Mental Health nursing Research Papers (original) (raw)

Children of parents with mental illness have been identified as a hidden population within mental health services, despite many clients being parents. In Australia, children of parents with a mental illness have been the focus of... more

Children of parents with mental illness have been identified as a hidden population within mental health services, despite many clients being parents. In Australia, children of parents with a mental illness have been the focus of initiatives aimed at promoting their health and well-being and developing family-focused services. However, there has been little focus on children visiting acute inpatient mental health facilities. The aim of this study was to understand the experiences of children, their parents and carers, and staff when children visit, to better inform service planning. A qualitative exploratory research framework was used, and data were gathered through interviews. This paper presents the findings from the perspective of staff. Findings indicated that staff experienced being in a dilemma about children visiting and there were barriers to implementing family-friendly services. While staff mostly agreed in principle that children's visiting was beneficial, there was a lack of local policy and guidelines, and ad hoc arrangements existed. In addition, staff were unsure of their role with children, felt ill-equipped to talk to children about mental illness; and lacked knowledge of age-appropriate resources. Models of inpatient care need to be developed with a family focus that acknowledges the parental roles of clients and supports children visiting.

U ndergraduate nursing students encounter many first-time, anxiety-provoking situations. They learn to manage their fears and perform practice skills according to the expectations of the psychiatric faculty and nursing staff. Perhaps one... more

U ndergraduate nursing students encounter many first-time, anxiety-provoking situations. They learn to manage their fears and perform practice skills according to the expectations of the psychiatric faculty and nursing staff. Perhaps one of the most upsetting clinical experiences for nursing students is the psychiatric-mental health practicum in which they are expected to communicate therapeutically with hospitalized patients who are mentally ill. Because of patient aggression and threats of violence in psychiatric settings (Morrison, 1998), caring for mentally ill persons invokes strong responses by the students, including "anxiety, learning, failure, and growth" (Frisch & Frisch, 1998, p. 5). To ease students' progression into the professional nursing role, psychiatric-mental health faculty prepare the students, during class and clinical conferences, for contact with patients who are mentally ill. Techniques used to prepare students include the following: (a) describing the biopsychosocial theories that explain the behavior of patients and the interventions of health care providers; (b) examining stereotypical behavior; (c) teaching students therapeutic communication approaches and safety techniques; (d) stimulating students to increase self-awareness; (e) reassuring students that seasoned staff and nursing faculty are nearby; and (f) asking students to seek faculty and staff assistance when they are concerned about the behavior of psychiatric patients. Few literature sources (Krikorian & Paulanka, 1984; Nieswiadomy, Arnold, & Johnson, 1989; Perese, 1996) have examined baccalaureate nursing students' clinical experiences in psychiatric-mental health settings. No specific investigations were located that examined nursing students' experiences when com

The transition from hospital to community care for people with long-term mental illness is of growing concern. The aim of the present study was to illuminate if and how people with long-term mental illness have affected their... more

The transition from hospital to community care for people with long-term mental illness is of growing concern. The aim of the present study was to illuminate if and how people with long-term mental illness have affected their neighbourhood after re-establishing themselves in apartments of their own. Nineteen neighbours of group homes for people with long-term mental illness, in seven different communities in eastern Norway, have been interviewed. The grounded theory procedures as well as the constant comparative method were employed to analyse the findings. From the data, one main category was identified: the need for information.

In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal... more

In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the authors. It was evaluated with the aim to increase effective behaviours by both patients and community psychiatric nurses (CPNs). To assess the feasibility and effectiveness of an intervention program for use by CPNs in the care of 'difficult' patients with non-psychotic chronic disorders, in a controlled pilot study. A mixed-methods quasi-experimental study using process and outcome measures across several dimensions. Measurements took place at 0, 3, and 6 months. Three community mental health centres in the centre of The Netherlands. 14 CPNs and 36 long-term non-psychotic patients who were perceived as 'difficult' were selected. Patients were offered either ICPT (20) or car...

