Barriers and Facilitators to Breast Cancer Screening for Women With Severe Mental Illness.

BACKGROUND: Women with severe mental illness (SMI) are diagnosed with breast cancer at later stages, with greater mortality rates than the general population. Although breast cancer screening is an acknowledged strategy for early breast cancer detection, women with SMI are 32% to 50% less likely to have regular mammography screenings, yet the specific factors related to the disparity in this population have not been determined. AIM: The purpose of this study was to identify the barriers and facilitators toward breast cancer screening in women diagnosed with SMI. METHOD: In collaboration with a community-based mental health services agency, women aged 40 and older, diagnosed with SMI, and treated at that agency, were identified and asked if they were willing to participate. Fifteen women agreed to be interviewed. An interpretive descriptive approach was utilized to analyze the qualitative data. RESULTS: The themes elicited included barriers and facilitators to screening. Barriers found were: Psychiatric Symptoms, Fear, Distrust in the Health care System, and Not my Priority. Among the facilitators were Support, Good Health care Experiences, Make it Easy, Integrated Care, and Self-Care. CONCLUSION: Unique to this study was the understanding by participants that physical health needed to be integrated into their mental health care services through direct support and education, primarily because the process of recovery from mental illness itself entailed the increasing ability for self-care, encompassing a focus on both mental and physical health needs and preventive care.

The Lived Experiences of New Nurses During the COVID-19 Pandemic and Their Contributions to Nursing Education and Professional Development.

Background The COVID-19 pandemic had a major impact on new nurses' transition to the staff nurse role in hospital settings. New staff nurses were not prepared to care for COVID-19 patients based on their previous nursing education. Method A qualitative descriptive design with purposive sampling was used for this study. Twenty-nine new nurses were recruited. They were interviewed using a semi-structured guide to elicit data that were coded and analyzed using content analysis. Results Five themes were identified: "You might have to risk your own life to save others," "I wish I had developed a thicker skin," "There is real world and there is nursing school," "Learning how to handle your own mental health," and "What I would tell them." Conclusion New nurses described their preparedness from baccalaureate education to clinical practice as insufficient in certain areas that were needed in the care of COVID-19 patients. Nurse educators who teach in pre-licensure and hospital orientation programs can revise or expand on the themes voiced by new nurses in order to improve their transition to the staff nurse role. [J Contin Educ Nurs. 2022;53(10):451-459.].

Using digital storytelling to understand service users' mental health recovery and address stigma among nursing students.

PURPOSE: Stigmatized attitudes towards people with mental illness from healthcare providers continues to be a problem affecting recovery in people with mental illness. The process of recovery was explored through digital stories created by service users, with support from nursing students. Stigmatized attitudes in nursing students and stigma resistance in service users were also investigated. DESIGN AND METHODS: A quasi-experimental, mixed-methods, pilot study in which service users/nursing student teams created digital stories. Surveys testing stigmatized attitudes and stigma resistance were employed. FINDINGS: Statistical significance was not found, however, qualitative analysis revealed recovery elements and greater appreciation of individuals with mental illness by the nursing students. PRACTICE IMPLICATIONS: Digital story-telling assists service users in doing the internal work of making meaning from experience. Nursing students benefit from involvement in the activity.

Challenges faced by new nurses during the COVID-19 pandemic.

