'Therapy as well as the tablets': an exploratory study of service users' views of community mental health nurses' (CMHNs) responses to hearing voices

Mental health nurses have traditionally been discouraged from engaging with service users' experiences of hearing voices and to reinforce reality. However, this may not be a helpful way of intervening in what can be a very distressing symptom. There is little evidence of service users' experiences of community mental health nurses' (CMHNs) responses to their voices. This paper presents the findings of an exploratory interview study of a sample (n = 20) of service users to ascertain their perception of CMHN responses to their experience of hearing voices. Data are both quantitative and qualitative in nature. Content analysis of the qualitative elements of the study suggests responses can be conceptualized as facilitators, barriers and attributions. CMHNs are considered to be allies and the quality of the relationship is deemed important. The therapeutic repertoire of CMHNs, however, is seen as limited and rarely extends beyond facilitating access to the psychiatrist for review of medication.     

Hearing loss and its impact on residents in long term care facilities: Asystematic review of literature

The prevalence of age-related hearing loss is high among older adults. Growing longevity and the older profile of aged care residents is likely to result in an increasing incidence of hearing loss among this cohort. This review reports on the findings of a systematic search of the academic databases CINAHL, Medline, PsychInfo and Scopus undertaken to investigate the hearing experiences of residents of aged care facilities. Twenty-two studies met the inclusion criteria. Our analysis revealed clear barriers and facilitators to optimal hearing experiences and indicated the importance of the physical and social environment for effective communication. Under-detection of hearing loss and underuse of hearing aids were prevalent. The findings highlight the importance of addressing these issues for this cohort's quality of life. Future trends that may impact on training needs are considered and recommendations are made.     

Evaluating a community nursing service: listening to the voices of clients with an intellectual disability and/or their proxies

The aim of this study was to evaluate a specialist nursing service programme for people with an intellectual disability residing in the community. It is important to correct the imbalance in the literature that has neglected the voices of the clients themselves or denied expression by their proxies. The aim of the study was to gain a better understanding of matters of importance for clients and their families and to involve them in the evaluation of a service that directly affects their care. Only three clients were able to participate; however, 17 parents (next of kin) agreed to be interviewed. In-depth interviews were audio-taped, transcribed and analysed relating to the questions asked and were checked against the domains of the nursing practice in the disability area: continuity of care, advanced nursing practice, education and credentialling, personal and professional attributes, primary health care, and normalization. The findings confirm the high regard in which the programme is held. Service evaluation is crucial in providing evidence for programme funders. The favourable outcome of this evaluation meant that the programme gained funding for another few years.     

Employment maintenance and the factors that impact it after vocational rehabilitation and return to work

Purpose.?To determine post-return-to-work disability and functioning amongst occupationally injured workers and to test the extent to which demographic and other variables relate to employment maintenance. In addition, the project sought to document what workers believe determined their work continuation.

Method.?Semi-structured in-depth interviews were conducted to inquire about participant's (N?=?150) post-vocational rehabilitation return-to-work experiences. Results were interpreted using the health and health-related domains from the International Classification of Functioning, Disability and Health.

Results.?Although most participants were working at the time of interview, almost all were experiencing functional- or activity-based restrictions. Factors differentiating those employed from those not, were largely contextual and included relationships with supervisors, economic climate, and working conditions.

Conclusions.?The findings stress the importance of considering environmental strains when planning return to work and indicate ways to assist workers to achieve return-to-work success.