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1.
J Psychosoc Nurs Ment Health Serv ; 58(11): 9-12, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33119116

RESUMO

The COVID-19 pandemic has changed psychopharmacological prescribing and management of patients around the world. Social distancing requirements led to a transition from face-to-face patient visits to telepsychiatry. Relaxed federal reimbursement policies during the COVID-19 pandemic expanded patient awareness and access to virtual care. For many psychiatric advanced practice RNs (APRNs), the transition to telepsychiatry was intended as a temporary solution until it is possible to return to in-person patient care. Instead, virtual care has become an expectation of patients and agencies. The current article presents a case study example of an adolescent psychiatric patient, exploring the challenges of therapeutic alliance, patient engagement, psychiatric evaluation, laboratory orders, deprescribing, and psychopharmacological adherence. The case study discusses considerations for APRNs who use telemental health in child and adolescent psychiatry and resources for clinical practice. [Journal of Psychosocial Nursing and Mental Health Services, 58(11), 9-12.].


Assuntos
Transtornos Mentais/terapia , Participação do Paciente/métodos , Participação do Paciente/psicologia , Enfermagem Psiquiátrica/métodos , Psiquiatria/métodos , Telemedicina/métodos , Adolescente , Humanos , Masculino , Transtornos Mentais/psicologia
2.
Curationis ; 43(1): e1-e7, 2020 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-32787430

RESUMO

BACKGROUND: Nurses are exposed to stress when working in the mental health care environment. This may be because of nurses being frontline health care providers. They develop close interpersonal relationships with mental health care users (MHCUs), which is inherent in the type of care that is provided. Mental health nursing may therefore be demanding and stressful, which could render mental health nurses susceptible to burnout. OBJECTIVES: To determine the prevalence of burnout among nurses working at a selected psychiatric hospital in the Western Cape. METHODS: A quantitative, descriptive, survey design, by using simple random sampling was used to select 198 nurses employed at a psychiatric hospital in the Western Cape, South Africa. Maslach Burnout Inventory-Human Services Survey measuring emotional exhaustion, depersonalisation and personal accomplishment was used to collect the data. Domain scores were calculated, and the influence of the demographic variables on the domains was tested with independent samples Kruskal-Wallis tests and Mann-Whitney U tests. RESULTS: The study had a 100% response rate. Most of the respondents experienced low emotional exhaustion, low depersonalisation and high personal accomplishment. Enrolled nursing assistants reported significantly higher emotional exhaustion than did the advanced psychiatric nurses and professional registered nurses. Respondents with more than 5 years of experience scored significantly higher in depersonalisation. No respondents met the criteria for burnout on all three domains. CONCLUSION: Maintaining a safe working environment with adequate nursing staff is recommended. Strategies to prevent burnout in the future include the provision of resources and the promotion of open communication between staff and management.


Assuntos
Esgotamento Profissional/etiologia , Enfermeiras e Enfermeiros/psicologia , Prevalência , Adulto , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Feminino , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/normas , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Enfermagem Psiquiátrica/métodos , Enfermagem Psiquiátrica/normas , Enfermagem Psiquiátrica/estatística & dados numéricos , África do Sul , Inquéritos e Questionários
3.
Curationis ; 43(1): e1-e9, 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-32633990

RESUMO

BACKGROUND: According to the World Health Organization (WHO), up to 25% of people worldwide will develop mental health disorders during their lifetime. Patients admitted to acute inpatient units for mood disorders experience emotional distress. Group therapy has the potential to foster the therapeutic change through specific therapeutic mechanisms. Psychiatric nurses working in inpatient units are in a unique position to offer group therapy. OBJECTIVES: Explore and describe stabilised acute psychiatric patients with mood disorders' lived experiences of group therapy facilitated by psychiatric nurses. Make specific recommendations for psychiatric nurses to facilitate constructive group therapy for stabilised acute psychiatric patients with mood disorders in an inpatient unit. METHOD: A qualitative, exploratory, descriptive and contextual design was used in the study. A purposive sample of all patients with mood disorders older than 18 years admitted to inpatient units who participated in group therapy was made. Data were collected through conducting phenomenological interviews, observation and field notes. Interviews focussed on the following open question: 'How did you experience group therapy facilitated by the psychiatric nurses?' An independent coder analysed the data by using thematic coding. Measures to ensure trustworthiness were applied. The following four ethical principles were adhered to: autonomy, non-maleficence, beneficence and justice. RESULTS: Three themes emerged from this study. Theme 1 entailed the psychological experiences of patients attending group therapy. Theme 2 highlighted the interpersonal experiences of patients. Theme 3 evolved around patients' experiences outside group therapy. Patients initially experienced attending group therapy as anxiety provoking. However, negative psychological experiences soon transformed into positive psychological experiences. CONCLUSION: The findings of this study were used to make specific recommendations to facilitate constructive group therapy for patients with mood disorders.


