International journal of mental health nursing最新文献

{"title":"Eliminating Seclusion Use for Women in Secure Forensic Hospitals. Are We Doing Enough to Consider Sex and Gender Differences for Elimination?","authors":"Alison Hansen","doi":"10.1111/inm.70260","DOIUrl":"10.1111/inm.70260","url":null,"abstract":"<p><p>The reduction and eventual elimination of seclusion is a global priority. In 2021, The Royal Commission into Victoria's Mental Health System recommended that seclusion use be eliminated from mental health services within 10 years. This is long needed given human rights concerns and known harms associated with seclusion use. Yet the Commission failed to adequately consider gender-specific needs of women, and women who may be at increased risk of harms associated with seclusion use. Further, current approaches for seclusion reduction lack an explicit gendered lens. There are noted gendered differences in women and men which can influence how mental ill health and trauma are experienced and expressed. Past experiences of trauma have a large negative impact. For women in secure forensic hospitals, the negative effects of seclusion may be more detrimental in exacerbating harm and trauma. While rates of seclusion are generally declining across general and forensic mental health services, seclusion remains higher in forensic hospitals, and there is a lack of transparency around the rates of seclusion for women. In this paper, the author explores differences between women and men in the context of mental ill health, current approaches for seclusion reduction and whether these adequately consider sex and gender differences. With Victoria approaching the halfway point to the elimination target, the author recommends transparency in reporting of seclusion rates separately for women, and greater focus is paid to the recognition of gender differences in approaches for seclusion reduction and eventual elimination.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 2","pages":"e70260"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral Courage and Ethical Decision-Making Among Registered Psychiatric Nurses in Western Canada: A Cross-Sectional Multiple-Methods Study.","authors":"Jordyn McBride, Kathryn Chachula","doi":"10.1111/inm.70262","DOIUrl":"10.1111/inm.70262","url":null,"abstract":"<p><p>Moral courage is a critical attribute for psychiatric and mental health nurses, who routinely navigate complex ethical dilemmas in mental health care settings. Despite its importance, limited research has explored moral courage and its relationship with ethical decision-making confidence among Registered Psychiatric Nurses. The purpose of this study was to examine the relationship between moral courage, ethical decision-making confidence, education level, and years of practice among Registered Psychiatric Nurses in western Canada. A cross-sectional multiple-methods design that adhered to the STROBE Checklist EQUATOR Network was used, involving 80 participants recruited within western Canada. Data was collected using the Nurses' Moral Courage Scale that utilised open- and close-ended questions as well as the Ethical Decision-Making Confidence scale. Statistical data was analysed using parametric and non-parametric tests to assess group differences. Narrative data was analysed using thematic analysis. The findings revealed a significant positive relationship between moral courage and ethical decision-making confidence. Ethical decision-making confidence scores were higher among nurses with graduate-level education compared to those with diplomas or baccalaureate degrees. However, no significant difference in moral courage scores was observed based on education level or years of practice, and no significant association was found between years of practice and moral courage. Qualitative findings revealed four major themes that included: (1) Advocating; (2) Patient Safety; (3) Reporting Co-Workers; and (4) Standing up to Co-Workers and Superiors. This study highlights the interconnectedness of moral courage and ethical decision-making among psychiatric nurses, while revealing that years of practice alone do not predict moral courage.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 2","pages":"e70262"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collaboration Between People Admitted to Acute Mental Health Units, Their Family Members and Nurses in the Detection of Mental State Changes and Recovery: A Qualitative Systematic Review.","authors":"Karen Foster, Linda Coventry, Yvonne Middlewick, Lindsay Smith, Beverley Ewens","doi":"10.1111/inm.70244","DOIUrl":"10.1111/inm.70244","url":null,"abstract":"<p><p>Mental health nurses can engage with people with mental health challenges and their families due to their presence on acute mental health units. This presence helps to facilitate recovery-focused care within a physically and emotionally safe environment. Mental health care should be person-centred, individualised, and include wherever possible family and other people in the person's support network. The objective of this systematic review was to explore the existing qualitative literature that describes experiences of collaboration between people with lived experience of mental health challenges, their family members, and nurses in relation to changes in mental state during an admission to an acute mental health unit. Qualitative systematic