Kevin Gournay - Academia.edu (original) (raw)
Papers by Kevin Gournay
British Journal of Psychiatry, Oct 1, 2001
Clinical Effectiveness in Nursing, Mar 1, 1997
Objectives: to test a cognitive behavioural treatment package for patients with Body Dysmorphic D... more Objectives: to test a cognitive behavioural treatment package for patients with Body Dysmorphic Disorder (BDD). Design: a randomized controlled trial. Setting: out patients. Participants: nineteen patients conforming to DSM IV criteria for Body Dysmorphic Disorder, whose primary concern was not weight or shape, randomly allocated to either a cognitive behavioural package or a waiting list. Main outcome measures: the BDD examination (observer rated), modifiedYale Brown Obsessive Compulsive Scale, Montgomery and Asberg Depression Rating Scale (observer rated), social phobia and anxiety inventory, hospital anxiety and depression inventory, perception of appearance-Derriford Scales. Results: there were highly significant changes from pre to post treatment for patients receiving cognitive behaviour therapy. There were no significant changes from pre-to post-treatment for patients in the waiting list condition. Conclusion: this pilot study establishes a case for more substantial testing of cognitive behaviour therapy for BDD in a randomized controlled trial with a larger sample and longer follow-up. Furthermore, the results show that given the considerable handicaps that accrue from BDD and the excellent response to treatments in our trial, this condition should become another target for nurse therapists in the future. The results also have implications for general medicine and surgery where psychological interventions for disfigurements are poorly developed.
Designations used by companies to distinguish their products are often claimed as trademarks. All... more Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Clinical management in mental health services / edited by Chris Lloyd. .. [et al.]. p. ; cm. Includes bibliographical references and index.
International Journal of Mental Health Nursing, Oct 15, 2012
Mental health nurses have a key role in improving the physical health of people with a serious me... more Mental health nurses have a key role in improving the physical health of people with a serious mental illness, however there have been few studies of their attitudes or the extent of their involvement in this work. The aim of this study was to examine mental health nurses' attitudes to physical healthcare and explore associations with their practice and training.
British Journal of Mental Health Nursing, 2015
Debbie Robson and Kevin Gournay discuss the advances in treatments for schizophrenia, and its imp... more Debbie Robson and Kevin Gournay discuss the advances in treatments for schizophrenia, and its implications for mental health nursing
Journal of Psychiatric and Mental Health Nursing, 2001
Assessing the tolerability and efficacy of treatment with antipsychotic medication is a vital par... more Assessing the tolerability and efficacy of treatment with antipsychotic medication is a vital part of mental health care. Research has suggested that many side-effects go undetected by clinicians and there is a need to use standardized assessment tools to ensure that treatments are comprehensively evaluated. The training of Community Psychiatric Nurses (CPNs), who provide much of patients' care, should focus on enhancing skills in using such assessments. This study aimed to examine differences in the use of standardized assessments of antipsychotic side-effects and psychopathology by CPNs and Thorn graduates who had received additional training in delivering psychosocial interventions. A questionnaire was sent to 240 Thorn graduates and CPNs practising in England, with an overall adjusted response rate of 54%. Thorn graduates reported using significantly more standardized assessments of side-effects and psychopathology than CPNs. A trend in both groups towards the use of measures that relied on patient self-report of side-effects was observed. This study identified important deficiencies in current CPN practice. A programme of targeted training may be a more realistic and efficient method of enhancing medication management practices in large numbers of CPNs compared to the more expensive and time-consuming Thorn programme.
Mental Health Practice, 2009
Primary Health Care, 2007
Background: The mental health impacts of the COVID-19 pandemic remain a public health concern. Hi... more Background: The mental health impacts of the COVID-19 pandemic remain a public health concern. High quality synthesis of extensive global literature is needed to quantify this impact and identify factors associated with adverse outcomes. Methods: We conducted a rigorous umbrella review with meta-review and present a) pooled prevalence of probable depression, anxiety, stress, psychological distress, and post-traumatic stress, b) standardised mean difference in probable depression and anxiety pre-versus-during the pandemic period, and c) comprehensive narrative synthesis of factors associated with poorer outcomes. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to March 2022. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the COVID-19 pandemic. Findings: Three hundred and thirty-eight systematic reviews were included, 158 of which incorporated meta-a...
