Cases for change in mental health: partnership working in mental health services

This article examines our current state of knowledge about partnership working between health and social care in UK adult mental health services. Drawing on a narrative review of the literature commissioned by the National Institute for Mental Health, this paper focuses on 43 documents from the review which discuss partnership issues. After exploring the rationale for partnership working, potential barriers and possible ways forward, the paper identifies gaps in the existing literature and discusses the implications of the review for current health and social care policy.     

Natural-orifice transluminal endoscopic surgery (NOTES) in Europe: summary of the working group reports of the Euro-NOTES meeting 2010

The fourth Euro-NOTES workshop took place in September 2010 and focused on enabling intensive scientific dialogue and interaction between participants to discuss the state of the practice and development of natural-orifice transluminal endoscopic surgery (NOTES) in Europe. Five working groups were formed, consisting of participants with varying scientific and medical backgrounds. Each group was assigned to an important topic: the correct strategy for dealing with bacterial contamination and related complications, the question of the ideal entry point and secure closure, interdisciplinary collaboration and indications, robotics and platforms, and matters related to training and education. This review summarizes consensus statements of the working groups to give an overview of what has been achieved so far and what might be relevant for research related to NOTES in the near future.     

Interprofessional education and working in mental health: in search of the evidence base

Aim To explore interprofessional attitudes arising from shared learning in mental health. Background Inter‐professional education in healthcare is a priority area for improving team‐working and communication. Many studies have attempted to evaluate its benefits and challenges, although few emanate from the mental health arena. However, producing evidence to link educational input with clinical outcomes is notoriously difficult. This project attempted to produce evidence for changes in interprofessional attitudes and stereotypes. Method(s) Mental health nursing students and clinical psychology trainees participated in inter‐professional education. An evaluation tool was designed to evaluate the experience and outcomes, and to consider implications for interprofessional working. Results There was an increase in clarity regarding roles, approaches and resources, and how to collaborate in practice. There was no significant change in professional identity. Many challenges were identified, including differences in academic level, previous experience, expectations, assessment, motivation and effort. Conclusion Despite the challenges, it remains important to offer collaboration with future mental health colleagues as a foundation for effective team‐working. Recommendations are made for creating inter‐professional education opportunities for diverse student groups. Implications for Nursing Management Mental health professionals need to work effectively in multidisciplinary teams. Drawing on available guidance, managers should encourage and support team members to undertake shared learning where possible, both within clinical settings and through more formal educational provision. In this way, managers can facilitate collaborative relationships which will pay dividends for the provision of effective mental health care. This project adds to the limited knowledge currently available on interprofessional learning and attitudes within a mental health context.     

Significance of comforting experiences in mental health (part 1)

This article begins with an overview of the program of research that has examined comforting in a variety of clinical settings (Bécherraz, 2001; 2002). Then, the context, participants and research question for this study are presented briefly. The article continues with an hermeneutic analysis of patient and clinician narratives. This hermeneutic analysis revealed four thematic categories related to comforting in mental health. These consist of (a) relational, (b) embodied, (c) social ties and (d) contextual dimensions. Further, the distribution of the 14 dyads along orthogonal axes as well as their composition will be presented and discussed. Finally, a paradigm case will illustrate all of the thematic categories, concluding with a brief synthesis.     

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.     

急诊科护士工作压力和心理健康状况的调查研究

目的了解急诊科护士工作压力、心理健康状况以及二者相互关系,为实施有针对性的护理干预措施提供依据。方法对梅州市4所医院共88名急诊科护士进行问卷调查,并对结果进行分析。结果急诊科护士压力源主要表现在工作量、工作时间和护理专业方面。护士的压力与心理健康水平成一定的正相关性。结论急诊科护士压力源主要来自专业及工作方面、工作量及时间分配、工作环境及资源、病人护理、管理及人际关系;SCL-90得分低于全国常模;压力源可对护士心理健康产生相应的影响。     

助产士工作压力源和心理健康状况的调查分析

目的了解助产士工作压力、心理健康状况以及相互关系,探讨改善护理管理、保障助产士心理健康的方法和途径。方法采用护士压力源量表、焦虑自评量表(SAS)以及抑郁自评量表(SDS)对在广州地区7所医院随机抽取的102名助产士进行问卷调查分析。结果助产士压力源主要存在于工作量与工作时间和护理专业方面。助产士的焦虑分值为(44.84±12.18)分,抑郁分值为(52.21±13.27)分,均高于常模,P<0.01。助产士焦虑和抑郁的发生均与护理专业工作、工作量及时间分配、患者护理和管理以及人际关系成正相关,P<0.01,而与工作环境及资源无关。结论缓解助产士工作压力,保障助产士心理健康急待社会的充分重视,特别是卫生行政管理部门,应积极采取有效的措施减轻助产士工作压力。     

Exploring mental health nurses' expectations and experiences of working in the community

As mental health care is increasingly being provided in community settings, a variety of job opportunities are becoming available to mental health nurses. The extent to which nurses' views and experiences of working in community settings have been explored, however, is limited. This paper reports on newly qualified nurses' plans in relation to taking up work in the community and, for those who thought it likely that they would take up such work, their reasons for doing so. Reasons for working in the community were diverse, and suggested that a range of satisfactions could be expected. The extent to which such expectations become a reality is considered in the light of findings from interviews with 12 nurses who were working in community settings. Satisfactions and difficulties experienced by the 12 nurses are described, and suggestions for tackling some of the difficulties are made.     

