Innovations in the teaching-learning process of psychiatric nursing and mental health.

OBJECTIVE: to know innovative pedagogical experiences developed by professors in the teaching of psychiatric nursing and mental health in undergraduate nursing courses at public universities in Rio de Janeiro State. METHOD: based on an ethnomethodological approach, individual semi-structured interviews and document analysis were carried out according to content analysis. RESULTS: despite the heterogeneity in the curriculum distribution of psychiatric nursing's and mental health's knowledge, the themes taught have similarities. The perceptions of innovation are mainly related to interdisciplinary practices and teaching, relational, and care technologies. Innovative teaching practices are focused on the use of active methodologies and collaborative activities. FINAL CONSIDERATIONS: innovating teaching requires creating strategies to teach people how to care for people, valuing human uniqueness. Student participation in health services is the key to the dialogue between knowledge produced in academia and that mobilized in health services.

A model for psychiatric nurses to facilitate the mental health of women living with borderline personality disorder.

BACKGROUND: Borderline personality disorder (BPD) is characterised by emotional dysregulation, feelings of worthlessness, impulsivity, suicidality and poor relationships. As a result of the challenges in the treatment of women living with BPD and the lack of skills from the psychiatric nurse, there was a need to develop a model for psychiatric nurses to facilitate the mental health of women living with BPD. OBJECTIVES: To describe the process that was followed in developing, describing and evaluating a model that could be used as a framework of reference for psychiatric nurses to facilitate the mental health of women living with BPD. METHOD: A theory-generative, qualitative, exploratory, descriptive and contextual study design was used to develop the model. The central concept of the model was derived from a previous study: 'The experiences of women living with borderline personality disorder'. The process entailed the identification of the central concept and other essential criteria, the classification of the central concepts and describing the relationships between the concepts. RESULTS: The central concept was identified as 'facilitation of self-empowerment' of women living with BPD. The concepts 'facilitation' and 'self-empowerment' were defined and classified. The identified and defined central concepts were placed into interrelated statements. The model to facilitate self-empowerment of women living with BPD was developed, described and evaluated. The model has not been implemented. CONCLUSION: The model provides a framework of reference for psychiatric nurses to facilitate self-empowerment of women living with BPD.

Categorías de análisis en los resultados en salud sensibles a la práctica enfermera en salud mental / Analysis categories in patient health outcomes in psychiatric mental health nursing

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"The Future of Nursing: Accelerating gains made to address the continuum of substance use".

PURPOSE: Guided by four key messages from the decade-old Institute of Medicine (IOM) report, "The Future of Nursing," this paper highlights the progress made by the nursing profession in addressing substance use and its related disorders and offers recommendations to sustain and advance efforts to enhance care for persons who use substances, one of the most stigmatized and vulnerable populations. RESULTS: Patterns of substance use have shifted over the past 10 years, but the associated harms remain consequential. As awareness of the continuum of substance use has expanded, the care of persons with substance use has also expanded, from the domains of psychiatric-mental health and addictions nursing specialties to the mainstream of nursing. Now, greater efforts are being undertaken to identify and intervene with persons at risk for and experiencing substance use disorders. Nurses have advanced the knowledge and skills necessary for substance-related nursing care including education and training, leadership, care innovations, and workforce expansion and can drive efforts to increase public knowledge about the health risks associated with substance use. Recommendations aligned with each of the four IOM key messages are offered. CONCLUSIONS: As a profession, nursing has a responsibility to expand the progress made in addressing substance use - from prevention and early intervention to tertiary care. Nurses at all levels of education and practice are in key positions to carry out the recommendations herein to accelerate the changes needed to provide high quality care for persons impacted by substance use.

Nursing in the American Justice System.

