Psychiatric Nursing Practice Research Articles

Influence of Clinical Nursing Competency and Nursing Working Environment of Psychiatric Nurses on Person-Centered Care

Purpose: The purpose of this study was to determine effects of clinical competency and working environment of psychiatric nurses on person-centered care.Methods: This study was conducted in five hospitals located in Daegu city and Gyeongsang-do of South Korea. Participants were 153 psychiatric nurses who had experienced psychiatric nursing practice for at least 12 months. Data were collected from November 15, 2023 to December 31, 2023 using a structured questionnaire. Collected data were analyzed through multiple regression analysis using the SPSS 21.0 program.Results: Participants had a person-centered care score of 3.93 out of 5, a clinical competence score of 3.58 out of 5, and a working condition score of 3.08 out of 4. Regression analysis showed that clinical competence (β=.47, <i>p</i><.001) and working conditions (β=.38, <i>p</i><.001) were factors affecting person-centered care, with an explanatory power for person-centered care of 49.8% (F=36.42, <i>p</i><.001).Conclusion: To enhance person-centered nursing competency of psychiatric nurses, it is essential to enhancing their working conditions and improving their clinical competence.

The resilience mediation effect on the relationship of suicide risk and psychological pain in nursing students: Structural equation modelling.

INTRODUCTION: Nursing students are a high-risk group for suicide. Psychiatric nurses should investigate risk factors for suicide. The aim of this study was to examine the resilience mediation effect in the relationship of suicide risk and psychological pain in nursing students. This cross-sectional study was conducted between March and May 2021 with 619 students in the Akdeniz University Faculty of Nursing. A Descriptive Information Form, the Suicide Probability Scale, the Psychache Scale and the Brief Resilience Scale were used to collect data. The structural equation model approach was used to examine the resilience mediating effect on the relation between suicide risk and psychological pain, and Path Analysis was performed. The reporting of the study was conducted according to STROBE. A semi-mediatory effect of resilience was found between psychological pain and the risk of suicide, and the effect size was determined to be broad (0.57). Resilience can be considered as a protective factor for suicide prevention in psychiatric nursing practices. Resilience has an effect on the relationship between psychological pain and suicide risk. The results of this study may guide psychiatric nursing practices in reducing and preventing suicide risk.

Knowledge and Practice of Psychiatric Nurses toward Side Effects of Clozapine Drug on Co-morbid Psychiatric Patients

Knowledge and Practice of Psychiatric Nurses toward Side Effects of Clozapine Drug on Co-morbid Psychiatric Patients

Looking Back to Advance Equity in Psychiatric Nursing: Strategies for the Classroom and for Practice.

With deep historical roots in psychiatry, structural racism persists in psychiatric nursing today. Psychiatric nurses may hold implicit biases and stereotypical beliefs that influence how they perceive, assess, and interact with people from different racial backgrounds, leading to discrimination, poor treatment, and misdiagnosis. To eliminate discrimination in clinical care and diversify the workforce, there is an urgent need to integrate teaching and learning strategies that address influences of racism and racial identity in psychiatric nursing education. This article explores the historical context and proposes antiracist psychiatric nursing teaching and practice interventions to reduce the harms of racism.

The effect of the “Femininity Identity Improvement Program” based on cognitive behavioral and expressive techniques applied to gynecological cancer patients on prolonged grief reactions: Study protocol for randomized controlled trial

The research was designed to determine the impact of the Femininity Identity Improvement Program based on cognitive-behavioral and expressive techniques applied to gynecological cancer patients on their prolonged grief responses. The research is the study protocol created for a randomized controlled experimental study. The research protocol prepared in accordance with SPIRIT 2013 was registered in the Clinical Trials system (XXXX). The research was conducted with 80 patients (40 patients in the intervention group and 40 patients in the control group) who underwent surgery in the gynecology and obstetrics clinic of a university hospital within the last year. Among these patients, those who had a surgery at least three months ago were included in the study. The intervention group participated in the Femininity Identity Improvement Program for 10 weeks, with sessions once a week, each lasting 90-120 minutes. The control group received no intervention. Measurements were taken before the program (pretest), at the end of the program (posttest at the 10th week), and three months after the program (follow-up measurement) to determine the effect of the program. Data were collected using the Prolonged Grief Disorder Scale-Patient Form. The Analysis of Covariance (ANCOVA) was used to analyze the data obtained at different times. The study integrates two psychotherapeutic interventions (cognitive-behavioral theory and art therapy) in an innovative way to structure the Femininity Identity Improvement Program for psychiatric nursing practice. Psychiatric nurses in oncology and other relevant clinical settings are recommended to apply this program to provide comprehensive care using current approaches.

