Psychiatric Nursing Care Research Articles

Stuart Stress Adaptation and Nola Pender's Model on Mental Nursing Care of Patients Schizophrenia: Case Study

To describe the application of the Stuart Stress Adaptation and Nola Pender Models in mental nursing care for a patient with schizophrenia and risk of violent behavior. This research method used case studies. The sample is one patient with schizophrenia. Data collection is done through direct observation, interviews, and patient medical records. The results showed that the client showed a major nursing problem in the form of risk of violent behavior. Predisposing factors included passive childhood experiences and socio-cultural issues, while precipitation included feeling disrespected by the husband's family. Nursing interventions provided to the patient included logotherapy, forgiveness therapy, and psychoeducation to the family. Family psychoeducation forms a supportive system in the client's recovery process. The results of this study indicate that there is a reduction in symptoms of violent behavior in schizophrenia patients. The importance of integrating the Stuart Stress Adaptation and Nola Pender Model in the psychiatric nursing care of patients with paranoid schizophrenia.

Asuhan Keperawatan Jiwa Pada Ny. T Dengan Masalah Utama Risiko Perilaku Kekerasan Akibat Skizofrenia Paranoid di Ruang Dewaruci RSJD Dr. Amino Gondohutomo Provinsi Jawa Tengah

Schizophrenia is a serious mental disorder with clinical manifestations such as: delusions (false beliefs), hallucinations, loss of contact wit reality (psychoisis), risk of violent behavior, abnormal thoughts that can inhibit daily activities that give rise to emotions, perceptions, thoughts, movement and behavior (Pertiwi et al., 2023). The purpose of this paper is to determine and provide psychiatric nursing care to Mrs. T with the main problem of the risk of violent behavior due to paranoid schizophrenia in the Dewaruci ward of dr. Amino Gondohutomo Mental Hospital, Cental Java Province in accordance with nursing standards. The method used is a descriptive method in the form of interviews, observations, documentation studies and literature studies. From the case review, it was found that the patients main complaint said “I was angry, shouted and even punched the door twice, ma’am”. There are 3 nursing problems, namely the risk of violent behavior, self-care deficit. Interventions are arranged base on TUM and TUK as well as on the client’s condition and can be implemented.

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.

The continuity psychiatric nursing care model to enhance medication adherence in schizophrenia patients in Indonesia: Participatory action research.

To develop a continuity of psychiatric nursing care model to enhance medication adherence in schizophrenia patients. The Participatory Action Research study was conducted from 2017 to 2018 in Pekanbaru, Riau, Indonesia, after approval form the ethics review committee of the Faculty of Nursing, Prince of Songkla University, Thailand. The sample included schizophrenia inpatients at a mental hospital, their family members and nursing staff. Qualitative data were gathered through in-depth interviews, observations, field notes, and photo records. Data was subjected to content analysis, while trustworthiness of the model was also determined. Of the 57 subjects, 22(38.6%) were schizophrenia patients, 22(38.6%) were family members, and 13(22.8%) were nurses. The continuity of psychiatric nursing care model consisted of three components: preparing for readiness to live a normal way of life; creating a supportive environment; and, sustaining the continuity of care until the community level care. The continuity of psychiatric nursing care model facilitated holistic nursing care aspects.

Syrian refugees’ experiences while receiving mental health services and psychiatric nursing care: A qualitative study

Introduction Millions of people have migrated because of violence, wars, disasters, and human rights violations, all of which have increased rapidly in recent years. Türkiye has hosted millions of refugees since 2010. Few studies have focused on the mental health needs of refugees or how these needs have been addressed in Türkiye.ObjectivesThis study examined the experiences of Syrian refugees in a community center in Turkiye as they access mental health services and receive psychiatric nursing care.MethodsA qualitative design was adopted in the study. Data were collected from southern Turkiye between November and December 2021. The researchers conducted three semistructured focus group interviews following Colaizzi’s phenomenological method to analyze the qualitative data. A total of 19 Syrian refugees participated in the focus group interviews.Results Three key themes related to immigrants’ experiences of receiving mental health services and nursing care were identified: barriers to receiving mental health services, coping with negative experiences in Turkiye, and satisfaction with mental health services. The participants identified the barriers they experienced while receiving health services as those pertaining to language, discrimination, and stigmatization. They also mentioned the methods of coping with these negative experiences in Turkiye. Despite their negative experiences, they expressed satisfaction with the mental health services they received, especially psychiatric nursing care.Conclusions This study determined that Syrian refugees face barriers to accessing and receiving mental health services. They stated that mental health professionals in Turkiye approach them with empathy, particularly those in psychiatric nursing. Healthcare professionals may be trained in culturally sensitive care to increase awareness. Studies have frequently examined the experiences of nurses providing care to refugees, but few have focused on evaluating nursing care from the perspective of refugees. Syrian refugees have reported various obstacles in accessing and receiving mental healthcare services. Health professionals, especially psychiatric nurses in mental health psychosocial support centers, must facilitate the processes to eliminate these obstacles.Disclosure of InterestNone Declared