Journal of Psychiatric and Mental Health Nursing, Dec 23, 2019
INTRODUCTION A fundamental component of nursing care is observations at night to ensure the wellb... more INTRODUCTION A fundamental component of nursing care is observations at night to ensure the wellbeing of patients. However, there is no literature on the lived experience by in-patients of such observations or of the general environment of a psychiatric ward at night. AIM/QUESTION This study aims (1) to understand the lived experience of being an in-patient on a psychiatric ward at night with a focus on intermittent observations, (2) contribute to developing a tool to monitor the psychiatric ward environment for use in quality improvement projects. METHOD Semi-structured interviews were conducted with twelve in-patients from 5 psychiatric wards who had experienced intermittent observations at night. These interviews were subsequently transcribed and analysed using content analysis. RESULTS Environmental disturbances including light and noise, invasion of privacy and safety considerations on the ward all contributed to sleep disturbance. The unintended consequences of disturbances caused by intermittent night observations, and by staff in general and other patients formed the core of the inpatients' experience. We developed a clinical tool that could be used to identify the factors that are relevant on an individual ward. DISCUSSION Participants interviewed unanimously agreed that poor sleep quality had a significant negative impact on their psychological and social wellbeing. These were discussed in relation to the environment and the experience of observations at night. IMPLICATIONS FOR NURSING PRACTICE Deprivation of inpatients' sleep is currently under-reported, and the usefulness of intermittent observations at night in psychiatric wards is questioned. Much could be done to adjust the environment at night to support quality sleep and improve psychiatric symptoms. This paper aims to highlight the lived experience of patients to help bring improvements.
British Journal of Psychiatry, Aug 1, 1996
<b>Copyright information:</b>Taken from "Training in dual diagnosis intervention... more <b>Copyright information:</b>Taken from "Training in dual diagnosis interventions (the COMO Study): Randomised controlled trial"http://www.biomedcentral.com/1471-244X/8/12BMC Psychiatry 2008;8():12-12.Published online 27 Feb 2008PMCID:PMC2277384.
Mental Health Practice, 2008
Mental Health Practice, 2004
Clinical Effectiveness in Nursing, 1997
Objective: to investigate the implementation of the Care Programme Approach (CPA) in an inner cit... more Objective: to investigate the implementation of the Care Programme Approach (CPA) in an inner city London service. Design: all persons subject to the CPA were interviewed (using a structured protocol) on their discharge from hospital and 3 months later. A review of their case notes was also undertaken at the 3-month follow-up. Setting: six acute wards of an inner city service. Participants: eighty people who had received in-patient treatment and who were subject to the CPA. Outcome meaures: interview protocols, including satisfaction ratings and case note audit. Results: seventy-one people (89% of the original sample) completed the first interview and 57 (71% of the original sample) completed the second interview. Some people still lost contact with services, more than half of the sample were not involved in their care planning and nearly half of the patients did not know who their key worker was at time of discharge. Conclusions: there are limitations regarding how far our findings can be generalized. However, the study does point to the importance of greater involvement of users and carers and highlights the importance of providing appropriate training to key workers.
Mental Health Practice, 2009
British Journal of Mental Health Nursing, 2016
In this article, BJMHN consultant editor Kevin Gournay discusses approaches to addressing dual di... more In this article, BJMHN consultant editor Kevin Gournay discusses approaches to addressing dual diagnosis both in the UK and internationally
British Journal of Mental Health Nursing, 2013
This article provides mental health nurses with an overview of alcohol dependency, and up-to-date... more This article provides mental health nurses with an overview of alcohol dependency, and up-to-date information on treatment approaches. It aims to assist mental health nurses to refocus their attention to this topic, bearing in mind that when most nurses think of alcohol dependency they will focus on those with problems at the severe end of the spectrum—particularly those with accompanying serious and enduring mental illnesses. It is argued that a shift of focus is necessary as there are many more people who are not moderately or severely dependent, who nevertheless are either drinking at hazardous levels, or have a mild level of alcohol dependency. Targeting this group may prevent physical and mental health problems developing. These patients will usually be encountered in primary care settings.
International Journal of Nursing Studies, 2000
Ethical Issues in Nursing and Midwifery Practice, 1998
Mental health problems are so common that at some point in our lives all of us will be affected e... more Mental health problems are so common that at some point in our lives all of us will be affected either by personal experience or the experience of those close to us. Thus, for example, the lifetime prevalence of schizophrenia, the most severe and enduring of mental illness, is 1 per cent and of depression more than 20 per cent (Department of Health, 1994). We know that roughly one in three of us will have a panic attack or panic attacks during our lifetime (Gournay, 1996) and up to 40 per cent of all general practitioner (GP) consultations concern medical problems for which no physical cause is evident. Mental health problems range from discrete episodes of anxiety and depression which last no more than a few days, to the most serious and enduring forms of illness such as schizophrenia and bipolar affective disorder. There is no simple spectrum covering the positions between these two extremes; mental health problems are best conceptualized as being multifaceted and multidimensional. Problems often present themselves somewhat paradoxically. For example, people with the most severe obsessions and compulsions may spend literally hours a day washing their hands while at the same time lead a very productive life in one of the professions and also have major familial and parental responsibilities.
