Health Nursing Practice Research Articles

The effect of listening to music and drawing on coping with dysmenorrhea complaints in nursing students: randomized controlled trial

AimTo examine the effect of listening to music and drawing on coping with dysmenorrhea complaints of nursing students.MethodsThe study was a double-blind, three parallel-group randomized controlled trial conducted between August 2023 and May 2024 at Bartın University, Faculty of Health Sciences, Department of Nursing. Ninety-six dysmenorrheic nursing students with regular menstrual cycles were included in the study and randomly assigned to three groups as drawing, music and control groups. Visual Analog Scale (100mmVAS of pain), Perceived Stress Scale (PSS) and Menstrual Symptoms Scale (MSS) were applied to the students at baseline, 1st and 2nd months. The interventions were as follows: the music group listened to a 29-minute and 32-second song three days before menstruation and on the first day of menstruation in the third month composed by Juan Sebastian Martin-Saavedra, while the drawing group created art for the same duration. The pain scores, perceived stress, and menstrual symptoms were measured in all groups after the interventions.ResultsPretest, 1st and 2nd months 100mmVAS of pain score averages were 7.16 ± 1.99, 7.16 ± 1.99 and 7.50 ± 1.98 for the control group, 7.22 ± 1.64, 4.84 ± 1.80 and 2.13 ± 1.45 for the music group and 6.69 ± 1.80, 5.09 ± 1.55 and 2.91 ± 1.33 for the drawing group, respectively. Pretest, 1st and 2nd months PSS score averages were 28.75 ± 3.71, 29.09 ± 3.87 and 30.03 ± 4.16 for the control group, 29.91 ± 3.98, 14.06 ± 4.06 and 3.59 ± 3.82 for the music group and 27.38 ± 3.63, 18.13 ± 5.60 and 8.34 ± 5.46 for the drawing group, respectively. Pretest, 1st and 2nd months MSS score averages were 79.25 ± 15.41, 88.00 ± 20.08 and 90.66 ± 19.13 for the control group, 85.41 ± 10.77, 62.41 ± 15.23 and 34.00 ± 12.62 for the music group and 80.69 ± 11.07, 65.53 ± 15.37 and 47.31 ± 15.11 for the drawing group, respectively. Mean menstrual pain intensity, mean perceived stress level, and mean menstrual symptoms level in the art and music group decreased significantly at 1st and 2nd months post-intervention (p < .001). A significant increase in score levels was observed in the control group.ConclusionsBoth art and music practices are effective in significantly reducing menstrual pain, perceived stress, and menstrual symptoms in nursing students with dysmenorrhea. It is important to include listening to music and drawing on women’s health and disease nursing practices to control menstrual pain, perceived stress, and menstrual symptoms in dysmenorrhea.Clinical trials registration numberhttps://clinicaltrials.gov identifier NCT06027489; registered August 30, 2023.

Qualitative Research Part 1: Understanding Its Place in Mental Health Nursing Practice.

Qualitative Research Part 1: Understanding Its Place in Mental Health Nursing Practice.

Patterns of utilization of advanced practice providers in reproductive endocrinology: a 2023 national survey

ObjectiveTo evaluate the current utilization of advanced practice providers (APPs) within the field of reproductive endocrinology and infertility (REI). DesignCross sectional. SubjectsA total of 201 APPs surveyed through the American Society of Reproductive Medicine APP Professional Group. ExposureAnonymized online survey. Main Outcome MeasuresDemographics, scope of practice and responsibilities, and training and onboarding. ResultsRespondents were primarily Family Nurse Practitioners (FNPs, 26.4%), Women’s Health Nurse Practitioners (WHNPs, 33.3%), or Physician Associates (PAs, 29.8%). Two-thirds (67.4%) reported that their scope of practice is limited by their employer or practice, 43.5% by state restrictions, and 25.2% by insurance. Survey respondents reported that 44.4% of their time at work is dedicated to performing procedures and scans and 30.6% to conducting consults and follow-ups. The most commonly reported duties were physical exams (88.6%), intrauterine inseminations (IUI; 86.6%), saline sonohysterograms (79.6%), endometrial biopsies (76.6%), ultrasounds (74.6%), and problem visits such as for pain, cysts, and bleeding (73.1%). The majority of survey respondents (61.7%) reported having autonomy in deciding protocols and treatment options for patients in their practice. Respondents described their onboarding training as including observation/on-the-job training (94.0%), independent reading of texts and journals (66.7%), ASRM online courses (45.3%), formal orientation (34.8%), and practice-organized training programs (29.4%). ConclusionsAPPs are highly trained members of the care team, but continue to be underutilized within the field of REI. Improvements in educational resources and/or use of a formalized program to train APPs to their full scope of practice may help increase clinic efficiency and improve patient access to care.

