对朝鲜族和汉族护生临床实习前后心理健康状况的研究

[目的]探讨朝鲜族与汉族护生临床实习前后心理健康状况。[方法]应用艾森克个性问卷及症状自评量表(SCL-90),对延边地区朝鲜族、汉族护生实习前后的心理健康状况进行评定。[结果]朝鲜族、汉族护生间的个性差异无统计学意义(P>0.05)。实习前护生SCL-90总均分、阳性项目数和各因子分均高于国内女性常模,差异有统计学意义(P<0.01或P<0.05);朝鲜族与汉族护生心理健康状况差异无统计学意义(P>0.05)。实习后护生躯体化、强迫症状、焦虑、精神病性、阳性项目数与国内女性常模比较差异有统计学意义(P<0.01或P<0.05),实习前后朝鲜族护生强迫症状、人际关系、焦虑、恐怖、偏执、精神病性、总均分、阳性项目数差异有统计学意义(P<0.01或P<0.05),而汉族护生实习前后各项差异均无统计学意义(P>0.05)。[结论]朝鲜族与汉族护生实习前后心理健康状况均较差,学校、实习医院护理管理者应给予重视。     

The importance of clinical experience for mental health nursing - part 1: undergraduate nursing students' attitudes, preparedness and satisfaction

Government inquiries and workforce data continue to draw attention to the current and impending crisis in mental health nursing. While undergraduate nursing education has been found at least partially responsible for the negative attitudes nursing students tend to hold towards mental health nursing, clinical experience has been identified as a potential strategy in enhancing more positive attitudes. However, research to date has not focused on the impact of clinical experience on specific factors such as attitudes to mental health nursing to people experiencing mental illness and perceived preparedness for the mental health field. This quasi-experimental study measured changes in students' attitudes to the three factors, including satisfaction with clinical experience following a placement in mental health nursing. A questionnaire was administered to undergraduate nursing students on the first and last day of a mental health clinical placement. This, the first of a two-part paper, compares student responses over the two-time periods and describes satisfaction with the clinical experience. The findings suggest that clinical experience in mental health nursing experience can positively influence attitudes, preparedness for practice, and the popularity of mental health nursing. Satisfaction with clinical experience was also high.     

医学院护理系男生心理健康状况分析

目的了解高校男护生心理健康状况及其影响因素。方法应用症状自评量表(SCL-90)和自制调查问卷,对护理系26名男生和33名女生进行心理健康状况调查。结果护理系学生与常模比较,强迫状态、焦虑、恐怖、精神病性因子分显著高于常模(P<0.05或<0.01)。男、女生分别与常模比较,男生强迫状态、精神病性因子分显著高于常模(P<0.05或<0.01);女生强迫状态、恐怖、精神病性因子分显著高于常模(P<0.05或<0.01)。男生与女生比较,男生恐怖因子分显著低于女生(P<0.05)。结论对医学院校学生,应加强心理辅导,促进其心理健康发展。男护生相对于女护生,对从事护理工作,有其优越性。     

The first experiences of clinical practice of psychiatric nursing students in Taiwan: a phenomenological study

Aims and objectives. The purpose of this study is to understand the experiences of psychiatric nursing students during their first encounters with psychiatric patients in a clinical setting. The objective is to assist educational professionals in mental health to improve teaching strategies. Background. In clinical settings, student psychiatric nurses have to face complex problems and situations that can result in distress. Sometimes the student nurse will be uncertain of their own ability and this is reflected in a sense of fear on the part of some nurses. However, little research has been conducted into the first clinical experiences of such nursing students in Taiwan. Design. A qualitative phenomenological study was devised to explore what psychiatric nursing students perceived during their first experiences of clinical practice and narratives were analysed using Colaizzi’s seven‐step method. Method. A phenomenological approach and purposive sampling were used in the study. Face‐to‐face interviews were conducted to collect the data and during the process of data analysis we established epochs (bracketing) and focused on the reality of the student nurses’ experience to keep the data objective. Results. Four themes were identified: breaking the stigma of mental illness, developing a trusting relationship with the patient, gaining professional knowledge and skills and the process of student growth. Conclusion. The findings from this study demonstrate that it is important to understand the perceptions of students during their first experiences of psychiatric nursing in a clinical setting and highlight the importance of educational programs. Relevance to clinical practice. By understanding the emotional process that psychiatric nursing students may go through during their clinical practice, educators can be better able to design suitable training courses in the future.     

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.     

The importance of clinical experience for mental health nursing - part 2: relationships between undergraduate nursing students' attitudes, preparedness, and satisfaction

Clinical experience is consistently emphasized in research findings as the primary influence in encouraging more positive attitudes to mental health nursing. The available research, however, presents two major limitations. First, it does not measure the specific factors that might contribute to a positive clinical experience. Second, it does not consider the relationship between clinical experience and attitudes towards people experiencing a mental illness or towards mental health nursing. This is the second of a two-part paper presenting findings from a statewide survey of undergraduate nursing students in Victoria. A pre-/post-test design was used to measure the impact of clinical experience on the following subscales: (i) attitudes towards people experiencing a mental illness; (ii) attitudes toward mental health nursing; and (iii) preparedness for mental health practice. Subscale (iv) satisfaction with clinical experience was also measured in the post-test phase. The findings demonstrated an improvement on all three subscales in the post-test phase and a high level of satisfaction with clinical experience. Furthermore, a relationship between all four subscales was evident.     

