Resilience as a protective factor on the quality of life (QoL) of Indian nursing students during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic negatively impacted the quality of life of individuals around the world, including health care professionals. There has been little research that examines the role of resilience concerning the impact of COVID-19 on the quality of life of nursing students. This study aimed to determine how resilience influenced the quality of life among nursing students during the COVID-19 pandemic. METHODS: A cross-sectional research design was adopted for this study. A total of two hundred sixty-eight nursing students from three universities, South India responded in the web-based survey. Data was collected using self-reported questionnaires in June 2021. RESULTS: Our findings revealed that the participants' resilience was normal, which had a moderate impact on the quality of life of nursing students during the COVID-19 pandemic. The COVID-19 impact on QoL significantly differed with year of education (F = 3.087; p < 0.02) and university (F = 6.697, p < 0.001). Bivariate analysis revealed significant inverse relationships between the impact of COVID-19 on quality of life with resilience (r = -0.259; p < 0.001) and perceived knowledge on COVID-19(r = -0.168; p < 0.006). CONCLUSION: In our study, we found that resilience had a moderate impact on the quality of life of nursing students during the COVID-19 pandemic. Therefore, it is important to promote students' resilience and improve their quality of life during stressful situations.

Violence Against Women with Mental Illness and Social Norms and Beliefs: Nursing Professional Perspective.

Violence against women is a priority public health issue globally and women with mental illness are at double disadvantage. While social norms and beliefs play a critical role in influencing violence among women, limited or no research is available from India. To explore nurses and nursing students' views on social norms and beliefs that support Violence against women with mental illness. A descriptive cross-sectional survey was carried out among randomly selected registered nurses and nursing students (N = 209) using self-reported questionnaires. Majority of the participants confronted norms (76.7%) and situations that justify (67.7%) abuse among women with mental illness. Nurses reported more negative attitudes than nursing students with regard to norms and beliefs (t = - 2.714, p < 0.007) and justifiability of abuse (t = - 3.089, p < 0.002). The findings suggest suitable academic programs to extinguish the prevailing cultural beliefs that support abuse in women with mental illness.

Empowerment of nurses' knowledge and skills on violence against women with mental illness: A randomized controlled trail.

BACKGROUND: Nurses play a key role in identifying and supporting women with abusive experiences. However, research that evaluated the effectiveness of educational interventions on violence against women is sparse from India. AIM: To evaluate the effectiveness of a training program in improving nurses' knowledge and skills related to the identification and management of abused Women with Mental Illness (WMI). METHODS: A randomized controlled trial design was adopted for the present study. A total of 68 nurses were randomly assigned to either the experimental or control group (34 in each group). The experimental group was provided eight interactive sessions based on a Nursing Module on abuse among women with mental illness. The assessments were done in both groups at baseline, after the intervention, at three months and six months. The data was collected using a self-rated questionnaire and case vignettes. RESULTS: The mean knowledge score increased significantly in the experimental group after the intervention from 12.26 (SD, 2.03) to 23.60 (SD,1.24) and sustained at three months (23.07 ± 0.94) and six months (23.13 ± 1.61). Similarly, there were significant differences in nurses' skills after the training program (t = 13.17, p < 0.001) and at different time points of assessment (p < 0.001). CONCLUSIONS: Results showed that training had a positive impact on nurses' knowledge and skills related to violence against women with mental illness. Therefore, it is necessary to provide continuous training on this issue to help nurses in providing holistic care to this vulnerable population.

Effectiveness of nurses training in routine screening of violence against women with mental illness: A randomized controlled trail.

BACKGROUND: Globally, people with mental illness are highly vulnerable to various forms of abuse. Yet, research on routine screening of violence by mental health professionals is limited. AIM: The aim of this study was to evaluate the impact of training on nurses' attitudes towards routine screening and confidence in implementing routine screening of violence among women with mental illness. METHODS: A randomized controlled trial design was adopted for the present study. The participants of this study were 68 nurses randomly assigned to either experimental or control group (34 in each group). The experimental group was provided eight interactive sessions based on a Nursing Module on abuse among women with mental illness. The assessments were done in both groups at baseline, after the intervention, at three months and at six months. All assessments were self-rated questionnaires to assess nurses' attitudes and confidence in implementing routine screening of violence attitudes. RESULTS: The experimental group showed a statistically significant improvement in the attitudes and confidence in implementing routine screening of abuse in women with mental illness (p < 0.05) than the control group. Repeated measures of analysis also revealed statistically significant differences related to attitude and confidence in implementing routine screening of abuse between the groups and within the experimental group at different time points of assessment (p < 0.001). CONCLUSION: This study concluded that training based on a nursing module improved nurses' attitudes and confidence to conduct routine screening of violence among women with mental illness. However, further studies are necessary to clarify whether the training is effective in implementing in nursing practice.