Efforts to provide humane care for the mentally ill has led to growth of more suitable services in community-based settings, yet resources are insufficient to meet the needs of mentally ill who interface with the criminal justice system. The resulting collateral damage has created a pathway to prison for massive numbers of impaired individuals, and the inhumane warehousing of thousands of mentally ill people is reminiscent of a century ago. The criminal justice system was never intended to be a safety net for the public mental health system. While advances in expanding the role of the nurse in the healthcare system have shifted because of efforts by nursing's response to the 2010 Institute of Medicine report, the challenges for correctional/custody nursing have not been adequately articulated. This paper seeks to enhance awareness of Correctional Nursing through a discussion of challenges posed to nurses who work at the intersection of justice and public health in prisons, jails, detention centers and community supervision in this response to the Future of Nursing report.

Prevalence and factors of compassion fatigue among Chinese psychiatric nurses: A cross-sectional study.

Compassion fatigue has emerged as a detrimental consequence of experiencing work-related stress among psychiatric nurses, and affected the job performance, emotional and physical health of psychiatric nurses. However, researches on Chinese psychiatric nurses' compassion fatigue are dearth. This cross-sectional study aimed to investigate the prevalence and factors of compassion fatigue among Chinese psychiatric nurses.All participants completed the demographic questionnaire and the Chinese version of Professional Quality of Life Scale (ProQOL-CN). One-way ANOVA, t-tests, Levene test and multiple linear regression analysis were conducted to evaluate factors associated with compassion fatigue.A total of 352 psychiatric nurses in 9 psychiatric hospitals from the Chengdu, Wuhan, and Hefei were surveyed. The mean scores of compassion satisfaction, burnout and secondary traumatic stress were 32.59 ±â€Š7.124, 26.92 ±â€Š6.003 and 25.97 ±â€Š5.365, respectively. Four variables of job satisfaction, exercise, had children, and age range from 36 to 50 years explained 30.7% of the variance in compassion satisfaction. Job satisfaction, sleeping quality, and marital status accounted for 40.4% variables in burnout. Furthermore, job satisfaction, average sleeping quality, and years of nursing experience remained significantly associated with secondary trauma stress, explaining 10.9% of the variance.Compassion satisfaction, burnout and secondary traumatic stress among Chinese psychiatric nurses were at the level of moderate. The higher job satisfaction, healthy lifestyle (high sleep quality and regular exercise), and family support (children, stable and harmonious marital status) positively influenced compassion satisfaction and negatively associated with burnout or secondary traumatic stress.

Mental health nurses' experiences of implementing a model to facilitate self-empowerment in women living with borderline personality disorder in South Africa.

In South Africa, various treatment models from abroad have been implemented for patients diagnosed with borderline personality disorder. This report is based on a South African model that has been developed, implemented, and evaluated for mental health nurses to use in facilitating the self-empowerment of women living with borderline personality disorder. The aim of this study was to describe the implementation of a model to facilitate self-empowerment in women living with borderline personality disorder and to describe mental health nurses' experiences of implementing this model. A qualitative, exploratory, descriptive, and contextual research design was used for the study. Participants were mental health nurses working in an inpatient psychotherapy unit in a mental health hospital. Findings revealed that mental health nurses experienced the model as a secure framework to assist women living with borderline personality disorder in making a shift to being self-empowered. The mental health nurses found that they had to adapt the model's timeframe to the women's own pace. Through use of the model, the mental health nurses also gained self-leadership. This report provides evidence from mental health nurses that the model was practical and helpful in working with women living with borderline personality disorder. The mental health nurses saw signs of self-empowerment in women living with borderline personality disorder.

Exploration of the factors related to self-efficacy among psychiatric nurses.

