Nursing Students’ Attitudes Towards People Diagnosed with Mental Illness and Mental Health Nursing: An International Project from Europe and Australia

The stigma associated with a diagnosis of mental illness is well known yet has not reduced significantly in recent years. Health professionals, including nurses, have been found to share similar negative attitudes towards people with labelled with mental illness as the general public. The low uptake of mental health nursing as a career option reflects these stigmatised views and is generally regarded as one of the least popular areas of in which to establish a nursing career. The aim of the current project was to examine nursing students’ attitudes towards the concept of mental illness and mental health nursing across four European countries (Ireland, Finland, Norway and the Netherlands), and Australia, using the Opening Minds Scale and the Mental Health Nurse Education survey. The surveys were distributed to students prior to the commencement of the mental health theory component. Attitudes towards mental health nursing were generally favourable. Differences in opinion were evident in attitudes towards mental illness as a construct; with students from Australia and Ireland tending to have more positive attitudes than students from Finland, Norway and the Netherlands. The future quality of mental health services is dependent on attracting sufficient nurses with the desire, knowledge and attitudes to work in mental health settings. Understanding attitudes towards mental illness and mental health nursing is essential to achieving this aim.     

Nursing and Maslow’s Hierarchy: A Health Care Pyramid Approach to Safety and Security During a Global Pandemic

The COVID-19 pandemic of 2020 tested health care organizations in ways many had never experienced. In response to new problems, nurses and other staff needed creative solutions that would allow them to quickly and safely provide care. Nurses concurrently experienced stressors to their personal needs. The authors collected examples of creative problem-solving through staff interviews and reflected on Maslow’s hierarchy of needs to consider how nurse’s needs were being met throughout the pandemic. Recognizing that basic needs must be addressed before an individual can ascend the levels to eventual self-realization, the authors share how one health care organization quickly and successfully met the patient care requirements while supporting nurses basic needs like safety and trust.     

It's the Anxiety: Facilitators and Inhibitors to Nursing Students’ Career Interests in Mental Health Nursing

Increasing the rate of recruitment of nursing students into mental health nursing (MHN) is vital to long-term sustainability of health care system support for people diagnosed with mental illness. However MHN is not a popular career path; this raises questions about what attitudes and beliefs may divert or attract students to this specialisation. The current research involved a survey of undergraduate nursing students at a regional university in Australia to clarify the nature of relationships between attitudes (e.g., the value of mental health nursing, stereotypes of people with mental illness) and how they may be antecedents to considering MHN as a career path. Through a structural equation model, it was ascertained that anxiety surrounding mental illness leads to less interest in MHN as a future career and suggests that anxiety is (a) partly due to negative stereotypes, and (b) countered by preparedness for a MHN role. Beliefs on how MHN can make a valuable contribution to people's well-being did not affect interest in pursuing MHN. These findings reconfirm the need to reduce anxiety about mental illness by educational approaches that effectively prepare students for MHN, combined with challenging negative stereotypes.     

Who Comes Back? Characteristics and Predictors of Return to Emergency Department Services for Pediatric Mental Health Care

Objectives: The objective of this study was to investigate predictors of emergency department (ED) return visits for pediatric mental health care. The authors hypothesized that through the identification of clinical and health system variables that predict return ED visits, which children and adolescents would benefit from targeted interventions for persistent mental health needs could be determined. Methods: Data on 16,154 presentations by 12,589 pediatric patients (≤17 years old) were examined from 2002 to 2006, using the Ambulatory Care Classification System (ACCS), a provincewide database for Alberta, Canada. Multivariable logistic regressions identified predictors, while survival analyses estimated time to ED return. Results: In the multivariable analysis, there were four patient factors significantly associated with ED return. Male sex (odds ratio [OR] = 0.78; 99% confidence interval [CI] = 0.69 to 0.89) was associated with a lower rate of return, as was child age. The likelihood of ED return increased with age. Children ≤5 years (OR = 0.26; 99% CI = 0.14 to 0.46) and between ages 6 and 12 (OR = 0.64; 99% CI = 0.51 to 0.79) were less likely to return, compared to 13‐ to 17‐year‐olds. Patients with families receiving full assistance for covering government health care premiums were more likely to return compared to those with no assistance (OR = 1.59; 99% CI = 1.33 to 1.91). Patients were more likely to return if their initial presentation was for a mood disorder (OR = 1.72; 99% CI = 1.46 to 2.01) or psychotic‐related illness (OR = 2.53; 99% CI = 1.80 to 3.56). There were two modest health care system predictors in the model. The likelihood of return decreased for patients triaged as nonurgent (OR = 0.62; 99% CI = 0.45 to 0.87) versus those triaged as urgent (level 3 acuity) and increased for patients with visits to general (vs. pediatric) EDs (OR = 1.25; 99% CI = 1.03 to 1.52). ED region (urban vs. rural) did not predict return. Within 72 hours of discharge, 6.1 and 8.7% of patients diagnosed with a mood disorder and psychotic‐related illness, respectively, returned to the ED. Throughout the study period, 28.5 and 36.6% of these diagnostic populations, respectively, returned to the ED. Conclusions: Among children and adolescents who accessed the ED for mental health concerns, being female, older in age, in receipt of social assistance, and having an initial visit for a mood disorder or psychotic‐related illness were associated with return for further care. How patient presentations were triaged and whether visits were made to a pediatric or general ED also affected the likelihood of return. ACADEMIC EMERGENCY MEDICINE 2010; 17:177–186 © 2010 by the Society for Academic Emergency Medicine     