Psychotherapy Skills for Psychiatric Mental Health Nurse Practitioner Students in the Age of Competency-Based Education.

As the field of nursing moves toward competency-based education, faculty need to adapt teaching and learning strategies to meet standards for assessing core behaviors of graduate psychiatric mental health nurse practitioner students. This article reviews a psychotherapy skills-based learning assignment at Frontier Nursing University that was adapted to meet developing competency-based learning standards. The assignment utilizes prerecorded video scenarios to provide students with opportunities to reinforce psychotherapy skills during didactic coursework. Assessment is conducted via an analytic rubric and specific feedback is given to each student in writing.

Optimizing Response Rates to Examine Health IT Maturity and Nurse Practitioner Care Environments in US Nursing Homes: Mixed Mode Survey Recruitment Protocol.

Survey-driven research is a reliable method for large-scale data collection. Investigators incorporating mixed-mode survey designs report benefits for survey research including greater engagement, improved survey access, and higher response rate. Mix-mode survey designs combine 2 or more modes for data collection including web, phone, face-to-face, and mail. Types of mixed-mode survey designs include simultaneous (ie, concurrent), sequential, delayed concurrent, and adaptive. This paper describes a research protocol using mixed-mode survey designs to explore health IT (HIT) maturity and care environments reported by administrators and nurse practitioners (NPs), respectively, in US nursing homes (NHs). The aim of this study is to describe a research protocol using mixed-mode survey designs in research using 2 survey tools to explore HIT maturity and NP care environments in US NHs. We are conducting a national survey of 1400 NH administrators and NPs. Two data sets (ie, Care Compare and IQVIA) were used to identify eligible facilities at random. The protocol incorporates 2 surveys to explore how HIT maturity (survey 1 collected by administrators) impacts care environments where NPs work (survey 2 collected by NPs). Higher HIT maturity collected by administrators indicates greater IT capabilities, use, and integration in resident care, clinical support, and administrative activities. The NP care environment survey measures relationships, independent practice, resource availability, and visibility. The research team conducted 3 iterative focus groups, including 14 clinicians (NP and NH experts) and recruiters from 2 national survey teams experienced with these populations to achieve consensus on which mixed-mode designs to use. During focus groups we identified the pros and cons of using mixed-mode designs in these settings. We determined that 2 mixed-mode designs with regular follow-up calls (Delayed Concurrent Mode and Sequential Mode) is effective for recruiting NH administrators while a concurrent mixed-mode design is best to recruit NPs. Participant recruitment for the project began in June 2023. As of April 22, 2024, a total of 98 HIT maturity surveys and 81 NP surveys have been returned. Recruitment of NH administrators and NPs is anticipated through July 2025. About 71% of the HIT maturity surveys have been submitted using the electronic link and 23% were submitted after a QR code was sent to the administrator. Approximately 95% of the NP surveys were returned with electronic survey links. Pros of mixed-mode designs for NH research identified by the team were that delayed concurrent, concurrent, and sequential mixed-mode methods of delivering surveys to potential participants save on recruitment time compared to single mode delivery methods. One disadvantage of single-mode strategies is decreased versatility and adaptability to different organizational capabilities (eg, access to email and firewalls), which could reduce response rates. DERR1-10.2196/56170.