INTRODUCTION: COVID-19 can be considered a unique and complex form of trauma with potentially devastating consequences for nurses in general and new nurses specifically. Few studies have been published that explain how relatively new nurses were prepared for COVID-19 in terms of knowledge and skill and how these nurses fared physically and emotionally. DESIGN: A qualitative descriptive design utilizing purposive sampling to recruit a diverse group of nurses who were within 2 years post-graduation from nursing school. METHODS: In-depth interviews of 29 nurses were conducted using a semi-structured interview guide to elicit data, which was coded and analyzed using thematic analysis. RESULTS: Six main themes and multiple subthemes were identified in the data. The main themes were: "We were not prepared," "I was just thrown in," "Avoiding infection," "It was so sad," "We did the best we could," and "I learned so much." CONCLUSION: The nurses who participated in this study expressed fear, weariness, exhaustion, isolation, and distress, observations echoed by studies from other countries. Retention of new nurses in acute care settings has always been a concern. In the recent Current Population Survey, a 4% reduction in nurses under 35 years of age has been reported, imperiling the retention of an effective workforce for decades to come. CLINICAL RELEVANCE: A recent report suggests that a larger than expected number of young nurses have left the profession in the wake of the pandemic. Staff shortages threaten the ability of the remaining nurses to do their jobs. This is the time to listen to the needs of new nurses to retain them in the profession and to avoid an even greater shortage in the near future.

The Effects of a Community-Based, Multicomponent, Depression Prevention Intervention in Mothers At-Risk.

The purpose of this study was to develop a 12-week multicomponent, depression prevention pilot intervention and evaluate its feasibility and preliminary effects on improving levels and correlates of depressive symptoms, including anger, self-esteem perceived stress, social support, and racism. A quasi-experimental, mixed-methods design and a community-based participatory research (CBPR) approach was employed. University faculty, students and community residents collaborated at a low-income housing complex in a low-resourced, urban community. Fifteen low-income, ethnic minority mothers ages 23-46 years completed the intervention and evaluation surveys. Eight mothers participated in a focus group. The intervention included social group-dance, health education, and socialization. t-Tests, sign-tests, and thematic analysis was employed. Mothers identified barriers and facilitators of program engagement. Depressive symptoms were significantly reduced (t(14) = 2.41, p = .030). Self-esteem (t(14) = 2.28, p = .039) and social support levels (M = 4.5, p = .035) were significantly increased. This multicomponent intervention is feasible. Preliminary efficacy evidence was mixed.

Using Mindfulness-Informed Photovoice to Explore Stress and Coping in Women Residing in Public Housing in a Low-Resourced Community.

The setting of the current study was an urban city where the majority of public housing residents are single females living in poverty. An adapted women's mindfulness program, including a Photovoice exercise, was offered to this vulnerable population. Stress contributes to poor mental/physical health. A Photovoice research method was used to elucidate the stressors and coping facilitators used by participants. Eleven participants took a digital photography workshop and then photographed stressors and coping facilitators. All 275 photographic submissions were analyzed thematically. Coping themes were: Aesthetics: Man-Made and Natural; Relationships: Pets and People; Self-Esteem and Cultural Identity; and Inspiration Through Religion and Social Media Messaging. Stress themes were: Urban Disarray and Existential Threat/Danger. Results showed that social connectedness, spirituality, improving neighborhood aesthetics, use of social media, and access to nature could support coping. [Journal of Psychosocial Nursing and Mental Health Services, 60(7), 23-31.].

Addressing Ageism and Ethnocultural Diversity With a Photo Essay Project.

BACKGROUND: By 2050, the percentage of older adults in the United States will double. By 2060, nonmajority individuals will comprise nearly half of our older adult population. Therefore, nursing students must have learning experiences that prepare them to care for a diverse population of older adults when they enter practice. METHOD: Photo-elicitation and a photo essay project was initiated in an Aging and Health in Global Communities course in which 75 students created and presented photo essays of a diverse group of older adults. RESULTS: Through spending time with older adults to create a photo essay, students ably portrayed lives rich in meaning and ethnocultural heritage. CONCLUSION: The natural intersection of aging and diversity that occurred in the photo essays enlightened students to the rich experience of age and the similarities and unique differences in the lives of the older people portrayed. [J Nurs Educ. 2021;60(1):44-47.].

Learning about mental healthcare in today's Cuba: An interview with the president of the Cuban society of psychology.