review. The Joanna Briggs Institute methodology for systematic reviews of qualitative evidence was followed, including the JBI quality appraisal checklist. The databases searched were CINAHL, Medline, Scopus, Emcare and PsycInfo. Included articles were written in English and published between January 2013 and September 2023. Data was extracted that provided the perspectives of adults (18-64 years), their family members and nurses (collectively known as the \"Triangle of Care\") regarding communication when mental state changes during an acute mental health admission to a public hospital. Perspectives of the three groups were explored separately then synthesised. The ConQual approach was used to assess confidence in the findings. This review included articles on the lived experience perspective (n = 17), the family perspective (n = 1), and the nurse perspective (n = 13). The identified articles presented common perspectives on how to facilitate person-first nursing care that is supportive of personal recovery, including the provision of one-to-one discussions and inviting input from family members. Nurses, in particular, highlighted systemic barriers and facilitators to the focus on personal recovery in clinical practice. Communication between the three members of the \"Triangle of Care\" is essential for the identification of mental state changes as a critical aspect of providing nursing care that promotes personal recovery. All three members of the \"Triangle of Care\" highlighted the importance of making time for one-on-one conversations, which are impacted by other factors such as competing demands on time and confidentiality. Further research is indicated to improve clinical practice and service provision, with extant research being particularly sparse in non-Western and non-English speaking regions. Literature Review Protocol: Prospero registration number: CRD420250639443.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 2","pages":"e70244"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional, Contextual, and Interventional Drivers of Formal Coercion in Acute Mental Health Units: A Feature Analysis.","authors":"Esario Iv Daguman, Jacqui Yoxall, Richard Lakeman, Marie Hutchinson","doi":"10.1111/inm.70240","DOIUrl":"10.1111/inm.70240","url":null,"abstract":"<p><p>Minimising formal coercion, such as seclusion, physical restraint, and forced medication, remains a global priority in acute mental health units. However, key drivers beyond individual-level features are poorly understood. This exploratory analysis was intended to identify the top functional, contextual, and interventional features linked to formal coercion in three Australian acute adult mental health inpatient units. Nested within a mixed concurrent control study, this feature analysis examined nurses' reports of 2955 de-escalation events over 324 days, from March 2024 to April 2025, including nurses' commentaries on the behavioural functions that triggered de-escalations. Fifteen inductively coded functional features were analysed alongside 15 contextual and 16 interventional features. Studied target variables included seclusion and physical restraint events and their durations, as-needed intramuscular psychotropic events, physical injury events, and Code Black activations. Features were analysed using bivariate statistics and machine learning techniques, including the Boruta algorithm for feature selection and random forest regressions for predictive modelling. Top drivers for the use of formal coercion included behavioural 'Responses to Challenging, Physical and External Stimuli,' incidents of self-harm, incidents directed towards nurses, and the application of specific de-escalation techniques. A hierarchy of behavioural functions is proposed as a by-product of this analysis. These findings provide nuanced insights into the drivers of formal coercion and the underlying value arrangements, as well as elevate the merit of ecological, bottom-up approaches in early warning signs work.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":"35 1","pages":"e70240"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Does Nature Exposure Affect Adults With Symptoms of Mental Illness? A Meta-Analysis.","authors":"Joanna E Bettmann, Elizabeth Speelman, Ellison Blumenthal, Scott Couch, Tara McArthur","doi":"10.1111/inm.13400","DOIUrl":"10.1111/inm.13400","url":null,"abstract":"<p><p>Existing research on the effects of nature exposure on the mental health of adults indicates that spending time in nature reduces depressive symptoms and stress, increases quality of life and mood and improves mental health. This meta-analysis aimed to answer the question: what are the effects of nature exposure on the social, mental and physical health of adults with symptoms of mental illness? The meta-analysis included all studies relevant to the study research questions which collected quantitative data on nature exposure using validated instruments for at least two time points on each participant and which were published between 1990 and 2020. Regarding the impact of nature exposure on adults with symptoms of mental illness, analyses showed significant, moderate effect sizes for all studies and smaller, but significant, effect sizes for studies with control groups Analyses also yielded critical information regarding the effect size of the type of nature dosage, nature setting, nature-based activity, key mental health outcomes and other factors. These findings from the present study results have important implications regarding the potential benefits of nature exposure for adults and its role in healthcare.