Violence against women with mental illness and routine screening: Nurses' knowledge, confidence, barriers and learning needs.

Violence against women is a major public health issue and women with mental illness (WMI) are at a double disadvantage. While nurses play a key role in identifying and responding to abused women, research is limited on this issue from India. This qualitative study was aimed to explore nurses' knowledge, confidence, and learning needs in the identification and responding to disclosure of abuse in women with mental illness. The focus group discussions were conducted among nurses (N = 21) working in psychiatry units at a tertiary care center. An interview guide with semi-structured questions was used to collect the data. Five dominant themes and fifteen sub-themes have emerged from qualitative analysis. The dominant themes include; Awareness of abuse among women with mental illness (AWMI), Experiences of recognizing and responding to abuse, Barriers for routine screening for abuse, Educational preparedness, and learning needs, and Prevention of abuse in women with mental illness. The identified barriers include personal related (personal discomfort, lack of knowledge, etc.), job related (Time consuming, not a nurse's job, lack of time, etc.) and organizational (lack of policies and administrative support, etc.). Most of the participants expressed that they lack confidence in the routine screening of women for abuse due to inadequate training. Therefore, it is critical to include a topic on domestic violence in the nursing curriculum and provide ongoing learning opportunities to the nurses through CNE programs, workshops, and conferences.

Eating Attitudes, Weight Control Behaviors, Body Image Satisfaction and Depression Level Among Indian Medical and Nursing Undergraduate Students.

This was a cross sectional descriptive study carried out among Medical and Nursing students to assess the presence of eating disorders. Data was collected using self administered 'Sick, Control, One, Fat, Food' (SCOFF) and 'Eating Attitudes Test (EAT-26)' questionnaires. It was found that 34.1% and 10.4% of the participants were at high risk to suffer from eating disorders on SCOFF and EAT-26 scales. Further, age, gender and education found to have significant association on SCOFF and EAT-26 scores (p < 0.05). Thus, the findings suggest the need for effective interventions to prevent depression and eating disorders among the future health professionals.

Nursing Students Attitudes and Understanding of Complementary and Alternative Therapies: An Indian Perspective.

UNLABELLED: AIM The purpose of the present study was to explore Indian nursing students' knowledge and attitudes regarding complementary and alternative medicine (CAM). BACKGROUND: Research on nursing students' knowledge of complementary and alternative therapies is limited in India. METHOD: This was a cross-sectional exploratory study carried out in a convenience sample of nursing students (N = 122) using self-administered questionnaires. RESULTS: A majority of the participants (89.3 percent) felt that Ayurveda is highly/moderately effective. A majority of participants agreed with most items, indicating positive attitudes toward CAM therapies. Lack of evidence, lack of staff training, unavailability of credentialed providers, and lack of appropriate equipment were seen as the main barriers to practicing CAM therapies. CONCLUSION: The findings suggest that introducing CAM in the nursing curriculum is needed to prepare future nurses. Continuing education/training in CAM is needed by nurses to provide holistic care.

Prevalence and clinical correlates of obsessive-compulsive disorder in schizophrenia.