Emotional Intelligence and Clinical Performance in Psychiatric Nursing Students

Emotional Intelligence (EI) has gained considerable attention in nursing due to its positive effects on nurses' well-being and its beneficial impact on patients and families. Emotional intelligence involves understanding and managing one's own emotions and the emotions of others, which is crucial for nurses who build relationships with patients, families, and healthcare team members. Despite the recognised importance of emotional intelligence, non-academic factors like emotional intelligence are rarely considered in nursing program admissions, with GPA being the primary indicator of academic performance. Given the limited studies on emotional intelligence and academic performance in the Philippines, this study aimed to determine the relationship between nursing students' emotional intelligence and their psychiatric nursing clinical practice performance. This study employed a descriptive correlational design and included a substantial sample of 173 fourth-year nursing students who completed their psychiatric nursing clinical practice and were enrolled in the academic year 2017. Total population sampling was utilised, ensuring a comprehensive representation of the student population. The Pearson product-moment correlation coefficient (Pearson-r) was used to determine the correlation between emotional intelligence and clinical performance. The results, based on these methods, indicated that all respondents had moderate to high levels of emotional intelligence. Nearly half of the respondents achieved a satisfactory grade, with the majority having average to satisfactory performance. Female respondents had slightly higher grades than male respondents, and there was a significant difference in performance based on the respondents' school but not their age. Importantly, there was no significant correlation between emotional intelligence and clinical performance in psychiatric nursing, a finding that was consistent with the literature. This insight is valuable for educators and curriculum developers, as it underscores the need to consider a broader range of factors beyond academic performance in nursing education. It also highlights the importance of providing support and resources to enhance students' emotional intelligence skills. Further research is recommended to explore the role of emotional intelligence in nursing education and consider additional factors that may influence academic and clinical performance.

The psychiatric nursing care quality questionnaire (PNCQQ)

Introduction: In response to the growing recognition of the importance of the quality care in psychiatric nursing, this study introduces the Psychiatric Nursing Care Quality Questionnaire (PNCQQ) designed to evaluate the quality of care provided to psychiatric patients from diverse cultural backgrounds. Aim: The aim of this research was to develop and validate a comprehensive tool that addresses the unique needs and perceptions of patients across various cultural contexts. Materials and Methods: The development of the PNCQQ involved a rigorous methodology encompassing item generation, expert review, and pilot testing to ensure its relevance and cultural appropriateness. Subsequently, a validation study was conducted with a diverse sample of psychiatric patients to assess the reliability, validity, and cultural sensitivity of the questionnaire. Results: A total of 932 psychiatric patients completed the Psychiatric Nursing Care Quality Questionnaire (PNCQQ) as part of the study. The sample consisted of 57.3% female and 42.7% male participants. The age of participants ranged from 18 to 75 years, with a mean age of 37.8 years. Results indicate robust psychometric properties, including high internal consistency and test-retest reliability, supporting the utility of the PNCQQ in assessing nursing care quality across diverse cultural populations. Conclusions: The implications of this research underscore the importance of culturally competent care in psychiatric nursing practice and highlight the value of utilizing validated instruments to enhance care delivery.

