Mental Health Of Nursing Students Research Articles

Reliability testing of the Health of the Nation Outcome Scales 2018.

The Health of the Nation Outcome Scales (HoNOS) is a widely used clinical measure designed to rate and monitor the outcomes of service users accessing specialist mental healthcare. Since its development (in 1996), numerous research studies have confirmed the HoNOS captures the aspects of care that it purports to (validity), and that clinicians' ratings are consistent both over time, and between different raters (reliability). In 2018, the HoNOS was reviewed with updates made to some terminology and other revisions intended to remove ambiguity in the guidance for raters. However, although the new version (HoNOS 2018) was accompanied by a recommendation that its validity and reliability be re-tested this was not undertaken. To our knowledge, this is the first study to re-assess the updated tool's reliability by measuring the level of agreement between different raters. Our findings confirm that there is an acceptable level of consistency between student mental health nurses that have been trained to use the (new) HoNOS 2018. The HoNOS is nationally mandated for use by all specialist mental healthcare providers in the UK. Our findings provide some assurance that, with appropriate update training and monitoring of organisational-level data sets, the original HoNOS glossary can safely be replaced with the HoNOS 2018 to ensure more contemporary routine outcome measurement can occur. INTRODUCTION: The Health of the Nation Outcome Scales (HoNOS) is a well-established clinician rated outcome measure for use in mental health services. Following an international review, an updated version (HoNOS 2018) was published with a recommendation that its psychometric properties be re-tested prior to widespread implementation. To date, only one such study has been published. To test the inter-rater agreement levels for HoNOS 2018. Third-year student mental health nurses received training to complete the HoNOS 2018. Following this timetabled session, they were each invited to independently rate two, randomly selected, videos of (simulated) patient interviews. The resulting data were then analysed to calculate the tool's internal consistency and inter-rater agreement levels. The 55 participants provided 106 ratings from four vignettes. Cronbach's alphas and McDonalds omegas confirmed the revised tool's internal consistency was acceptable. Average measure intraclass correlation coefficients for the four patient vignettes indicated excellent reliability. This study provides initial assurance that the HoNOS 2018 is a reliable clinician rated outcome measure suitable for use in routine clinical practice by relatively inexperienced mental health practitioners with limited training.

Angel in blue or registered mental health nurse? The impact of the angel and hero narrative on student mental health nurses

This article is a critical reflection on the media portrayal of nursing and its impact on student nurses and prospective students during the COVID-19 pandemic.

Support for culturally and linguistically diverse mental health and learning disability student nurses

This article explores the challenges faced by international mental health and learning disability student nurses studying in the UK and provides guidelines to address some of the issues raised. The definition of an international student is broadened to include culturally and linguistically diverse student nurses who encounter similar dynamics as traditional international students. The article highlights challenges faced by culturally and linguistically diverse students in university and practice settings, such as language proficiency, cultural barriers, limited learning opportunities and inadequate support. The article proposes practical interventions and pedagogical innovations to support culturally and linguistically diverse students in their nursing studies, aiming to enhance their academic success and transition into the nursing workforce.

Addressing the Mental Health of Nursing Students During the Pandemic: The Evaluation of a Needs Assessment by a College of Nursing Mental Health Task Force.

A Mental Health Task Force (MHTF) was developed in a large public college of nursing in the Southeastern United States to address the urgent mental health needs expressed by growing numbers of nursing students related to the coronavirus disease 2019 (COVID-19). The purpose of this study was to report on a needs assessment conducted by the MHTF. The needs assessment study design was a 16-item cross-sectional online survey and four "Town Hall" focus groups with nursing students, faculty, and staff (n = 1-8 participants per group). Survey data were analyzed using descriptive statistics and free-text questions from the survey and focus groups were analyzed using a qualitative descriptive approach. Undergraduate and graduate students (n = 115) ranging in age from 17 to 50 years completed the survey; 95% female, 94% full-time, 56% employed, 77% White, and 81% in the Bachelor of Science in Nursing program. Eleven students participated in the focus groups. The analysis of the free-text survey questions identified the students' perceived needs. Mental health care was the most frequently requested, followed by faculty check-ins, stress management, and peer support. The administration of the survey provided an opportunity for students to communicate concerns and make requests. To address the ongoing effects of the COVID-19 pandemic on nursing students, multi-modal needs assessments should be conducted periodically to identify priority mental health needs.