The education and training needs of qualified mental health nurses working in acute adult mental health services

This paper presents findings from a research study that investigated the education and training needs of qualified mental health nurses who work in acute adult mental health services in the UK. The study aimed to address a key knowledge 'gap' highlighted by recent Department of Health reports () that suggest that little is known regarding the education and training expectations, priorities and needs of mental health nurses who work in acute adult mental health services. This study aimed to identify (i) what type of post-registration education and training mental health nurses working in acute settings need; (ii) how the nurses want education and training to be delivered; and (iii) what qualifications and accreditation the nurses want to receive? The research consisted of two methods: focus groups and a questionnaire survey. This paper reports on the findings from the questionnaire survey. The results of the survey demonstrate that there is a real need for post-registration education and training for this group of nurses; to equip them with the relevant knowledge and skills to nurse people in the acute phase of their mental illness in acute inpatient settings.     

护士心理健康及工作压力的相关性

目的 观察某综合性医院护士的心理健康水平,探讨工作压力与心理健康的相关性及其影响因素.方法 采用横断面调查设计,以某三级甲等综合性医院270名护士为研究对象,用一般健康状况量表（GHQ-12）和压力反应量表来评价护士的心理健康水平、工作压力,并对两者的影响因素和相互关系进行统计分析.结果 在270名调查对象中有69名健康状况不良,健康状况不良检出率为25.50％.GHQ-12得分在不同的年龄、性别、科室、职称、学历和婚姻状况之间差异有统计学意义（P＜0.05）.工作压力与心理健康呈正相关,医务人员工作压力越大,心理健康不良的检出率越高.结论 护士的心理健康状况不良检出率较高,高于一般人群的心理健康不良水平.其中专业技术初级职称、大专、年龄＜ 30岁、已婚的护士较为严重.护士的工作压力状况与心理健康高度相关.     

Closeness, chaos and crisis: the attractions of working in acute mental health care

This paper makes a case for the attractiveness of acute mental health inpatient nursing (acute nursing) and argues that an altered perception of this work is essential if we are to provide the most acutely mentally ill and vulnerable people with a stable and expert nursing workforce. The discussion draws on an ethnographic study conducted in an inner-city psychiatric unit in England and the advantages of this method for understanding nursing work are described. Within our findings, we set out two overarching themes: the contextual realities of the contemporary acute ward and features of attraction that encourage nurses to work in the acute care setting. The former includes nurses' responsibility for the total ward environment and the latter the 'comfort of closeness' and 'surviving and thriving in chaos and crisis'. In conclusion, we argue that despite the unpopularity of the acute inpatient mental health environment, the highly sophisticated skills employed by acute nurses actually ensure the promotion of health for the majority of service users.     

Different voices: reviewing and revising the politics of working with consumers in mental health

ABSTRACT:  Working with consumers is now a common expectation in contemporary mental health services. Yet health professionals may not entirely understand the difference between patient and consumer roles. Alternatively, they may feel they do not have the skills or resources to deal with people in roles other than patient or carer. Nor may they be able to separate out their personal experiences with particular consumers from the ideals and goals for effective consumer partnerships. This paper reviews a concept known as the politics of difference as well as the rise of the consumer movement in order to explore areas of difference between consumers and providers, to reexamine how power and marginalization practices occur. It reminds professionals that generalizing from one failed experience relating with a consumer is just as invalid as idealizing the current policy of consumer inclusion. Inviting, allowing, amplifying and improving the effectiveness of the consumer voice in mental health services today requires active commitment, educative processes and novel strategies to move beyond superficial relationships so that consumers and professionals work together to make enduring change.     

Self-reports of recovery-oriented practices of mental health nurses in state mental health institutes: development of a measure

The focus of this study was to modify a measure of recovery practice for mental health nurses and explore nurses' self reports of recovery practices. Findings support the soundness of the Recovery Self Assessment-Registered Nurse Version (RSA-RN) as a self-assessment instrument designed to evaluate recovery-oriented nursing practice. More favorable perceptions of recovery practices were noted amongst older and more experienced nurses, those who had previous formal training or education in mental health recovery or psychiatric rehabilitation, and those who considered their facilities to be recovery-oriented. The RSA-RN can be use to identify nurses' and nursing departments' strengths in the provision of recovery-oriented interventions and lead to focused performance improvement.