Nurses attitudes towards the importance of families in psychiatric care following an educational and training intervention program

This study measures the attitudes of the psychiatric nurses, after having received an education and training intervention program (ETI-PROGRAM) in family systems nursing, towards the importance of the families in their care. Nurses' knowledge of the impact that family nursing intervention can have on family members may increase positive attitudes towards families. However, little is known about the impact that education and training intervention can have on nurses' attitudes, towards families in clinical practice. Quasi-experimental design was used to assess the change in nurses' attitudes towards families in psychiatric care after the intervention, which included a one-day seminar on the Calgary family nursing conceptual frameworks and skills training with clinical vignettes of families from psychiatry. The Families Importance in Nursing Care - Nurses' Attitude questionnaire was used to evaluate nurses' attitudes. A total of 81 nurses (65%) working in psychiatric care responded to the questionnaire. Nurses with more than 15 years of work experience were significantly more supportive of families in their care compared with less experienced nurses. Out of the 81 nurses, 52 (64%) answered the questionnaire again 14 months later. Furthermore, psychiatric nurses saw families significantly less burdensome after having participated in the ETI-PROGRAM.     

The needs of the family of critically ill neurosurgical patients: a comparison of nurses' and family members' perceptions.

In this study, researchers identified the important needs of family members of critically ill neurosurgical patients and explored the relationship between needs and unmet needs as perceived by nurses and family members. A total of 52 family members and 36 nurses in three neurosurgical special care units in Hong Kong were asked to complete the Chinese version of the 45-item Critical Care Family Needs Inventory. The rank order of most important needs reported by family members indicates that the majority of needs are related to assurance; needs for support and comfort were much less important. When rating needs, nurses underrated most of the needs considered important by family members. Needs for proximity were also underrated in importance by nurses when compared to family ratings, and needs for support were heavily overrated by nurses. The needs for proximity were least met. An inverse relationship between nurses' ratings of importance and the frequency of unmet needs was demonstrated. The most important need that was also largely unmet was having a specific person call when unable to visit. The findings of this study indicate areas of unmet need that require additional nursing interventions.     

The experiences of Chinese family members of terminally ill patients - a qualitative study

Aim. To describe and understand the experiences of Chinese family members of terminally ill patients during the end of life process in a palliative care unit. Background. Palliative care aims to provide care to dying patients and their family members. Skillful interventions are necessary to help family members cope with the impending death of the patient and maintain their emotional equilibrium. Hence, it is important to understand the experiences of family members of palliative care. Design. A phenomenological study was conducted. Data were collected by semi‐structured interviews. We interviewed a purposive sample of 20 family members of terminally ill patients in a palliative care unit in Hong Kong. The data were analysed following Colaizzi's phenomenological methodology. Results. Family members experienced anticipatory grief, with reactions that included anger, unease, sadness and helplessness. This was particularly acute when the patient was first admitted to the palliative care unit. However, the family members quickly accepted the reality and committed themselves to the care of the patient, seeking informational and emotional support from the nurses. The families wanted to be assured that the patient had been offered good care and suffered no pain. It was considered important to be with the patient during the dying process. Conclusion. This study demonstrated that Chinese family members were committed to the care of the patients in the palliative care unit. Cultural beliefs played a part in influencing family emotions and concerns. Relevance to clinical practice. This study offers a direction for family interventions that acknowledge the reactions of family members to the admission of a patient to a palliative care unit. It highlights that families need active informational and emotional support from nurses.     

Do nurses working in adult psychiatry take into consideration the support network of families affected by parental mental disorder?

The aim of this study was to gain information about registered and practical mental health nurses' activities concerning support network of families affected by parental mental illness. Data were collected using a structured questionnaire distributed to all 608 practical and registered mental health nurses working in adult psychiatric units in five Finnish university hospitals. A total of 311 nurses returned completed questionnaires (response rate 51%). Sixty per cent (n = 222) of registered nurses and 36% (n = 88) of practical mental health nurses responded. Information about family relationships and socio-economic situation was gathered regularly by all nurses. The nurses' individual characteristics, such as being a parent, further family education and use of family-centred care, were significantly related to their activeness in discussing the family's support network with the parents. Discussing family relationships and families support networks forms part of patient care in adult psychiatric nursing with families with dependent children (under 18 years of age). Nurses can work directly with the parents to aid them to strengthen their support network for themselves and their children.     

How nurses' experiences of domestic violence influence service provision: study conducted in North-west province, South Africa

This study was undertaken to determine whether nurses' experiences of domestic violence (DV) influence their management of DV and rape cases. In total, 212 nurses were interviewed in two South African health districts using a standardized questionnaire. We measured sociodemographic characteristics, quality of care in the areas of rape and DV management, and experiences of DV in their own lives and amongst family and friends. A total of 39% nurses reported having experienced either physical or emotional abuse themselves and 40.6% amongst family and friends. Having personally experienced DV had no influence on DV identification and management. Those with experience from friends and family were more likely to have provided better care for patients who presented after DV (mean quality of care score = 23.1), while nurses who reported no personal experience of DV, either in their own lives or among family and friends, had a lower quality of care score of 19.8 (P = 0.02). Having ever intervened in a domestic dispute was associated with higher quality of care (P < 0.001). This suggests that the greater degree to which nurses identify with DV and intervene, the more likely they are to provide higher quality of care. Training of nurses in DV must try to build such empathy.     