Background: Sexual assault examiners provides comprehensive health care to victims of sexual assault. Communication with the victim is important to collect relevant information from the victims. Ineffective communications can cause... more

Background: Sexual assault examiners provides comprehensive health care to victims of sexual assault. Communication with the victim is important to collect relevant information from the victims. Ineffective communications can cause re-victimization and hamper the medico-legal evidence collection. Main text: This article aims to orient the novice examiner and nurses to the prerequisites of medico-legal history collection, techniques of building trust, establishing rapport, ensuring privacy and confidentiality, taking consent, communicating effectively with the victims of sexual assault, and components of medico-legal history collection. Conclusions: Novice examiners and nurses need to be trained in collecting medico-legal history and evidence. The examiners who conduct the examination should be dedicated to delivering compassionate and high-quality care to individuals who have disclosed sexual assault.

BACKGROUND AND RELATED WORK Department of Veterans Affairs  Polytrauma Centers The signature injuries of soldiers returning from Afghanistan and Iraq are polytrauma and TBI [5-6]. In the majority of Department of Veterans Affairs (VA)... more

BACKGROUND AND RELATED WORK Department of Veterans Affairs  Polytrauma Centers The signature injuries of soldiers returning from Afghanistan and Iraq are polytrauma and TBI [5-6]. In the majority of Department of Veterans Affairs (VA) clinical cases, polytrauma and TBI are caused by blast injuries from improvised explosive devices, although TBI also results from noncombat events such as motor vehicle accidents. Polytrauma is defined as injuries to two or more body systems from one event. An extreme example would be injuries that simultaneously result in limb amputation, TBI, burns, deafness, and blindness, with long-term physical and cognitive impairments and functional disabilities.

Evidence-based practice has become an important approach to social work practice. This paper highlights some of the ethical dilemmas which may be implicated by this approach, and encourages social workers and social work researchers to... more

Evidence-based practice has become an important approach to social work practice. This paper highlights some of the ethical dilemmas which may be implicated by this approach, and encourages social workers and social work researchers to carefully consider these potential quandaries.

Consumer and carer involvement in mental health research is a growing and developing field. Whilst there has been policy and in-principle support for such involvement from governments around the world, lived experience researchers... more

Consumer and carer involvement in mental health research is a growing and developing field. Whilst there has been policy and in-principle support for such involvement from governments around the world, lived experience researchers conducting academic research in partnership with other consumers and carers remains uncommon. The Australian Capital Territory Consumer and Carer Mental Health Research Unit is based at The Australian National University and employs academic researchers with lived experience to undertake research directly relevant to the needs of mental health consumers and carers with the aim of influencing policy and practice. In this study, we share our experience of developing and conducting research within ACACIA to provide a model for meaningfully engaging mental health consumers and carers throughout the research process.

Remarks such as 'she's manipulative' and 'he's right off' are familiar to psychiatric nurses. This paper critiques the language nurses use in acute inpatient psychiatry services, highlighting the diverse discourses implicated in nurses'... more

Remarks such as 'she's manipulative' and 'he's right off' are familiar to psychiatric nurses. This paper critiques the language nurses use in acute inpatient psychiatry services, highlighting the diverse discourses implicated in nurses' writing and speaking about patients. Based on a review of the literature, this paper examines ethnographic studies and discourse analyses of psychiatric nurses' oral and written language. A prominent debate in the literature surrounds nurses' use of standardized language, which is the use of set terms for symptoms and nursing activities. This review of spoken descriptions of patients highlights nurses' use of informal and local descriptions, incorporating elements of moral judgement, common sense language and empathy. Research into written accounts in patient files and records show nurses' use of objectifying language, the dominance of medicine and the emergence of the language of bureaucracy in health services. Challenges to the language of psychiatry and psychiatric nursing arise from fields as diverse as bioscience, humanism and social theory. Authors who focus on the relationship between language, power and the discipline of nursing disagree in regard to their analysis of particular language as a constructive exercise of power by nurses. Thus, particular language is in some instances endorsed and in other instances censured, by nurses in research and practice. In this paper, a Foucauldian analysis provides further critique of taken-for-granted practices of speech and writing. Rather than censoring language, we recommend that nurses, researchers and educators attend to nurses' everyday language and explore what it produces for nurses, patients and society.

