Mental health nursing and physical health care: A cross‐sectional study of nurses' attitudes,practice, and perceived training needs for the physical health care of people with severe mental illness

Mental health nurses have a key role in improving the physical health of people with a serious mental illness, however, there have been few studies of their attitudes or the extent of their involvement in this work. The aim of this study was to examine mental health nurses' attitudes to physical health care and explore associations with their practice and training. A postal questionnaire survey including the Physical Health Attitude Scale for mental health nurses (PHASe) was used within a UK mental health trust. The 52% (n = 585) of staff who responded reported varying levels of physical health practice; this most frequently involved providing dietary and exercise advice and less frequently included advice regarding cancer screening and smoking cessation. Having received post‐registration physical health‐care training and working in inpatient settings was associated with greater reported involvement. More positive attitudes were also evident for nurses who had attended post‐registration physical health training or had an additional adult/general nursing qualification. Overall, the attitudes of mental health nurses towards physical health care appear positive and the willingness of nurses to take on these roles needs to be recognized. However, there are areas where nurses in our sample were more ambivalent such as cancer screening and smoking cessation.     

Strategies to promote nurses’ health: A qualitative study with student nurses

Developing strategies to support student nurses' health is a global priority for healthcare organisations and governments. This is because emerging international evidence indicates that improvements in student nurses' health are required to increase the longevity of careers and reduce the loss of time, skill and financial cost of sickness absence and workforce exit. However, we do not know what intervention strategies student nurses think would support their health. The study aim was to explore student nurses' views on factors that influence health-related behaviours and strategies that could improve health. Data were collected through participatory activities during focus groups with student nurses in Scotland. Analysis was theoretically informed and involved mapping to the Behaviour Change Wheel framework. Students identified several factors that influenced health-related behaviours. Four were ranked most important: knowledge, culture, time constraints, and stress. Strategies student nurses thought should be prioritised to improve nurses' health-related behaviours were: stimulating a health-promoting environment by reviewing shift work, improving workplace support, increasing staffing levels, subsidising and role-modelling of healthy food and exercise; and creating applied health-promoting curricula by integrating time and stress management training and lifestyle advice into nursing education. Educational and environmental interventions are needed to support student nurses’ health.     

Research Article: Cultural competence among Swedish child health nurses after specific training: A randomized trial

An urgent need to improve Swedish primary child health‐care nurses' cultural competence was revealed by previous research among nurses working in, and immigrant parents visiting, primary child health‐care services. The aim of this study was to evaluate the extent to which specific training affected how nurses rated their own cultural competence, difficulties, and concerns and to study how the nurses evaluated the training. Conducted as a randomized controlled trial, the effects on a study sample of 51 nurses were assessed by questionnaires in a pre‐ and post‐study design. The findings indicated that the 3 days of training were appreciated by the nurses and had some effects on their cultural competence, difficulties, and concerns. The training might have had positive effects on the nurses' working conditions as they rated it to have an impact on their ability to cope with the demands of their work activities in the health services. These effects are presumed to contribute to an improved quality of the health services, with a reduction in the risk for health‐care disparities among children of immigrant parents.     

Swiss nurses' knowledge related to health care reforms: an exploratory study

Swiss nurses' knowledge related to health care reforms: an exploratory study Background. This study examines health care reforms' implementation processes from the perspective of nurses' knowledge regarding the reforms. The research has been carried out in the Swiss (Canton Vaud) context, where health care reforms have been initiated, on the National (Federal) level, in 1996. Objectives. Three research questions were formulated: (a) What is the level of nurses' knowledge regarding the basic principles of LAMal (Loi fédérale sur l'assurance maladie, Federal Health Insurance Law)? (b) What is the level of nurses' knowledge concerning the principles of health care reforms in Canton Vaud (NOPS, Nouvelles Orientations de la Politique Sanitaire)? and (c) Are there knowledge differences relating to employment setting (hospital, community, and education), nurses' roles (managerial vs. staff nurses) and level of education? Methods. The sample consisted of a total of 74 nurses. Of these, 20 were employed in the community, 30 in hospital settings and 24 worked in schools of nursing. The research tool utilized was 40‐items nurses' knowledge questionnaire developed for the purpose of this study. Three knowledge subscales and a subscale of certainty were constructed. Results. Overall, data showed a moderate to high mean level of knowledge (around 70% correct responses) on all knowledge scales considered. Community setting, managerial position, and a nonacademic nursing degree were all positively related to higher levels of reforms' knowledge. On the contrary, employment in a hospital setting and having a university degree had both negative impacts on achieving a high score of knowledge. Levels of certainty were significantly higher for LAMal than NOPS and for correct rather than for wrong responses.     

