The attitudes of mental health professionals towards patients with mental illness in an inpatient setting in Palestine

Culture plays a vital role in shaping public and professional attitudes towards mental illness. In Arab cultures negative attitudes toward patients experiencing mental illnesses are common. There is a lack of studies that investigate the attitudes of professionals towards patients in inpatient mental health settings. This study aimed to assess the attitudes of professionals towards patients with mental illnesses in the only psychiatric hospital in Palestine. A survey was undertaken using the Attitudes Toward Acute Mental Health Scale (ATAMHS 33). The scale was distributed to a variety of professionals at the only psychiatric hospital in Bethlehem. Data was managed and analysed by using SPSS 15 (a statistical package for social sciences). The participants (mostly nurses) expressed both negative and positive attitudes toward patients, however, results revealed more negative than positive attitudes, particularly in relation to alcohol misuse, medication, patients' ability to control their emotions, and genetic predisposition to mental illness. This paper provides baseline data about the attitude of mental health professionals towards patients experiencing mental illnesses. Education and direct contact with patients with mental illness may not be enough to foster positive attitudes towards them. This may indicate the need to revise educational curriculum at the Palestinian universities and offer more training for mental health professionals in order to change their attitudes.     

精神病患者家属对精神疾病知识健康教育需求的调查分析

目的了解精神病医院患者家属对精神疾病知识健康教育内容和形式的需求情况,为有针对性地开展健康教育提供理论依据。方法采用自行设计的《患者家属健康教育需求情况调查表》对265名在精神病专科医院就诊的门诊和住院患者家属进行调查。结果认为自己的精神卫生知识不足及希望接受健康教育的家属分别占89．1％和87．9％：家属最希望了解的精神疾病知识（前3位）分别是如何防止复发及复发的早期表现（57．4％）,精神疾病的治疗手段与效果（39．2％）,如何帮助患者适应社会（38．5％）;最希望的健康教育形式（前3位）分别是派发相关知识小册子、传单（47．6％）,专家在电台、电视上进行咨询或讲座（45．7％）,定期或不定期的专家现场讲座（35．8％）;最希望开展健康教育的地点为家中或居住社区内（44．9％）,其次为就诊的门诊部（38．5％）;最希望开展健康教育的时间依次为就诊日白天（34．0％）,周末白天（33．2％）和工作日晚上（23．0％）;最希望开展健康教育的频度为每月1次（37．4％）,每周1次（28．7％）。结论精神病专科医院患者家属对健康教育需求高;他们最希望了解精神疾病知识主要是关于疾病症状稳定和患者康复的知识;对健康教育的形式主要追求便利性、易获得性和讲求实效。根据这些特点在这一群体中有针对性地开展精神疾病知识健康教育可收到较好的效果。     

Nature, sources, and impact of information on the adjustment of family caregivers: a pilot project.

The information conveyed to patients and families dealing with a health problem such as traumatic brain injury or stroke combines with what they already know to form a new pool of knowledge. The aim of this pilot study was to describe the information needs of family caregivers, their sources of information, their strategies for gathering information, and the impact of the information on their adjustment and their relationship with health professionals. Focus groups were held with close relatives of persons who had sustained a traumatic brain injury or a stroke and with health professionals from various disciplines working with theses clienteles. The information needs of relatives concerned the impact of the person's disabilities on their everyday lives. From the professionals' point of view, the information needs of close relatives concerned the person's disabilities, their coping strategies, and their information sources. Life experience was the main source of knowledge. The results form a basis for recommendations regarding interventions in acute care and rehabilitation.     