Assuntos
Acontecimentos que Mudam a Vida , Transtornos do Humor/terapia , Psicoterapia de Grupo/normas , Adulto , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Relações Enfermeiro-Paciente , Enfermagem Psiquiátrica/métodos , Enfermagem Psiquiátrica/normas , Enfermagem Psiquiátrica/estatística & dados numéricos , Psicoterapia de Grupo/métodos , Psicoterapia de Grupo/estatística & dados numéricos , Pesquisa Qualitativa , África do Sul
4.
Medicine (Baltimore) ; 99(29): e21083, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702852

RESUMO

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.


Assuntos
Fadiga por Compaixão/etiologia , Enfermeiras e Enfermeiros/psicologia , Enfermagem Psiquiátrica/normas , Adolescente , Adulto , Análise de Variância , China/epidemiologia , Fadiga por Compaixão/epidemiologia , Fadiga por Compaixão/psicologia , Estudos Transversais , Feminino , Humanos , Satisfação no Emprego , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/tendências , Prevalência , Enfermagem Psiquiátrica/métodos , Enfermagem Psiquiátrica/tendências , Qualidade de Vida/psicologia , Inquéritos e Questionários
5.
J Clin Nurs ; 29(17-18): 3435-3444, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32562579

RESUMO

AIMS AND OBJECTIVES: To identify and describe nursing interventions in patient documentation in adult psychiatric outpatient setting and to explore the potential for using the Nursing Interventions Classification in documentation in this setting. BACKGROUND: Documentation is an important part of nurses' work, and in the psychiatric outpatient care setting, it can be time-consuming. Only very few research reports are available on nursing documentation in this care setting. METHODS: A qualitative analysis of secondary data consisting of nursing documentation for 79 patients in four outpatient units (years 2016-2017). The data consisted of 1,150 free-text entries describing a contact or an attempted contact with 79 patients, their family members or supporting networks and 17 nursing care summaries. Deductive and inductive content analysis was used. SRQR guideline was used for reporting. RESULTS: We identified 71 different nursing interventions, 64 of which are described in the Nursing Interventions Classification. Surveillance and Care Coordination were the most common interventions. The analysis revealed two perspectives which challenge the use of the classification: the problem of overlapping interventions and the difficulty of naming group-based interventions. CONCLUSION: There is an urgent need to improve patient documentation in the adult psychiatric outpatient care setting, and standardised nursing terminologies such as the Nursing Interventions Classification could be a solution to this. However, the problems of overlapping interventions and naming group-based interventions suggest that the classification needs to be further developed before it can fully support the systematic documentation of nursing interventions in the psychiatric outpatient care setting. RELEVANCE TO CLINICAL PRACTICE: This study describes possibilities of using a systematic nursing language to describe the interventions nurses use in the adult psychiatric outpatient setting. It also describes problems in the current free text-based documentation.


Assuntos
Documentação/normas , Registros de Enfermagem/normas , Terminologia Padronizada em Enfermagem , Adulto , Assistência Ambulatorial/normas , Humanos , Enfermagem Psiquiátrica/métodos , Pesquisa Qualitativa
6.
Metas enferm ; 23(5): 49-60, jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194589

RESUMO

OBJETIVO: diseñar y validar la Escala de Predicción y Evaluación de Riesgo de Violencia (EPERV-55) en personas con trastorno mental grave (TMG) hospitalizadas en unidades de media y larga estancia. MÉTODO: se elaboró un cuestionario EPERV-55, con 55 ítems, en función de la literatura revisada y del conocimiento del equipo investigador sobre diferentes herramientas de predicción y evaluación de violencia en TMG. Se integraron datos clínicos de predicción y de gestión del riesgo, incluyendo la taxonomía NANDA/NOC. Para la validez de constructo se obtuvieron datos de pacientes ingresados en Unidades de Salud Mental del Hospital Parc Sanitari Sant Joan de Déu (Barcelona). Se valoró la consistencia interna de la escala con el coeficiente alfa de Cronbach. La validez convergente se evaluó mediante el coeficiente de correlación de Rho de Spearman comparando la EPERV-55 con la Escala de Riesgo de Violencia de Plutchik. Para medir la sensibilidad y especificidad se utilizó el test U de Mann-Whitney. Los análisis se realizaron con los programas estadísticos R 2.13 y SPSS 19. RESULTADOS: participaron 177 sujetos. A escala presentó un alpha de Cronbach de 0,92. La fiabilidad test-retest fue buena en 23 ítems de la escala y moderado en 32 ítems. La validez convergente fue significativa con las escalas EPERV-55-RV (correl. Spearman: -0,348 y -0,458 respectivamente; p < 0,001). En la sensibilidad y especificidad se objetivaron diferencias significativas en violencia general (p < 0,004) y violencia heteroagresiva (p < 0,005). El índice de la curva de Roc fue significativa en violencia heteroagresiva, hacia objetos y general. CONCLUSIONES: la escala EPERV-55 es un instrumento válido para evaluar y predecir el riesgo de violencia en personas con TMG hospitalizadas en unidades de media y larga estancia


