Journal of the American Psychiatric Nurses Association最新文献

{"title":"Bridging the Gap: Canadian Healthcare Providers' Perspectives of Harm Reduction and Substance Use Education in Hospital.","authors":"Leanne E Scott, Cheryl Forchuk, Rick Csiernik","doi":"10.1177/10783903251405853","DOIUrl":"10.1177/10783903251405853","url":null,"abstract":"<p><strong>Background: </strong>The complexity of health concerns associated with unregulated substance use has led to increased hospital utilization by people who use unregulated substances. Health care providers have described inadequate knowledge to adequately support this patient population during hospitalization.</p><p><strong>Aims: </strong>The aim of this research was to explore health care providers' perspectives on harm reduction and substance use education in hospital settings.</p><p><strong>Methods: </strong>A qualitative secondary analysis was conducted using an interpretive lens. The research was conducted across three hospitals in one city in Southwestern Ontario. To guide the research, 31 health care providers, the majority being nurses, participated in either focus groups or individual interviews based on preference. All focus group or interview data were analyzed using an ethnographic method of analysis focusing on the hospital environment and education.</p><p><strong>Results: </strong>Health care providers described two interconnected states regarding harm reduction and substance use education: the current state and the desired state. Key themes which emerged in the current state and desired state include: (a) <i>insufficient education</i>, (b) <i>lack of resources</i>, (c) <i>inconsistent policy</i>, (d) <i>culture of stigma and suboptimal care</i>, (e) <i>enhanced education</i>, (f) <i>resources</i>, (g) <i>policy change</i>, and (h) <i>culture shift and optimal care</i>.</p><p><strong>Conclusion: </strong>Findings of this study demonstrate the need for supportive policies, adequate resources, and enhanced harm reduction and substance use in hospital settings. Addressing these gaps is essential to transforming hospital culture and improving care for people who use unregulated substances. These insights can inform future policy, practice, education, and guide new research initiatives.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"187-197"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Untapped Solution to the Mental Health Crisis: Independent Practice for NPs.","authors":"Emily Fowler Bemben","doi":"10.1177/10783903251381365","DOIUrl":"10.1177/10783903251381365","url":null,"abstract":"<p><strong>Objective: </strong>Restrictive laws still impede nurse practitioners (NPs) from realizing the full scope of their training and education in too many states. While practice laws vary from state to state, working in states with restricted practice policies creates a multitude of barriers for patients seeking accessible, high-quality mental health care, especially in rural areas.</p><p><strong>Methods: </strong>One psychiatric mental health NP describes the multiple obstacles she faced in attempting to provide much-needed care to the perinatal mental health community in her state.</p><p><strong>Results: </strong>This review highlights evidence that supports full practice authority, showing improved patient access to high-quality care combined with anecdotal support describing the barriers faced by one clinician.</p><p><strong>Conclusions: </strong>Her journey directly speaks to harsh realities imposed by collaborative physician mandates and the urgent need for nurse practitioner independent practice.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"222-227"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232859","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":"Imprinted Arousal Pattern (IAP): A Transdiagnostic Clinical Reasoning for Compulsive Behaviors.","authors":"Raymond Zakhari","doi":"10.1177/10783903261443980","DOIUrl":"https://doi.org/10.1177/10783903261443980","url":null,"abstract":"<p><strong>Objective: </strong>Compulsive behaviors across psychiatric diagnoses often recur despite diagnostic clarity, pharmacologic stabilization, and structured psychotherapy. Substance use disorders and behavioral addictions demonstrate high relapse rates, particularly under stress, while many patients describe not a pursuit of pleasure but an inability to tolerate stillness, boredom, or emotional deadness. Although the <i>Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision</i> (DSM-5-TR) provides descriptive reliability and the Research Domain Criteria (RDoC) framework advances dimensional neurobiological insight, neither alone offers a clinically operational explanation for stress-triggered recurrence.</p><p><strong>Methods: </strong>This discussion paper proposes the Imprinted Arousal Pattern (IAP) framework, a transdiagnostic clinical reasoning model conceptualizing compulsive behaviors as conditioned arousal-affect-meaning-behavior loops consolidated through reinforcement and stress sensitization. The framework draws from addiction science, conditioning theory, attachment research, and trauma-informed neurobiology and is mapped onto RDoC domains.