精神病患者家属精神卫生知识水平及结构调查

目的了解精神病患者家属的精神卫生知识水平和结构,为开展健康教育提供临床依据。方法采用自行设计的《患者家属精神卫生知识调查表,》对随机抽取的、在精神专科医院就诊的门诊和住院患者的家属,共308人进行调查。结果认为自己的精神卫生知识不足及希望接受健康教育的家属分别占89.6%和88.6%。52.3%、62.7%和54.5%的家属对“药物的作用”、“药物的不良反应”及“如何进行家庭护理”等知识不了解;63.3%家属了解亲人“所患疾病的名称;”了解防止精神病复发主要方法的家属占62.3%;对精神病的病因表示不了解的家属占31.5%。结论精神病专科医院患者家属的精神卫生知识较为缺乏,知识结构不均衡。在这一群体中开展针对性的健康教育非常必要。     

CLINICAL SUPERVISION,BURNOUT, AND JOB SATISFACTION AMONG MENTAL HEALTH AND PSYCHIATRIC NURSES IN FINLAND

This paper presents the findings from a survey of Finnish mental health and psychiatric nurses. The aim of the study was to describe and evaluate the current state of clinical supervision, and ascertain the levels of burnout and job satisfaction experienced by these health care professionals. Clinical supervision was found beneficial for mental health and psychiatric health care professionals in terms of their job satisfaction and levels of stress. The findings seem to demonstrate that efficient clinical supervision is related to lower burnout, and inefficient supervision to increasing job dissatisfaction.     

Clinical supervision, burnout, and job satisfaction among mental health and psychiatric nurses in Finland

This paper presents the findings from a survey of Finnish mental health and psychiatric nurses. The aim of the study was to describe and evaluate the current state of clinical supervision, and ascertain the levels of burnout and job satisfaction experienced by these health care professionals. Clinical supervision was found beneficial for mental health and psychiatric health care professionals in terms of their job satisfaction and levels of stress. The findings seem to demonstrate that efficient clinical supervision is related to lower burnout, and inefficient supervision to increasing job dissatisfaction.     

Mental health assessment: Inference,explanation, and coherence

Mental health professionals such as psychiatrists and psychotherapists assess their patients by identifying disorders that explain their symptoms. This assessment requires an inference to the best explanation that compares different disorders with respect to how well they explain the available evidence. Such comparisons are captured by the theory of explanatory coherence that states 7 principles for evaluating competing hypotheses in the light of evidence. The computational model ECHO shows how explanatory coherence can be efficiently computed. We show the applicability of explanatory coherence to mental health assessment by modelling a case of psychiatric interviewing and a case of psychotherapeutic evaluation. We argue that this approach is more plausible than Bayesian inference and hermeneutic interpretation.     

“Left Alone with Straining but Inescapable Responsibilities:” Relatives’ Experiences with Mental Health Services

Relatives of persons with severe mental illness experience burden and straining changes in their lives that put their health at risk. Consequently, they need support from health professionals. The aim of this study was to describe experiences from encounters with mental health services as seen from the point of view of relatives of persons with severe mental illness. A qualitative, explorative study was performed, based on two open-ended questions in a cross-sectional study of relatives’ health, burden, and sense of coherence (n = 216). A manifest qualitative content analysis was used to describe the relatives’ experiences. The findings show that some relatives had experienced positive encounters with health personnel, but the majority of experiences reported were negative. The encounters can be summarized into one main category: “Left Alone with Straining but Inescapable Responsibilities.” Two categories emerged: “Striving for Involvement for the Sake of the Mentally Ill Person,” and “Wanting Inclusion for the Sake of Oneself.” There is a gap between relatives’ needs for support in order to handle their own situation in relation to their mentally ill next of kin, and what they actually receive from the mental health services. The findings suggest that health professionals should collaborate with and support these relatives.     

The well-being of gays, lesbians and bisexuals in Botswana

AIMS: To investigate the level of well-being of gays, lesbians and bisexuals (GLBs) in Botswana, how this level of well-being could be promoted and whether their health care needs were met by health care professionals. RATIONALE: It is illegal to engage in same-sex activities in Botswana, punishable by imprisonment. Although Botswana's citizens have one of Africa's best health care systems, little is known about the health status, health care needs and general well-being of Botswana's GLBs. This survey attempted to uncover some of these potential health care needs, impacting on the GLBs' well-being. DESIGN/METHODS: The research framework adopted was the health and human rights approach, placing dignity before rights. A survey design, with structured questionnaires, was used. Snow-ball sampling techniques were used. RESULTS: Results indicated that varying degrees of distress were experienced by 64% of the GLBs in this study. The GLBs identified a need for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) education and had concerns about their general health, discrimination against them and vulnerability to violence including sexual assaults. CONCLUSIONS: The well-being of the GLBs in Botswana was influenced by both positive internal acceptance of their sexual orientation and negative external acceptance by society. Health care professionals played insignificant roles in the promotion of GLBs' well-being, and could make greater inputs into health education efforts, and more significant contributions towards enhancing the GLBs' levels of well-being. Enhanced collaboration between health professionals and human rights activists are recommended to reduce violations of Botswana's GLBs' dignity and to improve their quality of life, including enhanced access to and utilization of health care services.     

