浅谈高护护生心理健康教育

为了更好地使高护护生在有限的临床实践中适应环境,适应临床不断发展的需要,培养出新一代的护理人才,应加强对高护护生的心理健康教育.     

An evaluation of practice-based interprofessional education initiatives involving service users

There is little published evidence regarding the impact of service-user focused interprofessional education in the practice setting. This article reports evaluative case studies of two practice-based interprofessional initiatives, in which service users played a central role. These initiatives formed part of the Trent Universities Interprofessional Learning in Practice (TUILIP) project ( http://tuilip.hwb.shu.ac.uk), a collaboration between Sheffield Hallam University and the University of Nottingham. Practice settings were an acute mental health service and a community organisation offering care and services to adults with learning disabilities. Interprofessional initiatives were developed by facilitators, and empirically studied at each site. Facilitators, managers, practitioners, students and service users took part in interviews and focus groups to discuss their perceptions of the initiative in their practice setting. The study revealed participants' perceptions of the projects' aims, process and outcomes, factors which facilitated success or proved challenging, and their impact upon individuals, clinical practice and the organisations involved.     

Partnerships with service users in interprofessional education for community mental health: a case study

Accidents in health care are mainly due to systemic communication errors. Errors occur more frequently in the operating theatre (OT) than other clinical settings. Hence, it is important that preventive communication practices are adopted in OT teams. Formal team pre-briefing has been shown to improve safety in high risk settings such as aviation, but such briefing is not common practice in OT teams. This paper reviews key literature demonstrating the value of briefing in high-risk practices; presents and analyses the results of a questionnaire survey on the status of briefing after its introduction to OT teams in one UK hospital; and analyses processes that frustrate widespread adoption of briefing. In comparison with other OT practitioners, surgeons generally reported differing perceptions of the meaning and value of briefing, often holding broad notions of what constitutes a “brief”, but also showing scepticism towards briefing. However, surgeons who had introduced briefing reported positive results such as greater efficiency, shared understanding, and increased team morale. Collaborative briefing that extends beyond the technical to include the interpersonal could be initiated in principle by any member of the OT team, but a number of factors inhibit this, and surgeons play a pivotal role in establishing briefing.     

The role of a mental health consumer in the education of postgraduate psychiatric nursing students: the students' evaluation

Recent Australian Government policy reflects the integral nature of active consumer participation to the planning and delivery of mental health services. The effectiveness of consumer participation in improving mental health services has received some attention in the literature. Commonwealth Government funding enabled the development of a partnership between the Centre for Psychiatric Nursing Research and Practice and the Melbourne Consumer Consultants' Group. The successful application enabled the employment of a mental health consumer as an academic staff member of the Centre for Psychiatric Nursing Research and Practice. One important aspect of this role involved the mental health consumer teaching a consumer perspective to postgraduate psychiatric nursing students. The primary aim was to increase the students' awareness of and sensitivity to greater consumer participation within the mental health arena. This paper presents the results of an evaluation of the consumer academic role in teaching within the Postgraduate Diploma in Advanced Clinical Nursing (Psychiatric Nursing). An evaluation form was distributed to students (n = 21) on completion of the semester. The findings suggest the experience was considered beneficial to students and was impacting significantly on their current practice. This project supports the value of consumer participation in the education of mental health professionals.     

护理学生心理健康教育与临床护理能力的关系研究

目的探讨对护理学生(以下简称护生)实施心理健康教育干预与提高临床护理能力的关系。方法我校2007级中专护生共4个班,随机选取一、二班为实验组(心理干预组),三、四班为对照组(未心理干预组)。实验组共90人,对照组共92人。对照组仅在学生入校后第2学期进行症状自评量表(SCL-90)评分;实验组采用心理健康教育方法进行心理健康干预,分别在学生入校后第2学期和实习末进行SCL-90问卷调查,并对两组的临床护理能力进行评价。结果通过心理健康教育干预后,实验组护生SCL-90得分均显著下降,心理健康水平明显提高(呈全面性正向反应)。实验组护生的护理技术操作能力、交流沟通能力、应付复杂护理工作能力等方面明显高于对照组护生。结论护理教育在强化基础知识与专业理论知识教育的基础之上,更要加强心理健康教育,从而有利于临床护理能力的培养和提高。     

Promoting mental health nursing: employing undergraduate nursing students as assistants in mental health

The difficulty in attracting graduates of nursing programmes into mental health nursing (MHN) remains an ongoing challenge. Moreover, it is frequently claimed that undergraduate nursing students do not always regard MHN favourably for future employment. Although undergraduate nurses are employed as assistants in nursing (AIN) in mental health settings, there is no published research exploring their role, the career trajectory into MHN, or its effectiveness as a recruitment strategy. In this paper, we draw on the literature to delineate factors that might contribute to the desire of AIN to work in MHN. Nine factors were identified: acceptance by nurses, fitting in with the culture, managing the workload, developing a realistic appraisal of the effectiveness and limits of psychiatry, constructive learning from direct interpersonal interactions with clients, practising communication skills, being supported in a structured way, working with positive role models, and the overall quality of the employment setting. A comprehensive understanding of these factors can enhance the experience of undergraduate nursing students working as AIN, and potentially increase recruitment into MHN.     

