Perceptions of shared decision-making in severe mental illness : an integrative review
- Authors: Huang, Chongmei , Plummer, Virginia , Lam, Louisa , Cross, Wendy
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Journal of Psychiatric and Mental Health Nursing Vol. 27, no. 2 (Apr 2020), p. 103-127
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- Description: Accessible SummaryWhat is known about shared decision-making? There is increasing evidence of the positive impact of shared decision-making on health outcomes. There has been little exploration of shared decision-making regarding people diagnosed with serious mental illness from the perspectives of key stakeholders including consumers, families and mental health professionals. What this paper adds to existing knowledge? Consumers show variability in the preference for their involvement. Most stakeholders acknowledge the importance of family involvement. MHPs should share the responsibility and right to facilitate consumer involvement. There is bidirectional association between shared decision-making and therapeutic relationships. The practice of shared decision-making is related to multiple factors, and one main perceived barrier is time. The majority of studies are from Western countries. What are the implications for practice? Elicit consumer preferences and establish a collaborative therapeutic relationship. Encourage and engage families in treatment decision-making. Inter-professional collaboration should be integrated into shared decision-making. It might require lengthier consultation time. Studies in non-Western countries are needed to fully understand the impact of culture on shared decision-making. Shared decision-making (SDM) has been broadly advocated in health services and constitutes an important component of patient-centred care and relationship-based care. To review available literature related to perceptions of key stakeholders about shared decision-making in serious mental illness. An integrative review was conducted through a search of four online databases from January 2012 to June 2019. Forty-six articles were included. Six themes were generated from the data analysis: (a) dynamic preferences for SDM, (b) various stakeholders are rarely involved, (c) SDM is not routinely implemented, (d) multiple facilitators and barriers to SDM, (e) SDM and therapeutic relationships interact, (f) SDM has a promising impact on health outcomes. Overall, most stakeholders have recognized the importance and flexibility of SDM in serious mental illness, although it is not routine in mental health service. Consumer preferences show variability in their involvement. Most stakeholders acknowledged the importance of family involvement to treatment decision-making. There are several significant challenges to practice SDM. It may require extended consultation times and increasing empirical evidence regarding the SDM outcomes, as well as integrating inter-professional collaboration into SDM. Most studies were conducted in Western culture. Mental health nurses should elicit consumer preferences and establish a collaborative therapeutic relationship. Encourage and engage families in treatment decision-making when consumers prefer their families to be involved. Inter-professional collaboration should be integrated into shared decision-making. The practice of shared decision-making might need extended consultation time and more robust evidence about the outcome of shared decision-making. Studies in non-Western cultures are needed to fully understand cultural issues of shared decision-making. IntroductionAimMethodResultsDiscussionImplications for practice
Validation of the distress thermometer for caregivers of children and adolescents with schizophrenia
- Authors: Bai, Xiaoling , Wang, Anni , Cross, Wendy , Lam, Louisa , Plummer, Virginia , Guan, Ziyao , Sun, Mei , Tang, Siyuan
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 76, no. 2 (Feb 2020), p. 687-698
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- Description: Aim To develop and psychometrically test the distress thermometer for caregivers (DT-C) and document the distress level in primary caregivers of children and adolescents diagnosed with schizophrenia. Design A validation diagnostic accuracy study and descriptive cross-sectional survey. Methods DT-C was adopted based on Harverman's distress thermometer for parents. The cut-off score was detected by using receiver operating characteristic analysis with the Depression Anxiety Stress Scale-21 as a reference standard in a sample of 324 caregivers of children and adolescents diagnosed with schizophrenia in China collected between Jan 2017 and Feb 2018. Results One-item DT of DT-C indicated a good retest reliability (r = 0.86) and one-item DT and the Problem List (PL) indicated good convergent validity (r = 0.67-0.88). Overall and individual PL domains showed good internal consistency (KR 20 values ranged from 0.70-0.90). Setting seven as the cut-off score, the values of sensitivity (0.72-0.81), specificity (0.86-0.90), Youden's index (0.61-0.70), positive predictive value (0.67-0.74), and negative predictive value (0.84-0.92) were most satisfactory and area under curve values showed significantly excellent discrimination (0.88-0.90). The average DT score for the 324 participants was 6.34 (SD 2.49), with 46.9% of the participants above the cut-off. Caregivers above the cut-off score faced significant multiple problems in practical, family/social, cognitive, emotional, and parenting domains. Conclusion The DT-C, with six domains containing 35 items in Problem List and with the cut-off score at seven, can be a rapid screening tool to measure distress in these caregivers. The level of distress in caregivers was relatively high. Psychoeducation on specific needs and a solid mutual support network are recommended for mitigating caregivers' distress. Impact This study adapted a reliable DT-C to measure distress of caregivers, which has the potential to be introduced to caregivers of other types of child and adolescent mental disorders in research, assessments and care planning for health professionals.
A wechat-based “three good things” positive psychotherapy for the improvement of job performance and self-efficacy in nurses with burnout symptoms : a randomized controlled trial
- Authors: Guo, Yu-Fang , Lam, Louisa , Plummer, Virginia , Cross, Wendy , Zhang, Jing-Ping
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Nursing Management Vol. 28, no. 3 (2020), p. 480-487
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- Description: Aim: To evaluate the effects of a WeChat-based “Three Good Things” on job performance and self-efficacy of clinical nurses with burnout symptoms. Background: Few studies have valued the impact of nurses' personal strengths and positive work environment on job performance, particularly in developing countries. Methods: A randomized controlled trial. The intervention group (n = 33) participated in WeChat-based Three Good Things, while the control group (n = 40) did not. Data were collected prior to and immediately after the intervention. WeChat, a popular social software, provides several communicating and recording functions. Results: The main intervention effects and interactions between time and intervention on job performance and self-efficacy were significant (each p < .05). The main time effects on self-efficacy were also significant (p < .05). The post-intervention scores for job performance and self-efficacy between the two groups were statistically different (each p < .05). The scores for job performance and self-efficacy of the intervention group were statistically different before and after the intervention (each p < .05). Conclusion: Three Good Things could significantly improve job performance and self-efficacy of nurses with burnout. Implications for Nursing Management: Nurse managers are recommended to include Three Good Things into their management systems to improve nurses' physical and mental health and work outcomes over the long term. © 2019 John Wiley & Sons Ltd.