Mental Health Nursing Research Articles

Generalized anxiety disorder and job performance can predict job stress among nurses: A latent profile analysis.

Nursing is a stressful profession that can impact the physical and mental health of nurses as well as the safety of patients. Furthermore, various factors may affect the job stress of nurses. However, recent studies mainly focused on the overall level of job stress and its related factors, ignoring the population heterogeneity of nurses' job stress. A total of 440 nurses participated in the questionnaire survey between March 2023 and April 2023. Data were collected using the Demographic Characteristics Questionnaire, the Nursing Job Stressor Inventory, the Generalized Anxiety Disorder 7-item Scale, and the Nurse Job Performance Scale. A latent profile analysis was used to identify the latent profiles of job stress. Kruskal-Wallis H test and ordinal logistic regression were used to explore the predictors of different profiles. The job stress of nurses could be classified into four profiles: relatively low job stress, relatively high job stress, high job stress, and the highest job stress. Generalized anxiety disorder, job performance, health status, and dislike of nursing as a career were predictors of different profiles. The majority of nurses were classified into profile 2, and their job stress was relatively high. Lowering anxiety levels, enhancing job performance, improving nurses' health status, and changing professional attitudes toward nursing may be effective ways to reduce nurses' job stress.

Men's mourning experiences for the death of a loved one: An integrative review.

To analyze the current state of knowledge regarding men's mourning experiences following the death of a loved one. An integrative review was conducted using quantitative, qualitative, and mixed-methods studies published in English or Spanish between 2017 and 2022 that investigated men's mourning experiences. Studies focused on grief in participants with different sexes or gender identities, maladaptive grief, persistent complex bereavement disorder, prolonged grief disorder, bereavement over pets, or losses other than a human death were excluded. Additionally, reviews, books, theses, editorials, and opinion pieces were not included. The search was conducted in CINAHL, PubMed, and Scopus in 2023. JBI tools were used for quality appraisal, and the analysis employed the constant comparative method. Our analysis of eight English-language documents with evidence levels IV-VI, informed by the Socioecological Model of Men's Grief, revealed that factors at individual, interpersonal, community, and public policy sublevels interact significantly to shape men's grief experiences. Themes emerged along a continuum of intuitive and instrumental coping responses, including adaptive and maladaptive coping strategies, loneliness and social support needs, the influence of societal constructions of masculinity and the grieving process in men. Men's mourning experiences are complex and multifaceted, influenced by diverse expressions of masculinity and the interaction of various contextual factors. The Mental Health Nursing Process should prioritize understanding and addressing the unique experiences of bereaved men.

Using practice development to recruit and retain forensic mental health nurses: a preceptorship support project

Using practice development to recruit and retain forensic mental health nurses: a preceptorship support project

Perceived Stress and Coping Strategies for Frontline Nurses Caring for COVID-19 Patients: A Path Analysis.

This cross-sectional study explored the relationships among perceived stress, social support, positive coping, and mental health in frontline nurses caring for patients with COVID-19 in China. A quantitative cross-sectional study. A convenience sample of 339 eligible frontline nurses was identified from a designated hospital for COVID-19 in Shanghai, China, between May 2022 and August 2022. Data from nurses were collected through an online survey that contained 4 measurement domains: perceived stress, social support, coping strategies, and mental health. Path analysis was used to analyze the data in SPSS 24.0 and AMOS 23.0. The model tested in the path analysis fit the data well. The results demonstrated relationships among perceived stress, social support, positive coping, and mental health among frontline nurses caring for patients with COVID-19. Social support had a positive effect on positive coping strategies and a negative effect on perceived stress and mental health. In addition, path analysis indicated that social support moderated the relationship between perceived stress and mental health in nurses. Nurses experienced work-related mental stress while providing COVID-19-related care. Based on study findings, social support is expected to play a key role in stress management in nurses. Expanding opportunities for social support is an essential step for nurses to improve their mental health and quality of life.

The Influence of Emotional Intelligence on Psychiatric Nurses' Care Behavior, and the Chain Mediating Role of Compassion Fatigue and Perception of Management.

