Janette Curtis

Skills, knowledge, and attitudes expected of a newly-graduated mental health nurse in an inpatient setting

Mental health nurses (MHN) are at the forefront of care and treatment within acute inpatient settings. Research suggests that newly-graduated MHN are unsure about the skills and knowledge that they are expected to possess, and are expected to practice at a level that they are not prepared for in their undergraduate courses; however, research focusing on competencies for newly-graduated MHN is scarce. This study aimed to identify competencies expected of newly-graduated MHN working in a regional mental health facility in New South Wales, Australia. Eight registered nurses (with varying levels of experience) participated in individual semistructured interviews. Four themes were identified, and termed: communication, safety, self-awareness, and treatment. Within these four themes, 14 competencies were described that detail clear aims for new graduates, provide a better understanding of mental health nursing, and promote specialized and competent practice in mental health.

New graduate mental health nurse competencies

Aggression during psychiatric hospitalization is frequent, problematic, and a major challenge for nurses and mental health services more generally. The strength of the therapeutic alliance between nursing staff and patients has been posited as an important protective factor that can limit the likelihood of aggression. This study examined the relationship between interpersonal style, perceived coercion, and psychiatric symptoms on the therapeutic alliance between patients and staff, and how each, in turn, is related to aggression. Participants in this study were 79 patients admitted to an acute psychiatric hospital. Each participant was interviewed to determine perceived coercion, symptoms of psychiatric illness, interpersonal style, and therapeutic alliance. Incidents of aggression were recorded at discharge through a review of incident forms, file review, and interviews with unit nursing staff. The results showed that a hostile-dominant interpersonal style and symptoms of paranoia predicted poor therapeutic alliance, contributing 14% of the variance in therapeutic alliance scores. A dominant interpersonal style predicted aggression towards staff. Therapeutic alliance, perceived coercion, and symptoms of psychiatric illness did not predict aggression. Implications for engagement in treatment and the prevention of aggression are discussed.

Attachment styles and alcohol problems in emerging adulthood: a pilot test of an integrative model

A pilot study tested a model of alcohol problems based on attachment theory. It was hypothesised that insecure attachment, particularly the fearful-avoidant attachment style, may be manifested in low levels of social support, which in turn might lead to alcohol problems in young adulthood. Problematic alcohol use is a key area of concern for individuals with a mental health disorder. Ninety university students completed self-report measures of attachment, perceived social support, parent/peer attachment and the Alcohol Use Disorders Identification Tool. Analyses for males indicated that attachment styles were associated in the expected direction with alcohol problem. Secure attachment was negatively associated with alcohol consumption, alcohol dependence and having experienced adverse consequences resulting from alcohol use, while fearful-avoidant adult attachment was positively correlated with alcohol dependence. While fearful-avoidant attachment was related to lower perceptions of social support, the pa...

A comprehensive mental health nursing assessment: variability of content in practice

Assessment is the foundation of mental health nursing practice, but little is known of how it is undertaken. This paper explores how mental health nurses describe the content of a comprehensive mental health nursing assessment. Eighteen nurses who worked in inpatient and community settings either as clinicians or managers, ranging from new graduates to nurses with greater than 20 years of experience, were interviewed and asked to describe the content of a comprehensive mental health nursing assessment. Transcribed interviews were analysed using a grounded theory methodology. The primary theme to emerge was one of variability. Most respondents hesitated and then identified different content areas that needed to be assessed as part of a comprehensive mental health nursing assessment. If the areas that are being assessed vary between nurses, then logically the types of interventions being offered will also vary. These results have implications for the education of nurses, their clinical practice, ongoing supervision and research into contemporary mental health nursing practice.Accessible summary • Little is known of how a comprehensive mental health nursing assessment is undertaken in practice. • Nurses describe the content of a comprehensive mental health nursing assessment in different ways. • Different content may lead to different interventions. • More work is required to ensure comprehensive mental health nursing assessments are undertaken in practice. Abstract Assessment is the foundation of mental health nursing practice, but little is known of how it is undertaken. This paper explores how mental health nurses describe the content of a comprehensive mental health nursing assessment. Eighteen nurses who worked in inpatient and community settings either as clinicians or managers, ranging from new graduates to nurses with greater than 20 years of experience, were interviewed and asked to describe the content of a comprehensive mental health nursing assessment. Transcribed interviews were analysed using a grounded theory methodology. The primary theme to emerge was one of variability. Most respondents hesitated and then identified different content areas that needed to be assessed as part of a comprehensive mental health nursing assessment. If the areas that are being assessed vary between nurses, then logically the types of interventions being offered will also vary. These results have implications for the education of nurses, their clinical practice, ongoing supervision and research into contemporary mental health nursing practice.

What is the process of a comprehensive mental health nursing assessment? Results from a qualitative study.