在校护生心理健康水平影响因素的路径分析

目的了解护生心理健康水平与心理社会因素的关系。方法采用症状自评量表、青少年生活事件量表和应对方式问卷、领悟社会支持量表、自尊量表对345名护生进行调查。结果成熟型应对方式、领悟社会支持量表得分、自尊量表得分与症状自评量表得分呈负相关,不成熟型应对方式、混合型应对方式、青少年生活事件量表得分与症状自评量表得分呈正相关。对症状自评量表得分有直接影响的变量按影响大小依次为成熟型应对方式、自尊、生活事件评分、社会支持总分,4个变量对心理症状均存在间接效应。结论成熟型应对方式、自尊、生活事件、社会支持是影响在校护生心理健康的重要因素。     

The clinical activity of mental health nurse lecturers

Concerns have been expressed about the ability of mental health lecturers to prepare practitioners with the skills, knowledge and attitudes needed to implement the National Service Framework for mental health. Specifically mental health nurse lecturers have been criticized for lacking clinical competence and credibility, and for being out of touch with developments in service delivery. This paper presents a selection of findings from a recent review into the clinical activity of mental health lecturers in higher education institutions in England. The issues discussed include roles in practice, questioning the value of face-to-face clinical work, the benefits of being clinically active, the difficulties of clinical academic roles, barriers to maintaining clinical activity, questioning the quality of the clinical workforce, and finally strategies to facilitate clinical activity. Whilst there is support among mental health nurse lecturers for the need to engage with practice at some level, there are inconsistencies in the ways that this is being achieved. Lecturers are, however, getting together to debate how best to keep up with changes in mental health practice and delivery.     

Developing more positive attitudes towards mental health nursing in undergraduate students: part 2--The impact of theory and clinical experience

Previous research examining the impact of education on nursing students' attitudes towards mental health nursing as a career has highlighted clinical experience as the primary influencing factor and generally has not considered the impact of theory. The current study compared a cohort of second-year and a cohort of third-year nursing students from the same university. Second-year students had received more theory and clinical experience than their counterparts. Questionnaires were distributed to the total population of students before commencement of, and after completion of clinical placement. This paper examines students' perceived preparedness for and satisfaction with clinical experience, attitudes towards people with mental illness, and attitudes towards mental health nursing as a career option following the completion of differing amounts of theory and clinical experience. The results demonstrate some statistically significant differences with increased amounts of theory and clinical experience in the second-year cohort being positively influential. The findings suggest that an increased component of theoretical and clinical experience in psychiatric/mental health nursing is likely to produce more positive attitudes towards people with mental illness and psychiatric/mental health nursing. However, little difference in perceived preparedness for and satisfaction with clinical experience was noted between the two cohorts.     

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.     

‘Anyone can have a mental illness’: A qualitative inquiry of pre‐registration nursing students’ experiences of traditional mental health clinical placements

Nurses play a crucial role in mental healthcare provision. Like many countries, Australian nursing students are educated in comprehensive pre‐registration programmes which include mental health clinical placements. Placements play a vital role in students’ education, providing the opportunity to engage with consumers and develop mental health nursing knowledge and skills. There is limited knowledge of student perspectives on traditional placements in contemporary recovery‐oriented mental health services. This interpretive qualitative inquiry aimed to explore nursing students’ experience of traditional mental health clinical placement and how it influenced their practice and their understandings of recovery from mental illness. Data were collected from focus groups with n = 31 nursing students in a large metropolitan public mental health service. Thematic analysis resulted in three themes of experience: humanizing people with mental illness; learning about recovery; and shifting perspectives on mental health nursing. Through a positive placement experience where they felt supported and included by staff, students came to see consumers as people rather than diagnoses, developed greater understanding of mental health nursing work and were more likely to consider mental health nursing as a career choice. Peer‐support workers were an important influence on students’ understandings of recovery and have a key role to play in educating students on placement. Students need to be prepared and supported by university and clinical staff to deal with vicarious trauma that may occur on placement. Mental health placements play a crucial role in attracting students into the field, and it is imperative they remain part of comprehensive pre‐registration education.     

The challenges of mental health care reform for contemporary mental health nursing practice: delivery of nursing care

This ethnographic account of mental health nursing in a 22-bed acute inpatient facility in New South Wales, Australia, uncovered cultural meaning and cultural realities associated with the delivery of nursing care within the context of current challenges, demands, and influences brought about by service reforms. The findings demonstrate that mental health nurses have been responsive to changes brought about by the reforms. The ability of nurses to readily identify service gaps in their everyday practice provides them with the opportunity to develop strategies to respond to workplace challenges. As such, findings of the study contribute to current discussions concerning acute inpatient mental health nursing practice.     

Rethinking mental health nursing education in Australia: a case for direct entry

Desperate times call for creative solutions. The mental health workforce shortage has created an opportunity to rethink current and future education and training needs in order to prepare competent and compassionate practitioners to meet the changing demands of consumers and their carers requiring mental heath treatment and support. This article urges consideration of an undergraduate direct entry mental health programme similar to that of midwifery or the nursing foundation/mental health branch programmes of the UK.