Nursing Health Services Research Articles

Psychosocial Correlates of Internalized Stigma Among Chinese Individuals With Severe Mental Illness.

The current study aimed to examine internalized stigma and its psychosocial factors among people with severe mental illness in China. A cross-sectional study was performed with 202 adults diagnosed with schizophrenia, bipolar disorder, or schizoaffective disorder in Beijing, China. Participants were evaluated using the Chinese version of the Internalized Stigma of Mental Illness (ISMI) scale, Perceived Devaluation and Discrimination scale, and the Medical Outcomes Study Social Support Survey. Correlation analysis and multiple linear regression analysis demonstrated that 19.8% of participants had moderate-to-high ISMI scores, whereas the sample as a whole indicated a mild level of internalized stigma. A higher level of internalized stigma was associated with greater perceived discrimination, lower social support, lower family income, older age, and distancing coping. These factors may be important to consider for developing tailored interventions in the future. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 37-44.].

Evidence-Based Practice Among Psychiatric Nurses: Knowledge, Attitudes, Organizational Readiness, Levels of Implementation, and Barriers and Facilitators.

The current study examined psychiatric nurses' views, knowledge, attitudes, organizational readiness, levels of evidence-based practice (EBP), as well as barriers and facilitators to EBP in a Nigerian tertiary neuropsychiatric hospital. This study used a cross-sectional descriptive research approach. Structured questionnaires were administered to all psychiatric nurses (N = 131) at the hospital. Results showed that psychiatric nurses had an acceptable degree of EBP knowledge and a positive attitude toward EBP. Levels of EBP implementation were below average, and organizational culture and preparation for EBP were moderate. Participants reported a moderate degree of barriers to EBP adoption (mean = 40.08, SD = 9.63), and a high level of assertion to positive facilitators of EBP (mean = 19.88, SD = 4.16). Findings show that although most psychiatric nurses had adequate knowledge and good attitudes toward EBP, certain barriers prevented its application. Thus, there is a need for a policy framework to mitigate existing barriers and improve EBP facilitators in psychiatric nursing practices in Nigeria to improve productivity measures. [Journal of Psychosocial Nursing and Mental Health Services, 61(9), 47-55.].

Adverse Childhood Experiences and Depression: The Mediating Role of Resilience and Emotional Regulation.

The current study examined the mediating roles of resilience and emotional regulation in the association between childhood trauma and depressive symptoms among individuals who experienced adverse childhood experiences (ACEs). Data from 200 women aged 17 to 77 years who were psychiatric outpatients were collected using self-reported questionnaires assessing child adversity, depressive symptoms, resilience, and emotional regulation. A positive correlation was found between a subscale of the ACE-IQ and depression. Childhood trauma was associated with higher risk of depressive symptoms among participants with lower resilience (an association that was partly explained by resilience level [mediation]). Emotional regulation was not a significant mediator in the childhood trauma-depression association. Our findings indicate that resilience is a key mediator between childhood trauma and depression. Individuals who experienced childhood trauma may benefit from evidence-based interventions focused on strengthening resilience and improving coping strategies. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 45-54.].

Evaluation of Renal Functions of Inpatients With Mental Disorders.

The current study aimed to investigate the renal functions of inpatients with mental disorders. Data for this retrospective and descriptive study were collected from January 2021 to April 2021 from the records of patients who were hospitalized in the psychiatry clinic of a training and research hospital between 2018 and 2020. The study sample comprised hospital records of 376 patients. A significant negative relationship was determined between patients' glomerular filtration rate (GFR) and glucose level, duration of mental disorder, number of hospitalizations, and duration of medication use (p < 0.05). According to the analysis of patients' renal functions, mean GFR was statistically significantly lower in women with physical chronic diseases and diagnosed with personality disorders. Psychiatric-mental health nurses should evaluate and monitor renal functions of individuals with mental disorders and take precautions before kidney diseases develop. [Journal of Psychosocial Nursing and Mental Health Services, 62(2), 47-55.].

Treatment in Children and Adolescents With Obsessive-Compulsive Disorder: Review for Practitioners.

Obsessive-compulsive disorder (OCD) is one of the most debilitating mental health conditions, interrupting functioning at school and social well-being in children and adolescents. Youth tend to delay interventions and when sought, response to treatment might not be optimal. The current article discusses treatment guidelines for youth with OCD and pediatric autoimmune neuropsychiatric symptoms. [Journal of Psychosocial Nursing and Mental Health Services, 61(8), 11-15.].

Assessment of a Unit-Level Acuity Tool in Inpatient Psychiatry.