This paper describes an audit of prevention and management of violence and aggression care plans and incident reporting forms which aimed to: (i) report the compliance rate of completion of care plans; (ii) identify the extent to which... more

This paper describes an audit of prevention and management of violence and aggression care plans and incident reporting forms which aimed to: (i) report the compliance rate of completion of care plans; (ii) identify the extent to which patients contribute to and agree with their care plan; (iii) describe de-escalation methods documented in care plans; and (iv) ascertain the extent to which the de-escalation methods described in the care plan are recorded as having been attempted in the event of an incident. Care plans and incident report fo s e e e a i ed fo all patie ts i e s a d o e s e tal health a e path a s who were involved in aggressive incidents between May-October 2012. In total, 539 incidents were examined, involving 147 patients and 121 care plans. There was no care plan in place at the time of 151 incidents giving a compliance rate of 72%. It was documented that 40% of patients had contributed to their care plans. Thematic analysis of de-escalation methods documented in the care plans revealed five de-escalation themes: staff interventions, interactions, space/quiet, activities and patient strategies/skills. A sixth category, coercive strategies, was also documented. Evidence of adherence to de-escalation elements of the care plan was documented in 58% of incidents. The reasons for the low compliance rate and very low documentation of patient involvement need further investigation. The inclusion of coercive strategies within de-escalation documentation suggests that some staff fundamentally misunderstand de-escalation.

This chapter discusses some of the complex issues surrounding the notion of cultural competence-and the critical need for practitioners to develop knowledge, skills, understandings and attributes to be responsive in diverse cultural... more

This chapter discusses some of the complex issues surrounding the notion of cultural competence-and the critical need for practitioners to develop knowledge, skills, understandings and attributes to be responsive in diverse cultural settings. The argument for culturally competent mental health practitioners and services is situated within a human rights framework which underpins the principles, standards and practice frameworks intended to facilitate/contribute to the capacity and empowerment of mental health practitioners and clients, families and communities. The National Practice Standards for the Mental Health Workforce 2013 (the practice standards) 1 outline core competencies (including cultural competence) regarded as essential for the mental health workforce: mental health nursing, occupational therapy, psychiatry, psychology and social work. The documented impact of these disciplines/professions on Aboriginal people requires new ways of working that are empowering, respectful and ethical. A case is made for the importance of practitioners providing more culturally inclusive and appropriate care to increase the likelihood that clients and their carers will experience a sense of cultural safety (as well as culturally appropriate services) for Aboriginal clients, their families and communities. The practice standards are complemented by professional guidelines and the National Standards for Mental Health Services 2010 (the service standards). 2 This chapter provides a range of tools and strategies and a Critical Reflection Framework for Analysis to assist students or practitioners to adopt a critical standpoint in order to develop key competencies (knowledge, skills, attitudes and values) to be culturally respectful and effective in their practice in Aboriginal and Torres Strait Islander mental health. Equally important is the need for strategies for self-care and support such as mentoring, journaling, peer support, counselling and engaging in self-reflective, transformative practice. The Framework aims to enhance practitioners' professional competence through critical reflection upon themselves, others, their discipline and professional codes of conduct and practice standards, and the broader contemporary and historical contexts in which practitioners, their clients, and their families and communities are situated, and in which policies are made and programs and services are delivered. It also discusses some of the cultural competence audit tools that can assist organisations to enact policies and processes intended to bring about system level change to enhance cultural competence across these sectors. THE MENTAL HEALTH PRACTITIONER Under the COAG mental health reform to improve Aboriginal and Torres Strait Islander health and wellbeing, health workers, counsellors and clinical staff in culturally-specific health services require the capacity and competence to identify and address mental illnesses and associated substance use issues and to recognise the distinctive and pervasive trauma, grief and loss experienced by Aboriginal people. They also need to work in accordance with the guiding principles contained in the Ways Forward National Aboriginal and Islander Mental Health Policy Report 3(pp19-20) reinforced in the Charge by Rob Riley (page xvi) which asked all mental health practitioners to 'take on board' the understanding that: z The Aboriginal concept of health is holistic. z Self-determination is central to the provision of Aboriginal health services. z Culturally valid understanding must shape provision of Aboriginal health (and mental health) care. z The experience of trauma and loss contribute to the impairment of Aboriginal culture and mental health well-being. z The human rights of Aboriginal people must be recognised and enforced (emphasis added). z Racism, stigma, adversity and social disadvantage must be addressed in strategies aimed at improving Aboriginal mental health. z The strength and centrality of Aboriginal family and kinship must be understood and accepted. z Diversity of groups needs to be recognised.

