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91.
An integrative review exploring the physical and psychological harm inherent in using restraint in mental health inpatient settings
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Pauline Cusack PG Cert HE MSc BA Dip. SW. Sue McAndrew PhD MSc BSc Mick McKeown PhD BA DPSN RMN RGN Joy Duxbury PhD MA PG Cert HE BSc. 《International journal of mental health nursing》2018,27(3):1162-1176
In Western society, policy and legislation seeks to minimize restrictive interventions, including physical restraint; yet research suggests the use of such practices continues to raise concerns. Whilst international agreement has sought to define physical restraint, diversity in the way in which countries use restraint remains disparate. Research to date has reported on statistics regarding restraint, how and why it is used, and staff and service user perspectives about its use. However, there is limited evidence directly exploring the physical and psychological harm restraint may cause to people being cared for within mental health inpatient settings. This study reports on an integrative review of the literature exploring available evidence regarding the physical and psychological impact of restraint. The review included both experimental and nonexperimental research papers, using Cooper's (1998) five‐stage approach to synthesize the findings. Eight themes emerged: Trauma/retraumatization; Distress; Fear; Feeling ignored; Control; Power; Calm; and Dehumanizing conditions. In conclusion, whilst further research is required regarding the physical and psychological implications of physical restraint in mental health settings, mental health nurses are in a prime position to use their skills and knowledge to address the issues identified to eradicate the use of restraint and better meet the needs of those experiencing mental illness. 相似文献
92.
Michael Nash MSc PCLT BSc RPN RNT Caitriona McDonagh RPN Imelda Noone MSc BNS RPN RGN RNT Agnes Higgins PhD MSc BNS RPN RGN RNT 《International journal of mental health nursing》2018,27(5):1449-1458
Rapid tranquillization is a pharmacological intervention sometimes employed in mental health care for the management of acute behavioural disturbance. It is a form of restrictive practice, which, along with seclusion and restraint, is a conventional and controversial intervention in the therapeutic management of risk in mental health settings. This study surveyed mental health nurses practice in rapid tranquillization. A self‐report questionnaire was utilized which addressed aspects such as definitions of rapid tranquillization, presence of rapid tranquillization policy, types of incidents where it is used and postintervention monitoring. The results demonstrate that rapid tranquillization is an intervention used in the management of acute behavioural disturbance in various mental health settings in Ireland. Respondents showed a basic understanding of rapid tranquillization as an intervention; however, some areas reported not having a specific rapid tranquillization policy. There was some evidence of a variation in postrapid tranquillization monitoring of psychiatric/mental health and physical health. Service user debriefing following rapid tranquillization was reported to be common; however, the content of this was not elaborated on. In the light of variations in practice, specific training and the development of rapid tranquillization policies are recommended. 相似文献
93.
Keeping the focus on children: the challenges of safeguarding children affected by domestic abuse
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Sue Peckover PhD MMedSci RHV Pg.Cert.Ed BSc.Econ Fiona Trotter RMN RGN DipHV MSc FHEA 《Health & social care in the community》2015,23(4):399-407
Safeguarding children affected by domestic abuse is a key responsibility for all professionals working with children and families, but can be difficult to achieve in practice. Despite a policy emphasis on early intervention and child‐centred work, limited attention has been paid to how professionals in universal and additional support services address this important area of work. This paper reports findings from qualitative research undertaken in one local authority area in the north of England during 2011 which examines the challenges facing professionals in safeguarding children affected by domestic abuse. Six mixed professional focus groups were held, attended by a total of 23 participants. Discussion focused upon participants’ awareness of domestic abuse, how they assessed and met children and young peoples’ needs, and their views about service provision and safeguarding processes. Data were transcribed and thematic analysis undertaken. The themes presented in this paper – embodied recognition, someone else's job, service gaps, skills deficits, and focusing upon children and young people – illustrate the scope and limitations of professionals’ work with children and young people affected by domestic abuse. Areas for practice improvement are discussed. 相似文献
94.
Experimental paradigms used in affective and clinical science often use stimuli such as images, scenarios, videos, or words to elicit emotional responses in study participants. Choosing appropriate stimuli that are highly evocative is essential to the study of emotional processes in both healthy and clinical populations. Selecting one set of stimuli that will be relevant for all subjects can be challenging because not every person responds the same way to a given stimulus. Machine learning can facilitate the personalization of such stimuli. The current study applied a novel statistical approach called a recommender algorithm to the selection of highly threatening words for a trauma-exposed population (N?=?837). Participants rated 513 threatening words, and we trained a user–user collaborative filtering recommender algorithm. The algorithm uses similarities between individuals to predict ratings for unrated words. We compared threat ratings for algorithm-based word selection to a random word set, a word set previously used in research, and trauma-specific word sets. Algorithm-selected personalized words were more threatening compared to non-personalized words with large effects (ds?=?2.10–2.92). Recommender algorithms can automate the personalization of stimuli from a large pool of possible stimuli to maximize emotional reactivity in research paradigms. These methods also hold potential for the personalization of behavioral treatments administered remotely where a provider is not available to tailor an intervention to the individual. The word personalization algorithm is available for use online (https://threat-word-predictor.herokuapp.com/). 相似文献
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97.
