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Autistic children and adolescents experience a range of co-morbidities, including diagnoses of mental illness. Animal-assisted therapies have advanced rapidly over recent years as an effective and accessible intervention for autistic children and adolescents with various health issues. Horses offer a unique opportunity for interaction as the young person can physically ride the animal, thus creating a therapy with different physical interactions from other animals. This qualitative study had two main aims: first, to understand parents' experiences of their autistic child's involvement with horse-based therapies; and second, to understand the experiences of the staff of organisations offering horse-based therapies to those on the autism spectrum. Twelve interviews were conducted with six parents across four interviews (four mothers and two fathers), and eight staff of equine therapy services in eight individual interviews, to understand their perceptions of the child's experience with horse riding and the perceived mental health impacts. Three emergent themes were prominent among parents and service providers alike: physical and social benefits, including health, self-management skills and social skills; protecting mental health; and recommendations for improvements and accessibility of horse-based therapies. Specifically, service providers with long-standing associations with horse-based therapies saw the actual and potential benefits of horse-based therapies for autistic children, particularly in promoting happiness, calm, resilience, and good mental health.
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Animals are increasingly being utilized to assist with therapies for people with various health conditions. Horses are often used as a mechanism of engagement and development for autistic children and adolescents. Horses offer a unique opportunity for interaction as the child or adolescent can physically ride and interact with the animal, thus creating a therapy that involves contact that is different to other animals. Benefits derived from equine-assisted therapies can be physical, social, behavioral, emotional, sensory, and cognitive. However, a current and specific research gap exists in understanding the potential mental health impacts of horse riding on autistic children and adolescents, as perceived and experienced by their parents, carers, and horse-riding service providers. This scoping review examined research on parents' and service providers' perceptions of the benefits of horse-related therapies, with a particular focus on perceptions of positive mental health impacts. A comprehensive electronic search across PubMed, Scopus and Cumulative Index to Nursing and Allied Health Literature identified 16 articles from 15 studies which met the inclusion criteria. Findings included non-mental health-related benefits (as perceived by parents and service providers), mental health-related benefits (as perceived by parents and service providers), benefits for those other than the child/adolescent, and limitations of equine-assisted therapies. With the increased use of equine therapy, and the mounting evidence of its positive impacts on mental health, it is timely to expand research on how to better harness interventions and maximize the mental health benefits for autistic children and adolescents.
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Encompassing many crafts, needlecraft has been popular, particularly amongst women, for centuries. This scoping review mapped and explored primary research on sewing, crocheting, knitting, lacemaking, embroidery and quilting and its impact on mental health and well-being. A comprehensive systematic search across PubMed, CINAHL, Scopus and Google Scholar was conducted in January 2024, identifying 25 studies that met the inclusion criteria. Four themes (and 15 subthemes) emerged from the data: (1) mental well-being; (2) social connection, sense of value and belonging; (3) sense of purpose, achievement and satisfaction; and (4) self-identity, family, culture and legacy. The review showed that needlecraft has an overwhelmingly positive effect on mental health and general well-being. This scoping review may be used to inform mental health nurses and other professionals of the benefits of needlecraft for a wide variety of consumers and may also find application in the well-being of healthcare workers.
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Autistic students experience elevated rates of school exclusion, whether this be through expulsion, suspension, informal suspension, refusal of enrolment, or school refusal. This exclusion can come about from a range of factors, including sensory or cognitive overload, a lack of training in neurodiversity for teachers, an absent sense of safety by the student at school, or poor attitudes towards the inclusion of autistic students in schools. The impacts of this exclusion on parents can be logistical, financial, and psychological, with a range of mental health outcomes. This Australian qualitative study presents case studies of seven parents of autistic students, as well as four themes that capture the recommendations of parents to address school exclusion. The findings demonstrate that parents experience stress in finding a suitable school for their child, working with staff to meet the needs of the child, and attempting to maintain employment and other commitments when the child experiences exclusion. Parents recommend greater acceptance of autism by education systems, better communication and use of neuro-affirming language, the option for flexible learning, and individualised support by the school for the student.
