Using mindfulness-based therapeutic interventions in psychiatric nursing practice--part II: Mindfulness-based approaches for all phases of psychotherapy--clinical case study

Finding effective nursing interventions for the treatment of mental illness is a major concern for advanced practice psychiatric nurses (APPN). Increasingly, innovative psychotherapeutic treatment modalities are being used for the treatment of individuals with serious mental illness. One such innovative approach, Mindfulness-based therapeutic interventions, has been shown to relieve distress for individuals with medical and psychiatric illnesses. In Part I of this two-part article, the authors described principle concepts of mindfulness, reviewed current research in the usefulness of mindfulness practice for treatment of psychiatric illnesses. The structure and content of mindfulness-based cognitive therapy (MBCT) was also outlined and provided the theoretical basis for this treatment approach. This alternative therapeutic approach offers potential usefulness for the treatment of individuals suffering from mental illness. Part II of this article presents a more detailed explanation of mindfulness-based therapeutic approaches for all phases of psychotherapy and identifies relevant research questions that will provide an empirical base to guide clinical practice. A case study illustrates mindfulness-based therapeutic interventions.     

Using bioinformatics and genome analysis for new therapeutic interventions

The genome era provides two sources of knowledge to investigators whose goal is to discover new cancer therapies: first, information on the 20,000 to 40,000 genes that comprise the human genome, the proteins they encode, and the variation in these genes and proteins in human populations that place individuals at risk or that occur in disease; second, genome-wide analysis of cancer cells and tissues leads to the identification of new drug targets and the design of new therapeutic interventions. Using genome resources requires the storage and analysis of large amounts of diverse information on genetic variation, gene and protein functions, and interactions in regulatory processes and biochemical pathways. Cancer bioinformatics deals with organizing and analyzing the data so that important trends and patterns can be identified. Specific gene and protein targets on which cancer cells depend can be identified. Therapeutic agents directed against these targets can then be developed and evaluated. Finally, molecular and genetic variation within a population may become the basis of individualized treatment.     

Using therapeutic touch in nursing practice

This article is an introduction to "therapeutic touch" and its implications for nursing. A case study provides an example of how therapeutic touch was used with an individual who fell from a ladder and injured his elbow. A brief history and assumptions that support the practice of therapeutic touch are discussed. Rogers' Science of Unitary Human Beings, a nursing theory, provides a theoretical basis for therapeutic touch. The method developed by Kunz and Krieger involves four phases and each of these is identified and described. General uses for therapeutic touch are presented and a variety of research studies validate the practice of therapeutic touch in nursing. Resources are provided for those who may be interested in learning more about therapeutic touch.     

Forensic psychiatric nursing: skills and competencies: I role dimensions

This paper reports on an investigation into the skills and competencies of forensic psychiatric nurses from the perspective of three groups: (A) forensic psychiatric nurses; (B) non-forensic psychiatric nurses; and (C) other disciplines. A national survey of forensic psychiatric services in the UK was conducted, and information gathered on the perceived skills and competencies in this growing field of psychiatric practice. From 3360 questionnaires, 1172 were returned, making a response rate of 35%. The results indicate a small discrepancy between forensic nurses' and non-forensic nurses' perceptions of the role constructs of forensic practice. However, a larger difference was noted between nurses' perceptions and other disciplines' perceptions of the constituent parts to forensic psychiatric nursing. Nurses tended to focus on personal qualities both in relation to themselves and the patients, while the other disciplines focused on organizational structures both in defining the role and in the resolution of perceived deficits. The findings have implications for multidisciplinary working, as well as policy formulation and curriculum development in terms of the skills and competencies of forensic nurse training.     

对精神病病人探视后的病情观察与护理干预

通过对住院精神病病人探视后病情变化的观察,认为不适宜的探视可加重病情或致疾病复发,甚至发生意外事件。做好对探视者的宣教、严密观察探视后病人的病情变化,采取适当的护理和管理措施,是防止意外事件发生、利于病人疾病康复的重要措施。     

Using self-help support groups: a framework for nursing practice and research

Social support groups are receiving increased attention in professional literature and the media and the number of groups is growing. Nurses are often urged to utilize social support groups as part of client care. These groups cannot be effectively used by nurses unless they are approached from the framework of the nursing process. This approach helps assure individualization of referrals and evaluation of the support group in relation to the client's needs. Based on the literature reviewed and the proposed nursing process framework, many research questions are identified.     

Interrelationship between core interventions and core competencies of forensic psychiatric nursing in Finland

The importance of core competencies (CC) and their relationship to core interventions in clinical practice guidelines on schizophrenia (CPGS), and the abilities to master these competencies were studied among registered nurses (RN) and practical mental nurses (PMN) in a forensic psychiatric setting. Data were collected from RNs, PMNs, and managers of all five forensic psychiatric facilities in Finland. The research material was obtained by using a 360-degree feedback method. The response rate was 68% (N = 428). The differences between the nurse groups were statistically significant (p ≤ 0.05) regarding the importance of and ability to master the following CCs: (1) pharmacotherapy, (2) knowledge in forensic psychiatry and violent behavior, (3) the treatment of violent patients, (4) processing patient's and own emotion, and (5) need-adapted treatment of the patient. Overall, RNs exceeded PMNs in mastering the CCs, however the principles of the CPGS were not achieved within the current resources in Finland. In summary, RNs, rather than PMNs, should be recruited for work in forensic psychiatric nursing, although a considerable amount of specific training would still be required to achieve competence. Implications of our research indicate that all nurses working in this area need to receive further education in forensic psychiatry and in forensic psychiatric nursing.     

