The concept of spiritual care in mental health nursing

AIM: In this paper we aim to clarify the issue of spiritual care in the context of mental health nursing. BACKGROUND: The concept of spirituality in nursing has received a great deal of attention in recent years. However, despite many articles addressed to the issue, spiritual care remains poorly understood amongst nursing professionals and, as a result, spiritual needs are often neglected within the context of health care. METHODS: A series of focus groups was conducted to obtain the views of service users, carers and mental health nursing professionals about the concept of spirituality and the provision of spiritual care in mental health nursing. RESULTS: According to the views expressed in our focus groups, spiritual care relates to the acknowledgement of a person's sense of meaning and purpose to life which may, or may not, be expressed through formal religious beliefs and practices. The concept of spiritual care was also associated with the quality of interpersonal care in terms of the expression of love and compassion towards patients. Concerns were expressed that the ethos of mental health nursing and the atmosphere of care provision were becoming less personal, with increasing emphasis on the 'mechanics of nursing'. CONCLUSIONS: The perceived failure of service providers to attend adequately to this component of care may be symptomatic of a medical culture in which the more readily observable and measurable elements in care practice have assumed a prominence over the more subjective, deeply personal components. In order for staff to acknowledge these issues it is argued that a more holistic approach to care should be adopted, which would entail multidisciplinary education in spiritual care.     

Perceptions of mental health among recently immigrated Mexican adolescents

Rates of anxiety, depression, and suicidal ideation are high among Latino adolescents in the U.S., many of whom are immigrants. Immigration during adolescence creates risk factors for mental health problems. The purpose of this study was to explore the health-related perceptions of Mexican-origin immigrant adolescents to inform the design of culturally and developmentally appropriate mental health services. This focused ethnography was guided by Bronfenbrenner's ecological framework and symbolic interactionism. Fourteen adolescents were recruited from two non-health-based community settings. Data from one-to-one semi-structured interviews and a visual narrative project were coded and analyzed inductively. Three thematic patterns were identified: "mentally healthy," "mentally unhealthy," and "health promotion." Increased awareness of cultural influences and immigration on Latino adolescents' mental health is needed. Mental health nurses are in a unique position to educate and to influence accessibility of services.     

Perceptions from the front line: Professional identity in mental health nursing

In the context of a growing population of people experiencing mental illness worldwide, mental health nurses are a crucial workforce. Their recruitment and retention, however, is in decline. Drawing on qualitative data obtained from interviews with mental health nurses (MHN) in Victoria, Australia, the paper employs a range of concepts from role theory to explore professional identity within mental health nursing. The data highlight three key issues in relation to the future recruitment and retention of MHN: (i) the ambiguity of the MHN role; (ii) the weak definition and lack of understanding of the scope of the MHN role by nursing students; and (iii) a lack of communication about MHN as a profession to a wider audience. These findings indicate three avenues through which recruitment and retention in mental health nursing could be improved: (i) public communication; (ii) training and educating of the next generation of MHN; and (iii) more accurately defining the role of the MHN.     

Physical restraint in mental health nursing: A concept analysis

ObjectivePhysical restraint is frequently used in medical services, such as in mental health settings, intensive care units and nursing homes, but its nature varies in different institutions. By reviewing related literature, this study aims to clarify the concept of physical restraint in mental health nursing.MethodThree databases (PubMed, PsycINFO and CINAHL) were retrieved, and Walker and Avant's concept analysis method was used to analyze the concept of physical restraint in mental health nursing.ResultsPhysical restraint is a coercive approach that enables the administration of necessary treatment by safely reducing the patient's physical movement. It should be the last option used by qualified personnel. Antecedents of physical restraint are improper behavior (violence and disturbance) of patients, medical assessment prior to implementation and legislation governing clinical usage. Consequences of physical restraint are alleviation of conflict, physical injury, mental trauma and invisible impact on the institution.DiscussionThis study defined the characteristics of physical restraint in mental health nursing. The proposed concept analysis provided theoretical foundation for future studies.     