Assault experiences: Lessons learned from mental health nurses in Taiwan

Mental health nurse are frequently subjected to patients' violent and aggressive behaviour. These assault experiences have given rise to mental health nurses' physical and psychological trauma, and negatively impact the quality of patient care. The purpose of the present qualitative study was to understand mental health nurses' experiences of being assaulted, the influences on their patient care, and their perspectives of the effectiveness of in‐service, violence‐prevention education. Ten mental health nurses from two different inpatient mental health facilities were interviewed using a semistructured interview guide. Thematic analysis of interview data found six themes: (i) violence is unpredictable; (ii) violence is normal; (iii) lasting psychological trauma; (iv) limited support from peers and the administrator; (v) violence prevention requires team cooperation; and (vi) doubting the effectiveness of in‐service education on violence prevention. Psychiatric ward administrators should assess nurses' learning and skill needs to determine whether these needs are met by existing in‐service training programmes. A culture of safety should also be promoted by building a warm and supportive ward climate for both staff and patients, which would include team cooperation and support for colleagues who suffer a violent incident.     

Knowledge of Jordanian nurses and attitudes toward patients with suicidal attempt

Nurses' attitudes toward attempted suicide may affect the quality of care provided to those patients. There is a significant relationship between suicide literacy level and stigmatizing attitudes toward suicide. This study aimed to examine nurses' knowledge and attitudes toward patients with suicidal attempts. A cross-sectional correlational design was used to guide this study, and data were collected using an online survey. The Stigma of Suicide Scale-short form (SOSS-SF) was used to measure stigmatizing attitudes toward suicide, while the Literacy of Suicide Scale (LOSS) was used to measure suicide literacy level. The sample consisted of 343 Jordanian nurses, and their mean age was approximately 31 years old. Only 58 (16.9%) nurses reported having suicide training. Nurses had low stigmatizing attitudes toward suicidal patients. Nurses showed low suicide literacy levels. Only 46% of nurses had scores equal to or higher than the passing score of the LOSS. Linear multiple regression was used to predict nurses' level of stigma toward suicidal patients. Among the four predictors entered in this analysis, only LOSS showed a significant and negative effect. This study highlighted the importance of suicide training and education for nurses because it may improve their attitudes, self-confidence, and professional practices when providing care for patients.     

Health literacy and functional health status in Korean older adults

Aims and objectives. The aim of the study was to investigate the relationships of health literacy to chronic medical conditions and the functional health status among community‐dwelling Korean older adults. Background. In the literature, limited health literacy has been reported to have adverse effect on health outcomes. However, the link between health literacy to health status among Korean older adults needs to be clarified. Design. A cross‐sectional survey. Methods. A cross‐sectional survey of 103 community‐dwelling Korean older adults was conducted from June 2007–September 2007. Health literacy was measured using the Korean Functional Health Literacy test and functional health status was measured using the subscales of the Medical Outcomes Study 12‐item Short‐Form Health Survey. Results. Individuals with a low health literacy had significantly higher rates of arthritis and hypertension. After adjusting for age, education and income, older individuals with low health literacy had higher limitations in activity and lower subjective health. In a model adjusting for age and income only, older individuals with low health literacy were more likely to report lower levels of physical function and subjective health and higher levels of limitations in activity and pain. Conclusions. Among community‐dwelling Korean older adults, limited health literacy is associated independently with higher rates of chronic medical conditions and lower subjective health status. Relevance to clinical practice. Nurses are key to providing health education to older adults. The understanding of the relationship of health literacy to health status is essential to develop communication and health education efforts for older adults in nursing practice.     

How can care managers strengthen health literacy among patients with common mental disorders? A qualitative study

Background

In order for persons with mental illness to be able to promote and preserve their health, sufficient knowledge about health is required. An effective means to improve the health of the patients is to strengthen their health literacy. The aim of this study was to explore how care managers work with health literacy in patients with common mental disorders to help them to better understand and manage their illness.

Method

A qualitative study was conducted, using written reports from 25 care managers regarding meetings with patients with common mental disorders in the primary care in a Swedish region. The care managers' reports were coded based on Sörensen's four dimensions for the domain “health care” and analysed deductively through systematic text condensation according to Malterud.

Results

The care managers described how they worked strategically and continuously with follow-up and wanted to be responsive to the patients' stories. They confirmed the patients' feelings with the goal of creating increased interaction, thereby involving the patients in their own care. The care managers also worked actively to provide well-balanced care at an early stage. Using various tools such as self-assessment instruments, the care manager started from the patient's basic problem, gave support and discussed strategies based on the patient's condition and situation.

Conclusions

The care managers used multifaceted health literacy interventions. They worked in a person-centred, strategic and encouraging manner based on the patient's unique conditions, where sensitivity and adapted information were important aspects. The aim of the interventions was for the patients to become knowledgeable, gain new insights and work independently with their own health.     

