What is Good Mental Health Nursing? A Survey of Irish Nurses

The practice, theory, and preparation associated with nursing people with mental health issues has changed in profound ways in recent decades. This has in part been reflected by a shift in nurses identifying as being mental health rather than psychiatric nurses. Context, theory, and values shape what it means to be a mental health nurse. Thirty experienced mental health nurses in Ireland completed a survey on what good mental health nursing is and a definition induced from their responses. Mental health nursing is a professional, client-centered, goal-directed activity based on sound evidence, focused on the growth, development, and recovery of people with complex mental health needs. It involves caring, empathic, insightful, and respectful nurses using interpersonal skills to draw upon and develop the personal resources of individuals and to facilitate change in partnership with the individual and in collaboration with friends, family, and the health care team. This appears to encapsulate the best of what it meant to be a psychiatric nurse, but challenges remain regarding how to reconcile or whether to discard coercive practices incompatible with mental health nursing.     

What Are the Perceptions and Experiences of Care Delivery Among Faith Community Nurses? A Systematic Review

ObjectiveThis systematic review set out to identify the unique perceptions and experiences of care delivery among faith community nurses (FCNs).Data SourcesThis review was conducted and has been reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted using the following databases, Medline (OVID), EmCare for Nurses (OVID), PsycINFO (OVID), CINAHL (EBSCO), Cochrane, and PubMed. The search strategies included the use of truncations, adjacency search parameters, and Boolean operators using a range of key search terms. Predetermined eligibility criteria were applied to all studies. The review process was managed using Covidence systematic review software. Data extraction and quality assessment was conducted across all included studies. Data were analyzed using a narrative synthesis approach.ConclusionThis review has made an important contribution by identifying the role that FCNs play in care delivery as trusted members of their communities who act as a conduit at the intersect of faith and health care. Irrespective of the location or faith denomination, what was common to FCNs was that they delivered care to address the physical, psychological, spiritual, congregational, communication, health system, and family-related needs of those in their care.Implications for Nursing PracticeThe nurses represented in the included studies expressed concerns that patients experienced unmet supportive care needs because of a fragmented and highly complex existing health care system. Often, FCNs provided a valuable contribution in supporting patients in their care pathways and facilitated continuity of care among people who lived with preexisting comorbidities and who had complex health care needs. Further research is needed to understand the role that faith community nursing models might have in cancer care from the perspective of patients and other members of the multidisciplinary team across different international contexts.     

Nurses’ Perspectives on the Care of Adults with Mental Health Problems and Histories of Childhood Sexual Abuse

Despite growing awareness and evidence linking childhood sexual abuse (CSA) to numerous ongoing health problems in adulthood, the integration of this knowledge into nursing practice remains inconsistent. This article reports the results of a study that explored nurses’ perspectives on, and experiences with, providing care for adults with mental health problems who may also have histories of CSA. Nurses’ views underscore the challenges and complexities involved when providing care for this population. The themes of nurses’ knowledge and comfort levels, ethical practice, patient care considerations, and system issues are used to discuss nurses’ understandings, perspectives, and experiences.     

What are the Barriers and Enablers to Physical Activity Participation in Women with Ovarian Cancer? A Rapid Review of the Literature

BackgroundEngagement in regular physical activity is recommended for women diagnosed with ovarian cancer due to aggressive treatment approaches, an increased risk of disease recurrence and low survival rates.ObjectivesTo synthesize the current available evidence identifying barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer.Data SourcesPeer-reviewed articles in electronic databases including CINAHL, Cochrane, Medline, Psych INFO and Scopus and key studies’ reference lists.ConclusionAlthough evidence pertaining to the study population was limited, the findings of this review suggest women with ovarian cancer experience similar barriers and enablers to the general population and other cancer cohorts. The primary barriers to physical activity participation reported by this population were treatment or disease related side effects, fear of injury or falling and the absence of physical activity counselling. Key enablers reported to facilitate physical activity participation were the implementation of individualized interventions with targeted goals in addition to support from health and medical professionals. Future research on ovarian cancer populations is warranted to further explore perceived barriers and enablers.Implications for Nursing PracticeNurses working within the oncology field are well positioned clinically to facilitate physical activity engagement and identify and overcome barriers to participation within a population that experiences high mortality rates and disease recurrence.     

Neuropathic Pain in Low Back-Related Leg Pain Patients: What Is the Evidence of Prevalence,Characteristics, and Prognosis in Primary Care? A Systematic Review of the Literature

This systematic review synthesizes literature describing prevalence, characteristics, and prognosis of low back-related leg pain (LBLP) patients with neuropathic pain in primary care and/or similar settings. Inclusion and exclusion criteria were developed and used by independent reviewers to screen citations for eligibility. The initial search yielded 24,948 citations; after screening 12 studies were included. Neuropathic pain was identified using case ascertainment tools (n = 5), clinical history with examination (n = 4), and using LBLP samples assumed neuropathic (n = 3). Neuropathic pain prevalence varied from 19% to 80%. There was consistent evidence for higher back-related disability (n = 3), poorer health-related quality of life (n = 2), and some evidence for more severe depression (n = 2), anxiety (n = 3), and pain intensity (n = 4) in patients with neuropathic pain. Results were less consistent when cases were identified through clinical history with examination than those identified using case ascertainment tools. Prognosis (n = 1) of LBLP patients with neuropathic pain was worse compared with those without, in all outcomes (leg pain intensity, leg and back-related disability, self-reported general health) except back pain intensity. No studies described prognostic factors. This systematic review highlights the evidence gap in neuropathic pain in LBLP in primary care, especially with respect to prognosis.

