Tanya Park

A randomized controlled trial undertaken to test a nurse-led weight management and exercise intervention designed for people with serious mental illness who take second generation antipsychotics

Aim To test the effect of a nurse-led intervention on weight gain in people with serious mental illness prescribed and taking second generation antipsychotic medication. Background Weight gain and obesity has reached epidemic proportions in the general population with the prevalence of Metabolic Syndrome reaching 20–25% of the global population. People with serious mental illness are at even higher risk, particularly those taking second generation antipsychotic medication. Design An experimental randomized controlled trial was undertaken. Method The control group received a 12-week healthy lifestyle booklet. In addition to the booklet, the intervention group received weekly nutrition and exercise education, exercise sessions, and nurse support. Participants (n = 101) were assessed at baseline and 12 weeks. Data were collected between March 2008–December 2010. Seven outcome measures were used: body measurements included girth (cm), weight (kg), height (cm), and body mass index (kg/m2); questionnaires included the medication compliance questionnaire, the Drug Attitude Inventory, the Liverpool University Neuroleptic Side Effect Rating Scale, and the Medical Outcomes Study Short Form 36. Differences in primary outcome measures between baseline and 12 weeks follow-up were compared between intervention and control groups using standard bi-variate statistical tests. The study was conducted between 2008–2010. Results The analysis of outcome measures for the control group (n = 50) and intervention group (n = 51) was not statistically significant. There was a mean weight change of −0·74 kg at 12 weeks for the intervention group (n = 51), while the control group (n = 50) had a mean weight change of −0·17 kg at 12 weeks. Conclusion The results were not statistically significant.

Conducting a Grounded Theory Study in a Language Other Than English: Procedures for Ensuring the Integrity of Translation

Translation can be a problem area for researchers conducting qualitative studies in languages other than English who intend to publish the results in an English-language journal. Analyzing the data is also complex when the research team consists of people from different language backgrounds. Translation must be considered as an issue in its own right to maintain the integrity of the research, especially in a grounded theory study. In this article, we offer guidelines for the process of translation for data analysis in a grounded theory study in which the research was conducted in a language other than English (Indonesian). We make recommendations about procedures to choose when, who, and how to translate data. The translation procedure is divided into four steps which are as follows: translation in the process of coding, translation in the process of team discussion, translation in the process of advanced coding, and ensuring the accuracy of translation.

The experience of weight gain as a result of taking second‐generation antipsychotic medications: the mental health consumer perspective

Accessible summary Weight gain is a known, predictable side-effect of second-generation antipsychotic drugs. Study participants reported struggling to manage the insatiable appetite and weight gained associated with the drugs. Cessation of prescribed medication was considered by most as a way of managing the weight gain associated with the drugs. Abstract This interpretive qualitative study aimed to describe and construct the meaning of the experience of living with the weight gain associated with second-generation antipsychotics. A qualitative study that incorporated the tenets of phenomenology and utilized in-depth interviews was conducted with eight mental health consumers. Thematic analysis resulted in three themes: Grappling with the weight; Living with the consequences of being overweight; and Experiencing negative emotions about the weight gain. The findings indicate that consumers struggle to manage the insatiable appetite and the related weight gain associated with second-generation antipsychotic medication, as well as the numerous associated physical and emotional issues. Adherence with prescribed second-generation antipsychotic medication was also affected and a number of the participants indicated they had ceased or considered ceasing their medication because of the weight gain associated with the drugs.This interpretive qualitative study aimed to describe and construct the meaning of the experience of living with the weight gain associated with second-generation antipsychotics. A qualitative study that incorporated the tenets of phenomenology and utilized in-depth interviews was conducted with eight mental health consumers. Thematic analysis resulted in three themes: Grappling with the weight; Living with the consequences of being overweight; and Experiencing negative emotions about the weight gain. The findings indicate that consumers struggle to manage the insatiable appetite and the related weight gain associated with second-generation antipsychotic medication, as well as the numerous associated physical and emotional issues. Adherence with prescribed second-generation antipsychotic medication was also affected and a number of the participants indicated they had ceased or considered ceasing their medication because of the weight gain associated with the drugs.