WITHDRAWN: “The closest touch to death in psychiatric nursing practice”: Experiences of nursing students in a psycho-oncology unit

ObjectiveCaring for a person with a cancer diagnosis is challenging, especially for nursing students at the beginning of their professional careers. Although there has been previous research on the experiences of students in oncology units, there have been none to date on their experiences in a psycho-oncology unit. In this qualitative study, we evaluated the experiences of nursing students practicing in a psycho-oncology unit. MethodsThis qualitative descriptive study was conducted with nursing students who practiced in the psycho-oncology unit of a comprehensive oncology hospital in Turkey. ResultsA total of 23 nursing students, 15 females, and 8 males, with a mean age of 22.73 years, described their practical experience in the Psycho-Oncology Unit of a comprehensive cancer hospital. A content analysis of the student narratives identified three main themes: gains, emotional dissonance, and challenges. The students stated that working with a person who is close to death is a very challenging experience, but it has many professional gains. ConclusionsWhen student statements are evaluated, practice in a psycho-oncology unit is considered a valuable contribution to learning. However, the results of this study suggest that bachelor's degree nursing students require more education and mentoring on cancer care. We recommend that students gain more education and experience in fields such as psycho-oncology and consultation-liaison psychiatry earlier in their education. More research is needed into the experiences of student nurses practicing in psycho-oncology units.

Positioning virtual reality as means of clinical experience in mental health nursing education: A quasi-experimental study

PurposeVirtual reality technology has been used to establish a risk-free environment in which students can practice psychiatric nursing. A quasi-experimental study was conducted to examine the effects of a virtual reality (VR) based mental health nursing simulation on practice performance of undergraduate nursing students. MethodsA quasi-experimental, pre- and post-test design was used. A total of 68 students were randomly assigned to an experimental group (n = 32) and a control group (n = 36). The control group received conventional simulation using text scenario-based role play. The intervention group received VR software consisting of 360° video clips and related quiz questions. ResultsThe self-reported perceived competency in nursing performance showed no statistically significant improvement in the experimental group, whereas the control group showed a statistically significant improvement in symptom management (t = 2.84, p = 0.007) and nurse-patient interaction (t = 2.10, p = 0.043). Scores from the assessor showed better performance scores in the experimental group in symptom management (t = −2.62, p = 0.011), violence risk management (t = −3.42, p = 0.001), and nurse-patient interaction (t = −3.12, p = 0.003). ConclusionsThe findings of this study indicate the potential of using VR for optimized mental health nursing simulation. VR technology allowed realistic experiences which may ensure students have a more comprehensive understanding of mentally ill patients and in doing so, overcome barriers of traditional simulation, resulting in better learning outcomes.

Psychiatric nurse and educator perspectives on professional boundaries in nursing education: An interpretive description study

BackgroundPsychiatric nurses are responsible for maintaining professional boundaries. However, professional boundaries are as described as unclear and psychiatric nursing students are at risk of crossing these boundaries. Educational instruction regarding professional boundaries within psychiatric nursing often lacks foundational structure placing students at risk of transgressions. PurposeThe purpose of the study was to describe boundaries in psychiatric nursing practice, identify strategies effective in teaching professional boundaries, and inform curriculum development in psychiatric nursing education. MethodInterpretive description was utilized to answer: How do psychiatric nurse educators interpret and explain professional boundaries in psychiatric nursing undergraduate education? Psychiatric nurse educators and psychiatric nurses were recruited from an academic institution in western Canada. Twenty participants engaged in semi-structured interviews. Eight of those participants also attended a focus group. ResultParticipants reported that ‘textbook’ definitions of boundaries were insufficient in illustrating the complexities of the construct. Rather, relational forms of learning such as educators sharing clinical stories, role play activities, clinical supervision, and clinical debriefing were described as helpful strategies. ConclusionFoundational knowledge regarding professional boundaries in psychiatric nursing practice appears to be incorporated in the formal curriculum. However, learning is enhanced through the informal and hidden curriculum.

The development and effects of an online-based community psychiatric nursing practice program with the ARCS model