OBJECTIVE: to design and validate the Violence Risk Prediction and Assessment Scale (EPERV-55) in persons with severe mental disorder (SMD) hospitalized in medium and long-stay units. METHOD: an EPERV-55 questionnaire was prepared, including 55 items, based on the literature reviewed and the knowledge by the research team about different tools for violence prediction and evaluation in SMD. Clinical data on risk prediction and management were incorporated, including the NANDA/NOC taxonomy. For construction validity, data were collected from patients hospitalized in Mental Health Units of the Hospital Parc Sanitari Sant Joan de Déu (Barcelona). The internal consistency of the scale was assessed with Cronbach's Alpha Coefficient. Convergent validity was evaluated through Spearman's Rho Correlation Coefficient, comparing EPERV-55 vs. the Violence Risk Scale by Plutchik. Mann-Whitney's U Test was used in order to measure sensitivity and specificity; analyses were conducted with the R 2.13 and SPSS 19 statistic programs. RESULTS: the study included 177 subjects. The model presented 0.92 in Cronbach's alpha. Test-retest accuracy was good in 23 items of the scale, and moderate in 32 items. Convergent validity was significant with the EPERV-55-RV scales (Spearman's Correlation: -0.348 and -0.458 respectively; p < 0.001). Regarding sensitivity and specificity, significant differences were observed in Overall Violence (p < 0.004) and Hetero-aggressive Violence (p < 0.005). The Roc Curve index was significant in Hetero-aggressive Violence, against objects, and general. CONCLUSIONS: the EPERV-55 scale is a valid tool to evaluate and predict the risk of violence in persons with SMD hospitalized in medium and long-stay units


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Previsões , Escalas de Graduação Psiquiátrica , Violência/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Enfermagem Psiquiátrica/métodos , Transtornos Mentais/enfermagem , Transtornos Mentais/psicologia , Curva ROC , Terminologia Padronizada em Enfermagem , Inquéritos e Questionários , Autocontrole/psicologia , Adaptação Psicológica
7.
J Clin Nurs ; 29(13-14): 2482-2494, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32242997

RESUMO

AIMS AND OBJECTIVES: Our aim was to examine the notes produced by nurses, paying specific attention to the style in which these notes are written and observing whether there are concerns of distortions and biases. BACKGROUND: Clinicians are responsible to document and record accurately. However, nurses' attitudes towards their patients can influence the quality of care they provide their patients and this inevitably impacts their perceptions and judgments, with implications to patients' care, treatment, and recovery. Negative attitudes or bias can cascade to other care providers and professionals. DESIGN: This study used a retrospective chart review design and qualitative exploration of documentation using an emergent theme analysis. METHODS: We examined the notes taken by 55 mental health nurses working with inpatients in the forensic services department at a psychiatric hospital. The study complies with the SRQR Checklist (Appendix S1) published in 2014. RESULTS: The results highlight some evidence of nurses' empathic responses to patients, but suggest that most nurses have a style of writing that much of the time includes themes that are negative in nature to discount, pathologise, or paternalise their patients. CONCLUSIONS: When reviewing the documentation of nurses in this study, it is easy to see how they can influence and bias the perspective of other staff. Such bias cascade and bias snowball have been shown in many domains, and in the context of nursing it can bias the type of care provided, the assessments made and the decisions formed by other professionals. RELEVANCE TO CLINICAL PRACTICE: Given the critical role documentation plays in healthcare, our results indicate that efforts to improve documentation made by mental health nurses are needed and specifically, attention needs to be given to the writing styles of the notation.