Obsessive compulsive symptoms frequently occur in a substantial proportion of patients with schizophrenia. The term schizoobsessive has been proposed to delineate this subgroup of schizophrenia patients who present with obsessive-compulsive symptoms/disorder. However, whether this co-occurrence is more than just co-morbidity and represents a distinct subgroup remains controversial. A striking variation is noted across studies examining prevalence of obsessive-compulsive symptoms/disorder in schizophrenia patients and their impact on clinical profile of schizophrenia. Hence, in this study, we examined the prevalence of obsessive-compulsive symptoms/disorder in a large sample of consecutively hospitalized schizophrenia patients and compared the clinical and functional characteristics of schizophrenia patients with and without obsessive-compulsive symptoms/disorder. We evaluated 200 consecutive subjects with the DSM-IV diagnosis of schizophrenia using the Structured Clinical Interview for DSM-IV Axis I disorders, Positive and Negative Syndrome Scale, Yale-Brown Obsessive-Compulsive Scale, Brown Assessment of Beliefs Scale, Clinical Global Impression-Severity scale, Global Assessment of Functioning Scale, Family Interview for Genetic Studies and World Health Organization Quality of Life scale. The prevalence of obsessive-compulsive symptoms in patients with schizophrenia was 24% (n=48); 37 of them had obsessive-compulsive disorder (OCD) and 11 had obsessive-compulsive symptoms not amounting to a clinical diagnosis of OCD (OCS). Schizophrenia patients with OCS/OCD had an earlier age at onset of schizophrenia symptoms, lower positive symptoms score, higher co-morbidity with Axis II disorders, higher occurrence of OCD in family and better quality of life. Findings of the study indicate a higher prevalence of OCS/OCD in schizophrenia. Schizophrenia patients with and without OCS/OCD have comparable clinical profile with few exceptions. High rates of OCD in first degree relatives suggest possible genetic contributions and differences in neurobiology. Finally, evidence to consider schizoobsessive as a distinct diagnostic entity is inconclusive and warrants further studies.

A report on successful introduction of tele mental health training for primary care doctors during the COVID 19 pandemic.

Treatment gaps of 60-70%, reflecting, amongst many other factors, Human Resources shortfalls means that 150 million India never accessed mental healthcare. In Punjab, mental health training is required in primary health centers. A short-term synchronous training was conceptualized by the National Institute of Mental Health and Neurosciences. A total of 114 primary care doctors participated for the training. Substantial positive changes in knowledge, attitudes and practices were noted. Task sharing and capacity building initiatives can be undertaken during the pandemic to meet the demand for mental healthcare service delivery.

'Unheard voices': Perceptions of women with mental illness on nurses screening routinely for domestic violence: A qualitative analysis.

OBJECTIVES: To explore women's experiences of violence and their opinion on routine screening for domestic violence by nursing professionals in mental health care settings. METHODS: This qualitative narrative research design was carried out among 20 asymptomatic women with mental illness at a tertiary care centre in Bangalore, India. RESULTS: Narrative content analysis was performed, and five dominant themes have emerged: 1. Understanding the nature and signs of violence (subtheme: Meaning of violence), 2. Abusive experiences of women with mental illness (subthemes: Physical violence, psychological violence, social violence, sexual violence and financial violence), 3. Experiences on disclosure of violence (subthemes: Identification of violence by nursing professionals, Experiences of disclosure of violence), 4. Barriers for disclosure of abuse(subthemes: Fear of consequences, the hectic schedule of nursing staff, helplessness and hopelessness, perceived poor family support). 5.Routine screening for violence by nursing professionals (subthemes: reasons for routine inquiry of violence, nature of inquiry by the nursing professionals). CONCLUSIONS: Women with mental illness were undergoing more than one form of violence, and most of the participants supported routine screening by nursing professionals. Nurses play an essential role in identifying and supporting abused women in mental health care settings.

Knowledge and perceptions of Indian primary care nurses towards mental illness.

