Sancia West

'Walking the tightrope': The role of peer support workers in facilitating consumers' participation in decision-making

In adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision-making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers participation in decision-making and recovery. Semi-structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor-centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision-making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery-oriented care.

Acid burn attacks: Looking beneath the surface

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/jan.13532 This article is protected by copyright. All rights reserved. PROFESSOR MICHELLE CLEARY (Orcid ID : 0000-0002-1453-4850)

Providing a Safe Environment in a Psychiatric Ward: Nurses and Vigilance in Iran

Abstract The aim of this study was to explore nurses’ use of vigilance in the provision of inpatient psychiatric care. In this qualitative exploratory descriptive design study, 16 nurses working in inpatient psychiatric units were recruited through purposive sampling. Data were collected by semi-structured interviews and fieldwork observations and analysed using conventional content analysis. According to participants, nurses’ vigilance is related to synthesising knowledge, experience, communication, and presence. This conclusion was derived from four main themes: understanding the context of the psychiatric ward; continuous monitoring; cognitive assessments; and involving others. The study highlights the significance of education for all mental health staff and provision of appropriate information to all patients and their companions about psychiatric disorders and the side effects of prescribed medications. Of importance is the skill of active listening to the concerns of patients and the demonstration of commitment by nurses to follow-up on reports from stakeholders. Imparting the skills and experiences of senior nurses to novice nurses and their presence alongside other nurses on work-shifts can be effective in promoting vigilance.

Promoting emotional intelligence and resilience in undergraduate nursing students: An integrative review

OBJECTIVEnTo synthesize the evidence that explored resilience and emotional intelligence in undergraduate nursing students.nnnBACKGROUNDnNursing is a demanding profession that offers unique challenges. Emotional intelligence and resilience are traits that can allow nursing students to effectively respond to challenges in professional placements and future practice.nnnDESIGNnAn integrative review incorporating both quantitative and qualitative research designs.nnnDATA SOURCEnStudies in the English language were identified through a systematic search in electronic databases: CINAHL, PubMed, ERIC, Scopus and PsycINFO. No restriction dates were used and the search was up until November 1, 2017.nnnREVIEW METHODSnMethodological quality was assessed using the Critical Appraisal Skills Programme checklist for qualitative research and the Newcastle-Ottawa Quality Assessment Scale for quantitative research. Data analysis was conducted based on the integrative review method.nnnRESULTSnFourteen articles were included. A positive relationship was found between resilience and performance in undergraduate studies including professional experience placements. While some studies observed an important role for emotional intelligence for nursing students, there is currently insufficient evidence to conclude that emotional intelligence improves nursing students communication, academic success and retention.nnnCONCLUSIONnDeveloping skills, such as resilience, as part of nursing programs allows students to be better prepared to deal with the unique challenges in nursing practice.

The effectiveness of interventions to improve resilience among health professionals: A systematic review

OBJECTIVEnTo assess the effectiveness of resilience interventions in improving resilience outcome among health professionals.nnnBACKGROUNDnThe nature of health professionals work is physically and emotionally demanding, with trauma a common consequence with the act of providing health care.nnnDESIGNnA systematic review.nnnDATA SOURCEnA comprehensive search of the literature was conducted in February 2018 using PubMed, PsychInfo, Cumulative Index of Nursing and Allied Health Literature (CIHAHL) and Scopus.nnnREVIEW METHODSnMethodological quality was assessed and a standardized data coding form was used to extract data.nnnRESULTSnOf the 33 included studies, 15 were single-arm pre-post-design, 10 were RCTs, five used a non-randomized controlled design, and three were qualitative. Eleven studies (out of 16) showed a significant improvement in resilience scores while five (out of eight) studies reported a significant difference in resilience scores between treatment and control groups.nnnCONCLUSIONnFindings suggest that resilience training may be of benefit to health professionals. However, not all interventions enhanced resilience with training volume being more effective. Not all studies reporting resilience used standard resilience instruments. The results of the current review may inform resilience programs as well as future interventional studies on resilience building.