Dance in mental health nursing: a hybrid concept analysis

The aim of this concept analysis is to describe the defining attributes and consequences of the concept of dance and to define it in a mental health nursing context using hybrid concept analysis. Dance is a human resource learned from culture. Dance implies body movements, steps, expression, and interaction. The outcomes of dance are mostly functional, including a client's physical and emotional health, well-being, ability to cooperate with other people in activities of daily life, and meeting role expectations within family and community. Based on the findings of this concept analysis, dance can be used as a nursing intervention.     

The concept of hope in nursing 2: hope and mental health nursing

This article is the second in a series of six that explores the nature of hope, reviews the existing theoretical and empirical work in several discrete areas of nursing, and provides case studies to illustrate the role that hope plays in clinical situations. In this article we focus on hope within the formal area of psychiatric/mental health nursing. The article points out that there is a limited empirical literature covering several aspects and issues of hope, hopelessness and hope inspiration within the domain of psychiatry. However, despite these studies many questions still remain unanswered. The bulk of this empirical literature focuses on hopelessness, and in the main hopelessness associated with suicide/depression. As a result of these investigations, a range of interventions has been identified for inspiring hope in different client groups with mental health problems, and a summary of these is given. Importantly, however, the basic social process of hope inspiration for each of these client groups is fundamentally the same, in that the process remains subtle, unobtrusive and associated with the therapy/relationship. We conclude by indicating key areas/questions for future research, and raise key questions regarding future policy/education issues.     

Patterns of self-disclosure among mental health nursing students

Self-disclosure, a process by which we let ourselves be known to others, is an important skill across a diverse range of therapeutic approaches used in mental health nursing. Previous studies of nurses' self-disclosure have been confined to small samples of female, adult nurses. This study aims to extend existing knowledge by providing information on a sample of male and female mental health nursing students.A modified version of Jourard's 25-item self-disclosure questionnaire (JSDQ) was utilized in the study. The findings from this study show that mental health students disclosed more items than adult students sampled in earlier studies (Jourards 1961, Burnard & Morrison 1992). However, students disclosed significantly fewer items to the patient as target-person than to other categories. No differences were observed in disclosure patterns for males and females. A discussion of these findings and their implications is offered.     

Choosing and remaining in mental health nursing: Perceptions of Western Australian nurses

Mental health nursing has an ageing workforce with a critical shortage of nurses in Western Australia. Additionally, mental health is not the preferred career for many graduate nurses. Current challenges with recruitment and retention suggest that strategies are needed to address this issue. This research project adopted a novel approach that focused on exploring the positive aspects of why mental health nurses remain, rather than why they leave. A cross‐sectional design was employed comprising a brief interview survey, and nurses working within one public mental health service in Western Australia were invited to participate. A total of 192 nurses participated across 5 months, from adult, older adult, forensic, and education/research programmes. Thematic analysis was conducted from five key questions, and responses from questions one and two are discussed in this paper: ‘Why did you choose mental health nursing?’ and ‘Why do you remain in mental health nursing?’. The main themes extracted in response to choosing mental health nursing were wanting to make a difference, mental health captured my interest, encouraged by others, and opportunities. Subsequent themes extracted from responses to remaining in mental health nursing were facing reality, passion for mental health nursing, patient‐centred caring, and workplace conditions. Findings will be utilized to inform strategies for recruitment and retention of graduate nurses; further development of support systems, such as preceptorship training and improving student clinical experiences; as well as improving professional development opportunities for existing mental health nurses.     

Perceptions of mental health nurses and patients about health promotion in mental health care: a literature review

The aim of this review was to examine the perceptions of patients with mental disorders and mental health nurses of health promotion targeting physical activity and eating habits in mental health care. An electronic search strategy was conducted. Furthermore, references were searched by hand-searching the reference lists of the retrieved articles from the electronic databases. The literature on perceptions of health promotion and lifestyle interventions in mental health care principally consist of qualitative studies using interviews and focus groups. Positive perceptions of both mental health nurses and patients towards health promotion targeting physical activity and eating habits in mental health care were identified. Contrary, several barriers for integrating healthy lifestyles into the daily life of patients were described. Patients usually want to learn more about healthy lifestyles, but see the ability to change their physical health as beyond their control. In this sense, support from mental health nurses is considered as important. Despite the awareness of the importance of health promotion in mental health care, it appears that visions and attitudes towards the potential of health promotion are in need of change.     

