Philippa Rasmussen

Using holistic interpretive synthesis to create practice-relevant guidance for person-centred fundamental care delivered by nurses.

Nursing policy and healthcare reform are focusing on two, interconnected areas: person-centred care and fundamental care. Each initiative emphasises a positive nurse-patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse-patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice-relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse-patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse-patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person-centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach.

Conceptualizing the clinical and professional development of child and adolescent mental health nurses

Aspects of mental health nursing and its subspecialties are not easily defined. Child and adolescent mental health (CAMH) nursing is a subspecialty of mental health nursing, and some of its characteristics are tacit. This paper presents a deeper understanding of the meaning that CAMH nurses make of their role and work in the inpatient setting. The research was undertaken through a PhD candidature. The epistemological framework for the research was social constructionism. Interpretive enquiry was the methodology, as it allowed for the interpretation of multiple realities, which resulted in a rich description of the role and work of CAMH nurses. Methods of data collection were document analysis, focus group interviews, and individual interviews. Participants included nurses and multidisciplinary staff. Iterative and aggregative analyses were utilized for the documents. The focus group and individual interview data were analysed utilizing a thematic analysis process. This paper presents the findings of the combined analysis and the resultant holistic conceptual framework for the work of the CAMH nurse in the inpatient unit. The findings have contributed new knowledge to mental health nursing, specifically CAMH nursing, making the parameters of practice more explicit. Implications for practice, education, and research are identified.

Yoga and mindfulness for anxiety and depression and the role of mental health professionals: a literature review

The purpose of this paper is to examine the role of yoga in the management of anxiety and depression, development of mindfulness and self-compassion and implications for mental health care delivery and mental health professionals, with a specific focus on nursing practice.,A search of electronic databases Scopus, CINAHL, EMBASE, Medline and Cochrane Library was undertaken.,There is growing research evidence supporting the use of yoga as an adjunct or combination therapy for the management of stress, anxiety and depression. Mindfulness has been indicated as a potential mechanism of change but needs further research. Health care professionals may play an important role in supporting consumers to engage in yoga as part of their mental health care.,Yoga research to date has been limited by methodological weaknesses including wide variation of yoga practices, styles and teaching methods; difficulties in double-blinding, suitable placebo-control; lack of randomised controlled trials and small sample sizes. The literature highlights that more high-quality yoga and mental health research is needed.,The paper introduces the potential role of yoga for anxiety and depression in the health care system and the role of mental health professionals in implementing and promoting holistic yoga-based therapies.,This paper proposes a yoga model for mental health and provides insight into a proposed new direction for future mental health care and the role of nursing practice and other mental health professionals.

Document analysis using an aggregative and iterative process.

This paper is a descriptive commentary concerning the use of document analysis in qualitative research concerned with developing an understanding of the role of child and adolescent mental health nursing in an inpatient. The document analysis was undertaken using thematic analysis with both an iterative process (Attride-Stirling) and an aggregative process, the Joanna Briggs Institute Thematic Analysis Program (TAP). After the initial iterative process the data were entered into an online software program, TAP, for aggregation and further analysis. The TAP software consisted of a three-step approach in the analysis of data extraction of illustrations, aggregation to categories and synthesis of categories into themes. A TAP chart was generated displaying the connections between the illustrations, categories and themes. The advantage and limitations of utilising the TAP software compared with Computer Assisted Qualitative Data Analysis Software were discussed. The program afforded direct involvement by the researcher in the cognitive process of the analysis; rather than just the technical process. A limitation of the program would be the volume of the data if the research involved a vast amount of data. The TAP program was a clearly defined three-step software program that was appropriate for the documents analysis for the research. The program would have a wide application for facilitating the thematic analysis of documents, although the program is suitable for smaller amounts of data.

Developing effective and caring nurse-patient relationships

Establishing positive and trusting therapeutic relationships with patients has long been recognised as an essential component of nursing practice and is important for effective care. There are various challenges in clinical practice that make it increasingly difficult to deliver effective care centred on such relationships. Understanding and addressing these challenges is crucial to ensure a positive experience of care for patients, families, carers and nurses. This article outlines how nurses can use a framework to develop therapeutic relationships with patients and use the best available evidence to deliver effective care. It also explores the challenges in developing effective therapeutic relationships with patients at the healthcare system level, and considers how these challenges can be addressed.