OBJECTIVES: To assess nurses' knowledge and perceptions towards mental illness. METHODS: This was a cross-sectional descriptive study conducted among 126 randomly selected nurses those are working under District Mental Health program in Karnataka (India). The data was collected through self-reported questionnaires Using the modified version of Public perception of mental illness questionnaire and Attitude Scale for Mental Illness. RESULTS: The findings revealed that majority of the subjects were women (74.4%), Hindus (92.1%) and were from rural background (69.8%). The mean Knowledge score 10.8±1.6 adequate knowledge (maximum possible =12) among 91% of the subjects, and 52% of them hold negative attitudes towards people with mental illness (88.9±13.6). While majority of the subjects hold negative attitudes in 'Separatism' (53.5%), 'Stereotyping' (73%), 'Benevolence' (54%), 'Pessimistic prediction' (53%) domains, they hold positive attitudes in 'Restrictiveness' (88%) and 'Stigmatization' (72%) domains. Women than men endorsed positive attitudes towards persons with mental illness in Stereotyping' (p<0.001), 'Restrictiveness' (p<0.01), 'Benevolence' (p<0.001) and 'Pessimistic prediction' (t= 2.22, p<0.05) domains. Similarly, Auxiliary Nursing Midwifery found to be less restrictive (p<0.05), more benevolent (p<0.001) and less pessimistic (p<0.05) compared to nurses with higher education (General Nursing and Midwifery and Bachelor of Science in Nursing). CONCLUSIONS: The present study showed adequate knowledge on mental illness among nurses. Yet they hold stigmatizing and negative attitudes towards mental illness. Hence, it is an urgent priority to develop and implement educational programs to inculcate positive attitudes towards people with mental illness to provide optimal care to this vulnerable population.

Indian nurses' Knowledge, Attitude and Practice towards use of physical restraints in psychiatric patients.

OBJECTIVES: To assess nurses' knowledge, attitude and practice towards using physical restraints among psychiatric patients. METHODS: A descriptive cross sectional survey was carried out among conveniently selected sample of nurses working in psychiatry departments at a tertiary care center. The data was collected using self reported questionnaires of Suen. RESULTS: The findings revealed that nurses had good knowledge (7.2±1.7, maximum posible=11), favorable attitudes 30.8± 3.3 (maximum posible=48) and good practice 31.2±6.2 (maximun posible=42) about use of physical restraints in psychiatric patients. Females had better knowledge (p<0.001), attitudes (p<0.05) than males towards use of physical restraints. Nurses those had more than ten years of experience found to have more favorable attitudes towards using physical restraints than nurses with less experience (p<0.05) and nurses with higher education differed significantly on practice score than nurses with basic education in nursing (p<0.05). CONCLUSIONS: This study revealed good knowledge, positive attitudes and good practices among nurses about using physical restraints in mental health services. However there is need to improve even more nurses practice through continuing education programs on this topic.

Medical and nursing students' attitudes toward mental illness: An Indian perspective.

OBJECTIVES: Compare the attitudes toward mental illness between medical and nursing undergraduate students from a university in India. METHODS: A cross sectional descriptive study was carried out among medical (n=154) and nursing undergraduate students (n=168) using Attitude Scale for Mental Illness (ASMI) questionnaire with six sub scales namely; Separatism, Stereotyping, Restrictiveness, Benevolence, Pessimistic prediction and Stigmatization. This was a 5-point Likert scale with 34 items to rate participants responses from totally disagree (1) to totally agree (5). The lower scores indicate positive attitudes toward persons with mental illness. RESULTS: Our findings revealed that 54.5% of medical students versus 64.8% of nursing students have positive attitudes toward mental illness. While medical students have better attitudes against separatism and stigmatization, nursing students have more positive attitudes in benevolence and against pessimism. CONCLUSIONS: An important proportion of medical and nursing students have negative attitudes toward mental illness. It is necessary to review and adapt the current curriculum to favor the positive attitude of future professionals toward people with these types of diseases.

Gender Differences in Body Mass Index, Body Weight Perception, weight satisfaction, disordered eating and Weight control strategies among Indian Medical and Nursing Undergraduates.

OBJECTIVES: To assess gender disparity in body weight perception, Body Mass Index (BMI), weight satisfaction and role of depression among undergraduate Medical and Nursing students. METHODS: A descriptive cross sectional descriptive study was conducted in conveniently selected medical (n=241) and nursing (n=213) students of Bangalore, South India. Data was collected using self-administered SCOFF questionnaires. RESULTS: Our findings revealed that men had a significantly higher BMI than women (t=5.403, p<0.001). More number of women compared to men, perceived themselves as over weight (74.8%) and not satisfied with their weight status (81.6%). More men than women scored positively for disordered eating behaviors on SCOFF (45.4% vs. 31.1%) and EAT scale (16.5% vs. 8.7%). While, 48.2% of the women practice binge eating, 41.2% of the men practice it (p<0.004); more men (47.4%) than women (25.4%) exercised for more than sixty minutes (p<0.001) to control their weight. CONCLUSIONS: Findings indicate small differences between the genders that have to be taken in consideration in planning interventional programs to prevent eating disorders in this population.