Competency Education and Validation in the United States: What Should Nurses Know?

This article provides an overview of the progress in the past decade toward effectively documenting the initial and continuing competence of registered nurses.     

Nursing Sabbatical in the Acute Care Setting: What Is the Evidence?

PURPOSE: To review and examine the literature supporting a professional sabbatical, a potentially viable and innovative change strategy that could renew, revitalize, and retain nursing staff practicing in the acute care setting. METHOD: A literature search was completed using multiple search engines to procure articles that could answer the question: What is the evidence related to professional sabbaticals in nursing? FINDINGS: The search yielded 19 articles: one historical document, eight scholarly business articles, and 10 nursing publications. The literature review revealed most sources described sabbaticals using anecdotal data and 14 of the 19 articles were labeled as expert opinion or consensus. CONCLUSION: Borrowing from the successes in academia and other non‐nursing professions, a human capital investment opportunity exists to design and test nursing sabbaticals. The authors identified a nursing sabbatical as a viable option, which can enhance nursing retention and revitalization.     

What Is the Relation Between Fear of Falling and Physical Activity in Older Adults?

Objective

To describe the association between fear of falling (FOF) and total daily activity in older adults.

Design

Cross-sectional observational study.

Setting

Ambulatory clinical research training center.

Participants

Community-dwelling older adults aged ≥64 years (N=78), who were independent in ambulation with or without an assistive device.

Interventions

Not applicable.

Main Outcome Measures

FOF was defined by self-reported fear ratings using the Survey of Activities and Fear of Falling in the Elderly and self-reported fear status determined by response to the following question: Are you afraid of falling? Physical function was assessed using the Late Life Function and Disability Instrument. Physical activity was recorded using an accelerometer worn on the waist for 7 consecutive days, and mean daily counts of activity per minute were averaged over the 7-day period.

Results

Fear ratings were related to total daily activity (r=−.26, P=.02). The relation was not as strong as the relation of function and physical activity (r=.45, P<.001). When stratified by exercise status or functional status, fear was no longer related to total daily activity. Physical function explained 19% of the variance in physical activity, whereas the addition of fear status did not add to the explained variance in physical activity.

Conclusions

FOF is related to total daily physical activity; however, FOF was not independently associated with physical activity when accounting for physical function. Some FOF may be reported as a limitation in function.     

What is needed for Trauma Informed Mental Health Services in Australia? Perspectives of clinicians and managers

Trauma Informed Care is an approach to the delivery of mental health care that requires sensitivity to the prevalence and effects of trauma in the lives of people accessing services. While TIC is increasingly emphasized in mental health policy and frameworks in Australia, people working in mental health settings have reportedly struggled to translate the values and principles into their everyday practice. This qualitative study used an experience‐based co‐design methodology to explore the potential for implementation of Trauma Informed Care into mental health services in Australia. The experiences of consumers, carers, clinicians, and managers were gathered. This paper presents the perspectives of clinicians (n = 64) and senior managers (n = 9) from across three Local Health Districts in New South Wales in Australia. All data were analysed thematically to address the research question: What is needed for Trauma Informed Mental Health Services in Australia? To be trauma‐informed, managers required: leadership at all levels, access to resource, relevant and accessible training, support for staff, resolution of wider systems issues, and clarification of the concept and actions of TIC. Clinicians identified that to be trauma‐informed they required services to: be aware of staff well‐being, support different ways of working, address workplace cultures and provide increased resources. The findings have implications for any service, team or individual seeking to implement TIC within mental health settings.     

A Systematic Review of Research on Trauma and Women’s Health in the Nurses’ Health Study II

ObjectiveTo synthesize research on interpersonal trauma and women’s health from the Nurses’ Health Study II (NHS II) and to analyze conceptualization of interpersonal trauma across studies.Data SourcesA literature review was conducted in PubMed using a systematic search strategy.Study SelectionArticles were included in the review if they used data from the NHS II and involved investigations of interpersonal trauma. Theoretical articles, methodologic articles, and other literature reviews involving the NHS II were excluded. Initially, the search returned 61 articles. After exclusions, 45 articles met the criteria for inclusion in the review and data extraction.Data ExtractionInformation was extracted and consolidated in an evidence table. Data included study time frame, sample, definition of trauma, outcomes studied, and journal of publication.Data SynthesisTrauma was not operationalized consistently across studies, even though the NHS II assessed trauma experiences in childhood, adolescence, and adulthood. Most investigations focused on childhood abuse, with investigations of childhood sexual abuse overrepresented in comparison to other abuse experiences. Authors conducting studies of trauma at any time in the life course consistently found a negative association with physical and mental health outcomes, which were increased by the presence of posttraumatic stress symptoms. Results from a small number of studies suggested a negative intergenerational impact of trauma on the children of women in the NHS II.ConclusionInterpersonal trauma across the life course was strongly associated with many leading causes of morbidity and mortality among female nurses. Trauma conceptualization and operationalization varied across studies, and future investigations should leverage the full range of trauma measures available in the NHS II data set.