Assuntos
Atitude do Pessoal de Saúde , Registros de Enfermagem , Recursos Humanos de Enfermagem no Hospital/psicologia , Adulto , Viés , Empatia , Feminino , Humanos , Transtornos Mentais/enfermagem , Enfermagem Psiquiátrica/métodos , Pesquisa Qualitativa , Estudos Retrospectivos
8.
Rev Bras Enferm ; 73(1): e20180175, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049233

RESUMO

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.


Assuntos
Processo de Enfermagem/tendências , Enfermagem Psiquiátrica/métodos , Brasil , Hospitais Psiquiátricos/organização & administração , Humanos , Entrevistas como Assunto/métodos , Enfermagem Psiquiátrica/tendências , Pesquisa Qualitativa
9.
Rev Bras Enferm ; 73(1): e20180208, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049240

RESUMO

OBJECTIVE: to report the experience of the Psychiatric Nursing professors of the Nursing Undergraduate Course of the Nursing School, Universidade Federal de Minas Gerais (UFMG) and the challenges faced to offer quality training. METHOD: This is an experience report about the experience of Psychiatric Nursing professors of the Nursing Undergraduate Course of the Nursing School, UFMG. RESULTS: After losing the workload of 120 hours in the Psychiatric Nursing Undergraduate Course, the area developed elective disciplines with a total of 330-hour load, in addition to extension and research projects. FINAL CONSIDERATIONS: the precariousness of the area of Nursing training after curricular restructuring in a higher education institution, whether in relation to hour load or in the allocation of teaching vacancies, is in line with advances of the Brazilian Psychiatric Reform and epidemiological data of psychic illness and drug use.


Assuntos
Bacharelado em Enfermagem/normas , Enfermagem Psiquiátrica/educação , Brasil , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/tendências , Humanos , Enfermagem Psiquiátrica/métodos , Escolas de Enfermagem/normas , Escolas de Enfermagem/tendências
10.
J Psychiatr Ment Health Nurs ; 27(2): 140-150, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31538692

RESUMO

WHAT IS KNOWN ON THE SUBJECT?: There is a drive to use positive and proactive approaches to mental health care to reduce the use of restrictive practices such as seclusion and restraint. Positive behaviour support plans have been used successfully to do this in learning disability services, and in England, it is now a regulatory requirement that anyone with challenging behaviour should have an individualized behaviour support plan. However, positive behaviour support plans specifically have not been evaluated as part of routine mental health care and mental health nurses' and relatives' attitudes towards them are unknown. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This evaluation of positive behaviour support plans in routine mental health inpatient care found that they had not been widely implemented or completed as intended. Barriers to the use of the plans included confusion among nurses and relatives around the principles of positive behaviour support, including how, when and for whom the plans should be used, difficulties in being able to describe the function of a patient's behaviour and lack of engagement with relatives and patients. Nevertheless, nurses and relatives valued the plans, in particular for their potential to facilitate holistic care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: To use the plans successfully, mental health nurses will need training to understand fully the rationale behind the positive behaviour support approach and will need to engage more with relatives and patients. Commitment to the approach from the whole care team and organization will be needed to implement the plans consistently for all patients. Abstract Introduction An international drive is to minimize restrictive practices in mental health care. Positive behaviour support plans (PBSPs) help staff prevent behaviour which would require restrictive intervention. Originating in learning disability services, data within mental health care are limited. Aims To evaluate PBSPs within a mental health inpatient service; understand mental health nurses' and relatives' attitudes to them; and understand the barriers and facilitators for their use in routine mental health care. Methods Mixed methods-quality ratings and interviews with relatives and nurses. Results Positive behaviour support plans were poorly implemented. Relatives and nurses valued the potential of PBSPs to facilitate holistic care, though no relative had contributed to one and not every eligible patient had one. Barriers to their use included confusion around positive behaviour support, including how, when and for whom PBSPs should be used, and difficulties describing the function of a behaviour. Discussion The potential of PBSPs to improve mental health care is recognized. However, there are barriers to their use which should be addressed to ensure that PBSPs have been properly implemented before their impact on patient care can be assessed. Implications for practice Mental health professionals implementing PBSPs should engage with relatives and patients, gain organizational commitment and ensure that those involved understand fully the positive behaviour support approach.