Psychiatric nurses' self-rated competence

This study explored the self-rated competence of 52 Swedish psychiatric nurses in three clinical environments: forensic psychiatry, general psychiatric inpatient care, and clinical non-residential psychiatric care. A questionnaire wtih 56 statements from nine areas of expertise was completed. Forensic nurses were more skilled in safety and quality and in dealing with violence and conflicts. Non-specialist nurses appreciated their skills more so than specialist nurses in health promotion and illness prevention and conduct, information, and education. Women were inclined to invite patients' relatives for education and information. Men attended to a patients' spiritual needs; they also coped with violence and managed conflicts.     

"Left alone with straining but inescapable responsibilities:" relatives' experiences with mental health services

Relatives of persons with severe mental illness experience burden and straining changes in their lives that put their health at risk. Consequently, they need support from health professionals. The aim of this study was to describe experiences from encounters with mental health services as seen from the point of view of relatives of persons with severe mental illness. A qualitative, explorative study was performed, based on two open-ended questions in a cross-sectional study of relatives' health, burden, and sense of coherence (n = 216). A manifest qualitative content analysis was used to describe the relatives' experiences. The findings show that some relatives had experienced positive encounters with health personnel, but the majority of experiences reported were negative. The encounters can be summarized into one main category: "Left Alone with Straining but Inescapable Responsibilities." Two categories emerged: "Striving for Involvement for the Sake of the Mentally Ill Person," and "Wanting Inclusion for the Sake of Oneself." There is a gap between relatives' needs for support in order to handle their own situation in relation to their mentally ill next of kin, and what they actually receive from the mental health services. The findings suggest that health professionals should collaborate with and support these relatives.     

Why the professional-client ethic is inadequate in mental health care

Patients who are subject to compulsory care constitute a substantial proportion of the work-load of mental health professionals, particularly psychiatric nurses. This article examines the traditional 'beneficence-autonomy' approach to ethics in compulsory psychiatric care and evaluates it against the reality of daily practice. Risk to the public has always been an important but often unacknowledged consideration. Inequalities exist among ethnic and socio-economic groups and there is a lack of agreement on what constitutes mental disorder. Two major changes in compulsory psychiatric care--community orders and care for patients with untreatable severe personality disorders--further challenge the traditional ethical approach. There are also important human rights implications. The simple patient-health professional relationship no longer provides an adequate framework for mental health professionals on which to base their ethical decisions. The public and organizations may have different perspectives and their interests are becoming increasingly important. Mental health professionals, particularly psychiatric nurses, may face ethical dilemmas because of these different perspectives.     

Psychiatric Nurses’ Self-Rated Competence

This study explored the self-rated competence of 52 Swedish psychiatric nurses in three clinical environments: forensic psychiatry, general psychiatric inpatient care, and clinical non-residential psychiatric care. A questionnaire wtih 56 statements from nine areas of expertise was completed. Forensic nurses were more skilled in safety and quality and in dealing with violence and conflicts. Non-specialist nurses appreciated their skills more so than specialist nurses in health promotion and illness prevention and conduct, information, and education. Women were inclined to invite patients’ relatives for education and information. Men attended to a patients’ spiritual needs; they also coped with violence and managed conflicts.     

