Smoking and mental health nurses: a survey of clinical staff in a psychiatric hospital

There is a lack of evidence on the prevalence of smoking among mental health nurses, and the beliefs and attitudes they hold about smoking at work. This paper describes results from a cross-sectional survey of clinical staff working in a UK specialist charitable-status psychiatric hospital and focuses on the responses of registered mental health nurses. Questionnaires specifically developed for this study were sent to all 1371 clinical employees. Completed questionnaires were returned by 167 of 429 (38.9%) registered nurses (RNs), 300 of 842 (35.6%) nursing assistants (NAs), and 123 of 200 (61.5%) other health professionals (OHPs). Twenty-nine (17.4%) RNs, 93 (31%) NAs and eight (6.5%) OHPs reported themselves as current smokers. Differences in response to attitudinal questions between groups could not be attributed to age. RN smokers were significantly more likely than RN non-smokers to state that staff should be allowed to smoke with patients, and to report therapeutic value for patients in this activity. RN smokers were less likely than RN non-smokers to report that patients should be encouraged to stop smoking. RNs were significantly more likely than OHPs to report therapeutic value for patients in smoking with staff, even after controlling for the possible confounding effect of smoking status. Implications of the survey are discussed in the context of the international literature, including the disproportionately high smoking prevalence among patients living in psychiatric institutions and current guidelines to move towards no 'smoking allowed' areas for staff working in them.     

Mental health professionals' attitudes towards people who have experienced a mental health disorder

The aim of this study was to gain information about the attitudes of mental health professionals towards people who have experienced a mental illness. The study involved a survey of 266 mental health professionals employed in a range of mental health treatment settings. Respondents were administered a questionnaire based on one of two vignettes describing a person with schizophrenia or depression. Attitudes were represented as beliefs about prognosis and long-term outcomes in relation to the two vignettes. Professional groups were found to be less optimistic about prognosis, and less positive about likely long-term outcomes, when compared with the general public. Medical staff were less optimistic about outcomes than other professional groups, with mental health nurses generally most optimistic. Most professionals based their attitudes on their experiences of working with people with mental health problems.     

Mental health literacy of Australian Bachelor of Nursing students: a longitudinal study

Many students have poor mental health literacy when they finish Bachelor of Nursing courses. This paper presents the findings of a longitudinal study of Australian Bachelor of Nursing students' mental health literacy about the effectiveness of interventions for people with schizophrenia. The 'Attitudes and Beliefs about Mental Health Problems: Professional and Public Views' questionnaire was used with a non-probability sample of nursing students. A time series approach to data collection was used, with data collected on three occasions between 2005 and 2007. Ethics approval was obtained from a university ethics committee. Data were analysed using SPSS Version 15.0. The students' views about the helpfulness of interventions showed a significant and positive improvement as they progressed through the course. There were significant differences over time in their views about the helpfulness of professional and lay interventions, their opinions about the helpfulness of mental health and other medications, and the usefulness of activity and non-pharmacological interventions. Because nursing students need to be mental health literate when they complete their course, mental health nursing content should be incorporated earlier in comprehensive undergraduate curricula and incrementally increased in each year of study.     

Advanced practice nurses led clinic in a psychiatric hospital: An outcome evaluation in Singapore

