Journal of the American Psychiatric Nurses Association最新文献

{"title":"APNA Position: Whole Health Begins With Mental Health.","authors":"","doi":"10.1177/10783903261447286","DOIUrl":"10.1177/10783903261447286","url":null,"abstract":"","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"381-382"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constant Observation in an Inpatient Psychiatric Setting: A Scoping Review.","authors":"Katherine E Holland, Meghan Attanasio, Alison A Tebbett-Mock","doi":"10.1177/10783903261478887","DOIUrl":"https://doi.org/10.1177/10783903261478887","url":null,"abstract":"<p><strong>Background: </strong>Observation of patients is integral to nursing's role in inpatient psychiatric settings. Constant observation (CO) is a common strategy for managing high-risk behaviors. Although widely used, the field seemingly does not have a standard definition of CO, and policies for the use of CO vary across institutions. To date, literature has focused on experimental data regarding CO improvement or has been limited in scope. Resultantly, researchers and clinicians have been restricted in their ability to characterize the usage of CO and the effectiveness of CO as a risk reduction strategy.</p><p><strong>Aims: </strong>The purpose of this scoping review was to characterize the extant data regarding CO use and to assess how CO is being discussed in the literature.</p><p><strong>Methods: </strong>This review included published manuscripts, that is, clinical discussions, critiques, commentaries, and research studies pertaining to CO within inpatient psychiatric units.</p><p><strong>Results: </strong>Fifty-nine articles were identified and reviewed. Findings suggested a lack of consensus regarding CO policy. Overall, more patients with more severe symptoms were more likely to receive CO, and high-risk behaviors were predictive of CO use. However, there is limited research suggesting that CO is an effective intervention to prevent or reduce high-risk behaviors. Even so, CO is generally well-accepted across disciplines and by patients, despite it being costly and resource-intensive. Some studies identified interventions such as restructuring staffing, increasing therapeutic interventions, and including patients in problem-solving as effective means of reducing CO use without increasing high-risk behaviors.</p><p><strong>Conclusions: </strong>The role of CO in psychiatric settings was examined, and recommendations were made.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261478887"},"PeriodicalIF":2.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review to Examine Barriers and Facilitators to Seeking Mental Health Services Among University/College Students in the United States.","authors":"Zainab S Almogheer, Sarret Seng, Donna L Schuman, Mary Kay Rayens, Debra Moser, Chizimuzo T C Okoli","doi":"10.1177/10783903261463187","DOIUrl":"https://doi.org/10.1177/10783903261463187","url":null,"abstract":"<p><strong>Background: </strong>University/college students experiencing mental health conditions often face barriers that limit their willingness to seek help. Conversely, some students may view their mental health conditions as facilitators to use available mental health services.</p><p><strong>Aim: </strong>This review explores barriers and facilitators to mental health help-seeking among college students.</p><p><strong>Methods: </strong>A systematic review of published data-based papers. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using three databases: Cumulative Index to Nursing and Allied Health, PubMed, and PsycINFO. The review examined articles from May 2013 until May 2025, specifically selecting articles addressing barriers and facilitators to mental health help-seeking among university/college students.</p><p><strong>Results: </strong>A total of 31 studies were included in the final analysis. Key barriers encompassed stigma, logistical barriers, and cultural issues. Conversely, person-related factors, a history of mental health problems, and positive experiences with mental health services emerged as facilitators for the use of mental health services.</p><p><strong>Conclusions: </strong>It is important to understand the impact of cultural disparities and personal beliefs on mental health, underscoring the significance of normalizing the recognition of mental health concerns and seeking mental health services among university/college students. It is imperative to develop interventions that facilitate students' involvement in professional mental health help-seeking within the university/college context.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261463187"},"PeriodicalIF":2.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemental Health Approaches for Rural Opioid Use Treatment: An Integrative Review.","authors":"Jayme K Weber, Roxanne K Vandermause, Cynthia M Schmidt","doi":"10.1177/10783903261473928","DOIUrl":"https://doi.org/10.1177/10783903261473928","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder (OUD) continues to disproportionately impact rural communities. Telemental health (TMH) offers a promising strategy to bridge this divide, especially in the context of expanding telehealth-delivered medication for OUD (tele-MOUD).