Development, implementation and evaluation of a process for allocating final placements to nursing students.

This paper reports on the implementation and evaluation of a process developed over two years, intended to aid student nurses to enhance job application writing skills and curriculum vitae development, and to provide an opportunity for students to have a choice in their final practice placement. The study aimed to explore students’ perceptions on the strengths and limitations, explore the perceived impact on application form and CV writing, and gain suggested improvements to the process to increase student experience. A cross-sectional design using online questionnaires (year one and two) and a focus group (year one) gathered quantitative and qualitative data from a volunteer sample of final year adult and mental health student nurses. The majority of participants were happy with the process and with their placement allocation. Three main themes were reported in both years; Choice, Process, and Employability skills/Readiness for employment, with the addition of a fourth in the second year; Fairness. The process allows students to develop skills in applying for jobs which they feel is beneficial for their future. Choice enables students to tailor their final experience to their career aspirations and skill development, ultimately smoothing the transition into their future positions.

What are nurse practice assessors’ priorities when assessing student mental health nurses? A qualitative content analysis

BackgroundUK healthcare policy has observed over a decade of changes that has focussed on healthcare staffs’ professional values as a marker for safe, high-quality care In 2018 the regulatory body for nursing and midwifery introduced several new proficiencies, with an emphasis on physical health assessment. However, a global debate has since surfaced regarding the generification of nurse education, which has been thought to have eroded field specific skills in mental health nursing. AimTo explore the priorities of practice assessors, articulated within the open comments written within online practice assessment documents. MethodsA qualitative study was conducted, with data collected from comments made within online practice assessment documents relating to the ongoing assessment of student mental health nurses at one UK University. 26 individual sets of assessor comments were collected. An inductive content analysis was used to explore the nature of qualitative feedback provided to student mental health nurses, generated by mental health practice assessors. The COREQ checklist was used for the reporting of the study. ResultsFindings demonstrated that practice assessors were prioritising two core areas or broad-based skills categories: ‘transactional’ and ‘transformational’ competencies. Transactional competencies related to the practical application of specific tasks. Transformational competencies were commented on more frequently and placed emphasis on the students’ personal attributes and characteristics, and how these contribute to ‘good’ mental health nursing practice. ConclusionMental health nurses prioritise assessing student nurses in relation to their personal attributes, work ethic, and values that are congruent with humanist perceptions of mental health nursing.

An Examination of Social Support and Mental Health in Nursing Students During COVID-19.

The COVID-19 pandemic limited social interactions and potential social support among residential nursing students. This study used a cross-sectional design to explore students' social living conditions and resources and their correlations with student mental health. Results demonstrated higher than expected levels of anxiety, depression, and loneliness. However, social living situation did not affect mental health. Both parental education and mental health therapy (used as a control) were significantly related to student-reported mental health.

Mental Health of Nursing Students and Associated Factors during the COVID-19 Pandemic: A Cross-sectional Web-based Study

Background: Specific conditions arising from the COVID-19 pandemic may affect the mental health of nursing students. Objectives: This study aimed to investigate the mental health of nursing students and associated factors during the COVID-19 pandemic at Ahvaz and Kermanshah Universities of Medical Sciences in Iran. Methods: This cross-sectional study was conducted on 384 nursing students at Ahvaz and Kermanshah Universities of Medical Sciences in Iran from May 10, 2021, to June 26, 2021. The required data were collected using a web-based questionnaire via social networks, such as WhatsApp and Telegram. Symptom Checklist-25 (SCL-25) was used to measure mental health. Descriptive statistics and stepwise linear regression were used to analyze the data. Results: The mean total mental health score was 47.48±16.03, and 235 (61.0%) students had good mental health, 124 (32.2%) cases had suspected mental disorders, and 26 (6.8%) respondents had severe mental disorders. Using the stepwise regression method, four variables, including gender, history of mental illness, history of coronavirus infection or being suspected of having coronavirus, and level of trust in statistics about the incidence and mortality rate of COVID-19 had the greatest impact on mental health modeling. Conclusion: In general, the COVID-19 pandemic may have a negative impact on the mental health of nursing students. Therefore, it is very important to identify and consider the factors that can reduce their mental distress.