Assessing acuity is deemed essential to staffing in intensive care nursing; however, it has not received sufficient attention in inpatient psychiatry, where acuity can fluctuate greatly within shifts. Staffing and admission decisions rely on the accuracy of this information. The current mixed methods study surveyed nurses from two hospitals within the same hospital system: one using an acuity tool and one naïve to acuity tools. The survey was followed by a focus group on the specific factors influencing acuity and nurses' assessment of needs. Results suggest that the current tool is not satisfactory for nurses who use it to help with staffing or admission decisions and it is not user-friendly. Most nurses from both hospitals indicated they would prefer an electronic version with automated features reflecting up-to-date patient and unit acuity that would assist in interprofessional collaborative admissions decisions and staffing. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 13-18.].

Creating Space for Adolescents and Families With Lived Experience of Homelessness to Build Familial Empathy, Communication, and Emotional Regulation: A Qualitative Study of Facilitators of Implementation.

Youth experiencing homelessness are vulnerable to commercial sexual exploitation (CSE). Structural racism disproportionately entraps marginalized youth into CSE while simultaneously obscuring their identification as victims. Adaptation and tailoring of effective interventions to mitigate associated sequelae and inequities is warranted. Support To Reunite, Involve, and Value Each Other (STRIVE) is a strengths-based dyadic intervention with demonstrated efficacy in reducing delinquency, substance use, and high-risk sexual behaviors among marginalized adolescents experiencing homelessness. The adapted STRIVE+ was piloted to explore potential for reducing youth risk factors for CSE. The current article reports findings from interviews exploring participants' experiences with STRIVE+. Youth and caregivers reported increased empathy, communication, and emotional regulation post-STRIVE+ and found relevance and meaning through participating in the adapted intervention. Feasibility of recruitment, engagement, and retention of minoritized adolescents and their caregivers were also demonstrated. Findings warrant larger scale implementation trials of STRIVE+ among minoritized youth at highest risk for CSE. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 27-35.].

Factors Influencing Professional Identity of Psychiatric Nurses as Second Victims: A Cross-Sectional Study.

The current study aimed to explore the status and influencing factors of professional identity among psychiatric nurses as second victims in China by using a cross-sectional design. We investigated 291 psychiatric nurses from two psychiatric hospitals. Participants were asked to complete a demographic questionnaire, Second Victim Experience and Support Scale, Multidimensional Health Locus of Control Scale, and Professional Identity Scale for Nurses. Scores of professional identity of psychiatric nurses as second victims were moderate. Regression analysis showed that the second victim experience and support and internal control were significant predictors, explaining 34.2% of the variance in professional identity. Identifying risk factors related to the professional identity of psychiatric nurses as second victims will help managers take timely preventive measures to improve the awareness of the self-health responsibility of psychiatric nurses and reduce the adverse effects of patient safety incidents to enhance their professional identity. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 47-54.].

Telephone-Based Cognitive-Behavioral Therapy for Depression in Family Caregivers of Persons Living With Dementia: A Feasibility Study.

The current study aimed to examine the usefulness of a telephone-based cognitive-behavioral therapy program for depression in 11 family caregivers of persons living with dementia. Data were collected and analyzed before (Session 1), after (Session 6), and at 3-month follow up using the Zarit Caregiver Burden Interview, General Self-Efficacy Scale, Rosenberg Self-Esteem Scale, and Self-Rating Depression Scale. Depression scores decreased significantly (p < 0.05) from Session 1 to Session 6. Results suggest that the program should address Proactivity of Action, a sub-item of self-efficacy, to reduce depression. In addition, the program enabled caregivers to reduce negative perceptions of their caregiving duty, which may lead to positive thinking and proactive behavior. Despite these findings, the program must be modified and research must continue, as this was a feasibility study with an intervention group only. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 37-45.].

Neuroscience-Based Nomenclature for Psychotropic Medication.

Neuroscience-based nomenclature (NbN) is a classification system for psychotropic medications based on pharmacology and mode of action. Rather than the current naming system, which is primarily based on a single indication or its chemical structure, NbN uses current scientific knowledge that provides a pharmacological rationale for medication choice. NbN limits confusion, especially when prescribing to children, as the medications are named and described in a way that is not stigmatizing or misleading. [Journal of Psychosocial Nursing and Mental Health Services, 61(7), 9-13.].

Substance Use Disorders in Older Adults.