What Is the Impact of Targeted Health Education for Mental Health Nurses in the Provision of Physical Health Care? An Integrated Literature Review

Individuals with a severe mental illness have a gap in life expectancy of up to 20 years in comparison to the general population. Nurses who work in mental health services have been identified as best placed to improve the physical health outcomes of individuals with mental illness. The literature identifies a lack of nursing knowledge related to physical health care and the presence of metabolic syndrome which is impeding nurses in providing essential physical health care to patients. An integrated literature review was carried out due to the dearth of research evidence pertaining to the impact of targeted education specifically with psychiatric/mental health nurses in the provision of physical healthcare. A search for literature included the following databases: CINAHL, Medline, PsycINFO, Embase and Web of Science revealed nine studies: seven quantitative, one qualitative and one mixed method. Qualitative synthesis has shed light on the value of targeted education on improving knowledge and skills in providing physical health care that can then be translated into clinical practice. Targeted education in physical healthcare grows psychiatric/mental health nurse's confidence and develops the skills necessary to enable them to screen and monitor and offer range of physical health interventions to individuals with severe mental illness.

Accessible summary ? The poor physical health outcomes and premature death of individuals with severe mental illness is of growing concern; a contributing factor is a lack of knowledge and confidence amongst psychiatric/mental health nurses to providing physical health screening and intervening in preventable diseases such as cardiovascular disease, stroke cancer, and type 2 diabetes mellitus.

? An integrated literature review was used to ascertain if targeted education on physical health care can improve the knowledge base of psychiatric/mental health nurses within physical health care.

? Nine studies were critically appraised, and the data reduced using a narrative synthesis that tells a story of the findings from these research studies.

? The review found that targeted education with psychiatric/mental health nurses does result in a statistical increase in knowledge This review finds that nurses have not been regularly supported with physical health education to alter existing practices. This lack of knowledge within physical healthcare is hindering psychiatric/mental health nurses to fully engaging in physical health care activities in practice.

     

Is E‐mail Communication a Feasible Method to Interview Young People With Mental Health Problems?

TOPIC: E‐mail interviewing—not to be confused with “online surveying”—shows promise for researchers working with adolescent mental health populations as a data collection method. PURPOSE: To explore potential advantages, constraints, and applications of e‐mail interviewing as a research method for staff working with adolescent mental health populations. CONCLUSIONS: At face value, there appear to be several advantages to e‐mail interviewing with young populations and further exploration of this method is warranted.     

Health Care Professionals’ Knowledge and Attitudes Toward Physical Activity in Cancer Patients: A Systematic Review

ObjectivesThe purpose of this study was to, combine current available literature across health professionals to determine commonalities and differences between knowledge and attitudes of physical activity (PA) and its importance within the cancer population. It aimed to identify any gaps in the literature to inform future study directions to enhance PA participation and improve health outcomes and quality of life.Data SourcesDesign: systematic review. Data sources: Google Scholar, EBSCO, PubMed, Scopus, Web of Science. Inclusion criteria: survey-based studies specifically reporting PA levels for both cancer patients and survivors from the perspective of oncology health care professionals. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to guide this review. The initial search highlighted 15,342 articles and returned 190 articles with relevant titles, of which 20 met the eligibility criteria; 15.8% of cancer patients reported to meeting PA guidelines during treatment and 36.5% after treatment. On average 58.1% of health care professionals self-reported discussing PA with their cancer patients, with the average referral rate to an exercise specialist or rehabilitation program being 18.3%.ConclusionOnly a limited number of health care professionals are initiating a discussion about PA with their cancer patients. Some health care professionals reported limited knowledge of PA guidelines for cancer patients. Their own personal PA levels do not seem to be associated with whether they discuss PA with their patients. Common barriers to providing PA advice were experienced across all health care professions such as time, limited referral pathways, and patient interest. Future research should be carried out to substantiate these barriers and discover which strategies could be implemented to improve the levels of PA discussions and referrals within clinical practice.Implications for Nursing PracticeGiven the position nurses hold within the health care system, it would be beneficial to upskill and improve their understanding of PA and exercise as medicine for the cancer population. This has enormous potential that could enhance PA advice and boost referrals to exercise professionals improving the health and quality of life of the cancer population.     