</p><p><strong>Aim: </strong>The purpose of this review was to examine the current evidence on TMH approaches for treating OUD among rural adults.</p><p><strong>Methods: </strong>Databases including EMBASE, MEDLINE, CINAHL, PsycINFO, Scopus, the Cochrane Library, and ClinicalTrials.gov were searched in July 2024. Searches were updated in May and November 2025. All studies of TMH care for OUD in rural, adult populations were included. After eligibility screening, findings were synthesized from 23 empirical studies published between January 2022 and November 2025. Reviews published during the pandemic highlighted the need for research in this area. The quality of the evidence was assessed with the Mixed Methods Appraisal Tool (MMAT).</p><p><strong>Results: </strong>In rural settings, TMH demonstrated greater access, retention, and patient satisfaction than traditional in-person care. Tele-mentoring expanded treatment capacity and supported provider confidence. However, disparities in broadband access, digital literacy, stigma, and organizational readiness hinder equitable implementation. Younger clients experienced lower retention, and low-income clients experienced limited access to video-based care. TMH was found to reduce public stigma, but stigma reduction education, particularly for frontline staff and pharmacies, is needed.</p><p><strong>Conclusions: </strong>Telemental health offers a scalable solution to rural OUD treatment inequities, but its success hinges on policy support, digital infrastructure investment, and culturallyresponsive, community-engaged implementation strategies. Future research should address long-term outcomes, standardized metrics, and broader innovations beyond tele-MOUD.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261473928"},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Walls or Digital Bridges? Telehealth for Mental Health Equity Among Palestinians in the West Bank and Gaza.","authors":"Ibrahim Aqtam","doi":"10.1177/10783903261477708","DOIUrl":"https://doi.org/10.1177/10783903261477708","url":null,"abstract":"<p><strong>Objective: </strong>The expansion of telehealth in mental health nursing raises questions about reducing or exacerbating health inequities. For Palestinians living in the West Bank and Gaza facing movement restrictions, infrastructure fragmentation, and chronic trauma, this question is pressing. This conceptual discussion paper critically examines whether telehealth is a \"digital wall\" reinforcing barriers or a \"digital bridge\" expanding equitable access.</p><p><strong>Methods: </strong>This paper synthesizes peer-reviewed literature and United Nations reports. Literature was purposively selected based on conceptual relevance to digital equity, conflict-affected settings, and psychiatric mental health (PMH) nursing, including literature specifically addressing the role of PMH nurses (PMHNs) in conflict zones. The Digital Health Equity Framework guides the thematic analysis organized around infrastructure, affordability, privacy, cultural appropriateness, and community resilience. This is not a systematic review.</p><p><strong>Results: </strong>Available evidence suggests telehealth may function as a barrier or facilitator depending on context. Infrastructure, economic, privacy, and cultural barriers risk making telehealth exclusionary. Conversely, telehealth may bridge access by reducing travel through checkpoints and enabling continuity during military escalations. The critical and underrecognized barrier of inadequate training in telemedicine practice threatens adoption across all provider levels in Palestine. PMHNs occupy a critical mediating role.</p><p><strong>Conclusions: </strong>Telehealth is neither inherently equitable nor inequitable. PMHNs should assess digital access as a social determinant, offer low-bandwidth alternatives, and advocate for structural investments. Capacity building to address the training gap is essential for telehealth integration. Telehealth equity in conflict-affected settings depends less on technology than on whether systems are designed around patients' actual conditions and community resilience.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261477708"},"PeriodicalIF":2.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphocytic Microscopic Colitis Associated with Paroxetine: A Psychiatric Nursing Case Report.","authors":"Matthew Milewski","doi":"10.1177/10783903261477364","DOIUrl":"https://doi.org/10.1177/10783903261477364","url":null,"abstract":"<p><strong>Objective: </strong>To describe a case of biopsy-confirmed lymphocytic microscopic colitis (MC) temporally associated with paroxetine (Paxil) therapy and to highlight psychiatric nursing implications for monitoring serotonergic adverse effects across the brain-gut interface.</p><p><strong>Methods: </strong>This case report was developed using clinical history, diagnostic findings, treatment course, and relevant literature on selective serotonin reuptake inhibitors, MC, and serotonergic signaling in gastrointestinal function.