Although substance misuse (primarily alcohol and prescribed benzodiazepines and opioids) among Americans aged ≥60 years is becoming an escalating health concern, substance use disorder (SUD) is often underestimated and/or undiagnosed, preventing older adults from receiving needed treatment. Chronic medical conditions, mental health issues, and psychosocial stressors increase older adults' risks for developing SUD. Racial/ethnic minority groups (e.g., American Indian, Alaska Native) experiencing health care inequities and limited resources are more vulnerable to developing SUD. It is recommended that SUD screening be included in annual check-ups using tools adapted to older adults. Clinicians should consider older adults' comorbidities to differentiate symptoms of substance use from neurocognitive disorders, depression, anxiety, and metabolic disorders. To ensure successful outcomes, interventions must be tailored to the specific needs of older adults. Building on the current federal government administration's support, SUD practice guidelines should be updated with older adults in mind. [Journal of Psychosocial Nursing and Mental Health Services, 61(7), 15-19.].

Strengthening School Nursing Through State-Level Infrastructure Supports.

State-level school nursing infrastructure supports are essential for building equitable, evidence-based, quality school nursing services. Two recently published instruments, the State School Health Infrastructure Measure (SSHIM) and the Health Services Assessment Tool for Schools (HATS), provide opportunities to assess the extent of state-level infrastructure supports for school nursing and school health services. These instruments can be useful for planning and prioritizing to address needs to improve system-level quality and equity in school health services for the preK-12 population in each state.

The effect of work setting and demographic factors on caring behaviour among nurses in the public hospitals and public health services, Sabah, Malaysia

BackgroundThe nursing profession's uniqueness contributes to the development of knowledge, experience, age, education, economy, and position, as well as a unique gender role. Thus, the development and advancement of demographic characteristics of nurses while in this profession influences their caring behavior.ObjectiveThe purpose of this study was to determine the effect of work setting and demographic factors on nurses' caring behaviour, as well as the differences in nurses' caring behaviour based on demographic factors between nurses in public hospitals and nurses in public health services in Sabah, Malaysia.MethodsThis research is a cross-sectional study using the survey method. Data were collected from 3,532 nurses (88.3% response rate) in public hospitals and public health services within Sabah, Malaysia. Data were analysed using two-way ANOVA.ResultsThe two-way ANOVA test revealed no significant impact of the work setting on CB, nor was there a notable interaction between the work setting and demographic factors influencing nurses’ CB. However, demographic factors such as gender, age, education, economic status, position, and experience had a significant effect on CB.ConclusionThe present research has provided convergent evidence on the effect of demographic factors on nurses caring behavior and the differences in caring behavior based on demographic factors among nurses in public hospitals and public health services in Sabah, Malaysia.

Peer Activate: A Feasibility Trial of a Peer-Delivered Intervention to Decrease Disparities in Substance Use, Depression, and Linkage to Substance Use Treatment.

Although effective evidence-based interventions (EBIs) exist, racial/ethnic minority individuals with lower income are less likely to have access to these interventions and may experience greater stigma in the health care system, resulting in disproportionate rates of morbidity and mortality. Peer recovery specialists (PRSs) may be uniquely suited to address barriers faced by those from impoverished areas; however, peers have not traditionally been trained in implementing EBIs. The current open-label trial (N = 8) was performed to evaluate implementation and preliminary effectiveness of an adapted EBI supporting recovery, linkage to treatment, and reduced depression. Results suggest the intervention was feasible, acceptable, and appropriate for linking individuals from a community setting to substance use treatment and could be delivered with fidelity by a peer interventionist. Participants who completed the intervention demonstrated clinically reliable decreases in substance use and depressive symptoms. Findings provide initial support for PRS dissemination of EBIs to increase linkage to care and support recovery in traditionally underserved populations. [Journal of Psychosocial Nursing and Mental Health Services, 61(11), 23-31.].

Infection Anxiety and Coping Strategies Among Individuals With Schizophrenia During the COVID-19 Pandemic: Mediating Effects of Protection Motivation.

The current study determined the mediating effects of protection motivation factors (PMFs) on the relationship between infection anxiety and coping strategies among individuals with schizophrenia during the coronavirus disease 2019 (COVID-19) pandemic. Data were collected using a questionnaire administered to 139 individuals with schizophrenia between September and October 2021. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and multiple regression analyses based on the Baron and Kenny criteria. Problem-based coping (PBC) was positively correlated with perceived vulnerability (r = 0.385, p < 0.001) and self-efficacy (r = 0.321, p < 0.001) among the PMFs and with infection anxiety (r = 0.517, p < 0.001); perceived self-efficacy (β = 0.23 p = 0.002) had a partial mediating effect (Z = 1.99, p = 0.047) on the relationship between infection anxiety and PBC, confirming the importance of perceived self-efficacy among individuals with schizophrenia in developing positive coping strategies during the COVID-19 pandemic. Therefore, developing measures that promote perceived self-efficacy and build accurate situational awareness are essential to strengthen such patients' coping strategies during a pandemic. [Journal of Psychosocial Nursing and Mental Health Services, 61(11), 43-51.].