Assuntos
Pacientes Internados , Transtornos Mentais/enfermagem , Serviços de Saúde Mental , Comportamento Problema , Unidade Hospitalar de Psiquiatria , Enfermagem Psiquiátrica , Restrição Física , Adulto , Idoso , Feminino , Humanos , Masculino , Serviços de Saúde Mental/normas , Pessoa de Meia-Idade , Enfermagem Psiquiátrica/educação , Enfermagem Psiquiátrica/métodos , Enfermagem Psiquiátrica/normas , Pesquisa Qualitativa
11.
Int J Ment Health Nurs ; 29(2): 299-311, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31538723

RESUMO

As involvement of consumers/survivors in planning, delivery, and evaluation of services has increased, expectations of authentic and effective engagement, versus tokenism, have also risen. Different factors contribute to, or detract from, authentic engagement. Writing from mental health consumer/survivor and nursing positioning, respectively, we aim to redress the common problem of including only a narrow range of views and voices. This paper introduces a conceptual model that supports leaders in research, clinical, service, and policy roles to understand the necessity of engaging with a broader spectrum of consumer/survivor views and voices. The model draws on published consumer/survivor materials, making explicit diverse experiences of treatment and care and identifying the subsequent rich consumer/survivor advocacy agendas. We propose that strong co-production is made possible by recognizing and welcoming consumer/survivor activist, facilitator, transformer, and humanizer contributions. The conceptual model forms the basis for a proposed qualitative validation project.


Assuntos
Pesquisa Biomédica/métodos , Política de Saúde , Serviços de Saúde Mental , Participação do Paciente/métodos , Sobreviventes/psicologia , Humanos , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Modelos Teóricos , Formulação de Políticas , Enfermagem Psiquiátrica/métodos
12.
J Nurs Res ; 28(2): e76, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31633642

RESUMO

BACKGROUND: The objective of this study was to investigate the impact on patient care quality of a positive, high-quality environment that is tailored to the practice of nursing. This study enabled nurses to show their professional skills and knowledge, which may help enhance job satisfaction. To date, little research has been done to assess the relationship between the nursing work environment and the job satisfaction of psychiatric nurses employed in acute wards of general hospitals. PURPOSE: This study was designed to explain the relationship between job satisfaction and the perceived indicators of a quality nursing work environment (QNWE) after adjusting for demographic characteristics and work characteristics. METHODS: A cross-sectional correlational design was employed, and a stratified random sample of 185 psychiatric nurses (99% response rate) working in acute wards in Taiwan was surveyed in 2013. Nurses were asked to complete a self-administered questionnaire that included measures of perceived QNWE and job satisfaction and demographic variables. RESULTS: A statistically significant, positive relationship was found between perceived indicators of QNWE and job satisfaction (r = .813, p < .001). In the hierarchical multiple linear regression model, for the subdimensions of QNWE, the variables "perceived indicators of professional specialization and teamwork" and "support and caring" showed a significant and positive association with job satisfaction, after adjusting for personal demographic characteristics. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Job satisfaction is related to the perception of nurses regarding their work environment. Therefore, nursing managers should improve workplace satisfaction by supporting and caring for nurses and creating better career development and teamwork opportunities for nurses through job training and planning.


Assuntos
Satisfação no Emprego , Local de Trabalho/normas , Adulto , Estudos Transversais , Feminino , Hospitais Gerais/organização & administração , Hospitais Gerais/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Enfermagem Psiquiátrica/métodos , Enfermagem Psiquiátrica/normas , Enfermagem Psiquiátrica/estatística & dados numéricos , Inquéritos e Questionários , Taiwan , Local de Trabalho/psicologia , Local de Trabalho/estatística & dados numéricos
13.
J Psychiatr Ment Health Nurs ; 27(2): 194-202, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31610067

RESUMO

WHAT IS KNOWN ON THE SUBJECT: The intersection of sexuality and psychosis has a long history, yet research in this area has been minimal over the past few decades. Mental health clinicians practice from within the confines of a mental health system that is founded on a conflict between containment and care and that positions the consumer as an object of care. At the same time, mental health services often have a Recovery approach to care. This presents a difficulty and tension in mental health clinical work because the Recovery approach is opposed to positioning the consumer as an object. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE: The findings suggest that sexuality and sexual needs are common to both clinicians and consumers, and via identification, make the two groups more similar than different. Sexuality can problematize and so open up questions about the objectification of consumers. Consideration of consumers' sexuality and sexual needs can therefore work as a resistance to the dominant mental health approach and, in doing so, produce a more Recovery-oriented approach to treatment in terms of how the consumer is positioned. Other aspects of living that escape capture by the diagnostic system may also operate as organizing factors for a more subject-to-subject approach to treatment. THE IMPLICATIONS FOR PRACTICE: Focusing on sexuality and other aspects of living that escape capture by the diagnostic system can bring into question the way consumers are objectified by the psychiatric model of care. Abstract Introduction The Recovery approach introduced a radical shift in the positioning of consumers as subjects rather than objects of mental health treatment. While this approach has been internationally adopted, the practice of Recovery has been under-researched and a knowledge gap exists regarding the intersection of sexuality and psychosis. Aim The study aim was to investigate how sexuality was governed in a long-stay mental health rehabilitation facility that was Recovery-oriented. Method A case study methodology with a conceptual framework using Foucault's work on disciplinary power was used. Results The findings illustrated how mental health clinicians were caught between two main and incompatible models of care: a psychiatric one and a Recovery one. Discussion While the policy framework authorized a Recovery approach, clinicians practised surveillance, hierarchical observation and normalization, which are tenants of a psychiatric model of care. However, the study found that sexuality was an area that opened questions about the psychiatric model for clinicians. Consideration of consumers' sexual needs allowed the clinicians to think of consumers more as subjects like themselves than as objects to be treated. Implications for practice Consideration of consumers' sexuality opens up possibilities for questioning the objectification of the consumer via the psychiatric model.