Dual Clinical Collaborator: A Pragmatic Role of nurses from developing countries

Collaboration is crucial in Professional nursing practice. Nurses act as a liaison between physicians and patients and their family members. Thus, it is vital to define the collaborative role of nurses in developing countries. The authors discuss pragmatic nurses' role by adopting the Dual Clinical Collaborator model to ensure offering the quality of care to their clients. Nursing is a healthcare profession that focuses on the care of individuals and their families to help them recover from illness and maintain optimal health and quality of life.(1) Health Care Professionals (HCPs) work together to provide quality health care and accomplish common goals. As healthcare delivery is becoming more complex, collaboration among healthcare workers and the patient can be a path to improve the quality of healthcare services. According to Walker and Avant's method, the conceptual definition of collaboration in nursing is an intra professional or interprofessional process by which nurses come together and form a team to solve patient care or healthcare system problem with members of the team respectfully sharing knowledge and resources.(2) Thus, collaboration is crucial in everyday professional nursing practice and should be considered a core value of nursing.(3)

Attitudes, knowledge, and willingness to donate organs among Indian nursing students.

Globally, there is an acute shortage of organs for transplantation. Health professionals play an important role in raising awareness, motivating, and subsequently increasing the organ donation rates. Research related to nursing students' attitudes toward organ donation is limited from India. We aimed to assess undergraduate nursing students' knowledge, attitudes, and willingness to donate organs. This was a cross-sectional descriptive study carried out among conveniently selected undergraduate nursing students (n = 271) using self-reported questionnaires. All the participants were aware of organ donation. A majority (n = 251, 94%) of them were unaware of organ donation law. The mean score indicates that 66.7% of the participants had adequate level of knowledge [mean ± standard deviation (SD), 7.34 ± 1.61] and 72.3% hold positive attitudes (mean ± SD, 83.9 ± 1.01) toward organ donation. Statistically significant correlation (r = 0.265, P <0.001) was observed between knowledge and attitudes of the participants toward organ donation. The findings suggest the need for revising the nursing curricula to prepare the future nurses' competent in encountering the issues related to organ donation and fostering.

'Unheard voices': Perceptions of women with mental illness on nurses screening routinely for domestic violence: A qualitative analysis / "Voces no escuchadas": Percepciones de las mujeres con enfermedades mentales sobre el cribado rutinario de la violencia doméstica por parte de las enfermeras. Un análisis cualitativo / "Vozes não ouvidas": percepções de mulheres com transtorno mental sobre o rastreamento cotidiano da violência doméstica por enfermeiras. Uma análise qualitativa

Objective. To explore women's experiences of violence and their opinion on routine screening for domestic violence by nursing professionals in mental health care settings. Methods. This qualitative narrative research design was carried out among 20 asymptomatic women with mental illness at a tertiary care centre in Bangalore, India. Results. Narrative content analysis was performed, and five dominant themes have emerged: 1. Understanding the nature and signs of violence (subtheme: Meaning of violence), 2. Abusive experiences of women with mental illness (subthemes: Physical violence, psychological violence, social violence, sexual violence and financial violence), 3. Experiences on disclosure of violence (subthemes: Identification of violence by nursing professionals, Experiences of disclosure of violence), 4. Barriers for disclosure of abuse(subthemes: Fear of consequences, the hectic schedule of nursing staff, helplessness and hopelessness, perceived poor family support). 5.Routine screening for violence by nursing professionals (subthemes: reasons for routine inquiry of violence, nature of inquiry by the nursing professionals). Conclusion. Women with mental illness were undergoing more than one form of violence, and most of the participants supported routine screening by nursing professionals. Nurses play an essential role in identifying and supporting abused women in mental health care settings.