The role of mental health nursing in pediatric hematology/oncology - Part 3: Evaluating feasibility, acceptability, and appreciation.

In February 2022, we introduced the innovative new role of mental health nurse clinician (MHNC) in pediatric hematology/ oncology in a pediatric hospital in Quebec with the aim of better addressing the needs of young cancer patients and their families. In two previous articles, we explained the method used to develop the role, as well as the strategy employed to implement it. In this article, we seek to evaluate the effectiveness of the implementation strategy by measuring role feasibility. We will also examine role acceptability and appreciation 1 year following implementation. We asked three groups of participants (adolescents, parents and care providers) to complete a research questionnaire based on the Theoretical Framework of Acceptability (TFA), with good inter-rater reliability and discriminant validity. The questionnaire, which was made available online, consisted of statements with Likert-scale responses (from 1 to 5), as well as open questions. We performed a standard descriptive analysis and used the responses to the open questions to support or add nuance to the quantitative results. In total, 31 healthcare professionals, 10 adolescent cancer patients and 10 parents of adolescent cancer patients filled out the questionnaire. Between February 2022 and February 2023, the MHNC provided a total of 691 interventions to 112 individuals (patients and parents). Follow-up sessions were offered to 61 individuals, and 99.6% of them accepted. We found a very strong correlation (r = 0.96) between the number of hours worked by the MHNC and the number of interventions provided. The vast majority of participants from all three groups agreed that the role is appropriate, appreciated and necessary, and that it brings much-needed clinical expertise in mental health to the department. Care providers, adolescents, and parents indicated that they would request this service again and would recommend it to others, if it were needed. The results, therefore, demonstrate excellent feasibility and high levels of acceptability and appreciation. Our study shows that the implemented MHNC role helps improve the clinical management of the mental health of adolescents with cancer, as well as their parents. The role brings much-needed expertise in psychiatric nursing care and supports the clinical practice of care providers. Another study will be conducted in the near future to measure the effectiveness of the MHNC's interventions.

Experiences of Psychiatric Nurses Working in a Closed Psychiatric Unit during the COVID-19 Pandemic

Purpose: This study aimed to understand the experiences of psychiatric nurses providing care for inpatients with mental illness during the COVID-19 pandemic.Methods: Data were collected from 18 April to 10 July 2023. Eleven psychiatric nurses in closed psychiatric units were recruited using purposive and snowball sampling. In-depth individual interviews were conducted for data collection, and reflexive thematic analysis was used for data analysis and the development of themes. Results: The five resulting themes were as follows: ‘prioritizing infection control over psychiatric nursing duties’, ‘increased burden of nursing care due to the complexities of mental illness’, ‘challenges in closed wards due to staffing shortages and susceptibility to infection’, ‘providing optimal psychiatric nursing care with limited resources’, and ‘change and growth of psychiatric nurses through the pandemic crisis’. Conclusion: Training in infection control and crisis response should be provided to psychiatric nurses in preparation for future pandemic crises. Facility and personnel support, guidelines, and patient education strategies that account for psychiatric characteristics should be provided. In addition, stress management and burnout prevention programs for psychiatric nurses are needed.

Syrian refugees' experiences while receiving mental health services and psychiatric nursing care: A qualitative study.