</p><p><strong>Results: </strong>A 27-year-old male with generalized anxiety disorder, panic disorder, agoraphobia, and irritable bowel syndrome developed chronic watery diarrhea, abdominal pain, bowel urgency, and one episode of fecal incontinence while receiving paroxetine, which had previously produced sustained psychiatric remission. Differential considerations included an irritable bowel syndrome flare, infectious diarrhea, inflammatory bowel disease, medication-associated diarrhea, and medication-associated microscopic colitis. Colonoscopy with biopsy confirmed lymphocytic MC. Paroxetine was discontinued, and the patient was treated with budesonide (Entocort EC) and adjunctive gastrointestinal therapies, leading to resolution of gastrointestinal symptoms. After recurrence of anxiety and panic symptoms and poor tolerability or inadequate response to alternative psychotropic medications, paroxetine extended-release was cautiously reintroduced with interdisciplinary monitoring. Gastrointestinal symptoms did not recur during the 1-year follow-up period.</p><p><strong>Conclusions: </strong>This case illustrates the importance of psychiatric nursing vigilance for persistent gastrointestinal symptoms in patients receiving serotonergic antidepressants. Recognition of possible medication-associated MC may support timely referral, interdisciplinary collaboration, and individualized psychopharmacologic decision-making.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261477364"},"PeriodicalIF":2.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Lock and Protect\" as a Risk Reduction Quality Improvement Project in Adolescent Outpatient Mental Health.","authors":"Kathy Stanton, Hadassah Joseph, Amelia Mathew, Julie A Thompson, Sean Convoy","doi":"10.1177/10783903261474453","DOIUrl":"https://doi.org/10.1177/10783903261474453","url":null,"abstract":"<p><strong>Background: </strong>Suicide is a leading cause of adolescent death in the United States (US), with access to lethal means significantly increasing mortality risk. Parents are crucial to prevention but often lack knowledge and confidence in lethal means restriction (LMR). Despite evidence-based support and national guidelines, LMR counseling remains inconsistently implemented in outpatient settings.</p><p><strong>Purpose: </strong>This project evaluated the feasibility, acceptability, and impact of the Lock and Protect (L&P) online decision aid in an outpatient mental health clinic, examining parent-reported changes in lethal means storage practices.</p><p><strong>Methods: </strong>A 12-week quality improvement project was conducted in a suburban southeastern US outpatient mental health clinic. Parents and guardians of adolescents accessed the L&P decision aid via QR-code flyers during visits or through electronic health record portal messages. Participants completed anonymous surveys assessing the tool's usefulness, approachability, relevance, and planned storage practice changes. Descriptive statistics were used to analyze responses.</p><p><strong>Results: </strong>Of 165 families invited, 31 completed surveys (18.8%), with in-person QR-code distribution yielding higher engagement than electronic messaging. Most participants found the tool useful (83.9%) and reported that it made discussing this difficult topic more approachable (90%). Overall, 67.7% planned to change the storage of at least one lethal means type, most commonly medications (43.3%). Among families with unsecured firearms, 66% planned to adopt more secure storage practices.</p><p><strong>Conclusion: </strong>Used in an outpatient mental health setting, the L&P decision aid demonstrated utility, approachability, and relevance with increased intent to secure lethal means. Findings support this LMR education as a scalable, low-burden suicide prevention strategy appropriate for outpatient practice.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261474453"},"PeriodicalIF":2.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship of Child Sexual Abuse and Youth Suicide: A Qualitative Systematic Review.","authors":"Pamela Adamshick","doi":"10.1177/10783903261471541","DOIUrl":"https://doi.org/10.1177/10783903261471541","url":null,"abstract":"<p><strong>Background: </strong>In 2023, suicide emerged as the second leading cause of death for 10- to 24-year-olds in the United States, accounting for over 40,000 deaths across the age group. Recent research identified childhood adverse experiences, including sexual, physical, and emotional abuse and neglect, as possible links with youth suicidal behavior.</p><p><strong>Aims: </strong>This review aimed to synthesize qualitative evidence on childhood sexual abuse (CSA) and the relationship to self-harm, suicidal ideation, or attempts.</p><p><strong>Methods: </strong>CINAHL, OVID Medline, and PsycInfo databases were searched for qualitative research articles relevant to youth sexual abuse, trauma, and suicidal behaviors.</p><p><strong>Results: </strong>Of 442 records screened, 11 qualitative studies met the criteria for the systematic review. Four themes emerged: CSA and the perpetrators; suicidal behaviors and self-harm; shame, self-blame, and guilt; and disclosure.</p><p><strong>Conclusions: </strong>Despite the growing prevalence of childhood sexual abuse and other traumas, there is a lack of boundaries and safety for youth and an absence of effective strategies to mitigate CSA and related suicidality. Opportunities for youth disclosure about child sexual abuse initiate the work of healing from shame and should be provided in a timely manner. Researchers acknowledge the powerful impact of disclosure and advise ongoing therapy for recovery, with emphasis on safe environments.