</p><p><strong>Results: </strong>IAP reframes compulsive behaviors as learned regulatory architectures-once adaptive solutions for managing threat, shame, or dysregulation, now rigid and self-perpetuating across contexts. The framework provides a structured explanation for intolerance of low-arousal states and predictable stress-reactive relapse and translates into practical assessment and treatment considerations for psychiatric-mental health nurse practitioners.</p><p><strong>Conclusions: </strong>By shifting focus from symptom suppression to restructuring maladaptive regulatory systems, IAP offers a coherent, dignity-preserving formulation for compulsive behaviors. As a portable explanatory framework, it provides structured language for patterns long recognized in psychiatric nursing practice but insufficiently named.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261443980"},"PeriodicalIF":1.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774955","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 Qualitative Study of Nurses' Perceptions and Experiences in Caring for Adolescents With Self-Injurious and Suicidal Behaviors.","authors":"Mahdi Shaabani, Kourosh Amini, Farhad Ramezani-Badr, Seyed Kazem Mousavi","doi":"10.1177/10783903261427380","DOIUrl":"https://doi.org/10.1177/10783903261427380","url":null,"abstract":"<p><strong>Background: </strong>Adolescent self-injurious behaviors (SIBs) present a global public health concern. Nurses, as frontline caregivers, play a crucial role in managing these cases, where their perceptions influence care quality. However, qualitative research deeply exploring these perceptions, particularly in the Zanjan, Iran context, remains scarce.</p><p><strong>Aims: </strong>To explore the perceptions and experiences of Zanjan nurses caring for adolescents with SIB.</p><p><strong>Methods: </strong>A qualitative content analysis study. Twelve nurses from general and psychiatric hospitals in Zanjan were purposively sampled. Data from in-depth, semi-structured interviews in Farsi were analyzed using the Graneheim and Lundman approach with MAXQDA software.</p><p><strong>Results: </strong>Analysis of the data generated 449 initial codes, from which three main categories emerged: (1) Conceptualizing Self-Harm: A Spectrum from Distress to Crisis, encompassing subthemes of persistent mental rumination, perceived precipitating factors, and profound emotional impact; (2) Systemic and Clinical Challenges in Care Delivery, comprising subthemes of organizational barriers, care complexities, and limitations in available treatments; and (3) Emotional and Cognitive Responses to the Adolescent, including subthemes of attributions about the person, perceptions of psychological suffering, and recognition of familial struggles.</p><p><strong>Conclusion: </strong>Nurses' perceptions ranged from empathy to frustration. Notably, they often conceptualized non-suicidal self-injury and suicidal behaviors as interconnected expressions of distress rather than distinct phenomena. The findings highlight an urgent need for specialized nurse education, institutional support, and interdisciplinary collaboration to improve care. While insightful, the study's focus on one Zanjan province and a small sample size suggests cautious interpretation and indicates a need for broader research.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261427380"},"PeriodicalIF":1.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775011","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":"Two-Eyed Seeing and Community Sovereignty: Philosophical Extensions for the Mental Health Ambassador Model.","authors":"Trae Stewart","doi":"10.1177/10783903261442945","DOIUrl":"https://doi.org/10.1177/10783903261442945","url":null,"abstract":"","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261442945"},"PeriodicalIF":1.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717184","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":"Saving Lives in Crisis: A Literature Review for Adolescent Crisis Response.","authors":"Faith Carini-Graves","doi":"10.1177/10783903261429446","DOIUrl":"https://doi.org/10.1177/10783903261429446","url":null,"abstract":"<p><strong>Introduction: </strong>Only 50% of children with mental illnesses receive the appropriate mental health care, leading to an increase in acute hospitalizations for crisis events. Community-based psychiatric care programs, such as the Youth Assertive Community Treatment (Youth ACT) programs, offer a novel, community-based crisis intervention for adolescents with complex psychiatric needs. However, many times these programs experience capacity limitations due to staff burnout, stress, and low levels of competence as reported by staff.</p><p><strong>Methods: </strong>Fifty-seven articles were screened for relevance, with 31 meeting inclusion criteria based on predefined appropriateness and exclusion standards.</p><p><strong>Results: </strong>Despite many advances in pediatric psychiatry, crisis management remains a persistent challenge. This review found themes of crisis management guidelines for best practices, crisis management education, crisis management debriefing, crisis management tools, and the role of nursing in crisis management. Multiple trials found reduced hospitalizations and improved psychiatric symptoms with evidence-based guidelines and strategies. Education and debriefing opportunities improved staff self-perceived resilience and self-confidence ratings.