Concept analysis of psychiatric nursing competency in psychiatric nursing.

This concept analysis study identified attributes and defined psychiatric nursing competency among psychiatric nurses. The approach of Walker and Avant was used for concept analysis, and a literature review was completed including eight steps. The concept of psychiatric nursing competency was identified as five attributes: professional assessment, situation coping skills, communication, cooperation, and self-management. Antecedents of the concept were psychiatric nursing education and experience, and the consequences were patient outcomes, patient safety, and efficiency of care. Psychiatric nursing competency was defined as the comprehensive ability to care for psychiatric patients appropriately and effectively in the nursing situation. This study is meaningful in that it clarified psychiatric nursing competency among psychiatric nurses, and the attributes and empirical referents of this study will be the basis for development to a psychiatric nursing competency measurement tool.

Allyship with Psychiatric Patients for Health Care Practice Reform: A Case Study of a Narrative Approach Using Patient-Authored Medical Records.

Introduction: To facilitate partnerships between nurses and their patients with psychiatric illness, it is important to provide a safe narrative space for both parties where patients can voice their opinions. Purpose: A case study shows how the Patient-Authored Medical Record (PAMR) can contribute to health practice reform. Methods: A patient who visited an outpatient psychiatric clinic was asked to describe his life events. The researchers created the patient's PAMR, a first-person account of how he thought his illness could be cured, which was used when conducting follow-up meetings. The contents of the PAMR and that of subsequent meetings were used to evaluate the tool's usefulness. Results: The narrative content of the PAMR and the follow-up meetings reflected a reduction in the patient's symptoms and a change in his perception of his illness. Conclusions: Patient-authored medical records could be a step toward health-care reform. Allyships created with patients can form new cooperative two-way relationships that are more equal than authoritative one-way relationships.

Experiences of Mental Health Nurses in Providing Care to Patients Receiving Electroconvulsive Therapy in South Korea.

In recent years, the demand for electroconvulsive therapy has been increasing in South Korea. However, there are problems due to mental health nurses' lack of understanding about electroconvulsive therapy and the absence of systematic education. This study aimed to explore mental health nurses' experiences of providing care to patients receiving electroconvulsive therapy in South Korea. We used content analysis to analyse the data collected from focus group interviews with 22 mental health nurses working in mental health hospitals. The results revealed four themes and 10 subthemes. More specifically, the results showed that mental health nurses consider themselves helpers in recovery. They pursue the physical and emotional well-being of patients receiving electroconvulsive therapy and strive to ensure that patients receive electroconvulsive therapy comfortably and safely. However, contentious issues such as concerns about patient dignity and autonomy lead to differing perceptions and attitudes towards electroconvulsive therapy and cause internal conflict during therapeutic interactions. Furthermore, insufficient education on electroconvulsive therapy leads to a lack of knowledge and difficulties in fulfilling the role of an information provider. The shortage of coping measures and support systems for issues such as extensive adverse effects and restricted medication increases the work burden immensely. These findings can serve as foundational data for the development of standardised nursing practices and systematic education for electroconvulsive therapy.

Family resilience experiences of individuals with schizophrenia-family caregivers dyads: Qualitative study.