Assuntos
Atitude do Pessoal de Saúde , Serviços de Saúde Mental , Pessoas Mentalmente Doentes , Enfermagem Psiquiátrica , Reabilitação Psiquiátrica , Transtornos Psicóticos/reabilitação , Instituições Residenciais , Esquizofrenia/reabilitação , Sexualidade , Adulto , Humanos , Enfermagem Psiquiátrica/métodos , Reabilitação Psiquiátrica/métodos , Pesquisa Qualitativa
14.
Nurse Educ Today ; 84: 104219, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31731222

RESUMO

Theory and clinical practicum in mental health are an important component for students in most nursing curriculum. Some studies have shown that knowledge and confidence in caring for people with mental illness improve after mental health clinical placements while others had contrasting results. Our study examined the relationship between clinical placement, confidence and stigma surrounding mental illness. We undertook a cross-sectional, descriptive correlational study in a sample of 144 undergraduate nursing students in Singapore who had completed their theoretical and clinical practicum in mental health using the Clinical Placement Survey Clinical Confidence Scale and Social Distance Scale. Descriptive, correlations and multiple regression were used to analyse the data. The results showed the mean scores for the social distance scale, clinical confidence scale and clinical placement survey were 19.92 out of 35, 49.29 out of 80 and 103.43 out of 154 respectively. Attitudes toward clinical placement experiences were significantly correlated with both stigmatising attitudes and clinical confidence of which, intentions of working in mental health settings were specifically significantly associated with stigmatising attitudes and attitudes toward clinical placement experiences, with emphasis on greater sense of preparedness, lesser perceived anxiety and greater preference for a future career in mental health nursing. This study highlighted the need to improve current mental health clinical placements to better build nursing students' confidence in caring for mentally ill patients. The interest toward specialising in mental health nursing is still lacking in nursing undergraduate students despite mental health clinical placements.


Assuntos
Competência Clínica/normas , Enfermagem Psiquiátrica/educação , Estigma Social , Estudantes de Enfermagem/psicologia , Adulto , Atitude do Pessoal de Saúde , Competência Clínica/estatística & dados numéricos , Correlação de Dados , Estudos Transversais , Bacharelado em Enfermagem/métodos , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/psicologia , Preceptoria/métodos , Preceptoria/estatística & dados numéricos , Enfermagem Psiquiátrica/métodos , Singapura , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários
15.
J Clin Nurs ; 29(7-8): 1102-1114, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31793106

RESUMO

AIMS AND OBJECTIVE: To capture the experiences of nurses in relation to the acutely physiologically deteriorating consumer. BACKGROUND: Improving the physical health care of consumers with mental illness has been widely adopted as a priority for mental health nursing. Much of the effort thus far has focused on routine screening, prevention and treatment of common comorbidities including cardiovascular disease, diabetes mellitus and cancer. There has been less focus on the acutely physiologically deteriorating consumer in the mental health setting. Further study is warranted since this issue poses a set of highly complex challenges for nurses within the inpatient setting. METHOD: An exploratory, descriptive study was employed using focus groups to gather narrative data, which was then subject to qualitative analysis. Eleven mental health inpatient wards within a local health district in Sydney, Australia, were studied, comprising ward-based nurses (n = 64) and nurse unit managers (n = 8). This paper follows the COREQ guidelines for reporting qualitative health research. RESULTS: Qualitative data analysis revealed three themes central to the nurses' experience: (a) lack of clarity (subthemes: procedures and leadership accountability); (b) confidence in the workforce (subthemes: knowledge and skills, training needs, relevant experience, collaboration with emergency and medical teams, stigmatising attitudes); and (c) complexity (subthemes: complexity as the new norm and suitability of the mental health environment). CONCLUSION: The themes found in this study can be used to guide and inform healthcare policy, protocols, education and processes around building a more confident nurse workforce for the acutely physiologically deteriorating consumer. RELEVANCE TO CLINICAL PRACTICE: Findings provide a rich data set for the generation of measurement tools and protocols to guide physical health care and evaluate performance.