The WALC intervention was designed to motivate exercise in the elderly. Persons with schizophrenia spectrum disorders (SSDs) face similar exercise barriers. We described theoritical underpinnings of theWALC intervention and how we adapted... more

The WALC intervention was designed to motivate exercise in the elderly. Persons with schizophrenia spectrum disorders (SSDs) face similar exercise barriers. We described theoritical underpinnings of theWALC intervention and how we adapted it for SSDs. We conducted a feasibility study of the adapted intervention in 17 persons with SSDs. The adapted intervention incorporated low intensity stretches, exercise education and exercise cues. The intervention was feasible and acceptable to participants; approximately two-thirds of all groups were attended and nearly half of participants attended at least 75% of groups. Follow up studies should examine the effect of the intervention upon future exercise behavior, with the goal of identifying evidence based interventions to increase exercise in this group.

The views and opinions of people who use mental health services are being increasingly acknowledged in relation to rights-based, socially-inclusive, and recovery-oriented care. However, little is known of the experiences of lesbian, gay,... more

The views and opinions of people who use mental health services are being increasingly acknowledged in relation to rights-based, socially-inclusive, and recovery-oriented care. However, little is known of the experiences of lesbian, gay, bisexual, and transgender (LGBT) people in this respect. The aim of the present study was to explore the experiences and needs of LGBT people in relation to mental health services. The study was an exploratory design utilizing mixed methods. Both quantitative and qualitative data were collected using a survey instrument (n = 125) and in-depth semistructured interviews (n = 20) with a sample of people who had completed the survey. This paper will report on the findings from the interview data. The data were thematically analysed, and the main themes that emerged included accessing services, treatment choices, mental health service experiences, and other supports. The findings inform the discussion, and recommendations are made in terms of future ment...

Workplace violence directed at nurses working in both the mental health and general areas of the hospital is a common occurrence and the impact of these events on all parties may be severe. A consequence of these confronting situations is... more

Workplace violence directed at nurses working in both the mental health and general areas of the hospital is a common occurrence and the impact of these events on all parties may be severe. A consequence of these confronting situations is the possibility that nurse victims will leave the profession. To help administrators facilitate nurses' psychological recovery, this qualitative study identified how nurses in several areas of a hospital setting adapted to workplace violence, research which has been previously unexamined. This study was the first of its kind to use a theory of cognitive adaptation to explore nurses' experiences of workplace violence. Participants were found to use the cognitive processes of finding meaning, gaining mastery and enhancing the self to adapt to workplace violence. Critical incident debriefing may facilitate the nurse victim's psychological recovery following an episode of workplace violence.

Individuals diagnosed with mental illness experience high rates of morbidity and mortality as a result of poor physical health and unhealthy lifestyle behaviours. The aim of this paper is to systematically review the literature on health... more

Individuals diagnosed with mental illness experience high rates of morbidity and mortality as a result of poor physical health and unhealthy lifestyle behaviours. The aim of this paper is to systematically review the literature on health behaviour interventions to improve the physical health of individuals diagnosed with a mental illness. A systematic search strategy was undertaken using four of the major electronic databases. Identified articles were screened for inclusion, included articles were coded, and data were extracted and critically reviewed. A total of 42 articles were identified for inclusion. The most commonly targeted physical health behaviour was weight management. The majority of studies reported improvements in health behaviours following interventions. The findings provide evidence for the positive effect of health behaviour interventions in improving the physical health of individuals diagnosed with a serious mental illness. A focus on health behaviour interventions within the mental health nursing profession might lead to improvements in health behaviours and general health in consumers of mental health services.