Engaging and supporting fathers to promote breastfeeding: a new role for Health Visitors?

Scand J Caring Sci; 2011; 25; 467–475
Engaging and supporting fathers to promote breastfeeding: a new role for Health Visitors? Background: Health visitors have a central role in delivering and leading on the new UK government targets on breastfeeding as part of the strategy to reduce health inequalities. This article explores fathers’ views and proposes that health visitors are best placed to engage with fathers in supporting the initiation and continuance of breastfeeding. Aim: To conduct initial pilot scoping of fathers’ views on breastfeeding in order to provide insights into possible interventions which could contribute to increasing rates of exclusive breastfeeding. Methods: Eight individual in‐depth interviews were conducted with fathers (aged 28–47) from different socio‐economic groupings living in Brighton and Hove (UK). Data were collected as part of a larger social marketing project focussing on increasing rates of exclusive breastfeeding in Brighton and Hove. Fathers were recruited through their partners whom had been interviewed previously about breastfeeding. Interviews were digitally recorded, transcribed, and analysed using a ‘framework’ approach. Findings: Data reveal that fathers are interested in breastfeeding and want to be involved more broadly in preparation for, and supporting of, breastfeeding. Fathers reported requiring more relevant and accessible information about the benefits of breastfeeding as well as details concerning some of the practical issues involved in supporting their partner’s breastfeeding. Discussion and conclusion: Although in our study fathers reported wanting to be involved in supporting breastfeeding, it is likely that current discourses about men and fathers as well as more practical worries and concerns may prevent some health visitors and other health professionals from involving them in meaningful ways. Whilst our study is limited in its scope and more research is needed, our data indicates that fathers are potentially a missing part of the jigsaw in terms of breastfeeding support.     

The Study of Nursing Care project: back to the future for contemporary nursing research?

smith k.m. & crookes p.a. (2012)?The Study of Nursing Care project: back to the future for contemporary nursing research? Journal of Advanced Nursing68(11), 2586-2593. ABSTRACT: Aims. To discuss the Study of Nursing Care project, an initiative from the late 1970s in the UK. The article explores the impact of the Study of Nursing Care on nursing research, and considers to what extent it presents a useful model for contemporary nursing research. Background. It is acknowledged internationally that the nursing academic workforce is ageing and dwindling. Many possible solutions are being debated with all agreeing that the next generation of evidence based nurse leaders is urgently required. Data sources. In this article, the authors survey existing workforce schemes, describe the Study of Nursing Care series, published in the 1970s, and draw on interviews and correspondence conducted in 2009 with four of the original Study of Nursing Care research assistants. Discussion. The Study of Nursing Care project poses a potential response to academic workforce issues. This article discusses the evolution of the project, its methods and operation and considers its possible implications for contemporary practice. Implications for nursing. The Study of Nursing Care model demonstrates the clear benefits of fully committed funding, a programmatic approach towards research development, and the importance of selecting the right kind of people for the work, in a National scheme. Conclusion. The authors argue that although the clinical outcomes it set out to achieve remain elusive, the project produced a cohort of nurse researchers who went on to give important leadership in nursing, including in nursing academia/research. A contemporary version of the Study of Nursing Care has important potential to generate the next generation of nurse researchers, and leaders, into the twenty-first century.     

“The Second Thing to Hell is Living under that Bridge”: Narratives of Women Living with Victimization,Serious Mental Illness,and in Homelessness

The increasing rates of violence committed against homeless women living with serious mental illness (SMI) have been well documented. These increasing rates of violence need attention as they are a serious public health concern. The purpose of this qualitative study is to increase our understanding of victimization among this population as perceived by those who have lived the experience. The study sample consists of 15 homeless adult women who self-reported having been diagnosed with a SMI. The findings highlight the reality that, provided with the right type of resources, positive growth can occur among these women despite lifelong events of trauma, victimization, and loss.     

The Health and Social Care Bill: value for money or service improvement?

Over the past couple of weeks, I have found myself yet again examining the proposed new Health and Social Care Bill. Although the Bill has cleared the House of Commons for now, it is being scrutinized in the House of Lords, who have had plenty of critical and uncomplimentary things to say. My concern regarding the progress of the Bill and the negative response surrounding it prompted me to revisit the legislation.