British Journal of Psychiatry, Oct 1, 2001
Clinical Effectiveness in Nursing, Mar 1, 1997
Objectives: to test a cognitive behavioural treatment package for patients with Body Dysmorphic D... more Objectives: to test a cognitive behavioural treatment package for patients with Body Dysmorphic Disorder (BDD). Design: a randomized controlled trial. Setting: out patients. Participants: nineteen patients conforming to DSM IV criteria for Body Dysmorphic Disorder, whose primary concern was not weight or shape, randomly allocated to either a cognitive behavioural package or a waiting list. Main outcome measures: the BDD examination (observer rated), modifiedYale Brown Obsessive Compulsive Scale, Montgomery and Asberg Depression Rating Scale (observer rated), social phobia and anxiety inventory, hospital anxiety and depression inventory, perception of appearance-Derriford Scales. Results: there were highly significant changes from pre to post treatment for patients receiving cognitive behaviour therapy. There were no significant changes from pre-to post-treatment for patients in the waiting list condition. Conclusion: this pilot study establishes a case for more substantial testing of cognitive behaviour therapy for BDD in a randomized controlled trial with a larger sample and longer follow-up. Furthermore, the results show that given the considerable handicaps that accrue from BDD and the excellent response to treatments in our trial, this condition should become another target for nurse therapists in the future. The results also have implications for general medicine and surgery where psychological interventions for disfigurements are poorly developed.
Designations used by companies to distinguish their products are often claimed as trademarks. All... more Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Clinical management in mental health services / edited by Chris Lloyd. .. [et al.]. p. ; cm. Includes bibliographical references and index.
International Journal of Mental Health Nursing, Oct 15, 2012
Mental health nurses have a key role in improving the physical health of people with a serious me... more Mental health nurses have a key role in improving the physical health of people with a serious mental illness, however there have been few studies of their attitudes or the extent of their involvement in this work. The aim of this study was to examine mental health nurses' attitudes to physical healthcare and explore associations with their practice and training.
British Journal of Mental Health Nursing, 2015
Debbie Robson and Kevin Gournay discuss the advances in treatments for schizophrenia, and its imp... more Debbie Robson and Kevin Gournay discuss the advances in treatments for schizophrenia, and its implications for mental health nursing
Journal of Psychiatric and Mental Health Nursing, 2001
Assessing the tolerability and efficacy of treatment with antipsychotic medication is a vital par... more Assessing the tolerability and efficacy of treatment with antipsychotic medication is a vital part of mental health care. Research has suggested that many side-effects go undetected by clinicians and there is a need to use standardized assessment tools to ensure that treatments are comprehensively evaluated. The training of Community Psychiatric Nurses (CPNs), who provide much of patients' care, should focus on enhancing skills in using such assessments. This study aimed to examine differences in the use of standardized assessments of antipsychotic side-effects and psychopathology by CPNs and Thorn graduates who had received additional training in delivering psychosocial interventions. A questionnaire was sent to 240 Thorn graduates and CPNs practising in England, with an overall adjusted response rate of 54%. Thorn graduates reported using significantly more standardized assessments of side-effects and psychopathology than CPNs. A trend in both groups towards the use of measures that relied on patient self-report of side-effects was observed. This study identified important deficiencies in current CPN practice. A programme of targeted training may be a more realistic and efficient method of enhancing medication management practices in large numbers of CPNs compared to the more expensive and time-consuming Thorn programme.
Mental Health Practice, 2009
Primary Health Care, 2007
Background: The mental health impacts of the COVID-19 pandemic remain a public health concern. Hi... more Background: The mental health impacts of the COVID-19 pandemic remain a public health concern. High quality synthesis of extensive global literature is needed to quantify this impact and identify factors associated with adverse outcomes. Methods: We conducted a rigorous umbrella review with meta-review and present a) pooled prevalence of probable depression, anxiety, stress, psychological distress, and post-traumatic stress, b) standardised mean difference in probable depression and anxiety pre-versus-during the pandemic period, and c) comprehensive narrative synthesis of factors associated with poorer outcomes. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to March 2022. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the COVID-19 pandemic. Findings: Three hundred and thirty-eight systematic reviews were included, 158 of which incorporated meta-a...