Shane Cullinan Aoife Fleming Denis O'Mahony Cristin Ryan David O'Sullivan Paul Gallagher Stephen Byrne 《British journal of clinical pharmacology》2015,79(5):860-869
Aims
Older patients commonly suffer from multimorbidites and take multiple medications. As a result, these patients are more vulnerable to potentially inappropriate prescribing (PIP). PIP in older patients may result in adverse drug events (ADEs) and hospitalizations. However, little has been done to identify why PIP occurs. The objectives of this study were (i) to identify hospital doctors'' perceptions as to why PIP occurs, (ii) to identify the barriers to addressing the issues identified and (iii) to determine which intervention types would be best suited to improving prescribing.Methods
Semi-structured interviews based on the Theoretical Domains Framework (TDF), a tool used to apply behaviour change theories, were conducted with 22 hospital doctors. Content analysis was conducted to identify domains of the TDF that could be targeted to improve prescribing for older people. These domains were then mapped to the behaviour change wheel to identify possible intervention types.Results
Content analysis identified five of the 12 domains in the TDF as relevant: (i) environmental context and resources, (ii) knowledge, (iii) skills, (iv) social influences and (v) memory/attention and decision processes. Using the behaviour change wheel, the types of interventions deemed suitable were those based on training and environmental restructuring.Conclusion
This study shows that doctors feel there is insufficient emphasis on geriatric pharmacotherapy in their undergraduate/postgraduate training. An intervention providing supplementary training, with particular emphasis on decision processes and dealing with social influences would be justified. This study has, however, uncovered many areas for potential intervention in the future. 相似文献98.
The development and initial validation of a questionnaire to measure help‐seeking behaviour in patients with new onset rheumatoid arthritis
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Rebecca J. Stack BSc MBPsS MSc PhD Christian D. Mallen BMBS FRCGP PhD Chris Deighton BMedSci MD FRCP Patrick Kiely BSc MBBS PhD FRCP Karen L. Shaw BSc MBPsS PgCert PhD Alison Booth RN MSc Kanta Kumar RN MSc Susan Thomas BA MA Ian Rowan Rob Horne BSc MSc PhD MRPharm Peter Nightingale BSc PhD Sandy Herron‐Marx RGN DPSN BA PGcap PhD Clare Jinks BA MPhil PhD Karim Raza FRCP PhD 《Health expectations》2015,18(6):2340-2355
99.
Parents' experiences of living with a child with hydrocephalus: a cross‐sectional interview‐based study
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Joanna Smith PhD MSc BSc RSCN RGN Francine Cheater PhD MA RGN Hilary Bekker PhD MSc BSc 《Health expectations》2015,18(5):1709-1720
Background
Shunts, the main treatment for hydrocephalus, are problematic because they frequently malfunction. Detecting shunt malfunction is challenging because symptoms are similar to those of common childhood illnesses, particularly viral infections. Parents are responsible for identifying shunt malfunction and responding accordingly. Understanding parents'' experiences has the potential to improve parent–professional collaboration and the management of the child''s condition.Aim
To explore parents'' experiences of living with a child with hydrocephalus and their decisions when they suspect shunt malfunction.Design and methods
A cross‐sectional interview‐based survey using qualitative methods was undertaken. Twenty‐five parents participated in the interviews. Framework approach underpinned data analysis.Findings
Three concepts, ‘uncertainty’, ‘developing expertise’, and ‘a normal life’, were identified. These concepts were dynamic in nature as parents learned through experience, adapted to changes in their child''s health status and made decisions about their needs. Uncertainty because of the unpredictability and life‐threatening nature of shunt malfunction dominated parents'' accounts. Through experience, parents learned to differentiate between symptoms that suggested a shunt problem and those of other childhood illnesses, but perceived their expertise was not always valued by health professionals or used to inform clinical decisions. Decisions about where or when to seek advice related to prior experiences of health‐care services and minimizing disruption for the whole family.Conclusion
Parents can recognize illness symptoms suggestive of shunt malfunction and want to collaborate with health professionals about the management of their child''s condition. Collaboration with parents requires health professionals to listen to parents'' concerns and value their experiences. 相似文献100.
Supporting public involvement in research design and grant development: a case study of a public involvement award scheme managed by a National Institute for Health Research (NIHR) Research Design Service (RDS)
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Jonathan D. Boote MA MSc PhD Maureen Twiddy BSc MSc PhD Wendy Baird BSc MSc PhD Yvonne Birks BSc DPhil RGN Clare Clarke BSc Daniel Beever LLB 《Health expectations》2015,18(5):1481-1493