Using mentoring circles to support Aboriginal and Torres Strait Islander nursing students: Guidelines for sharing and learning

Abstract A mentoring circle is a teaching and learning strategy that has been used to support students in tertiary education. In this study researchers implemented a mentoring circle at a remote James Cook University satellite campus in the Torres Strait. The aim of the study was to foster the emotional and social growth of Aboriginal and Torres Strait Islander nursing students to improve the students’ experience and retention rates. Early results of the study showed mentoring circles support the development of time management, communication skills and self awareness, which students need to work effectively in a university setting. Although this study was conducted within a nursing degree in a Torres Strait Island community, its findings have potential for use in other contexts. In this paper researchers offer guidelines to establish a mentoring circle in a tertiary setting.

Mental health nurses employed in Australian general practice: dimensions of time and space.

Almost half the Australian population, aged 16-85 years, are affected by mental illness at some point in their life, and general practice plays a key role in providing effective mental health care. This paper presents the findings from a study that explored how people living with mental illness are supported in Australian general practice. A descriptive, exploratory study was conducted using semistructured interviews to gather data. The role of mental health nurses in the care and support of people with mental illness emerged from the data. This was explored further and resulted in two key themes: dimensions of time and dimensions of space. Findings from this study present key similarities and differences in the role of mental health nurses, as compared to general practitioners, in relation to dimensions of time and space. Dimensions of time and space are important considerations for general practices when planning to introduce a mental health nurse into their interprofessional team.

Caring for physical health: developing a nurse-led healthy lifestyle program for people with schizophrenia

Perspective taking, the main cognitive component of empathy, has a particularly important and complex role to play in the clinician-client relationship, particularly in mental health nursing. However, despite extensive investigation into the outcomes of this construct (e.g. sympathy, altruism), the process by which people take anothers psychological point of view has received comparatively little attention. The purpose of this study was to investigate what the individual does when attempting to take the perspective of another person. The aims were to identify the specific strategies people used to accomplish this task, to consider how and why these strategies were chosen, and the relationship between the strategies and subsequent outcomes. Participants described an example of their own perspective-taking experience. Adopting an interpretive phenomenological approach, analysis resulted in the generation of several themes of direct relevance to both the perspective taking process and the wider empathic experience. Of particular importance were two superordinate themes, use of other-information and use of self-information. One significant subordinate theme (within use of selfinformation) to emerge was that of past experience, where the participant had experienced either (a) a similar role to that which they occupied in the present situation, or (b) a similar situation to that of the target person. Both of these experiences were determinants of how easy participants perceived the task of apprehending the target’s perspective. Within the wider empathic experience, themes included emotional manifestations (e.g. sympathy), as well as judgements of appropriate behaviours. Implications of findings when working in clinical and mental health settings are discussed.There have been a number of studies overseas investigating collaborative inter-professional educational models for preparing mental health professionals who work in integrated or multidisciplinary mental health services. Recent implementations include the Canadian Collaborative Mental Health Initiative Tool kit, and the NHS Quality Improvement Scotland Standards for Integrated Care Pathways for Mental Health. Integrated and multi-disciplinary models of primary health service delivery have been shown to be effective and suitable for delivery of services in regional and remote rural areas and for Indigenous clients in Australia. The key strengths of multidisciplinary mental health service models may be attributed to their client focus and adaptation to complexity. The overarching aim of this Australian Learning and Teaching funded project is to develop effective, collaborative, cross-disciplinary leadership frameworks for university learning and teaching which enhance the professional preparation of the multidisciplinary mental health workforce. We are developing strategies that will prepare students in professional health training programs to be better equipped to work in multidisciplinary settings. This paper presents an overview of the project and the results of the first sets of interdisciplinary workshops.