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":" ","pages":"1889-1907"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Disability Nursing Practice in Australia: Addressing Educational Preparedness.","authors":"Natasha Jojo, Rhonda L Wilson","doi":"10.1111/inm.13373","DOIUrl":"10.1111/inm.13373","url":null,"abstract":"<p><p>People with intellectual disabilities (IDs) face significant health challenges, including poor outcomes, limited access to health care, and a 26-year life expectancy gap compared with the general population. This highlights the need for improved public health and social policies to enhance the quality of care in hospital and community settings. An integrated literature review was conducted to examine the state of disability nursing practice in Australia following the implementation of the National Disability Insurance Support (NDIS) scheme. The review included English-language studies published from 2010 to 2023. Systematic searches in five databases resulted in a final sample of 28 studies. The data were then thematically analysed, and the following three themes emerged: Workforce development and professional standards, hospital experience and support needs of individuals with IDs, and nursing curriculum and ID. Study findings suggest that nurses lack preparation for effective health communication with individuals with IDs and their families. Evidence is insufficient to guide nursing practice and policies in ID care. Varying understandings of practice standards exist among nurses. Nursing curriculums in Australia fail to adequately prepare students to manage the unique needs of individuals with IDs, perpetuating the high mortality rates in this population. Specialised nursing practice areas are vital for meeting the complex needs of individuals with IDs. Reintroducing a disability nursing specialty and integrating dedicated study units and clinical placements in undergraduate programmes are recommended steps to improve care outcomes and support the overall well-being of this population.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":" ","pages":"1637-1665"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social support for young people with eating disorders-An integrative review.","authors":"Lucie M Ramjan, Brandon W Smith, Jane Miskovic-Wheatley, Sheeja Perumbil Pathrose, Phillipa J Hay","doi":"10.1111/inm.13363","DOIUrl":"10.1111/inm.13363","url":null,"abstract":"<p><p>Eating disorder treatment should be underpinned by a recovery-oriented approach, be therapeutic, personalised and trauma informed. Within such models of care, social support is an important factor to explore in terms of its influence in supporting hope for recovery, reducing stigma, and mitigating life stressors. Limited research has been conducted to understand the types of social support that are available to young people formally diagnosed with an eating disorder, their feasibility and acceptability and the positive outcomes. This integrative review sought to explore the positive outcomes of social support or social support programs for young people with eating disorders. An integrative review was conducted based on a search of five electronic databases from inception to 31 March 2023. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools and findings have been narratively synthesised and presented in accordance with the review's aims and questions. Seven studies (total 429 individuals, range 3-160) published between 2001 and 2023 were included in the final synthesis. Overall social support interventions showed promising preliminary evidence as a feasible and acceptable adjunct to treatment for young people with an eating disorder motivated to change, with some clinical improvements in psychopathology. Social support augmented existing relationships, providing a human element of open dialogue, friendship and a sense of hope for recovery. Despite the small number and heterogeneity of the studies, this review has highlighted some promising preliminary benefits. Future treatment for eating disorders should embrace adjunct modalities that enhance psychosocial recovery for young people with eating disorders.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":" ","pages":"1615-1636"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141177151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Technology-Delivered Psychosocial Interventions for Family Caregivers of Patients With Dementia: A Systematic Review, Meta-Analysis and Meta-Regression.","authors":"Jing Ying Cheng, Saatirah Bte Mohamad S Nurul, Ling Jie Cheng, Hong-Gu He","doi":"10.1111/inm.13390","DOIUrl":"10.1111/inm.13390","url":null,"abstract":"<p><p>Family caregivers living with patients with dementia (PwD) face psychological challenges due to care burden. Technology-delivered psychosocial interventions (TPIs) have played a promising role in improving health outcomes among family caregivers living with PwD. This review aims to synthesise evidence of the effectiveness of TPIs on primary (burden and depression) and secondary outcomes (self-efficacy, stress and anxiety) for family caregivers living with PwD. Random-effects meta-analyses