Reliability of the Mental Health Nurse Competency Assessment Tool (ECOEnfSM): A pilot study

AimTo evaluate the reliability of the ECOEnfSM scale as a tool to assess the professional competencies of Mental Health Nurse Practitioners (MHNP) in their clinical practice. MethodA pilot study, observational, descriptive and cross-sectional, focuses on MHNP who have completed their Specialized Health Training Program (SHTP) in Spain. The data were collected by general and collaborators mentors of the Multiprofessional Teaching Units (MTUs). The Mental Health Nursing Competency Assessment Tool (ECOEnfSM) was used, which consists of three subscales and eight Competence Units (CU). A reliability and validity analysis were conducted (Cronbach's alpha and Spearman's correlation coefficient). ResultsThe Rotation Assessment subscales showed excellent reliability (r > 0.90) with high and very high correlations (r > 0.6) in all UCs with high levels of significance (P < .01). The Annual Assessment subscale showed good reliability (r > 0.80) with a medium and very high correlation (r > 0.4) with high levels of significance (P < .01). All UCs showed a good to excellent consistency (r > 0.80). The “Home Visits” assessment criterion showed heterogeneity of data due to there are few MTUs that fully develop it. ConclusionThe ECOEnfSM scale showed very high reliability in MHNP during their training program in Spain. The ECOEnfSM is considered the only objective tool in Spain to assess the professional competencies in this population.

Profiles and Characteristics of Mental Health Nurses in Community-Based Health Care for People with Mental Illness - Integrative Review and Thematic Framework Analysis

To examine the specific scope of practice of community mental health nurses (CMHNs) across CMHN roles and care contexts. Systematic literature searches in CINAHL, PubMed/Medline, Google and Google Scholar, supplemented by a search of various publishers' databases. Data were analyzed and synthesized using the framework analysis method. This paper identifies two role profiles in CMHN practice that describe distinct functions in the outpatient care of people with mental illness: (A) Primary Care CMHN and (B) Specialized Care CMHN. For each role profile, contextual factors and specific role content are described and analyzed for similarities and differences. The described role profiles can serve as a template for the development of curricula in the field of CMHN. It is important to consider the national context as well as the current and future need for psychosocial care.

Fiabilidad de la escala de Evaluación de Competencias Enfermeras en Salud Mental: estudio piloto

AimTo evaluate the reliability of the ECOEnfSM scale as a tool to assess the professional competencies of Mental Health Nurse Practitioners (MHNP) in their clinical practice. MethodA pilot study, observational, descriptive and cross-sectional, focuses on MHNP who have completed their Specialized Health Training Program (SHTP) in Spain. The data were collected by general and collaborators mentors of the Multiprofessional Teaching Units (MTUs). The Mental Health Nursing Competency Assessment Tool (ECOEnfSM) was used, which consists of three subscales and eight Competence Units (CU). A reliability and validity analysis were conducted (Cronbach's alpha and Spearman's correlation coefficient). ResultsThe Rotation Assessment subscales showed excellent reliability (r > 0.90) with high and very high correlations (r > 0.6) in all UCs with high levels of significance (p <0.01). The Annual Assessment subscale showed good reliability (r > 0.80) with a medium and very high correlation (r > 0.4) with high levels of significance (p <0.01). All UCs showed a good to excellent consistency (r > 0.80). The “Home Visits” assessment criterion showed heterogeneity of data due to there are few MTUs that fully develop it. ConclusionThe ECOEnfSM scale showed very high reliability in MHNP during their training program in Spain. The ECOEnfSM is considered the only objective tool in Spain to assess the professional competencies in this population.