An Educational Program for Mental Health Nurses and Community Health Workers from Pacific Island Countries: Results from a Pilot Study

Delivery of mental health care relies upon professionals with the latest evidence upon which to base their care. This research reports on a pre-test/post-test evaluation of a four-week education program delivered to Pacific Island participants (n = 18) to enhance knowledge, skills, and attitudes (KSAs). The education program used a combination of formal lectures, tutorials, clinical visits, simulations, and laboratory sessions. The measure used was the Nurse Self Report (NSR) questionnaire. Results indicate an education intervention can be an effective tool for improving the knowledge, skills, and attitudes of Pacific Island people who care for persons experiencing mental health problems.

Participants' Voices From Within a Healthy Lifestyle Group

Weight gain is a serious health concern. People with mental illnesses are at increased risk of weight gain. The primary treatment is lifestyle changes such as increasing physical activity and dietary changes. This qualitative study explored the experience of people with schizophrenia who participated in a healthy lifestyle program. Four themes were identified. The findings indicate that benefits of the program were more than physical health improvements and included regular access to a health professional, gaining social relationships, and a sense of belonging. Future recommendations include retaining a group structure in lifestyle interventions to facilitate these additional benefits.

The Challenges of Conducting a Nurse-Led Intervention in a Randomized Controlled Trial with Vulnerable Participants

This paper discusses the challenges encountered by researchers while conducting a randomized controlled trial (RCT) testing the efficacy of a healthy lifestyle educational and exercise intervention for people with serious mental illness. RCTs, even though considered the “gold standard” of research designs, are still prone to risks of potential bias and threats to their validity. Based on researcher reflexivity, the combination of reflection and action, during the conduct of the study, this paper outlines a number of challenges faced by the researchers. These included managing the need of participants to tell their story and be heard, reluctance of participants to remain in allocated groups, participant literacy, dual role of the nurse nurse-researcher, and reporting the benefits of nonstatistical results of a quantitative research project. Recommendations for conducting future behaviour intervention studies of this type include the incorporation of a reflexive component for the nurse nurse-researcher, highlighting the importance of taking a reflexive stance in both qualitative and quantitative research designs.

The experience of weight gain as a result of taking second-generation antipsychotic medications: the mental health consumer perspective: Weight gain and antipsychotics

Accessible summary Weight gain is a known, predictable side-effect of second-generation antipsychotic drugs. Study participants reported struggling to manage the insatiable appetite and weight gained associated with the drugs. Cessation of prescribed medication was considered by most as a way of managing the weight gain associated with the drugs. Abstract This interpretive qualitative study aimed to describe and construct the meaning of the experience of living with the weight gain associated with second-generation antipsychotics. A qualitative study that incorporated the tenets of phenomenology and utilized in-depth interviews was conducted with eight mental health consumers. Thematic analysis resulted in three themes: Grappling with the weight; Living with the consequences of being overweight; and Experiencing negative emotions about the weight gain. The findings indicate that consumers struggle to manage the insatiable appetite and the related weight gain associated with second-generation antipsychotic medication, as well as the numerous associated physical and emotional issues. Adherence with prescribed second-generation antipsychotic medication was also affected and a number of the participants indicated they had ceased or considered ceasing their medication because of the weight gain associated with the drugs.This interpretive qualitative study aimed to describe and construct the meaning of the experience of living with the weight gain associated with second-generation antipsychotics. A qualitative study that incorporated the tenets of phenomenology and utilized in-depth interviews was conducted with eight mental health consumers. Thematic analysis resulted in three themes: Grappling with the weight; Living with the consequences of being overweight; and Experiencing negative emotions about the weight gain. The findings indicate that consumers struggle to manage the insatiable appetite and the related weight gain associated with second-generation antipsychotic medication, as well as the numerous associated physical and emotional issues. Adherence with prescribed second-generation antipsychotic medication was also affected and a number of the participants indicated they had ceased or considered ceasing their medication because of the weight gain associated with the drugs.