A mentor-mentee support program for people with anorexia nervosa

Background: Successful mentorship enhances quality of life, hope for recovery and empowers people with anorexia nervosa (AN) to develop health-promoting strategies, with immeasurable benefits for both mentor and mentee. Aims: To develop and evaluate, in consultation with stakeholders (people with AN and recovered individuals), a mentorship support program for people with AN in NSW. Methods: This study is a mixed methods participatory action research (PAR) project. Participants are pivotal in the development and design of a tailored program. Researchers work closely with stakeholders to bring and evaluate change, through cycles of learning and reflection, actively engaging participants in the research process. Results: During workshop discussions, participants (4 mentors and 5 mentees) defined the program, examined roles and responsibilities, partnerships, interaction, use of funds, conflict resolution and risk management. The workshop, conducted informally in a setting that simulated a home environment, reduced anxiety levels. Uncertainty evolved into an appreciation for the program, development of new relationships, learning that everyone had similar reservations yet reassurance that people were there to support and encourage recovery. Participants were positive and optimistic for the program’s trial. Conclusion: PAR is an apt research method for actively engaging stakeholders in the development of a tailored program to support recovery

The mental health imaginary vis-a-vis its nurses and Australian environs : an essay

This paper aims to contribute to a debate around the state of mental health nursing in the early 21st century. The author uses his nursing background in mental health in Australia as well as his training in philosophy to attempt to say something about what he terms the mental health imaginary. The research in situ commences with an outline of the philosophical traditions that are called upon, in particular Husserlian phenomenology, before launching into an experiential exegesis. Tracing his memory of a work history in mental and general health the author seeks to uncover constitutive elements of nursing in mental health. Outlining the evolution of nursing in mental health in Australia, as he recalls it, he touches on developments in education, professional amalgamations and the introduction of crisis teams. The question of risk and uncertainty is opened up to reveal that the assimilation of these elements into practice is what distinguishes nursing in mental health from nursing in other areas. The questions of subjectivity and objectivity are addressed throughout in relation to how they might operate within the imaginary

Understanding the experience of women admitted to a psychiatric hospital in Sydney with psychosis or mania following childbirth after World War II (1945-1955)

In the present study, we investigated a unique set of historical health-care records of women admitted to a psychiatric hospital in Sydney, Australia with a diagnosis of psychosis or mania after childbirth in the post-World War II (WWII) period, from 1945 to 1955. This research is part of a larger project examining how the descriptions of these women documented in the health-care records from 1885 to 1975 affected their treatment and the outcome of their admission. In the present paper, we report on the findings from an intensive examination of the post WWII documents. Eighteen health-care records from a psychiatric facility (Gladesville Hospital) were identified from admission registers housed in the State Records Office of New South Wales in 2014. Although seven records had been destroyed, 11 were transcribed verbatim. The records contain demographic information; descriptions of the women’s signs and symptoms on admission; and information about the women before, during, and after their admission found in letters from relatives or medical staff. A content analysis of admission information showed how the women were described by health-care professionals, but a textual analysis of the records revealed that there were other factors that could have contributed to the women’s condition, which might not have been taken into consideration when treatment and care were devised. The present study demonstrates the value of investigating historical health-care records to understand how prevailing attitudes and practices might affect diagnosis and treatment

Nursing documentation : how meaning is obscured by fragmentary language

This article looks at the effect of using fragmentary language in nursing documentation. Fragmentary language is defined as phrases and abbreviations found in records of nursing care that are understood at the local ward level but would make it difficult for anyone reading the documentation beyond this local level to construct meaning. Sixty-seven entries of nursing documentation were investigated using textual analysis. Each entry was examined to determine how grammatical and linguistic features of the text could impede meaning. Three entries are discussed in detail to demonstrate possible difficulty for readers in understanding the patient’s condition and care. Education programs that encourage nurses to view their documentation as a crucial aspect of care are recommended. Writing nursing documentation in a manner that allows readers from both within and outside the profession to understand the patient’s condition and care required is supported. If readers cannot understand what is written in nursing documentation, there is a danger that misinterpretations could lead to clinical errors and adverse events

The impact of a changed environment on arousal levels of patients in a secure extended rehabilitation facility

This study sought to investigate the effect of changes of the physical ward environment on levels of arousal and aggression in long-stay patients in a secure extended rehabilitation facility. Seclusion episodes, extended seclusion episodes, staff report of aggressive incidents and Brief Psychiatric Rating Scale (BPRS) measures of psychopathology were compared in the same group of long-stay rehabilitation patients over a period of 3 months before and 3 months after a move from a temporary, refurbished medical ward to a large, light-filled, purpose-built facility. Fifteen patients were present during both investigation periods. The majority were male (80%) and had a diagnosis of schizophrenia (53%) or schizoaffective disorder (13%). There were statistically significant reductions in the mean number of seclusion episodes, mean number of extended seclusion episodes (_4 hours) and BPRS total score following the move. There were statistically significant increases in ambient light conditions in the new unit. The physical environment of long-stay rehabilitation wards may influence aggressive behaviour and arousal in chronically ill patients