Key stakeholder perspectives on expert-by-experience involvement in the values-based recruitment of student mental health nurses: A co-produced qualitative study

BackgroundValues-based recruitment is a mandatory process for nursing programmes within UK higher education, with the Nursing Midwifery Council expecting that experts-by-experience are engaged in these recruitment and selection processes. The wider involvement of experts-by-experience in healthcare education is gaining momentum internationally with calls for engagement in all aspects of design and delivery; however, the impact of such involvement in recruitment of nursing students has received little attention, particularly in mental health nursing. AimTo understand the impact of expert-by-experience involvement in the values-based recruitment of mental health nursing students from the perspective of candidates, experts-by-experience, and academic staff. Design and methodsThis qualitative approach was co-designed and implemented by a research team comprised of academics, experts-by-experience, and student mental health nurses. Focus groups and an on-line survey were used to collect data, with Burnard's thematic analysis providing a framework for data analysis. Setting/participantsThis study took place at one UK university. Participants included nurse academics, experts-by-experience, and student nurses with experience of a values-based recruitment process. ResultsThematic analysis identified four themes: starting out, collaboration, rich assessment, and stakeholder gains. Whilst not without its challenges, the involvement of experts-by-experience in the recruitment of mental health nursing students was identified as delivering a robust recruitment process, encompassing academic abilities alongside the personal qualities required to make a ‘good nurse’. Personal benefits for experts-by-experience, candidates, and academics were also reported. ConclusionThis study provides insights into the impact of experts-by-experience in supporting values-based recruitment. The approach is identified as enhancing the selection process by drawing from academic and lived experience perspectives and highlights to potential candidates, at the outset of their career, the value of meaningful engagement. These findings support the Nursing Midwifery Council's position that experts-by-experience should be engaged in the recruitment and selection of student nurses.

The Use of 360-Degree Video in Developing Emotional Coping Skills (Reduced Anxiety and Increased Confidence) in Mental Health Nursing Students: A Protocol Paper.

Higher education institutions are uniquely placed to introduce emotional coping skills to promote resilience in pre-registration nurses in order to reduce anxiety and increase confidence before they enter clinical placement for the first time. In this qualitative study, we will explore the use of a 360-degree video in developing skills for coping. The participants will be mental health nursing students. We will develop a 360-degree video in collaboration with a mental health service user. All participants will watch the video. A sub-group will receive a supportive clinical supervision discussion within a cognitive reappraisal/solution-focused/VERA framework. We will record the experiences of the participant to explore: (1) how students felt about the use of 360-degree video, as an education tool to build skills of resilience; (2) whether the students involved felt more confident and less anxious about the situation in the video as a result of participating in the cognitive reappraisal/solution-focused/VERA supervision discussion.

Building Spiritual Care Competency in Undergraduate Psychiatric Mental Health Nursing Students: A Quality Improvement Project.

Purpose: The spiritual care of patients is often overlooked in health care as many nurses are unprepared to provide competent, holistic care that addresses patients' spiritual needs. Since undergraduate academic instruction prepares nurses for practice, innovative strategies that train pre-licensure nurses to care for the spiritual needs of patients are essential. Design: A course needs assessment identified spiritual care as the most deficient competency for undergraduate psychiatric students. A three-phase quality improvement project designed to increase student awareness and practice of spiritual care included (a) development of a quality improvement plan, (b) implementation, and (c) outcome evaluation. Methods: Spiritual care was introduced into the Spring 2020 semester through didactic content and experiential practice. Additionally, an evidence-based spiritual assessment tool (i.e., HOPE questions) was integrated into the course to train students for use in clinical and simulation. Surveys were used to compare the 2019 and 2020 cohorts. Findings: Results showed a statistically significant increase in students' perception of spiritual care competency after project completion. Conclusions: Future implications include the use of similar methods to improve spiritual care competency for pre-licensure nursing students. Keywords: Spiritual care, undergraduate nurse, spiritual assessment.