Exploring evidence of the therapeutic relationship in forensic psychiatric nursing

While the body of nursing research in forensic psychiatry is growing rapidly, the therapeutic nurse-patient relationship in secure hospitals needs to be further examined. This paper reports on a research project that found two representations of the nurse-patient relationship in two male acute secure inpatient units. One representation was formed by the data collected from the unit nurses in semistructured interviews. The nurses valued the relationship and described their practice as therapeutic, however, evidence from the interviews would suggest that the nurses operate from a social frame of reference. Examination of the nurses 'entries in patients' case files formed the other representation. Through their documentation practices, nursing was represented as being oriented to custodial care. While neither representation can capture the clinical reality, these findings are relevant to forensic psychiatric nurses as their entries are a historical record through which their practice will become known to others, and in some cases, judged by others.     

An examination of frequent nursing interventions and outcomes in an adolescent psychiatric inpatient unit

ABSTRACT: Little is known about which nursing interventions used in adolescent psychiatric inpatient treatment demonstrate improvements in outcome in the ‘real world’ setting, despite an increase in external outcomes reporting requirements.This paper examines nursing and other multidisciplinary interventions commonly used at the Youth Inpatient Unit, Christchurch, New Zealand, in relation to improvements in outcomes as measured by the Health of the Nation Outcome Scales for Children and Adolescents, utilizing data gathered prospectively as part of an ongoing quality assurance and outcomes project. We found the majority of interventions investigated were utilized equally across diagnostic groups, although stress management and problem‐solving education was used more for patients with mixed affective disorders. Further, the results contribute to growing evidence toward the value of providing medication and problem‐solving education to this population. Mental health nurses working with children and adolescents should be supported to utilize and develop their unique skill set to offer targeted interventions and to examine their practice to identify the most valuable interventions for their patients within this developmental context.     

The stigma of a psychiatric diagnosis: prevalence, implications and nursing interventions in clinical care settings

The stigma associated with psychiatric and substance abuse disorders is a formidable barrier to the achievement of health and well-being for persons who carry such a diagnosis or who exhibit symptoms. Attitudes of nurses and treatment providers toward patients with comorbid psychiatric and substance abuse disorders can be influenced by stigma, which can have a negative impact on the therapeutic process and development of trust necessary to support good patient outcomes. Understanding the interrelated components of stigma, including labeling, stereotypes, and discrimination, can help nurses to reduce its impact in clinical care settings to improve the care experience for patients and nurses. Implementing interventions based on the core values of the nurse-patient relationship to enhance understanding, mutual trust, and acceptance of differences can contribute to improved communication and patient assessments in an effort to improve patient outcomes.     

Anemia in cancer: therapeutic implications and interventions

Significant progress has been made in the prevention and management of many symptoms associated with cancer and its therapy. Anemia in cancer may be secondary to blood loss, displacement of normal bone marrow cells by malignant cells, myelotoxic therapy, or the tumor itself. Practitioners may not always adequately assess anemia unless it represents a source of significant symptoms or patient distress. Risk factors include platinum-based treatment regimens, specific tumor types, and low baseline hemoglobin levels. Anemia may have an impact on patient performance status, quality of life, clinical symptoms, and possibly therapeutic efficacy and survival. Treatment interventions, directed toward the underlying etiology of the anemia, involve iron supplementation, blood transfusion, and administration of recombinant human erythropoietin. Future advances may include new tools to assess physical or functional symptoms and predict therapeutic response more accurately, and more cost-effective, convenient agents to prevent or treat anemia in cancer. Novel approaches that may add to the armamentarium of strategies designed to address anemia in patients with cancer currently are being developed.     

Masochism: implications for psychiatric nursing.

Psychiatric nurses often encounter patients who seem to be victims of negative circumstances and are unable to reverse these situations. This article explores the phenomenon of masochism as an outcome of the fear of separation or abandonment. A unified theory is presented, and a case is used to demonstrate the theory.     

The history of psychiatric nursing in Rio Grande do Sul: Part I

The objective of this article is to contribute towards the history and historiography of Psychiatric Nursing in Rio Grande do Sul by reconstituting the Professional School of Nursing that functioned from 1939 to 1952 at the S?o Pedro Hospital. Since this is recent history, documentary research and oral history were used as primary sources of information. It was possible to characterize the context that favored its organization, the main characteristics of the process used to train nurses in the field of psychiatry and its effects in attaining the discipline of these professionals in relation to the psychiatric project, which at that time was hegemonic.