BackgroundAgeing population and rising patients' expectations, coupled with the shortage of physicians and the increasing pressure to contain health care costs, have resulted in rapid growth of advanced practice nurses (APNs), and the gradual shift of care from physicians to them. Though it was reported that APNs can provide safe, effective and quality care for patients, the evidence in mental health is lacking both locally and internationally.ObjectivesThis study evaluated the effectiveness of mental health APN-led clinic through examining the participants' clinical outcomes, satisfaction and perceived recovery.MethodsPre-post test study design was used, whereby 100 participants were surveyed by questionnaires, in addition to retrospective review of participants' medical records. Comparison was made from data obtained two years prior to and two years after participant's first consultation with APNs.ResultsParticipants had their psychiatric symptoms well-controlled (M = 24.71, SD = 1.18). There was no significant difference in readmissions (p = 0.320) and the emergency room visits (p = 0.320) over two years before and two years after participants' first consultation with APNs. However, there was a significant difference in default rates (p = 0.020). Participants seen by APNs had better attendance for their appointments than those seen by doctors. Participants reported being satisfied with APNs (M = 121.07, SD = 10.82), had good adherence to medications (M = 7.26, SD = 2.42), good perception of mental health recovery (M = 94.43, SD = 12.53) and had confidence in achieving their goals (M = 31.44, SD = 5.78). Characteristics of participants were not correlated with outcomes, with exception that age was correlated to drug adherence (p < 0.001). Satisfaction with APNs was also noted to correlate with mental health recovery (p < 0.001) and general self-efficacy (p < 0.001).ConclusionThis study supported the evidence that mental health advanced practice nurses can provide safe, effective and quality care for patients.     

Prevalence of auditory hallucinations in nurses in mental health

Seventy-nine nurses and student nurses working in the mental health field were asked to complete a questionnaire that asked about the prevalence of their experience of events that might be considered as examples of auditory hallucinations. Eighty-four per cent of the 55 nurses who returned the questionnaire described having experiences that might be described as auditory hallucinations. This level of prevalence is broadly consistent with other studies, and the difference between voices considered to indicate 'schizophrenia' and voices perceived as normal or unimportant is discussed. The relevance of these findings for the process of diagnosis and for the attitudes of nurses working in the mental health field towards voices reported by clients is highlighted.     

驻沈某部队医院医护人员心身健康状况1 100名体检者资料分析

目的从心理、社会因素与健康、疾病关系的角度,调查医护人员的健康和心理状况,为改善医护人员生活质量提供依据.方法对2004-01/2004-12沈阳军区总医院医护人员1100人进行体检,常规检测内科、外科、五官科、妇科,辅助检查项目为生化、X光、心电图、B超等.并采用ZUNG焦虑自评量表和ZUNG抑郁自评量表分析体检者的主观感受,衡量抑郁状态的轻重程度,评定时间跨度为最近1周内,均为20题,均采用1～4制计分,总分乘以1.25,四舍五人取整数,即得标准分.ZUNG焦虑自评量表50分以上,为有焦虑倾向,分值越高,焦虑倾向越明显;ZUNG抑郁自评量表得分,无抑郁(≤49分),轻度抑郁(50～59分),中度(60～69分)和重度(≥70分).采用百分率和卡方检验对体检医护人员1100人的焦虑自评量表、抑郁自评量表得分进行评价,观察常见患病种类及患病率,性别和年龄差异.结果按意向处理分析,受检者1100人全部进入结果分析.①焦虑和抑郁发生与社会因素和对疾病的了解显著相关(社会环境好,231/24.71%,225/24.06%;差,126/76.36%,52/31.52%;χ2=1.10,1.77,P＜0.05;对疾病了解,142/13.73%,162/15.7%;不了解,45/68.2%,54/46.7%;χ2=0.13,3.81,P＜0.05),且抑郁的发生尚与性别和文化程度高低有关(男女比较,371/43.5%,113/56.3%,χ2=3.48,P＜0.05;大专以下与本科及以上文化程度者比较,69/75.0%,651/81.25%,χ2=2.33,P＜0.05).②1100人受检者中1078人(98%)存在不同程度的健康问题,729例(占66.27%)有较严重的健康问题,前3位常见疾病分别为高血压(28.18%),高脂血症(24.55%),脂肪肝(20%),发现早期恶性肿瘤3例(肝癌1例,肾癌2例).③男女总患病率基本一致(98.24%,97.17%),但男性高脂血症和脂肪肝患病率明显高于女性(25.67%,23.09%;16.6%,9.31%;t=1.921,2.036,P＜0.05),女性痔患病率明显高于男性(14.17%,3.52%,t=2.029,P＜0.05).④55岁以前困扰医护人员健康的突出问题是高脂血症、脂肪肝和高血压(135/21.67%,116/18.62%,114/18.30%),55岁后发病前3位的疾病变化为高血压、白内障和高脂血症(195/40.88%,155/32.49%,135/28.30%).结论参加体检的医护人员经济条件好、家庭和睦、社会关系良好者,焦虑及抑郁的程度明显下降,反之则上升,另外对自己疾病了解,焦虑的程度减轻,反之则明显增加.疾病的发生率和发病种类与年龄有关,医护人员总体心身健康状况欠佳,应缓解工作和生活压力,改善饮食结构,加强身体锻炼和健康保健.     