This study examined the experiences of Syrian refugees in a community centre in Turkiye as they access mental health services and receive psychiatric nursing care. A qualitative design was adopted in the study. Data were collected from southern Turkiye between November and December 2021. The researchers conducted three semi-structured focus group interviews. Colaizzi's phenomenological method was followed to analyse the qualitative data. A total of 19 Syrian refugees participated in the focus group interviews. Three key themes related to immigrants' experiences of receiving mental health services and nursing care were identified: barriers to receiving mental health services, coping with negative experiences in Turkiye and satisfaction with mental health services. The participants identified the barriers they experienced while receiving health services as those pertaining to language, discrimination and stigmatization. They also mentioned the methods of coping with these negative experiences in Turkiye. Despite their negative experiences, they expressed satisfaction with the mental health services they received, especially psychiatric nursing care. This study determined that Syrian refugees face barriers in accessing and receiving mental health services. They stated that mental health professionals in Turkiye approach them with empathy, particularly those in psychiatric nursing. Healthcare professionals may be trained in culturally sensitive care to increase awareness. Studies have frequently examined the experiences of nurses providing care to refugees, but few have focused on evaluating nursing care from the perspective of refugees. Syrian refugees have reported various obstacles in accessing and receiving mental healthcare services. Health professionals, especially psychiatric nurses in mental health psychosocial support centres, must facilitate the processes to eliminate these obstacles. The consolidated criteria for reporting qualitative research (COREQ) were used. No patient or public involvement.

PELATIHAN COMMUNITY MENTAL HEALTH NURSING (CMHN) BAGI PERAWAT DAPAT MENINGKATKAN PENANGANAN MASALAH KESEHATAN JIWA DI MASYARAKAT

Community-based psychiatric nursing care is a nursing approach to mental patients, which is carried out directly to patients and their families at home by health center nurses who have received previous training. Nurses who have been trained are expected to have competence, one of which is being able to provide nursing care to patients with mental disorders in the community, so that patients with mental disorders can be handled optimally. This research is to see the relationship between the Effectiveness of CMHN Training Implementation in 31 Public Health Centers in North Aceh District. The study was conducted at 31 Community Health Centers in North Aceh District. The research design used a correlational design with a total sampling technique. Data collection was carried out by distributing questionnaires online via the Google form to respondents in July 2022. Data analysis used the Chi Squere test with a 95% confidence interval. The research results obtained p value = 0.000, α = 0.05, p value ≤0.05, the statistical results are significant, meaning that there is a relationship between the effectiveness of implementing CMHN training on improving the handling of mental health problems in North Aceh District.

Nurse views of obstacles encountered by nurses in Saudi Arabia during the provision of psychiatric care

BackgroundNursing staff within the mental health sector are major actors in delivering healthcare. They face considerable obstacles that may hinder the provision of high-quality care to patients with mental health challenges. AimThe current study offers a description of mental health nurses' viewpoints, insights into obstacles encountered during their experiences, and recommendations for enhancing psychiatric inpatient nursing care and achieving progress toward the goals set out by Saudi Vision 2030. MethodsThe study employed a phenomenological qualitative design. Semistructured interviews were conducted with 10 currently practicing mental health nurses during two focus group sessions. The inductive data produced underwent member and peer checking. Emergent themes and subthemes were extracted. ResultsTwo main themes and related subthemes were identified. The first theme—obstacles faced by mental health nurses—was composed of the following subthemes: policy at institutions; clear job roles; low professional self-confidence and inadequate support; stressed, insecure, and unsafe; and stigmatization. The second theme—recommendations to improve the quality of mental health nursing—was composed of two subthemes: to enhance mental health awareness and improve professional skills and education. ConclusionThe data suggest that maintaining high-quality nursing standards within an inpatient psychiatric facility requires a consistent and accountable organizational structure, which can lead to fostering the development and improvement of relevant nursing skills through continuing education, improved awareness of mental health disorders and care within the community, and initiatives to combat the stigma of mental disorders among patients, families, and communities.

A Study to Assess the Satisfaction Level of Clients towards Team of Psychiatric Care Admitted in Selected Psychiatric Hospital, Kolkata

Abstract: Patient satisfaction has been viewed as valid outcome measure of a health care delivery system. Assessing patient satisfaction with team of psychiatric care is important in evaluating whether patients’ needs are fulfilled and subsequently facilitating in the planning as well as implementing appropriate interventions for patients. The investigator has conducted a study to assess the satisfaction level of clients towards team of psychiatric care admitted in selected Psychiatric Hospital, Kolkata. The objective of the study was to find out satisfaction level of clients towards team of psychiatric care. Conceptual framework of the study was based on Fishbone Model created by Kaoru Ishikawa (1968). Non-experimental descriptive survey design was adopted for the study. 112 samples were selected by non- probability purposive sampling technique. Demographic data was collected by interviewing using the semi-structured interview schedule and record analysis. Data related to patients’ level of satisfaction regarding psychiatric nursing care, medical care and others’ care were collected by interviewing method using rating scale.