Psychiatric Mental Health Nurse Practitioner Job and Patient Outcomes: A Scoping Review

Psychiatric–mental health nurse practitioners (PMHNPs) offer a solution to the shortage of mental health care providers in a time of increased mental health demand. However, little is known about their job and patient outcomes. This scoping review aimed to explore PMHNP job outcomes, including satisfaction, burnout, and quality of work life, and patient mental health outcomes of PMHNP-delivered care. Twenty-four articles met the inclusion criteria and were published from January 2002 through October 2023. The existing research suggests that PMHNP-delivered care results in positive patient mental health outcomes for a variety of mental health conditions. For job outcomes, further research is warranted.

Understanding Clinical Learning Quality Aspects in Mental Health Nursing Practice Course among Students: A Comprehensive Examination.

There is a growing demand for comprehensive evaluations of the clinical learning quality of nursing education and the necessity to establish robust predictors and mediators for enhancing its outcomes within the context of mental health practice. This study is threefold: 1. Evaluating nursing students' clinical learning quality before and after mental health nursing practice; 2. Establish if the grade of a theoretical course in mental health nursing and the student's perception of their theoretical knowledge level predicts the grade of mental health nursing practice; 3. Explore how model learning opportunities, self-directed learning, safety, and nursing care quality mediate learning environment quality and tutorial strategies quality following mental health nursing practice. Using a before and after the study, 107 undergraduate nursing students at an Israeli university completed a questionnaire and the Clinical Learning Quality Evaluation Index tool to assess their perceptions of clinical learning quality before and after mental health nursing practice. The results showed a decline in students' perceptions of tutorial strategy quality following mental health practical learning in clinical settings, with the theoretical course grade predicting the practical experience grade and underscoring the mediating role of learning opportunities between the learning environment and tutorial strategies. The study's findings emphasize the importance of an adaptive learning environment and a solid theoretical foundation in fostering effective tutorial strategies and enhancing the overall learning outcomes for nursing students in mental health education.

The Future for Women's and Gender-Related Healthcare for Women's Health Nurse Practitioners.

This commentary examines the future of women's health and gender-related healthcare for Women's Health Nurse Practitioners (WHNPs) within the framework of National Association of Nurse Practitioners in Women's Health's (NPWH's) mission and vision. Emphasizing the importance of addressing menopause, maternal health, and reproductive health, it discusses the significance of WHNP education, certification, and workforce contributions. Despite their critical role, challenges including recognition as maternity care providers and disseminating WHNP-specific outcomes remain. WHNPs play a vital role in providing comprehensive healthcare for women and gender diverse individuals. Guided by the mission and vision of the NPWH, WHNPs address key priority areas including menopause, maternal health, and reproductive health. However, challenges such as recognition as maternity care providers, publishing outcomes specific to WHNP practice, and collecting comprehensive workforce data persist. To advance women's and gender-related healthcare, concerted efforts are needed to address challenges faced by WHNPs. This includes advocating for recognition within maternity care, promoting the dissemination of WHNP-specific research, and improving workforce data collection. By overcoming these challenges, WHNPs can continue to play a pivotal role in promoting the health and well-being of women and gender diverse individuals, shaping the future of women's health and gender-related healthcare delivery.

L’imagination soutenue par les thérapies brèves

L’imagination soutenue par les thérapies brèves

Using Delphi method to address factors contributing to aggressive behaviour in mental health settings.