Communication and information needs of a random sample of community psychiatric nurses in the United Kingdom

This paper reports on a cross-sectional survey investigating communication and information needs of community psychiatric nurses attached to community mental health teams in the United Kingdom. Community psychiatric nurses' access to and communication with other professionals was also assessed. In total, 200 teams were randomly sampled UK-wide, and postal questionnaires were sent to community psychiatric nurses attached to these teams; 110 questionnaires were completed and returned (55% response rate). Spearman's rho, Pearson's correlation and the chi-square test were used in bivariate analyses and multiple logistic regression in multivariate analysis. Participants reported to be mainly in contact with psychiatrists (71%) and other community psychiatric nurses (52%). Eighty-four per cent and 91% reported psychiatrists and community psychiatric nurses, respectively, to be quite/extremely helpful when consulted; the proportions were lower for general practitioners and counsellors/therapists (32% and 31%, respectively). All reported lack of time and 84% reported communication problems with other professionals as barriers to their work. Although 70% reported having the necessary training/skills for managing severe cases, 76% indicated they had information needs. Being a long-serving community psychiatric nurse (OR = 4.51, 95% CI = 1.06-19.20), perceiving the discussion of cases with other professionals as less helpful (OR = 4.82, 95% CI = 1.16-20.01), being mainly in contact with other CPNs (OR= 6.72, 95% CI= 1.21-37.15), reporting not having the necessary training/skills (OR = 7.78, 95% CI = 1.37-44.25), and wanting information on mental health law (OR= 12.27, 95% CI = 1.75-86.36) were significant predictors of having information needs. This survey provided valuable information on problems facing these nurses and highlighted the need for training and for easier access to and increased communication with other professionals.     

Exploratory study of mental health consultation-liaison nursing in Australia: Part 1. Demographics and role characteristics

Mental health nursing roles in Consultation-Liaison (CL) psychiatry and emergency departments are rapidly developing within Australia since the mainstreaming of mental health services within the general health-care system. Anecdotal evidence suggests that many of these positions have been initiated and developed in relative isolation and with little formalized support. Consequently, a comprehensive understanding of these roles and the nurses who occupy them is limited. A survey was developed and distributed to gather information on CL nurses in Australia. The survey was aimed at CL nurses working in a range of settings and included questions relating to demographics, qualifications, experience, clinical practice, organizational structure, education, clinical supervision, education and training and work satisfaction. This, the first of a two-part paper, will present the key findings relating to demographics and characteristics of the role. Overall, the findings demonstrated that the CL nurses who responded to the survey (n = 56) were experienced psychiatric/mental health nurses working primarily in general hospital wards and/or emergency departments; receive requests for consultation from a range of health professionals but predominantly nurses; provide education to a range of staff groups; and use a range of titles to identify their role.     

The universal, situational, and personal needs of cancer patients and their main carers.

The importance of psychosocial factors in the cancer journey for both patients and their carers has been recognised in UK health policy. The aim of this paper is to consider--(1) which needs are regarded as important by patients and their carers; (2) which are the unmet needs of patients and their carers. The study focuses on the responses of 233 paired cancer patients and their carers derived from a cross-sectional questionnaire survey in three health authorities in North West England. The majority of patient-carer pairs expressed the importance of having good relationships with health-care professionals and receiving good-quality information. These can be identified as "universal" needs. A minority of patient-carer pairs expressed the importance of other kinds of needs. These items were mainly to do with managing daily life, emotions, and social identity and can be identified as "situational" or "personal" needs. Where there were discrepancies between patients and carers, patients were likely to identify more needs as important. In contrast, carers have more unmet needs, reflecting their comparative neglect. Broadly, "universal" needs are being met, but "situational" and "personal" needs, particularly among carers, are relatively unmet and require greater attention on the part of nurses and primary care professionals.     

Child and adolescent mental health web resources.

There are many Web resources for health professionals seeking guidance to meet the mental health needs of their clients. Some of those resources are specifically designed for professionals working in schools. School nurses participate in assessment teams and contribute to individual education plans to enable students with mental health needs to achieve academic success. Mental health issues in a school setting involve preventive care, as well as providing and advocating for an environment and policies that promote healthy students and school employees. This article identifies valid and reliable mental health Web resources for school nurses.