Promoting a sustainable mental health nursing workforce: an evaluation of a transition mental health nursing programme

The recruitment and retention of the mental health nursing workforce has been identified as a major issue both nationally and internationally. Transition to practice programmes has been identified as an important strategy in addressing these issues. There is, however, a paucity of literature addressing the potential or effectiveness of transition programmes in achieving these aims. This paper reports the findings of a survey administered to registered nurses at the commencement and completion of the Transition Programme into Mental Health Nursing, in Sydney, Australia. The findings suggest a high level of satisfaction with the programme. The results are directing the ongoing development of clinical placements, clinical supports, education programmes and recruitment and retention initiatives for nurses within the Central Sydney Area Mental Health Service.     

Evaluation of the content and interaction in an online clinical conference for students in advanced psychiatric mental health nursing

Clinical conferences have traditionally been a significant part of the education of psychiatric nurses. With the innovation and increasing popularity of Internet courses, the value of these conferences may be diluted or even lost. This study evaluates an online clinical conference for advanced psychiatric mental health students. The issues raised by students in the conferences were relevant to the objectives of the course. Content analysis of representative conferences indicated that the characteristics of involvement: personal, emotion, and metacognition, and interactivity were evident. Students reported advantages to online discussions, but acknowledged the loss of the greater spontaneity in face-to-face meetings.     

见习护士心理健康现状及与学历的关系

目的调查见习护士心理健康现状,并探讨其与学历之间的关系。方法采用目的抽样的方法对某三级甲等教学医院120名见习护士进行问卷调查,见习护士的心理健康状况采用症状自评量表（SCL-90）进行测定,并进行不同学历之间的比较。结果共发放问卷120份,回收问卷104份,回收率为86．67％,其中有效问卷101份,有效率为97．12％。101名见习护士SCL-90量表结果与常模组比较,躯体化[（1．73±0．31）比（1．37±0．48）]、强迫症状[（1．82±0,24）比（1．62±0．58）]、抑郁[（1．86±0．31）比（1．50±0．59）]、焦虑[（1．78±0．37）比（1．39±0．43）]、恐怖[（2．06±0．46）比（1．23±0．41）]均高于常模组,两组比较差异均有统计学意义（t值分别为7．42,3．44,6．07,8．88,19．50;P〈0．05）。不同学历之间SCL-90量表结果强迫症状、抑郁、焦虑、恐怖等因子分差异均有统计学意义（P〈0．05）。结论躯体化、强迫症状、抑郁、焦虑、敌对是见习护士最主要的心理问题,不同学历见习护士心理健康状况不同,提示护理教育者需要针对不同学历的见习护士给予个性化干预,以改善见习护士的心理健康状况。     

隐性课程视角下护理学专业学生心理健康教育路径探析

心理问题在我国护生中较为突出.如何加强心理健康教育,促进护生的心理健康非常重要.文章针对目前护生心理健康教育中存在的问题,结合隐性课程的特点,提出护生心理健康教育路径,以达到拓宽护生心理健康教育方式,实现心理健康教育全覆盖的目标.     

Emergency department mental health triage consultancy service: an evaluation of the first year of the service

This article presents the findings of a review of the first year of a night emergency department (ED) mental health triage and consultancy service. During the first 12 months of operation of the service, data on key performance indicators were entered into an emergency mental health triage and consultancy database. Data were also obtained from pre- and post-satisfaction surveys completed by ED staff and from self-appraisal statements generated by the five mental health nurses who undertook the position during the review period. The findings show the ED mental health triage and consultancy service positively impacted on the functioning of the emergency department. This was evidenced by staff' perceptions regarding the value of the service and through shorter "seen by times", a reduction in the number of patients with psychiatric/psychosocial problems who left the department without being seen, and the effective management of patients presenting with psychiatric/psychosocial problems, particularly those presenting with deliberate self-harm. The review provided evidence regarding the value of the emergency mental health triage and consultancy service and highlighted the advanced practice role undertaken by mental health nurses in this position.     