The mental health plight of unaccompanied asylum‐seeking children in detention

Children are at risk of physical and psychological injury due to the escalation of war and conflict across the globe. Consequently, children often become refugees with their families, or worse, alone as orphans. Asylum is sought across a diverse range of nations, sometimes close to home and sometimes far away in nations of different language and cultural identity to their own. This article is protected by copyright. All rights reserved.

Suicide by charcoal burning: a digital age phenomenon

Charcoal burning is a method of suicide that has only recently been identified, but now attributes to a significant an ever-increasing number of suicides. Before 2000, this method was relatively unknown and the exact mechanism of death unclear. Media coverage has more recently raised awareness of the phenomenon (Chen et al., 2016). The method involves burning of barbecue charcoal in a confined space, leading to carbon monoxide (CO) poisoning (Chen, Yip, Lee, Gunnell, & Wu, 2015). Charcoal is particularly predisposed to smouldering, which results in less effective combustion and more CO emissions than CO2 (Schmitt, Williams, Woodard, & Harruff, 2011). So recent is the uptake of this method that charcoal burning, that it still lacks a specific code under the International Classification of Diseases 10th Edition (Ji, Hong, Stack, & Lee, 2014). Correct categorisation of suicide by charcoal burning is unlikely to persist. A sharp rise was noted in the incidence of charcoal burning in the early 2000s in Japan (Yoshioka, Saijo, & Kawachi, 2016). Following the first reported case of a 38-year old woman in Hong Kong, in 1998 (Liu et al., 2007), it is now one of the most common modes of suicide in Asia, accounting for 20% of all suicides in Hong Kong and Taiwan. In Japan, it accounts for 12.8% of male suicides and 5.9% of females (Kato et al., 2013), with increases also noted in South Korea, Singapore (Cheng, Chang, Guo, & Yip, 2015) and Taiwan, where this method increased 65-fold between 1995 and 2011 (Chang, Kwok, Cheng, Yip, & Chen, 2015). This increase in charcoal suicides in Hong Kong have not been compensated by decreases in other methods, indicating that the availability of this method of suicide may be contributing to increased suicide rates (Liu et al., 2007). Its influence has also been felt in Western nations, with a study in Washington, United States, finding that charcoal burning was increasing with a correlated decrease in suicide by automotive exhaust fume inhalation (Schmitt et al., 2011). Although the study happened to be in a community with the largest Asian population in the USA, the highest incidence was 88% amongst Whites, suggesting no transnational nor cultural boundaries in this area. The concentration of suicides by charcoal burning in Asia and the acceptance of this method by non-Asians in a Western community suggests increased rates of suicide by this method as awareness increases outside of Asia. The emergence and increasing rates of suicide by charcoal requires explanation. Several authors have highlighted the increased accessibility of charcoal for cooking and heating purposes (Cheng et al., 2015), the inexpensiveness of acquiring charcoal (Schmitt et al., 2011), the higher degree of effectiveness (and therefore mortality) than alternatives such as hanging (Ji et al., 2014). The increase in charcoal burning as a mode of suicide has occurred in parallel with the effectiveness of efforts to decrease the toxicity of car exhaust fumes via use of catalytic converters (Schmitt et al., 2011). So convenient and effective is the method of charcoal burning that one Japanese study revealed that increased charcoal burning suicide occurred over a period where the rate of suicide had an overall increase, indicating that acceptance of this method had resulted in more suicides (Yoshioka et al., 2016). The media and Internet have played a significant role in the rising use of charcoal burning as a form of suicide. Over the last two decades there has been a significant rise in the use of the Internet, particularly in Asia, and this has resulted in detailed technical information about methods of suicide becoming readily available to a wide audience (Chang et al., 2015; Cheng et al., 2015). One study found that an increase in Google search volume relating to charcoal burning was related to the incidence of suicide by this method in that same week as suicides increased and in the week following this change (Chang et al., 2015). A further study noted that of the 18 wiki-style pages that detailed suicide methods, none encouraged a person considering suicide to seek help (Cheng et al., 2015). This ready access to information is amplified during periods of media focus on the topic of suicide by charcoal burning. A study in Taiwan found that 87% of survivors of a suicide attempt by charcoal burning had been influenced by media coverage (Chang et al., 2015). The authors observed that the substance of media reporting promoted this method as one that was painless and effective, thereby increasing its appeal to this audience, a finding echoed by Chen et al. (2016). Chen et al. (2016) found that the first news report of a suicide by charcoal burning in Hong Kong described the method in detail and hence it is likely that media influence can increase the cognitive availability of methods in those with suicidal ideation. Media exposure of this particular suicide was then observed to have resulted in a copycat suicide in Taiwan (Ji et al., 2014). Chang et al. (2015) found that in the early stage of the charcoal burning uptake (1998–2000) one media article on the issue was associated with a 16% increase in the use of this method on the following day. The impact of media is amplified by the reporting of “celebrity suicide”. Much research has focused on the impact of a person with a public profile using a particular form of suicide and the resulting trends in choice of method by others in the immediate aftermath. Cheng et al. (2015) identified that after the death by charcoal burning by a notable South Korean actor in 2008 the rate of charcoal burning rose from 0.7% at that time to 7.9% in 2011. DOI: 10.1111/jan.13531