The authors conducted an all-Wales survey of community mental health nurses (CMHNs) to determine their levels of stress, coping and burnout. A total of 301 CMHNs were surveyed in 10 NHS Trusts in Wales. A range of measures were used.... more

The authors conducted an all-Wales survey of community mental health nurses (CMHNs) to determine their levels of stress, coping and burnout. A total of 301 CMHNs were surveyed in 10 NHS Trusts in Wales. A range of measures were used. These included the General Health Questionnaire (GHQ-12), Maslach Burnout Inventory (MBI), Rosenberg Self-Esteem Scale (SES), Community Psychiatric Nursing (CPN) Stress Questionnaire, and PsychNurse Methods of Coping Questionnaire. The findings from the Rosenberg SES are reported here. Community mental health nurses in Wales scored as having average self-esteem. When the data were divided into high and low self-esteem, a large group of CMHNs (40%) were found to have low self-esteem. Factors that are associated with low and high self-esteem were identified. Alcohol consumption and being on lower nursing grades (D, E, F) were associated with low self-esteem, whilst amount of experience working as a CMHN was associated with high self-esteem.

The aim of this project was to investigate in members of the Vietnamese community in Melbourne the impact of Mental Health First Aid (MHFA) training on attitudes to people with mental illness and on knowledge about mental disorders. Our... more

The aim of this project was to investigate in members of the Vietnamese community in Melbourne the impact of Mental Health First Aid (MHFA) training on attitudes to people with mental illness and on knowledge about mental disorders. Our hypotheses were that at the end of the training participants would have increased knowledge of mental disorders and their treatments, and decreased negative attitudes towards people with mental disorders.

Aims. The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK.Methods. The research instruments used were the Maslach... more

Aims. The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK.Methods. The research instruments used were the Maslach Burnout Inventory and the Manchester Clinical Supervision Scale. At the time of the survey 817 community mental health nurses were reported to work within Wales. Two hundred and sixty (32%) community mental heath nurses working in 11 NHS Trusts responded to the survey.Results. One hundred and eighty-nine (73%) community mental heath nurses had experience of clinical supervision in their present posts and 105 (40%) in their previous posts. The findings from the Maslach Burnout Inventory indicated high levels of emotional exhaustion for 36%, high levels of depersonalization for 12% and low levels of personal accomplishment for 10% of the community mental heath nurses surveyed. Univariate analysis showed that those community mental heath nurses who were younger, male and who had not experienced six or more sessions of clinical supervision were more likely to report cold negative attitudes towards their clients as indicated by higher scores on the depersonalization subscale of the Maslach Burnout Inventory. One hundred and sixty-six community mental heath nurses had experienced six or more sessions of clinical supervision and had completed the Maslach Burnout Inventory. Higher scores on the Manchester Clinical Supervision Scale were also associated with lower levels of measured burnout, with significant negative correlations between the total Manchester Clinical Supervision Scale score and the emotional exhaustion subscale (r = −0·148, P = 0·050) and the depersonalization subscale (r = −0·220, P = 0·003) of the Maslach Burnout Inventory. These findings suggest that if clinical supervision is effective then community mental heath nurses are likely to report lower levels of emotional exhaustion and depersonalization.Conclusions. The findings from this study suggest that if clinical supervision is effective then community mental heath nurses report lower levels of burnout. Further research is required to determine the long-term benefits of implementing clinical supervision and to determine which other factors have an influence on levels of burnout for this group of nurses.Relevance to clinical practice. Health service organizations have a responsibility for ensuring that all individual practitioners have access to effective clinical supervision and the Nursing and Midwifery Council could extend the registered nurses personal accountability to include – to seek clinical supervision as and when necessary.

During protected engagement time (PET), ward routines are adjusted so that staff can spend time together with patients without interruption. The aim of PET is to increase staff and patient interaction on wards, and ultimately patient... more

During protected engagement time (PET), ward routines are adjusted so that staff can spend time together with patients without interruption. The aim of PET is to increase staff and patient interaction on wards, and ultimately patient well-being. Although PET has been implemented on inpatient wards within the UK, including older adult wards, there is no systematic evidence as to how PET is carried out or how it is experienced by staff, patients, and families. Semistructured interviews were conducted with 28 participants (8 patients, 10 family members, and 10 ward staff) from three different wards with PET, and transcriptions were analysed using thematic analysis. Three themes were identified: (i) the patient is at the heart of care; (ii) PET depends on staff; and (iii) tensions in how PET operates. There was support in our sample for the principles of PET and its potential for a positive impact on patient well-being. However, the implementation of PET was identified as challenging, h...