To investigate psychiatric nurses' emotional intelligence and its effect on care behavior, while also examining the mediating effect of compassion fatigue and perception of management. This cross-sectional study was conducted in several specialized psychiatric hospitals with 360 psychiatric nurses. Self-report surveys were administered, which included the Caring Factor Survey-Caring of Manager, Caring Behaviors Inventory, Compassion Fatigue Short Scale, and Wong Law Emotional Intelligence Scale. Data were analyzed using descriptive, correlation, and path analyses. Mean score for care behavior was 4.78 (SD = 0.83), which was at a moderate level. Compassion fatigue exhibited negative correlations with other variables. Results of mediation effect analysis showed that emotional intelligence directly predicted care behavior (p < 0.001). Emotional intelligence also indirectly affected care behavior through the mediating roles of perception of management and compassion fatigue, and affected care behavior through the chain mediation effect of perception of management and compassion fatigue. Nurse managers should pay attention to the influence of emotional intelligence on care behavior and improve care behavior by strengthening leadership and alleviating compassion fatigue. [Journal of Psychiatric Nursing and Mental Health Services, xx(xx), xx-xx.].

Understanding the Process of Acceptance Within the Nurse–Patient Therapeutic Relationship in Mental Health Care: A Grounded Theory

Background/Objective: Deepening knowledge about the meaning of acceptance in the context of the nurse–patient relationship will help us to understand the importance and value that people with mental health challenges attach to this attribute in the process of the therapeutic relationship. The objective of this study was to understand the process of acceptance as part of the therapeutic relationship between nurses and patients in the field of mental health. Methods: This study employed a qualitative research design using Strauss and Corbin’s grounded theory approach. Using theoretical sampling, data were collected through unstructured interviews with mental health nurses and with people with mental health challenges. Results: Acceptance is a complex and dynamic process that takes place when both patients and nurses feel and make the other feel like an individual human being. Acceptance is not an automatic process; rather, it requires awareness on behalf of both parties involved in the therapeutic relationship. The creation of a non-hierarchical caring environment is fundamental for fostering mutual acceptance and engagement in the therapeutic process. Conclusions: Nurses must develop self-awareness and reflect on their attitudes and biases to provide person-centered care. Nurse training and personal development are essential requirements for achieving an effective therapeutic relationship and empowering patients in their recovery process.

Mental health nursing students and generic proficiencies: how educators can support assessment.

Recent shifts in nursing education towards generic proficiencies pose challenges to the unique demands of mental health nursing education. Student mental health nurses at the authors' higher education institution (HEI) have provided service feedback that has expressed the difficulties they have encountered. This article examines the issues faced by students, assessors and educators in interpreting and applying the proficiency standards set by the Nursing and Midwifery Council. Addressing the complexities of mental health nursing education, as well as the barriers to learning and attainment, requires a collaborative effort and innovative solutions if HEIs are to successfully prepare future mental health nurses to meet the evolving demands of their role. The proposed solution is a 'Proficiency Directory', which provides structured resources for mental health nursing students to align learning experiences with assessment criteria, facilitating a more comprehensive and meaningful learning journey.

Developing the emergency response for mental health patients.

Carly Lynch, Consultant Nurse for Mental Health, London Ambulance Service (carly.lynch@nhs.net), was the winner of the Gold Award in the Mental Health Nurse of the Year category of the BJN Awards 2024.

The mediating role of surface and deep acting and the moderating effect of occupational identity in workplace violence and sleep quality among psychiatric nurses: a cross-sectional study.

Psychiatric nurses often encounter patients with mental health disorders and consequently experience prolonged periods of high stress, increased workload, and frequent incidents of workplace violence. These aspects can lead to a higher incidence of poor sleep quality. This study examined the interplay between workplace violence and emotional labour (surface and deep acting) to suggest measures for enhancing sleep quality among psychiatric nurses. A total of 300 completed and valid online questionnaires were collected. The Pittsburgh Sleep Quality Index was used to measure sleep quality, Workplace Violence Scale (WVS) to measure the occurrence of workplace violence, and Emotional Labour Scale to measure surface and deep acting. The data were analysed using Hayes' PROCESS macro with SPSS. Independent samples t-tests and one-way ANOVA were used to compare differences in sleep quality and emotional labour (surface and deep acting) between psychiatric nurses with different demographics. The prevalence of poor sleep quality (PSQI > 5) was 55% among the nurses. Surface acting in emotional labour partially mediated the relationship between workplace violence and sleep quality(a1*b1=0.035,95%CI: 0.002, 0.079), whereas deep acting had a suppressive effect(a2*b2=-0.033,95%CI: -0.071, -0.003). Occupational identity had a positive moderating effect on the relationship between workplace violence and surface acting(Effect=0.091,95%CI: 0.004, 0.179). The relationship between workplace violence and poor sleep quality was partially mediated by surface acting and suppressed by deep acting. Moreover, nurses with higher occupational identity engaged in more surface acting after workplace violence. Workplace violence, surface acting, and deep acting emerged as significant factors influencing sleep quality among psychiatric nurses. Deep acting can reduce the impact of workplace violence on sleep quality. The results provide a new and expanded view of the interplay between workplace violence and emotional labour concerning sleep quality. Interprofessional collaboration with clinicians, administrators, educators, and spiritual leaders can contribute to the development of related education and training. Chinese Clinical Trial Registry ChiCTR2200062347. https://www.chictr.org.cn/showproj.html?proj=173264.