Assuntos
Deterioração Clínica , Transtornos Mentais/enfermagem , Enfermagem Psiquiátrica/métodos , Adulto , Austrália , Feminino , Humanos , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/organização & administração , Pesquisa Qualitativa
16.
Rev. cuba. enferm ; 36(2): e:3704, abr.-jul.2020.
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-1104099

RESUMO

Introducción: La pandemia de la COVID-19 ha puesto a prueba los sistemas de salud en casi todos los países del mundo, los resultados de la propagación de la enfermedad han indicado que la seguridad psicológica del personal sanitario es condición indispensable para brindar cuidados a los enfermos, sin embargo, los documentos vigentes no tienen en cuenta de forma explícita ese aspecto. Objetivo: sintetizar acciones para la gestión de la seguridad psicológica del personal sanitario en condiciones de emergencia por pandemia de la COVID-19 en el contexto hospitalario o de aislamiento. Métodos: revisión bibliográfica sistemática, basada en los protocolos de atención a pacientes con COVID-19, documentos técnicos de la OPS- Enfermedad por el coronavirus y de artículos científicos publicados en el período desde diciembre 2019 hasta abril 2020 en revistas nacionales e internacionales indexadas en las bases de datos: Sage Journal, Oxford University Press (OUP), Elsevier y Science. Conclusiones. Un sistema de acciones para organizar el trabajo de profesionales de la salud permitirá verlos no solo como tratantes de la enfermedad, sino como personas vulnerables y necesitadas de ser objeto de la gestión de su seguridad para su salud mental.(AU)


Assuntos
Humanos , Enfermagem Psiquiátrica/métodos , Saúde Mental , Pessoal de Saúde/psicologia , Infecções por Coronavirus , Pandemias , Serviços de Saúde Mental
17.
Enferm. clín. (Ed. impr.) ; 29(6): 370-375, nov.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184658

RESUMO

Los sistemas sanitarios tienen la responsabilidad de dar respuesta a las nuevas necesidades de salud de la población, que se caracterizan por factores como el envejecimiento, la cronicidad y/o las situaciones de dependencia y que requieren de cuidados de calidad, especializados y adaptados a diferentes ámbitos donde la atención se presta, cuidados ofertados por profesionales formados y cada vez más cualificados para mejorar los resultados en salud de las personas que cuidan. En el año 2016, en Andalucía se publica el marco normativo por el que se crea la categoría profesional estatutaria de enfermero/a especialista, entre las que se incluye la especialidad de Enfermería de Salud Mental en el Servicio Andaluz de Salud. En el ámbito de la Salud Mental, el desarrollo de este marco normativo y la definición y ocupación de puestos permitirá al sistema sanitario conjugar el papel de las enfermeras especialistas con el de las enfermeras que prestan cuidados generales, enfermeras de Grado, en pro de avanzar en la mejor respuesta a las necesidades de salud de la ciudadanía en este ámbito de atención. El desarrollo de la especialidad podrá suponer un valor añadido tanto para la mejora de los resultados en salud de las personas con problemas de salud mental como para mejorar la calidad asistencial, la eficiencia y la sostenibilidad de los sistemas sanitarios


Health systems have a responsibility to respond to the new health needs of the population, which are characterized by factors such as aging, chronicity and/or dependency situations and which requires quality and specialized care adapted to different areas where care is provided, care offered by trained and increasingly qualified professionals to improve the health outcomes of the caregivers. In 2016, in Andalusia the regulatory framework by which is created the statutory professional category of nurse/specialists is published, including the specialty of Mental Health Nursing in the Andalusian Health Service. In the field of Mental Health, the development of this normative framework and the definition and occupation of positions, will allow the health system to combine the role of nurse specialist nurses with that of nurses who provide general care, registered nurses, in order to advance in the best response to the health needs of citizens in this area of care. The development of the specialty will be an added value both to improve the health outcomes of people with mental health problems, and to improve the quality of care, efficiency and sustainability of health systems