WHAT IS KNOWN ABOUT THE SUBJECT?: Nurses' perspectives and consensus on the possible key factors contributing to aggression at inpatient units can be summarized into patients' related factors, staff related factors and environment related factors. Results of the possible factors contributing to aggression at inpatient units reflect the complicated nature of this problem. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: Perspectives of nurses as frontline mental health professionals on factors contributing to aggression as one of the psychiatric emergencies were considered through an iterative process. This approach gave nurses an opportunity to revisit their own views in each round to provide an in-depth reflection in the light of the contribution of others. WHAT ARE THE IMPLICATIONS FOR MENTAL HEALTH NURSING PRACTICE?: Nursing curricula should focus on nurses' communication skills and emotion regulation training. An open dialogue between nurses and people with mental health issues should be initiated to discuss the possible key factors contributing to aggressive behaviour at inpatient units from both standpoints. Mental health nurses' turnover at inpatient settings could be targeted through the design and implementation of aggression prevention protocols ABSTRACT: Introduction Aggression at inpatient units is a universal problem leading to hazardous outcomes. Aim To generate group consensus about factors contributing to aggressive behaviour among patients with mental health issues at inpatient units. Methods Nurses working at inpatient psychiatric departments were approached, and purposive sampling was employed to implement Delphi technique. A total of three Delphi rounds were conducted online. The average percent of majority opinions method was followed to measure consensus in which questions with a cut-off rate below 69.7% were included in the next round. Results Twenty-one nurse experts with different skills participated in this study. Consensus increased among nurse experts across rounds for the following items: Patients' misinterpretation of the attitude of the healthcare providers, severity of mental health issues, attitude and communication style of the healthcare providers, nurses limited emotional regulation capacity and the inadequate staff-patient ratio in psychiatric wards. Discussion The complicated nature of aggressive behaviour displayed by people with mental health issues is reflected on the results of the current study; patients' related factors, staff related factors and environment related factors constitute interacting facets for this issue. Implications for Mental Health Nurses Nurse scientists could use insights derived from this study to design studies aiming at assessment and management of aggression at inpatient units guided by implementation science frameworks. Additionally, open dialogues between nurses and people with mental health issues could be initiated about factors contributing to aggression at inpatient units. Mental health nursing training should focus on nurses' communication and emotion regulation skills.

Korean Nursing Students' Experiences of Virtual Simulation Programs Replacing In-Person Mental Health Nursing Practicum during the COVID-19 Pandemic.

This qualitative study explored the experiences of nursing students whose clinical practice in mental health nursing had been substituted with virtual simulation programs due to the COVID-19 pandemic. The participants were ten nursing students who had undergone a virtual simulation program-centered practice, replacing the traditional clinical practice in mental health nursing and previous clinical practice in mental health nursing. The data were collected through in-depth individual interviews from January to February 2021. Following Braun and Clarke's method, the thematic analysis identified five themes and ten sub-themes. The five themes included the following: (1) lack of vibrancy in the actual clinical setting, (2) limited direct and indirect practical experience, (3) performing diverse roles in a virtual setting, (4) learner-directed practicum, and (5) sense of relief due to a safe virtual practicum environment. The participants recognized the limitations of the practice, particularly regarding communication with patients with mental disorders in the virtual simulation program. However, their perception of nursing underwent a positive change through the indirect clinical practice experience. Accordingly, it is necessary to develop a platform for the mental health nursing practicum that can easily interact with clients and to establish a hybrid practice that combines the clinical practice and virtual simulation practice.

Lived experiences of mental health nurses who care for clients who are parents: An approximation of Tronto's definition of care.

Adult psychiatric services typically focus on the mental health needs of the client but they do not support his or her parenting role. Many authors highlight the importance of a non-judgmental approach when providing support and care to clients with mental illness who are parents. Assessments frequently focus on the negative aspects while the strengths of these families were often overlooked. There is a lack of scientific literature exploring nurses' experiences when caring for parents with mental illness and their families. Trust is the basis that helps clients to be open to receiving care and answering parenting-related questions. Therefore, without adequate professional-client trust, some care and interventions addressed to parents with mental illness could be poorly received by the client. Tronto's phases of care facilitated the collection of data and exploration of mental health nurses' experiences of care. Mental health nurses should be aware of the potential needs of these families, as described in the scientific literature, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique. Mental health nurses must take the person's environment into account (family, social and political aspects and different forms of stigma) since all these factors may influence how parents with mental illness receive and provide care. Introduction Many authors highlight the importance of a non-judgmental approach when providing care to parents with mental illness. However, assessments frequently focus on the negative aspects while the strengths of such families were often overlooked. Aim To explore the lived experiences of mental health nurses who care for clients who are parents. Method We conducted a qualitative phenomenological study. The main data collection technique was in-depth interviews. Data were analysed according to Colaizzi model, subsequently, the main categories that arised were compared and related to the five phases of Tronto's care. Results The main categories identified from the analysis of the interviews were: (1) individualized care, (2) continuity of care, (3) psychoeducation and counselling, (4) trust and (5) context of the client. Discussion Trust is the basis that helps parents with mental illness to be open to receiving care and answering parenting-related questions. Without trust, some interventions could be poorly received by the client. Implications for Practice Mental health nurses should be aware of the potential needs of these families, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique.

