Karen-Leigh Edward

Resilience: When Coping Is Emotionally Intelligent

The potential for resilient behaviors and emotional intelligence involves an interplay between the individual and his or her broader environment. Studies that have examined resilience explore factors or characteristics that assist individuals to thrive from and in adversity. These protective factors are part of an individual’s general makeup. Some of these factors are considered genetic, such as a personality that is outgoing and social; however, many protective behaviors can be learned. Coping in the face of adversity involves emotional intelligence and resilience, both of which can be developed through support and education. In this context, fostering resilience and emotional intelligence has the potential to improve clinical outcomes for mental health consumers.

Nursing and aggression in the workplace: a systematic review

Personal experiences of aggression or violence in the workplace lead to serious consequences for nurses, their patients, patient care and the organisation as a whole. While there is a plethora of research on this topic, no review is available that identifies types of aggression encountered, individuals perceived to be most at risk and coping strategies for victims. The aim of this systematic review was to examine occupational anxiety related to actual aggression in the workplace for nurses. Databases (MEDLINE, CINAHL and PsycINFO) were searched, resulting in 1543 titles and abstracts. After removal of duplicates and non-relevant titles, 137 papers were read in full. Physical aggression was found to be most frequent in mental health, nursing homes and emergency departments while verbal aggression was more commonly experienced by general nurses. Nurses exposed to verbal or physical abuse often experienced a negative psychological impact post incident.

Resilience: A Protector From Depression

Personality type and resilient behaviors provide protection from the experience of depression, and resilience can increase the risk of not being depressed. Psychiatric–mental health nurses are well positioned to facilitate the development of resilience qualities in people who are depressed. Clinical strategies, which could be undertaken by the psychiatric–mental health nurse, include early intervention, promoting a positive social and familial climate, promoting self-esteem and support building, social and life skills/vocational education, and linking and brokering clients into extracurricular activities.

An Integrative Review of Paternal Depression

The aim of this project was to review current research regarding postnatal depression in fathers and to present potential screening and referral options. The search was limited to scholarly (peer reviewed) journals and all articles were retrieved with date limits. Initial search parameters were the following: antenatal depression OR pregnancy depression OR postnatal depression OR perinatal depression AND father* OR men OR paternal. The search yielded 311 abstracts returned. With reference to the inclusion criteria and primary and secondary outcomes intended for the focus of this review, N = 63 articles were retrieved and read in full by the researchers. These articles were included in the final integrative review. Depression in fathers following the birth of their child was associated with a personal history of depression and with the existence of depression in their partner during pregnancy and soon after delivery. Based on the review the authors suggest routine screening and assessment of both parents should occur across the pregnancy and postnatal period. The use of the Edinburgh Postnatal Depression Scale for screening of depression in men needs to be linked to referral guidelines for those individuals who require further investigation and care.

Nursing Care of Clients Treated with Atypical Antipsychotics Who Have a Risk of Developing Metabolic Instability and/or Type 2 Diabetes

OBJECTIVE The aim of this article is to present a current discussion related to the nursing care of clients treated with atypical antipsychotic medicines and who have a risk of developing metabolic instability and/or Type 2 diabetes. The importance of such a discussion is to provide both the novice and the experienced nurse with additional knowledge of this current health issue with which to inform their nursing practice. DISCUSSION The potential for psychosis to be a chronic condition is very high, and often people require antipsychotic medicine for lengthy periods throughout their lives. Sometimes, treatment is for life. The second generation of antipsychotic medicines was greeted with much enthusiasm since it was better tolerated than the first generation. However, each medication has desired and adverse effects and, when taken for lengthy periods, these effects may produce physical illness. Studies show that the prevalence of Type 2 diabetes and the metabolic syndrome was significantly higher in clients with a chronic psychiatric disorder, particularly schizophrenia. CONCLUSIONS Metabolic instability, especially weight gain, is associated with some psychotropic medicines. Nursing interventions need to include care assessment, planning, intervention, and evaluation for clients treated with antipsychotic medicines in terms of risk minimization strategies in routine nursing care.

The extension of Colaizzi’s method of phenomenological enquiry

Abstract Aim: Originating from unfunded research undertaken in 2007, this paper offers an overview of Colaizzi’s method of phenomenological analysis and proposes an extension to the original seven step approach enhancing rigour and, expanding information sources to enhance in-depth descriptions of phenomena for study. Background: The focus on human experience emanates from the human sciences in which the everyday lived world of humans constitutes the ontological and epistemological focus of enquiry – understanding of human experiences. Since the emergence of phenomenology as a method of enquiry, advances in phenomenological thought and research methods have emerged. Method: Colaizzi’s phenomenological method of enquiry was used as the basis of enquiry in this study. Findings: The extension to Colaizzi’s method of analysis emanated from recent research conducted by the authors to allow participants to express their experiences through everyday language. These ‘expressions of life’ included – art, music, poetry, metaphor as symbolic representations – as a vehicle for participants’ to explicate their experiences. Conclusion: The additional step proposed as an extension to Colaizzi’s seven step analysis offers researchers using Colaizzi’s method greater access to implicit and explicit meanings embedded in participant descriptions by utilising ‘expressions of life’ – art, music, poetry, metaphor as symbolic representations – as articulated by the participants in explicating their experience of the phenomenon.