WHAT IS KNOWN ON THE SUBJECT?: Family resilience is an important determinant of family caregivers' coping with difficulties of life and stress effectively. Family resilience factors contribute to the family's adaptation to difficulties. From the perspective of the individual living with schizophrenia and family, family resilience focuses not on the losses experienced but on the strengths. WHAT DOES THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Many factors such as routines, positive cognitions, intra-family communication, family support and love as a healing force that contribute to family resilience were identified from the common perspective of the individual diagnosed with schizophrenia-family caregiver dyads. The climate of love within the family is an important strength both for the patient diagnosed with schizophrenia and for the family caregivers. Mutual support between family members, their listening to each other and sharing experiences with each other during this disease process are therapeutic for both parties and make them resilient. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Family resilience factors should be considered in planning psychosocial interventions to be applied to individuals diagnosed with schizophrenia and family caregivers. The clinical use of psychosocial support interventions in family resilience which help both the individual diagnosed with schizophrenia and the family caregivers to gain a positive perspective, to improve their problem-solving skills, and to support each other within the family should be expanded. Displaying approaches aimed at increasing the climate of love and strengthening correct communication techniques within the family towards both the individual diagnosed with schizophrenia and the family caregiver should be supported. Psychiatric nurses' focusing on family resilience from a systemic perspective in chronic mental illnesses such as schizophrenia strengthens the patient and the family. This perspective focuses on functional dimensions and protects mental health despite existing problems. ABSTRACT: INTRODUCTION: Family resilience is one of the important concepts that should be addressed in chronic mental illnesses. AIM: This study was aimed at investigating family resilience experiences from the perspective of individuals diagnosed with schizophrenia-family caregiver dyads. METHOD: The study was conducted in the Adult Psychiatry inpatient and outpatient unit of a university hospital in a province in western Turkey using the phenomenological method. By using the purposeful sampling method, 20 participants were selected in the study. Of them, 10 were family caregivers and 10 were patients diagnosed with schizophrenia. The results of the study were analysed with a dyadic approach within the framework of key processes of Walsh family resilience model. The directed content analysis method was used to analyse the data obtained from the study. COREQ checklist was used to report the research. RESULTS: After the analysis, the following five main themes emerged: positive cognitions, routines, family support, intra-family communication and love as a healing force. DISCUSSION: Family resilience is a structure shaped by the relationship between family members. The factors that contribute to the individual diagnosed with schizophrenia-caregiver dyads' ability to overcome difficulties in family resilience are discussed in line with the relevant literature. IMPLICATIONS FOR PRACTICE: Intervention programs should be implemented to create an environment of love by improving relationships and communication in the family, improving problem solving and increasing support resources.

Transformative impact of positive psychotherapy-based hope placement program on life goals and hope level of individuals with multiple sclerosis.

AIM: This study aimed to assess the impact of a positive psychotherapy-based hope placement program on life goal setting and hope levels in individuals diagnosed with multiple sclerosis (MS). METHOD: A Solomon Four-Group experimental design was used, involving 50 individuals diagnosed with MS who sought treatment at a university hospital's neurology outpatient clinic. Experimental (1-2) and control (1-2) groups were randomized, and pretests were administered exclusively to the experimental and control groups. Data were collected using a Personal Information Form, the Herth Hope Scale, and the Scale for Determining Life Goals in the Context of Positive Psychotherapy. A 5-week/10-session Positive Psychotherapy-Based Hope Placement Program was conducted online for the Experimental groups. The research was conducted in the form of group therapy. Post-tests were administered to all groups upon program completion. RESULTS: The experimental 1-2 group exhibited statistically significant improvements in the Scale for Identifying Life Goals in the Context of Positive Psychotherapy and Herth Hope Scale scores (p < .05). The Positive Psychotherapy-Based Hope Placement Program effectively enhances hope levels and life goal setting for individuals diagnosed with MS. CONCLUSION: The results indicate that the program increased the sense of purpose in life and elevated levels of hope among MS patients. These findings suggest that positive psychotherapy-based interventions significantly improve the quality of life for MS patients. CLINICAL OR METHODOLOGICAL SIGNIFICANCE OF THIS ARTICLE: This study examines the impact of a Positive Psychotherapy-based hope placement program on determining hope and life purpose in patients with Multiple Sclerosis (MS). This research shows that HOPP (Hope Placement Program), an intervention based on Positive Psychotherapy, can significantly improve the quality of life of MS patients. These findings support the consideration of Positive Psychotherapy-based approaches as a potential therapeutic option that can positively influence the life experiences of MS patients. Therefore, this article makes an important contribution to researchers interested in using Positive Psychotherapy-based interventions in clinical practice and related research.

The Memoir of a Ghost: The Invisible Plight of Mental Health Nurse Education in the United Kingdom Following the Nursing and Midwifery Council's Move Towards Genericism.