Experiences of Inpatient Psychiatric Nursing Care among People Who Have Survived a Suicide Attempt

ABSTRACT Nurses are front line providers for people who have been hospitalized following a suicide attempt, yet few studies have explored this population’s experiences specifically with nursing care in inpatient psychiatric units. The purpose of this study was to hear directly from people who have survived a suicide attempt about their experiences with inpatient psychiatric nursing care following a suicide attempt in order to identify strengths and weaknesses of current practices and elicit suggested improvements. Qualitative in-depth interviews were conducted with people who were previously psychiatrically hospitalized following a suicide attempt (N = 9; M age=42). Applied thematic analysis was used to identify themes related to positive and negative experiences with nursing care during hospitalization and advice for nurses. Findings demonstrated that positive experiences with nurses related to empathy, friendliness, feeling supported, flexibility, and active listening, while negative experiences centered around feeling stigmatized, invalidated, degraded, and coerced. Advice for nurses included being self-aware of preconceived or stigmatized notions, practicing empathy, listening, and humanity. The results of this study indicate the need for compassionate care, training to reduce nurse stigma, and adequate resources for nurses to mitigate emotional strain and burnout.

Factors limiting presence: Perceptions of nurses working in a public psychiatric hospital.

Presence is a therapeutic skill that has a healing effect not only on the mental healthcare user but also the nurse. There was a need to explore nurses' perceptions on factors that limit presence, especially in a public psychiatric hospital in a rural province such as North West, South Africa, where there are limited resources and nurses need to rely heavily on their therapeutic use of self. To report on nurses' perceptions of factors limiting presence when working in a public psychiatric hospital. A qualitative descriptive inquiry was applied, with purposive sampling. Semistructured individual interviews were held with 10 nurses. Thematic data analysis was applied. Intrapersonal factors that were found to limit presence arose from the view that mental healthcare users (MHUs) are difficult to engage with; the tendency to view 'good care' primarily as physical care with limited insight into presence was also recognised. Interpersonal and transpersonal factors related to difficulties in communicating with MHUs and in the work environment. Addressing factors that limit presence were found to require courage, the overcoming of interpersonal distance and a transformational process.Contribution:This article contributes important insights that can be used by nurse leaders to promote the practice of presence to improve the quality of psychiatric nursing care in developing contexts, such as a rural province in South Africa.

Expressive writing therapy to a client with low self-esteem, hallucination and post-traumatic syndrome

Schizoaffective is a mental disorder that exhibits psychotic symptoms of schizophrenia and mood disorders which can be depressive episodes, manic episodes, or a mixture of the two episodes. This paper reported a case study of Ms. R, a 24-year-old woman diagnosed with schizoaffective disorder. She has self-esteem problems, hallucinations, and post-traumatic syndrome that interfere with her productivity and social life functions. The generalist psychiatric nursing care process and expressive writing therapy were implemented for her treatment for 18 days. The result supports that the combination of the two interventions positively impacted reducing signs and symptoms of low self-esteem, hallucinations, and anxiety symptoms in a client with schizoaffective. 

Effectiveness of Structured Teaching Program on Nurses' Knowledge on Safe Handling of Psychotropic Drugs

Background: Nurses play a major role in the management of psychiatric patients including the administration and handling of psychotropic drugs. They are in a pivotal position to educate the patient and family members about the medication and they should possess knowledge and competencies of psychotropic drugs to ensure safety. Materials and Methods: The authors have applied quantitative approach, preexperimental design, one group pre-test and post-test design for this study. Fifty-two newly recruited nursing officers were participated in this study. The authors have assessed the nurses' baseline knowledge on psychotropic drugs and the safe handling of such drugs. Followed by that, structured Teaching Program (STP) was designed, developed, and imparted to improve the nurses' knowledge and skills on psychotropic drugs by the authors. A post-STP assessment was conducted to identify the change in nurses' knowledge. Results: Baseline assessment revealed that the nurses were obtained poor scores in knowledge on psychotropics scale and safe handling of psychotropics scale. The median pretest score was seven on knowledge of psychotropics scale and four on the safe handling of the psychotropics scale. Two weeks' posttest scores were 15 and 11, respectively. The results showed significant difference between pre-test and posttest median scores and Wilcoxon signed-rank test (P < 0.001). Sociodemographic variable such as the age of the participants was correlated positively with baseline scores of safe handlings of psychotropic drugs and their post-graduate training in psychiatric nursing was associated with knowledge score. Conclusion: The results of the study revealed that the STP me about knowledge on psychotropic drugs and safe handling of psychotropic drugs was effective in improving the knowledge of newly recruited staff nurses. Continuing nursing education on psychotropic drugs and its safe handling skill among nurses may result in better psychiatric nursing care outcomes.