驻沈某部队医院医护人员心身健康状况1100名体检者资料分析

目的：从心理、社会因素与健康、疾病关系的角度，调查医护人员的健康和心理状况，为改善医护人员生活质量提供依据。方法：对2004—01／2004—12沈阳军区总医院医护人员1100人进行体检，常规检测内科、外科、五官科、妇科，辅助检查项目为生化、X光、心电图、B超等。并采用ZUNG焦虑自评量表和ZUNG抑郁自评量表分析体检者的主观感受，衡量抑郁状态的轻重程度，评定时间跨度为最近1周内，均为20题，均采用1～4制计分，总分乘以1．25，四舍五人取整数，即得标准分。ZUNG焦虑自评量表50分以上，为有焦虑倾向，分值越高，焦虑倾向越明显；ZUNG抑郁自评量表得分，无抑郁（≤49分），轻度抑郁（50-59分），中度（60-69分）和重度（≥70分）。采用百分率和卡方检验对体检医护人员1100人的焦虑自评量表、抑郁自评量表得分进行评价，观察常见患病种类及患病率，性别和年龄差异。结果：按意向处理分析，受检者1100人全部进入结果分析。④焦虑和抑郁发生与社会因素和对疾病的了解显著相关（社会环境好，231／24．71％，225／24．06％；差，126／76．36％，52／31．52％；χ^2=1.10，1．77，P〈0．05；对疾病了解，142／13．73％，162／15．7％；不了解，45／68．2％，54／46．7％；χ^2=0．13，3．8l，P〈0．05），且抑郁的发生尚与性别和文化程度高低有关（男女比较，371／43．5％，113／56.3％，χ^2=3．48，P〈0．05；大专以下与本科及以上文化程度者比较，69／75．0％，651／81．25％，χ^2=2．33，〈0．05）。②1100人受检者中1078人（98％）存在不同程度的健康问题，729例（占66．27％）有较严重的健康问题，前3位常见疾病分别为高血压（28．18％），高脂血症（24．55％），脂肪肝（20％），发现早期恶性肿瘤3例（肝癌1例．肾癌2例）。③男女总患病率基本一致（98．24％，97．17％），但男性高脂血症和脂肪肝患病率明显高于女性（25．67％，23．09％；16．6％，9．3l％；t=1．921．2．036，P〈0．05），女性痔患病率明显高于男性（14．17％，3．52％，t=2．029，P〈0．05）。④55岁以前困扰医护人员健康的突出问题是高脂血症、脂肪肝和高血压（135／21．67％，116／18．62％，114／18．30％），55岁后发病前3位的疾病变化为高血压、白内障和高脂血症（195／40．88％，155／32．49％，135／28.30％）。结论：参加体检的医护人员经济条件好、家庭和睦、社会关系良好者，焦虑及抑郁的程度明显下降，反之则上升，另外对自己疾病了解，焦虑的程度减轻，反之则明显增加。疾病的发生率和发病种类与年龄有关，医护人员总体心身健康状况欠佳，应缓解工作和生活压力，改善饮食结构，加强身体锻炼和健康保健。     

精神科护理人员心理压力分析与干预

目的探讨精神科护理人员在工作中面临的心理压力,为制定相应干预措施提供依据。方法采用症状自评量表对100名精神科护理人员进行测评,并与国内常模进行对比分析,并制定相应干预措施。结果精神科护理人员症状自评量表总均分、阳性项目数及躯体化、强迫症状、抑郁、焦虑及敌对等因子分均显著高于国内常模(P均<0.01)。而相关分析发现,护理人员心理问题与社会支持、个人收入呈负相关,与生活事件、时间紧迫感、无端敌意呈正相关。结论精神科护士的心理健康状况较一般人群差。     

