Hülya Bilgin

PSYCHIATRIC INTENSIVE CARE UNITS : A LITERATURE REVIEW

Background: Psychiatric Intensive Care Units (PICU) have been part of most inpatient psychiatric services for some time, although information about their functioning and outcome has not previously been collated. Aim: To conduct a systematic literature review to assess the current state of knowledge about such services. Method: A search of electronic databases was undertaken, followed by obtaining additional references from items obtained. Results: Over 50 papers in English containing some empirical data were identified. Most studies were retrospective. Typical PICU patients are male, younger, single, unemployed, suffering from schizophrenia or mania, from a Black Caribbean or African background, legally detained, with a forensic history. The most common reason for admission is for aggression management, and most patients stay a week or less. Evidence of the efficacy of PICU care is very poor. Conclusions: Most research so far has been small scale, and more substantial work using better methodologies is clearly required.

Reproductive health in women with serious mental illnesses

AIMS AND OBJECTIVES To determine what problems female psychiatric patients have in terms of reproductive health. BACKGROUND The reproductive health problems faced by female psychiatric patients are matters that have been neglected in the areas of both psychiatry and womens health. This study aims to make a contribution from Turkey to the literature in this neglected field. DESIGN The study is descriptive and was conducted with 292 female patients treated in an acute inpatient psychiatric ward. METHODS Data were collected through face-to-face interviews and a questionnaire based on the literature and prepared by the researchers which was designed to determine the kinds of reproductive health issues the patients were experiencing. RESULTS It was found that compared with healthy women, the distinctive features of the participants in terms of sexuality were more negative; in particular, patients diagnosed with bipolar disorder were more likely to have been forced by their partners to have sex, they had suffered from rape or sexually transmitted diseases, the majority of those who had previous sexual experience had tried to use contraceptives but had been unable to continue using them, they were most likely to choose the method of withdrawal for contraception, their rates of pregnancy and abortion were high, they received less antenatal care, and they were more likely to have smoked during pregnancy. CONCLUSIONS It was found that female patients with psychiatric disorders had more negative attributes with regard to marriage, sexuality, family planning, maternal characteristics and pregnancy, compared with a corresponding healthy population. RELEVANCE TO CLINICAL PRACTICE The results of this study may be useful for nurses in the clinical field for calling an attention and raising an awareness of the reproductive health problems of women with psychiatric disorders, taking the necessary preventive measures, and developing damage-reducing strategies.

Contributing Factors to Aggressive Behaviors in High School Students in Turkey

Violence among young people is an important public health topic as a universal problem. One of the recent issues concerning both the media and parents is the aggressive behavior among the high school students in Istanbul and the worldwide. The aim of this study was to investigate the types and rates of aggressive behavior and the contributing factors to this behavior among high school students. Sample was composed of 805 students of 14–18 ages attending five high schools in Istanbul. The most common aggressive behavior among the students was found to be “beating others,” 34.5% (n = 278). Past experiences of violence of high school students (direct exposure to violence/witnessing violence/exposure to/witnessing attack with knife/gun) were determined as the most contributing factor to aggressive behavior. The present study investigated the nature of violent behaviors and associations between violent behaviors and contributing factors among high school students from Turkey.

Psychometric properties of the Turkish version of the Depression Coping Self-efficacy Scale

Reliable and valid instruments are needed to assess and deal with the problems that are encountered by depressed patients in psychiatric nursing practice. The aim of this study was to assess the reliability and validity of the Turkish version of the Depression Coping Self-efficacy Scale. A descriptive and correlation design was used to determine the psychometric properties of the Scale. The study population was 105 depressed inpatients from acute psychiatry services. The study confirmed that the Scale is reliable and valid for assessing depression coping self-efficacy of depressed patients in acute psychiatric wards in Turkey.

The relationship between attachment styles and childhood trauma: a transgenerational perspective - a controlled study of patients with psychiatric disorders.

AIMS AND OBJECTIVES This study had two aims. The first aim was to compare attachment styles and traumatic childhood experiences of women with psychiatric disorders and their children to a control group. The second aim was to determine the relationship between attachment styles and traumatic childhood experiences both in mothers and their children. BACKGROUND According to attachment theories, trauma in an early relationship initiates a developmental cascade in which insecure attachments may occur. DESIGN A cross-sectional, descriptive study which, employed a case-control design, was performed between May 2013-March 2014. METHODS This study was conducted in 63 women with psychiatric disorders and their children. The control group consisted of 63 women without any psychiatric disorders and their children. Data were collected using questionnaire forms, including the Adult Attachment Style Scale and the Childhood Trauma Questionnaire for both mothers and children. Descriptive statistics, a Pearson correlation and comparative statistics were used to analyse data. RESULTS The childhood trauma scores of both the women with psychiatric disorders and their children were higher than the control group scores. Compared to the control group, the mothers with psychiatric disorders and their children were found to have less secure attachment styles. It was determined that the mothers and children with insecure attachment were more likely to have been abused. CONCLUSION These results point to a relationship between trauma in childhood and attachment style. They also suggest that this relationship may undergo intergenerational transfer. RELEVANCE TO CLINICAL PRACTICE This study contributes to the existing literature on the relationship between childhood traumas and attachment. Psychiatric nurses should focus not only on psychiatric disorders but also on the difficulties a patient faces regarding being a parent.

Psychiatric/Mental Health Nursing Nonphysical Competencies for Managing Violence and Aggression: De-escalation and Defusion

Even the most cursory of reviews of relevant literature will show the documented increase in the frequency of aggression and violence, all around the world, is difficult to ignore. Further this body of work illustrates how in the majority of cases, both historic and contemporary, the predominant response to aggression/violence is a “physical” one, emphasizing containment and custodial aspects. Accordingly, this chapter will review relevant information about “nonphysical aggression/conflict management (de-escalation),” and it will explore de-escalation/defusion of violent incident interventions. It begins by exploring the data regarding the “mechanics” of conflict situations and then proceeds to explore definitions of de-escalation. Following this, the chapter proceeds to consider the principles, rationales, and basics of efforts to implement de-escalation approaches, looks at theoretical models of de-escalation, and then reviews the evidence and outcomes associated with de-escalation interventions/philosophy. The chapter concludes by examining the skills needed for engaging in successful de-escalation.