THE RISK OF VIOLENT BEHAVIOR : A CASE STUDY

Background: Risk Violent behavior is an individual condition that will endanger oneself, others, family and society. Individuals at risk of violent behavior need psychiatric nursing care to overcome the nursing problems they experience. This study aims to discuss nursing care comprehensively from assessment to evaluation of clients at risk of violent behavior. Case report: The results of the client have a history of traffic accidents and experienced a collision in the head area but at the request of the family, surgery was carried out. After the accident, the family got changes in the client, namely irritability, tantrums, talking and smiling by themselves and seeing things that were not tangible. The implementation of nursing is given to clients in the form of physical exercises: deep breaths and hitting the pillow mattress, assertive exercises and spiritual exercises. The client's family is given nursing education about how to care for the client. The nursing evaluation found that the client was able to do physical exercise and assertive exercise. Families can recognize problems and motivate clients to do the exercises that have been taught by the nurse. Conclusion: The risk of violent behavior is one of the mental nursing problems that can be found in clients with mental disorders with a history of head trauma.

Nurses' experiences in response to COVID-19 in a psychiatric ward in Singapore.

AimTo understand nurses’ responses to COVID‐19 and identify their uptake of changes in the procedure required for the management of COVID‐19 in an inpatient psychiatric ward.BackgroundThe infection risk for COVID‐19 in an enclosed inpatient psychiatric ward is high due to living arrangements in the ward and the nature of the infectious disease.IntroductionThis paper describes inpatient nurses’ experiences, challenges and strategies deployed at the institutional and national levels to contain the spread of infection.MethodsWritten feedback was collected to understand nurses’ responses and identify their uptake of changes in procedure following the COVID‐19 outbreak in the ward.FindingsNurses felt shocked, worried, isolated, expressed a lack of confidence, and experienced physical exhaustion. COVID‐19 specific challenges were highlighted in the delivery of safe and quality nursing care. Nurses were satisfied with the hospital policy and strategies implemented during the outbreak, acknowledging the importance of support from nursing leaders.DiscussionPractical support and strong nursing leadership have been imperative in the battle against the COVID‐19 outbreak in the psychiatric hospital. Psychiatric nursing care was maintained with a modified management and treatment approach.Implications for Nursing practiceNurses' willingness to adjust to the reconfiguration of operations to accommodate changes has been crucial for the healthcare system to run effectively. Good practices and policies established during this crisis should be developed and established permanently in nursing practice.Implications for Health PolicyPrompt and effective contingency planning and policymaking at the national and institutional level, targeting human resource management and infection control, can introduce changes and alternative options for nursing care in a pandemic.ConclusionWith support from influential nursing leaders, strategies and policies are imperative in ensuring the successful management of COVID situations in an inpatient psychiatric setting.

Nurses' leadership in psychiatric care-A qualitative interview study of nurses' experience of leadership in an adult psychiatric inpatient care setting.