</p><p><strong>Conclusion: </strong>Many programs struggle to provide crisis management that reduces psychiatric emergency department visits and hospitalizations. This review highlights how nurses can support crisis care staff by facilitating the recognition of guidelines, providing targeted education, designing crisis management tools, and offering structured debriefings.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261429446"},"PeriodicalIF":1.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690642","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 Effects of Solution-Focused Approach on Psychosocial Adjustment and Treatment Adherence in Individuals Diagnosed With Schizophrenia: A Randomized Controlled Trial.","authors":"Fatih Şahin, Özlem Ulaşoğlu","doi":"10.1177/10783903261427421","DOIUrl":"https://doi.org/10.1177/10783903261427421","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is a chronic psychiatric disorder characterized by persistent impairments in psychosocial functioning and treatment adherence. Community-based mental health services require nursing interventions that support recovery-oriented, person-centered care.</p><p><strong>Aim: </strong>This study aimed to examine the effects of a solution-focused approach (SFA) on psychosocial adjustment and treatment adherence in individuals diagnosed with schizophrenia.</p><p><strong>Method: </strong>This randomized controlled pretest-posttest study, conducted at a community mental health center in Türkiye, assigned participants to an experimental (initial <i>n</i> = 30; completers <i>n</i> = 27; mean age = 48.4 ± 13.47; 66.7% male) or a control group (initial <i>n</i> = 30; completers <i>n</i> = 26; mean age = 55.0 ± 7.03; 87.6% male) via gender-stratified, computer-assisted randomization. The experimental group received six weeks of individual, face-to-face solution-focused sessions led by a psychiatric nurse, while the control group continued routine care. Psychosocial adjustment and treatment adherence were assessed pre- and post-intervention using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) and the Morisky-Green-Levine Adherence Scale (MGL).</p><p><strong>Results: </strong>Groups were similar at baseline. Post-intervention, the experimental group showed a significant reduction in PAIS-SR scores, indicating improved psychosocial adjustment, with notable gains in occupational functioning, family environment, social relationships, and psychological distress. No significant change occurred in the control group. Delta and mixed ANOVA analyses confirmed significantly greater improvement in psychosocial adjustment for the experimental group (<i>p</i> < .001). Treatment adherence also increased significantly in the experimental group, with a statistically significant between-group difference (<i>p</i> = .002).</p><p><strong>Conclusion: </strong>A 6-week, nurse-led solution-focused intervention significantly enhanced psychosocial adjustment and treatment adherence in individuals with schizophrenia. This approach can substantially contribute to recovery-oriented, person-centered psychiatric nursing practices in community-based mental health services.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261427421"},"PeriodicalIF":1.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593056","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":"Enhancing Canada's National Suicide Prevention Plan: Key Recommendations.","authors":"Rosina Mete","doi":"10.1177/10783903261436315","DOIUrl":"https://doi.org/10.1177/10783903261436315","url":null,"abstract":"<p><strong>Objective: </strong>Suicide is a significant public health crisis in Canada, claiming approximately 4,500 lives annually. Despite decades of localized efforts, Canada remains one of the few G7 nations without a national suicide prevention strategy until 2024. This discussion paper examines Canada's newly launched National Suicide Prevention Action Plan (2024-2027) and provides a critique of its structural framework, collaborative mechanisms, and evidence-based approaches.</p><p><strong>Methods: </strong>The article outlines a brief historical overview of Canada's development of the current National Suicide Prevention Action Plan. A review of the Plan's four strategic pillars, specifically, data and monitoring, research and evaluation, support and services, and governance, reveals both progress and ongoing issues. The plan's equity-focused approach, multisectoral collaboration, and integration of Indigenous perspectives mark notable achievements, whereas data infrastructure gaps, funding uncertainties, and implementation dependencies present ongoing concerns.</p><p><strong>Results: </strong>Drawing on successful Canadian and international policy models and provincial innovations, this paper provides concrete recommendations to strengthen implementation and ensure sustained impact on Canada's persistent suicide rates.</p><p><strong>Conclusion: </strong>Canada's National Suicide Prevention Action Plan (2024-2027) constitutes a significant federal milestone in addressing a persistent public health concern. However, to further enhance the current plan, specific details on evaluation, assessments, and outcome measures should be included. In addition, collaboration with provincial and territorial organizations that are currently involved in suicide prevention initiatives would strengthen the plan. More tailored approaches to support diverse groups within Canada and Indigenous populations are additional suggested improvements.