Restraint of older persons in inpatient and residential care is used to control aggression, and prevent falls and other adverse outcomes. Initiatives to reduce these practices are being implemented worldwide. However, there has been... more

Restraint of older persons in inpatient and residential care is used to control aggression, and prevent falls and other adverse outcomes. Initiatives to reduce these practices are being implemented worldwide. However, there has been little examination of restraint practice in psychiatric services for older persons. This paper reports a retrospective comparative analysis of restraint use in three acute and two extended care psychiatric inpatient wards in Australia. The analysis involved examination of restraint incidents and comparison of restrained and non-restrained patients. There was significant variation in restraint use between wards. On one acute ward, 12.74% of patients were restrained, although restraint use declined during the data collection period. Patients with dementia were restrained at higher rates than patients with other diagnoses, and restrained patients stayed in hospital for a longer duration. Restraint occurred early in admission, and few differences emerged between those restrained once or multiple times. Mechanical restraint was more prevalent than physical restraint, with restraint predominantly used to manage aggression and falls. Findings provide new data on restraint in older persons' psychiatric services. Greater conceptual understandings of behaviours associated with dementia and the unique needs of patients with these disorders may assist in reducing restraint use in these settings.

Nursing handover is an established practice that involves an interchange of information between nurses to inform of the condition of patients. It is essential to nursing practice in terms of continuity and quality of patient care.... more

Nursing handover is an established practice that involves an interchange of information between nurses to inform of the condition of patients. It is essential to nursing practice in terms of continuity and quality of patient care. However, there is a lack of agreement about the quality, content, and process of handover and, in particular, a lack of information specific to mental health contexts. This paper reports the results of exploratory research of the practice and beliefs about verbal nursing handover within an inpatient mental health rehabilitation setting. Qualitative data were obtained from audiotaped handovers and interviews with nurses and analysed using content analysis. Handovers were found to lack structure and content, be retrospective, problem-focused and inconsistent. The findings were fairly consistent with the literature and would likely be applicable across nursing settings; however, the need to appraise nursing handover in unique contexts was also revealed. The study raised questions about how nursing handover reflects the goals and philosophies of mental health rehabilitation and whether nursing handover is an activity fully integrated with the focus of mental health rehabilitation.

There is a growing body of evidence that suggests that many community mental health nurses (CMHNs) experience considerable stress and burnout. This review aimed to bring together the research evidence in this area for CMHNs working within... more

There is a growing body of evidence that suggests that many community mental health nurses (CMHNs) experience considerable stress and burnout. This review aimed to bring together the research evidence in this area for CMHNs working within the UK. Seventeen papers were identified in the literature, seven of which looked at stress and burnout for all members of community mental health teams (CMHTs) and the remaining 10 papers focused on CMHNs. The evidence indicates that those health professionals working as part of community teams are experiencing increasing levels of stress and burnout as a result of increasing workloads, increasing administration and lack of resources. For CMHNs specific stressors were identified. These included increases in workload and administration, time management, inappropriate referrals, safety issues, role conflict, role ambiguity, lack of supervision, not having enough time for personal study and NHS reforms, general working conditions and lack of funding and resources. Areas for future research are described and the current study of Welsh CMHNs is announced. This review has been completed against a background of further significant changes in the health service. In the mental health field, specific new initiatives will have a significant impact on the practice of community mental health nursing. A new National Framework for Mental Health, along with a review of the Mental Health Act (1983), will undoubtedly help to shape the future practice of mental health nursing.

Quality of life is a holistic approach that not only emphasizes on individual's physical, psychological and spiritual function but also their connections with their environment and opportunities for maintaining and emphasizing skills.... more

Quality of life is a holistic approach that not only emphasizes on individual's physical, psychological and spiritual function but also their connections with their environment and opportunities for maintaining and emphasizing skills. Objectives:  To assess the level of quality of life and life satisfaction among senior citizens.  To compare the level of quality of life and life satisfaction among senior citizens  To associate the level of quality of life and life satisfaction of senior citizens with their selected demographic variables. Methodology: A descriptive research approach was selected to assess the quality of life and life satisfaction among100 senior citizens in selected areas of Tirupati. The samples were identified and collected the data by applying Quality of Life WHO-BREF Scale and life satisfaction index. Results: Among 100 senior citizens 6% had poor quality of life, 34% had moderate quality of life, and 60% had high quality of life. Regarding life satisfaction 47% had average and 53% had high. There was a significant association between the quality life with their education, occupation, health status, NGO's programs available for them financial support, medical help, and Government schemes. The life satisfaction associated with their health status NGO's programs, Government schemes available for them, education, family income, financial support, and medical help. There was a positive correlation 0.543 between quality of life and life satisfaction among senior citizen. Conclusion: Based on the obtained findings the researcher prepared a book let which will help them to improve their quality of life and life satisfaction by following the tips for coping with change, staying connected, sleeping, wholesome eating, coping with grief, prevention and control of problems which arise during their old age.