Purpose: This study aimed to identify whether there is a difference between an online-based community psychiatric nursing practice program with the ARCS model and a conventional community psychiatric nursing practice program in promoting nursing students’ learning motivation, knowledge of community psychiatric nursing, communication skills, and learning self-efficacy.Methods: This study used a quasi-experimental design with a non-equivalent control group. The participants were 44 nursing students at three nursing colleges in Gyeongsangbuk-do. The experimental group was provided the online-based community psychiatric nursing practice program with ARCS model, while the control group was provided the conventional community psychiatric nursing practice program from July 9, to September 3, 2022. Both groups received practice training 8 hours a day, 5 days two weeks. The collected data were analyzed using the exact χ<sup>2</sup>, Mann-Whitney U-test, and Quade’s two-way ANCOVA with the IBM SPSS Statistics 28.0 program.Results: The results of the comparison of an experimental group training with the online-based community psychiatric nursing practice program with ARCS model and a control group training with the conventional community psychiatric nursing practice program showed that, there was no statistically significant difference between the two groups in learning motivation knowledge of community psychiatric nursing, and learning self-efficacy. However, communication skills were statistically significantly higher in the experimental group (F=6.23, p=.017).Conclusion: The online-based community psychiatric nursing practice program with ARCS model can be used as a substitute learning to improve community psychiatric nursing capabilities in situations when clinical practice is suspended due to infectious diseases such as coronavirus disease 2019 or when is a shortage of community psychiatric nursing practice institutions.

Challenges Faced by University of Limpopo Learner Nurses during Psychiatry Clinical Exposure: A Qualitative Study.

Clinical exposure of learner nurses to psychiatric hospitals is a requirement by the South African Nursing Council. Clinical experience helps learner nurses build cognitive and affective skills, cultural acculturation, and professional identity. The clinical placement also aids nursing learner nurses in making decisions regarding future career paths. The goal of psychiatric nursing practice is to enhance mental and physical health and improve the patient's quality of life and rehabilitation. A qualitative research approach was followed, and a descriptive, explorative, and contextual design was used in this study to explore the challenges faced by University of Limpopo learner nurses during psychiatry clinical exposure. The population included learner nurses from level two to level four who registered for psychiatric nursing science practice. Convenience sampling was adopted. Semi-structured interviews were used to collect data, and the data were analyzed using the Tesch open coding method. Measures to ensure trustworthiness were adhered to, and ethical considerations were observed. The findings of this study indicated that learner nurses go through challenges and discomfort in the form of mental health care users, clinical environment matters, and the attitude of clinical staff in the hospital. Proper preparation of the learner nurses and clinical areas can assist in reducing the challenges that learner nurses go through.

Advancing behavioral health and social justice: A century of global interdisciplinary progress in psychiatric mental health nursing.

This article explores the century-long history of psychiatric nursing through the dual lens of behavioral health and social justice, emphasizing the pivotal role of psychiatric nurses in mental health. Focused on the contributions of nurse members and leaders from the American Orthopsychiatric Association (later known as the Global Alliance for Behavioral Health and Social Justice), the article will provide a comprehensive timeline that showcases the evolution of the field. It will discuss diverse aspects of psychiatric nursing, including role development, work with children and families, minority populations, integrated care, mental illness prevention, mental health promotion, community mental health, and global mental health nursing. Moreover, the article will identify and examine barriers that have historically hindered, and continue to impact, the practice of psychiatric nursing and the delivery of quality mental health care universally. The influence of culture and stigma on mental health and the profession will be discussed, shedding light on how these factors have shaped psychiatric nursing. The article will delve into the future direction of the field, emphasizing the growing importance of global mental health, integrated care, workforce development, and the continued need for interdisciplinary collaboration. Through this exploration, the article aims to offer insights into the significant progress and enduring challenges faced by psychiatric nursing, ultimately underscoring its indispensable role in advancing mental health and social justice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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.

The Effects of Low-Fidelity Simulation on Students' Perceived Abilities to Build Therapeutic Relationships.

The combination of nursing student anxiety toward patients with mental health conditions, along with their unpreparedness for exercising active listening, empathy, and self-awareness in clinical situations, creates a barrier to achieving therapeutic nurse- patient relationships. A quantitative quasiexperimental study with a one-group pretest-posttest design was used to determine whether a low-fidelity communication simulation laboratory would decrease nursing students' perceived anxiety levels toward mental health patients and increase students' perceived empathy, self-awareness, and active listening levels. After completing the communication simulation laboratory, students' anxiety decreased significantly (p < .001) and active listening increased significantly (p < .001); empathy and self-awareness levels were relatively unchanged. Using a communication simulation laboratory effectively decreased nursing students' perceived anxiety levels toward patients and improved their perceived active listening skills. The findings of the study support the use of low-fidelity simulations to prepare students for psychiatric nursing clinical practice. [J Nurs Educ. 2023;62(10):575-579.].