'It's good to have the knowledge and the confidence': Mental health student nurses' views of a medication workshop.

ABSTRACTThe administration of medication in a safe manner is a key nursing role and nursing regulatory bodies mandate that it is part of undergraduate training. However, it has been noted that qualified nursing staff are dissatisfied with the knowledge demonstrated by students. As such, a 2‐day evidence‐based workshop on medication management for final‐year nursing students was facilitated to address knowledge deficits. Content was delivered by academics and practicing nurses. The aims of this study were to evaluate internship mental health student nurses' experiences of a 2‐day medication management workshop. A qualitative descriptive design was adopted. Three focus group interviews were held with student nurses who partook in the workshop. Data were analysed using reflexive thematic analysis. Three themes were identified: Developing Confidence around Medication Management, Reflections on Learning Gained from the Workshop, and Enhancing Awareness and Vigilance of Medication Errors. Overall, participation in the workshop was identified as having a positive impact on students' knowledge, competence, and confidence in relation to becoming a safe practitioner. Students reported that the timing of the workshop – during internship – was appropriate for their knowledge needs. Findings indicate that the right amount of information was delivered by the right people, at the right time, in the right way. This study has highlighted the positive impact of a 2‐day workshop delivered in the final year of mental health student nurse training, on their confidence and competence in the area of medication management. It provides some insight into how a practical collaborative approach to this type of education between academics and clinicians can help students bridge the theory–practice gap.

Exploring the experiences of student mental health nurses from ethnic minority backgrounds working through the COVID-19 pandemic: a phenomenological approach

Background/aims The COVID-19 pandemic has impacted individuals from ethnic minority backgrounds more than any other group. The purpose of this study was to explore the experience of mental health students from ethnic minorities who worked during the COVID-19 pandemic in a mental health NHS trust. Methods This study used phenomenology as the theoretical framework and thematic analysis as a method for data analysis. Data were collected through semi-structured interviews with 12 student mental health nurses, which were held via Microsoft Teams. Results The four themes that emerged from this study were altruism, a sense of connectedness, support and learning opportunities, and role clarity. Students described a sense of altruism while deciding to opt-in to the extended placement. Some also found their faith to be a source of support and resilience, which provided a sense of connectedness. Support was an essential element that emerged in this study where students could rely on both the university and the mental health NHS trust. The learning opportunities that COVID-19 has presented have helped bridge the gap between the physical and mental wellbeing of patients; however, a lack of clarity in their roles was highlighted. Conclusions Adequate and appropriate policies and guidance to support student nurses are needed when working in crisis situations.

Standing out on the Margins: Using Dialogical Narrative Analysis to Explore Mental Health Student Nurse Identity Construction and Core Modules

Literature and experience suggest that student mental health nurses feel marginalised in core modules. A focus group was held to explore mental health nurse students’ experiences of whole cohort core modules in nursing. Students from a university in the North of England attended a one hour focus group followed by dialogical narrative analysis of transcripts. Stories of shared professional identity, marginal status, critical thinking, and practical application of theory were shared by the group. Greater presence of mental health stakeholders earlier in the programme and more applied field specific teaching offer a means to bolster professional identity in mental health nursing students.