The aim of this paper is to identify barriers to quality mental health nurse education in the United Kingdom and show these through the sharing of personal experiences of working as a mental health nurse academic. Since the Nursing and Midwifery Council introduced their 'future nurse' education standards in 2018, mental health content for mental health nurses has been argued to have been marginalised. The sense of a diluted mental health nurse education was supported by an open letter, signed by over 100 mental health nurses, with representation across 33 universities. Nonetheless, the approach taken by the NMC has been defended. Meanwhile, mental health nurse academics all over the United Kingdom are having varying experiences, some of incredible discomfort and invalidation. The movement 'mental health deserves better' arose through many of these mental health nurses feeling they had no representation or channel to voice their concerns. This is a personal position paper which outlines barriers to autonomy for mental health nurse academics, and shares personal opinion on experiences which have impacted the ability to deliver a depth of knowledge, skill and critical thinking to students, impacting the quality of new mental health nurse graduates. The issue is discussed using contemporary literature to support lines of argument, which are augmented by personal experiences of working in nurse education. There are complex interconnected issues within nurse education which can hinder the autonomy of mental health nursing to decide its own future. This paper recounts a personal journey. Often we cannot understand the failings of a system until we try to navigate it from the inside.

A qualitative study of hermeneutic analysis in individuals with schizophrenia, psychiatrists and psychiatric nurses writings on selected narratives.

WHAT IS KNOWN ON THE SUBJECT?: In daily psychiatric practice, understanding individuals often involves formulating the clinical case, which may lead to viewing them solely as symptoms to be solved. Consequently, it can be challenging to see the individual beyond their symptoms. However, trying to understand the individual by his/her writings about narratives can offer broader perspectives and extend beyond being a medium for patients to express their experiences. On understanding writing, hermeneutics will be a resourceful method. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study aims to propose a reevaluation of the nature of therapeutic communication among individuals with schizophrenia, psychiatrists, and psychiatric nurses by interpreting their writings on the same written narratives through a hermeneutic analysis. Our study has unique features compared to previous studies on communication between mental health professionals and patients. We directly investigated the act of understanding through the writings of the three groups of participants. The participants were also engaged in reading and writing about the narratives instead of relying on clinical interviews or self-report questionnaires. To the best of our knowledge, our study is the first hermeneutic study to examine the nature of reflection while all three groups encounter the same narratives as readers. IMPLICATIONS FOR PRACTICE?: The results point to the need for psychiatrists/psychiatric nurses to develop new perspectives and skills in understanding/interacting with individuals with schizophrenia. Our study could be a pioneer sample in applying hermeneutics as a prevailing method to mental health nursing practice. ABSTRACT: INTRODUCTION: Understanding individuals with schizophrenia is an essential but challenging phenomenon in psychiatry. AIM/QUESTION: This study proposes a reevaluation of the nature of therapeutic communication among individuals with schizophrenia, psychiatrists and psychiatric nurses by interpreting their writings on the same written narratives through a hermeneutic analysis. METHOD: In this study, employing a qualitative descriptive methodology utilising hermeneutic analysis, participants read the five narratives, wrote down their opinions on each narratives and answered nine questions to express their own personal writing experiences. RESULTS: Participants from each group acted as both 'readers' and 'authors' while rewriting the selected five short narratives based on their own sense of readings. The expression, rewriting refers to the act of reading and written interpretations of participants and researchers in this study. While individuals with schizophrenia primarily focused on the text (narrative) in their readings and writings, psychiatrists and psychiatric nurses tended to focus on reader (themselves) in their interpretations. DISCUSSION: Although reading should be approached as a process of discovery rather than merely seeking predetermined knowledge, psychiatrists and psychiatric nurses read the narratives as if the author were a patient or as the signs of an illness. IMPLICATIONS FOR PRACTICE: The results point to the need for psychiatrists/psychiatric nurses to develop new perspectives and skills in understanding and interacting with individuals with schizophrenia.

The resilience mediation effect on the relationship of suicide risk and psychological pain in nursing students: Structural equation modelling.