The average length of hospital stay in the psychiatric ward is longer, and the risk of patient-to-nurse violence is higher than that in other departments. Therefore, psychiatric nurses' work environment may differ from that of other nurses. The factors related to psychiatric nurses' self-efficacy may also differ from those of general workers or other nurses. Mental health care that considers the characteristics of psychiatric nurses requires exploration of self-efficacy unique to psychiatric nurses. This cross-sectional study aimed to explore the distinct factors related to psychiatric nurses' self-efficacy. The developed 24 items related to improvement in self-efficacy and 25 items related to decrease in self-efficacy were examined. The Generalized Self-Efficacy Scale was used to measure the validity of the factors. To extract the factors of self-efficacy, data from 132 nurses and assistant nurses who provided informed consent were analyzed, and the reliability and validity of the factors were calculated. The factors associated with improvement in self-efficacy were "Positive reactions by patients," "Ability to positively change nurse-patient relationship," and "Practicability of appropriate nursing." The factors associated with decrease in self-efficacy were "Uncertainty in psychiatric nursing" and "Nurses' role loss." The Cronbach's α for all factors exceeded .70. Of the five factors, four had significant weak-to-moderate correlations with the Japanese version of the Generalized Self-Efficacy Scale; therefore, the validity was quantitatively confirmed with four factors. Interventions based on these four factors may improve psychiatric nurses' self-efficacy. Additionally, it is possible that this tool assesses the unique facets of self-efficacy rather than psychiatric nurses' general self-efficacy. Interventions to improve psychiatric nurses' self-efficacy based on the characteristics of psychiatry are needed.

Nursing care in mental health based on the TIDAL MODEL: an integrative review.

OBJECTIVES: to identify the applicability of the Phil Barker's Tidal Model in mental health nursing care. METHODS: an integrative literature review carried out by LILACS, MEDLINE, Scopus and Web of Science. Data were collected from December 2017 to March 2018. After selecting the studies, the sample totaled 24 articles. RESULTS: the articles are in English (91.7%), were published in nursing journals (87.5%), are reflective and/or theoretical (50%) and have level of evidence VII (79.2%). The model brings contributions to nursing science, enabling person-centered care, with an emphasis on interdisciplinary work, nurses' protagonism and the empowerment of subjects in mental suffering. FINAL CONSIDERATIONS: the use of the Tidal Model enables changes in nurses practice working in the context of mental health. Its application by nurses who work in mental health services in Brazil is recommended.

El arte de la psicoterapia enfermera / The art of nursing psychotherapy

El progreso y transformación de los cuidados enfermeros en pleno siglo XXI, inherente al propio proceso de globalización y evolución social, conlleva cambios en la educación, formación y capacitación de las enfermeras. Esto da como resultado profesionales cada vez más competentes, eficientes y con autonomía suficiente para dar respuesta a las distintas necesidades de cuidados y requerimientos en salud y bienestar de las personas, familias, grupos sociales. En el ámbito de la práctica y cuidados en salud mental, las transformaciones propuestas en los sistemas sanitarios son claras, debiendo las mismas ser impulsadas por los consumidores, orientadas a la recuperación, basadas en la mejor evidencia disponible y orientadas hacia sistemas coordinados y colaborativos de atención y cuidados. Dentro de esta transformación en los sistemas de atención sanitaria, la psicoterapia enfermera, como competencia avanzada de las enfermeras especialistas, ha venido a consolidar el aporte, compromiso y valor social del cuidado enfermero. El objetivo de este artículo es presentar cómo se ha venido configurando, desde su emergencia, la psicoterapia enfermera en tanto que marco de acción en el quehacer de los cuidados profesionales especializados en salud mental; un recorrido que nos acerca a su conceptualización más internacional para derivar finalmente en la propuesta que desde la Asociación Española de Enfermería de Salud Mental (AEESME) se promueve para su implementación en la Cartera de Servicios del Sistema Nacional de Salud de España