were performed to determine effect size. Using Cochran's Q and I² tests, statistical heterogeneity was evaluated. Sensitivity, subgroup analyses and meta-regression were employed to explain statistical heterogeneity. Twenty-eight trials comprising 4160 family caregivers from eight countries were included. Our meta-analysis revealed that TPIs resulted in slight reduction in depression, probably resulted in a slight reduction in burden and anxiety and slight increase in self-efficacy. Subgroup differences were detected in geographical regions (Western Pacific and Southeast Asia) for burden. While there were no significant subgroup differences in other factors, TPIs with preventive function and mobile applications had a more prominent larger effect size. Meta-regression analysis showed that attrition rate was a significant moderator on depression. Results are limited by the high risk of bias of included trials, which may reduce certainty of evidence. This review suggest TPIs are recommended as an adjunct treatment for alleviating burden and depressive outcomes in healthcare institutions. PROSPERO Registration Number: PROSPERO (CRD42023387962).</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":" ","pages":"1796-1816"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Overshadowing of Chronic Hepatitis C in People With Mental Health Conditions Who Inject Drugs: A Scoping Review.","authors":"Regan Preston, Michael Christmass, Eric Lim, Shirley McGough, Karen Heslop","doi":"10.1111/inm.13396","DOIUrl":"10.1111/inm.13396","url":null,"abstract":"<p><p>Diagnostic overshadowing refers to a phenomenon whereby people with mental health conditions encounter inadequate or delayed medical attention and misdiagnosis. This occurs when physical symptoms are mistakenly attributed to their mental health condition. This paper presents a scoping review focusing on direct causes and background factors of diagnostic overshadowing in the context of hepatitis C infection in people who inject drugs and have concurrent mental health conditions. Despite significant strides in hepatitis C treatment with direct-acting antiviral drugs, the complex interplay of mental health conditions and physical symptoms necessitates a nuanced approach for accurate diagnosis and effective screening. This review was conducted using Joanna Briggs Institute's methodology for scoping reviews. The databases searched included Medline, Embase, PsycInfo, Global Health, CINAHL and Scopus. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search strategies identified 1995 records. Overall, 166 studies were excluded. Forty-two (42) studies met the inclusion criteria. Three (n = 3) studies represented direct causes, and 39 (n = 39) with background factors related to diagnostic overshadowing. Studies highlighted six key themes encompassing diagnostic overshadowing, with communication barriers, stigma and knowledge deficiencies being the most prominent. Recognising and addressing diagnostic overshadowing in chronic hepatitis C will lead to increased screening, diagnosis and timely administration of life-saving antiviral therapy, resulting in profound enhancements in well-being and health outcomes. Moreover, this proactive approach will play a pivotal role in advancing the global effort towards eliminating hepatitis C by 2030.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":" ","pages":"1840-1873"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Crisis: An Evolutionary Concept Analysis.","authors":"Emilie Hudson, Pierre Pariseau-Legault, Christine Cassivi, Chad Chouinard, Marie-Hélène Goulet","doi":"10.1111/inm.13412","DOIUrl":"10.1111/inm.13412","url":null,"abstract":"<p><p>The term 'mental health crisis' is a widely used concept in clinical practice and research, appearing prominently in mental health literature across healthcare and social science disciplines. Within these contexts, the term is frequently either left undefined or defined rather narrowly, confined to clinical observations or guidelines targeted at healthcare providers and negating the multifaceted nature of crisis as described by those with lived experience. Therefore, the aim of this paper is to explore the characteristics of and provide a conceptual definition for the concept of 'mental health crisis'. Rodgers' method of evolutionary concept analysis was employed and 34 articles, ranging from 1994 to 2021 and a variety of disciplines, were analysed. The results highlighted the contrast between clinically oriented surrogate terms and related concepts and those used by individuals with lived crisis experience. Antecedents of crisis included underlying vulnerabilities, relational dysfunction, collapse of life structure and struggles with activities of daily living. The concept's attributes encompassed the temporality of crisis, signs and symptoms of crisis, functional decline and crisis in family and caregivers. Finally, the consequences comprised looking inward for help, looking outward for help, and opportunities and dangers. This concept analysis serves as a foundational step in understanding 'mental health crisis' and its various dimensions, facilitating more nuanced discussions and interventions in the realm of mental healthcare.</p>","PeriodicalId":94051,"journal":{"name":"International journal of mental health nursing","volume":" ","pages":"1908-1920"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}