WHAT IS KNOWN ON THE SUBJECT?: Suicide is an important health problem that has been common all over the world in recent years. Nursing students are a high-risk group for suicide. Factors affecting suicide risk should be investigated and included in psychiatric nursing interventions. Psychological pain is a predisposing condition for suicide risk. Studies focus on the relationship between suicide risk and psychological pain. Studies examining the moderator factors affecting this relationship are limited. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: By means of the structural equation model, the effect of resilience mediation on the relationship of suicide risk and psychological pain has been shown. In the process of going from psychological pain to suicide, resilience takes on a buffer function with its mediating effect, and this process can be prevented by the development of resilience. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Resilience can be added as a protective factor for suicide to the practices of psychiatric nursing. Initiatives to strengthen resilience can be added to psychiatric nursing practices. In this way, psychological pain and the risk of suicide can be reduced by strengthening resilience. Psychological pain can be added as a risk factor for suicide to the practices of psychiatric nursing. Within the scope of psychiatric nursing practices, nursing interventions can be structured to assess and reduce psychological pain. Interventions on strategies to manage and cope with psychological pain and initiatives to strengthen resilience can be added to suicide prevention programs created for nursing students. ABSTRACT: INTRODUCTION: Nursing students are a high-risk group for suicide. Psychiatric nurses should investigate risk factors for suicide. AIM: The aim of this study was to examine the resilience mediation effect in the relationship of suicide risk and psychological pain in nursing students. MATERIALS AND METHODS: This cross-sectional study was conducted between March and May 2021 with 619 students in the Akdeniz University Faculty of Nursing. A Descriptive Information Form, the Suicide Probability Scale, the Psychache Scale and the Brief Resilience Scale were used to collect data. The structural equation model approach was used to examine the resilience mediating effect on the relation between suicide risk and psychological pain, and Path Analysis was performed. The reporting of the study was conducted according to STROBE. RESULTS: A semi-mediatory effect of resilience was found between psychological pain and the risk of suicide, and the effect size was determined to be broad (0.57). DISCUSSION: Resilience can be considered as a protective factor for suicide prevention in psychiatric nursing practices. CONCLUSION: Resilience has an effect on the relationship between psychological pain and suicide risk. IMPLICATIONS FOR PRACTICES: The results of this study may guide psychiatric nursing practices in reducing and preventing suicide risk.

Understanding Thai Community Nurses' Experiences of Caring for Psychiatric Patients in Primary Care Units: A Phenomenological Study.

Background: Mental illness has been a significant public health challenge in Thailand, where there is a shortage of specialists. Consequently, community nurses (CNs) who are not specialists have been tasked with enhancing mental health outcomes in the primary care system of the country. This study aims to shed light on CNs' lived experiences of caring for psychiatric patients within the primary care units (PCUs). Methods: A phenomenological research approach and in-depth interviews were conducted with nine CNs responsible for psychiatric patient care purposefully selected at nine PCUs in southern Thailand, including Nakhon Si Thammarat, Krabi, Phangnga, and Chumporn provinces, between March and December 2019. Data analysis was carried out using Colaizzi's method. Results: The experiences of CNs were expressed through three main themes: "Confronting role expansion in long-term psychiatric care responsibilities," "Insecurity in role ambiguity," and "Duty of supportive caring for marginalized people." Conclusion: Thai CNs face significant stress when providing care for psychiatric patients, grappling with their acknowledged lack of specialization and essential expertise in the field. Alongside the issue, they knew that supportive caring for marginalized people is their duty to humanity. Primary care systems must recognize CNs' vital role in enhancing psychiatric patient care. Comprehensive training empowers them, fostering confidence and enabling better connections and care management. This can lead to improved patient outcomes and overall care quality.

Social-ecological barriers and facilitators to seeking inpatient psychiatric care among transgender and nonbinary people: A qualitative descriptive study.

