Undergraduate nursing students' attitudes towards mental health nursing: determining the influencing factors

Available evidence clearly demonstrates that undergraduate nursing students typically hold unfavourable attitudes towards psychiatric / mental health nursing as a career. It has been suggested that students' negative attitudes towards mental illness and consumers of mental health services may be responsible for the unpopularity of this specialty area; however, research exploring the relationship between career choices and students' attitudes is lacking. A sub-set of data from a large Victorian study that examined undergraduate nursing students' attitudes towards mental illness, mental health nursing, and mental health clinical placement experiences was used to clarify the nature of this relationship. In total, complete data was available from 605 students undertaking their first mental health placement who provided responses to a 24-item pre-placement survey. This survey assessed the following three areas: 1. preparedness for the mental health field; 2. attitudes towards mental illness; and 3. attitudes towards mental health nursing. The findings demonstrate significant relationships between students' attitudes, beliefs, and characteristics and desire to pursue a career in psychiatric mental health nursing. The identification of these relationships provides a basis from which interventions to influence nursing students' attitudes towards psychiatric/mental health nursing, can be planned.     

A systematic review of the effectiveness of in-home community nurse led interventions for the mental health of older persons

Aims and objectives. The aim was to systematically review evidence about the effectiveness of in‐home community nurse‐led interventions for older persons with, or at risk of, mental health disorders, to inform best practice nursing care with this focus. The primary review question was ‘How effective are in‐home community nurse‐led interventions for older persons with or at risk of mental health disorders for improving mental health?’ The outcome indices of interest were nursing actions to determine incidence or prevalence of mental health disorders, any change in a patient’s attitude towards their mental health condition, any change in objective measurement of mental health, or a change in diagnostic status. Background. The rising incidence of mental health disorders in older persons is a major concern for community nurses in developed countries. Effectively facilitating improved mental health for older persons is necessary in this era of ageing populations with increased demands on health funding. Disseminating systematically reviewed evidence for in‐home community nursing that positively impacts on the mental health of older persons is crucial to ensure effective care is provided to this vulnerable patient group. Results. This review reveals that there is evidence to support the superiority of applying validated screening tools for mental health disorders over relying on community nurses’ opinions and non‐validated tools about this matter. Design. Systematic review. Methods. Search of electronic databases. Conclusion. A clear need for replication and multi‐centre trials of reviewed pertinent studies is identified. Relevance to clinical practice. Community nurses should consider using validated screening tools for this focus. Until such time as higher quality evidence is available about other nursing interventions, the reviewers suggest that the prime nursing action should be the identification of whether older persons receiving community nursing care might have a mental health disorder and, if so, then collaborative referral is made to appropriate services.     

The real‐life practice of acute inpatient mental health nurses: an analysis of ‘eight interrelated bundles of activity’

This study focuses on nursing in an inpatient mental health setting. Its analytic structure follows from a previous review of nursing studies by Allen, which did not include studies of mental health nursing. Allen's review concluded that the nurses’ role could be understood as that of healthcare intermediary and that nurses’ work could be analysed as eight interrelated bundles of activity. These bundles include such matters as managing the work of others. This study aims to assess the fit of this model to mental health nursing and to add to the body of work concerning the social organisation of nursing. The research materials discussed are derived from an ethnography of a psychiatric unit. The analytic framework employed leads us to conclude that the work of mental health nurses can be understood, too, as that of the healthcare intermediary. However, one bundle is found to fit less well and this is attributed to the fragile uncertainty of knowledge in psychiatry. The use of an additional bundle to describe in‐context nursing interventions is suggested. It is argued that getting to grips with the reflexive relationship between individual patient care and the social organisation in which this is practised is essential for any practice development efforts.     

Spirituality,religiousness, and mental health: A review of the current scientific evidence

Research in the field of “Spirituality and Health” has been growing, with spirituality/religiousness (S/R) being consistently related to both physical and mental health. The objective of this article is to provide an updated review of the current scientific evidence on the relationship between S/R and mental health, highlighting the most important studies. As a secondary objective, the mechanisms that explain this relationship and the interventions that utilize this information in treating mental disorders will be discussed. The findings reveal a large body of evidence across numerous psychiatric disorders. Although solid evidence is now available for depression, suicidality, and substance use, other diagnosis, such as post-traumatic stress disorder, psychosis, and anxiety, have also shown promising results. The effects of S/R on mental health are likely bidirectional, and the manner in which religious beliefs are used to cope with distress (i.e. negative and positive), may affect mental health outcomes. Despite these findings, the mechanisms that explain these associations and the role of S/R interventions need further study. Concerning clinical practice, mental health providers should ask patients about S/R that are important in their lives to provide holistic and patient-centered care.     

