Survey of knowledge, self-efficacy, and attitudes toward suicide prevention among nursing staff.

OBJECTIVE: This study aimed to explore the knowledge, self-efficacy, and attitudes toward suicide prevention among nurses with different demographic characteristics. METHODS: A cross-sectional descriptive design was adopted, and the study was conducted between August and September 2020. The content of the questionnaire included basic demographics, knowledge, self-efficacy, and attitudes toward suicide prevention. Correlation analysis was performed to determine nurses' knowledge, self-efficacy, and attitudes toward suicide prevention. RESULTS: The sample comprised 778 nursing staff from a medical center in southern Taiwan. The results showed that age, years of nursing experience, department type, education on suicide prevention, and care experience of nursing staff were associated with their knowledge, self-efficacy, and attitudes toward suicide prevention in general hospital patients. Younger and less experienced nurses demonstrated superior knowledge, self-efficacy, and attitudes toward suicide prevention. Nurses who received suicide-related education and training exhibited better self-efficacy and attitudes than those who did not. Nurses with care experience had better knowledge of suicide prevention than those without experience. Knowledge and self-efficacy in suicide prevention were both significantly and positively correlated with attitudes. CONCLUSION: Younger, less experienced, psychiatric nurses demonstrated superior knowledge, self-efficacy, and attitudes toward suicide prevention. Therefore, education on suicide prevention should be strengthened for older, experienced, and non-psychiatric nurses.

Work-related frustration among senior nurses at a medical centre.

AIMS AND OBJECTIVES: To investigate the levels and causes of work-related frustration among senior nurses. BACKGROUND: Role changes and the associated expectations and setbacks faced by senior middle-aged nurses can easily result in low morale. Therefore, working setbacks experienced by senior nurses must be investigated. DESIGN: A cross-sectional questionnaire study. METHODS: Purposive sampling was used to select questionnaire recipients. In total, 482 senior nurses completed and returned a structured questionnaire. RESULTS: The predictive factors for frustration at work among senior nurses included age, service unit, and the impact of sleep disorders, which jointly explained 54% of the variance. In particular, age and service unit were important predictive factors for frustration at work. CONCLUSIONS: Senior nurses had medium-to-low scores for frustration at work and did not perceive a high level of frustration. RELEVANCE TO CLINICAL PRACTICE: The outpatient departments and other medical departments in this sector should provide a reasonable system of incentives and promotion opportunities if they are to retain their most senior and experienced nurses. The results of this study could serve as a reference for hospital administrations.

[Factors Related to the Unplanned 90-Day Readmission Rate Among Elderly at a Geriatric Medicine Center].

BACKGROUND: Unplanned readmissions increase healthcare utilization rates and healthcare costs. The Taiwan Healthcare Indicator Series regards the rate of hospital readmission as an important indicator of inpatient-care quality. The elderly face a higher risk of unplanned readmission due to elderly-specific health and disease characteristics such as deteriorating body functions and the relatively high incidence of complications after the treatment of acute diseases. PURPOSE: To explore the factors that relate to the unplanned readmission of elderly within 90 days of discharge at a geriatric medical center. METHODS: We retrospectively reviewed the medical records of inpatients aged ≥65 years who had been admitted between January 2013 and December 2014. Related factors that affected the rate of unplanned readmission within 90 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. RESULTS: The 90-day unplanned readmission rate was 20.3%. Factors that were found to relate to unplanned readmissions were: emergency room admission (88.7%), lack of regular outpatient follow-up (60.4%), cerebrovascular incidents (43.4%), osteoporosis (32.1%), gastrointestinal diseases (45.3%), and a hemoglobin level < 10.0 mg/dL (35.8%). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results of the present study may help the healthcare team better understand the factors that affect unplanned readmission in the elderly. We suggest that these teams provide timely health education for elderly, integrative healthcare for chronic diseases, and appropriate nutritional supplements in order to reduce unplanned readmissions.

Healing and recovering after a suicide attempt: a grounded theory study.

AIMS AND OBJECTIVES: To explore the healing and recovery process following a suicide attempt over 12 months ago. BACKGROUND: Literature has explored the process leading up to attempted suicide. However, there is a lack of information exploring the healing and recovery process after a suicide attempt. DESIGN: Qualitative research using the grounded theory approach. METHODS: Data were collected during 2010-2011 from the psychiatric outpatient's centre in Taiwan. Interviews were conducted with people who had attempted suicide more than 12 months prior to data collection and had not reattempted since that time (n = 14). Constant comparison analysis was used to scrutinise the data. RESULTS: Findings demonstrated that healing and recovering evolved in five phases: (1) self-awareness: gained self-awareness of their responsibilities in life and their fear of death; (2) the inter-relatedness of life: awareness of the need to seek help from professionals, friends and family for support; (3) the cyclical nature of human emotions: reappearance of stressors and activators causing psyche disharmony; (4) adjustment: changes in adjustment patterns of behaviour, discovering and owning one's own unique emotions, deflecting attention from stressors and facing reality and (5) acceptance: accepting the reality of life and investing in life. CONCLUSION: The healing and recovery process symbolises an emotional navigation wheel. While each phase might follow the preceding phase, it is not a linear process, and patients might move backwards and forwards through the phases depending on the nursing interventions they receive coupled with their motivation to heal. It is important for nurses to use advanced communication skills to enable them to co-travel therapeutically with patients. RELEVANCE TO CLINICAL PRACTICE: Listening to patients' voices and analysing their healing and recovery process could serve as a reference for psychiatric nurses to use to inform therapeutic interventions.

[Enhancing the capability of medical team to manage aggressive events in acute psychiatric wards].

Incidences of violence in acute psychiatric ward can lead to not only facility destructions, but also mental, physical injuries and even medical disputes. As part of efforts to enhance medical team abilities to manage aggressive events, this study aimed to provide references for reducing both aggressive events and resultant damage. Over two-thirds (69%) of all unanticipated occurrences registered by our unit in 2003-2004 were classed as "aggressive events", i.e. there were 27 occurrences (0.09%) in which 0.04% resulted in staff injury. Events were mainly attributable to psychiatric symptoms, poor impulse control and interpersonal conflicts. For this study, we used several intervention methods, including categorizing patients by "risk of violence" rank, revising the hospital's standard operation processes for handling violence and revising the nursing rules to enhance nurse skills at managing violent events, countering patient violence, helping patients safely vent their anger and physical force, listening to relax music and conducting behavior modification. As a result, aggressive event prediction sensitivity increased from 56% to 100%, with successful prevention rates reaching 80%. The rate of aggressive event occurrence reduced from 0.09% to 0.06% and staff injuries decreased from 0.04% to 0.02%. Intervention methods employed were shown to be quite effective. If medical teams elsewhere enhanced their sensitivity and abilities to avoid aggressive events, injury and damages could be prevented and medical care quality enhanced.