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Padres , Investigación Cualitativa , Humanos , Padres/psicología , Padres/educación , Australia , Niño , Masculino , Femenino , Adulto , Trastorno Autístico/psicología , Adolescente , Instituciones Académicas , Estudiantes/psicologíaRESUMEN
Despite legislative and policy mechanisms that promote inclusion in education for children with disabilities, many students still experience exclusion from the education setting. For example, autistic children are more likely than their neurotypical counterparts to be expelled or suspended from school or to refuse to attend school on an ongoing basis. This situation gives rise to various challenges for their parents. This discursive paper synthesizes current knowledge on school exclusion involving autistic children, including the causes and consequences of exclusionary practices. The paper also considers the negative impacts of these exclusionary practices on the emotional and psychological well-being of parents and caregivers. Mental health nurses who understand the issues related to school exclusion can better support the educational, social, and developmental needs of autistic children and the mental health needs of parents or caregivers.
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Trastorno Autístico , Salud Mental , Niño , Humanos , Padres , Estudios Longitudinales , Instituciones AcadémicasRESUMEN
OBJECTIVES: Up to a quarter of the world's population experience chronic pain, which, in addition to interfering with daily activities and waking function, is often associated with poor sleep. Individuals experiencing poor sleep are often encouraged to implement sleep hygiene strategies. However, current sleep hygiene strategies have not been developed considering the unique challenges faced by individuals with chronic pain and therefore they might not be as effective in this population. The aim of this scoping review is to map the state of the existing literature examining sleep hygiene strategies in individuals with chronic pain. DESIGN: This scoping review included a search of four online databases (Medline, Embase, PsycINFO and CINAHL) to identify articles examining the use of sleep hygiene strategies in populations with chronic pain. RESULTS: Thirty articles investigated at least one sleep hygiene strategy in individuals with chronic pain, with improvements to sleep reported for six sleep hygiene strategies (education, exercise, limiting alcohol use, limiting tobacco use, prebed state and sleep environment). However, the timing of these strategies was often not reported which limits the degree to which these strategies can be generalised for use as a presleep strategy. CONCLUSION: This scoping review examined the existing literature focusing on sleep hygiene strategies for people with chronic pain. There are limitations to the methodology of the existing literature and gaps in our understanding of sleep hygiene strategies in some chronic pain conditions that must be addressed in future research before the effectiveness of these strategies can be understood.
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Dolor Crónico , Higiene del Sueño , Humanos , Dolor Crónico/terapia , Sueño , Consumo de Bebidas Alcohólicas , Enfermedad CrónicaRESUMEN
INTRODUCTION: People living with complex regional pain syndrome (CRPS), a rare chronic pain disorder, must become experts in their own self-management. Listening to the voice of the patient is often advocated in the pain literature. However, the patient's option is rarely asked for or considered by clinicians, even when they live with a condition that health professionals have rarely heard of. PURPOSE: To explore what people living with complex regional pain syndrome (CRPS) think health professionals should know about their condition to provide appropriate care. DESIGN: A heuristic, hermeneutic phenomenological study was conducted asking people about their experiences living with CRPS. This paper reports on the findings of an additional question asked of all participants. PARTICIPANTS: Seventeen people living with complex regional pain syndrome were interviewed. FINDINGS: Overwhelmingly, participants felt that health professionals do not know enough about CRPS, or chronic pain and believe their health outcomes are affected by this lack of knowledge. Sub-themes identified were don't touch unless I say it is okay; be patient with the patient/ it is important to develop a relationship; educate yourself and educate the patient; choose your words carefully and refer to others as needed. An additional theme, it is very hard to describe CRPS was also identified. CONCLUSIONS: Including patients as a member of the healthcare team is recommended to help people take control and self-manage their pain. For true patient centered care to be achieved, health professionals must accept and respect patients' descriptions of pain and their pain experience. This may require additional health professional education at both undergraduate and post-graduate levels in pain and communication to increase their bedside manner and therapeutic communication to deliver care in partnership with the patient.