The progress and transformation of nursing care in the middle of the XXI century, attached to the process of globalisation and social development itself, entail changes in education, training and qualification of nurses. As a result, professionals are more and more competent, efficient and with autonomy enough as to meet the various needs for care and the demand for health and welfare of the people, families and social groups. In the field of mental health care practice, there are evident initiatives of transformation in the health system, which ought to be driven by customers, aimed at recovery, evidence-based and directed towards collaborative and coordinated care and assistance systems. Within this process of transformation, and as an advanced competency of nurse specialists, Nurse Psychotherapy has consolidated the contribution, commitment and social value of nursing care. The aim of this article is to shed light on how Nurse Psychotherapy has developed since its inception as a framework for specialized, professional mental health care. Beginning with its international conceptualisation, it then drifts to the proposal promoted by the Spanish Mental Health Nursing Association (AEESME) for its implementation in the portfolio of healthcare Services of the Spanish National Health System

W(h)ither psychiatry? Contemporary challenges in Australian mental health workforce design.

OBJECTIVE: To consider the changing profile of Australia's mental health workforce and the implications, particularly for specialist psychiatry services. METHOD: We analyse data from a national collection that describes changes in the workforce over a decade, to 2017-2018. RESULTS: While single practitioner-based psychological services flourish, other areas of more complex and team-based care are struggling to remain relevant. Psychiatry and mental health nursing, two areas that previously led Australia's response to complex mental illness, are under enormous pressure. CONCLUSION: The shifting balance of specialised mental health workforces is affecting the mental healthcare available in each region of Australia. Questions arise regarding the desired or optimal mix of professionals we wish to deploy. What roles should each professional group play and how should they work together? What does this mean for how various groups should be trained and paid? These data challenge the role specialist psychiatry wishes to play in leading reform. Current mental health reforms risk foundering should psychiatrists fail to take up the challenge of leadership.

Nursing practices in a psychological care center.

OBJECTIVE: To analyze the practices developed by nursing professionals in a Psychosocial Care Center (CAPS). METHOD: A qualitative and evaluative research based on the Fourth Generation Assessment and conducted in a CAPS II of Santa Catarina State in 2014. For data collection, semi-structured interviews, field observation, and data recycling group were used with workers. Constant Comparative Method was used for data analysis. RESULTS: Practices aimed at the subject and their clinical, social, prevention, treatment and articulation with the health network were identified. Medication care is a specificity of nursing that aims to promote autonomy and social reintegration. There is a need for greater articulation between the nursing and pharmacy staff, as well as creating spaces for users to talk about medication. CONCLUSION: Nursing practices are focused on biopsychosocial care, aiming to deconstruct care models focused on the disease and symptoms.

Nurses' experiences of informal coercion on adult psychiatric wards.

BACKGROUND: Informal coercion, that is, situations where caregivers use subtle coercive measures to impose their will on patients, is common in adult psychiatric inpatient care. It has been described as 'a necessary evil', confronting nurses with an ethical dilemma where they need to balance between a wish to do good, and the risk of violating patients' dignity and autonomy. AIM: To describe nurses' experiences of being involved in informal coercion in adult psychiatric inpatient care. RESEARCH DESIGN: The study has a qualitative, inductive design. PARTICIPANTS AND RESEARCH CONTEXT: Semi-structured interviews with 10 Swedish psychiatric nurses were analysed with qualitative content analysis. ETHICAL CONSIDERATIONS: The study was performed in accordance with the Declaration of Helsinki. In line with the Swedish Ethical Review Act, it was also subject to ethical procedures at the university. FINDINGS: Four domains comprise informal coercion as a process over time. These domains contain 11 categories focusing on different experiences involved in the process: Striving to connect, involving others, adjusting to the caring culture, dealing with laws, justifying coercion, waiting for the patient, persuading the patient, negotiating with the patient, using professional power, scrutinizing one's actions and learning together. DISCUSSION: Informal coercion is associated with moral stress as nurses might find themselves torn between a wish to do good for the patient, general practices and 'house rules' in the caring culture. In addition, nurses need to be aware of the asymmetry of the caring relationship, in order to avoid compliance becoming a consequence of patients subordinating to nurse power, rather than a result of mutual understanding. Reflections are thus necessary through the process to promote mutual learning and to avoid violations of patients' dignity and autonomy. CONCLUSION: If there is a need for coercion, that is, if the coercion is found to be an 'unpleasant good', rather than 'necessary evil' considering the consequences for the patient, it should be subject to reflecting and learning together with the patient.

