International Journal of Mental Health Nursing

doi: 10.1111/inm.12745pmid: N/A

Usher, Kim

doi: 10.1111/inm.12880pmid: 33960098

Paradis‐Gagné, Etienne; Pariseau‐Legault, Pierre; Goulet, Marie‐Hélène; Jacob, Jean Daniel; Lessard‐Deschênes, Clara

doi: 10.1111/inm.12855pmid: 33694266

The use of coercion in psychiatric and mental health nursing is a major challenge, which can lead to negative consequences for nurses and patients, including rupture in the therapeutic relationship and risk of injury and trauma. The concept of coercion is complex to define and is used in different ways throughout the nursing literature. This concept is defined broadly, referring to both formal (seclusion, restraint, and forced hospitalization), informal (persuasion, threat, and inducement), and perceived coercion, without fully addressing its evolving conceptualizations and use in nursing practice. We conducted a concept analysis of coercion using Rodgers’ evolutionary method to identify its antecedents, attributes, and associated consequences. We identified five main attributes of the concept: different forms of coercion; the contexts in which coercion is exercised; nurses’ justification of its use; the ethical issues raised by the presence of coercion; and power dynamics. Our conceptual analysis shows the need for more nursing research in the field of coercion to achieve a better understanding of the power dynamics and ethical issues that arise in the presence of coercion.

Dabkowski, Elissa; Porter, Joanne E.

doi: 10.1111/inm.12872pmid: 33856744

Mental health and suicide prevention are national health priorities in Australia, with research currently focussed towards the ZERO Suicide (ZS) initiative. The aim of this review was to evaluate the impact of suicide prevention programmes, in particular the ZS prevention initiative. A systematic review using the PRISMA guidelines was conducted using six EBSCO Host databases; Academic Search Complete, Australian/New Zealand Reference Centre, CINAHL Complete, MEDLINE, APA PsycINFO, and APA Psyc Articles. The data extracted from the eligible papers were analysed using a thematic approach. The final data set consisted of fourteen (n = 14) peer‐reviewed articles meeting the eligibility criteria, which included quantitative (n = 10), mixed methods (n = 2), and qualitative studies (n = 2). Results indicated variances between suicide prevention programmes with some papers examining single workshops and others assessing multimodal, organizational interventions. Five major themes were produced from this review including measuring the success of suicide prevention programmes, improvements to the delivery of suicide prevention programmes, barriers to implementing changes, cultural considerations, and further research required for suicide prevention programmes. This review concludes that further long‐term research is required to evaluate the implementation and efficacy of suicide prevention programmes in health care. Cultural awareness in suicide prevention training is another area that may benefit from further research. A growing body of evidence establishes the need for multimodal and organizational approaches for suicide prevention initiatives.

Foster, Kim; Roche, Michael; Giandinoto, Jo‐Ann; Platania‐Phung, Chris; Furness, Trentham

doi: 10.1111/inm.12823pmid: 33280229

Mental health nursing is widely recognized as a stressful occupation; however, little is known about the relationship between work‐related stress and health‐related quality of life of mental health nurses (MHN). This study aimed to identify MHN health‐related quality of life (HR‐QoL) and work‐related stressors; associations between stressors and HR‐QoL; and predictors of HR‐QoL. An online cross‐sectional survey collected demographic data, work‐related stressors and HR‐QoL (SF‐12v2) of n = 498 Australian MHN. Prominent consumer/carer‐related stressors were verbal (90%) and physical aggression (85%). Collegial stressors included staff conflict (71%) and bullying (55%), and colleague‐perpetrated verbal (34%) and physical aggression (7%). Key organizational stressors included high workloads (74%), lack of organizational support (60%) and lack of adequate resources to perform nursing role (58%). The mean physical health score was 52.62 (SD = 8.30), and mental health score was 43.59 (SD = 11.34), with mental health substantially lower than national norms (mean difference = 10.11). There were statistically significant negative correlations between the number of work‐related stressors and HR‐QoL. Younger (21–30 years) and less experienced (<1–4 years) MHN had substantially lower mental health. Higher mental health was predicted with < 15 stressors, >4 years’ experience and working in the community. The poorer mental health of MHN has concerning implications for the well‐being, retention and practice of the largest group in the mental health workforce. There is a critical need for organizations to enact effective policy and initiatives to reduce workplace aggression, improve staff psychological and physical safety, and strengthen well‐being and resilience. New graduates are a priority group for urgent intervention.