Unveiling Shadows: Challenges Encountered by Mental Health Nurses and Health Cadres in the Delivery of Care to Persons With Mental Illness in Indonesia.

Mental health nurses and health cadres in Indonesia who provide care to persons with mental illness (PWMI) report encountering several challenges and obstacles to the delivery of quality care. At present, there is a paucity of research on this topic. The objective of this study was to examine the challenges encountered by mental health nurses and health cadres in their interactions with the families of PWMI in the community. This descriptive qualitative study employed focus group discussions, conducted in three Indonesian cities: Banda Aceh, Surabaya and Yogyakarta. Thematic analysis was utilised to analyse the data. The study revealed that the theme of this research is nurses and health cadres experienced challenging family behaviours toward a PWMI. The initial subtheme of family behaviour is 'concealing the PWMI.' This subtheme encompasses instances where families attempted to hide the mental health condition of the PWMI. The second subtheme is 'unsupportive families'. This subtheme is characterised by reluctance to engage in treatment or outright rejection of hospital care. This is often due to factors such as familial busyness. The third subtheme is 'poor parenting styles'. This subtheme highlights how inadequate parenting practices, domestic violence and lack of family support contribute to stress and exacerbation of mental disorders in PWMI. The fourth subtheme is 'hidden motive related to wills and testaments', which reveals how families may attempt to manipulate treatment to remove the inheritance rights of PWMI. The fifth subtheme is 'abandonment by family', which describes scenarios where families completely neglect PWMI, leading to inadequate care and medication adherence. The final subtheme, 'removal of PWMI from family units', describes instances where families sent PWMI to mental health facilities for permanent separation, sometimes even relocating to another city. To address these issues, a comprehensive approach is required that considers both the affected individuals and their families. An understanding of the motivations behind these behaviours is essential for the development of targeted interventions that promote family support, reduce stigma and improve the overall mental health environment in communities.

Integrating large language models in mental health practice: a qualitative descriptive study based on expert interviews

BackgroundProgress in developing artificial intelligence (AI) products represented by large language models (LLMs) such as OpenAI’s ChatGPT has sparked enthusiasm for their potential use in mental health practice. However, the perspectives on the integration of LLMs within mental health practice remain an underreported topic. Therefore, this study aimed to explore how mental health and AI experts conceptualize LLMs and perceive the use of integrating LLMs into mental health practice.MethodIn February–April 2024, online semi-structured interviews were conducted with 21 experts (12 psychiatrists, 7 mental health nurses, 2 researchers in medical artificial intelligence) from four provinces in China, using snowballing and purposive selection sampling. Respondents’ discussions about their perspectives and expectations of integrating LLMs in mental health were analyzed with conventional content analysis.ResultsFour themes and eleven sub-themes emerged from this study. Firstly, participants discussed the (1) practice and application reform brought by LLMs into mental health (fair access to mental health services, enhancement of patient participation, improvement in work efficiency and quality), and then analyzed the (2) technological-mental health gap (misleading information, lack of professional nuance and depth, user risk). Based on these points, they provided a range of (3) prerequisites for the integration of LLMs in mental health (training and competence, guidelines for use and management, patient engagement and transparency) and expressed their (4) expectations for future developments (reasonable allocation of workload, upgrades and revamps of LLMs).ConclusionThese findings provide valuable insights into integrating LLMs within mental health practice, offering critical guidance for institutions to effectively implement, manage, and optimize these tools, thereby enhancing the quality and accessibility of mental health services.

Student nurses’ experiences of restraint − a qualitative study

Background/Aims Restraint is a complex issue that is associated with multiple legal and ethical challenges. National scandals have highlighted a lack of adequate training among healthcare staff in restraint. While education should start with nurses in training, evidence suggests that the experiences of student nurses in relation to restraint has not been addressed. This study aimed to explore the lived experiences of student nurses when encountering restraint. Methods A qualitative methodology was used to investigate student nurse experiences of restraint. Seven semi-structured interviews were undertaken with student nurses in their second (n=3) and third year (n=4) of an undergraduate nursing degree, with a specialism in mental health nursing. Data were analysed using a thematic analysis approach. Results Three overarching themes were identified from the data: a ‘clinical–theory gap’, referring to a gap in students’ theoretical learning and clinical placements; ‘learning from each other’, where students felt a need for increased shared learning surrounding restraint; ‘wellbeing’, highlighting a lack of sufficient supportive and timely interventions to appropriately aid student wellbeing after witnessing restraint. Conclusions These findings highlight the need for improved communication between higher education institutions and clinical practice in relation to restraint. Opportunities for debriefs within higher education learning environments should be considered in order to improve student nurses’ wellbeing and experiences of their nursing degree programme.