本科护生专业自我概念与心理健康状况的相关性研究

目的了解本科护生专业自我概念、心理健康状况,并分析二者之间的关系。方法采用护理专业自我概念量表和症状自评量表对203名大学2年级和3年级的全日制4年制本科护生进行调查。结果本科护生护理专业自我概念量表总分为(86.57±6.08)分;症状自评量表总分为(152.80±37.00)分,各因子得分均高于成人常模(P0.01);本科护生专业自我概念总分、技能、灵活性得分分别与症状自评量表总分、强迫、抑郁、焦虑得分呈负相关(P0.01);满意度得分与强迫、抑郁得分呈负相关(P0.01)。结论本科护生具有较高的专业自我概念水平,心理健康水平不容乐观,在护理教育过程中应积极促进本科护生专业自我概念的发展,提高其心理健康水平。     

A concept analysis of empowerment: its relationship to mental health nursing

The concept of empowerment is described as being intuitively attractive to nurses and the nursing profession. This concept analysis represents an attempt not only to clarify meaning but also to describe the relationship, if any, between empowerment and mental health nursing. It is the argument of this author that the conceptual ambiguity said to blight the implementation of empowerment practice is underpinned by a tendency to describe the concept without direct reference to theories of power. As regards mental health nursing the author concludes that there should be an end to the quest for professionalism personified by notions such as individualized care. In its place should be an approach that recognizes that nurses and users must unite to pursue forms of knowledge that precipitate a challenge to the current hegemony of the medical and scientific elite.     

Stress in mental health nursing

Although there have been growing concerns about stress in nursing over recent years, research has primarily focused on general nurses. This paper reports on stress in mental health nursing. The data were obtained, via questionnaires, from mental health nurses at the end of their training. Four-hundred and forty-seven questionnaires were returned, an 80% response rate. Open-ended questions were asked about the nurses' experiences of stress during their time as a student, and what they anticipated would be stressful once qualified. A wide range of stresses were identified, many similar to those reported in previous studies. The open-ended nature of the questions, however, provided greater detail about the nature of stress in mental health nursing than has been reported hitherto. This detail points to broader perspectives which might be taken in future research which, in turn, may lead to a fuller understanding of nurses' experiences of stress.     

Chinese students' concept of mental health

This study explored Chinese students' concept of mental health through a questionnaire completed by 999 students from six primary schools, six high schools, and three universities in Shanghai. The results confirmed the expectation that Chinese students' mental health concept would be multifaceted and would reflect psychological, physical, and sociocultural factors. An exploratory factor analysis on 12 mental health items with a subsample extracted a three-factor model, which was cross-validated by confirmatory factor analysis with a different subsample. These three factors were labeled as Affective Strength, Adaptive Strength, and Personal Strength. No gender differences were found. The grade differences supported the notion that Chinese students' concept of mental health seems to be more consistent with the developmental paradigm of health. The senior years in primary school could be the turning point at which children start to conceptualize health as a holistic experience by recognizing the importance of mental health.     

在校护生心理健康水平影响因素的路径分析

目的了解护生心理健康水平与心理社会因素的关系。方法采用症状自评量表、青少年生活事件量表和应对方式问卷、领悟社会支持量表、自尊量表对345名护生进行调查。结果成熟型应对方式、领悟社会支持量表得分、自尊量表得分与症状自评量表得分呈负相关,不成熟型应对方式、混合型应对方式、青少年生活事件量表得分与症状自评量表得分呈正相关。对症状自评量表得分有直接影响的变量按影响大小依次为成熟型应对方式、自尊、生活事件评分、社会支持总分,4个变量对心理症状均存在间接效应。结论成熟型应对方式、自尊、生活事件、社会支持是影响在校护生心理健康的重要因素。