Health behaviour interventions to improve physical health in individuals diagnosed with a mental illness: a systematic review

Individuals diagnosed with mental illness experience high rates of morbidity and mortality as a result of poor physical health and unhealthy lifestyle behaviours. The aim of this paper is to systematically review the literature on health behaviour interventions to improve the physical health of individuals diagnosed with a mental illness. A systematic search strategy was undertaken using four of the major electronic databases. Identified articles were screened for inclusion, included articles were coded, and data were extracted and critically reviewed. A total of 42 articles were identified for inclusion. The most commonly targeted physical health behaviour was weight management. The majority of studies reported improvements in health behaviours following interventions. The findings provide evidence for the positive effect of health behaviour interventions in improving the physical health of individuals diagnosed with a serious mental illness. A focus on health behaviour interventions within the mental health nursing profession might lead to improvements in health behaviours and general health in consumers of mental health services.     

Evidence for psychiatric nursing practice: an analysis of three years of published research

Psychiatric and mental health nursing practice continues to be strongly influenced by tradition, unsystematic trial and error, and authority. Yet the need for quality care that is based on the best and most current empirical research is well documented. Achieving evidence-based practice in the psychiatric nursing specialty will require that qualified nurse researchers conduct research relevant for practice and appropriately disseminate that research to those who can best use it, practicing nurses. This State of the Evidence Review analyzed the 227 data-based studies published in the five most commonly read American psychiatric nursing journals from January 2000 through December 2002. Five major research foci were found: global perspectives, psychiatric nurses as subjects, studies of family caregivers, research with clients across the life span, and testing of nursing interventions. About 88% of the studies were conducted in the United States; 63% involved recipients of mental health care services; but only 11% tested psychiatric nursing interventions. Promoting evidence-based practice in psychiatric nursing will require increasing the numbers of psychiatric nurse researchers, enriching the research process (i.e., increasing relevance and appropriate dissemination), and implementing changes in practice that are based on the best and most currently available evidence, rather than on the equivalents of "Old Wives' Tales."     

Transition to mental health nursing through specialist graduate nurse programs in mental health: a review of the literature

Specialist graduate nurse programs (GNPs) in psychiatric/mental health nursing have been widely implemented across public healthcare services throughout Victoria, Australia. Broadly, these programs aim to assist newly graduated nurses during the transition from nursing student to registered nurse. This paper presents a review of the literature relevant to GNPs; specifically focusing on graduate transition. An adequate orientation to clinical areas and ongoing support throughout the transition process were identified as significant determinants of new graduates" satisfaction with the initial post-qualification period. However, the literature suggests that the inadequacy of psychiatric/mental health nursing content in undergraduate nursing courses creates additional difficulties within this specialty area of practice. Moreover, the current literature review emphasises the need for further research to evaluate the effectiveness of GNPs for nursing in general and for psychiatric/mental health nursing in particular.     

The mental health nurse: a valuable addition to the consultation-liaison team

Nurses, particularly those working in non-psychiatric settings, report that they do not feel adequately prepared to meet the mental health needs of patients. The psychiatric consultation-liaison nursing role has arisen in part, as a response to these difficulties and aims to facilitate access to mental health nursing expertise for general hospital patients and staff. The impact of the introduction of a nursing position into an established consultation-liaison psychiatry service was evaluated using an activity audit, a staff attitude survey, and staff focus groups. The findings demonstrated that the addition of the nursing role to the consultation-liaison psychiatry service improved access of general hospital patients to specialist mental health care. It also provided valued expert assistance to staff in the provision of care to this patient group, particularly those with complex problems and significant psychiatric comorbidity. The study found that the nursing consultation was particularly helpful because of its focus on practical and care-orientated interventions. The model of practice that evolved out of this project is described and the findings support the use of both direct and indirect patient interventions as important psychiatric consultation-liaison nurse activities.     

精神科轮班护士心理健康状况的调查分析及其健康维护

[目的]了解精神科轮班护士心理健康状况，探讨维护其心理健康的措施。[方法]采用症状自评量表（SCL-90）厦疲劳量表-14（FS-14），对30名精神科轮班护士及32名综合科轮班护士进行调查。[结果]轮班护士总体心理健康水平高于常模；精神科轮班护士除人际关系、敌对外，SCL-90总分及各因子分均高于综合科护士，其中强迫、抑郁、焦虑差异有统计学意义（P〈0．05），且FS-14总分高于综合科轮班护士，差异有统计学意殳（P〈0．05）；精神科轮班护士心理健康水平与护龄相关（P〈0．05）。[结论]精神科轮班护士存在明显的心理健康问题，应加强精神科轮班护士特别是护龄较长的轮班护士的心理健康维护.     

The place of the family in mental health nursing: past, present and future

The importance of the family system has, in recent years, been de-emphasized in the planning and delivery of mental health services A sample of the psychiatric nursing literature over the last 4 decades is reviewed to reveal that this is not a new phenomenon with regard to psychiatric nursing practice The shortcomings of such a de-emphasis are discussed, some exceptions to the rule are described and some suggestions for future development of family interventions by mental health nurses are made     

Knowledge and theoretical studies in psychiatric nursing and mental health

The present article consists of a bibliographical research developed with 109 articles published in Brazilian journals classified by CAPES as 'National B' or superior. Of these articles, 33 focused on knowledge and theoretical studies in psychiatric nursing and mental health which were rearranged in the sub-themes: theoretical studies with historical focus (focus in the sheltering model and focus in the transformation of the attendance of psychiatric nursing), participation of the family in the patient's process health-disease, the bearer's of psychic suffering comprehension of him/herself, stigma, use of the results of the research in psychiatric nursing, rethinking of the teaching, research instruments and work in nursing.     