AIM(S): To assess barriers and facilitators to seeking inpatient psychiatric treatment among transgender and nonbinary people. DESIGN: Qualitative interview study. METHODS: Semi-structured interviews were conducted from March 2019 to June 2022 with transgender and nonbinary people admitted to an inpatient psychiatric hospital in the United States during the past 5 years. Data were analysed using thematic analysis and constructed within a modified social-ecological model of stigma. Standards for Reporting Qualitative Research were used for this study. RESULTS: Participants (N = 15) described barriers and facilitators across all three social-ecological levels. i) Individual themes included distrust of the mental healthcare system, feeling unsafe, loss of autonomy, minimizing one's own mental health needs, and feelings of accountability to others. ii) Interpersonal themes included: lack of support for transgender/nonbinary identity, limited transgender/nonbinary knowledge among mental healthcare professionals, and allyship. iii) Structural themes included: carceral setting, financial costs, and availability of non-profit treatment options. CONCLUSION: Multi-level themes were identified as barriers and facilitators to seeking inpatient psychiatric care for transgender and nonbinary people, providing opportunities among inpatient settings to improve care delivery and engagement. Greater health equity can be achieved by addressing barriers to care. IMPLICATIONS: Incorporating inclusive and affirming practices in inpatient psychiatric services presents an opportunity to reduce barriers to seeking care. IMPACT: The present study describes the experiences of transgender and nonbinary people as they determine whether to voluntarily seek inpatient psychiatric treatment. This perspective allows nurses, health systems, and policymakers to integrate transgender and nonbinary people's needs to improve healthcare delivery. PATIENT/PUBLIC CONTRIBUTION: Transgender and nonbinary participants were recruited in collaboration with community organizations. Members of the transgender and nonbinary community participated in study design development and analysis and were part of the study team.

Nurse Strategies to Improve the Quality of Psychosocial Care During the COVID-19 Pandemic.

Background: Nurses play a critical role in combating the COVID-19 pandemic, facing numerous challenges in providing care to COVID-19 patients, particularly addressing their psychological issues. This study aims to explore nurses' experiences in overcoming care challenges and enhancing nursing strategies. The study was held in Indonesia. Materials and Methods: Primary nurses and nurse managers responsible for COVID-19 patient care were interviewed extensively for data collection. The Collaizi method was used for data processing. Results: The study identified three key themes: psychosocial nursing interventions, addressing obstacles in psychosocial care, and enhancing the quality of psychosocial nursing care. Conclusions: Comprehensive nursing care proves effective in addressing the psychosocial challenges faced by COVID-19 patients.

Developing evidence-based medication therapy management tools for psychiatric nurses: An evaluative qualitative case study.

RATIONALE, AIMS AND OBJECTIVES: Clinical use of psychotropic medications involves diverse risks, addressable by nursing interventions. The research had a dual purpose: developing an "Evidence-Based Medication Therapy Management Guideline" and a "Medication Administration-Tracking Chart" and evaluating their use through an evaluative case study. METHODS: Evidence-based guideline and chart development and evaluative case study. Initially, Evidence-Based Medication Therapy Management Guideline and Medication Administration Tracking Chart for managing medication in a psychiatric unit were developed. Subsequently, their efficacy was evaluated in a case study involving 10 participating nurses used in the psychiatric unit with 123-bed of a training and research hospital in Turkey. Data was collected through personal forms, interviews, medication charts, and researcher observations, and the analysis employed Merriam's case study method. RESULTS: Three themes (inception, implementation, termination, and sustainers) and 12 sub-themes emerged. Nurses stated that the research tools filled their information gaps, enhancing the medication therapy management process's effectiveness and safety, improving nursing care quality and continuity, and benefiting patient outcomes. Nurses expressed a desire to consistently use the tools in the unit and provided suggestions. CONCLUSION: Nurses highlighted the tools' potential to enhance medication safety, psychiatric care, and patient outcomes. However, their stance on using evidence-based tools revealed an approach/avoidance conflict, balancing benefits and barriers. Experience emerged as a hindrance in embracing evidence-based clinical tools. This study is among the first to comprehensively develop evidence-based medication management guideline and administration-tracking chart for psychiatric nurses globally and in our country. Routine use of the tools is expected to enhance nurses' expertise in psychotropic medication management, leading to improved patient outcomes in medication-related aspects.

