused on the dimensions of attempted suicide. The key finding was that young people in sexual minority groups exhibit more suicidal ideation, more suicide attempts and are more at risk of completed suicide than heterosexual individuals. Family-centered care for young people can therefore be one of the basic principles of nursing practice. Nurses can routinely ask adolescents about their sexual orientation and identity to provide appropriate assessment and care. Additionally, nurses can use educational, counseling, case manager and therapist roles to avoid negative experiences such as homophobia, stigmatization and the discrimination of sexual minorities.

The care burden and coping levels of chronic psychiatric patients' caregivers.

PURPOSE: This descriptive study was conducted in order to determine care burden of caregivers of chronic psychiatric patients and their levels of coping with stress. METHODS: The study was conducted with 134 caregivers of chronic psychiatric patients. The following data collection tools were used: the personal information form, the ZBI and SCI. The study participants were selected from the population by using an improbable random sampling method. RESULTS: The average age of the caregivers was 49.95±13.68 and the majority were married and primary school graduates. CONCLUSION: This study determined that caregivers experienced a high level of burden. However, while the deal with their difficulties of providing effective care was found to have more coping methods they use.