Current Situation and Enlightenment of Core Competence Development of Psychiatric Nurses in China

Managed care organizational complexity and access to high-quality mental health services: Perspective of U.S. primary care physicians

Mental Health Care Reforms in Latin America: Child and Adolescent Mental Health Services in Mexico

Background and Objectives: Knowledge and practice of core competencies in nursing field is very essential for staff nurses to provide safe, ethical and quality care to the patients. As there is need for creating greater awareness among staff nurses regarding the importance of core competencies in nursing practice, the present study was undertaken to assess the existing knowledge of core competencies in nursing and to find the association between knowledge and demographic variable of the respondents. An information booklet was developed to help staff nurses to improve knowledge of core competencies in nursing practice. Objectives: To assess the knowledge of staff nurses on core competencies in nursing. To find the association between knowledge with selected demographic variables. To provide an information booklet to improve core competencies in nursing practice. Method: The study design was descriptive survey design. Simple Random sampling technique was used to draw 80 staff nurses as samples. Data was collected by self-administered questionnaire method. Results: The findings showed that the mean knowledge score of the subjects which was 59.5 percent was found to be significant with a calculated 't' value of 3.46, P<0.05. Association between mean knowledge score and selected variables like age, gender, religion, experience, educational qualification, additional nursing qualification and In-service education programme. Interpretation and conclusion: The data was analyzed by applying descriptive and inferential statistics. The results of the study indicated that staff nurses do have moderate knowledge level on core competencies in nursing. This assessment project has helped the investigator to develop an information booklet to improve core competencies in nursing practice.

Experts Outline Costs, Barriers To High-Quality Depression Treatment

A system that provides accessible, high-quality mental health services includes services that are safe and evidence‑based, delivered in a timely, continuous manner, while being developed close to the community and taking into account individual needs and preferences. High-quality mental health services outcomes and experiences, and support people to recover from, or better manage, mental health conditions. OECD countries have been making efforts to improve their services, including to improve accessibility and quality. However, this chapter shows room for improvement remains, as unmet need for mental health care remains high, and high rates of emergency care use, repeat admissions to inpatient care and high suicide rates after discharge points to key gaps in quality of care. This chapter identifies some policies and practices that can be implemented to improve access to and quality of mental health services, while calling for improvements in data availability to better measure how effectively mental health services are delivering improved outcomes for service users.

Students as future generations need to be equipped with high-level abilities, such as creative thinking and critical scientific thinking. The purpose of this research is to know how much creative thinking skills and scientific critical thinking are possessed by high school students in Bandung. In this research, the instrument used is a test-shaped essay as many as 12 questions about static fluid topic. The appreciation instruments used in this study were Critical Thinking (ACTA) type instruments. Tests of students’ critical thinking skills were analyzed using the Rasch model. The research population is a grade XI student in one high school in Bandung City. Research samples were selected with a random sampling technique of 32 students. Research results show that students have not been able to analyze the arguments, assess or evaluate, make decisions or solve problems, and make conclusions using inductive or deductive reasoning. It is shown by the low percentage of scientific critical thinking ability on every aspect, Critical thinking ability of 1 26.5%, Critical thinking ability of 2 23%, Critical thinking ability of 3 13%. It was concluded that the student’s scientific critical thinking skill level in the static fluid is motionless very low.