Investigating Effects of COVID-19 Pandemic on the Mental Health of Nursing Students During Remote Learning: An Experience from Dong A University, Vietnam

There was a radically changed in nursing education during the nationwide lockdown due to the COVID-19 outbreaks. The transition to remote learning stressed nursing students in many countries, particularly in Vietnam. However, there is still lacking a novel study to describe the mental characteristics of nursing students in detail. To assess the mental health of nursing students, including stress, anxiety, and depression, and to identify the related factors to their mental health during the online study period because of the COVID-19 pandemic. A cross-sectional survey was conducted on 540 nursing students at Dong A university using a socio-demographic questionnaire, the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21). Data were analyzed by descriptive statistics and tests, including Mann-Whitney, Kruskal-Wallis, and Spearman's correlation to identify the related factors. In total 540 participants, nursing students reported stress (N = 120, 22.2%), anxiety (n = 195, 36.1%), and depression symptoms (n = 135, 23.1%). There was a significant relationship between age, work status, married status, number of children, stress, anxiety, and depression (P < 0.01). In addition, our study showed a negative correlation between frequency of physical activity, perceived health and stress (r = -0.117; p < 0.01, r = -0.127, p < 0.01), anxiety (r = -0.133; p < 0.01, r = -0.112, p < 0.01), depression (r = -0.134; p < 0.01, r = -0.135, p < 0.01). A significant relationship was observed between e-learning space and Internet status with mental health (p < 0.05). Especially, there was no association between average online learning time, academic workload, stress, anxiety, and depression (p > 0.05). However, the authors found a positive association between perceived level of stress related to evaluative activities and stress, anxiety, depression (r = 0.120, p < 0.01; r = 0.089, p < 0.05; r = 0.088, p < 0.05). Nursing students suffered stress, anxiety, and depression during online learning due to the COVID-19 pandemic in the presence of some related factors. Therefore, this study may increase more attention of universities, families, and governments to reduce the stress of nursing students during distance education.

Sexuality, student mental health nurse and lecturer experience in education and practice

This article presents a critical reflection on an experience relating to sexuality from two perspectives, a mental health nursing student and a lecturer. It took place during stage 1 of a graduate entry nursing 2-year Master of Science mental health nursing programme at a UK university. Student mental health nurses in higher education who identify as lesbian, gay, bisexual or transgender can feel less safe than others, which affects performance. Lecturers can make a difference to the educational experience of student nurses who are lesbian, gay, bisexual or transgender and this can have an impact on clinical practice. The emotional impact of ‘coming out’ in the classroom can have far-reaching consequences for their mental health. The response of educational staff can have a huge impact on the ability to learn and the marks achieved. Student–lecturer relationships can have transformative consequences. Student mental health nurses make meaning from their educational experiences in the classroom and clinical practice. If they do not see themselves represented, this can affect engagement and motivation. Safe nursing practice is role modelled from lecturer to student and has implications for service user experience in clinical settings.

Decider Life Skills training as a method of promoting resilience with mental health student nurses on clinical placement

AimThe aim of this study is to explore mental health student nurses’ perceptions and application of a CBT-orientated training programme – the Decider Life Skills programme. BackgroundThe undergraduate nursing degree programme is a challenging one and places high demands both professionally and personally on students. Mental health nursing students are faced with particular stressors including working with people in significant psychological distress, which can result in students feeling overwhelmed and emotionally burdened. There is a requirement for student nurses to be supported to cope with professional and personal difficulties while on practice placement. The Decider Life Skills is a one-day training programme that aims to build resilience and increase effective coping skills. This programme was offered to internship mental health nursing students with the aim of providing them with a toolbox of skills to maintain their wellbeing while on clinical placement. MethodsA qualitative descriptive design was used, and data were collected through two 45-min focus group interviews with mental health students (n = 10) on their internship placement. These students had received a one-day training in Decider Life Skills prior to their clinical placements. Full ethical approval was achieved for this study. ResultsParticipants reported that they found the skills imparted in the training easy to understand and apply in both their professional and their personal lives. ConclusionsThe findings from this study that the Decider Life Skills helped students cope in stressful situations and become more mindful of protecting their own mental health is important, as there is a need to safeguard the emotional well-being of mental health nursing students and support them to become resilient practitioners.

Achieving culturally competent mental health care: A mixed-methods study drawing on the perspectives of UK nursing students.