ADHD and Everyday Life: Healthcare as a Significant Lifeline

Aim: The aim of this qualitative study was to explore parental experiences of how healthcare practices and healthcare professionals in hospital clinics in Denmark influence everyday life of parents with a child with ADHD. Design and Methods: The methodology was focused ethnography. Participant observation and interviews were used as the primary data collection methods. Fifteen families of children with ADHD were included from somatic and psychiatric hospital clinics. Results: Three main themes emerged from the experiences of the families: When the house of cards collapses in everyday life, Treading water before and after receiving the ADHD diagnosis, and Healthcare as a significant lifeline. Conclusions: Accessibility to healthcare, trusting relationships and healthcare professionals recognizing how ADHD pervades all aspects of everyday life appear to be important factors in providing a lifeline for parents to help them regain confidence and control in disruptive phases. The parents depend on help from healthcare professionals and family‐centred care to manage the complex challenges in everyday life. Highlights:ADHD pervades all aspects of the familys everyday life.Health professionals are important allies in overcoming disruptive phases.Parents should be involved as experts.Mental and physical aspects should be integrated in healthcare.Health professionals should provide care using a family‐centred approach.

An analysis of the work of Child and Adolescent Mental Health nurses in an inpatient unit in Australia

This paper briefly describes the methodology and the initial findings of research carried out as part of a PhD thesis in nursing. The intention of the research was to identify the theoretical and operational parameters of Child and Adolescent Mental Health (CAMH) nursing in an inpatient unit in Australia. This will add to the body of mental health nursing knowledge and identify the characteristics of the role. It is anticipated that these characteristics will contribute to the development of competencies that will complement the existing Australian College of Mental Health Nurses Inc (2010). There is no single definition of the CAMH nurse role and the specific contribution that they make remains undefined but implicitly accepted according to McDougall (2006) who suggests that this role is a holistic one, within the context of individual and family systems.

Identifying the scope of practice in nursing specialties using child and adolescent mental health as an illustration

Purpose – The purpose of this paper is to explore the applicability of the process of identifying a conceptual framework of practice to areas of nursing without a current clearly identified scope of practice. Worldwide, nursing is a diverse profession with many recognised sub-specialties, some of which are under threat. Nurses with specialised knowledge, experience and education are needed to provide specific care in nursing sub-specialties. However, some of these characteristics are implicit and not clear to the wider nursing community. This paper presents an overview of research to identify the parameters of practice for a sub-specialty of nursing. Design/methodology/approach – The methodology was interpretive enquiry as it allowed for the interpretation of multiple realities which resulted in a rich description of the work of a sub-specialty. The research used document analysis, focus group interviews and individual interviews as the methods of collecting data. Documents were analysed using iterative a...

Attention Deficit Hyperactivity Disorder in Childhood: Healthcare Use in a Danish Birth Cohort during the First 12 Years of Life

Objectives To compare the mean number of medical and psychiatric hospital‐based services in children with and without attention deficit hyperactivity disorder (ADHD) and to assess the effect of ADHD on hospital‐based service use, including child‐, parental‐, and socioeconomic‐related risk factors. Study design A Danish birth cohort was followed through 12 years, and children with ADHD were identified using Danish nationwide registries. Poisson regression analyses were used to assess the association of ADHD with service use and to adjust for a comprehensive set of explanatory variables. Results Children diagnosed with ADHD used more medical and psychiatric hospital‐based healthcare than those without ADHD. In children with ADHD, intellectual disability and parental psychiatric disorder were associated with increased medical and psychiatric service use. Low birth weight and low gestational age were associated with increased medical service use. Psychiatric comorbidity and having a divorced or single parent were associated with increased psychiatric service use. Conclusions ADHD independently affected medical and psychiatric hospital‐based service use even when adjusting for a comprehensive set of explanatory variables. However, the pattern of medical and psychiatric hospital‐based service use is complex and cannot exclusively be explained by the child‐, parental‐, and socioeconomic‐related variables examined in this study.

Mindfulness, self-compassion, anxiety and depression measures in South Australian yoga participants: implications for designing a yoga intervention

AIM The aim of the study was to examine the demographic and practice characteristics of current yoga participants and assess their levels of mindfulness, self-compassion, stress, anxiety, depression and wellbeing and implications for designing a yoga intervention. METHODS A web-based survey was administered to South Australian yoga teachers and students from September 2014 to February 2015. RESULTS Results showed a positive correlation with mindfulness and self-compassion and negative correlation with Depression, Anxiety and Stress scores with months of practice. Mindfulness and self-compassion scores were significantly higher with two or more classes per week and mindfulness higher in those with a regular meditation practice. DISCUSSION Key findings indicate that class frequency, practice experience and meditation practice are important factors in designing a yoga intervention examining mindfulness and mental health. CONCLUSION Findings provide important information for guiding development of a yoga intervention for anxiety and depression.