Individual Nurse-Led Active Listening Intervention for Spouses of Individuals With Depression: A Pre-/Posttest Pilot Study.

The current pre-/posttest pilot study investigated the impact of an individual nurse-led active listening intervention for spouses of individuals with depression (herein referred to as patients) on spouses' psychological states and patients' depressive symptoms. Sixteen couples participated in the study. Individual sessions were conducted over 10 weeks to help spouses express their thoughts and feelings. Psychological measurement scale scores did not change markedly postintervention for spouses; however, their subjective evaluations of the intervention were positive. In the qualitative analysis, spouses stated that they were able to express their thoughts and feelings and that the sessions were meaningful. Moreover, postintervention depressive scores of patients improved significantly. Findings suggest that the nurse-led intervention of active listening for spouses may provide a better environment for improving the depressive symptoms of patients. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 19-25.].

Factors Associated With Psychological Distress of Individuals With COVID-19 Isolating at Home: A Cross-Sectional Correlational Study.

The purpose of the current study was to clarify the effects of illness perceptions, coping styles, and social support on psychological distress of individuals with coronavirus disease 2019 (COVID-19) isolating at home. A cross-sectional study was performed in a state hospital in Turkey with 112 individuals with confirmed cases of COVID-19. Data were collected online using self-report scales between June 8, 2020, and December 25, 2020. Regression models were used to determine predictors of psychological distress. Significant predictors were cognitive and emotional illness representations, self-blame, and positive reinterpretation coping methods. Health care providers should consider individuals' illness perceptions and coping methods and their effect on psychological distress when providing in-home and follow-up care. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 27-36.].

Biopsychosocial Factors of Depression Among Hispanic Women Aged ≥50 Years.

The purpose of the current study was to identify biopsychosocial factors associated with depressive symptoms among Hispanic women aged ≥50 years. Cross-sectional data related to 10 biological, psychological, and social factors were analyzed. Center for Epidemiologic Studies Depression Scale scores suggested that 32% of the sample had depressive symptoms. Self-esteem, self-perception of health status, income, and chronic pain had statistically significant associations with depressive symptoms. A logistic regression analysis showed that increasing self-esteem scores were associated with decreases in the likelihood of having depressive symptoms. Findings underscore that depression is associated with biological, psychological, and social factors. Culturally tailored interventions that aim at targeting these factors may have an impact on Hispanic women's depression and overall well-being. [Journal of Psychosocial Nursing and Mental Health Services, 61(11), 32-42.].

Opioid Literacy Among Individuals Living in Rural Alabama: The Role of Social Determinants of Health.

Using the social determinants of health (SDOH) framework, the current study aimed to examine opioid literacy and the role of SDOH on opioid literacy. This study used a cross-sectional survey design to collect self-reported data from people living in four rural Alabama counties affected by the opioid crisis. Participants reported moderate levels of opioid knowledge. There were no significant predictors of general knowledge. For opioid overdose knowledge, the strongest individual predictors were educational level (Bachelor's degree) and self-rated financial strain, which contributed to higher scale scores. For the models evaluating opioid overdose response knowledge, the strongest individual predictors were minority status (inverse), self-rated mental health, and interpersonal safety. Our findings indicate that SDOH, such as financial strain and interpersonal safety, are significantly linked to opioid literacy. Educational efforts to enhance opioid literacy, proper usage, and management in rural counties should consider SDOH factors. Findings further outline the team's integrative approach to developing intervention strategies for opioid treatment and recovery that can benefit the northwest Alabama community and beyond. [Journal of Psychosocial Nursing and Mental Health Services, 61(10), 52-59.].

Reducing Drug Overdose Deaths: Significant Changes Needed in U.S. Drug Treatment Policy.

Slow and incremental changes in federal and state drug policies are neither meeting treatment needs nor reversing yearly increases in drug-related mortality. U.S. drug policies convey confounding messages that non-sanctioned substance use leads to health problems that need treatment while simultaneously being legal problems that must be punished. As a result, drug treatments remain a sequestered component of health care, with onerous treatment requirements for patients and providers that act as barriers to the treatment that policies seek to allow. A new direction in drug policy is needed that broadens rather than restricts access to care and that also focuses on prevention. Policies must consider the totality of health and wellness, not just "last resort" safety nets for urgent needs. For substantive change in drug-related morbidity and mortality, forward-thinking policy must focus more on addiction prevention and address the known risks of developing a substance use disorder. [Journal of Psychosocial Nursing and Mental Health Services, 61(6), 7-10.].