This study aimed to examine the degree of cross-cultural competency among UK mental health student nurses, and the care delivery challenges arising from their internalized cultural assumptions. This study adopted a mixed-methods design. Participants were final-year nursing students in the United Kingdom. The results revealed participants had a moderate level of cultural awareness and competency but highlighted many challenges to providing cross-cultural care arising from the meanings, enablers, and values they attributed to culturally competent mental health care. As cultural competency is considered an essential characteristic of effective nursing care, greater attention should be paid to how student nurses assimilate cultural awareness to develop confidence in their day-to-day practice.

Undergraduate mental health nursing students’ reflections in gaining understanding and skills in the critical appraisal of research papers – An exploration of barriers and enablers

AimTo explore a cohort of mental health nurses’ views and experiences in developing and applying critical appraisal of research skills to identify helping and hindering factors. BackgroundIn accordance with evidence-based practice principles, there is an expectation that student (mental health) nurses will become competent in understanding research to make judgements about its trustworthiness and applicability in the clinical setting. This process is termed the ‘critical appraisal of research’ and it is deemed important to healthcare professionals because it facilitates the use of evidence from research to underpin practice. DesignThe study incorporated qualitative secondary research using thematic analysis and a poststructural lens. MethodsFollowing undertaking a module including tuition on the critical appraisal of research, a cohort of student mental health nurses’ submitted essay reflections focusing on critical appraisal experiences were thematically analysed. The thematic analysis included both deductive and inductive components in adjunct to a poststructuralist analysis to explore influencing factors of language, meaning and subjectivity. ResultsThe study identified there are both pedagogical factors and wider societal considerations influencing the critical appraisal of research experiences. Psychological and emotional factors, incorporating anxiety components were identified as a key barrier to engagement and understanding which has not previously been identified in comparable research. Enablers to the understanding and application of critical appraisal skills were identified as peer learning, accessing academic supervision, gaining a satisfaction of personal learning and self-directed learning with library skills support. ConclusionsThe findings indicate that there are specific pedagogic considerations which can be applied when supporting mental health student nurses in developing and gaining skills in the critical appraisal of research. It is recommended that these are applied universally for nursing students and considered for other populations of healthcare students.

Student mental health nurses’ understanding of recovery: A phenomenographic study

AimTo explore the variation in mental health nursing students’ understanding of recovery. BackgroundIn mental health practice clinical understanding of recovery has been challenged with a new understanding based on the individualised experiences of the person, often referred to as personal recovery. Despite international policy endorsement, practice has been slow to embrace the principles of personal recovery and little is known about student nurses’ understanding of the concept. DesignQualitative phenomenographic study MethodIn-depth semi-structured interviews including discussion of a clinical scenario, were conducted with 13 pre-registration student nurses. Data was analysed iteratively using a seven stage phenomenographic framework, identifying categories of description and the outcome space. ResultsAnalysis revealed a branched outcome space with four qualitatively distinct ways of understanding recovery. Branch one can be broadly aligned to clinical recovery and contains one category only, ‘Recovery as Clinical Improvement’. It is distinctly different from branch two which contains three categories on a continuum, which represent more and less complete ways of understanding personal recovery: ‘Recovery as Making Progress’, ‘Recovery as Managing to Live Well’ and ‘Recovery as Learning to Live Differently’. Most participants demonstrated understanding in the less sophisticated categories. ConclusionRecovery is central to mental health nursing, yet this study suggests it is a problematic concept for students. Features of personal recovery can be found in the second branch of the outcome space, with the most sophisticated category ‘Learning to Live Differently’ best representing the principles of recovery espoused in nursing literature and international policy. Phenomenography has allowed a more complex picture to emerge, replacing the dichotomy between clinical and personal recovery and enabling a differentiation between more and less complete ways of understanding personal recovery. This study addresses the lack of attention given to student nurse experiences of recovery. The insights support educators, both in clinical and academic settings, to address personal recovery in more explicit way where partial understanding can be explored.