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261436315"},"PeriodicalIF":1.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581510","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":"Unlocking the Power of Mindfulness to Enhance Tobacco Treatment Training for Health Care Providers.","authors":"Kent Brouwer, Lee Anne Walmsley, Emily Koyagi, Heather Robertson, Bassema Abufarsakh, Chizimuzo T C Okoli","doi":"10.1177/10783903261433553","DOIUrl":"https://doi.org/10.1177/10783903261433553","url":null,"abstract":"<p><strong>Objectives: </strong>Tobacco cessation remains a challenge for patients in psychiatric settings, with behavioral health care providers (BHCPs) often lacking training in mindfulness-based interventions. This gap may limit BHCPs' ability to offer holistic, evidence-based support to patients struggling with tobacco dependence. Experiential Learning Theory underpinned the mindfulness intervention, emphasizing hands-on learning. Through active participation, such as role-playing and discussion, BHCPs developed practical skills to incorporate mindfulness techniques into patient interactions. Incorporating mindfulness education may enhance tobacco treatment (TT) training, potentially improving outcomes for patients with psychiatric challenges.</p><p><strong>Methods: </strong>A pilot evaluation was conducted on a brief 1-hr online training on mindfulness-based TT strategies. Pre- and post-intervention surveys were used to assess changes in knowledge scores. Post-surveys assessed confidence and intent to apply the learned skills in practice. Changes in knowledge scores were analyzed using paired-sample <i>t</i>-tests, and descriptive statistics were used to present results on confidence and intent to apply learned skills scores after the intervention.</p><p><strong>Results: </strong>Of 28 BHCPs attending the training, 18 completed pre- and post-test surveys. Among these, there was an increase in knowledge scores (<i>t</i> = -2.496, <i>p</i> = .012) post-intervention. After the intervention, on a scale of 0 to 4, participants (<i>n</i> = 18) rated the intervention as highly effective in supporting their learning (<i>M</i> = 3.57, <i>SD</i> = 0.59) and also reported moderate levels of confidence (<i>M</i> = 2.87, <i>SD</i> = 1.06) and high intention (<i>M</i> = 3.70, <i>SD</i> = 0.55) scores to integrate mindfulness practices to support TT.</p><p><strong>Conclusions: </strong>Our findings support the feasibility of a 1-hr mindfulness-based training to change BHCPs' knowledge and support confidence and intention to enhance TT efforts.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261433553"},"PeriodicalIF":1.7,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513228","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":"Evaluation of Suicidal Behavior in Young Populations: Sociodemographic Factors Associated.","authors":"Paula Frieiro Padín, Ángela Carbonell, José Domínguez, Sabela Pérez-Martín","doi":"10.1177/10783903261425612","DOIUrl":"https://doi.org/10.1177/10783903261425612","url":null,"abstract":"<p><strong>Background: </strong>Suicide represents a serious public health issue and lacks a singular, universally accepted definition, which complicates its study and comprehensive prevention. Its prevention requires a multidimensional framework encompassing individual, social, and structural factors, as the interaction among these elements significantly increases risk. Moreover, its impact varies across sociodemographic contexts, highlighting the need for tailored strategies that address the specific realities of each population.</p><p><strong>Aims: </strong>This study aimed to examine suicidal behavior among young people and analyze its prevalence in relation to gender, sexual orientation, country of origin, education, employment status, and family relationships.</p><p><strong>Methods: </strong>The sample consisted of 539 young individuals aged 15 to 30 years (<i>M</i> = 20.64, <i>SD</i> = 3.61). Participants completed the Suicide Behaviors Questionnaire-Revised to assess suicidal behavior and provided information on 11 independent variables grouped into sociodemographic, educational, occupational, personal, and familial domains. Descriptive and multivariate analyses were conducted using MANOVA.</p><p><strong>Results: </strong>Most participants exhibited a low risk of suicide; however, nearly 20% showed moderate to high risk levels. Higher vulnerability was observed among women, migrants, and lesbian, gay, bisexual, transgender, intersex, queer, and questioning (LGBTIQ+) individuals. In addition, adverse family relationships and socioeconomic precarity were associated with increased susceptibility to suicidal behavior, as were personal, educational, occupational, and familial factors.</p><p><strong>Conclusions: </strong>The findings enhance understanding of suicidal behavior among young people. The results underscore the urgent need for preventive strategies grounded in an intersectional perspective, integrating educational interventions, public welfare policies, and family support initiatives that address the structural inequalities affecting youth mental health.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261425612"},"PeriodicalIF":1.7,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494200","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}