PURPOSE: Little is known about Cuba's mental healthcare system. We present background information and an interview with the President of the Cuban Society of Psychology to learn about current mental healthcare in today's Cuba. CONCLUSIONS: Mental and medical healthcare are free and fully integrated. Early diagnosis and intervention is standard as each patient is known by their community doctor/nurse team from infancy through old age and by yearly home visits. PRACTICE IMPLICATIONS: Free and integrated medical and mental healthcare facilitates early detection and intervention. Individuals in Cuba are assisted in maintaining job and schooling during treatment. Therapy is multimodal and eclectic.

Facilitating Social Integration for People With Severe Mental Illness Served by Assertive Community Treatment.

PURPOSE: This article explores the experience of workers on Assertive Community Treatment (ACT) teams surrounding their efforts to facilitate social integration for their clients. DESIGN AND METHODS: Sixteen workers were individually interviewed and eight additional workers participated in two focus groups. FINDINGS: The formation of caring relationships between worker and client was an important first step towards social integration for ACT clients. Community activities offer opportunities for social interaction. PRACTICE IMPLICATIONS: The frequency of community based activities should be increased. Social integration should be a targeted focus of service by structurally embedding a social integration specialist onto the ACT model.

Clinical Use of an Autovideography Intervention to Support Recovery in Individuals with Severe Mental Illness.

The current authors introduced an innovative autovideography intervention asking mental health consumers to use video cameras for 1 month to tell about their recovery. The research approach was based on a participatory research model with workers and consumers of a recovery education center fully involved with the study design and implementation. Twelve individuals who had graduated from a recovery program participated. The participant-produced videos were qualitatively analyzed using thematic analysis. The use of autovideography was found to be feasible and can be used clinically to support the process of recovery by providing opportunities for reciprocity, self-reflection, and advocacy. Consumer-produced videos provide a voice to inform others with and without mental illness about the concerns of individuals with mental illness and the process of recovery. [Journal of Psychosocial Nursing and Mental Health Services, 54(5), 33-40.].

Autovideography: The Lived Experience of Recovery for Adults with Serious Mental Illness.

Mental health services have been transforming toward a recovery orientation for more than a decade, yet a robust understanding of recovery eludes many providers, and consensus on a conceptual definition has yet to be reached. This article examines mental health consumers' lived experience of recovery and evaluates the usefulness and comprehensiveness of CHIME, a major framework conceptually defining recovery for adults with serious mental illness. Researchers partnered with a mental health association in a major US city to engage in research with graduates of a recovery and education class for adults diagnosed with serious mental illness. Twelve participants were loaned video cameras and invited to "Tell us about your recovery" through autovideography. Of the 12 participants, six produced videos directly responding to the overall research question and were subsequently included in the present analysis. Data were analyzed thematically, and CHIME adequately represented the major domains presented in consumer videos with two notable modifications: subdomains of "reciprocity" within relationships and "contributing to others" were added to comprehensively represent consumer perspectives about recovery. Adding two subdomains to CHIME more effectively represents consumer narratives about recovery, contributes to the social construction of the personhood of people with serious mental illness, and offers a more robust description of the process of recovery.

The phenomenon of social isolation in the severely mentally ill.

PURPOSE: The phenomenon of social isolation is closely linked with the experience of having a severe mental illness (SMI). This paper offers scholarly perspectives and analyses of the phenomenon of social isolation as it applies to people with SMI by highlighting relevant definitional, historical, theoretical, and conceptual understanding surrounding this phenomenon. CONCLUSIONS: Stigma, alienation, and existential loneliness when taken together provide an understanding of the multidimensional problem of social isolation for people with SMI. PRACTICE IMPLICATIONS: Mental health services should be provided which take into account the importance of human contact and social connection for people who live with SMI. Services can be offered which are designed to develop social skills, as well as to create opportunities for social connection and community involvement.

Photo elicitation: enhancing learning in the affective domain.

This column offers tips for using photo essays in both traditional and online learning settings.