To examine the relationships between critical thinking ability and nursing competence in clinical nurses. There are few evidance-based data related to the relationship between critical thinking ability and nursing competence of clinical nurses. A cross-sectional and correlation research design was used. A total of 570 clinical nurses at a medical centre in southern Taiwan were recruited into this study. Two self-report questionnaires, the Watson-Glaser Critical Thinking Appraisal (WGCTA) and the Nursing Competence Scale (NCS), were used to collect data. The critical thinking ability of clinical nurses was at the middle level. The highest score for the subscales of the WGCTA was 'interpretation ability' and the lowest was 'inference ability'. The nursing competence of clinical nurses was at the middle level and above. The highest score for the subscales was 'caring ability' and the lowest was 'research ability'. Critical thinking ability had a significantly positive correlation with nursing competence. Critical thinking, working years, educational levels and position/title were the significant predictors of nursing competence, accounting for 32·9% of the variance. Critical thinking ability had a significantly positive correlation with nursing competence. The critical thinking ability of clinical nurses with a master's degree was significantly better than those with a bachelor's degree or a diploma and nurses with over five working years was significantly better than those with under five years. The findings of this study can further serve as a reference for nursing education to improve nursing curricula and teaching strategies for nurse preparation. It could also be a guideline for nursing administration personnel in on-the-job training and orientation programs for nursing staff.

Objective To understand the current status of primary hospital clinical nurses ’ critical thinking ability and self-learning ability and to explore the relationship between them , so as to provide theoretical basis and reference for continuing medical education .Methods Totals of 345 clinical nurses in three county hospitals were surveyed by general information questionnaire , Critical Thinking Disposition Inventory-Chinese Version （ CTDI-CV ） and nurse self-learning ability rating scale .Results The total score of clinical nurses ’ critical thinking ability was （276.08 ±34.31）, and the self-learning ability score was （121.40 ±18.42）. Based on the above results , Except that cognitive maturity had no significant correlation with task analysis , self-monitoring and regulation , critical thinking ability was positively related to self -learning ability and other dimensions （P 〈0.05）.Conclusions The critical thinking and self-learning ability of clinical nurses in primary hospital need to be improved .Because of their mutual positive impact , nursing managers should take a variety of measures to develop and improve these abilities . Key words: Clinical nurse; Critical thinking ability; Self-learning ability; Correlation; Primary hospital

Objective To explore the effect of combining graduate education of Master of Nursing Specialist with standardized training in a college in Chongqing. Methods Cluster sampling was used to select 25 of the class of 2015 nursing degree graduates who had participated in the standardized training of nurses, and 18 of the class of 2018 nursing degree graduates who had not participated in the standardized training of nurses. The core competencies of nurses for the grade 2015 and 2018 was investigated. In addition, the satisfaction of grade 2015 students was investigated, and the training effect and existing problems of the Double Track In One clinical practice training mode were analyzed in combination with the standardized training results of nurses.At the same time, the Double Track In One clinical practice training mode was described. Results The total score of the core competence of nurses of grade 2015 was 108.40±20.47, and the total score of the core competence of nurses of grade 2018 was 128.68±26.83. The score of the students of grade 2015 was higher than that of the students of grade 2018 in clinical ability, critical thinking and scientific research ability, interpersonal relationship, leadership, ethics and legal practice, and the difference was statistically significant (t=-3.05, P < 0.05). The total score of the satisfaction survey was 88.12±12.44, which was at a medium level. Conclusion Chongqing Medical University has conducted the clinical practice training of Double Track In One for Master of Nursing Specialist, which has achieved good results and effectively improved the core competence of nurses for nursing graduate students, providing a good reference for further promoting the link between nursing graduate education and professional qualification. Key words: Double track in one; Master of Nursing Specialist; Clinical practice

Objective To investigate the core competence of nurses in class Ⅲ grade A level hospitals in Xi′an City and its influencing factors so as to provide evidences for managers to enhance the core competence of clinical nurses and promote the quality and safety of nursing. Methods A total of 890 registered nurses from class Ⅲ grade A hospitals in Xi′an city were investigated usingthe competency inventory for registered nurse scale (CIRN) from July to September 2015. Statistical software SPSS 19.0 was used to analyze the data. Influencing factors of the core competence of nurses were analyzed using multiple linear regression analysis. Results The total score of core competences of clinical registered nurses was (159.12±33.21) . The dimension with highest score was ethical/legal practice ability with an average score of (3.01±0.64) . The dimension with lowest score was critical thinking/scientific research ability with an average score of (2.70±0.67) . The scores of nurses from emergency and critical care were higher than those of nurses from general departments in the dimensions including clinical nursing, interpersonal relationship, ethical/legal practice, professional development and critical thinking/research ability. The differences were statistically significant (Z=-3.496, -2.688, -3.727, -2.969, -3.911; P<0.05) . Multivariate linear regression analysis showed that technical title, age, department training, and professional qualification were influencing factors of the nurses′ core competence (P<0.05) . Conclusions The core competence of registered nurses in classⅢ grade A hospitals in Xi′an city is at above medium level. The scores of nurses from emergency and critical care are higher than nurses from general departments in several dimensions. Age, technical title, department training and professional qualification are main influencing factors of core competence of nurses. Interventions to improve the core competency of nurses with low grade, low technical title and non-specialist qualification are necessary. Key words: Registered nurses; Core competence; Influencing factor