Mental health nursing roles and functions in acute inpatient units: caring for people with intellectual disability and mental health problems--a literature review

The purpose of this paper is to review current national and international perspectives on the role and function of mental health nursing in dual disability within acute mental health inpatient settings. A universally accepted definition of the role and function of psychiatric nursing has been elusive. The role and function may be presumed to have core attributes that differ according to local conditions. The articulation of the role and function will contribute to the body of knowledge of psychiatric nursing and to improving the understanding of the nurse-patient relationship for those caring for people with dual disability in acute mental health inpatient facilities. The two identified key roles and functions of mental health nursing practice for people with intellectually disabilities within acute inpatient mental health facilities in Victoria will be discussed.     

Knowledge,attitude and behaviours toward people with mental illness among Tunisian nursing students and nonhealth care students: A cross-sectional study

BackgroundAlthough being in the frontline of healthcare and having a crucial role in the reduction of stigma, evidence has shown that nurses and undergraduate nursing students hold unfavourable attitudes toward mental illness. There is, to our knowledge, no previous study that explored attitudes toward mental illness among nursing students in Tunisia, nor in North African countries.AimWe aimed to assess stigma in nursing students as compared to nonhealth care students, and the relationship between stigma and education variables in the nursing students group.MethodsThe 'Community Attitudes toward the Mentally Ill', the 'Mental Health Knowledge Schedule', and 'Reported and Intended Behaviour Scale' were administered to 255 nursing students and 332 nonhealth care students.FindingsDespite nursing students being more knowledgeable about mental disorders than nonhealth care students; they held significantly more stigmatising attitudes toward people with mental disorders in two dimensions: Authoritarianism and Community mental health ideology. After controlling for confounders, we found that having taken mental health courses significantly predicted more favourable attitudes toward people with mental disorders and better knowledge of mental health stigma. Being interested in working in psychiatric wards helped predict more favourable attitudes and intended behaviours.DiscussionIn general, results from this study are of concern as it presents evidence of an overall similar or even greater tendency to negative attitudes toward mental illness among nursing students than among nonhealth care students.ConclusionThere is an urgent need for antistigma interventions in nursing schools. These interventions should target nursing students with the most negative attitudes, including male students and those who have never had personal experience with mental illness. Interventions should also work to build up nursing students’ interest in mental health nursing during their undergraduate years.     

The place of the unconscious in mental health nursing

ABSTRACT:  This paper acknowledges the concept of the unconscious in psychiatric discourse and explores the importance of this for mental health nursing practice. Mental health nursing practice has always been strongly influenced by psychiatric discourse because of its dominance in the clinical setting. The most recent edition of the American Psychiatry Association's Diagnostic and Statistical Manual has signalled that the concept of the unconscious is re-emerging in psychiatric discourse. This re-emergence provides the opportunity for mental health nurses to re-affirm or develop their psychotherapeutic skills in the nurse−patient relationship. The psychotherapeutic relationship could focus on ways for the patient to find meaning in their lives that recognize and value difference and multiple ways of being.     

Anxiety disorders in children and adolescents.

BACKGROUND: Children and adolescents frequently have symptoms of anxiety. In addition, anxiety disorders are some of the most frequent psychiatric disorders in this age group. METHODS: We used computerized literature searches (MEDLINE and PSYCHLIT) to identify clinical, research, and review articles on this subject. Various journals and textbooks from the psychiatric, medical, and psychology literature were accessed. RESULTS: This review includes findings on the epidemiology, developmentally normal anxiety, clinical presentations, course and outcome, and treatment interventions. CONCLUSIONS: Pediatricians and family practitioners should be familiar with the spectrum of anxiety in children and adolescents. Guidelines for referral to a mental health practitioner are reviewed.     

Psychiatric nurses and undergraduate nursing students' perceptions of preceptorship in the mental health setting

The importance of clinical education for nursing is widely acknowledged and considerable effort has been invested into identifying the most effective models. Psychiatric nursing has the additional imperative of increasing recruitment into the field. While clinical experience has been found to influence nursing students' attitudes towards psychiatric nursing and people experiencing a mental illness, little attention has been paid towards the factors that influence these outcomes. This study addresses the question, what is the experience of preceptorship for mental health nurses and undergraduate nursing students' in the mental health setting? An examination of the interactions within this model and the development of a substantive theory are facilitated by utilising the qualitative methodological approach, grounded theory. Findings indicate that psychiatric nurse preceptors seek to accomplish connectedness in the preceptorship relationship, through overcoming fear and other misconceptions. In addition, a number of factors emerged where commonality exists between the experiences of mental health nurse preceptors andthe nursing students. These included the need to manage the reconciling of difference between general acute health and mental health settings, the challenge for both groups to address student fear and preconceived ideas of mental illness and the need of preceptors to 'protect' the students.