The effectiveness of specialist roles in mental health metabolic monitoring a retrospective cross-sectional comparison study

BackgroundPeople with serious mental illness (SMI) exhibit a high prevalence of cardiovascular diseases. Mental health services have a responsibility to address poor physical health in their consumers. One way of doing this is to conduct metabolic monitoring (MM) of risk factors for cardiovascular diseases. This study compares two models of MM among consumers with SMI and describes referral pathways for those at high risk of cardiovascular diseases.MethodsA retrospective cross-sectional comparison design was used. The two models were: (1) MM integrated with case managers, and (2) MM integrated with case managers and specialist roles. Retrospective data were collected for all new episodes at two community mental health services (CMHS) over a 12-month period (September 2012 - August 2013).ResultsA total of 432 consumers with SMI across the two community mental health services were included in the analysis. At the service with the specialist roles, MM was undertaken for 78% of all new episode consumers, compared with 3% at the mental health service with case managers undertaking the role. Incomplete MM was systemic to both CMHS, although all consumers identified with high risk of cardiovascular diseases were referred to a general practitioner or other community based health services. The specialist roles enabled more varied referral options.ConclusionsThe results of this study support incorporating specialist roles over case manager only roles for more effective MM among new episode consumers with SMI.

A systematic review and meta-analysis of factors that relate to aggression perpetrated against nurses by patients/relatives or staff

AIMS AND OBJECTIVES The aim of this meta-analysis was to identify the factors that related to aggression (verbal abuse or physical abuse/assault) perpetrated against the nurse or other health professionals by patients/relatives or staff. In the light of the paucity of systematic reviews on this common issue in nursing, the objective was to present a comprehensive systematic review and meta-analysis of these papers. BACKGROUND Aggression towards nurses is common around the world and can be the impetus for nurses leaving the profession or developing anxiety when working in particular settings. DESIGN Systematic review with meta-analysis. METHODS Meta-analyses were conducted to assess the effect of the factors of gender and context (dichotomised as mental health/psychiatric or nonmental health/psychiatric). The databases of Medline (1966-2015), CINAHL (1982-2015) and PsychInfo (1920-2015). RESULTS A total of 1571 papers were screened by two reviewers. At the final decision 14 were selected for analysis. A higher proportion of female nurses than male nurses were reported to be the victims of verbal abuse, with the difference in proportions being statistically significant. A statistically significant higher proportion of male nurses than female nurses were reported to be the victims of physical abuse. There was a significantly higher proportion of mental health nurses reported experiencing physical abuse as compared to nonmental health nurses. CONCLUSIONS The analysis reveal female nurses have greater odds of verbal abuse than male nurses and male nurses have greater odds of physical abuse than female nurses. Overall mental health nurses had three times higher odds of physical assault than other nurses. RELEVANCE TO CLINICAL PRACTICE In the light of the findings it is recommended organisational support improve in high aggression potential clinical areas and for nursing curriculums to incorporate education about the management of challenging behaviours in undergraduate programmes.

An integrative review of the benefits of self-management interventions for adults with epilepsy

The life-limiting effects of epilepsy are well documented in the literature, where the management of epilepsy and seizure control relies heavily on the self-management abilities of the individual. The psychosocial impact of epilepsy on the person and their family is profound and has been studied extensively. Interventions such as educational programs and lifestyle management education to improve self-mastery and quality of life in people with epilepsy are not necessarily integrated in standard care practices. The aim of this integrative review was to systematically identify and appraise research that reported findings related to self-management interventions for adults with epilepsy. A search of bibliographic databases was conducted, and a total of n=14 articles were included in this review. The main finding was that self-management education for adults with epilepsy shows promise to improving knowledge and self-confidence in managing ones own condition including the management of the psychosocial stressors, improvement in seizure control, and enhancement of quality of life. Self-management interventions were delivered in diverse formats, and the inclusion of this type of intervention should be part of the comprehensive care for people living with epilepsy.

Recovering from an acute cardiac event - the relationship between depression and life satisfaction

AIMS This study sought to measure the rates and trajectory of depression over six months following admission for an acute cardiac event and describe the relationship between depression and life satisfaction. BACKGROUND Co-morbid depression has an impact on cardiac mortality and is associated with the significant impairment of quality of life and well-being, impairments in psychosocial function, decreased medication adherence and increased morbidity. DESIGN This was a descriptive, correlational study. METHOD The study was undertaken at a large public hospital in Melbourne. Participants were asked to complete a survey containing the cardiac depression scale (CDS) and the Personal Well-being Index. RESULTS This study mapped the course of depression over six months of a cohort of patients admitted for an acute cardiac event. Significant levels of depressive symptoms were found, at a level consistent with the literature. A significant correlation between depressive symptoms as measured by the CDS and the Personal Well-being Index was found. CONCLUSIONS Depression remains a significant problem following admission for an acute coronary event. The Personal Well-being Index may be a simple, effective and non-confrontational initial screening tool for those at risk of depressive symptoms in this population. RELEVANCE TO CLINICAL PRACTICE Despite the known impact of depression on coronary heart disease (CHD), there is limited research describing its trajectory. This study makes a compelling case for the systematic screening for depression in patients with CHD and the importance of the nursing role in identifying at risk individuals.