The COVID-19 pandemic has intensified global mental health challenges, particularly for vulnerable groups like female entertainment workers (FEWs), a critical HIV-affected population in Cambodia. Already facing pre-existing inequalities, FEWs encountered heightened difficulties due to the pandemic's disruption of their livelihoods. Their susceptibility to mental health problems is exacerbated by poverty and the occupational stressors they regularly endure. This study aims to identify COVID-19-related factors adversely impacting the mental well-being of FEWs in Cambodia and explore potential interventions to mitigate these effects. In December 2021, we conducted a two-day workshop in Phnom Penh using a group model-building approach with stakeholders from diverse backgrounds to gather collective insights. We employed the qualitative system dynamics method of causal loop diagram mapping to visualize the factors affecting FEWs' mental health. Based on participants' perceptions and experiences, we constructed a causal loop diagram to develop a comprehensive systems perspective. The workshop involved 27 stakeholders, including representatives from national institutions (n = 3), local NGOs (n = 17), an international NGO (n = 1), and the FEW community (n = 6). Our analysis identified 13 feedback loops highlighting key factors influencing the mental well-being of FEWs during the pandemic. These factors included the loss of family members, financial instability, fear of COVID-19 infection, the pressure of children's homeschooling due to school closures, and food insecurity. In response, stakeholders proposed a range of interventions, including alternative vocational training, increased awareness of mental health issues, access to mental health services, and programs targeting gender-based violence within FEW communities. A collaborative, multi-sectoral approach is crucial to addressing the mental health challenges of FEWs in Cambodia. Prioritizing the establishment of accessible, affordable, and high-quality mental health services, alongside the implementation of targeted interventions, is essential to mitigate the negative mental health impacts of the pandemic and enhance the overall well-being of FEWs.