Academic and Employment Preferences of Nursing Students at the University of Las Palmas of Gran Canaria: A Cross-Sectional Study

Background/Objectives: It is well known that there are differences in the academic and employment preferences of nursing students once they have completed their undergraduate studies in nursing. These preferences are largely influenced by students’ affinity for certain thematic areas over others. Therefore, the objective of this study was to identify the employment and academic preferences of third- and fourth-year Nursing Degree students at the University of Las Palmas de Gran Canaria (ULPGC). Methods: A cross-sectional, descriptive observational study was conducted among nursing students across three campuses of the ULPGC (Canary Islands, Spain). An online questionnaire was used to collect various sociodemographic and academic variables, as well as preferences across ten thematic areas. Descriptive and bivariate inferential analyses were performed, along with a correlation analysis among the areas. Results: The areas of highest preference were “Emergency Nursing”, “General Nursing”, and “Family and Community Nursing”. The areas of lowest preference were “Other Areas (teaching, management, research)”, “Mental Health and Psychiatric Nursing”, and “Geriatric Nursing”. Three clusters of closely correlated areas were identified: cluster 1 (Intensive and Critical Care Nursing, Emergency and Emergency Nursing and Operating Theatre and Anaesthesia Nursing), cluster 2 (Obstetric-Gynaecological Nursing–Midwifery, Paediatric Nursing and Mental Health and Psychiatric Nursing) and cluster 3 (remaining areas). A significant proportion of students expressed intentions to pursue postgraduate studies. Conclusions: Strategies should be implemented to enhance students’ preferences in the areas of “Mental Health and Psychiatric Nursing” and “Geriatric Nursing”, which are areas where there is a high demand for nurses. It is also necessary to increase their interest in research, management, and teaching. This study was not registered.

Experiences of Growing Up with Mothers with Schizophrenia in South Korea: A Qualitative Study.

The purpose of this study was to explore the experience of living with mothers with schizophrenia from childhood to the present from the perspective of their now-adult child. Individual interviews were conducted with 10 adult children of mothers with schizophrenia. The data were collected in South Korea from July 2017 to March 2018 and thematic analysis was employed. Purposive sampling was used. Four themes were identified: (1) Navigating Childhood Confusion and Isolation Due to Maternal Schizophrenia, (2) Journey Through Loneliness, Resentment, and Emerging Responsibility, (3) Facing real-life difficulties as an adult child with vulnerability, and (4) Satisfaction in well-grown self. Notwithstanding the real-life difficulties due to unstable life with their mothers with schizophrenia, the children still had faith and confidence in themselves as well-grown thus far. Reflection on memories with their mothers served as a basis for continued maternal-child relationship and for taking on the role of guardians despite the negative experiences of their mothers' psychotic symptoms. Mental health nurses and school health professionals should pay attention to the children of mothers with schizophrenia and their difficulties in providing appropriate mental health services.

Is epistemic injustice a worthy application to mental health nurse education?

This paper explores the philosophical concept of epistemic injustice and contends its significance and relevance to mental health nurse education and clinical practice. The term epistemic injustice may be unfamiliar to mental health nurses, yet the effects are readily visible in the dismissing, silencing, and doubting of service users' knowledge, testimony, and interpretation. Existing professional values and clinical standards lack depth and critical exploration pertaining to epistemology and associated ethical concerns. Despite central tenets of person-centred care and valuing the service users' voice, epistemic injustice continues to occur. Epistemic injustice cannot be summed up merely by asking nurses to listen to service users. This represents an oversimplification of epistemology, ignoring the complexities of social influence and knowledge exchanges. Epistemic injustice brings something new and innovative to the nursing curriculum and fits within the principles of heutagogy. It encourages deep reflexivity surrounding the ethical issues of power inequalities and intersectionality. Inclusion in mental health nursing education allows for the social and political powers of psychiatric diagnosis as a form of silencing and stigma to be examined. Practical application is made to mental health nursing education and practice with epistemological values and ethical reflexive prompts. These can be utilised by educators and lecturers for pre-registration mental health nurse education, post-registration, and continued professional development.