Two approaches, one goal: How mental health registered nurses' perceive their role and the role of peer support workers in facilitating consumer decision‐making

Recovery-oriented principles underpin modern-day mental health care and are enhanced by consumer participation in decision-making. Understanding how consumer participation can be maximized is central to promoting recovery-oriented care. This study explored the key strategies used by mental health registered nurses and perceived by nurses to be used by peer support workers in facilitating consumer decision-making to determine similarities, differences, and possible tensions. A qualitative descriptive approach using semi-structured interviews was conducted with nine nurses employed in mental health care. Thematic analysis was conducted using open coding. Frequency of views expressed and prevalence of these amongst participants were noted to determine the most common strategies and challenges. Registered nurses use strategies aimed at empowerment, self-management, and managing expectations to facilitate decision-making but are challenged by entrenched coercion within the system. These same nurses view peer support workers as using their lived experience to build rapport, role model, and advocate for consumers. Tensions arise in how the peer support workers lived experience should be used and how this impacts on professional and therapeutic boundaries. Nurses expressed support for the role of peer support workers and viewed their inclusion in facilitating consumer decision-making positively. Their own role is perceived as being caught between modern-day service principles of empowerment and long-standing practices based on coercion.

Bringing research to the bedside: Knowledge translation in the mental health care of burns patients

Advances in surgical techniques and wound management have improved outcomes for burn patients; however, the psychological impacts on burn survivors have had less attention. There is a higher rate of mental health disorders amongst burns victims, with those with pre-existing mental health conditions likely to have worse outcomes. To implement effective burns care and rehabilitation, knowledge and understanding of mental health issues is required. This position paper discusses the extent to which clinicians currently translate knowledge around mental health and burns into practice to identify enables and inhibitors. Successful knowledge translation requires dissemination and accessibility of information with the capacity and readiness for change. Clinicians and researchers need to identify how translating research to practice can meet the needs of burn survivors. There is a gap in the utilization of evidence concerning mental health and the needs of burns survivors, and we need to understand what we know as compared to what we do. Clinicians are well placed to determine how and why knowledge does not necessarily translate to practice and how they can better accommodate the needs of burn survivors.

Cosmetic camouflage improves quality of life among patients with skin disfigurement: A systematic review

This study systematically reviewed the impact of cosmetic camouflage use on different psychosocial outcomes in patients with disfiguring skin disorders. Electronic databases and reference lists were searched in February 2018 for studies reporting the impact of cosmetic camouflage on different quality of life (QoL) outcomes. Eighteen studies met the inclusion criteria: six randomized controlled trials, two quasi-experimental studies, nine single group before and after interventions, and one comparative study with single post-intervention measurement. Quality appraisal of included studies was undertaken using the Joanna Briggs critical appraisal tools. While the studies varied in design, those included in this review indicated significant improvement in QoL after the use of cosmetic camouflage. The mean reduction in Dermatological Life Quality Index scores ranged from 1.4 to 6.4 signifying improvement in QoL of participants after treatment with cosmetic camouflage. Cosmetic camouflage can be an effective therapy in improving QoL among patients with skin disfigurement.