医科大学五年制护理系女生心理健康状况分析

目的 了解医科大学护理系女生的心理健康状况及其影响因素。方法 采用SCL-90，RD-16和《青少年生活事件量表》对75名护理系女生和91名医疗系女 生进行评定，结果 护理系女生中存在心理问题6人（8.5%)；SCL-90总均分及各因子分与常模比较均玩显性差异；医疗系女生的“精神病性”因子分显高于护理系女生，总均分和其余因子分无显性差异；护理系女生的阳性症状主要表现为人际关系敏感和精神病性症状，SCL-90总均分及各因子分与生活事件呈正相关。结论 护理系女生心理健康状况总体上和普通人群无显性差异，部分护理系女生的心理问题产生的原因可能与学生压力过大，人际关系处理不良和受惩罚有关，有必要加强护理系女生的心理健康教育服务。     

Addressing the mental health nurse shortage: Undergraduate nursing students working as assistants in nursing in inpatient mental health settings

The population of mental health nurses is ageing and in the next few years we can expect many to retire. This paper makes an argument for the employment of undergraduate nursing students as Assistants in Nursing (AINs) in mental health settings as a strategy to encourage them to consider a career in mental health nursing. Skill mix in nursing has been debated since at least the 1980s. It appears that the use of AINs in general nursing is established and will continue. The research suggests that with the right skill mix, nursing outcomes and safety are not compromised. It seems inevitable that assistants in nursing will increasingly be part of the mental health nursing workforce; it is timely for mental health nurses to lead these changes so nursing care and the future mental health nursing workforce stay in control of nursing.     

藏区免费职业教育护生心理健康状况调查研究

目的了解藏区免费职业教育护生心理健康状况,以开展针对性的心理辅导。方法随机抽取藏区免费职业教育学校中的120名护生,采用症状自评量表进行调查。结果藏区免费职业教育护生在条目总均分、躯体化、强迫症状、人际关系敏感、抑郁、敌对、偏执、精神病性因子得分均高于常模(P0.01或P0.05)。藏区免费职业教育1年级护生躯体化、人际关系敏感和敌对因子得分明显高于其他两个年级(P0.01或P0.05);2年级护生抑郁和精神病性因子得分高于其他两个年级(P0.01或P0.05);3年级护生焦虑得分明显高于其他两个年级(P0.05)。结论藏区免费职业教育护生心理健康状况较差,不同年级的藏区免费职业教育护生存在不同的心理健康隐忧,应对藏区免费职业教育护生进行针对性的心理辅导。     

Listening to young voices: challenges of research with adolescent mental health service users

Young people who have mental health problems and use the mental health services need to be consulted about their views regarding their experiences of care and treatment in the same way as adults do. Doing research with children and young people is relatively new but it is becoming more common and recent literature highlights a need to balance respect for their voices with responsibility for their best interests. This can be achieved by paying close attention to ethical and methodological issues throughout the course of every study. This paper reviews some of the issues involved in consultation research with adolescent mental health service users, and illustrates them with examples taken from an ongoing study into the experiences of young people in three Scottish child and adolescent mental health services.     

浅谈护理专业学生的压力应对教育

近年来，大学生心理健康问题受到一定程度的关注，国内外有不少关于大学生心理健康状况的报道。护理学是一门应用性较强的科学，实践性也强，它结合了自然科学与社会科学理论，形成了护理的理论体系与护理技术操作。护理技术操作是满足病人治疗需要的重要手段，从事该职业的工作者必须经过科学的培训、严格的考核才能取得从业资格。因此，学生在校学习期间就必须接受严格的训练，除了要掌握相关的医学基础理论之外，对于一些常用的护理技术操作要求达到熟练掌握，并且树立起救死扶伤为己任的高尚医德、医风和时时刻刻都不能有丝毫懈怠的社会责任感。这就使得护生要比其他大学生承受更大的心理压力。     

The evaluation of an online orientation to rural mental health practice in Australia

The aim of this study was to develop and evaluate an online, interprofessional education programme for clinicians commencing work in rural mental health services in New South Wales, Australia. Twenty-eight participants, including nurses, psychologists, social workers and occupational therapists, completed a 24-week education programme (Introduction to Rural Mental Health Practice programme) that orientated clinicians to working in rural settings. The online programme included an orientation to online learning and clinical skills such as risk assessment, therapeutic communication and de-escalation skills applied in rural settings. Twenty-four participants provided pre- and post-evaluation responses that were matched and analysed using paired t-tests to identify any significant differences in mean scores across the domains of interest. Fifty per cent (n= 13) of participants had a background in nursing and 49% were allied health clinicians (psychologists, social workers and occupational therapists). Statistically significant improvements (P < 0.05) were detected in participant confidence in responding to common mental health problems, knowledge about the role of different services in rural mental health care, perceived safety of work and perceived self-efficacy in dealing with challenging or aggressive behaviours. The Introduction to Rural Mental Health Practice programme was successful in orienting clinicians to rural mental health but the small sample size highlights the need to evaluate the programme with a larger cohort of rural clinicians. The attrition at the early stages of the study highlights significant challenges in the retention of rural clinicians in online education programmes. Factors that promoted participation and retention included the provision of study leave and orientation to the online environment.