Journal of Psychiatric and Mental Health Nursing, Dec 23, 2019
INTRODUCTION A fundamental component of nursing care is observations at night to ensure the wellb... more INTRODUCTION A fundamental component of nursing care is observations at night to ensure the wellbeing of patients. However, there is no literature on the lived experience by in-patients of such observations or of the general environment of a psychiatric ward at night. AIM/QUESTION This study aims (1) to understand the lived experience of being an in-patient on a psychiatric ward at night with a focus on intermittent observations, (2) contribute to developing a tool to monitor the psychiatric ward environment for use in quality improvement projects. METHOD Semi-structured interviews were conducted with twelve in-patients from 5 psychiatric wards who had experienced intermittent observations at night. These interviews were subsequently transcribed and analysed using content analysis. RESULTS Environmental disturbances including light and noise, invasion of privacy and safety considerations on the ward all contributed to sleep disturbance. The unintended consequences of disturbances caused by intermittent night observations, and by staff in general and other patients formed the core of the inpatients' experience. We developed a clinical tool that could be used to identify the factors that are relevant on an individual ward. DISCUSSION Participants interviewed unanimously agreed that poor sleep quality had a significant negative impact on their psychological and social wellbeing. These were discussed in relation to the environment and the experience of observations at night. IMPLICATIONS FOR NURSING PRACTICE Deprivation of inpatients' sleep is currently under-reported, and the usefulness of intermittent observations at night in psychiatric wards is questioned. Much could be done to adjust the environment at night to support quality sleep and improve psychiatric symptoms. This paper aims to highlight the lived experience of patients to help bring improvements.
British Journal of Psychiatry, Aug 1, 1996
<b>Copyright information:</b>Taken from "Training in dual diagnosis intervention... more <b>Copyright information:</b>Taken from "Training in dual diagnosis interventions (the COMO Study): Randomised controlled trial"http://www.biomedcentral.com/1471-244X/8/12BMC Psychiatry 2008;8():12-12.Published online 27 Feb 2008PMCID:PMC2277384.
Mental Health Practice, 2008
Mental Health Practice, 2004
Clinical Effectiveness in Nursing, 1997
Objective: to investigate the implementation of the Care Programme Approach (CPA) in an inner cit... more Objective: to investigate the implementation of the Care Programme Approach (CPA) in an inner city London service. Design: all persons subject to the CPA were interviewed (using a structured protocol) on their discharge from hospital and 3 months later. A review of their case notes was also undertaken at the 3-month follow-up. Setting: six acute wards of an inner city service. Participants: eighty people who had received in-patient treatment and who were subject to the CPA. Outcome meaures: interview protocols, including satisfaction ratings and case note audit. Results: seventy-one people (89% of the original sample) completed the first interview and 57 (71% of the original sample) completed the second interview. Some people still lost contact with services, more than half of the sample were not involved in their care planning and nearly half of the patients did not know who their key worker was at time of discharge. Conclusions: there are limitations regarding how far our findings can be generalized. However, the study does point to the importance of greater involvement of users and carers and highlights the importance of providing appropriate training to key workers.
Mental Health Practice, 2009
British Journal of Mental Health Nursing, 2016
In this article, BJMHN consultant editor Kevin Gournay discusses approaches to addressing dual di... more In this article, BJMHN consultant editor Kevin Gournay discusses approaches to addressing dual diagnosis both in the UK and internationally
British Journal of Mental Health Nursing, 2013
This article provides mental health nurses with an overview of alcohol dependency, and up-to-date... more This article provides mental health nurses with an overview of alcohol dependency, and up-to-date information on treatment approaches. It aims to assist mental health nurses to refocus their attention to this topic, bearing in mind that when most nurses think of alcohol dependency they will focus on those with problems at the severe end of the spectrum—particularly those with accompanying serious and enduring mental illnesses. It is argued that a shift of focus is necessary as there are many more people who are not moderately or severely dependent, who nevertheless are either drinking at hazardous levels, or have a mild level of alcohol dependency. Targeting this group may prevent physical and mental health problems developing. These patients will usually be encountered in primary care settings.
International Journal of Nursing Studies, 2000
Ethical Issues in Nursing and Midwifery Practice, 1998
Mental health problems are so common that at some point in our lives all of us will be affected e... more Mental health problems are so common that at some point in our lives all of us will be affected either by personal experience or the experience of those close to us. Thus, for example, the lifetime prevalence of schizophrenia, the most severe and enduring of mental illness, is 1 per cent and of depression more than 20 per cent (Department of Health, 1994). We know that roughly one in three of us will have a panic attack or panic attacks during our lifetime (Gournay, 1996) and up to 40 per cent of all general practitioner (GP) consultations concern medical problems for which no physical cause is evident. Mental health problems range from discrete episodes of anxiety and depression which last no more than a few days, to the most serious and enduring forms of illness such as schizophrenia and bipolar affective disorder. There is no simple spectrum covering the positions between these two extremes; mental health problems are best conceptualized as being multifaceted and multidimensional. Problems often present themselves somewhat paradoxically. For example, people with the most severe obsessions and compulsions may spend literally hours a day washing their hands while at the same time lead a very productive life in one of the professions and also have major familial and parental responsibilities.