Factors influencing work engagement among psychiatric nurses in Japan.

AIM: To identify the factors influencing work engagement among psychiatric nurses. BACKGROUND: Work engagement is an essential outcome that promotes nurses' performance, but studies investigating its influencing factors remain limited in psychiatric settings. We hypothesized that job resources and personal resources positively predict psychiatric nurses' work engagement and have a particularly positive impact on engagement when job demand is high. METHODS: This cross-sectional study included 425 Japanese psychiatric nurses. Data regarding demographics, job resources, personal resources (emotional intelligence), job demand (patients' attitude towards nurses) and work engagement were collected followed by data analysis using hierarchical multiple regression. RESULTS: Reward, supervisor support, nurse-physician collaboration, other-emotion appraisal and use of emotions were positively related to work engagement. Patients' unpleasant attitude towards nurses boosted the association of reward and supervisor support with work engagement. CONCLUSIONS: Certain job resources, empathic ability and self-motivation ability may enhance work engagement. Furthermore, reward and supervisor support may be particularly useful when psychiatric nurses face patients' unpleasant attitude. IMPLICATIONS FOR NURSING MANAGEMENT: For enhancing psychiatric nurses' work engagement, nursing leaders should educate nurses' skills related to empathy and self-motivation, consider whether nurses are confronted with patients' unpleasant attitude, and improve the job resources.

Nursing practices in a psychological care center / Prácticas de enfermería en el centro de atención psicosocial / Práticas de enfermagem no centro de atenção psicossocial

ABSTRACT Objective: To analyze the practices developed by nursing professionals in a Psychosocial Care Center (CAPS). Method: A qualitative and evaluative research based on the Fourth Generation Assessment and conducted in a CAPS II of Santa Catarina State in 2014. For data collection, semi-structured interviews, field observation, and data recycling group were used with workers. Constant Comparative Method was used for data analysis. Results: Practices aimed at the subject and their clinical, social, prevention, treatment and articulation with the health network were identified. Medication care is a specificity of nursing that aims to promote autonomy and social reintegration. There is a need for greater articulation between the nursing and pharmacy staff, as well as creating spaces for users to talk about medication. Conclusion: Nursing practices are focused on biopsychosocial care, aiming to deconstruct care models focused on the disease and symptoms.

RESUMEN Objetivo: Analizar las prácticas desarrolladas por profesionales de enfermería en un Centro de Atención Psicosocial (CAPS). Método: Investigación cualitativa y evaluativa, basada en la Evaluación de Cuarta Generación, realizada en un CAPS II de Santa Catarina en 2014. Para la recolección de datos, se utilizaron entrevistas semiestructuradas, observación de campo y grupo de reciclaje de datos con los trabajadores. Método comparativo constante se utilizó para el análisis de datos. Resultados: Se identificaron prácticas dirigidas al sujeto y su clínica, social, prevención, tratamiento y articulación con la red de salud. El cuidado de la medicación es una especificidad de la enfermería que tiene como objetivo promover la autonomía y la reintegración social. Existe la necesidad de una mayor articulación entre el personal de enfermería y farmacia, así como la creación de espacios para que los usuarios hablen sobre la medicación. Conclusión: Las prácticas de enfermería se centran en la atención biopsicosocial, con el objetivo de deconstruir modelos de atención centrados en la enfermedad y los síntomas.