护士素质需求调查结果对临床教学的启示

目的调查不同人群对护士素质的需求，为临床教学提供方向。方法用便利抽样法，采用开放式问题．对110名患者，114名患者家属，119名医院工作人员及42名新护士进行护士素质需求调查，并将所得资料进行整理，提炼相关素质项目和类别进行分析。结果新护士认为技术精湛和理论知识丰富最重要，但患者、患者家属、医院工作人员则认为服务态度、责任心、沟通能力、团队精神等人文素质才是最重要的。结论新护士对护士必需素质的认识与其他人群存在很大的差异。临床带教中带教老师应该加强对学生服务意识、人文关怀、沟通能力、敬业精神的培养。     

Mental health nurses' work with family caregivers of older people with depression: review of the literature

Australia, along with the rest of the world, is moving towards providing mental health services in the community rather than in hospital settings. This raises critical questions of what the impact of community-based care is on family members of people with mental illness, and how mental health care professionals, particularly mental health nurses, work with these family members to meet their needs. Considering the current trend of an increasingly aging population, the issue of late-life depression needs further attention, as it is known to be the most common mental illness in the elderly. The purpose of this article, therefore, is to paint a picture of family caregiving in the mental health arena, identify important roles that community mental health nurses play in this context, and address the significant gaps in the knowledge and nursing practice regarding community mental health nurses' work with families of older patients suffering from depression.     

Measuring intensive care nurses' perspectives on family-centered end-of-life care: evaluation of 3 questionnaires.

BACKGROUND: Attempts to improve end-of-life care increasingly focus on family-centered care, but few validated assessment tools exist. OBJECTIVES: To evaluate 3 new short questionnaires measuring nurses' perspectives on family-centered end-of-life care in the intensive care unit and to show the usefulness of the questionnaires. METHODS: Principal components analysis of data from 141 critical care nurses evaluating care given to families of 218 patients was used to develop domain scores for number of nursing activities with each family, number of barriers experienced, and nurses' satisfaction that the family's needs were met. Random effects models were used to test associations between critical care processes and outcome. RESULTS: Nursing activities fell into 2 domains: general and culture-related communication/support. Barriers consisted of 2 domains: patient/family barriers and system/team barriers. Meeting the needs of patients' families represented a single dimension. In a path model based on domain scores, general activities had significant associations with both nurse communication and meeting families' needs; patient/family barriers, with nurse communication; and nurse and physician communication, with meeting families' needs. In a path model based on total activities and barriers scores, total activities and total barriers had significant associations with nurse communication ratings and meeting families' needs. Patients' and nurses' characteristics were not significant independent predictors of meeting the needs of patients' families. CONCLUSIONS: The 3 questionnaires provide a consistent, valid picture of nurses' perspectives on family-centered critical care and may be useful in evaluating family care processes and outcomes and in targeting areas for improvement.     

Patient-family-nurse interactions in the trauma-resuscitation room.

BACKGROUND: Controversy about the presence of patients' family members in the emergency department has centered on the trauma-resuscitation room. Little is known about interactions of patients' family members with the patients and with nurses or about the ramifications of the presence of patients' family members at the bedside. OBJECTIVES: To describe behavioral responses offamily members of patients and the interactions of thefamily members with nurses and the patient in the trauma room. METHODS: A secondary analysis was done of 193 videotapes of trauma room care. Of these, 88 tapes showed the presence of patients' family members, for a total of 42 hours. Qualitative ethology and a model of suffering as a scaffold were used to analyze verbal and nonverbal interactions between nurses, patients' family members, and patients. Behaviors and verbal interactions of patients and their families were coded as to persons who were enduring and persons who were emotionally suffering. Categories were described. RESULTS: Whether a patient's family members entered the trauma room depended on the patients condition, the patient's behavioral state, and the nature of the treatments. Categories of interactions were families learning to endure, patients failing to endure, family emotionally suffering and patient enduring, patient and family enduring, and resolution of enduring. The interaction style of the nurses involved was particular to each of these states. Two instances of inappropriate interactions occurred. CONCLUSIONS: Nurses can use the Model of Suffering as a framework to assess behavioral and emotional states and to select appropriate strategies to comfort patients' family members.     

Creating a new whole: helping families of people with schizophrenia

Collaboration between psychiatric nurses and family members is considered an important part of caring for people with schizophrenia either in hospital or at home after discharge. Studies have demonstrated family involvement in terms of caring for patients who have been discharged early from hospital. An extensive review of the literature and related studies regarding nursing interventions have been done, but there have been limited studies on what psychiatric nurses actually do when working with the families of people with schizophrenia in Thailand. The purpose of the present study was to explore relationships between Thai psychiatric nurses and families in terms of administering nursing care to patients. Grounded theory methodology was used to examine the processes through which psychiatric nurses work with families. Data were collected by 16 psychiatric nurses through in-depth interviews, observations, and field notes. Data were analyzed using constant and comparative methods of other studies, which revealed the process by which nurses can create a new whole between families, patients, and Thai psychiatric nurses. The process consists of four major stages: establishing trust, strengthening connections, promoting readiness to care, and supporting family.     

Nursing students' beliefs about families in nursing care

Caring for families is a growing part of nurses' professional work in various health care settings and consequently an important issue for nursing education. One way to determine the readiness for nursing students to meet families is to reveal their beliefs about families. Beliefs can be uncovered through interpretation of conversations, as beliefs are embedded in our stories. The aim of this study was to explore nursing students' beliefs about families in nursing care. Nine nursing students, three from each year of a three-year programme, were interviewed individually. The interviews were tape-recorded and transcribed verbatim. First, a manifest content analysis was performed followed by a latent content analysis in order to reveal underpinning beliefs. The results demonstrate beliefs about families and nurses and their relationship, for example, if family members are close to each other and when the patient is cared for in his/her own home, it reduces suffering for the whole family, and if nurses create a trusting relationship and atmosphere, it fosters the families' well-being. Although the beliefs uncovered are seen as facilitative ones, educational efforts are essential to implement family nursing both theoretically and practically in curricula throughout the nursing education.