Transforming personally and professionally through global cultural experience: A grounded theory study

Participation in international educational programs during nurses' and midwives' preregistration education provides an opportunity to experience healthcare in different cultures. Short-term outcomes of participation have been reported; however, little has been published regarding long-term outcomes and theoretical processes for nurses and midwives who participate in such programs. To provide in-depth understandings through a theoretical model of long-term outcomes and impacts for nurses and midwives who participate in international educational programs during their preregistration education. Constructivist grounded theory methodology was employed in this study. Thirteen general nurses, two mental health nurses, three midwives, and four dual-qualified nurse/midwives from eight different countries were interviewed. The substantive theory, "Transforming personally and professionally through global cultural experience," presents an explanation of processes and long-term impacts for those who participated in international programs during their preregistration education.

Service Users' Perspectives on Communicating Compassion in Mental Health Practice.

When people talk about their healthcare experience, compassion is often a common ingredient in the stories they share. After a decade of healthcare reforms and research on compassion, the experience of receiving compassionate care has been shown to be important to patients and their families. Yet, there is little guidance to inform compassionate practice in the context of providing mental health care. In this article, the authors suggest three things that mental health nurses can use in their practice to demonstrate compassion.

Elevating the Role of School Nurses in School-Based Mental and Behavioral Health: A Consensus Document.

School nurses are members of the school-based mental and behavioral health support team. This consensus document was developed by school nurses and school nurse leaders in collaboration with leaders from national associations and organizations with a vested interest in K-12 mental and behavioral health. The document is also publicly available on the National Association of School Nurses website.

Work Environment and Socio-Demographic Factors of Psychiatric Nurses: A Cross-Sectional Study in Hospitals of Eastern Saudi Arabia.

The work environment in healthcare institutions, especially in psychiatric hospitals, plays a crucial role in shaping the experiences and efficacy of nurses' performance. This environment is influenced by various factors such as facility design, resource availability, workplace culture, support systems, and interpersonal dynamics. Understanding the intricate dynamics of the work environment in psychiatric hospitals is essential for ensuring the provision of high-quality mental healthcare services and enhancing the overall quality of life for both patients and healthcare providers, including nurses. However, the work environment of psychiatric nurses in the eastern region of Saudi Arabia is still inadequately understood. Objective: This study aimed to examine the work environment of nurses working in psychiatric hospitals in the eastern region of Saudi Arabia. Method: A cross-sectional research design was employed on a sample of 346 nurses using a non-probability convenience sampling technique. The survey method was adopted with the Practice Environment Scale of the Nursing Work Index (revised, Arabic version). Results: The study found a significant association between psychiatric nurses' work environment and their socio-demographic characteristics. Demographic factors, such as age and years of experience, were identified as influencing factors of nurses' perceptions of their work environment. Younger nurses and those with fewer years of experience reported greater job satisfaction when their work environment was positive. Conclusions: This study underscores the critical importance of maintaining a supportive work environment for psychiatric nurses due to its possible direct influence on their job satisfaction, work performance, quality of life, and overall well-being. Tailoring interventions to address demographic variations in perceptions of the work environment can enhance the well-being of nurses and improve the quality of care provided to psychiatric patients. These findings contribute to the body of knowledge on psychiatric nursing and have clinical implications for healthcare institutions that aim to optimize their work environments and retain a skilled and satisfied nursing workforce.

Forensic Mental Health Nurses' Perceptions and Experiences of Trauma-Informed Care in a High-Secure Hospital.

Implementation of trauma-informed care (TIC) into forensic clinical practice may contribute to positive outcomes for both patients and staff. The current study aimed to describe forensic mental health nurses' perceptions and experiences of using TIC within a high-secure forensic hospital. Twenty-seven forensic mental health nurses were interviewed regarding their experiences of using TIC within a high-secure hospital. Participants recognized the importance of understanding the past traumatic experiences of patients in their care but described a number of barriers to the implementation of TIC. A lack of organizational support, the negative impact of patient psychopathology on nurse well-being, and environmental factors were all perceived to negatively impact the successful delivery of TIC. Participants also discussed a widespread lack of knowledge and confidence in the application of TIC but expressed great desire for training to improve service delivery. The application of TIC into daily clinical practice appears to be suboptimal. To support nurse and patient well-being and contribute to a highly skilled trauma-informed workforce, further training in this area is vital. Training in TIC may contribute to enhanced patient outcomes and promote nurse well-being and should be supported organizationally with sufficient resources.