Objetivo. Explorar las experiencias de violencia que sufren las mujeres y su opinión sobre el cribado rutinario de la violencia doméstica por parte de los profesionales de enfermería en los centros de salud mental. Métodos. Esta investigación narrativa cualitativa se llevó a cabo con 20 mujeres asintomáticas con enfermedades mentales en un centro de atención terciaria en Bangalore, India. Resultados. Se realizó un análisis de contenido narrativo y surgieron cinco temas dominantes: 1. Comprensión de la naturaleza y los signos de la violencia (subtema: Significado de la violencia), 2. Experiencias abusivas de las mujeres con enfermedades mentales (subtemas: Violencia física, violencia psicológica, violencia social, violencia sexual y violencia económica), 3. Experiencias sobre la revelación de la violencia (subtemas: Identificación de la violencia por parte de los profesionales de enfermería, Experiencias de revelación de la violencia), 4. Barreras para la revelación del abuso (subtemas: Miedo a las consecuencias, el agitado horario del personal de enfermería, impotencia y desesperanza, percepción de un escaso apoyo familiar). 5. Indagación rutinaria de la violencia por parte de los profesionales de enfermería (subtemas: razones para la indagación rutinaria de la violencia, naturaleza de la indagación por parte de los profesionales de enfermería). Conclusión. Las mujeres con enfermedades mentales sufrieron más de una forma de violencia y la mayoría de las participantes apoyó el cribado rutinario por parte de los profesionales de enfermería. Las enfermeras desempeñan un papel esencial en la identificación y en el apoyo a las mujeres maltratadas en los entornos de atención en la salud mental.

Objetivo. Explorar as experiências de violência sofrida por mulheres e sua opinião sobre o rastreamento rotineiro de violência doméstica por profissionais de enfermagem em centros de saúde mental. Métodos. Esta pesquisa narrativa qualitativa foi realizada com 20 mulheres assintomáticas com doença mental em um estabelecimento de cuidados terciários em Bangalore, Índia. Resultados. Realizou-se uma análise de conteúdo narrativo e emergiram cinco temas dominantes: 1. Compreendendo a natureza e os sinais da violência (subtópico: Significado da violência), 2. Experiências abusivas de mulheres com transtorno mental (subtópicos: Violência física, violência psicológica, violência social, violência sexual e violência econômica), 3. Experiências sobre a divulgação da violência (subtópicos: Identificação da violência por profissionais de enfermagem, Experiências da divulgação da violência), 4. Barreiras para a divulgação do abuso (subtópicos: medo das consequências, enfermagem ocupada horas de trabalho, desamparo e desesperança, percepção de pouco apoio familiar) 5. Inquérito de rotina sobre violência por profissionais de enfermagem (subtópicos: motivos de inquérito de rotina sobre violência, natureza do inquérito por profissionais de enfermagem). Conclusão. Mulheres com doença mental sofreram mais de uma forma de violência e a maioria das participantes apoiava o rastreamento de rotina pelos profissionais de enfermagem. Os enfermeiros desempenham um papel essencial na identificação e apoio às mulheres agredidas em ambientes de cuidados de saúde mental.

An 11- to 13-year follow-up of 75 subjects with obsessive-compulsive disorder.

OBJECTIVE: There is a paucity of data on the long-term course and outcome of obsessive-compulsive disorder (OCD). Available data suggest that OCD runs a chronic course with waxing and waning severity. However, most previous studies included severely ill patients who were often clinically referred and hospitalized. The present study reports the course and outcome of OCD in patients who were largely outpatient, self-referred, and drug-naive. METHOD: Seventy-five of the 105 subjects (71%) with DSM-IV-diagnosed OCD were followed up 11 to 13 years after initial consultation in 1991 and 1992 at a major psychiatric hospital in India. A majority were self-referred (N = 63, 84%), drug-naive (N = 54, 72%), and outpatients (N = 60, 80%). The follow-up evaluations were carried out by experienced clinicians using various scales and structured instruments. The course and outcome were determined according to predefined criteria. Multinomial logistic regression analysis was performed to identify potential predictors of outcome. RESULTS: A majority of subjects were adequately treated with medications (N = 57, 76%). Out of 75 subjects, only 18 subjects (24%) had clinical OCD. Overall, 57 subjects (76%) had a favorable outcome: 32 subjects (43%) had no OCD and 25 (33%) had subclinical OCD. Mixed OCD and any Axis I lifetime comorbidity predicted "clinical OCD" outcome. CONCLUSIONS: Outcome of OCD is better than generally assumed, and the findings of this study offer a new perspective on the long-term outcome of OCD. Poor outcome in previous studies may have been due to the inclusion of severely and chronically ill patients.