BACKGROUND: Within the past decade, the mental health care system in the United States has undergone a significant transformation in terms of delivery, financing and work force configuration. Contracting between managed care organizations (MCOs) and providers has become increasingly prevalent, paralleling the trend in health care in general. These managed care carve-outs in behavioral health depend on networks of providers who agree to capitated rates or discounted fees for service for those patients covered by the carve-out contracts. Moreover, the carve-outs use a broader array of mental health providers than is typically found in traditional indemnity plans, encourage time-limited versus long-term treatments and favor providers who are engaged in outpatient care. This phenomenal growth in managed behavioral health care over the past decade includes the rapid growth and quick consolidation of mental health MCOs. The period 1992-1998 shows steady and substantial annual increases in the number of enrollees in mental health MCOs, the figure more than doubling from 78.1 million people in 1992 to a projected 156.6 million in 1998, or 70% of insured lives. Moreover, these vast numbers of enrollees are becoming increasingly consolidated into a smaller number of firms. In 1997, 12 companies controlled nearly 85% of the managed behavioral health care market, with 60% of the market held by the three largest firms. STUDY AIMS: This article reviews empirical data and draws policy implications from the literature on managed behavioral health care in the United States. Starting with spending and spending trend estimates that show the average annual growth rate of mental health expenditures to be lower than that of health care expenditures in general over the past decade, the author examines utilization and price factors that may account for managed-care-induced cost reductions in behavioral health care, with special attention to hospital use patterns, fee discounting and the supply and earnings patterns of various types of mental health provider. In addition, data on staffing ratios and provider mixes of health maintenance organizations and mental health MCOs are reviewed as they reveal at least part of the dynamics of reconfiguration of the mental health work force in this era of managed care. CONCLUSIONS: As measured by changes in utilization and price, widespread application of "classic" managed care techniques such as preadmission review (gatekeeping), concurrent review, case management, standardized clinical guidelines and protocols, volume purchase of services and fee discounting appears to have led to significant cost reductions for providers of both impatient and outpatient mental health services. However, amidst a complex flux of market variables such as risk shifting, changing financial incentives and intensity of competition, not all of the reduction or slowdown in spending can be clearly and purely attributed to managed care. The data on the ongoing reconfiguration of the mental health work force are clearer in their implications: with an oversupply of all types of mental health providers, managed care has significant potential to increase the incidence of provider substitutions and spur the growth of integrated group practices. IMPLICATIONS FOR FURTHER RESEARCH: The current body of empirical and policy literature in mental health economics suggests several salient areas of follow-up. Is the proportionately greater impact of managed care on the annual growth rate of mental health care spending a temporary phenomenon or does it signal an enduring difference in the rates of increase between behavioral health care and health care in general? Beyond industry downsizing, what are the substitutions among mental health providers that are going on, and will go on, to produce cost-effective practices? What are the new financial or risk-sharing arrangements between providers and MCOs that will produce appropriate and high-quality mental health services?

The core competencies in disaster nursing of new graduate nurses in Guangdong, China: A cross-sectional study

This research aims to describe the critical thinking abilities of SMA Negeri 5 Model Palu students, especially in Linear program material. This research is descriptive research with a qualitative approach. The subjects in the research were students with high, medium and low mathematics abilities obtained from the results of report cards who were then given a critical thinking ability test. The research was conducted by interviewing students' test results and conducting time triangulation. The results obtained show that students with high ability fulfill all the indicators of interpretation, analysis, evaluation and inference, while students with medium ability only do not meet one indicator, namely inference, and students with low ability only master two indicators of critical thinking, interpretation and analysis abilities. In conclusion, with the differences in students' critical thinking abilities, teachers should pay attention to the differences in students' abilities to think critically in learning, in this case linear programming. Keywords: Critical Thinking Ability, Linear Program Material

Objective To investigate the current status of critical thinking ability and commu-nication ability of nursing students, therefore providing reference for teaching reform. Methods The Critical Thinking Scale translated and revised by Pro. Peng MeiZi of Hong Kong Polytechnic University, and Supportive Communication Scale (SCS) edited by Whetten and his colleague were used to investi-gate nursing students' levels of critical thinking and communication ability among 176 selected nursing students in our college, with method of Random Cluster Sampling. Descriptive analysis, single sample t-test, and two independent sample t-test were applied to the collected data with SPSS l7.0. Results ①The average score of critical thinking for the investigated college nursing students was (264.54±29.94). 72.73% of them got 210~280 points, in which three items: cognitive maturity (t=4.695, P=0.000), open mind (t=4.016, P=0.000), and intellectual curiosity (t=2.973, P=0.003) were greater than 40 points. And the differences were statistically significant; compared to different individual character-istics, being a student cadre (t=3.494, P=0.001) or not is of statistical significance. ②The total average score of communication ability (t=3.219, P=0.002) for college nursing students, as well as the score of providing effective negative feedback (t=6.790, P=0.000) and supportive communication (t=4.267, P=0.000) were significantly higher than median 3.00. And the differences were statistically significant. Conclusion In order to improve the critical thinking ability and interpersonal communication ability of nursing students, and educate the nursing students to adapt to society and complicated clinical nursing environment, it is necessary to reform the curriculum setting, curriculum design and teaching method. Key words: Nursing students; Critical thinking ability; Communication ability; Investiga-tion and study