Robert L. Anders

State University Collaboration to Transform Practice in Public Sector Psychiatric Nursing

In 1986 and again in 1988, Hawaii was ranked by the Torrey report as being 51st in the nation in caring for its persistent and seriously mentally ill. After several years of being ranked last in the nation, and with the threat of a consent decree from the U.S. Department of Justice, the state of Hawaii made a commitment to improve the psychiatric mental health care of its citizens. The states Department of Health, in September 1990, contracted with the University of Hawaiis School of Nursing to provide joint appointment faculty to consult with the nursing staff and to provide the departments chief of nursing. Working together with the joint appointment faculty, the permanent staff began the journey toward creating a state-of-the-art facility. The article discusses how change of such magnitude has been created.

ASSESSMENT OF ACUTELY MENTALLY ILL PATIENTS' SATISFACTION OF CARE: THERE IS A DIFFERENCE AMONG ETHNIC GROUPS

The relationship between quality of care and patient satisfaction has been documented. The specific research aim related to this study is to determine if differences exist among Caucasians, Asians, and Pacific Islanders who are hospitalized for an acute mental illness with regard to their perceived satisfaction with the care. The results of the overall study have been reported elsewhere. The sample was composed of 138 patients, of whom 34.7% were Caucasian, 31.2% Pacific Islanders, and 34.8% Asians. Within 24 hours of discharge, patients completed the Perceptions of Care instrument. Caucasians were over-represented in our sample in comparison to their percentage in the general population of Hawaii. These patients were significantly more satisfied (p = .04) with their care than the other ethnic groups. No single variable was found to specifically indicate why they were more satisfied than Pacific Islanders and Asians.

Prevalence of Mental Health Issues in the Borderlands: A Comparative Perspective

The purpose of this paper is to (a) examine the results of a binational study of two colonias near El Paso, Texas, and Ciudad Juarez, Mexico, focusing on mental health and (b) analyze those results in relation to the existing literature on Hispanic mental health to determine how border regions compare with Hispanic enclaves in nonborder regions. We focus on gender, birthplace, length of residency, and level of acculturation correlated with self-reported diagnoses of depression in our analysis. Our survey instrument incorporates portions of the Behavioral Risk Factor and Surveillance Survey; the SF36, version 2; and the CAGE scale for alcohol use and abuse. We found that birthplace, acculturation, and length of residency at the border did not correlate in the same ways to mental health issues as in nonborder regions.

Assessment of inpatient treatment of mentally ill patients in Thailand: Implications for practice

Given the demand for services, psychiatric facilities in Thailand, strive to provide quality care despite limited resources. Patient quality of care initiatives are limited.The purpose of this investigation is to assess the quality of inpatient treatment among a group of acutely mentally ill hospitalized Thai patients. This study presents important data on the standards of care provided to mentally ill patients at one inpatient facility in Thailand.This study is one of the first to look at the inpatient care for Thais with a diagnosis of an acute mental illness. Areas for improvement identified in this research include master treatment planning and documentation of care, patient teaching, and management of aggressive behavior. This study provides an insight into the patient profile and major nursing problems facing Thai nurses.The article also highlights areas of concern such as the high use of ECT and mechanical restraint. How pervasive these deficiencies are in other settings is not known. The findings in this study were shared with the professional staff. It is hope that the nursing staff armed with the results of this study will develop performance improvement activities to improve the quality of care.

Ethnicity, Marginalisation and Mental Illness in Hawaii

This study examines the characteristics, treatment and care of severely and persistently mentally ill patients at Hawaiis largest public sector psychiatric facility, Hawaii State Hospital. The implications of this information are then discussed, in terms of treatment and care. Consistent with previous studies, the 88 patients included in this study were most often male, less than 40 years of age, with a high school education or less, and hospitalized under a penal code. More remarkable variations were revealed, however, when patients were grouped according to ethnicity and racial origin. For example, patients from marginalised groups had a significantly higher likelihood of violence than patients from more politically, economically and socially powerful groups in Hawaii. The findings of this research challenge health care providers in general, and nurses in particular, to combine social advocacy with clinical expertise to ensure that patients receive effective and complete treatment and care.

Severely and persistently mentally ill in Hawaii: profile and implications.

This study examines the characteristics, treatment, and care of severely and persistently mentally ill clients at Hawaiis largest public-sector psychiatric facility, Hawaii State Hospital. The implications of this information are discussed in terms of treatment and care. As was found in previous studies, the 88 participants included in this study were mostly male, less than 40 years of age, with a high school education or less, and hospitalized under a penal code. More remarkable variations were revealed, however, when clients were grouped according to ethnicity and racial origin. For example, clients from marginalized groups had a significantly higher likelihood of violence than clients from more politically, economically, and socially powerful groups in Hawaii. The findings of this research challenge nurses to combine social advocacy with clinical expertise to provide effective and complete treatment and care.

Characteristics of long-term psychiatric patients hospitalized in Tokyo, Japan

This study examined the records of all psychiatric patients hospitalized over 1 year who were committed as a result of a penal code violation at a public sector hospital located in Tokyo, Japan. The 30 patients were all men, Japanese, and primarily unmarried. Affective and organic disorders were totally absent. None of the new antipsychotic medications were used. There was no relationship between nursing diagnosis and Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnosis. The demands for health care reform are beginning in Japan. Managing the integration of the long-term psychiatric patient into the community is one of the main challenges identified in this study.

Evidence-based nursing-sensitive indicators for patients hospitalized with depression in Thailand.

The aim of this study was to develop and validate nursing-sensitive indicators for patients hospitalized with depression in Thailand. The initial draft, consisting of 12 categories with 37 subcategories, was then evaluated by experts in the US and Thailand. Hospital records were then utilized to evaluate the feasibility and efficacy of the indicators. The finalized instrument consisted of 11 categories with 43 items with a validity of .98 and internal consistency of .88. This is the first set of indicators developed to evaluate nursing-sensitivity for patients hospitalized with a diagnosis of depression in Thailand. Having nursing indicators for depressed patients provides nurses with concrete tools to evaluate their work with depressed patients, allowing these staff to assess their work in a very specific, methodical, and consistent manner. When problems are discovered, both the staff and administration can work to address these issues through training, procedural changes, and departmental shifts.