The application and tailoring of Colaizzi's phenomenological approach to a hospital setting

Husserl's descriptive phenomenology is a popular methodology in health research as it provides a way to understand people's experiences. Positioned in Husserl's phenomenology, Colaizzi's approach offers a way to analyse data and develop trustworthy findings. However, it can pose methodological and practical challenges

Historical perspectives : a snapshot of women admitted to psychiatric facilities with psychosis or mania after childbirth in the late Victorian and inter-war periods

Aim. This study analysed historical healthcare records to investigate how women diagnosed with mania or psychosis and admitted to two mental health facilities in Australia following childbirth, were described in the late Victorian (1885–1895) and inter-war period (1925–1935). Background. Although historians have examined the history of mental health systems in Australia, there is no published scholarship that considers the healthcare records of these women. This was a unique opportunity to explore these documents. Design. An historical study examining healthcare records. The data collection occurred in 2012. Methods. Women admitted to mental health facilities with a diagnosis of psychosis or mania were identified in the admission registers found in the State Record Office of New South Wales and, if available, their healthcare record was transcribed verbatim. The records were imported into NVivo 10 for content analysis to determine the range and scope of information. A further textual analysis was conducted to see if the woman’s diagnosis was congruent with the outcome of her admission. Results/findings. 155 cases were identified across the two periods. Although, demographic data and the description of the women on admission were remarkably similar, 17% of women were physically, rather than mentally, ill and died soon after admission. The findings demonstrate the importance of current practices such as taking a comprehensive healthcare assessment and the use of antibiotics and sanitary measures during labour and in the postnatal period. Conclusion. Historical investigations of healthcare records provide legitimacy for current healthcare practices

Obtaining individual narratives and moving to an intersubjective lived-experience description : a way of doing phenomenology

In this paper, the authors describe a way of doing phenomenology using exemplars drawn from a doctoral study of Australian nurses’ lived experiences following a disaster. Phenomenology is concerned with the essence of things as they are appearing in the conscious awareness of the first person. This paper emphasises a way of doing phenomenology based on maintaining orientation to the uniqueness of the ‘thingness’ of the phenomena being uncovered. While there is no one way to do phenomenology, this paper shows a way of doing phenomenology from obtaining individual narrative and moving to an intersubjective lived-experience description

Instilling hope for a brighter future : a mixed-method mentoring support program for individuals with and recovered from anorexia nervosa

Aims and Objectives: To investigate the feasibility of a 13-week mentoring program in providing social support to promote hope for recovery in anorexia nervosa. Background: With no clear first line psychological treatment for people with anorexia nervosa, mentoring support programs, as an adjunct to treatment, may provide the social support necessary to promote hope for recovery. Design: A mixed method study; Participatory action research. Methods: Women (n=11), recovering and who had recovered from anorexia nervosa, participated in the program and completed self-report questionnaires related to quality of life, distress and the mentoring relationship at different time points. Qualitative feedback from logbooks, workshop evaluation questionnaires, interviews and focus groups was also collected to assess the program’s acceptability. Results: General compliance for completing most study outcome questionnaires was 90% however the mentoring relationship questionnires were not completed to the same degree. Five key themes emerged from the focus group/interview data: 1) She understands me and could relate to me; 2) Re-connecting with the world - Asking questions and being challenged; 3) Mentors’ altruistic motivations and the transformation and discovery of self; 4) Instilling hope - Recovery is possible; and 5) Effective communication - The key to successful mentoring. Conclusions: Further research is needed however the results provide preliminary support for the mentoring program’s feasibility as an adjunct to treatment. We found that having someone who understands, to talk and share with, met a clear need for people with anorexia nervosa. Relevance to clinical practice: While further research is warranted mentoring support or recovered mentors may play a potentially valuable role in supporting those in community settings

Participatory action research for women with anorexia nervosa

Aim. To discuss the application of the principles of participatory action research (PAR) in a project that developed and evaluated a mentor-mentee support programme for women with anorexia nervosa. Background. A programme was developed and implemented in which mentors and mentees participated in workshops, social activities and focus groups that sought to support and develop resilience for those experiencing anorexia nervosa. Discussion. PAR principles were mirrored in the programme, paying respect to the views and needs of each participant, an open trajectory to possible conclusions and a continuous feedback cycle. Mentees had a sense of empowerment, ownership of the programme and hope that recovery was possible. It allowed their voices to be heard and provided them with belief they could begin new relationships and friendships. Conclusion. The principles of PAR suited a project aimed at developing self-determination and resilience in women with anorexia nervosa. Implications for research/practice. PAR would be readily transferable to a number of mental health settings where empowerment is of paramount concern