Non-adherence to antipsychotic medication is associated with relapse of psychiatric symptoms and readmission to inpatient mental health services. The important role of the mental health nurse in facilitating adherence has been... more

Non-adherence to antipsychotic medication is associated with relapse of psychiatric symptoms and readmission to inpatient mental health services. The important role of the mental health nurse in facilitating adherence has been acknowledged, however, there has been little exploration of how nurses themselves perceive this aspect of their role. A qualitative study was conducted to explore the perceptions of mental health nurses employed in inpatient settings regarding their role in facilitating medication adherence. Focus groups were conducted with 22 nurses from three inpatient settings in metropolitan Melbourne. The main themes to emerge from the data were: nurses' responsibilities in medication management; ways in which nurses are educated about antipsychotic medication; barriers to the provision of medication management, and barriers to effective patient adherence. Recommendations for more effective practice are discussed.

The use of coercion in mental health care is not self-evident and requires moral justification. A joint understanding is difficult to achieve, because patients and health professionals often evaluate coercion differently. The present... more

The use of coercion in mental health care is not self-evident and requires moral justification. A joint understanding is difficult to achieve, because patients and health professionals often evaluate coercion differently. The present study aims to discuss patients' 'moral' evaluation of coercion. We believe that such a focus can form the basis for a better and more differentiated understanding of how we evaluate coercion. This is a qualitative study based on participant observation and interviews with patients. In order to focus specifically on the moral evaluation of coercion, we looked within patients' narratives to examine whether we could differentiate between how they experienced coercion and how they morally evaluated its use, and how they envision/describe good coercion. We found that patients differentiated implicitly between experiences and moral evaluation. The findings have been ordered into three types of reactions: agreeing and accepting, fighting or resisting, and resignation. Further reflection upon patients' positive and negative moral evaluations of coercion resulted in the formulation of different concrete elements at three levels: threshold elements, process elements, and empathic elements. These elements helped us to understand what these patients considered 'good coercion'. The implications are that good clinical practice cannot be separated from the formal, moral evaluation of coercion. A differentiated moral understanding of coercion can form the basis for better and more sensitive communication about coercion among all those involved. A more respectful dialogue on the moral evaluation of coercion might also raise awareness during both the decision-making process and the actual practising of coercion.

Touch in mental health nursing: an exploratory study of nurses' views and perceptions The aim of this study was to explore psychiatric nurses' perceptions of physical touch with people who experience mental health problems. A descriptive... more

Touch in mental health nursing: an exploratory study of nurses' views and perceptions The aim of this study was to explore psychiatric nurses' perceptions of physical touch with people who experience mental health problems. A descriptive exploratory qualitative research design was used. Semi-structured interviews were carried out with 10 registered psychiatric nurses who met the inclusion criteria and were randomly selected to participate in the study. Burnard's 14 stage-by-stage process of coding and categorization was used to analyse the data. Watson distinguished between two kinds of physical touch: instrumental and expressive. The findings indicated that physical touch was used in mental health nursing; however, it was only considered to be therapeutic to clients if used judiciously, with effective interpersonal skills. The participants in this study clearly identified the need to be sensitive to both the individual client needs, and honour their personal space and cultural background. A significant issue in this study was male participants concerns that touching female clients would be misinterpreted as a sexual advance. To protect themselves, male participants used touch in a cautious and minimal manner, and only in a public space, where others could view the interaction. In the absence of research on physical touch in mental health nursing there is a need for further research to explore in detail these findings.