Ngune, Irene; Hasking, Penelope; McGough, Shirley; Wynaden, Dianne; Janerka, Carrie; Rees, Clare

doi: 10.1111/inm.12825pmid: 33269517

Non‐suicidal self‐injury (NSSI) is a major public health concern and is also associated with increased risk of suicide. The type of care people with NSSI receive at the hospital impacts their health outcomes. This study explored emergency department (ED) and mental health nurses’ (MHNs) understanding, attitudes, empathy and confidence to work with people presenting with NSSI. ED and MHNs who belonged to either the College of Emergency Nursing Australasia (CENA) or the Australian College of Mental Health Nurses (ACMHN) were invited to complete an online survey through a group email from their college. One hundred and one nurses (56 ED and 45 MHNs) completed the survey. The results revealed that nurses from both groups had an accurate understanding of NSSI and had positive attitudes about patients who self‐injure. However, confidence was higher among MHNs. Greater knowledge of NSSI was correlated with increased confidence, positive attitudes and empathy. For mental health nurses, but not ED nurses, years of clinical practice was associated with nurses’ confidence. In contrast, ED nurses with more than 10 years’ experience were less confident in addressing NSSI than ED nurses with less experience. Issues that affect both ED and MHNs’ knowledge, attitude, empathy and confidence to care for patients who self‐injure are multifactorial. Future education and training should focus on therapeutic interactions with people at risk of repeat NSSI. Further, more research is recommended to explore patients’ perspectives of nurses’ attitudes in care for people who self‐injure.

Goh, Yong‐Shian; Ow Yong, Qing Yun Jenna; Chen, Terri Hui‐Min; Ho, Su Hui Cyrus; Chee, Yin Ing Cornelia; Chee, Tji Tjian

doi: 10.1111/inm.12826pmid: 33280242

Given Singapore’s high population density and extensive geographical interconnections, it is unsurprising that the country reported one of the highest numbers of COVID‐19 cases in Asia. Past pandemic studies have suggested that nurses working in such crises might experience a deterioration of mental health, which could persist for years beyond the initial outbreak. This study used a qualitative descriptive design to explore nurses’ experiences of working in tertiary hospitals during the COVID‐19 pandemic. A total of 17 registered nurses who had worked for at least one year prior to the start of the COVID‐19 pandemic were recruited from a University Health System in Singapore from March to June 2020. Data were collected through semi‐structured interviews lasting at least an hour conducted over an online platform by the principal investigator. The data were analysed through Braun and Clarke’s six‐step thematic analysis independently by two researchers. Three main themes emerged: (i) challenging moments of COVID‐19, during which the participants reported physical and psychological challenges relating to working conditions of the hospital in the initial months of the pandemic; (ii) the professional role as nurses, in where the participants dispelled their worries and demonstrated commitment to their role as nurses; and (iii) support for nurses, which originated from their family, friends and leaders from their organizations for them to persevere and overcome the unprecedented challenges of COVID‐19. The nurses in this study demonstrated resilience and professionalism despite the challenges of COVID‐19. The findings highlighted the importance of a robust support system for healthcare professionals.

Lefebvre‐Durel, Camille; Bailly, Isabelle; Hunault, Johanna; Jovic, Ljiljana; Novic, Martine; Vorspan, Florence; Bellivier, Frank; Drunat, Olivier; Kerever, Sébastien

doi: 10.1111/inm.12831pmid: 33314689

Wayland, Sarah; Coker, Sarah; Maple, Myfanwy

doi: 10.1111/inm.12829pmid: 33355984

There is currently limited information about the impact and experiences of a suicide attempt on the well‐being of a person providing care before, during, or after the attempt. Scant evidence available suggests that providing care has a profound impact on the support person or carers’ own physical and psychological health; they may experience adverse health, financial, and functional outcomes, collectively described as ‘caregiver burden’. This project sought to understand insights into the experience of providing care for someone who has previously attempted suicide. The larger study was designed in three phases consisting of an online survey, semi‐structured interviews, and a follow‐up survey. This paper reports the qualitative findings of the interviews which were thematically analysed. Two symbiotic themes emerged: the lived experience of caring and the impact of engagement and support from the healthcare system. The authors concluded that that the carer position is a multidimensional role involving informal agreements and situational or time‐based support. Further, awareness of this shifting relationship needs to be embedded in the provision of care by health professionals following a suicide attempt. Recommendations for enhanced health system response are proposed.

Arthur, Yaw Amankwa; Boardman, Gayelene H.; McCann, Terence V.

doi: 10.1111/inm.12832pmid: 33368929

Improved knowledge about, and positive attitudes towards, people with mental illness could lead to improved support and decreased stigma for people with mental illness, including their families and carers. The aims of our study were to evaluate the perspectives of community leaders about the usefulness of a cluster randomized trial of a problem‐solving and Story‐bridge based mental health literacy (MHL) programme and to understand whether they utilized the knowledge acquired from the programme in their usual interactions with people with mental illness and their families. Twenty‐five participants were sampled randomly from the intervention cluster of the trial to participate in a qualitative process evaluation, and individual interviews were used to collect data. A thematic analysis of the data was undertaken. Three themes were abstracted from the data, reflecting participants’ perspectives about the usefulness of the programme: overcoming fear of perceived dangerousness, increasing willingness to engage, and becoming empathetic and non‐judgemental. This qualitative process evaluation offers insights into how a problem‐solving and Story‐bridge based MHL programme to a targeted group could lead to real and supportive actions/attitudes to people with mental illness. The findings have clinical relevance for a collaboration among family members and caregivers, community leaders and community psychiatric nurses, and other primary healthcare workers to develop community MHL strategies to improve the quality of care, support and life of people with mental disorders.