COOMBS T., CURTIS J. & CROOKES P. (2013) What is the process of a comprehensive mental health nursing assessment? Results from a qualitative study. International Nursing Review60, 96–102 Background:  It is a truism that nursing care must be informed by assessment, otherwise how can one know what care is required or that it has been successfully delivered? Yet, little is known about the process of comprehensive mental health nursing assessment in practice. If the education of mental health nurses is to be effective, it is essential that the key content of, and the processes involved in carrying out a mental health nursing assessment in practice are able to be articulated to learners. Aim:  To identify the processes of assessment that occur in mental health nursing practice based on interviews with mental health nurses working in clinical and management roles in clinical areas. Method:  Interviews were undertaken with 18 nurses who worked in inpatient and community mental health settings either as clinicians or managers. The nurses ranged from new graduates to those with more than 20 years of experience. Findings and discussion:  Clear processes were reported to be involved in undertaking a comprehensive mental health nursing assessment in practice, with three main themes emerging during analysis. First is the importance of engaging the patient; second is tell me what the problem is? with one subtheme reconcile inconsistencies; and finally, the ongoing nature of the assessment process. Conclusion:  Common processes emerged when the nurses described their individual approaches to undertaking comprehensive mental health assessment. The results have important policy implications for the educational preparation of mental health nurses, their ongoing supervision and further research into contemporary mental health nursing practice.BACKGROUND It is a truism that nursing care must be informed by assessment, otherwise how can one know what care is required or that it has been successfully delivered? Yet, little is known about the process of comprehensive mental health nursing assessment in practice. If the education of mental health nurses is to be effective, it is essential that the key content of, and the processes involved in carrying out a mental health nursing assessment in practice are able to be articulated to learners. AIM To identify the processes of assessment that occur in mental health nursing practice based on interviews with mental health nurses working in clinical and management roles in clinical areas. METHOD Interviews were undertaken with 18 nurses who worked in inpatient and community mental health settings either as clinicians or managers. The nurses ranged from new graduates to those with more than 20 years of experience. FINDINGS AND DISCUSSION Clear processes were reported to be involved in undertaking a comprehensive mental health nursing assessment in practice, with three main themes emerging during analysis. First is the importance of engaging the patient; second is tell me what the problem is? with one subtheme reconcile inconsistencies; and finally, the ongoing nature of the assessment process. CONCLUSION Common processes emerged when the nurses described their individual approaches to undertaking comprehensive mental health assessment. The results have important policy implications for the educational preparation of mental health nurses, their ongoing supervision and further research into contemporary mental health nursing practice.

Choosing to Use Compared to Taking Medication: The Meaning of Medication as Described by People Who Experience Schizophrenia

PURPOSE The use of medication is an important aspect within the experience of schizophrenia. DESIGN AND METHODS Interviews with 14 people with schizophrenia were analyzed using van Kaams psychophenomenological method, and findings revealed two opposing and important attitudes toward medication. FINDINGS Adopting an attitude of choosing to use prescribed medication means autonomously self-managing medication and taking prescribed medication means feeling challenged and being under external pressure through being told or forced by others and therefore having no personal connection to the details or purpose of medication. PRACTICE IMPLICATIONS Nurses need to actively work in partnership to support consumers to take an active stance toward choosing to use medication rather than ensuring consumers take medication.

The perceptions of the ward atmosphere in four Jordanian psychiatric hospitals from the perspective of patients' relatives.

PURPOSE To describes the perceptions of the ward atmosphere of psychiatric hospitals from the perspective of the relatives of people who were inpatients in those hospitals. DESIGN AND METHODS A nonexperimental descriptive survey was used. Data were collected using the Arabic version of Moos Ward Atmosphere Scale Ideal and Real forms. FINDINGS Data indicate that even though relatives of Jordanian mental health patients were generally positive about the ward atmosphere, they would like to see changes. PRACTICE IMPLICATIONS By describing their current and ideal treatment environments, participants have provided information that can guide interventions to change the ward atmosphere and thus help foster better patient treatment outcomes.Purpose To describes the perceptions of the ward atmosphere of psychiatric hospitals from the perspective of the relatives of people who were inpatients in those hospitals. Design and Methods A nonexperimental descriptive survey was used. Data were collected using the Arabic version of Moos Ward Atmosphere Scale Ideal and Real forms. Findings Data indicate that even though relatives of Jordanian mental health patients were generally positive about the ward atmosphere, they would like to see changes. Practice Implications By describing their current and ideal treatment environments, participants have provided information that can guide interventions to change the ward atmosphere and thus help foster better patient treatment outcomes.

The needs of people with alcohol-related brain injury (ARBI): a review of the international literature

Purpose – Alcohol-related brain injury (ARBI) is part of a group of conditions that do not fit easily into existing systems of care. People living with ARBI require flexible health and social services to ensure they receive person-centred, therapeutic care and treatment. Effective service provision promotes recovery for people who continue to experience significant levels of morbidity and mortality due to symptoms that are potentially reversible or at least amendable to appropriate care and treatment options. There exist significant gaps in the provision of this care for these vulnerable populations. Design/methodology/approach – A literature review was undertaken of various scholarly databases (e.g. CINAHL, MEDLINE and Web of Science), as well as government and non-government publications and reference materials. Publications were included for analysis if they reported participant cohorts who had a diagnosis of ARBI or were carers or service staff involved with individuals who lived with ARBI. Findings –...

Factors Affecting the Quality of Life for People with Schizophrenia in SaudiArabia: A Qualitative Study

Background: Quality of life (QoL) for people with schizophrenia has been a focus of concern in order to improve their standard of life to lead to more satisfaction, happiness and well-being. However, a little is known about how Saudi Arabian people with schizophrenia perceive their QoL. Purpose: This study presents the findings of a qualitative study that explored the QoL for 159 people with schizophrenia. Method: Structured face-to-face interviews were conducted with people with schizophrenia who live in the community. Results: A thematic analysis identified two main factors affecting the QoL for people with schizophrenia: 1) the shame of having schizophrenia was a barrier to their QoL and 2) the positive role of religion was a facilitator for their QoL. Conclusion: This study concluded the following: 1) Religion helps Saudi Arabian people with schizophrenia cope with and manage their mental illness, which improves their QoL, and 2) the shame of having a mental illness negatively affects the social engagement of Saudi Arabian people with schizophrenia, limiting their participation in leisure and work activities and therefore diminishing their QoL. The implications of these results in improving the QoL for people with schizophrenia and other mental illness in Saudi Arabia are discussed.