Children who have lived with parental mental illness experience long-standing reduced health and social outcomes, alongside ongoing personal distress. While there has been some dialogue regarding interventions to support children who are... more

Children who have lived with parental mental illness experience long-standing reduced health and social outcomes, alongside ongoing personal distress. While there has been some dialogue regarding interventions to support children who are living with parental mental illness, there remains a paucity of knowledge regarding adult children's experiences and potential needs. Given this, the aim of the present study was to establish parenting narratives of adult children who had experienced childhood parental mental illness. This included their experiences of being parented alongside their own subsequent parenting roles. Three men and 10 women, ranging from 30 to 78 years old, met individually with a researcher to tell their stories. Narratives were thematically analysed to establish themes. The findings of the study demonstrated that individuals who have lived with childhood parental mental illness dehumanized their parent with mental illness. The authors argue that all mental health ...

Chpt in R. Kunzendorf (Ed.) Imagery: Recent Developments, NY: Plenum Press, 1991, p. 101-112.

Shaping built environment of psychiatric hospitals is a process that requires predominantly adaptation of introduced solutions to particular patterns of patient behaviour. In contrast to other health care facilities, a psychiatric... more

Shaping built environment of psychiatric hospitals is a process that requires predominantly adaptation of introduced solutions to particular patterns of patient behaviour. In contrast to other health care facilities, a psychiatric hospital admits patients with severe disorders of various origins. In a majority of cases, admitted patients in severe condition pose threat to themselves and/or for those around them.

Background: Many children suffer from attention deficit hyperactivity disorder (ADHD), which is defined as a persistent pattern of inattention or impulsivity that is formed during growth. It is manifested in two or more contexts (e.g., at... more

Background: Many children suffer from attention deficit hyperactivity disorder (ADHD), which is defined as a persistent pattern of inattention or impulsivity that is formed during growth. It is manifested in two or more contexts (e.g., at home, school or work) and negatively affects the individual"s social, academic or occupational functioning. ADHD is usually co-occurring with LD. Early identification and intervention of these problems are very important to address issues at early age. The studies include systematic review of effectiveness of various teaching programs on knowledge and attitude regarding Attention deficit hyperactivity disorder (ADHD) and learning disabilities (LD) of children among primary school teachers. Objectives: To establish the new findings on the effectiveness of various teaching programs on knowledge and attitude regarding Attention Deficit Hyperactivity Disorder (ADHD) and Learning disabilities (LD) of children among primary school teachers. Methodology: The search of significant articles was carried out in PubMed/ Medline, SCOPUS, CINAHL, PsycINFO, Embase, Elsevier and Google Scholar with the following key words: "teaching program", "Knowledge", "Attitude", "Primary school teachers", "ADHD", "LD", "Children", "Systematic review". Systematically searched for studies including knowledge and attitude regarding Attention Deficit Hyperactivity Disorder (ADHD) and Learning disabilities (LD) of children among primary school teachers. The included studies were evaluated according to predefined quality criteria. Results: Analysis was done in terms of Meta analysis. 92 papers were retrieved by the search. Among them, 27 were evaluated to be of higher quality. Studies recruiting sample of primary school teachers and excluded parents. Conclusion: Based on the review it was concluded that ADHD was found to be co morbid with LD. Both ADHD and LD were more prevalent in primary school age children and prevalence increased as per age. There was less knowledge and less favorable attitude among primary school teachers regarding ADHD and LD. Teaching programs were effective in improving knowledge and attitude among primary school teachers regarding ADHD and LD. Education programs should be established to increase awareness about ADHD and LD among primary school teachers.

This case report of a 31 year old woman who described her main problem as an uncontrollable urge to gamble on electronic gaming machines describes the application of exposure therapy (ET) by videoconferencing and the use of a clinical... more

This case report of a 31 year old woman who described her main problem as an uncontrollable urge to gamble on electronic gaming machines describes the application of exposure therapy (ET) by videoconferencing and the use of a clinical therapy assistant in the treatment of pathological gambling. The case study is used to demonstrate the effectiveness of this treatment with six sessions of therapy and 4 year follow up. The use of videoconferencing is discussed in relation to treatment effectiveness, ongoing follow up for the client and education and support for a community mental health nurse, therapy assistant, in a rural setting in South Australia. The implications of using this modality for the treatment of rural patients with problem gambling is discussed.