The Opinions of District Nurses regarding the Knowledge,Management and Documentation of Patients with Chronic Pain

This is the first of two studies investigating district nurses' opinions regarding the knowledge, management and nursing documentation of patients with chronic pain conditions, before and after the introduction of ‘pain advisers’ in one health care region in Stockholm. Seventy (97%) district nurses at 12 selected primary health care centres (PHCCs) answered a questionnaire. The study showed that 85% of the district nurses met patients with chronic pain conditions at least once a week. None of the 12 PHCCs had any written information/policies on pain control. Many district nurses did not perform any individual analysis of the patients' pain and very few used any tool, such as VAS, to assess or evaluate the patients' pain. The district nurses reported insufficient pain documentation. A number of district nurses were dissatisfied with the present management of patients with chronic pain at their PHCCs, their own knowledge of pain control, their own preparedness to meet these patients, their own follow-ups and their own documentation. The study also showed that the district nurses' attitudes to pain and pain control varied, depending on how satisfied they were with their own management of patients with chronic pain conditions.     

Impact of training on intensive care providers’ attitudes and knowledge regarding limitation of life‐support treatment and organ donation after circulatory death

The limitation of life‐sustaining treatment is common practice in critical care units, and organ donation after circulatory death has come to be included as an option within this care plan. Lack of knowledge and misunderstandings can raise barriers between health‐care providers (e.g., confusion about professional roles, lack of collaboration, doubts about the legality of the process, and not respecting patients' wishes in the decision‐making process). The aim of the present study was to determine the knowledge and attitudes of intensive care physicians and nurses before and after a multidisciplinary online training program. A cross‐sectional study was performed, and comparisons between the two groups were made using a χ²‐test for categorical data and unpaired t‐test or Mann–Whitney rank sum test for continuous data according to its distribution. Training benefited both professional categories, helping nurses to be more open‐minded and willing to collaborate, while physicians became more aware of nurses' presence and the need to collaborate with them.     

儿科护士健康教育素养的现状调查

目的 通过调查了解国内儿科护士健康教育素养现状及影响因素,为指导管理者制订有针对性的培训方案,提高儿科护士的健康教育素养提供依据。方法 采取普查的方法,选取31个省份各级医院儿科护士作为调查对象,发放自制儿科护士健康教育素养调查问卷对其进行健康教育素养知、信、行三方面的调查,并采用多元线性回归法分析健康教育素养的影响因素。结果 共回收15 800份问卷,其中有效问卷15 765份,有效回收率为99.78%,此次31个省份参与调查。儿科护士健康教育素养知识得分为（37.80±4.46）分,态度得分为（31.74±3.60）分,行为得分为（77.03±7.76）分。多元线性回归分析显示,职称、发表过健康教育相关论文、参加过健康教育相关培训为儿科护士健康教育素养的主要影响因素（P<0.05）。 结论 儿科护士的健康教育素养处于中等水平,有待进一步提高。护理管理者根据临床需要为护士提供切实可行的、有效的培训,提高儿科护士的健康教育素养。     

健康素养在门诊原发性高血压患者自我管理和社会支持的中介作用

目的探讨高血压患者健康素养在社会支持和自我管理中所起的作用,为今后改善居民健康素养并最终提高自我管理水平寻找理论依据。方法采用慢性病患者健康素养问卷、高血压患者自我管理问卷和社会支持评定量表对419例原发性高血压患者进行调查。结果高血压患者的健康素养总分为(102.36±10.93)分,75.89%的患者具备健康素养;自我管理总分为(74.18±9.64)分,处于中等水平;社会支持总分为(40.44±6.56)分,处于中等水平;健康素养和社会支持均与自我管理呈显著正相关(P0.01);健康素养在自我管理和社会支持之间存在中介作用。结论对原发性高血压患者通过健康素养的培养训练,能够提高患者自我管理能力,增加患者的社会支持,有利于患者的病情控制。     

The context of care: Issues of power and control between patients and community mental health nurses

Issues of power and control are inevitably linked to the nurse–patient relationship within mental health settings. This paper discusses power relations between nurses and patients within the context of the home visit as an important component of the provision of care to patients living with enduring mental illness. An interpretive ethnographic account was adopted to explore how nurses and patients negotiated issues of power and control with respect to the specific responsibilities associated with community mental health nursing practice. The home visit involved a shifting of power in favour of the patient; patients behaved as ‘hosts’ and nurses as ‘guests’. However, within this framework, nurses still exerted power in relation to certain aspects of patients' daily living which are deemed to be within the domain of nursing, and so legitimise the nurse's interventions. This study explicates the daily exigencies of community mental health practice and provides insights into difficult aspects of nurses' work, which have received little attention in the nursing literature to date.