Experience of violence, social support, nursing practice environment, and burnout on mental health among mental health nurses in South Korea: A structural equation modeling analysis.

AIMS: This study examined the relationship between the experience of violence, social support, nursing practice environment, and mental health among South Korean mental health nurses. METHODS: Structured questionnaires were distributed to participants who worked in twelve mental health hospitals, each with at least 200 beds, in South Korea. We analyzed 243 questionnaires and used AMOS 25.0 to explore the relationships between the constructs. RESULTS: The total and indirect effects of the experience of violence and of social support on mental health were significant. The effects of burnout and of the nursing practice environment on mental health were positively significant. Burnout revealed a mediating association with the relationship between the experience of violence, social support, and mental health. CONCLUSION: The study confirmed that the experience of violence negatively affects burnout among mental health nurses, while social support relieves burnout and strengthens mental health. IMPLEMENTATION: Our research model shows that the experience of violence could affect burnout and mental health among mental health nurses. Therefore, nursing administrators should develop violence prevention policies and manuals for coping with the violence that can frequently occur in psychiatric wards.

Psychoeducation group facilitation training for nurses: A quality improvement project.

BACKGROUND: According to the 2020-2021 National Survey of Children's Health, 23.3% of children and adolescents met criteria for one or more mental, emotional, developmental, or behavioral problems. However, the prevalence of depression, anxiety, and post traumatic stress disorder have risen dramatically since the COVID-19 pandemic, leading to an increase in suicidal ideations, completed suicides, and pediatric psychiatric hospitalizations. There is a critical need for high quality mental healthcare treatments, including psychoeducation. Inpatient psychiatric nurses are well positioned to lead psychoeducation groups, but few receive training. LOCAL PROBLEM: Nurses at a designated inpatient pediatric psychiatric unit expressed discomfort in facilitating psychoeducation groups. METHODS: This is a one-group prepost and follow-up quality improvement study designed to improve the quality of psychoeducation group facilitation skills provided by nurses at a child and adolescent inpatient psychiatric unit. A convenience sample of nurses (N = 16) participated. Baseline (T1), post-test (T2), and follow-up (T3) data were collected regarding nurses' self-efficacy, evidence based-practice attitudes, and knowledge of psychoeducation group facilitation. INTERVENTIONS: Nurses received 45 min of psychoeducation group facilitation education and 15 min of skills simulation. RESULTS: The nurses' knowledge, self-efficacy, and attitudes toward evidence-based practice when facilitating psychoeducation groups increased significantly from the baseline to the post-test, which was sustained from the post-test to the follow-up period. CONCLUSION: Study findings indicate the importance of supporting nurses in their role of psychoeducation group facilitation through education and program structure. Further research is needed to assess longer term sustainability and efficacy in leading psychoeducation groups.

The role of emotional regulation on early child school adjustment outcomes.

Emotional regulation involves managing attention, affect, and behavior, and is essential for long-term health and well-being, including positive school adjustment. The purpose of this secondary data analysis from the Durham Child Health and Development Study was to explore how parent and teacher reported emotional regulation behaviors related to school adjustment outcomes (social skills, academic performance, and academic achievement) during early childhood. Parent and teacher reports on emotional regulation behaviors showed mixed concordance, however they correlated with critical aspects of school adjustment. Clinical and practical implications are discussed, including the role of psychiatric nurses in promoting positive emotional regulation and school adjustment outcomes across settings.

Promoting Spiritual Coping of Family Caregivers of an Adult Relative with Severe Mental Illness: Development and Test of a Nursing Intervention.

