234 research outputs found

    Perceptions of Jordanian children with cancer regarding concealing the true nature of their diagnosis: An interpretive phenomenological analysis study

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    An interpretative phenomenological analysis approach was used to explore and document the experiences of children diagnosed with cancer regarding the true nature of their diagnosis in the first three months after diagnosis. Face to face semi-structured interviews were conducted with fourteen children diagnosed with cancer and three major themes emerged during data analysis: (1) Surrounded by silence, (2) Confusing the silence, and (3) Try to make sense of the silence. During the journey to diagnosis most participants reported that people around them conceal the true nature of their illness. Participants were left to their own to make sense of the silence that was surrounding them. This created an unintentional division between the participants, their parents and health team members. This also deprived the participants of important sources of support and compromised their emotional and psychosocial well- being. Jordanian parents and health team members need to follow other countries lead and declare the diagnosis of cancer to children in order to effectively prepare them for the challenges they face to cope with their illness

    Development of a falls risk assessment and management tool for older adult mental health units

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    Fall prevention in Western Australian hospitals is monitored with a monthly generic falls assessment/management tool. Whilst this practice is suitable for bed ridden patients, it fails to capture the falls risk for older adult mental health patients who are predominantly ambulant and frequently confused. This paper describes the development of a specific mental health falls risk management tool (MHFRMT) for use in older adult mental health units. The development of this tool evolved from formative focus group research which successfully identified relevant predictors of risks for falls in this population. Corresponding management strategies were then developed for each criterion to the assessed levels of risk. Fall prevention management strategies included referral to physiotherapists for gait and balance testing, referral to occupational therapists for functional ability status and to podiatry for foot care. The new tool was initially piloted across three older adult mental health units in Western Australia with staff feedback resulting in some formatting revisions. The tool was then piloted at a fourth older adult mental unit with no further revisions required. The result was a new tool encompassing a weekly assessment rather monthly like the current generic falls form. Staff feedback was mainly about the format of the new tool rather than the content, suggesting that future studies need to focus on investigating the reliability and validity of the MHFRMT. Finally, although some staff were not happy with the increased work load associated with a weekly assessment, the weekly reporting highlighted two key issues in this patient group over three weeks: (1) fluctuating cognition and (2) mental state and behaviour changes. Additionally, the medication alert system identified the number of medications that increase falls risk and also indicated the risk alert level associated with each medication

    Preventing falls in In-Patient Older Adult Mental Health Services: Different Causative Factors in Mental and Neurocognitive Disorders

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    Aims: To compare falls sustained in two groups of patients (one with mental disorders and the other neurocognitive disorders), in two acute inpatient older adult mental health services in Western Australia (WA). Background: Falls are the most common adverse event experienced during inpatient care. Older people with mental disorders and neurocognitive disorders constitute a high-risk group for accidental falls in hospitals. Methods: Data relating to 207 fall events from 2010-2011 reported in medical records and incident reports were collected. Individuals who sustained a fall were grouped as having a mental disorder (n=73) or neurocognitive disorder (n=134) according to their primary ICD10 diagnosis. Results: Significant differences in the factors that contributed to the fall between the two groups were highlighted. Falls sustained by those with a neurocognitive disorder were due to confusion and disorientation, and psychotropic medication effects. Their falls were more likely to be unwitnessed and injuries were generally less severe. Falls sustained by older adults with mental disorders were attributed to symptoms of their illness or medication side effects and tended to result in more severe injuries requiring medical treatment or further investigation. Conclusions: Older adults with neurocognitive disorders and behavioural and psychological symptoms associated to dementia have different falls risk factors related to their specific illness and cognitive functioning. There is a need for health professionals to receive training to assess, manage and provide appropriate interventions to reduce the specific falls risks in patients with both mental disorders and neurocognitive disorders

    A synopsis of the mental health concerns of university students: results of a text-based online survey from one Australian university

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    Within the university community, student demographic data highlights a high level of cultural diversity and an ‘at-risk’ population for the onset of mental health problems. Moreover, the transition to higher education is itself associated with a range of emotional, social and academic demands that can cause psychological distress. Therefore, at any one time, a substantial number of students may be attempting to complete university studies while managing problematic symptoms, behaviours or an emerging or diagnosed mental disorder. The aim of this paper is to provide a snapshot of these students' experiences to enable strategic planning of future university support services. Of particular importance was the identification of facilitators and barriers that this group of students faced while engaged in university life. Participants were 1378 students enrolled at a Western Australian university who accessed a text-based online survey during May 2009. The students provided descriptions of the range of problematic symptoms, behaviours and/or disorders that were causing interference with their lives, and university career. Not surprisingly, the most commonly identified disorders with the participant population were depression, anxiety and stress-related concerns. More than half the sample had not sought professional help. The results highlight the fact that universities are well placed to play a major role in improving pathways to primary care and early intervention for students with an emerging or diagnosed mental health problem and to identify and support students trying to manage the ‘normal’ psychological demands associated with higher education

    Consumers’ Perceptions of Nurses Using Recovery-focused Care to Reduce Aggression in All Acute Mental Health Including Forensic Mental Health Services