WHAT IS KNOWN ON THE SUBJECT?: Previous studies on leadership in psychiatric care have focussed on a diversity of staff and on different healthcare settings. Nurses in both Sweden and internationally, working with patients newly diagnosed with psychosis and addiction, describe an overwhelming workload. Existing research points out that experience and leadership training are the most important factors to exert a good nursing leadership. In Sweden, requirements for leadership exists already from the first day of a nurse's career. The relationship and communication between nurses in psychiatric care and members of the staff is decisive for whether the leadership will work. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: The study adds knowledge regarding the challenges leading the nursing care for patients diagnosed with psychosis and addiction. Ambivalence in the leadership role is prominent among nurses in psychiatric care and feelings of responsibility and meaningfulness are mixed with feelings of powerlessness and uncertainty. Swedish psychiatric nurses lack mandate to lead psychiatric nursing care. This may increase the feelings of uncertainty in their leadership role. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: A mandate to lead as well as a leadership guidance in communication and teambuilding will enhance the leadership, especially among newly graduated nurses. Heightened awareness within the healthcare organization about nurse's experience of difficulties in leading the psychiatric nursing care of the most severe psychiatric illnesses could increase the right prerequisites for leadership. ABSTRACT: Introduction Research shows that psychiatric nursing care puts additional demands on the nurse as a leader due to the psychological complexity of care. Experience and leadership training are most important to exert leadership. In Sweden, demands for leadership exist already at the beginning of a nursing career, and in psychiatry, it may lead to an overwhelming workload. Aim/Question The aim of the present study is to highlight nurses' experiences of leading the psychiatric nursing care in an adult psychiatric context. Method A qualitative interview study of eleven registered nurses within psychiatric inpatient care. Content analysis was used for analysis. Results Leading with combined feelings of both meaningfulness and uncertainty were the theme arising from the result. Discussion Findings from Swedish and international studies stress special demands on leadership in psychiatric care. The result shows that nurses perceived an ambivalence of their leadership in terms of both meaningfulness and uncertainty. Implications for Practice An official mandate to lead as well as leadership guidance in communication and teambuilding will enhance leadership, especially among newly graduated nurses. Heightened awareness within healthcare organizations about difficulties in leading psychiatric nursing care could increase the possibility to create right prerequisites for leadership.

Patients’ satisfaction with psychiatric nursing care in Benin, Nigeria

In many low-middle income countries including Nigeria, shortage of psychiatric nurses and adverse working conditions, potentially impairs quality of nursing care provided. Quality of care may influence uptake of available mental health care services. This study was aimed at assessing level of psychiatric patients’ satisfaction with nursing care in one of two public mental health hospitals in South-South Nigeria. Study design was cross-sectional descriptive, with use of simple random sampling technique to recruit patients from Federal Neuropsychiatric Hospital, Benin, Edo State, Nigeria. Data analysis was done using SPSS version 21, with chi-square as inferential statistic, and p-value set at 0.05. One hundred and eighty-five (185) respondents were surveyed, with mean age of 36.3 ± 10.1 years. Common psychiatric diagnoses were schizophrenia (40.0%) and depression (34.1%). Mean satisfaction was 3.53 ± 0.69 ranging from 1.6 to 5.0. There was 52.4% prevalence of satisfaction and 47.6% prevalence of dissatisfaction with nursing care provided. Common areas of dissatisfaction were privacy nurses gave (61.1%), nurses’ willingness to respond to subjects’ needs (55.7%), and nurses’ awareness of subject’s needs (55.1%). Common areas of satisfaction were nurses putting relatives’ mind to rest (61.6%), nurses’ capability at their job (60.5%). Dissatisfaction was significantly commoner among males and those diagnosed with depression and bipolar affective disorder (p < 0.05). This study identified key areas of dissatisfaction and satisfaction with mental health nursing services in a low-middle-income country setting. Psychiatric nurses need to be aware of these areas, towards optimization of mental healthcare provision peculiar to their settings.

Putting Restraint on Chemical Restraint: Exploring the Complexity of Acute Inpatient Mental Health Nurses' Experience of Chemical Restraint Interventions

While there is a growing body of research available on general restraint intervention in acute adult psychiatric settings, relatively little is known about nurses’ experiences of administering chemical restraint. The research question explored in this study was: what are mental health nurses’ experiences of using chemical restraint interventions in times of behavioural emergency on adult inpatient acute mental health units? Through this Canadian study understanding of direct care nurses’ first-hand experiences of the use of chemical restraint interventions was sought. Eight adult acute inpatient mental health nurses were interviewed using hermeneutic phenomenological method. Two major themes that emerged from data analysis are explored to illuminate the existing tension between therapeutic, person-centred care and coercive control to maintain safety: taking control to maintain safety and working within constraints. Integral ways that nurses make meaning from administering chemical restraint were found, as well as some of the complex clinical and ethical decision-making aspects involved in psychiatric nursing care. Implications for practice, education, and policy are discussed. Research findings indicated a need for further focus on medication best practice, policy development and nurse education. These exploratory research findings can be used to both inform and challenge dominant inpatient mental health practice to guide nurses, health care leaders, and policy makers by increased understanding of the complex ethical decision making required for use of chemical restraint interventions.