新加坡医院内护士职业生涯规划

护士职业生涯规划是设计护理人员专业发展的计划,目的在于实现组织与护理人员的共同成长、共同受益。新加坡医院采用护士职业生涯规划,通过对护士的认证和晋升体制的实施,培养出不同级别的护士,根据不同的级别分配不同的工作,从而提高护理质量和护理效率。这样,既满足了医院对护理人员不断提升护理质量的要求,又满足了护理人员个人职业发展的愿望。     

Stigmatization by nurses against schizophrenia in Turkey: a questionnaire survey

Individuals who have been diagnosed with schizophrenia face discrimination, exclusion and stigmatization by society. Nurses who work on psychiatric wards frequently face individuals diagnosed with schizophrenia throughout their careers. This study was conducted for the purpose of evaluating nurses' opinions about individuals who had been diagnosed with schizophrenia. A total of 543 nurses working on the psychiatric wards of 27 university hospitals (164), six training and research hospitals (21) and six psychiatric hospitals (358) in Turkey completed the questionnaire. The majority of the nurses stated that schizophrenia is caused by social problems, that they would be able to work with someone who has schizophrenia, that they would not be able to marry someone with schizophrenia, that they would not be bothered by having a neighbour with schizophrenia, that schizophrenia cannot be completely cured, that it can be improved with psychotherapy, that schizophrenic patients are aggressive and that medications used to treat schizophrenia have serious side effects and are addictive. It is important for nurses to avoid stigmatizing patients in order to promote a therapeutic environment--particularly on the wards--and also to improve individual awareness and perceptions in society.     

综合医院精神科护士心理健康状况调查

目的探讨精神科护士的心理健康状况及影响因素,为提高精神科护士的心理健康水平提供依据。方法采用症状自评量表对西京医院精神科42名护士进行调查,并与全国常模进行比较。结果精神科护士症状自评量表总分、强迫、人际关系、抑郁、焦虑、躯体化、恐怖、偏执、敌对因子分均显著高于全国成人常模（P〈0．05或0．01）。结论综合医院精神科护士心理健康状况较差,需要医院管理阶层给予更多的关注。     

Job satisfaction and resilience in psychiatric nurses: A study at the Institute of Mental Health,Singapore

Job satisfaction ranks highly as one of the main factors influencing turnover rates among nurses. Mental health nursing has been reported to be a particularly stressful specialty, yet little is known about the level of job satisfaction among psychiatric nurses in Singapore. Resilience is defined as a means of adapting to stress at the workplace, and could serve as a factor influencing job satisfaction. The present study aimed to explore the current level of job satisfaction among psychiatric nurses working in the only tertiary psychiatric institution in Singapore, the influencing factors, and the relationship between resilience and job satisfaction. A survey questionnaire consisting of the following was administered to all eligible nurses working in the Institute of Mental Health between the period of 16–24 December 2014: (i) The McCloskey and Mueller Satisfaction Scale; (ii) The Resilience Scale; and (iii) sociodemographic data form. A total of 874 nurses were eligible for participation in the study, and a total of 748 nurses responded, totalling 85.6% response. A mean satisfaction score of 95.21 and mean resilience score of 125.74 were obtained. Mean satisfaction and resilience scores were the highest for nurses with longer working experience and those of older age. A positive and significant association between satisfaction and resilience scores (P = 0.001) was obtained. Psychiatric nurses in Singapore are generally satisfied with their job, but this can be further improved with the strengthening of personal resilience.     

我院聘用护士的培养方法与成效

目的为适应军队实行精简整编及军队医院建设的需求,探讨聘用护士的培养方法。方法采取与地方院校联合办学,严格选拔来院实习护生;对实习护生和聘用护士进行军事素质训练、岗前培训等。结果培养了聘用护士的业务素质与军事素质,使聘用护士的综合素质得到提高。结论我院聘用护士的培养方法科学、有效,可供同行借鉴。