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    Recovery-focused care is now the preferred model of care that health professionals can utilize to support people with a mental illness to achieve their personal and clinical recovery. However, there remains a lack of practice guidelines and educational opportunities to support nurses to use recovery-focused care with consumers who may become aggressive. Objective: This paper reports the findings of research conducted with consumers to obtain their perception of how nurses can use recovery-focused care to reduce aggression in all acute mental health including forensic mental health services. Research Design and Methods: Thirty-one people diagnosed with a mental illness participated in this study. The constructivist grounded theory method guided data collection, coding, and analysis to generate categories that described the consumer perspective. Results: Five categories emerged, and these were: 1) see the person as an individual with a unique lived experience, 2) dialogue to explore the reason for the behaviour, 3) use positive communication to encourage self-management, 4) promote personal comfort to de-escalate the risk for aggression, and 5) travel alongside the person to co-produce strategies for reducing aggression. Conclusion: The findings may be tested in future research to translate recovery principles into acute mental health settings. They can also be incorporated into nursing education and professional development training to increase understanding of consumer perspective of recovery-focused care in all acute mental health including forensic mental health services

    Experiential learning not enough for organ procurement surgery: implications for perioperative nursing education

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    Context —Perioperative nurses play a vital role in assisting in surgical procedures for multiorgan procurement, receiving little education apart from on-the-job experiential learning when they are asked to participate in these procedures. Objectives —Within an Australian context and as part of a larger study, this article describes issues that hindered perioperative nurses’ participatory experiences as a result of lacking education, previous exposure, and preparation for assisting in surgical procedures for organ procurement. Design —The grounded theory method was used to develop a substantive theory of perioperative nurses’ experiences of participating in surgical procedures for multiorgan procurement. Participants —Thirty-five perioperative nurses who had experience in surgical procedures for organ procurement from regional, rural, and metropolitan hospitals of 2 Australian states, New South Wales and Western Australia, participated in the research. Results —Levels of knowledge and experience emerged from the data as an influencing condition and was reported to affect the perioperative nurses’ participatory experiences when assisting in procurement surgical procedures. Six components of levels of knowledge and experience were identified and are described. Conclusion —The findings from this study provide a unique contribution to the existing literature by providing an in-depth understanding of the educational needs of perioperative nurses in order to assist successfully in multiorgan procurement procedures. These findings could guide further research with implications for clinical initiatives or education programs specifically targeting the perioperative nursing profession both locally and internationally

    The perception of adolescents’ inter-parental conflict and accompanied emotional security: A descriptive study

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    How Egyptian adolescents respond to their parents’ inter-parental conflict is relatively unexplored. This descriptive study was completed with adolescents to determine their perceptions of inter-parental conflict and the impact of this on their level of emotional security. Two hundred students from Zagazig city in Egypt aged between 13 and 17 years completed the “Children’s perception of inter-parental conflict scale” and “Security in the inter-parental system scale”. The findings showed that when adolescents witnessed inter-parental conflict they felt scared, sad, emotionally charged or unable to stop thinking about the conflict that they had witnessed. However, participants were unprepared to assist in trying to solve their parents’ conflict. Nurses need to be aware of the negative impact that inter-parental conflict may have on adolescents in their care. Interventions should focus on the preservation of the adolescent’s emotional security to prevent negative psychosocial effects occurring in the future

    The power of vivid experience in hand hygiene compliance

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    Summary In recent years, explicit behavioural theories have been used insome research into hand hygiene behaviour. One of the most prominent ofthese has been the theory of planned behaviour (TPB). In this qualitativestudy aimed at increasing understanding of infection prevention practicein the acute care setting, TPB was identified as a suitable framework forthe emergence of new insights that have the potential to improve thepower of existing education and training. The theory emerging from the researchwas based on a finding that individual experience is of greater importthan formal education in explaining hand hygiene behaviour. Thisindicated that exposure to vivid vicarious experience is a potential meansto improving the power of existing training methods and increasing the propensityfor instilling sustainable adequate hand hygiene habits

    Types of patients in a psychiatric intensive care unit

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    Objective: This paper reports the findings of a descriptive study of a patient populationover a three-month period on an eight bed psychiatric intensive care unit (PICU) in Western Australia. The report provides a quantitative insight into the profile of patients in PICUs. It provides information on patients' diagnoses, presenting signs, symptoms and/or behaviours,legal codes assigned to patients, treatment interventions and management. Method: Data were collected prospectively from August to October 1999. A total of 122 patients were admitted to the PICU during the review period. Data were entered into an Access program then exported to SPSS (Version 9 for Windows) for analysis and frequency distributions were obtained. Results: The results confirmed that the majority of patients admitted to the PICU were assessed as a high level of risk or needed containment. This finding is in line with the admission criteria developed by staff working in the PICU. It also supports the view that staffworking in these units require expertise and confidence to communicate with and manage potentially aggressive and highly aroused patients. Conclusion: This study demonstrates the importance of ongoing evaluations of patient populations in promoting best practice initiatives in psychiatric care
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