Assuntos
Humanos , Especialidades de Enfermagem , Enfermagem Psiquiátrica/métodos , Enfermagem em Saúde Comunitária/métodos , Enfermagem em Saúde Comunitária/organização & administração , Saúde Mental , Sistemas de Saúde/organização & administração
18.
Cult. cuid ; 23(55): 283-294, sept.-dic. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-190677

RESUMO

La enfermería ha faltado un modelo teórico específicamente para la especialidad de enfermería psiquiátrica y salud mental. Este falta se da a nivel mundial, no solo en México, y puede limitar el desarrollo de la práctica independiente de la enfermería psiquiátrica. También puede limitar la habilidad de la enfermería a trabajar en el equipo multidisciplinaria en una manera conjunta en condición de igualdad. En el siglo XVI México tuvo un modelo de enfermería psiquiátrica de los Hermanos de la Caridad, basado en el amor al prójimo y respeto a la persona con necesidad de la enfermería. Actualmente existe un modelo teórico específicamente para la enfermería psiquiátrica y salud mental. El Modelo Tidal, con sus metáforas sobre la vida y sus crisis como un barco en el mar, tiene un enfoque sobre el respeto para la historia y la experiencia de la persona con necesidad de la enfermería


Nursing has lacked a theoretical model specifically for the specialty of psychiatric nursing and mental health. This lack occurs worldwide, not only in Mexico, and may limit the development of the independent practice of psychiatric nursing. It can also limit the ability of nursing to work in the multidisciplinary team in a joint manner on an equal basis. In the XVI century Mexico had a model of psychiatric nursing of the Brothers of Charity, based on love for neighbor and respect for the person in need of nursing. Currently there is a theoretical model specifically for psychiatric nursing and mental health. The Tidal Model, with its metaphors about life and its crisis as a ship at sea, focuses on respect for the history and experience of the person in need of nursing


A enfermagem carece de um modelo teórico específico para a especialidade de enfermagem psiquiátrica e saúde mental. Essa falta ocorre em todo o mundo, não apenas no México, e pode limitar o desenvolvimento da prática independente de enfermagem psiquiátrica. Também pode limitar a capacidade de enfermagem de trabalhar na equipe multidisciplinar de maneira conjunta em igualdade de condições. No século XIV, o México tinha um modelo de enfermagem psiquiátrica dos Irmãos da Caridade, baseado no amor ao próximo e no respeito pela pessoa necessitada de enfermagem. Atualmente existe um modelo teórico específico para enfermagem psiquiátrica e saúde mental. O Modelo das Marés, com suas metáforas sobre a vida e sua crise como navio no mar, tem como foco o respeito pela história e experiência da pessoa que necessita de enfermagem


Assuntos
Humanos , Enfermagem Psiquiátrica/métodos , Modelos de Assistência à Saúde , Modelos de Enfermagem , México
19.
Arch Psychiatr Nurs ; 33(6): 103-109, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31753214

RESUMO

BACKGROUND: Audit and feedback was the main strategy to facilitate implementation of The National Guideline for Persons with Concurrent Substance Use Disorders and Mental Disorders in specialist mental health services. Studies have shown that leadership support contributes to implementation success. The aim of the study was to explore how first-line managers in a District Psychiatric Centre experienced using audit and feedback cycle. METHOD: The study had a qualitative case study design with individual interviews with five first-line managers from a District Psychiatric Centre in Norway. Qualitative content analysis was conducted. RESULTS: First-line managers were positive to contribute to better practice for the patient group and apply available tools. Four themes emerged: 1) Lack of endurance, where first-line managers saw their role as being process leaders, but failed to persist, 2) Lack of support in the process, where first-line managers called for a stronger organisational focus 3) Lack of ownership, where first-line managers felt the process was imposed on them, and 4) Lack of leader autonomy, where first-line managers seemed insecure about their role between professional leadership and own management. CONCLUSION: First-line managers were not sufficiently experienced or equipped to solve the implementation process satisfactorily. They were torn between different commitments, without the autonomy to act as process drivers or facilitators, and without taking the necessary leadership role. The potential impact of the use of audit and feedback may thus not be fully realized, in part, because of limited organisational support and capacity to respond effectively.


Assuntos
Feedback Formativo , Auditoria Médica/métodos , Serviços de Saúde Mental/organização & administração , Feminino , Humanos , Entrevistas como Assunto , Liderança , Masculino , Auditoria Médica/organização & administração , Transtornos Mentais/terapia , Estudos de Casos Organizacionais , Enfermagem Psiquiátrica/métodos , Enfermagem Psiquiátrica/organização & administração , Pesquisa Qualitativa , Melhoria de Qualidade/organização & administração
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