Advancing Behavioral Health Equity Through Telehealth and Remote Training of Newly Certified Psychiatric-Mental Health Nurse Practitioners.

Rural communities are disproportionately impacted by acute shortages of mental health providers. This problem, combined with complex behavioral health conditions, elicited the need for a university-based, remote telepsychiatric traineeship for newly board certified psychiatric-mental health nurse practitioners (PMHNPs). The Psychiatric Advanced Practice Registered Nurse TechNology Enhanced Residency (PARTNER) Program was developed to advance behavioral health equity by increasing state-wide access to care, removing geographical barriers, and enhancing PMHNP workforce readiness by strengthening trainees' ability to manage complex behavioral health conditions. In a southeastern state over a period of 3 years, six PMHNPs cumulatively provided behavioral health services to 1,195 patients, managed >118 diagnoses, and completed 3,535 visits, with 95.6% of visits comprising provision of care to patients residing in rural areas. Care was provided through the implementation of a collaborative-interdisciplinary-care model provided by route of telehealth and comprising a partnership between PMHNPs and patients' primary care providers. The training program enhanced providers' clinical proficiency, improved patient outcomes, and increased the number of skilled providers trained to manage patients with complex behavioral health conditions. [Journal of Psychosocial Nursing and Mental Health Services, 62(8), 19-24.].

Oral Health Nursing Education and Practice Program: Ten-Year Outcomes.

The Oral Health Nursing Education and Practice Program (OHNEP), a core partner of the National Interprofessional Initiative on Oral Health, is a national initiative focused on implementing an interprofessional oral health workforce innovation to influence change in clinical education, practice, and policy. OHNEP aims to address oral health disparities by enhancing the nursing profession's role in integrating oral health and its links to overall health in both academic and clinical settings. Leveraging the opportunity to cultivate faculty, preceptors, and clinicians as oral health champions, OHNEP aims to integrate interprofessional oral health clinical content and competencies in undergraduate and graduate nursing programs through faculty and preceptor development, curriculum integration, and establishing oral health as a standard of care in clinical settings. Outcomes include widespread dissemination of OHNEP virtual products and resources used by a significant number of undergraduate and graduate programs nationwide. OHNEP has a notable impact on policy related to integrating oral health and its links to overall health in undergraduate and graduate nursing programs, thereby increasing interprofessional oral health workforce capacity and aiming to improve oral health equity.

"It was a reflection of myself, that i was weak": The impact of depression on the sense of self - An interpretive phenomenological analysis.

The World Health Organisation states that more than 350 million people experience depression globally. The phenomenological changes in individuals experiencing depression are profound Phenomenological research can further researchers' and clinicians' understanding of this experience. This study aimed to gain a phenomenological understanding of how individuals with depression understood and made sense of their experiences. A methodology of interpretative phenomenological analysis was adopted. In-depth semi-structured interviews explored the lived experience of depression for eight individuals. Data were analysed into the superordinate theme Broken Self - Transforming the Self. The superordinate theme developed from the subordinate themes of 'unknown self, loss of self and one's identity', 'desperate for a way out', and thirdly, 'conflict with self and what's known', which related directly to how individuals made sense of their experience of depression. These research findings highlight the human implications of the experience of depression and the limitations of viewing depression from a biological or medical model lens. Understanding the human impact is essential for the effective, holistic practice of mental health nursing.

Exploring individuals' experiences of hope in mental health recovery: Having a sense of possibility.