Severe mental illness disrupts daily functioning, burdening family caregivers, who often adopt spiritual coping strategies. With comprehensive skills, mental health nurses can promote well-being and mental health. The aim is to develop and test the nursing intervention "promoting spiritual coping" in the family caregivers of home-dwelling people with mental illness. This study was conducted in two distinct stages. Initially, the intervention was developed according to the first phase of the Framework for Developing and Evaluating Complex Interventions. Secondly, the intervention protocol was tested in a mixed-method pilot study. An intervention protocol was developed and tested on ten family caregivers. The intervention comprised three sessions, and before-and-after assessments were conducted. Significant improvements were observed in the outcomes, with caregivers expressing that discussing spirituality and religiosity benefited them. This intervention prioritized the therapeutic relationship of the nurses and family caregivers. The intervention "promoting spiritual coping" was created and evaluated as a suitable approach for mental health nurses to use in a psychotherapeutic context with family caregivers of individuals with mental illness.

Reliability of the Mental Health Nurse Competency Assessment Tool (ECOEnfSM): A pilot study.

AIM: To evaluate the reliability of the ECOEnfSM scale as a tool to assess the professional competencies of Mental Health Nurse Practitioners (MHNP) in their clinical practice. METHOD: A pilot study, observational, descriptive and cross-sectional, focuses on MHNP who have completed their Specialized Health Training Program (SHTP) in Spain. The data were collected by general and collaborators mentors of the Multiprofessional Teaching Units (MTUs). The Mental Health Nursing Competency Assessment Tool (ECOEnfSM) was used, which consists of three subscales and eight Competence Units (CU). A reliability and validity analysis were conducted (Cronbach's alpha and Spearman's correlation coefficient). RESULTS: The Rotation Assessment subscales showed excellent reliability (r > 0.90) with high and very high correlations (r > 0.6) in all UCs with high levels of significance (P < .01). The Annual Assessment subscale showed good reliability (r > 0.80) with a medium and very high correlation (r > 0.4) with high levels of significance (P < .01). All UCs showed a good to excellent consistency (r > 0.80). The "Home Visits" assessment criterion showed heterogeneity of data due to there are few MTUs that fully develop it. CONCLUSION: The ECOEnfSM scale showed very high reliability in MHNP during their training program in Spain. The ECOEnfSM is considered the only objective tool in Spain to assess the professional competencies in this population.

Stakeholder perspectives on continuous observation in inpatient psychiatric wards.

WHAT IS KNOWN ON THE SUBJECT?: Continuous observation is often used in mental health wards to support the safety of service users, where they will be constantly watched by a member of staff. Evidence suggests that continuous observations may be unhelpful and restrictive, but not enough is known about the practice or the best ways to improve it. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This evaluation integrates the perspectives of service users, informal carers and staff to explore current continuous observation experiences and inform future improvements. While previous research highlights the importance of therapeutic engagement, this study additionally emphasizes how the observation procedure could be adapted to individual needs. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Continuous observations could be more beneficial if they are therapeutic, proportional to the level of risk and co-developed with the service user, informal carer and staff. Further training about communication could support staff engagement and the observation process could be formalized to ensure regular collaborative reviews. ABSTRACT: INTRODUCTION: Continuous observation is a frequently used tool to manage high levels of risk on psychiatric wards. However, there is little previous research on its use in practice. AIM: This qualitative service evaluation aims to explore the continuous observation experiences of service users, informal carers and staff in a local NHS Mental Health Trust, informing suggested future improvements to current practice. METHOD: Five service users, three informal carers and seven healthcare staff completed semi-structured interviews, which were thematically analysed to create four themes. RESULTS: Positive interaction and engagement in activities were critical for a therapeutic approach to observations, supporting service users and staff to minimize the unproductive behaviours that can arise. Difficulties balancing safety with privacy could suggest the importance of proportionate and tailored observation procedures for each service user. Ensuring the voices of service users and informal carers remain central to decisions regarding care could further improve the observation experience. IMPLICATIONS FOR PRACTICE: This study highlights therapeutic, proportionate and co-produced observations as key characteristics to improve practice. Further training and formalization of the observation process could foster cultural changes towards more long-term approaches to risk management.

Uncovering Complexities in Reducing Aggression, Conflict and Restrictive Practices in Acute Mental Healthcare Settings: An Overview of Reviews.