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261471541"},"PeriodicalIF":2.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report: Cobenfy in a Middle-Aged Man with Schizophrenia.","authors":"Mady Stovall","doi":"10.1177/10783903261473927","DOIUrl":"https://doi.org/10.1177/10783903261473927","url":null,"abstract":"<p><strong>Objective: </strong>Schizophrenia is a serious mental illness with symptoms that impact mood, behavior, perceptions of reality, and cognition. This case report highlights the challenges faced in achieving optimal outcomes.</p><p><strong>Method: </strong>This case report was compiled using data synthesis, literature review, and an evidence-based description of the case.</p><p><strong>Results: </strong>A man living with schizophrenia had been stable for about 8 years, working and thriving, living alone, when he stopped taking his medications and suffered a global functional decline and required inpatient psychiatric hospitalization. He was initiated on oral quetiapine and discharged with persistent moderate positive, negative, and cognitive symptoms. At his initial outpatient evaluation, he expressed difficulty with adherence, so treatment was initiated with long-acting injectable risperidone. In his third monthly visit post-hospitalization, he continued to have symptoms across all domains that were significantly disrupting life, so xanomeline with trospium chloride (Cobenfy^®) was added to his long-acting injectable (LAI) treatment. In less than a week, his mother called and noted significant global improvements in his functional status.</p><p><strong>Conclusions: </strong>This case highlights the benefit of adding xanomeline with trospium chloride to traditional antipsychotic treatments in improving patient outcomes.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261473927"},"PeriodicalIF":2.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidal Ideation in Graduate Students: Psychometric Validation of the Brazilian Version of the Frequency of Suicidal Ideation Inventory.","authors":"Jaqueline Galdino Albuquerque Perrelli, Elisete Maria Umbelino Alves da Silva, Marcela de Araujo Cavalcanti Maciel, Paulo Dias de Amorim Neto, Robson Gomes Dos Santos, Girliani Silva de Sousa, Juliana Lourenço de Araújo Veras, Maycoln Leôni Martins Teodoro, Cecilia Maria Farias de Queiroz Frazão","doi":"10.1177/10783903261471537","DOIUrl":"https://doi.org/10.1177/10783903261471537","url":null,"abstract":"<p><strong>Background: </strong>Graduate students are a particularly vulnerable group in terms of suicidal behavior, which highlights the need for psychometrically robust instruments for assessing suicidal ideation within academic environments.</p><p><strong>Aims: </strong>To evaluate the validity evidence of the Frequency of Suicidal Ideation Inventory - Brazilian version among Brazilian graduate students.</p><p><strong>Methods: </strong>A total of 701 participants participated in this psychometric study. The construct validity of the model was evaluated using Confirmatory Factor Analysis, as well as the model fit indices and unidimensionality metrics. The reliability and precision of the scores were assessed using McDonald's omega coefficient, marginal reliability, determinacy and sensitivity indices, as well as the factor replicability index. The correlation with the Kessler Psychological Distress Scale was used to evaluate convergent validity, whereas criterion-related validity was assessed using ROC analysis, taking self-reported suicide attempts within the past 12 months into account as the external criterion.</p><p><strong>Results: </strong>This instrument demonstrated a unidimensional structure, which was supported by high factor loadings (λ = .806-.928) and substantial communalities (0.649-0.861). The presence of a dominant general factor was confirmed by the unidimensionality index (UniCo = 0.999; Explained Common Variance (ECV) = 0.958; Mean of Item Residual Absolute Loadings (MIREAL) = 0.176). The model fit was satisfactory (Comparative Fit Index (CFI) = 0.998; Tucker-Lewis Index (TLI) = 0.995; Standardized Root Mean Square Residual (SRMR) = 0.031), although the RMSEA was high (0.096), likely due to the low degrees of freedom in the model. The reliability and precision of scores were excellent (ω = .958; <i>H</i> = 0.954; marginal reliability = 0.950; factor determinacy = 0.975). Convergent validity was supported by a moderate positive correlation with the Kessler Psychological Distress Scale (ρ = 0.583; <i>p</i> < .001). An ROC analysis indicated excellent discriminatory capability (AUC = 0.921), sensitivity of 91.67%, and specificity of 86.79%.</p><p><strong>Conclusions: </strong>The results demonstrate robust evidence of structural validity, high score precision, and excellent discriminatory performance, supporting the use of the FSII-Br as a reliable tool for assessing suicidal ideation among Brazilian graduate students.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261471537"},"PeriodicalIF":2.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}