RESUMO Objetivo: Analisar as práticas desenvolvidas pelos profissionais de enfermagem em um Centro de Atenção Psicossocial (CAPS). Método: Pesquisa qualitativa e avaliativa, baseada na Avaliação de Quarta Geração, realizada em um CAPS II de Santa Catarina em 2014. Para coleta de dados, utilizaram-se entrevistas semiestruturadas, observação de campo e grupo de reciclagem de dados com os trabalhadores. O Método Comparativo Constante foi utilizado para a análise dos dados. Resultados: Identificaram-se práticas voltadas para o sujeito e seus aspectos clínicos, sociais, de prevenção, tratamento e articulação com a rede de saúde. O cuidado à medicação é uma especificidade da enfermagem que visa promover autonomia e reinserção social. Há necessidade de maior articulação entre a equipe de enfermagem e farmácia, além da criação de espaços aos usuários para falar sobre a medicação. Conclusão: As práticas de enfermagem são voltadas para o cuidado biopsicossocial, visando desconstruir modelos de atenção focados na doença e sintomas.

Nursing care in mental health based on the TIDAL MODEL: an integrative review / Cuidado de enfermería en salud mental fundamentada en el TIDAL MODEL: revisión integrativa / Cuidado de enfermagem em saúde mental fundamentado no TIDAL MODEL: revisão integrativa

ABSTRACT Objectives: to identify the applicability of the Phil Barker's Tidal Model in mental health nursing care. Methods: an integrative literature review carried out by LILACS, MEDLINE, Scopus and Web of Science. Data were collected from December 2017 to March 2018. After selecting the studies, the sample totaled 24 articles. Results: the articles are in English (91.7%), were published in nursing journals (87.5%), are reflective and/or theoretical (50%) and have level of evidence VII (79.2%). The model brings contributions to nursing science, enabling person-centered care, with an emphasis on interdisciplinary work, nurses' protagonism and the empowerment of subjects in mental suffering. Final considerations: the use of the Tidal Model enables changes in nurses practice working in the context of mental health. Its application by nurses who work in mental health services in Brazil is recommended.

RESUMEN Objetivos: identificar la aplicabilidad del modelo de marea de Phil Barker en el cuidado de enfermería en salud mental. Métodos: revisión integradora de la literatura, realizada por las bases de datos LILACS, MEDLINE, Scopus y Web of Science. Los datos se recopilaron de diciembre de 2017 a marzo de 2018. Después de seleccionar los estudios, la muestra totalizó 24 artículos. Resultados: Los artículos están en idioma inglés (91,7%), se publicaron en revistas de enfermería (87,5%), son reflexivos y/o teóricos (50%) y tienen nivel de evidencia VII (79,2%). El modelo aporta contribuciones a la ciencia de enfermería, permitiendo el cuidado centrado en la persona, con énfasis en el trabajo interprofesional, el protagonismo de las enfermeras y el empoderamiento de sujetos en el sufrimiento psíquico. Consideraciones finales: el uso del Tidal Model permite transformaciones en la práctica de las enfermeras que trabajan en el contexto de la salud mental. Recomendamos su aplicación por enfermeras que trabajan en servicios de salud mental en Brasil.

RESUMO Objetivos: identificar a aplicabilidade do Tidal Model, de Phil Barker, no cuidado de enfermagem em Saúde Mental. Métodos: revisão integrativa da literatura, realizada pelas bases LILACS, MEDLINE, Scopus e Web of Science. A coleta dos dados ocorreu em dezembro de 2017 a março de 2018. Após seleção dos estudos, a amostra totalizou 24 artigos. Resultados: os artigos estão na língua inglesa (91,7%), foram publicados em revistas de enfermagem (87,5%), são reflexivos e/ou teóricos (50%) e possuem nível de evidência VII (79,2%). O modelo traz contribuições para a ciência em Enfermagem, possibilitando um cuidado centrado na pessoa, com ênfase no trabalho interprofissional, protagonismo do enfermeiro e empoderamento dos sujeitos em sofrimento psíquico. Considerações finais: o uso do Tidal Model possibilita transformações na prática do enfermeiro que atua no contexto da Saúde Mental. Recomenda-se sua aplicação por enfermeiros que atuam em serviços de Saúde Mental no Brasil.