The Lived Experiences of Non-face-to-face Psychiatric Nursing Practice among Nursing Students: A Parse research Method study

This study is a qualitative study to clarify meaning and structure of lived experiences of non-face-to-face psychiatric nursing practice among nursing student by applying Parse research method. The research question was Would you tell me about your experience of non-face-to-face psychiatric nursing practice? which was examined based on Parse's research method. Participants were 10 nursing students at a community central region of South Korea. As a result, the core concept of lived experiences of non-face-to-face psychiatric nursing practice among nursing student is as follows; Expanding awareness of self and other understanding, Preparation of communication for the formation of therapeutic relationships, Perspective through exploring the meaning of nursing.

Development of a Pediatric Behavioral Early Warning Scale (PEDI-BEWS) for Children.

Background and Purpose: The prevention of aggressive behavior in child and adolescent inpatient settings is essential. However, it can be difficult to prompt a quick appropriate intervention without an early warning scale for the prevention and management of behavioral emergencies in a psychiatric inpatient adolescent unit. Behavioral emergencies often result in restraint/seclusion and/or administration of psychotropic medications. The objectives are to develop and evaluate the Pediatric Behavioral Early Warning Scale (Pedi-BEWS) as a screening tool to prompt quick appropriate interventions and to decrease incidents of restraint/seclusion and/or administration of psychotropic medications. Methods: A two-phase methodological design was applied. A total of 447 inpatients and 21 nurses were used to test internal consistency reliability and validity. Results: Receiver operating characteristic curve areas for the developed instrument were calculated to be 0.890 (Cognition), 0.959 (affect), and 0.951 (behavior). The overall Pedi-BEWS indicated high reliability (Cronbach's alpha = .98). Conclusions: The Pedi-BEWS shows high internal consistency and validity. The use of the newly developed tool may reduce or eliminate episodes of seclusion and restraint for pediatric patients with a behavioral problem. In addition, the tool has the potential to enhance psychiatric nurses' assessment skills and competencies. The use of the newly-developed Pedi-BEWS can promote an appropriate and timely nursing assessment and intervention before the deterioration in psychiatric nursing practice.

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.].

Community Psychiatric Mental Health Nursing: Practice and Challenges

Due to the rising incidence of social risk incidents, the Mental Health Act was amended to provide community treatment and community support for patients with mental illness. Community mental health centers have added a public sector function to follow-up with the care of mentally ill patients using case management as an integrated service model. Under this amendment, the unique role and task of community psychiatric mental healthcare should be framed and developed. The National Health Research Institutes have advocated recovery-oriented case management as a mental health policy. Thus, in line with this policy, the authors developed a need-tailored recovery program led by nurses that has demonstrated significant effectiveness with regard to the recovery of mentally ill patients. Also, a mobile-care platform was subsequently developed to assess the care needs of community-dwelling patients with mental illness, implement recovery-oriented care, and evaluate its effectiveness, which may be incorporated into evidence-based community psychiatric mental healthcare guidelines. To improve the practice of community psychiatric mental health nursing, this article addresses key community nursing contexts, including: psychiatric home treatment and care, community mental health centers, the needs-tailored recovery-oriented case management model, and the roles and certification of community psychiatric mental health nurses promoted by the psychiatric mental health nurses association. Finally, future challenges and strategies are proposed to improve the quality of community psychiatric mental healthcare and to assist patients move from mental disorder to recovery.

Evidence-based Practice in Psychiatric Nursing

Evidenced-based practice is a decision-making process to the clinical problems faced by the nurses during clinical practice. Mental health nursing is a specialty that focuses upon the individual’s not only physical but emotional and psychological needs. Unlike other nursing specialties, mental health nursing practice is an evidence-based practice with certain challenges and barriers. This article discusses the barriers and the possible solutions to overcome the problems that come across when implementing EBP in the clinical area by nurses and also suggests some resources for the EBP in mental health nursing practice.