Aggression, conflict and restrictive practices present complexities in acute mental health services, as do implementing service changes to reduce them. Existing published literature needs to offer more high-level guidance on the effectiveness of these service changes and their associated implementation factors. As a result, an overview of systematic reviews was undertaken to identify (i) nonpharmacological interventions to reduce conflict, aggression and restrictive practices in acute mental health settings, and (ii) their effects across different clinical outcomes. A parallel re-extraction from primary studies was then utilised (iii) to identify factors influencing successful intervention implementation. Of 124 articles sourced from nine databases and registries, four reviews were retained for the final analysis, using the direction of effect and tabular and narrative summaries. These reviews included programmes or interventions focused on inpatient adolescent, adult and older adult populations. They reported on alternative containment strategies, risk assessments, Safewards, sensory rooms and equipment, Six Core Strategy-based interventions and staff training. The overview found that a combination of interventions intended to improve relationships and reduce interpersonal conflict may help reduce aggression, conflict and restrictive practices. At the same time, stand-alone staff training and sensory rooms and equipment may have mixed effects. The quality of the evidence linking these interventions to reductions in aggression, conflict and restrictive practices is limited. Successful implementation hinges on multiple factors: intervention characteristics, preparation and planning, evaluation and monitoring, outcome interpretation, stakeholder involvement/investment, staff-related factors and contextual factors. Any implementation initiative may benefit from using pragmatic and complexity-informed research methodologies, including integrating meaningful involvement with service users, peer workers and culturally diverse groups.

Mental health nurses' attitudes towards consumers with co-existing mental health and drug and alcohol problems: Adescriptive study.

WHAT IS KNOWN ON THE SUBJECT?: Dual diagnosis is one of the leading causes of disability globally. There is limited evidence on mental health nurses' attitudes towards consumers with dual diagnosis. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Mental health nurses have positive attitudes towards consumers with dual diagnosis. A positive attitude at work is influenced by various factors, including feeling that one's role is appropriate and legitimate. This also includes receiving support in that role, being motivated to work, having confidence in completing tasks and feeling satisfied with one's job. ABSTRACT: BACKGROUND: Dual diagnosis is a global health concern. This descriptive research assessed mental health nurses' attitudes towards consumers with dual diagnosis in Australian mental health settings. The research question was: What is the attitude of mental health nurses towards consumers with co-existing mental health and drug and alcohol problems? MATERIALS AND METHODS: This cross-sectional survey included 103 mental health nurses who work with consumers with dual diagnosis. Participants were recruited from various mental health settings through convenience sampling. The Comorbidity Problems Perceptions Questionnaire was used to assess attitudes. Descriptive data and multiple regression analyses were conducted. We utilized the consensus-based checklist for reporting results of this study. RESULTS: Mental health nurses positively perceived consumers with dual diagnosis. Factors associated with a positive attitude were a higher level of work experience, feeling that one's role is adequate, perceiving one's role as legitimate, receiving increased support in one's position, having high work motivation, possessing high task-specific self-esteem and experiencing higher levels of work satisfaction. Work experience predicted role adequacy. Position predicted role support. The work sector predicted role-related self-esteem. CONCLUSIONS: As mental health nurses gain work experience; they develop positive attitudes that boost their self-esteem and sense of importance towards consumers with dual diagnosis. This constructive mindset also positively affects their work motivation and job satisfaction towards consumers with dual diagnosis. Conducting interventional studies is necessary to examine how clinical experiences, work environments, and job positions can impact attitudes, aiming to improve mental health nursing interventions towards consumers with dual diagnosis. IMPLICATIONS TO PRACTICE: The study found that mental health nurses' positive attitudes towards consumers with dual-diagnosis are influenced by their experience and knowledge. Moreover, mental health nurses who feel supported, motivated and confident in their roles are more likely to provide high-quality care to consumers with dual diagnosis. Mental health nurses could provide better care and support if they took a proactive approach and addressed the challenges associated with this consumer population. To be successful in their roles, mental health nurses require access to resources and support from healthcare organizations. As a result, their job satisfaction and attitudes towards consumers with dual diagnosis will be enhanced. In this way, consumers as well as healthcare organizations will benefit.