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Dolor Crónico , Síndromes de Dolor Regional Complejo , Comunicación , Síndromes de Dolor Regional Complejo/terapia , Personal de Salud , Humanos , Atención Dirigida al PacienteRESUMEN
OBJECTIVE: To discover if nursing students have improved their level of pain knowledge and their attitudes towards pain management over the last 20 years. DESIGN: Systematic review utilising the Kable, Pich, and Maslin-Prothero 12 step approach to document a search strategy. DATA SOURCES: A search was conducted from 2000 to 2020 using CINAHL, PubMed, Embase and ProQuest. REVIEW METHODS: Studies exploring the level of pain management knowledge and attitudes of nursing students were included. The Critical Review Form - Quantitative Studies provided the appraisal framework (Law et al., 1998). A narrative synthesis of eligible studies was undertaken. RESULTS: Six studies with a total of 1454 participants were included. The studies demonstrated that nursing students have not improved their level of pain knowledge and attitudes towards pain management in the last 20 years. Whilst many nursing students thought they possessed adequate pain knowledge, the studies all demonstrated that their pain knowledge is lacking and that they do not have appropriate attitudes towards pain. Students did not recognise the patient who was not grimacing as being in pain despite the patient report of pain. CONCLUSIONS: These findings support the notion that nursing education does not include sufficient focus on pain identification and management. Alignment of nursing pain education with the curriculum developed in 1993 by the International Association for the Study of Pain is needed to ensure nurses have appropriate knowledge so that patients can receive effective pain management.
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Enfermeras y Enfermeros , Estudiantes de Enfermería , Actitud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Dolor , Manejo del DolorRESUMEN
Complex regional pain syndrome (CRPS) has never comprehensively been examined from a lived experience perspective. Patients generally have a poorer quality of life than people with other chronic pain conditions. This study aimed to understand the essence of living with CRPS. Data were collected from 17 patients via in-depth interviews. Hermeneutic discussions with four health professionals generated deeper insights. Internet blogs and a book containing patient stories were included for theme verification and triangulation. CRPS is seen as a war-like experience and five themes were identified within the battle: "dealing with the unknown enemy", "building an armoury against a moving target", "battles within the war", "developing battle plans with allies" and "warrior or prisoner of war". Patients live with a chronic pain condition and experience problems unique to CRPS such as fear of pain extending to other parts of their body. Use of the model generated by this research may assist patient/clinician interactions and guide therapeutic discussions. Support for people living with CRPS does not always exist, and some healthcare professionals require additional education about the condition. Better health outcomes are experienced by patients when their personal situation and experiences are heard and understood by health care professionals. PERSPECTIVE: This article presents the lived experience of CRPS. This information and the model generated can help clinicians to better understand their patients and deliver appropriate patient-centered care.
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Dolor Crónico/psicología , Síndromes de Dolor Regional Complejo/psicología , Relaciones Profesional-Paciente , Adulto , Humanos , Narrativas Personales como Asunto , Investigación CualitativaRESUMEN
BACKGROUND: The positive effect of the Geriatric Emergency Department Intervention (GEDI) model, on the outcomes of frail older adults, is established. This study aimed to describe and evaluate the structures and processes required for the effective delivery of the GEDI model to assist in its potential translation into emergency departments in Australia and overseas. METHODS: This was a descriptive qualitative study. Twenty-four semi-structured interviews were conducted with emergency department staff and GEDI doctors and nurses from a regional hospital in Queensland, Australia. An a priori framework guided interview questions and analysis. RESULTS: Structures required for successful model deployment included having an emergency department physician champion and nurses with gerontology experience, adequate funding, and geriatric specific resources. Processes identified as fundamental to the GEDI model included having a targeted approach to assessment, a patient-centred approach to care, and staff with inter-facility, intra-facility and inter-personal communication skills. CONCLUSIONS: The GEDI model addresses the specific care needs of our aging population. For optimal performance of the model, key structures and processes require identification and acknowledgement. Research involving qualitative methodology is vital for successful translation and integration of emergency department models of care.