WHAT IS KNOWN ON THE SUBJECT?: Mental health recovery is acknowledged as a process of transformation and a way of living a meaningful life despite the presence of mental ill-health. Experiencing hope has been articulated as intrinsic to service users experience of a meaningful life. The social construction of mental illness and stigma are recognised as barriers to experiencing hope. Mental health professionals have responsibility to positively influence the experience of hope. WHAT THIS ARTICLE ADDS TO EXISTING KNOWLEDGE?: Individuals in mental health recovery experience hope as the embodiment of having a sense of possibility in life. Individuals' sense of possibility in life is underpinned by a belief and confidence that they will be ok. This belief is informed by 'feeling safe' and 'feeling connected'. This article generates an increased understanding of the dynamic relational processes that unpin hope generation. WHAT ARE THE IMPLICATIONS FOR MENTAL HEALTH NURSING PRACTICE?: Mental health stakeholders need to be more explicit in exploring 'hope' and uncovering its therapeutic potential. Mental health practitioners need skill in enabling individuals to feel safe and connected while understanding its role in cultivating hope. ABSTRACT: Introduction The experience of hope is widely acknowledged and empirically supported as a key catalyst of mental health recovery. Lived experience accounts of hope are critical in accessing data on what has been termed a nebulous concept. This article is the second presentation of data from this study and provides further context to improve understanding of hope and optimise its therapeutic potential. Aim To explore how individuals describe and make sense of their experience of hope in mental health recovery. Method A qualitative Interpretative Phenomenological Analysis (IPA) approach was used. Results This article explores the second of three experiential group themes: Hope as Having a sense of possibility 'I will be ok' which is informed by feeling safe and feeling connected. Discussion Having a sense of possibility is easier when basic needs are met and people feel connected to self, others and the universe. The use of creativity as a pathway to the imagination is positively experienced. The role of family, friends and healthcare professionals as hope reservoirs is critical. Finally, the framing of medication use emerged as significant. Implications for Practice It is important that all stakeholders appreciate the interpretation of hope and use the understanding and skill in harnessing its therapeutic potential.

Impact of Virtual Reality Mental Health Nursing Simulation on Nursing Students' Competence.

This study investigates the impact of a Virtual Reality (VR)-based Mental Health Nursing Practice Simulation (MHNPS) on nursing students' competency in caring for individuals with mental disorders. Nursing students often face fear, anxiety, and helplessness during mental health (MH) rotations, impeding the attainment of learning objectives in the MH nursing practicum. Therefore, innovative strategies offering practice opportunities are crucial for their competence development. Using a one-group pretest-posttest repeated measures experimental design, 50 nursing students, having completed at least one MH theory course but not yet engaged in MH clinical practicum, were enrolled. Data collection occurred from October 30, 2022, to January 6, 2023. The VR simulation included six modules covering delusion, hallucination, mania, geriatric depression, adolescent depression with suicidal ideation, and obsessive-compulsive disorder. Pre-simulation questionnaires and post-simulation surveys were administered through provided links. Data were analyzed using descriptive statistics and paired t-tests to assess changes over time. Immediate and sustained improvements were observed in mental disorder-related nursing knowledge, communication self-efficacy, critical thinking ability, and MH nursing clinical confidence. Attitudes toward mental illness improved significantly post-intervention (t=-2.22, p=0.031), while the problem-solving process exhibited significant enhancement six weeks later (t=3.87, p<0.001). The findings affirm the simulation intervention's effectiveness in enhancing nursing students' knowledge, self-efficacy, critical thinking, and confidence in MH nursing practice, with no compromise to patient safety. Integrating simulation into MH nursing practicum narrows the gap between theory and clinical practice, elevates MH care quality, and instills confidence in nursing students as professionals. Despite potential subject selection bias in this single-group pre-post intervention study, the program's comprehensive impact on knowledge, skills, and attitudes suggests opportunities for expanding psychiatric nursing practice capabilities through subsequent studies. Caution is warranted in interpreting results, but the developed program lays the groundwork for advancing nursing students' capabilities in psychiatric nursing practice.